The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

October 20, 2010 #3,988 Publisher-Barry Block, DPM, JD

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MA Podiatrist Discusses Shoes and Aging Feet

Unfortunately, as we age, our feet can feel the brunt. "Our feet can actually get wider, and they can change shape," says Emily Cook, podiatrist at Boston's Beth Israel Deaconess Medical Center. "They can change size. You can lose flexibility within your joints. Certain foot deformities — bunions, hammertoes" — can worsen over time. Weakened ligaments and joints, arthritis and a thinning of the fatty pads on the bottom of our feet can also cause complications.

Dr. Emily Cook

Cook says there can be remedies. Many problems, she says, can be diminished by simply buying more appropriate shoes. And she offers a number of suggestions: First off, shoes should fit properly. It's best to buy shoes at the end of the day, as feet can swell as the day wears on. Also, get your feet measured routinely. Aging feet can get wider and longer.

Source: Patti Neighmond, NPR [10/18/10]

TUSPM Honors PA Podiatrist at Gallery of Success Awards

Jay Schnitzer, DPM was named as one of the awardees at the recent Temple University Gallery of Success Awards. The Career Center's Gallery of Success portrays successful alumni from Temple University. One graduate from each of Temple University’s 17 graduate schools is honored yearly in "The Gallery of Success" located in Temple University. 

Dr. Jay Schnitzer

The Gallery’s mission is to provide current students an opportunity to recognize and be inspired by the success of Temple graduates who have gone before them and achieved success in their chosen fields and to honor Temple alumni who have distinguished themselves in their careers. Schnitzer was awarded The Certificate of Honor from Temple University in 2008.

Pakistan-SALSA Toe and Flow Connection Highlights Vascular and Podiatric Synergies

The Southern Arizona Limb Salvage Alliance (SALSA) of the Department of Surgery, University of Arizona hosted Dr. Iram Naz, Consultant Vascular Surgeon from Aga Khan University Hospital, Karachi, Pakistan. Her month-long experience will bring her in-depth exposure to the "Toe and Flow" philosophy of amputation prevention advocated by the SALSA team. "We're so pleased to have Dr. Naz with us over the next month", noted David G. Armstrong, Professor of Surgery and Director of SALSA, "To share experiences, tips, and techniques is something that brings us closer together, no matter where we practice."

David G. Armstrong and Iram Naz, Consultant Vascular Surgeon, Aga Khan University Hospital, Karachi, Pakistan

SALSA, which routinely plays host to visitors, worldwide, has developed in-depth relationships with centers from more than two dozen countries in this manner. "To develop a partnership with a shared vision to make a difference is, I should think, the reason that we all want to practice this craft in the first place--It's part of our very fiber." Pakistan, as with the rest of South Asia, has among the highest rates of diabetes and resultant diabetic foot problems in the world.

Leading Lights of Diabetic Limb Salvage Gather in Washington, DC

The fourth annual Georgetown University Hospital Diabetic Limb Salvage Conference brought the leading lights of diabetic limb salvage medicine to the JW Marriott Washington DC October 14-16. More than 1,100 physicians, surgeons, and other diabetic limb salvage specialists from 39 U.S. states, five Canadian provinces, and 35 countries attended the conference. “The education sessions were so well attended, we often had a standing room only crowd in the education ballroom,” said Dr. Christopher E. Attinger, MD, co-chair of the conference.

Live Surgery at DLS Conference

 “This meeting embodies the team approach to diabetic limb salvage by leveling the playing field and exposes the audience to medical and surgical aspects of DLS,” said John S. Steinberg, DPM, associate professor and co-director of the Wound Healing Center at Georgetown, and co-chair of the conference. The 2011 conference is set for September 22-24, 2011 at the JW Marriott Washington DC.

TX Podiatrist to Be Featured Speaker at IAAP-WAC Meeting

James Kutchback, DPM, and Brett McCormick, PT, LAT, of Memorial Hermann The Woodlands Hospital, will be the featured speakers at the International Association of Administrative Professionals (IAAP-WAC) chapter meeting Thursday.

Dr. James Kutchback

Kutchback earned his medical degree from Temple University School of Podiatric Medicine in Philadelphia. He completed his residency in podiatry at Northwest Medical Center in Houston. He now provides services in podiatry and podiatric surgery. He and his family live in The Woodlands.

Source: The Courier [10/17/10]

IL Podiatrist Indicted on Tax Fraud Charges

Federal prosecutors say a Chicago podiatrist with offices in Northbrook and Orland Park is facing tax fraud charges. A nine-count indictment unsealed last week alleges that 62-year-old Randy Pachnik failed to pay more than $500,000 in federal income taxes on approximately $1.8 million in gross income from his medical practice over four years, as well as from an inheritance.

Randall Samborn, a spokesman for the U.S. Attorney's office, says Pachnik appeared in U.S. District Court on Monday and pleaded not guilty to four counts of tax evasion, four counts of failing to file a federal income tax return and one count of obstructing and impeding the IRS from collecting taxes.

Source: Chicago Tribune [10/18/10]

Query: Malpractice Limits

I will be moving from CT to Florida soon. My malpractice limits now are 1 million/3 million. My new carrier has told me that the limits I choose will be the limits for any retroactive claims. I do not have any malpractice history, but can anyone speak to experience or advise if taking out a new policy with lower limits: I think 250k/750K is what is being proposed.
 
Brian W. Fullem, DPM, New Haven, CT

Editor's comment: PM News does not provide legal advice. It's generally "pennywise, pound foolish" to elect for lower policy limits. The savings of choosing lower policy limits do not justify the added risk of exposing your personal assets to a judgment. Many recent judgments in podiatric cases have exceed the $250,000 threshold.

Query: RAC Audit of of CPT 99243-25 & CPT 29540 

I received a Recovery Audit Contractor demand for payment because I used a consultation code (on a new patient) with a strapping code on the first visit. When I billed the claim, I applied a "-25" modifier to the E/M code. The RAC auditor is stating that "The E/M service is included in the global surgery package not separately payable."

I'm wondering what I did wrong. Is the modifier incorrect? Should I have considered using a "-57" modifier on the E/M with the strapping code, since the strapping code is a surgical code and it was done on the same day as the new patient consultation? How should I appeal this?

Katheryne Glantz, DPM, Sparks, NV

Response: First off, you did not necessarily do anything wrong. RAC audits look for targeted areas to investigate. You can appeal this demand for payment. Payment for a strapping with an E/M is appropriate. You billed it correctly with the "-25" modifier. The "-57" modifier would not be appropriate as that is used when you perform a surgery that has a 90-day Medicare global on the same day as an E/M service.

Ask for an appeal. Submit your chart notes with your consult letter to validate you met all the criteria for a consultation and the strapping.

Tony Poggio, DPM, Alameda, CA

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RE: Doctor (DPM) Doctor? (Randall Brower, DPM, Tilden Sokoloff, DPM, MD)
From: Arnold Wolf, DPM, Bryan Markinson, DPM

It is amusing to see podiatrists who muse about the definition of our specialty. By definition, the only physicians are primary care physicians, i.e., family doctors, internists, and critical care providers of service. All the rest of the allopaths, osteopaths, and podiatric specialists are truly only technicians. Ophthalmologists rarely practice gynecology, while orthopedists avoid diagnosing chimera.

The degree one gets does not entitle them to be called physicians because we all diagnose and treat human ailments of body parts. The great thing about podiatry is that for most states' insurance programs, podiatrists are considered physicians and paid for their E&M and procedures.

Arnold Wolf, DPM, Houston, TX, ajwps@yahoo.com

I would like to thank Dr. Brower for alluding to my “dinosaur" status when it comes to podiatric medical education. He is correct, podiatric medical students are much better trained now than when I attended. However, every action in my personal career proves that I am not living in the past, but have fought with every breath to enhance podiatric students, residents, and practitioners. I have progressed not by thumping my chest, but by demonstrating what I have learned and what I can do, and pointing out to my colleagues how much pathology there is in the foot.

This current problem is as much political as it is...

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

RE: Rules for Rewarding Patient Referrals (Joel Lang, DPM)
From: Michael Brody, DPM

While I agree with Dr. Lang's sentiments, I find that most physicians and others who are referral sources use PDA's and no longer use the calendar books he refers to. I believe you will get much more mileage from flash drives with your practice information embossed on the outside. In bulk, they are less than $10 each. In addition with 'Meaningful Use' requiring you to provide patients with electronic copies of their health information, this same flash drive can be provided to your patients with their health information. Patients will use that flash drive to bring information regarding the care they received at your offices to other physicians to allow them to keep their records up-to-date.

Having a patient walk into an office with personal medical info on a flash drive is sure to impress another doctor, and with your practice info on the flash drive, this can only enhance the image of your practice.

Michael Brody, DPM, Commack, NY, mbrody@tldsystems.com 

RE:  Rules for Rewarding Patient Referrals (Pasquale Cancelliere, DPM)
From: Peter Walimire, DPM, Pasquale Cancelliere, DPM

I made the assumption in my previously posted question that if I thought something was illegal, most readers would assume that I would also think it to be unprofessional, which I do. That was obviously lost on Dr. Cancelliere. I have no intention of doing these things which the author of the CD (who is not a physician) recommends to increase patient referrals. I am in no way promoting these practices, but the suggestion of doing so by this marketing "guru" prompted me to ask the question. I was just hoping for someone with experience in practice marketing or medical law to weigh in. The state statutes appear to make the practice illegal, but there is a lot of gray area, which is why I phrased my question the way I did. There is often no clear-cut definition of what IS or IS NOT acceptable.

Dr. Cancelliere wrote, "We already still have a hard enough time being recognized as professionals and physicians." I don't know about his situation, but being accepted as a professional and a physician in this community has been the easiest part because of how I represent myself. Based upon his comments and my time spent with him in school, I'll bet that what he's still struggling with the most is the professionalism part.        

Peter Walimire, DPM, Cape Coral, FL, pwalimire@gmail.com

It was not my intention to personally attack Dr. Walimire in my statement. I just find it un-becoming of any physician to undertake such schemes in the interests of self-promotion. I think highly of our profession and we have a long way to go to be truly integrated and respected by allopathic and osteopathic colleagues. My position on this does not change, but I wanted to apologize to Dr. Walimire, who is a friend of mine, for singling him out and attacking him.

Pasquale Cancelliere, DPM, Scranton, PA, pcancell@bidmc.harvard.edu 

PART-TIME / FULL-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

PART-TIME ASSOCIATE PODIATRIST WANTED - CENTRAL NEW JERSEY

Growing practice in need of an outgoing, hard-working associate. House calls, nursing homes and a busy, well-established office setting. At least a PSR12 preferred. Fax CV to 732 699 1901.

PART-TIME/FULL-TIME PODIATRIST NEEDED - INDIANA

Part-time full-time Podiatrist needed for our Indiana offices. Must have Indiana license. Must have completed two years of surgical residency. If qualified email to f-massuda@footexperts.com

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

PART-TIME PODIATRIST NEEDED - LOS ANGELES, CALIFORNIA

Busy Podiatrist looking for assistance with patients located in facilities, homes, office etc. Flexible hours, independence, and great compensation. If interested email CV to homefootcare@hotmail.com or call Terri at 323-353-8103.

ASSOCIATE POSITION - NORTHERN NEW MEXICO

Associate needed for a dynamic group practice in Northern New Mexico. We are looking for a well-trained 3-year surgical resident to help us build our practice leading to partnership. In New Mexico we have a leg law. Besides a great professional experience, we have the mountains for skiing, fishing, hunting, and horseback riding. Ideal for an experienced podiatrist looking for a location change. Please send a resume to FootandAnkleAssociates@comcast.net

ASSOCIATESHIP - MARYLAND

A great opportunity to join and gain ownership interest of a well established, diversified practice in Maryland. 2-year residency needed, EHR, ultrasound, ASC, hospital close by with wound care center. Fax resume to 410-749-6807.

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

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.

EQUIPMENT FOR SALE: PADNET SYSTEM BY BIOMEDIX

Less than 1 yr old. Two computer laptops included to allow flexibility of testing in 2 offices. Training by Biomedix included in price. Willing to sell for remainder of balance on lease. Contact by email at hassenfratz@hotmail.com

SPORTS MEDICINE FELLOWSHIP

The Palo Alto Medical Foundation Surgical/Sports Fellowship Aug 1, 2011 thru July 31, 2012. APPLICANTS MUST BE ABLE TO OBTAIN A CALIFORNIA LICENSE. Responsibilities include assisting in all types of foot and ankle surgery (approximately 500 cases), seeing patients in the sports clinic and completing 2 papers/research projects. Benefits include salary of $56,500/yr, medical, dental, malpractice, and CME allowance. Interviews at the Midwest Podiatry Conference Mar 3-5, 2011 & ACFAS Mar 8-10, 2011, but on-site visit is preferred. Minimum 24-month surgical residency training pre-requisite. Send a letter of interest, CV and three letters of recommendation to: Amol Saxena, DPM. HeySax@AOL.com

TRAUMA FELLOWSHIP - FOOT & ANKLE

Broadlawns Medical Center in Des Moines, IA is currently accepting applications for its 12 month trauma surgery fellowship beginning August 1, 2011. Fellowship to include advanced techniques in all foot and ankle surgery with an emphasis on lower extremity trauma, reconstruction & total joint replacement. Residency training required. Competitive salary and benefits. Please submit a letter of interest, CV, and 3 letters of recommendation to: Ben Olsen, DPM, Director: Foot and Ankle Trauma Fellowship, Broadlawns Medical Center,  1801 Hickman Road, Des Moines, IA 50314, 515-282-7927,  bolsen@broadlawns.org 

ACTIVE PRACTICE FOR SALE - NEW YORK CITY

Part-time practice available Mid-town Manhattan. Doctor is retiring. (212) 247-5148.

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

PM News Classified Ads Reach over 12,500 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. 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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