The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

October 08, 2010 #3,978 Publisher-Barry Block, DPM, JD

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Tired, Swollen Feet Can Affect Sleep: IL Podiatrist

We know sore, aching feet can put a damper on a night out (and darken a good mood), but it turns out they can ruin a night in, as well. “If feet are fatigued or swollen, the discomfort can affect the quality of your sleep,” explains Chicago-area podiatrist Dr. Elizabeth Kurtz. And bad sleep, in turn, can affect everything from your stress levels to metabolism.

Dr. Elizabeth Kurtz

The sore feet-bad sleep connection can become even more pronounced when traveling, says the doctor, thanks to the combination of air travel (which can cause swelling) and days spent exploring cities, strolling the beach, or pounding the theme park pavement.

Source: Sandra Ramani, Organic Spa Magazine [October 2010}

TX Podiatrist Chairs P.A.D. Coalition

APMA Vice President Joseph Caporusso, DPM recently became chairman of the Peripheral Arterial Disease (P.A.D.) Coalition Steering Committee. Dr. Caporusso had served as the vice chair for the past two years. 

(L-R) Drs. Joseph Caporusso and Kirk Geter

Kirk Geter, DPM, was re-elected to the committee and is also chair of the Communications Committee.

Source: APMA Daily eNews [10/6/10]

IPMA Elects New Officers

The Illinois Podiatric Medical Association (IPMA) has announced that the following podiatrists have been elected:  
 

Dr. Marlene Reid

Marlene Reid, DPM – President
Ada V. Paolucci, DPM – President Elect
David A. Yeager, DPM – Vice President
Francis John Rottier, DPM – Treasurer
Brent D. Parry, DPM – Secretary
Joseph S. Borreggine, DPM – Immediate Past President

FL Podiatrist Makes Opening Remarks 5th Annual Diabetes Educational Forum

The University of South Florida, College of Medicine in Tampa hosted the 5th Annual Diabetes Educational Forum on September 24, 2010. Dr. Chet Evans, chair of the Florida Governor’s Diabetes Advisory Council gave opening remarks and a welcome to the more than 160 attendees.

(L to R) Ms. Nicole Johnson, Dr. Chet Evans, and Dr. Ann Albright, Director of the Division of Diabetes Translation, Centers for Disease Control and Prevention

The event was chaired by Ms. Nicole Johnson, Executive Director of Bringing Science Home of USF Health, former Miss America 1999, and member of the Florida Alliance for Diabetes Prevention and Care.

ONC Lists Certified EHRs on Website

The Office of the National Coordinator for Health Information Technology at HHS has opened the official federal website for listing health IT products that have been independently tested and certified as eligible for incentive payments under the American Recovery and Reinvestment Act of 2009.

The list includes electronic health-record systems and EHR modules that the ONC-authorized testing and certification bodies have approved. According to an ONC statement, only those systems appearing on the list will be granted a reporting number that will be accepted by the CMS for attestation under federal EHR incentive programs. 

Source: Joseph Conn, Modern Healthcare [10/6/10] 

Query: Private Practice to Clinic Employment

I, along with the one other podiatrist in our small city, have been approached by the one and only clinic in our city to join them as employed physicians. Virtually all medical services in the city are provided at this clinic with the exception of our two private podiatry offices. While the list is long for reasons to pursue a relationship with the clinic, I also have a few reservations (autonomy, flexibility, patient preference for small office, etc.). 

The clinic will not purchase our practices, but may purchase equipment, instrumentation, etc. While I realize the variables are endless, have those of you who made this transition been happy with it? Is there a golden nugget of advice that you would give someone looking at this proposition? Also, is there an individual or service who would be recommended to counsel me and my colleague through the upcoming negotiation process? I will be consulting with my accountant next week, however, I am not sure that he has all the answers. 

Name Withheld

RE: Too Many Stress Fractures in House School Athletes (Eric Edelman, DPM)
From: Keith Gurnick, DPM, Shari Lewis Kaminsky, DPM

One season in particular back in the  1980's, I was consulted in the care of a  number of UCLA football players who developed stress fractures of the 5th metatarsal base. After investigating, we thought the cause to be due to an arrangement that the football coach had with an athletic shoe company that required all  the players to use a specific make of shoe.  We had the players involved change their shoes, but camouflage/modify the new shoes to appear on the outside like the required shoes. The rash of foot injuries resolved. You might want to check your patients' shoes. 
 
Keith Gurnick, DPM, Los Angeles, CA, keithgrnk@aol.com

Try checking their Vitamin D levels. I check all Vitamin D levels on patients with fractures who come through my office. I also check Vitamin D before MT osteotomies. St Louis enjoys very few perfect outdoor days, and we are conditioned to wear sunscreen. The guidelines for dosing Vitamin D have probably been off for years. Most folks (95%) I test are significantly low and surprising enough, so was I.

Shari Lewis Kaminsky, DPM, sharikaminsky@hotmail.com

RE: Medicare to Cover Holistic Therapies
From: Bob Kornfeld, DPM

Dean Ornish, MD (who did groundbreaking work on lifestyle and diet modification and its reversing effects on cardiovascular disease), reports that after 16 years of perseverance, his program was recently approved for coverage by CMS. A similar integrative program by Herbert Benson, MD and Eileen Stuart, RN, PhD, was also approved. Under the approval, Medicare will guarantee coverage in either program for 36 sessions within an 18 week period, with a possible extension to 72 sessions for 36 weeks.

The details of actual amounts of coverage are still under negotiation, however, the CMS decision indicates ...

Editor's Note: Dr. Kornfeld's extended-length letter can be read here.

RE: Medicare Jibberish
From: George Jacobson, DPM

I received a recoupment letter dated August 4, 2010. It was on six patients dating from 2007-2009 for $86.56. It probably wasn't worth my time to "rebut" the claims, but I performed the services and should be paid. All claims related to "routine foot care." Two were for 286.5 which is the older ICD-9 code which should have been 286.9. Others were for 250.60/61 where we did not provide a Q code. Our LCD says no Q code is necessary for Dx 250.60/61 or 286.9. We sent in our notes (which do contain class findings) and a copy of the LCD for the first step called "Rebuttal."

We just heard back. I was denied because I did not state full name of and signature of the person filing the request. My name is on my letterhead, the chart note had my name and address, and it was initialed and dated when it was entered into the chart. There are no instructions telling us of these requirements. Today, we have moved onto the redetermination process. We have resubmitted the exact same information but titled it "Redetermination", wrote "Filed By...", signed it, and attached the cover letter showing reason for dismissal (lack of name and signature). We have now paid for certified postage twice and spent a lot of time for $86.56. I believe these recoupment letters went out nationally and wonder what experiences others have had. Oh, I forgot that we are also being blackmailed into paying now, or the interest keeps accruing at 11% (11%! Banks get money for 0-.25%; prime rate is 3.25).  
 
George Jacobson, DPM, Hollywood, FL, fl1sun@msn.com

RE: Sage Advice From a Podiatric Legend (Tip Sullivan, DPM)
From: Robert Bijak, DPM

I do not appreciate the parental admonition proposed by a  politically correct podiatrist implying that well meaning, constructive criticism is "moaning, groaning and badmouthing." I'd rather entertain all opinions and make my own decisions without a verbal policeman, thank you. It seems suppression of language is the ammunition used by some who find other's "words" uncomfortable. As for touting particular podiatrists' accomplishments, let's not forget some had the advantage of military training by MD orthopods before they "appeared" on the podiatric scene. Others were never given competent (or any) residencies, so their potential accomplishments went stillborn.

How about a word of praise for the "forgotten podiatrist" with a weak or no program who, through self-study and initiative, practices at a level much higher than would have been expected. Many of the residents were trained by the average DPM. Now that they have their "residency" paper, they look down on the Drs. whose patients they "trained" on, but at the time were grateful just to be able to suture. 

Robert Bijak, DPM,  Clarence Center, NY, rbijak@aol.com

RE: Extortion By Patient
From: James E. Spitsen, ARM, CIC

I wanted to respond to the post regarding the issues around the ‘extortion by patient.’ I am an insurance agent who has specialized in malpractice insurance for 23 years and have worked with podiatrists for over 10 years. I feel that there are two main issues that need to be discussed. I am not an attorney and am speaking only regarding the insurance issues that arise.

When a patient asks for their money back, a red flag should go up immediately, and here is why. In most malpractice applications there are...

Editor's Note: Mr. Spitsen's extended-length letter can be read here.

RE: PECOS for DME Suppliers
From: Paul Kesselman, DPM

Several months ago, the National Supplier Clearinghouse (NSC) announced that supplier enrollment would be transferred to the PECOS database during the fall of 2010. True to their promise, the NSC has announced that the PECOS database is now available for supplier applications. This would include initial enrollment, modification of current enrollment, and re-enrollment.

Submitting supplier applications into the PECOS database via paper (855S) or via the Internet route remains the supplier's choice, similar to that for physicians applying to the PECOS database. More information will soon be forthcoming from the National Supplier Clearinghouse.

Paul Kesselman DPM, Woodside, NY, pkesselman@pol.net

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION - DAYTON, OHIO

Join a well-established modern practice with an excellent reputation and referral base. Base salary $100,000 and benefits with a bonus structure. EMR, diagnostic ultrasound, all aspects of DME, Padnet vascular studies, and CO2 lasers. We seek a surgeon that is well trained, personable and motivated to join our group of 3 Podiatric Surgeons. Would like this individual to buy in the practice eventually. Please send resume and photo to Ohiodoctors@aol.com

ASSOCIATE POSITION - NYC, NY

Part/time, full/time associate for busy, well established multi-doctor, multi-office NYC group. Seeking motivated, ethical, NYC licensed DPM with excellent office management and clinical skills in all phases of Podiatry. Board Qualified/Certified preferred. Salary plus incentives, pension/medical/dental. Partnership potential. Fax CV to 631-369-6570.

ASSOCIATE POSITION - ST. LOUIS, MO 
 
Leading group practice looking to add one podiatrist to established location. Group's podiatrists enjoy incentive compensation plan (production and sharing group profits), benefits including health and malpractice, and supported with integrated practice management and EMR systems. Perfect opportunity for solo practitioner to join group setting. Could also be part time opportunity for the right individual.  Please forward CV to StlPodGroup@gmail.com

PART-TIME PODIATRIST NEEDED ASAP CHICAGO

Part-time podiatrist needed for 2 offices in Chicago with an average of 20 hours/week. Must have Illinois license. Must have completed 2 years of surgical residency. If qualified, email to f-massuda@footexperts.com

ASSOCIATE POSITION - MASSACHUSETTS

Well established, multi-office, group practice, North of Boston, seeking a well-trained (PSR 24/36) Associate to start July, 2011. This is an excellent opportunity for an energetic, hardworking individual with strong surgical and medical skills, desiring a fast-track opportunity for partnership. Our practice is well rounded in all aspects of forefoot/rearfoot reconstructive surgery, pediatrics, sports medicine and general care. Competitive salary and benefit package available. Send a cover letter, CV, and two letters of reference to: drfleishman@nefootankle.com. Visit our website at www.nefootankle.com for more information about our practice.

ASSOCIATE POSITION – LONG ISLAND

FT/PT Associate position available with busy multi-office podiatry group on Long Island. Our practice is state-of-the-art, and encompasses all phases of podiatric care. We welcome new practitioners, or someone who would be open to merging a smaller practice with ours, and benefitting from our practice management overlay. We also invite residents graduating in 2011 who want to practice on Long Island to apply for this position. Compensation includes competitive salary and bonuses. Vacation pay and malpractice insurance are also offered with a full time position. Please send your CV by fax (631) 293-3462 or e-mail to mets724@gmail.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 - NEW JERSEY

Ambitious podiatrist needed for part-time work in Bergen County office, nursing homes, rehabilitation centers and assisted living facilities. Hours are flexible. PRS 24 needed. Candidate should be hardworking and willing to travel throughout Bergen County. Please send CV to facnj@yahoo.com or fax 201-599-5960.

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

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 - WEST CENTRAL FLORIDA 
 
A great opportunity to join a  very busy, well established, diversified practice in Clearwater, Florida. We are seeking an Associate who is BC/BE and highly motivated, minimum PSR24+. We offer a competitive salary and benefits. Please send your resume to Jaye@fdn.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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