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PM News |
The Voice of Podiatrists
Serving Over 22,082 Subscribers Daily
October 10, 2023 #7,602 Publisher-Barry Block, DPM, JD
A partner of Podiatry Management https://podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2023- No part of PM News can be reproduced without the
written permission of Barry Block
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PM NEWS QUICK POLL |
Do you support a CPME-approved mandatory pain management/substance use disorder rotation during residency training?
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INTERNATIONAL PODIATRISTS IN THE NEWS |
Canadian Podiatrist Teaches Bunion Surgery to Others
Bunions are one of the most common foot problems preventing people from being active. Almost a third of us have one. Hartley Miltchin, DPM, a Toronto podiatrist who has dubbed himself “the Bunion King,” said that if feet—the body’s foundation—aren’t performing properly, they throw everything else off. “They’re like the base of the Tower of Pisa. When they’re off, the tower leans.”
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Dr. Hartley Miltchin |
Troy Gubb, golfer, suffered from bunions. Gubb had Miltchin remove his bunion with a surgery the podiatrist developed that he says is quicker, less invasive, and has a faster recovery time. Dr. Miltchin trains other podiatrists, as well as orthopaedic surgeons, in the procedure, during which he uses precision instruments to make small cuts in the bones to bring the big toe back into alignment. Six weeks after his surgery in April 2022, Gubb was golfing again.
Source: Sydney Loney, Reader's Digest Canada [10/5/23]
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PODIATRISTS IN THE COMMUNITY - PART 1 |
Logansport Memorial Physician Network Welcomes OH Podiatrist
Logansport Memorial Physician Network has welcomed Scott E. Marsh, DPM. Dr. Marsh earned his podiatric medical degree from the Ohio College of Podiatric Medicine.
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Dr. Scott Marsh |
Dr. Marsh completed his podiatric residency at The Jewish Hospital in Cincinnati, OH. He is board certified in reconstructive rearfoot/ankle surgery by the American Board of Foot and Ankle Surgery.
Source: Pharos Tribune [10/7/23]
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PODIATRISTS IN THE COMMUNITY - PART 2 |
TX Podiatrist Joins Sports Medicine Associates of San Antonio
Stephen Smith, DPM recently joined Sports Medicine Associates of San Antonio. Dr. Smith earned his podiatric medical degree at the Arizona College of Podiatric Medicine at Midwestern University.
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Dr. Stephen Smith |
Dr. Smith completed his podiatric residency at UT Health San Antonio followed by a fellowship at Sports Medicine Associates of San Antonio. He is an associate member of the American College of Foot and Ankle Surgery.
Source: Linkedin
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PRACTICE MANAGEMENT TIP OF THE DAY |
Five Financial Reports You Need to See Monthly
There are five financial reports that physicians should review no later than the tenth day of every month, for the previous month's activity.
2. Aged Accounts Receivable (A/R) - The A/R report summarizes your practice's lifeblood - the potential revenue from payers and patients for services you've rendered. That's right: potential - because any number of things can hinder (or halt) payment to your bank account. And that's precisely why physicians must review their A/R on a monthly basis. Start with "Days in A/R," which indicates the average number of days it takes to collect on an account. [Total A/R ÷ (annual gross charges ÷ 365)]. "Days" of 30 or less is good. "Days" of 50 or more is not so good. And look at the percentage of total A/R in each aging category. More than 10-15 percent in the 120+ days indicates a problem.
If the indicators signal trouble, analyze further. For instance, review A/R by individual payer to determine if specific companies are slow to pay, and identify why by analyzing explanation of benefits (EOB) for denial patterns such as non-covered service, applied to deductible, patient ineligible, or wrong modifier. If necessary, modify your operations or train staff accordingly to minimize denials.
source: Cheryl L. Toth, Logan Lutton, Physicians Practice
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CODINGLINE CORNER |
Query: Recurrent IPK and Treatment
I have a patient who returned to my office for recurrent six intractable porokeratosis. I have treated this situation for the patient about three months previously and I billed CPT 17110 after treating it with an application of canthrone. Can I bill CPT 17110 at this second visit?
New York Codingline Subscriber
Response: Is treatment of an intractable porokeratosis (IPK) with canthrone curative? Does the literature that supports treating IPKs in this manner recommend treatment every three months? Is this more of a palliative treatment versus a true “destruction of a benign lesion” as the code implies?
My opinion is that you should be billing CPT 11055, CPT 11056, or CPT 11057 for this service. Yes… there are rules when using these codes and it is possible that your patient may not be covered. This would then have to be a CASH service.
Tony Poggio, DPM, Alameda, CA
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RESPONSES/COMMMENTS (INTERNATIONAL PODIATRISTS IN THE NEWS) |
RE: OPMA Salutes Hartley Miltchin, DPM
From: Ontario Podiatric Medical Association
It is a pleasure to again bring to your attention another special recognition earned by our long-time professional colleague, Hartley Miltchin. When any Ontario podiatrist earns global and national recognition, the entire profession benefits.
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Dr. Hartley Miltchin |
Let's congratulate Hartley on being named a Reader's Digest Readers' Choice Award (Canada & International) Recipient as the "BUNION KING"! Keep up the best practices, Hartley.
Ontario Podiatric Medical Association
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RESPONSES/COMMENTS (NON-CLINICAL) - PART 1 A |
From: David E. Samuel, DPM, Gary Dorfman, DPM
The APMA has not gotten us equal pay for equal work in the 30 years I’ve been paying dues. That was and still is priority #1. At this point, does this really shock anyone we are left out of a package insert.
David E. Samuel, DPM, Springfield, PA
Keith: as you well know, the manufacturer of Krystexxa is just repeating history. They just don’t get it! Think back, were you ever detailed on Uloric or Zyloprim when they were first introduced. I know I wasn’t. I don’t know how many gouty patients the average podiatrist sees in a month, but when I was in active practice, I would see on average at least four or five. And generally, one half of those patients presented after they had seen their GP or internist who treated them with antibiotics for a “foot infection” with antibiotics.
Most of the time we diagnosed and medicated these patients based upon exam and history, even before we confirmed the diagnosis, with a serum uric acid or joint aspiration simply because of our experience with gout. I guess these manufacturers play the numbers and feel we don’t represent a sufficient monetary recognition…..that is, until we do!
Gary Dorfman, DPM. Dana Point, CA
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RESPONSES/COMMENTS (NON-CLINICAL) - PART 1 B |
From: Allen Jacobs, DPM
Horizon has marketed a number of products to podiatrists, including a variety of anti-inflammatory medications as well as Krystexxa. They have regularly provided speakers to podiatric seminars, both physicians and podiatrists. Prior to the acquisition of Krystexxa by Horizon, I had the opportunity to meet with the prior manufacturers in New York. Those attending the meeting included multiple APMA officers as well as other podiatrists.
Krystexxa is an IV administered medication with a not insignificant risk of infusion reaction and anaphylaxis. It is used to treat hyperuricemia. Although we as podiatrists diagnose gout and treat the acute exacerbations, the etiology of hyperuricemia and lowering of uric acid or the treatment of the underlying disorders causing hyperuricemia are not what we as podiatrists...
Editor's note: Dr. Jacobs' extended-length letter can be read here.
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RESPONSES/COMMENTS (PM EDITORIALS) |
From: Bob Sage, DPM
I am an avid reader, not so common commenter of PM News. Reading the PM September Editorially Speaking, I couldn't agree more. Thank you for encouraging our fellow colleagues to join APMA and to speak at career days.
APMA has been doing its best to put more money in the pockets of our members by doing things like making sure we were viewed as essential during the shutdowns. Fighting the "Podiatry-Specific" E/M codes and enabling us to bill like all the rest of our colleagues by "time" and "risk". That victory alone has given us an enormous financial benefit. Passing the VA Parity Bill, putting podiatrists in the same pay category as other physicians. Stopping the mandatory Cigna -25 modifier policy, adding money in both reduced costs to our offices and increased...
Editor's comment: Dr. Sage's extended-length letter can be read here.
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YOU CAN'T MAKE THESE THINGS UP' |
RE: Outrageous Shoes of the Day
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Aptly named "Who Needs Wings" |
Source: Aycin Aydogan via Virtual Shoe Museum
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MEETINGS & WEBINARS
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NEED CME CREDITS FAST?
PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
You can Earn up to 50 Continuing Education Contact Hours (CECH) Online
Earn 15 CECH only $279 (less than $19 per CECH)
podiatrym.com/cme.cfm
All required credits can be taken online for AL, AK, AR, CA, CO, DE, HI, IN, KS, LA, MA, ME, MI, MI, MS, NV, NJ, NM, ND, OH, OR, PA, RI, SC, SD, UT, VA, VT, WV, and WI
Partial required credits can be taken online for AZ, FL, GA, ID, KY, IL, ID, IA, MD, MN, MO, MT, NE, NH, NY*, NC, OK, PR, TN, TX, WA, and DC
Choose any or ALL from 25+ CECH Category-1 articles posted
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CLASSIFIED ADS - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PM NEWS CLASSIFIED ADS REACH OVER 22,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 22,000 subscribers. For details, click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details.
PRACTICE FOR SALE - NEW PORT RICHEY FLORIDA
Immediately available; retiring. 40+ years in practice. Excellent location; in complex with over 20 groups. All hospitals available. General practice. 727-869- 9559. Or 727 863 9991 nights or weekends.
PRACTICE FOR SALE – LANCASTER COUNTY, PA
3,000+sq.ft. beautiful podiatry office with 4 well-equipped exam rooms, digital x-ray, EMR, Q-Clear laser, enPuls radial shockwave device, centrifuge for PRP injections, diabetic shoe room, autoclave and ultrasonic instrument cleanser, orthotic 3D scanner, outsourced billing, free parking, handicapped accessible first floor location for sale. Contact PApodpractice@gmail.com
PRACTICE FOR SALE - SUBURBAN MINNEAPOLIS, MN
Busy, 41 year old solo practice. Large modern clinic. Huge patient list & population draw. Close to surgery centers. Grossing over 500K with only 24 clinic hours per week. Everything needed to produce immediate income. Unlimited potential. Wonderful area to live and practice. Affordable. Easy financing. Will stay for transition. For more info: wwfoot4sale.com
ORTHOTIC LAB FOR SALE
Established custom Foot Orthotic Lab for Sale in Berkeley Heights, NJ. State-of-the-art CAD/CAM technology. Over 4500 doctors in our database. Great opportunity to expand your business/lab. If interested - Email: sherylfrasco@gmail.com
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CLASSIFIED ADS - ASSOCIATE AND FACULTY POSITIONS, AND FELLOWSHIPS |
PM NEWS CLASSIFIED ADS REACH OVER 20,000 DPMs AND STUDENTS\
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 22,000 subscribers. For details, click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details.
CLINICAL FACULTY POSITION – UNIVERSITY OF ALABAMA AT BIRMINGHAM (UAB)
Join 3 DPMs and 7 Vascular Surgeons in a robust multi-disciplinary limb-salvage program with practice locations at UAB and the Birmingham VA. Practice includes a dedicated NP, clinical nurse and scheduler support. Send cover letter and CV to: Dr. Adam Beck, Division Director of Vascular Surgery at awbeck@uabmc.edu
ASSOCIATE POSITION - PENNSYLVANIA
Multi-doctor, multi-office, podiatric practice looking for a full-time Associate to support growing practice with patient demand. Candidate must be highly motivated, team-oriented, hardworking, and exhibit excellent bedside manner. Competitive salary (base + bonus) offered with benefits. Must be actively seeking Board Qualification or already Board Certified. email CV to: brhodes.podmed@gmail.com
ASSOCIATE POSITION – GRAPEVINE AND KELLER TEXAS
Successful, well rounded multi office podiatry practice with laser, digital x-rays, diagnostic ultrasound, and ancillary services including a shoe store and on-site physical therapy: seeking highly motivated, hard-working podiatrist proficient in surgery as well as sports medicine and biomechanics. Compensation includes base salary + production bonus. Our clinics are located in Grapevine and Keller, Texas – in the heart of the DFW metroplex. Send CV to nstickney5@gmail.com
FULL-TIME PODIATRIST NEEDED – AUGUSTA, GA
Well-established (general podiatry) practice seeking a surgical Podiatrist. Skilled in forefoot surgery (at minimum). Ongoing mentorship to foster professional growth. Will cover our growing Grovetown and Martinez offices. No nursing homes, Modern offices/technology, Streamlined Workflow. Ownership options available. base salary/bonus/benefits/malpractice/continuing education. Confidential. Contact info: HR@26Medical.com www.26FootandAnkle.com
PODIATRIST - PHOENIX, AZ
Immediate position available. Excellent opportunity for a physician who wants to grow. Established practice offering state-of-the-art equipment, wonderful and caring associates, kind and well trained staff, great reviews, and a growing inflow of new patients. AZ License Holders Preferred. Please email CV ArizonaFootDocs@gmail.com
ASSOCIATE POSITION AVAILABLE - SUFFOLK COUNTY, NY
Multi-office podiatry practice in Suffolk County, NY actively seeking full time/part time associates, with partnership opportunity. New York State license required. Must be self-motivated and energetic. Competitive compensation package, paid time off, 401K retirement plan. Email CV to newpodiatrist@optimum.net
ASSOCIATE POSITION - PROVO, UT
Immediate Doctor of Podiatric medicine position for a well-trained, highly motivated individual. Location: Provo, Utah. Competitive salary with commission structure. Benefits include: PTO, CME allowance, health and malpractice insurance. Must be confident in surgical and wound care practices. Please email Cover Letter and CV to laney@summitmedicalpartners.com
FULL TIME PODIATRIST - NEW JERSEY
Established Podiatry practice in New Jersey with multiple locations and Doctors. We are currently looking for a full-time motivated and caring doctor to join our busy practice. Benefits include: competitive six-figure salary, generous guaranteed bonus structure, health insurance (including vision & dental), paid vacation time off, paid malpractice insurance and CME time off. Great prospects for experienced doctors as well as new Associates. This is an excellent opportunity to expand your podiatric medical and surgical experience in an office-based practice! If interested, please submit your CV to DrSamofal@PodiatryCenterNJ.com
ASSOCIATE POSITION – MIDTOWN MANHATTAN
Looking for a full time/part time Podiatric Associate for a busy Midtown practice Please email CV to amaltese2185@yahoo.com
ASSOCIATE POSITION – ST. LOUIS, MO
Are you unhappy in practice? Established podiatry practice in St. Louis suburb looking for a full-time, experienced, motivated and caring doctor to join our busy practice. Must be BC. Competitive six-figure salary with bonus structure. Opportunity for ownership. Independent, office-based practice. Amazing opportunity! Must be available now. If interested, please submit your CV to stcpod@att.net or call Edward Stein, DPM 314-565-2739
ASSOCIATE POSITION – LOS ANGELES, LONG BEACH OR ORANGE COUNTY
We are seeking a podiatrist to join our rapidly expanding and outstanding network. The ideal candidate will provide top-notch, mobile-based care for podiatric issues to our patients in either the Los Angeles, Long Beach or Orange County areas. Enjoy the perks of being your own boss with a flexible work-life balance, ability to set your own schedule and highly competitive compensation. We offer both full-time and part-time opportunities, primarily conducting home visits and serving luxury retirement communities. Our complete office support ensures smooth operations for optimal patient care. A current CA license is required. Please email your CV to: info@anywherefootandanklecare.com
IMMEDIATE FULL-TIME OR PART-TIME ASSOCIATE POSITION AVAILABLE- CHICAGO IL
Seeking full-time or part-time associate to work in a well-established three-office podiatry practice in Chicago with on-site Joint Commission accredited office-based surgical facility. Must be reliable, personable, and self-motivated. Board qualified or board-certified DPM with surgical residency with excellent references preferred. Competitive compensation package with bonus structure and benefits available. Spanish speaking a plus. Please forward CV via email to mddpm2@gmail.com or call 773-230-7526
ASSOCIATE POSITION - CHICAGO SUBURBS
Looking to hire Summer 2024. Thriving podiatry practice in Chicago suburbs looking for an associate to take practice to the next level. Must be highly motivated and have the ability to WOW our patient with your charismatic personality and professionalism. This is an excellent opportunity to work in a state-of-the-art office (which includes MRI) with a team-oriented culture. 3-year surgical residency required. Submit CV to jswalter@hotmail.com
ASSOCIATE POSITION - DURANGO, CO
Established and fast growing multi-specialty group is looking for a full-time podiatrist in the Durango Colorado area. Interested in an energetic team member who is able to manage and direct all aspects of podiatry. Salary -$150-200K based on experience. Bonus structure. Benefits. Please send your CV to nick@innovationmedgroup.com
ASSOCIATE POSITION - CT (FAIRFIELD, GREENWICH, AND NORTH HAVEN)
Full time position available immediately. A very busy schedule and competitive compensation package is being offered. Our EMR system is MacPractice and digital x-ray is 20/20 Imaging. Sonoace ultrasound, a PinPointe laser, and an EPAT by Curamedix as well. Please visit our website www.greatfootcare.com and send resume to DrKassaris@GreatFootCare.com
ASSOCIATE POSITION – ST. GEORGE, UTAH
Immediate Doctor of Podiatric medicine position for a well-trained, highly motivated individual. Location: St. George, Utah. Competitive salary with commission structure. Benefits include: PTO, CME allowance, health and malpractice insurance. Must be confident in working solo in your own office environment. Please email Cover Letter and CV to laney@summitmedicalpartners.com
ASSOCIATE POSITION - ASHEVILLE/HENDERSON NC AREA
US Foot and Ankle Specialists (USFAS), one of the largest podiatric groups in the United States is hiring! USFAS is looking for an experienced associate doctor to join our team in the Asheville/Henderson NC area. Our group of physicians use state of the art, podiatry-specific technology, and software to stay on top of today’s changing medical trends and provide our patients with the highest quality care. USFAS is an excellent opportunity for those who are seeking long-term employment. Please send a cover letter and resume to recruiting@footandankle-usa.com. Candidates must be either licensed or in the process of becoming licensed.
ASSOCIATE POSITION - SOUTHEAST FLORIDA
Busy group practice seeking to add a full time associate. Practice comprises a mixture of hospital, clinic and nursing home patients. Candidates must be hard working with surgical training of at least a 36 month residency. BQ/BC applicants preferred. Competitive salary and benefits. E-mail CV to eastfloridafootdoc@gmail.com
ASSOCIATE POSITION FOR FELLOWSHIP TRAINED IN PODIATRIC TRAUMA/SURGERY – BEAUTIFUL SUBURBS OF NYC
Looking to grow and be challenged and get Board-Certified? Our Associate Mentorship Program in our well-established practice will help you achieve your goals. High-Volume Surgery, modern equipment, with great work culture. ABFAS BQ/BC required. Competitive Salary + Bonus, PTO, Paid Vacations and Paid Holidays, Retirement Plan with Employer Matching, All Professional Fees Paid, Generous Signing Bonus. Income: $275,000 - $350,000. Send CV to: linchpindpm@yahoo.com
ASSOCIATE POSITION – BECKLEY AND CHARLESTON, WEST VIRGINIA
US Foot and Ankle Specialists (USFAS), one of the largest podiatric groups in the United States is hiring! USFAS is looking for an experienced Associate Doctor that has a specialty in surgery and rear foot to join our team in Beckley and Charleston, West Virginia. Our group of physicians use state of the art, podiatry-specific technology, and software to stay on top of today’s changing medical trends and provide our patients with the highest quality care. Please send a cover letter and resume to recruiting@footandankle-usa.com. Candidates must be either licensed or in the process of becoming licensed.
IMMEDIATE POSITIONS – FLORIDA AND SOUTH CAROLINA
KG Health Partners is seeking full-time and part-time podiatrists to provide mobile lower extremity care to long-term care residents in Florida and South Carolina. Monday through Friday schedule, competitive wages, malpractice insurance, and benefits for full-time employees. Email CV to Kgadmin@kghealthpartners.com
ASSOCIATE POSITION – MARYLAND
Established Maryland practice with three locations close to DC/Virginia looking for an associate podiatrist. Our ideal candidate will be trained surgically or non-surgically and able to retain patients in a protocol-based office setting. Privileges at three local hospitals. This position is M- F,7:30 AM -4:30 PM, with no weekend or on-call responsibility to ensure you have an outstanding work-life balance! Salary plus bonus contract, Health, vision, and dental at no cost to the employee, No holidays, No weekends, CME allowance, Malpractice at no cost, Paid Vacation/sick/CME time, relocation allowance, and 401K with employer match. Please e-mail Jelena@somdfootandankle.com
ASSOCIATE POSITION - CHARLOTTE, NC
Associate physician position open immediately to join our team! Expanding Charlotte metro area podiatry practice looking to hire a full-time podiatrist with significant growth potential. We have 4 locations and 5 doctors. Our podiatrists treat all aspects of foot and ankle pathology, in all age groups. We offer medical, disability, 401 K, malpractice, CME, and a highly competitive base salary with production incentives. BC or BQ status required. Please email CV to footdocs@carolinapodiatry.net
ASSOCIATE POSITION – LANGHORNE / BUCKS COUNTY
Full and Part time available. Seeking highly motivated candidate with confident surgical skills to join highly esteemed, diverse practice with 2 offices. High volume surgical practice. 2 different hospital systems. Long-term potential/partnership. Salary + Bonus, 401K, malpractice, vacation, CME. Send resume to bucksfoot@gmail.com
ASSOCIATE POSITION - CALGARY, CANADA
We are looking for a podiatrist comfortable with all aspects of the profession, ranging from foot care to surgery. We have four exam rooms and an in-office surgical suite. Must be able to practice in Canada. Well-established podiatrists and new residency graduates encouraged to apply. Please contact lalani@alpinefootankle.com
ASSOCIATE POSITION – NEW YORK CITY BOROUGHS
Busy and rapidly expanding practice looking for a full time associate. Multiple locations in Queens, Brooklyn, and Staten Island, Bilingual preferred. Opportunity to take call with several podiatry programs. Great balance between surgery and medicine. Ideal for recent graduates. Competitive compensation. Please submit CV to careersmobilepodiatry@gmail.com
ASSOCIATE POSITION – NORTHERN CALIFORNIA SOUTH BAY AREA
Well established podiatry practice seeking to hire a full-time podiatrist. Candidate will be able to treat all aspects of foot and ankle pathology. We offer Medical, 401 K, malpractice, CME, Highly competitive based salary with potential for partnership. Please email CV to lgfootcntr@aol.com
FULL-TIME or PART-TIME PODIATRIST - DALLAS/FORT WORTH AREA
PSR 24-36 Trained Multi-dimensional, Multi-office group treating a wide range of patients to include: forefoot, rearfoot, diabetic wound care, sports medicine and work-related injuries. Modern offices and equipment. A great opportunity for driven personable individual. Please e-mail Cover letter, CV, Letter of references Email: cnunez1940@gmail.com
IMMEDIATE, FULL-TIME ASSOCIATE POSITION AVAILABLE- ALBUQUERQUE, NEW MEXICO
Foot & Ankle Specialists of New Mexico has an exciting, immediate full-time position open for a board qualified or board-certified foot and ankle surgeon. You can view our website at footanklenm.com. Spanish speaking and Fellowship are a plus but not a requirement. Billing/coding experience is preferred. Compensation is a competitive salary plus a percentage bonus structure to start. Please email CV and cover letter to ACharlie@footanklenm.com
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Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management® Magazine and Podiatry Management® Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
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