The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

October 08, 2011 #4,374 Publisher-Barry Block, DPM, JD

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Using Ultrasound Reduces Number of Steroid Injections: MO Podiatrists

Judy Redel suffers from plantar fasciitis in her right foot. It's the most common cause of heel pain and is caused by an inflammation of the ligament that runs from the heel to the ball of the foot. “It helps in the support of the arch when standing and walking," Dr. Jody McAleer, a podiatrist with the Jefferson City Medical Group said. In the past, stretching and applying ice did the trick, but last fall, when the pain came back and the same treatments didn't work, she agreed to a steroid injection.

(L-R) Drs. Jody McAleer and William Duke

"Most people are surprised afterwards, 'Oh it wasn't as bad as I thought.’” Dr. Bill Duke, a podiatrist with the Jefferson City Medical Group said. The key to making the treatment work is the way it's now delivered McAleer and Duke said. An ultrasound machine helps the doctors see the inflamed ligament and place the injection where it can do the most good. McAleer said the approach has paid off with patients requiring fewer injections.

Source: Teresa Snow, KRCG-TV CBS 13 Connect Mid-Missouri (MO) [10/5/11]

Aussie Podiatrist Heads to Harvard on a Fulbright Scholarship

There’s no time for Hylton Menz to put his feet up, with the La Trobe University professor heading overseas to research, well, feet. While not everyone’s favorite body part, Professor Menz says he’s tickled pink by feet, which can give some fascinating insights into the rest of the body. Combining his clinical background as a podiatrist with physiology studies, he is examining mobility issues in older people. 

Hylton Menz

He said that while there had been general research into falls and balance, little had been done specifically about foot and ankle problems. “Foot disorders are far from trivial complaints,” Professor Menz said. “They are a common but largely under-researched public health problem. One in three Australians over 65 years of age will fall in any given year ... falls are the leading cause of injury-related death in older people.” The director of La Trobe’s Musculoskeletal Research Centre, Prof Menz has been awarded one of two Fulbright Senior scholarships to travel to the U.S. for five months.

Source: Hannah Donnellan, Heidelberg Leader

Parents Need to Be Vigilant About Children's Shoes: APMA President

What is it about children's feet that make them seem like the fastest-growing part of their body? With back-to-school shopping behind you for another year, you might hope you can stop spending on shoes - at least until flip-flop season arrives with spring. But kids' feet do grow year round, right along with the rest of them. In fact, according to the American Podiatric Medical Association, a child's shoe and sock sizes may change every few months. 

Dr. Michael King

"A pair of well-made shoes can keep children safe from foot problems such as sprains and strains - both in class and on the playground," says Dr. Michael J. King, president of APMA. "Unless your child complains of discomfort, you may not realize he or she needs new shoes. Parents need to be vigilant to ensure kids are wearing shoes that fit properly and provide the stability and support kids need."

Source: Milwaukee Journal-Sentinel [10/5/11]

AZ & CA Podiatrists Win SAWC Poster Award

The Symposium on Advanced Wound Care (SAWC) has awarded David G. Armstrong, DPM, MD, PhD, William A. Marston, MD, Alexander M. Reyzelman, DPM and Robert S. Kirsner, MD, PhD the highest scoring abstract in the clinical research category for their poster entitled, "Comparative Effectiveness of Mechanically and Electrically Powered Negative Pressure Wound Therapy (NPWT) Devices: A Multicenter Randomized Controlled Trial." Addressing a major healthcare concern, the poster highlights the treatment options of chronic wounds, and includes analysis in support of the safety of NPWT, the delivery of negative pressure for wound healing. This winning abstract will be presented at the upcoming SAWC Fall 2011, October 13-15, in Las Vegas. 

Drs. David Armstrong and Alexander Reyzelman

The winning poster highlights a 17-center randomized-controlled trial (RCT), which enrolled 132 subjects with chronic, non-infected, non-ischemic, non-plantar lower extremity diabetic and venous wounds. The study was designed to compare the ultra-portable mechanically powered SNaP(R) Wound Care System from Spiracur, Inc. to the electrically powered Vacuum-Assisted Closure (V.A.C.(R)) Therapy System from Kinetic Concepts, Inc. Data includes promising analysis supporting the efficacy and safety of the SNaP System in the treatment of chronic lower extremity wounds.

Receives U.S. Patent for Cold Compression Device

Dr. Mark Wolpa, founder of the Bay Area Foot & Laser Podiatry Group, received a U.S. Patent for a novel cold compression device that helps to reduce swelling following surgery and injuries. "The application of ice, compression, and elevation following surgery or injury will never go out of style, and my device will assist the patient with this process by applying pneumatic compression along with the application of cold simultaneously and efficiently as opposed to just using an ice bag and elastic wrap," explains Dr. Wolpa.

Dr. Mark Wolpa

"After much experimenting, I came up with a device that wraps around the foot with cold packs inserted into it along with an attached pneumatic compression pump. The pump helps control the swollen extremity as well as drive the cold deeper into the tissues where it is needed," explains Wolpa.

Source: San Francisco Chronicle [10/5/11]

Repeal SGR but Save Doc Pay: Medical Groups

Medicare should repeal the Medicare physician payment formula but do so without other cuts to physician pay, according to a letter to the Medicare Payment Advisory Commission from the American Medical Association and 42 other medical groups.

Specifically, they wrote, MedPAC should revise the sustainable-growth-rate proposal that Medicare's leading advisory group began considering in September. That proposed plan would pay for the replacement of the SGR with $333 billion in beneficiary and provider payment cuts, including about $100 billion from first cutting and then freezing most non-primary-care physician payments. Among the likely unintended consequences of such an approach, according to the physician advocates, is an increase in medical costs for Medicare.

Source: Rich Daly, Modern Physician [10/4/11]

Query: Billing for a Physician Assisting Surgery

The doctor performed the following hammertoe corrections,

CPT 28285-T7, CPT 28285-T8, CPT 28285-T9.

How would I bill the assistant surgeon?

Tressa Mooers, Billing, Office of Gerard Busch, DPM, Edina, MN

Response: According to CMS, an assistant surgeon is not billable/reimbursable with CPT 28285 (hammertoe correction).

Mark Schilansky, DPM, Catskill, NY

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RE: Painful 1st MTPJ (Name Withheld)
From:  Richard Gosnay, DPM

I am dubious about the potential of saving the joint because of the uneven joint space narrowing (50%), and possible old fibular sesamoid fracture. Most of all, I think that the crepitus is an ominous finding. You can restore motion with a joint-sparing procedure. But it is likely to be painful motion. A healthy, active, 50 year-old with good bone stock is the perfect candidate for a 1st MTPJ fusion. He is already accustomed to the lack of ROM. I tell patients that the goal is to take a painful, non-functioning joint and make it a pain-free, non-functioning joint.

Note that if a joint sparing procedure is attempted, it does not address the 1st metatarsal/cuneiform hypermobility which is an underlying cause of this pathology. So a Lapidus fusion would be in order along with any attempt to spare the 1st MTPJ.

Richard Gosnay, DPM, Danbury, CT, glabroushead@gmail.com

RE: Podiatrist Lands on Front Page of AARP Convention Issue  (Michael M. Rosenblatt, DPM)
From: Estelle Albright, DPM

I am both saddened and angry about this article. When I see ads on TV for motorized scooters advertised aggressively by a company that advertises they will bill Medicare, and insurance,...and that people pay little or nothing for a scooter, and, that if we can't get you covered, your scooter is FREE.

It makes me wonder why Medicare isn't going after the big fish like this?  Not to mention how many OTHER kinds of doctors commit much worse fraud, and for much greater amounts. Why is AARP making front page news of one bad apple in a minority profession like podiatry?  Apparently, this bad apple should have been stopped when first discovered, but Medicare failed to do so, so the fraud continued on their watch. I have been an AARP member for years, and am sorely disappointed by this article.

Estelle Albright, DPM,  Indianapolis, IN,  estellealbright@hotmail.com

RE: Is Podiatry Turning Away from Biomechanics? (Dennis Shavelson, DPM)
From: Elliot Udell, DPM

Dr. Shavelson, who is our most outspoken colleague on the need to keep biomechanics on the front burner, notes that labs are often inconsistent in the way they approach biomechanics and the making of custom orthotics. This examines the problem from a different perspective. Yes there are professional differences in the way experts such as Dr. Shavelson and others approach biomechanics and the making of orthotics. The study is still evolving and if one were to hear back-to-back lectures from Drs. Shavelson, Glaser, Kirby, and other experts, one might leave the room feeling a bit confused as to who is correct.
 
Controversy, however, is okay. It means that we as a profession need to not only hear  all of these points of view but absolutely need to promote more research. Only then will evidence reduce conflicting theories. This is where the schools, the labs, and even some of our podiatry associations need to make a greater commitment.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: OH Court Rules That Podiatrists Need ABPS Certification for Staff Privileges
From: Tip Sullivan, DPM

What is ABPS certification anyway? It is documentation that a podiatrist has gained a certain amount of experience in the surgical arena. What does your hospital credentialing committee look at when granting privileges? Education and EXPERIENCE. One way in the surgical area for them to be assured that a podiatrist is qualified to do surgeries is for them to recognize the standard required by ABPS - just as they do any other specialty board. I do not think that the debate is whether or not ABPS accurately depicts one's experience in performing surgeries. If I were someone on a hospital committee who did not know much about podiatric training, I would think that using board certification as a criterion would be a good, safe thing to use to help decide surgical qualifications.

There seems to be some issue with podiatric training and...

Editor's note: Dr. Sullivan's extended-length letter can be read here.

PRACTICE FOR SALE - SOUTHERN OH

Busy, well-established, full-time home visit practice. 100% referral-based. Wound care, pain management, routine care & DME’s. Excellent income, low overhead. Great opportunity for husband/wife business team. DPM relocating out-of-state for family. Contact: nanetter@zoomtown.com

PRACTICE FOR SALE - ARKANSAS

Busy, well established practice of 13 years grosses 160K/year for the past 5 years, while working 3.5 days/week. Nursing homes available. 50% Medicare, average of 15 new patients/week. Doctor retiring. Please call 800-983-4194 for more details, or e-mailcontactus@podiatrypracticeconsultants.com

ASSOCIATE POSITION - NASSAU COUNTY, NY

Podiatrist needed in Nassau county to start immediately. Flexible hours 2 days a week. Please email pittpod@gmail.com with inquiries.

ASSOCIATE POSITION - EAST TENNESSEE

30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. Extremely competitive base salary with bonus incentives and benefits. Knoxville is consistently ranked in top 5 places in U.S. Post-residency experience a plus. Please send resume to ddavidphawk@yahoo.com

ASSOCIATE POSITION - NORTH CENTRAL NJ

Well established busy solo physician seeking a well trained podiatrist (PMS 36) to join our growing practice. Bilingual English Spanish a big +. Competitive salary/benefits package. Send CV to fax 732-520-6468 or send to fjr20032003@yahoo.com.

ASSOCIATE POSITION – IOWA CITY AREA

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Immediate position for busy surgery practice looking for BQ/BC by ABPS in RRA candidate for associate position. Bilingual a plus. Must be comfortable in complex reconstructive ankle and hindfoot cases. Ankle replacement certification a plus but not necessary. email CV and samples of RRA cases done recently to: susmitad86@yahoo.com

SOUTHEAST GEORGIA & SOUTH CAROLINA

Seeking associate physician to join practice to cover nursing home facilities. Comprehensive package including Salary, Travel and Bonus benefits. Email cover letter and CV tomelissafoot@pol.net.

ASSOCIATE POSITION - SOUTH WEST FLORIDA

Full-time associate positions for an established group practice in Southwest Florida. Willing to train the right new graduates. Job will involved all aspects of podiatric care. You must be ambitious, hard-working and should have good people skills. Please e-mail your resume/CV tocontactus@ankleandfoot.net

FULL-TIME ASSOCIATE POSITION - SOUTHERN NEW HAMPSHIRE

Well-established, rapidly growing practice. Motivated, ethical and personable with well-trained PSR-24/36. Modern office with complete EMR, digital radiography, diagnostic ultrasound, and laser. Competitive salary/benefits package. If interested please email your CV, letter of intent and references to: NHFootDoc@yahoo.com

ASSOCIATE POSITION - DAYTON, OH

Join a Well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and current photo to Ohiodoctors@aol.com

SEEKING ASSOCIATE POSITION - SUBURBAN DETROIT

ABPS certified podiatrist with several years experience seeking part-time position in suburban Detroit. On staff at area hospitals. Excellent clinical, surgical, and practice management skills. Please respond to michpod@hotmail.com

SELL OR MERGE YOUR PRACTICE - SOUTH FLORIDA

Looking for an exit strategy? If you would like to discuss options such as phasing out, selling your practice, or merging with a larger group in South Florida, please email your interest and contact info to foot369@yahoo.com

SPACE AVAILABLE - NYC & LI

SUB LEASING TIME on MRI (NYC)

.31 tesla extremity MRI in state-of-the-art midtown Manhattan office location. Lease time on magnet in compliance with the Stark laws. This magnet is the only one that will be accepted by Medicare and all other insurance as of 2012. Why not bill out for your own MRI's??? Email today dri@myfcny.com

EQUIPMENT FOR SALE - CLASS FOUR LASER

I have a class four pain laser for sale. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

EQUIPMENT FOR SALE - ULTRASOUND, CRYO-PAC, FLOUROSCAN

Ultrasound w/printer, Cryo-Pac w/two probes, Flouroscan w/printer. There may be other surgical equipment as well. Please contact Jolene as young_jolene@yahoo.com

PM News Classified Ads Reach over 13,500 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 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 for a 50-word ad 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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