The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

October 07, 2009 #3,668 Publisher-Barry Block, DPM, JD

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We just posted an article titled: A Comparison of Negative Casting Techniques Used for the Fabrication of Custom Ankle Foot Orthoses by Douglas Richie, Jr., DPM and Jeff Root. 

You can read this informative and useful article at: http://www.podiatrym.com/pmarticle.cfm?id=127 

50 NYCPM Student Volunteers Perform Foot Screenings At ADA's Diabetes Expo

On Saturday, September 26, fifty NYCPM student volunteers, working in two shifts, donned their white coats at the American Diabetes Association's Diabetes Expo, held in New York's Javits Center, and performed nearly 300 foot screenings for Expo attendees.  Many more people stopped by the Foot Center of New York/NYCPM booth to ask questions and to pick up informational literature. 

Dr. Anthony Iorio, DPM (center) with some of the NYCPM student volunteers who performed foot screenings at Diabetes Expo.

Anthony Iorio, DPM, Associate Professor and Chair, Department of Community Health and Medicine at NYCPM, was instrumental in organizing the College’s presence at Diabetes Expo.  Along with Dr. Iorio, also supervising the student volunteers were NYCPM faculty members Sharon Barlizo, DPM, Assistant Professor of Podiatric Medicine, and Director of the Wound Care Clinic at NYCPM’s affiliated Foot Center of New York; Johanna Godoy, DPM, Instructor of Surgical Sciences; and Steven Goldman, DPM, Clinical Associate Professor of Medicine.

Supreme Court Declines to Review Death Penalty for IL Podiatrist

The court did not comment on its action Monday to leave in place the conviction and sentence of Ronald Mikos, a foot doctor who was facing allegations of Medicare fraud. He was sentenced to death in 2005 on charges that he shot a disabled nurse and former patient, Joyce Brannon, to keep her from testifying against him.

Mikos did not testify in his own defense during his trial. His lawyers said prosecutors told the jury his decision not to testify showed a lack of remorse for what he did. During the penalty phase, the jury said his lack of remorse contributed to the decision to sentence him to death. Mikos's lawyer said his silence did not show a lack of remorse and objected to the prosecution's tactic of using it against him.

Source: Associated Press [10/5/09]

Where to Get a Return on Your EMR Investment

Converting to an electronic medical record system can result in cost-cutting. Although increased efficiencies may allow staff cuts, many practices retain and retrain staff.

Material costs: The cost of stocking paper file folders and printing paper can add up to thousands of dollars annually. A system with e-prescribing also can eliminate the costs of prescription pads.

Storage: Practices often have to pay rent to store some files offsite. Once files are scanned into an EMR, those costs will be cut. In-house storage areas can be re-purposed as an exam room, creating an opportunity for increased revenue.

Workers' compensation claims: Practices spend thousands of dollars a year preparing files for workers' compensation cases. Most EMR systems will allow the claims process to be handled through e-mail, eliminating the price of copies, faxes and mailings.

Dictation/transcription: Many systems will allow physicians to dictate directly into an EMR, eliminating the need for transcription services.

Telephone use: Using an EMR, especially one with e-prescribing or online scheduling integrated into the system, can significantly reduce the volume of phone calls in and out of your practice.

Data destruction: To comply with patient privacy and security laws, many practices often hire outside companies to destroy paper files with personal health information. Eliminating paper will eliminate this cost.

Source: AM News [10/12/09]

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: Do you think the future of podiatry is in group practices or multi-specialty practices? What do you see as the difference?

Dr. Barry Block

Barry Block: I think it is both. First of all, a group practice is far more efficient than a solo practice because of the economy of scales. It also gives you a chance to get sick, which happens to all of us once in a while. I certainly have had my share of medical problems. It allows you to take a vacation and guess what? When it is time for you to retire, it gives you an automatic buy-out, which is a concern to a lot of baby boomer-type practitioners who are getting into the 50s and 60s. Now they are thinking about retiring.  If they are solo, they have a lot less options than if they are in a group practice. 

As to multi-specialty practice, the October issue of PM features an article on that subject by Jarrod Shapiro in which he talks about the pluses and minus of the multi-specialty practice. Certainly you have got built-in referral sources right there.  Also you have this great education opportunity to share medical concepts with practitioners who are trained from a different perspective. As podiatrists, we sometimes tend to have tunnel vision; we see things only as podiatrists.
 

Dr. Warren Joseph

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's guest is PM  Hall of Fame podiatrist, Warren Joseph, DPM,  an authority on infectious diseases of the foot . You can register for this event  by clicking here

Query: Surgery Coding

How would this be coded?

1. Excision, soft tissue mass, 3rd metatarsal interspace, left
2. Release intermetatarsal ligament between 2nd and 3rd metatarsal heads, left foot (to release compression on intermetatarsal nerve/neuroma)
3. Excision, soft tissue mass, 3rd metatarsal interspace, right
4. Release of ligament between 2nd and 3rd metatarsal heads, right

Lisa Goodman, Clearwater, FL

Response: If we're speaking of an excision of a neuroma, that would be coded:

CPT 28080-RT
CPT 28080-59-LT

The transverse intermetatarsal ligament is typically severed in neuroma surgery, As such, it is incidental to the neuroma excision. It would not be separately billable.

If you're not referring to the excision of a Morton's-type neuroma, please let us know what the pathology report said, and expand on the description of the procedures so we can tell you how to bill the lesion excision.

Paul Kinberg, DPM, Dallas, TX

Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm

RE: Scope of Practice to Treat Obesity (Tip Sullivan, DPM)
Query: Elliot Udell, DPM, Diane (Barry) Branks, DPM

The American Society of Podiatric Medicine in conjunction with the American Podiatric Medical Association has coordinated a number of lectures at both national and regional conventions on the area of controlling obesity. In all cases, we had nationally recognized authorities in both nutrition and/or bariatric surgery lecture at these events.
 
The reason why we brought in these esteemed experts was to educate participants on what is available in the realm of medical, nutritional and surgical treatment for the obese patient. As podiatric physicians, we have an obligation to refer these patients to appropriate experts in the above areas just as we would refer patients with other systemic conditions to appropriate specialists. As for prescribing medications to enhance weight loss, I learned from moderating the above lectures that medical and/or surgical intervention in the control of obesity is generally not successful unless it is part of a whole picture, which includes ongoing counseling on diet and eating habits. Hence, it would be best for the patients if podiatrists not take on the medical management of obesity, even if it proves legal in some states, but make proper and timely referrals to experts in the area of weight loss management. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

Neither we nor the vascular surgeons I work with ever prescribe medications to treat obesity. I work for a large HMO in California. We are allowed to refer to certain of the various clinics the HMO has set up for obesity help, but when it comes to morbid obesity and a referral for bariatric surgery.... then this referral must come only from the primary care doctor because of the complications after this surgery.

The bariatrics doctor basically wants to know that the PCP is comfortable treating the lifelong complications of the surgery. It is frustrating both for us podiatrists and our vascular surgeons, as we both feel that patient could benefit from even the prior 6 month enrollment as the program is more than excellent to get the patient motivated to lose weight. But many times, the PCP has refused enrollment, and is just not comfortable having to deal with the bariatric complications. I hope this information helps you. Our vascular chief is presently trying to get a vascular internist who specializes in complex patients that would be willing to take this load off the shoulders of the PCP. We are presently waiting for approval. 
 
Diane (Barry) Branks, DPM, Baldwin Park, CA, barrydiane@hotmail.com

RE: Obama’s Healthcare Plan  (Arden Smith, DPM)
From: Bob Kornfeld, DPM

Just another perspective: http://podiatrym.com/go.cfm?n=434

Bob Kornfeld, DPM, Manhasset, NY, holfoot153@aol.com

DIABETIC RURAL OUTREACH PROGRAM - FLORIDA

We are seeking ethical, motivated podiatrists to treat homebound diabetic patients in Central and North Florida. Minimal travel. Must have valid Florida License and Active FL Medicare and Medicaid numbers. FAX CV TO 866- 258-9993 or call 800-779-8551.

EQUIPMENT FOR LOCUM TENENS/ASSOCIATE—PHOENIX

Busy multi-location practice in South East Valley seeks immediate well-trained personable individual. Part time Locum position may lead to permanent part-time, full-time, and buy- in potential if desired. Please send letter of interest and C.V. to AzToesRus@aol.com

ASSOCIATE POSITION - WASHINGTON, DC

Interested in working in Washington D.C.? Our group is looking to add a highly motivated, hard working, well trained podiatrist to our practice. Must have surgical training. We have a very busy multi-office practice. We practice state of the art podiatry with EMR and digital radiography. Associate to partner on a fast track for the right person. E-mail CV and cover letter to Washingtonpod@aol.com

ASSOCIATE POSITION (SURGICAL) – CONNECTICUT

Connecticut Surgical Group is seeking a Board-Certified podiatrist to add to our Surgical Podiatry division based in Central Connecticut. This podiatrist will provide all aspects of Podiatric care with a focus on wound and surgical care to a well-established patient base. We require PSR-36 training and board certification or eligibility, excellent surgical and wound care skills, a strong focus on providing compassionate care to our patients, and the ability to work as part of a team in a group practice setting. To apply please visit our website . EOE

ASSOCIATE POSITIONS - INDIANA/OHIO

PrimeSource Healthcare is a leading provider of mobile, on-site healthcare services at long-term and skilled nursing facilities. Our exceptional growth has created an immediate need for traveling, independent contractors of podiatry services in Indiana/Ohio. Earn between $175k and $225k per year. E-mail CV to kwright@pshcs.com. Visit us at pshcs.com.

ASSOCIATE POSITION - FREDERICK, MD
Well-established and growing 2 office state-of-the-art practice located in medical/professional buildings. EMR, Digital X-ray, Ultrasound, DME provider, etc. Competitive Base Salary plus bonus, malpractice, health insurance, etc. PSR 24 minimum/Board Qualified or Certified with ability and desire to take ER call. If interested, forward CV to DOCSBNB@aol.com

EQUIPMENT FOR SALE - HISTOFREEZER H60

170 ml gas, 30 2mm, 30 5mm applicators in original box, never used. Retail $299, only $225! I have five to sell. Closing satellite office. Other items available. 30 ga 1” and ½” BD needles only $15.00/box, retail $25.00. 941 922-3840

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

EQUIPMENT FOR SALE - ORTHOTIC FABRICATION SYSTEM

Amfit Orthotic Insole Fabrication System with Footfax SL Contact digitizer- For Sale Machine, Laptop, rolling bag, small inventory of shoes, insoles, all cords, parts and hardware Asking $8k. OBO! Please contact Jeff at Jhunt@psbank.net for further information, pictures.

ASSOCIATE POSITION - AUSTIN AND SAN ANTONIO AREAS

Seeking well-trained ABPS board certified/qualified foot surgeons for surgical practice with national foot/hand/orthopedic surgery group.  Excellent salary/benefits. Email CV and cover letter to: slb99@pdq.net

PRACTICE FOR SALE - FLORIDA - ST. PETERSBURG AREA 

Part-time office, remodeled 4 years ago. Fully equiped and stocked, 2 treatment rooms, x-ray and processor, billing software. Low overhead ,good signage. Asking $40k. Contact mwftdr@aol.com

EQUIPMENT FOR SALE - AMFIT ORTHOTIC MANUFACTURING MACHINE

Includes digitizer, fabricating mill, new updates have been added and enough supplies to pay for the machine in the long run. At $200 per pair = about $28,000. Selling FOR $25,000, O.B.O, F.O.B. americanfoot@email.com or 405-733-2783.

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

PODIATRY PRACTICE FOR SALE- NEW YORK

Excellent Bayside location. Established twenty years. Fully equipped and computerized. Part-time, mostly palliative care, podiatric  medicine, and orthopedics. Very little surgery. Priced to sell. Call weekdays after 8pm...718-465-5239

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Looking for board certified/board eligible ABPS associate to join a multi doctor practice with 2 offices. May lead to eventual buy-in and purchase. Must have minimum 2-year residency and comfortable with rearfoot procedures and diabetic care, ER call. Must be dependable, honest, ethical individual. Send cover letter and CV to familyfootcenter@earthlink.net

OFFICE SPACE/ MRI RENTAL – NYC, LI

Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, Hicksville and/or Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to fmassuda@footexperts.com

PM News Classified Ads Reach over 11,500 DPM's and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 11,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451

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