The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

September 25, 2010 #3,967 Publisher-Barry Block, DPM, JD

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NC Podiatrist Discusses Preventive Measures for Diabetics

Larry Lee, 67, has been going to a podiatrist every three months as a way to help manage the diabetes he has had for 30 years. "(Patients) are coming as a preventative measure, so that we can talk about their circulation," said Dr. Jeremy Thomas, a podiatrist in Cary. "We can talk about diabetic shoes, diabetic foot washes, diabetic creams."

Dr. Jeremy Thomas

A while back, Thomas prescribed special socks and custom-made shoes for Lee, tailored to his foot and with custom inserts. "A lot of people will say it almost feels like they're walking on clouds or walking on marshmallows when they're walking around,” Thomas said.

Source: Allen Mask, MD, WRAL [9/23/10]

OCPM to Reduce Class Sizes Due to Residency Shortages

For the 2011 recruitment year, the Ohio College of Podiatric Medicine (OCPM) has voluntarily agreed to reduce its first year class size by 10%. The college is temporarily reducing its entrance numbers in response to the potential shortage of residency programs for its students. 

Dr. Thomas V. Melillo

“OCPM is committed to placing its 4th year classes into residency programs” said Thomas V. Melillo, DPM, president of the Ohio College of Podiatric Medicine. “We are taking this measure in an effort to assure that all our students get 100% residency placement. OCPM, along with other podiatric organizations such as the American Podiatric Medical Association (APMA), American Association of Colleges of Podiatric Medicine (AACPM), the Council of Podiatric Medical Education (CPME), and the Council of Teaching Hospitals (COTH), are working in collaboration to address the residency shortage.”

MI Podiatrist Charged with Heathcare Fraud

A Flint podiatrist and a Davison woman have been accused of operating a healthcare scam in Bay City. Dr. Richard A. Behnan, 54, and his office assistant, Kelly Morel, 48, allegedly traveled to senior centers where they diagnosed patients with fictitious foot and toe infections and billed insurance providers for surgical procedures that were never performed, said Barbara L. McQuade, U.S. attorney for the Eastern District of Michigan in Bay City.

The allegedly fraudulent charges totaled about $883,000 paid by Medicare and Blue Cross Blue Shield of Michigan, McQuade said. A federal grand jury in Bay City issued a 48-count indictment charging conspiracy to commit health care fraud and substantive health care fraud. Both charges are 10-year felonies.

Source: LaNia Coleman, The Bay City Times [9/23/10]

Evaluate and Improve

Profiting from great ideas requires great people to execute your strategies. What can you do if your staff already is stretched to the limit and you lack the funds to hire more people?

Strategy: Sit down with your staff to evaluate job descriptions and task lists. Ask staffers what they like doing and what they don’t like doing. Swap staff assignments to satisfy people where you can, and rewrite job descriptions to reflect the current situation. Look for inefficiencies too, and eliminate them when possible. As a result, you will increase productivity, reduce conflict, and boost workplace morale.

Source: Adapted from “Creating a Workplace That Works,” NZ Business via Communication Briefings.

Query: Chronic Skin Irritation

I have a patient with an 11 year history of chronic irritation on the medial aspect of the feet. He is in his late 50's, with no predisposing illnesses such as diabetes, has normal neurovascular status, etc. He denies any exposure to chemicals. Basically, when working in his boots, he noticed it itched and began scratching it, and has been scratching it for 11 years. Has been seen by other doctors and given multiple topicals.  The only thing that seems to work, is a cortisone injection that stops it for 3-4 months, skin returns to normal, then it breaks out again. 

Chronic Skin Irritation

Cultures are negative. His feet do sweat a lot, especially in the damaged area. We have tried topicals for the sweating which helps, and Novacort which helps. Part of the problem is his continued scratching cycle, which has to be broken. I am wondering if the basal layer of skin has been damaged due to chronic scratching. Any suggestions.  
 
James Breedlove, DPM, San Luis Obispo, CA

Query: AZ Scope of Practice

I have a question that  may be specific but hits home and may spark a discussion regarding national scope of practice. With two big powerhouses in prominent national and international positions of influence, Dr. Kathleen Stone DPM, APMA president and David Armstrong DPM, director of SALSA, both living in Arizona, I'm stunned that both these accomplished podiatrists practice in Arizona; Arizona law still prohibits toe amputation, but allows for ankle reconstruction and trauma. How can we, as a profession, utilize these great individuals on a state and national level to achieve parity nationally and fix these antiquated state laws? Any suggestions?

Randall Brower, DPM, Prescott Valley, AZ

Query: Stump Neuroma Excision

How would you code a resection of a stump neuroma? The patient had previous neuroma resection by another podiatrist and has symptoms consistent with stump neuroma that have not responded to injections, physical therapy, shoe modifications, oral medications, or topical pain relievers.

Is this a CPT 28080 (excision of interdigital Morton's neuroma) or CPT 64782 (excision of neuroma, hand or foot, except interdigital nerve)? Or is it considered a different type of procedure?

Robert Lagman, DPM, Mandeville, LA

Response: I code this CPT 64782 (excision of neuroma; hand or foot, except digital nerve) .

By virtue of the previous resection, I believe this resection to be more extensive, requires a more proximal or other-sided incision (not typically interdigital), and is not just a CPT 28080 (excision, interdigital [Morton] neuroma).

Walter Pedowitz, MD, Linden, NJ

Codingline subscription information can be found here
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RE: George Vito's Interview

On Tuesday night on Meet the Masters, Dr. George Vito shared his complete story and  many points were uncovered. For example, in Georgia, DPMs are NOT allowed to do cosmetic surgery. Do other states have this in their state laws? If your state allows you to do a bunion surgery that is symptomatic, is doing the same procedure that is not symptomatic outside of the law? What if the patient “physiologically” wants to get rid of the bunion that is not symptomatic? What about treating onychomycosis for a cosmetic end-point? Please share your comments and please feel free to listen to Dr. Vito’s interview at www.PodiatricSuccess.com

Bret Ribotsky, DPM, Boca Raton, FL, ribotsky@yahoo.com

RE: Midmark Chair Repair (Joe Borden, DPM)
From: Keith Gurnick, DPM

Call RedMed  800-733-6334 and ask for the repair services of Michael Silva. They are located in Pomona, CA, and he does repairs in our area. I have 2 Midmark 117's still in service, and he has done a very good job on my repairs at a fair price when I had some pedal and capacitor problems. The capacitors sometimes go out when they get old, and also sometimes they leak oil which can be repaired. Last time he was out, I was ready to buy two new chairs, but he did repairs that cost me about $400 total and both work as good as new.

By the way, about a year ago, I had them both reupholstered at an auto repair shop in Los Angeles. I took all the cushions (Velcro) and arm rests (they unscrew) off, and the head rests, and had them recovered over Christmas vacation. Both of these chairs look like new, and run pretty darn well. 
 
Keith Gurnick, DPM, Los Angeles, CA, e-mail keithgrnk@aol.com

RE: Charge for Filling Out Disability Form (Paul Kesselman, DPM)
From: Phil Davidson, DPM

The gentleman who founded our Academy of Podiatric Practice Management (Dr. B. C. Egerter) had a simple philosophy as he and staff cared for 60-some patients daily. He espoused:
 
   A) Give the patient more than they expect.
   B) Do it better than anyone else.
   C) Charge them less than they thought it would be.

So what if you fill such a form once-in-a-while? I'd gladly do it with a smile on my face and reap the goodwill that accrues. Do we measure everything by the 'dollar yardstick'?
 
Phil Davidson, DPM, Youngstown, OH, Ohiofoot@aol.com

RE: Fat Chance to Heal Infections  (Albert Nejat DPM)
From: Neil A Burrell, DPM

The "cellulitis " cream (cellulite cream) would probably heal her cellulitis quicker than it will cure cellulite. People will believe anything. 

Neil A Burrell, DPM, Beaumont, TX, nburrell@gt.rr.com

ASSOCIATE POSITION - FREDERICK, MARYLAND

Well-established group practice is located only 45 minutes from both DC and Baltimore. Immediate opening for a minimum PSR 36 Podiatrist for full time position. We have it all: EMR, digital x-ray, ultrasound, ASC, etc. Excellent salary with bonus structure and benefits. Please email resume to docsbnb@aol.com

NORTHEAST OHIO PODIATRY OPPORTUNITY

Western Reserve Senior Care, an innovative home visit practice that makes visits to seniors in assisted living facilities and SNF’s, is recruiting for a Part-Time Podiatrist. Make a true difference as you make visits to homebound seniors while managing the full scope of podiatric disease. This opportunity offers a perfect balance of superb lifestyle and excellent compensation. Practice is affiliated with world class health systems in Cleveland, OH. Email CV to wmills@westernreserveseniorcare.com

PART TIME PODIATRIST NEEDED-LOS ANGELES, CALIFORNIA

Busy podiatrist looking for assistance with patients located in facilities, home, office etc. Flexible hours, independence, and great compensation. If interested email CV to homefootcare@hotmail.com or call Terri at 323-353-8103.

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION -CT (FAIRFIELD AND NORTH HAVEN)

Great opportunity. Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices. Electronic medical records, digital x-ray, diagnostic ultrasound, Padnet vascular studies, nerve conduction studies, pinpoint and CO2 lasers, electrical stimulation and ultrasound therapies. Seeking a well-trained, personable, and highly motivated individual. Please send resume and current photo to dr.kassaris@yahoo.com

PART-TIME, LICENSED PODIATRIST - WEST BLOOMFIELD, MICHIGAN
Immediate opening for treating patients in a nursing facility setting. If interested, please e-mail drteetime@aol.com

ASSOCIATE POSITION – LONG ISLAND, NY
 
Associate full-time. Well-established, busy, well-rounded podiatry practice looking for a motivated podiatrist. Suffolk Co. LI NY. Board eligible, Board certified PSR-24/36 trained. Fax resume to 631-581-0857

ASSOCIATE POSITION - WEST COAST, FLORIDA

Outstanding opportunity for PSR-36 graduate to join successful group podiatry practice in Summer 2011. Seeking a sociable, articulate graduate who is confident in rearfoot and ankle reconstructive cases but also enjoys all phases of podiatry. Long-term opportunity for the right candidate with generous pay and benefits. Reply to jwicks@cortezfootandankle.com

ASSOCIATE WANTED - DELRAY BEACH FLORIDA AVAILABLE IMMEDIATELY

Rapidly growing well established practice seeking part-time leading to full-time. PSR 12-36. Great opportunity for highly motivated, personable individual. Please reply by emailing a CV to nursebsf@aol or fax (561) 498-9068.

ASSOCIATE POSITION - TEXAS 
 
IMMEDIATE OPENING for motivated podiatrist with good people skills.  Associateship leading to PARTNERSHIP for the right applicant. Northside San Antonio Texas practice. Attractive office and beginning income. Current TEXAS license a must. CV and letter of interest to sadpmoffice@gmail.com

PRACTICE FOR SALE - MARYLAND, DC SUBURB

Great opportunity. Retiring after 38 years in practice at the same location. Practice is fully equipped with digital x-ray, diagnostic ultrasound, computer network, orthotic scanner and state licensed ambulatory surgical center that is fully equipped. Owner will stay on as needed for easy transition. dpmpracticeforsale@yahoo.com

AMBULATORY SURGICAL CENTER PRIVILEGES AVAILABLE - NJ

Privileges available in a new 2 ORs. New certified multi-specialty ambulatory surgical center in Fairlawn, NJ - 8 minutes to the George Washington bridge. Specializing in podiatric surgery. Center will pick up and return patient home. Syndication is available. Center will accommodate doctors in Manhattan, Queens, Brooklyn, Bronx, Staten Island, and long Island. Will assist in getting NJ License. Call for information (516)476-1815 e-mail podo2345@aol.com. To view center, go to FAIRLAWNASC.SHUTTERFLY.COM

MEDICAL SPACE AVAILABLE- MANHATTAN

Multispecialty Medical Building with 24/7 doorman. Prime Luxury Building and Location, Gramercy, Stuyvesant, Peter Cooper Area. 305 Second Avenue (17th-18th). Prior tenants past 23 years; podiatrist, dentist (plumbing/electric intact), internist. Ideal for podiatry, co-share with dentist, MD, etc. (flexible lease terms). E-Mail; jbdrun@aol.com

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