The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

October 13, 2009 #3,673 Publisher-Barry Block, DPM, JD

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Today's Runners Need to Wear Shoes: DC Podiatrist

Howard Osterman, president of the District of Columbia Podiatric Medical Association, says, in theory, efforts to strengthen feet and ankles by gradually withdrawing the support that running shoes offer makes sense. But in the real world, he believes, "we lack the intrinsic musculature to run barefoot, or run in minimalist shoes, without risking injury."

Dr. Howard Osterman

Without running shoes, people would be susceptible to injuries from glass, rocks, and other objects. And many exercise regimens would be ended, he says. "The advent of the more structurally supportive, more cushioned running shoe has taken a lot of people off the couch and allowed them to start exercising," Osterman says.

Source: Lenny Bernstein, The Washington Post [10/9/09]

TX Podiatrist Discusses Cheerleading Injuries

Last year, 16,000 cheerleaders were injured seriously in accidents involving dramatic stunts and tumbles. Dr. Tyson Green, a podiatrist at Center for Orthopedics, sees the effects that elite cheerleading can have on a young woman's feet. "With cheerleading," he said, "there are more ballistic activities, so when they're coming down, they can easily sprain their ankle."

Dr. Tyson Green

Ankle sprains and strains account for more than half of all cheerleading injuries. "...the tibia and the fibula, and the ankle ligament structures that will come at the end of this bone will sometimes be disrupted with an inversion ankle sprain," Dr. Green said. "Any type of ankle support would probably be a good idea," he said, "good trainers that tape up your ankles, just like with any other sport would be great, especially for those elite athletes in cheerleading."

Source: NBC33-TV [10/8/09]

Systagenix Appoints FL Podiatrist as Medical Director 

A practicing podiatrist and wound specialist, Dr. Robert Snyder will underpin the company’s already impressive clinical evidence credentials by developing close relationships with major specialist organisations and thought leaders in the wound care field, worldwide. As an internationally recognized, well-published, and distinguished wound care practitioner, his first project will be to form and lead a new international Systagenix Medical Advisory Board that will meet at specific intervals to provide feedback, input and guidance on company clinical and commercial strategies.

Dr. Robert Snyder

Dr. Snyder, a professor (adjunct) at Temple University College of Podiatric Medicine, will also be responsible for the review and management of all current and new clinical evidence to support many of the company’s key departments, including Research and Development, Professional Education, Medical Affairs and Marketing. Maintaining his strong links with clinical practice, Dr. Snyder will continue to treat patients at his private practice and serve on various professional medical bodies and associations linked to wound care.

Source: Business Wire [8/8/09]

Malpractice Reform Would Save $54B: Study

Reforming medical-malpractice laws could save the federal government $54 billion over 10 years and slash doctors’ and hospitals’ insurance costs by 10 percent, according to a congressional study released Friday.  But there’s one problem  - none of the Democratic-run  proposals advancing in Congress include any of the reforms covered in the Congressional Budget Office Analysis.  

Savings would be realized by reducing “defensive” medicine costs that doctors use to avoid litigation and through lower malpractice payments. That means that doctors would order fewer unnecessary , but costly lab tests. The CBO estimates that healthcare providers are paying $35 billon this year for malpractice liability.

Source: Carl Campanile, NY Post [10/9/09]
 

Basic Medical Communication Principles

1. Speak slowly and distinctly. Patients do not want to feel rushed.
2. Repeat the message frequently. Patients are nervous, intimidated, and scared. They may not hear the message the first time you say it. Have the patient repeat the message back to you.
3. Use simple, non-medical words. Your language is not their language. They do not know the technical terms or the abbreviations and may feel “stupid” asking questions.
4. Use the patient’s name throughout your communication. Using the patient’s name every two or three sentences will bring them back to the moment.
5. Reinforce oral communication with written descriptions. Patients only absorb about 20 percent of oral language.
6. Talk to patients as equals. They do not want the physician to “talk down” to them.
7. Ask for patient input regarding their diagnosis and treatment.
8. Inform patients about services provided by the practice. Also, inform patients about relevant services outside the practice.

Source: Meg Heim, BioMedix Vascular Solutions, Inc. For information on AAPPM, click here.

Query: Life Expectancy of Swanson Implant

Does anybody know the life expectancy for the Swanson 1st MPJ, double-stem, no grommets implant? Is there any literature regarding this?

Nathan Schwartz, DPM, Smyrna, GA

RE: APMA Coding Resource Center (CRC)
From: Kathleen M. Stone, DPM

Dear Colleagues, as the APMA Educational Foundation President, I would like to tell you about a remarkable resource that has been a great investment in my practice and in our profession. A goal of APMA’s Vision 2015 is attracting the best and brightest to our colleges, and one way we can all participate in this goal is by subscribing to the APMA Coding Resource Center (CRC).

As a subscriber, you will have access to the most updated coding and billing information while investing in a resource tool that provides scholarships to podiatric medical students. As an association, APMA reinvests CRC proceeds into APMA programs and the Educational Foundation which provides annually 150 – 200 scholarships to podiatric medical students. To subscribe, click here.  For more highlights, continue reading…

• CRC’s $189.00 annual subscription rate for APMA members provides access to CPT®, ICD-9 and HCPCS priced at 1/3 the cost of purchasing CPT®, ICD-9 and HCPCS books, and 1/3 the cost of other electronic options.
• CRC is accessible via high-speed Internet connection – in the office, hospital, ASC, or home. 
• Log in and use throughout the day with multiple users. 
• With a few clicks navigate from CPT® to state Medicare LCDs to ICD-9 (“ICD-9 Quick List”) and links to CCI edits,  Access updated 2010 ICD-9.
• Coming soon… CRC will offer CPT procedure code links to ICD-9 coding examples, DME Local Coverage Determinations, latest CCI edits, and a new tab – Reference – which lists hundreds of reference websites.

Ongoing costs for this dynamic on-line coding resource are offset by a generous grant from Merz Pharmaceuticals, which allows APMA to offer this low-cost, comprehensive, state-of-the-art coding and billing resource while reinvesting proceeds in APMA programs and Scholarships. On behalf of the APMA Educational Foundation Board, thank you for considering the CRC as your coding resource tool.

Kathleen M. Stone, DPM, President, APMA Educational Foundation

RE: Message from a Fulbright Scholar
From: Leonard A. Levy, DPM, MPH

Greetings from Bratislava, Slovakia. I am at the medical school of Comenius University in this Eastern European democracy as a Fulbright Scholar, a program funded by the Fulbright Commission of the U.S. Department of State. My experience has been personally fulfilling but it has also further opened my eyes as to what podiatric medicine must do world-wide. The globe continues to shrink rapidly. If our profession is not an entity at least at the level it is in the U.S., it deprives the public health of the world from access to limb saving, and yes, even life saving, podiatric medical and surgical comprehensive care. Of course, with that deficit, it also adversely affects our public image in the U.S. as a member of the physician community.

It has been both a joy and revelation to be in discussions with people from the Comenius University medical school faculty and administration, the World Health Organization local office, and the U.S. Embassy in this capitol city to at least introduce the concept of our profession. However, this is only a beginning, and perhaps others in the profession, especially those in academia, will also seek Fulbrights, expanding our efforts to become an internationally recognized fully empowered healthcare participant. While I may be the first Fulbright from the profession, I do hope that I will not be the last.

Leonard A. Levy, DPM, MPH, levyleon@nova.edu

RE: Qualifying Routine Foot Care (Greg Amarantos, DPM)
From: Chris Browning, DPM, Shari Kaminsky, DPM

The debate on RFC amazes me. My 2 year old saw a local ENT doctor who billed a 99213 and also billed a procedure code for "wax removal."  He charged $300 for the wax removal which his assistant performed with an ear loop in less than 1 minute. My insurance paid over $200 for the wax removal AND also paid the office visit fee. I have to beg Medicare to pay $36 dollars to pay for RFC and then waste valuable time making sure it is well-documented. Too many ridiculous rules and hoops to jump through to qualify this care. I spend 10 times more time performing RFC on high risk patients whose limbs could be threatened or lost without this service. Surely, this is just as important as "wax removal." I am sure there are thousands of similar examples that could be stated regarding other specialties. APMA needs to take a long overdue stance on this issue!
 
Chris Browning, DPM, Nederland, TX, chrisbrowning@att.net

Editor's Note: Dr. Kaminsky's extended-length note can be read at: http://www.podiatrym.com/letters2.cfm?id=29543&start=1
 

RE: A Comparison of Negative Casting Techniques Used for the Fabrication of Custom Ankle-Foot Orthoses (Michael Turlik, DPM)
From: Kevin A. Kirby, DPM, Michael Turlik, DPM

Dr. Turlik wrote, “It is always comforting to review a publication whose conclusions are in line with my personal beliefs and treatment paradigms” when he was referring to the article, “Foot orthoses: how much customization is needed?” This is the same article that, in its final sentence of the first paragraph, made the following summary: “Nevertheless, it would take a very brave individual to claim that foot orthoses are nothing more than rebranded arch supports, particularly when an entire industry is sustained by the premise that modern foot orthoses are somehow different.” I am surprised that a former Chairman of the Department of Biomechanics and Orthopedics of one of our nation’s podiatric medical colleges could hold such a dismal view of the therapeutic effectiveness of custom foot orthoses.

Rather than the disappointing view that Dr. Turlik has of custom foot orthoses, I would rather hope that the teachers of our podiatric medical students would have sufficient positive clinical experience with custom foot orthoses to be able to confidently promote their many therapeutic benefits, rather than being comforted by a paper that compares custom foot orthoses to “nothing more than rebranded arch supports.” In the quarter century that I have been teaching custom foot orthosis therapy, my students fully understand that the podiatric physician who best understands the mechanical effects of the various modifications which can be made to custom foot orthoses, will also be best able to allow patients to perform their weight-bearing activities with the least pain and with the greatest efficiency. If Dr. Turlik needs more research evidence that foot orthoses are therapeutic, he should review the paper I wrote on the subject a few years ago (Kirby KA: Foot orthoses: therapeutic efficacy, theory and research evidence for their biomechanical effect. Foot Ankle Quarterly, 18(2):49-57, 2006).

Kevin A. Kirby, DPM, Sacramento, CA, kevinakirby@comcast.net

Editor’s Note: An extended-length letter by Dr. Turlik appears at:
http://www.podiatrym.com/letters2.cfm?id=29504&start=1

RE: Obama’s Healthcare Plan 
From: Russell J. Barone, DPM, Robert Boudreau, DPM

I agree with the Congressman who proposed that whatever healthcare package is passed, the Congress, the US Senators, and the President should have the same healthcare. The Congressman is a medical doctor who represents a district from a southern state. He attempted to put an amendment on the House of Representatives healthcare plan and it was shut out. I don't care whether you are a Democrat or Republican, I will go along with the public option as long as the Congress, the U.S. Senators, and the President have the same healthcare plan. This should include federal workers, union workers, and anyone else you want to include! Don't laugh this off as if they are allowed to have a different plan than you should have. I am going to write my Congressman and U.S. senators and demand that whatever is passed that they have the same healthcare that will be given my family, my patients and me. Does anybody disagree with that statement? 
 
Russell J. Barone, DPM, Hendersonville, NC, LPJRBar@aol.com

We have lived in one of the greatest societies in history. The United States of America is ALWAYS the first on the scene, be it a natural disaster or a despot ruler subjecting his citizens to genocide.  If "government" would let the free market and capitalism proceed unheeded, as our founding fathers intended, I believe that churches, families, philanthropy, and the generosity of medical care-givers providing free services (as physicians have always done) our citizens would not go without. Socialism is the PROBLEM, not the ANSWER. When people have to hand over 60-70% of their earned income to "taxes", people are much less inclined to donate to charity. People can do things better than government any day.
 
Robert Boudreau, DPM, Tyler, TX, rbftdoc@aol.com

DIABETIC RURAL OUTREACH PROGRAM - FLORIDA AND GEORGIA

Seeking DPM to join our program due to a high demand for Podiatric Care to off-site settings in SNF, ALFs and House Calls. Applicants must be willing to travel and must have experience. Current State License, Medicare and Medicaid numbers required. Seeking highly motivated individuals who can be team players, yet work independently. Must have strong work ethic and excellent communication skills. APPLY: Fax CV to: 866-258-9993 include 3 professional references. Please provide the geographic area where you can provide services. Further information call 800-779-8551 or email: info@DROPInternational.org. Visit our website

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 - 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

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 - 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.

ASSOCIATE POSITION, VICTORIA, BC

Beautiful Victoria, B.C. Canada on the ocean, fast growing area. Associate for multi-office full scope practice. Reply to dr.cole@shaw.ca

ASSOCIATE POSITION - CHICAGO AREA
 
Well-established, state of the art medical-surgical podiatry practice seeking well-trained motivated individual to work full-time with future partnership possible. Will start with full schedule. PSR-24 a minimum. Email resume to Howard4624@gmail.com

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

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 - 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

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

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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