The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

October 18, 2008 #3,377 Editor-Barry Block, DPM, JD

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OH Podiatrist Uses Simple Test To Detect Diabetic Neuropathy

A simple test could help those with diabetes or circulation problems reduce the odds of amputation or other complications. Since diabetes is a condition which causes sugar in the blood to go outside normal ranges, managing blood sugar is critical to preventing neuropathy, which can reduce feeling in the feet:.

Dr. Brian Ash

Podiatrist Dr. Brian Ash said, “Eventually as you lose feeling in your feet, you could step on something and not know it, you could walk around for weeks with a staple in your foot.” Ash administers a mono-filament test, that measures light touch sensation. A doctor can perform this test at any diabetes follow-up visit or refer a patient to a podiatrist.

Source: WHAM-TV (Rochester, NY) [10/17/08]

NYCPM Holds Inaugural Planning Dinner for Centennial Celebration

In a little over two years, the New York College of Podiatric Medicine (NYCPM) will be marking the 100th anniversary of its founding in 1911. And while there will certainly be gala events celebrating the College’s centennial, NYCPM also plans to enlist its alumni and friends in an initiative aimed at strengthening the College and enhancing the contributions of podiatry to the future of medical care in this country and around the world.

Louis L. Levine, President & CEO of NYCPM, describes the newly-completed renovations and upgrades to the computer labs and to several classrooms, as well as the creation of new spaces for several College departments.

To get the ball rolling, and to begin involving alumni, the College recently held an inaugural planning dinner in its newly-created Bruce J. Frankel, DPM Conference Center. The attendees included a number of leaders of past graduating classes, as well as other leaders of the profession, including representatives from the New York State Podiatric Medical Association. In attendance from NYCPM were President and CEO Louis L. Levine, Michael J. Trepal, DPM, Vice President for Academic Affairs and Dean, Mark H. Swartz, MD, Professor of Podiatric Medicine and Vice President, Medical and Professional Affairs, Howard Rusk, Jr., Director of Alumni Affairs, and Harold Wolchok, Special Consultant, Centennial Planning.

NY Podiatrist Forced to Sit Out Financial Crisis

As devastating as it is to hear about the global financial crisis, to watch institutions collapse and investors panic, it’s not exactly a picnic out here on the sidelines. Countless ordinary Americans are now dealing with a crisis of a personal nature. They’re stunned by how quickly the turmoil on Wall Street is spilling over to their own lives and wallets. And few have the slightest idea how to cope, now that normal remedies don’t seem to apply.

Dr. John Hoina

John Hoina, a podiatrist in Bethpage, NY, said he couldn’t see any reason to save. “You wish you had more in reserves. But I look at my investments and think, my God, all that savings — lost.” Although he would like to take his money out of the market, that seems even more pointless. “If I take it out, I get hit with a loss and I’m penalized on top of it. So you have to sit with it.”

Source: M. P. Dunleavey, New York Times, [10/17/08]

Monthly Part B Premiums for Most Beneficiaries Will Stay the Same in 2009.

But the break might not last long, because premiums are tied in part to increases in Medicare physician pay. If Congress blocks a roughly 20% projected doctor pay cut for 2010, these premiums likely will make an upward leap after next year.

Note: Since 2007, beneficiaries with higher incomes pay higher premiums, on a sliding scale. For 2009, beneficiaries will pay higher premiums if income exceeds $85,000 for individuals or $170,000 for couples.

Source: Centers for Medicare & Medicaid Services Via AMNews [10/20/08]

Annual Performance Appraisals

Plan now for annual performance appraisals. If an appraisal will be negative in nature, be sure to focus on actions, not the person. Your staff will be better served if you preserve the person's self-worth

Source" Adapted from Get Your People to Work Like They Mean It! by Jean Blacklock and Evelyn Jacks

Query: EDL Tendon Z-Plasty Code

What is the best code for z-plasty lengthening of the extensor tendon performed through a separate incision along with an arthroplasty performed at the proximal interphalangeal joint?

Syed Ghani, DPM, Sterling Hts., MI

Response: You will not find any code specific for lengthening a tendon at the level of the foot you note. While there is code, CPT 27685, lengthening or shortening of tendon, leg or ankle, this code would be inappropriate for the anatomic location you have described.

When a tendon lengthening or shortening is done in the foot, and is not "related to another procedure", I would recommend using CPT 28208, repair tendon, extensor, foot primary or secondary, each tendon, if a repair is actually performed. The other option is to bill CPT 28899, unlisted code, and submit for individual review and consideration. Include copy of operative report with your billing slip and request peer review.

Howard Zlotoff DPM, Camp Hill, PA

Codingline subscription information can be found here

RE: White Marks on Nails (Dennis R. Frisch, DPM)

The white lines that affect all nails are Beau's lines, and indicate some type of systemic problem, such as ingestion of a medication or an illness.

Marjorie Miller-Khawam, DPM, Long Beach, CA, footssy@aol.com

RE: Feedback on Staff (Mark Gotfryd, DPM)
From: Barry Block, DPM, JD

There are several effective ways of obtaining patient feedback about staff. The most cost-effective is to print up brief surveys and provide them to patients, along with a stamped self-addressed envelope sent to your home address or to a post box. Attach a short note such as “This office prides ourselves on the high quality of patient service we provide. Kindly fill out and mail back this anonymous survey, so we can better serve you.”

Ask a few objective questions, such as, “How long did you have to wait before being seen?” as well as some subjective questions, such as “Was the staff friendly to you?”

Barry Block, DPM, JD, Forest Hills, NY, bblock@podiatrym.com

RE: Misrepresentation by Yogatoes
From:Joseph Borreggine, DPM

Recently, I saw an ad for a product called Yogatoes . According to their before and after photos, hammertoes and bunions can be permanently eliminated...hence my conclusion from the ad… is that patients with these conditions no longer need to see a podiatrist. This profession needs to take a stand on these unscrupulous ads that provide false information to the public.

I know that there is freedom of speech...but spreading lies is not part of that amendment. Look at the promises in Yogatoes’ lifetime money-back guarantee. APMA needs to get on this one...otherwise, who needs a podiatrist when this product will do!

Joseph Borreggine, DPM, Charleston, IL footfixr@consolidated.net

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

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 full-time podiatrist in a multi practice location in the Chicagoland and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

SURGICAL EQUIPMENT FOR SALE

One Storz-Ergo Surgical Kit - Oscillating and reciprocating plus K-Wire driver. In very good operating condition. $4,500.00 Complete set of surgical instruments for any type of foot surgery. Includes osteotomes, implant prep osteotomes, hemostats, rongeurs, Allis clamps, retracters, bone forceps, etc, in excellent condition. Approximately 80 instruments. $1,500.00. e-mail Marstubass@aol.com

SURGICAL PODIATRIST - CONNECTICUT

Connecticut Surgical Group, one of the largest multi-specialty surgical group practices in New England, is seeking a Board-Certified podiatrist to add to our four-physician podiatry division based in Hartford. 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 bc/be. Competitive salary and productivity bonus, partnership opportunities, excellent benefits, and reasonable overhead. Please apply online or via our website , or fax your CV to 860-524-2653. No phone calls, please. EOE

ASSOCIATE WANTED - SOUTH JERSEY

Part time/ Full time Full scope, well established group practice located between Phila. and the Shore. Digital X-ray, EMR, Diag U/S. Prefer PSR 24-36 individual with several years previous experience but will consider the right recent grad. Must be willing and able to provide quality palliative and surgical care. Medicare and NJ Blue Shield provider numbers is a plus. Competitive financial and benefits package. E-mail resume & references to: Toetrukr@aol.com

EQUIPMENT WANTED – AUTOCLAVE/CHAIRS

Wanted to buy – Used New Style (not pressure cooker) desktop digital autoclave (e.g. Midmark Ritter) and 2 waiting room chairs. Call 212-724-4457 or e-mail frottenberg@juno.com

EQUIPMENT FOR SALE – PAD SYSTEMS

2 SensiLase 3000 PAD Systems used for Skin Perfusion Pressure (SPP) & Pulse Volume Recording (PVR) tests for micro and macro-circulatory assessment. I’m selling because podiatrists no longer qualified to do studies and get reimbursed in Colorado. Paid $24,390. Sell for $20,000 each. Purchased from Vasamed. Call or e-mail Jack Burgin A Step Ahead Foot & Ankle Center 2001 S. Shields St., Bldg. F, Fort Collins, CO, 80526, (970) 232-1717 jack@asafoot.com

turn-key operation grossing $570,000 annually based on one full-time doctor; practice is in a growing retirement area in the center of the state. Option to purchase or lease real estate. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours, so it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725 for details and ask for Lee.

ASSOCIATE POSITION - NORTHWEST IOWA

Great opportunity for hard-working, ethical podiatrist to join Midwest multi-physician, podiatric group with multiple locations. A well-established, successful, growing practice with strong hospital affiliations seeking FT and PT surgically trained physician. Applicant should be well-trained in all aspects of surgical care, completed a 24-36 month residency, & at least board eligible. Diverse practice offering high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume to: 712-258-9977

PODIATRISTS NEEDED - CHICAGO -- NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. 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

PODIATRISTS NEEDED – DALLAS/ FT WORTH – TEXAS AREA

Texas Home Footcare Associates, a podiatry exclusive company specializing in house calls and visits to facilities for the elderly, is looking to hire podiatrists. We are located in the Dallas area. Full and part-time positions are available. Immediate Openings Available. Must have a Current Texas license. Competitive Compensation Package. If interested fax curriculum vitae to 972 931-4819 or e-mail gjmdpm@tx.rr.com. For further information, call 972-380-8028.

ASSOCIATE POSITION - NORTHERN VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes.Top hospitals. Fax CV with references to 703-491-9994

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