The Voice of Podiatrists

October 22, 2006 #2,720 Editor-Barry Block, DPM, JD

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VA Podiatrist Opens Full Service Foot Care Center

When his partner retired about three years ago, Suffolk, VA podiatrist Dr. Matthew Dairman decided to go in a new direction - a direction that's rare on the East Coast and unheard of in Hampton Roads.

Dr. Matthew Daimon

1Foot2Foot combines medical and surgical services for feet and ankles, plus a pedicure salon, a foot spa specializing in massage and paraffin waxes, a physical therapy office focusing on feet to knees, and a shoe store that carries medically correct shoes. The facility also includes a second doctor, two nurses, a master massage therapist and a staff of seven.

Source: Linda McNatt, Virginian-Pilot [10/21/06]

"Podiatrist to the Celebrities" Ben Kauth Celebrates 92nd Birthday

Friday was a special day at the Famed Manhattan Friar’s Club which hosted the 92nd Birthday party of its longtime member Benjamin Kauth, DPM. Kauth, who once shared friendships with show business legends such as Ed Sullivan and Frank Sinatra, reminisced about his early days in podiatry and the screen, stage, and TV stars of yesteryear.

Dr. Benjamin Kauth

Kauth’s contributions to podiatry are legendary. He was the first podiatrist to write a book (Walk and Be Happy) for the lay public, and was a co-founder of the American Podiatric Medical Writers Association. He also served for many decades as a Trustee at NYCPM and Delegate to NYSPMA. Kauth’s many friends and family, as well as the staff of the Friar’s Club toasted him and wished him many more happy years.

HIPAA Security Compliance Still a Problem: Study

HIPAA as a compliance issue may be "old news" to some, but HIPAA as a security issue is very much new and still a problem. Most "covered entities" have complied to some extent with the majority of HIPAA regulations, but security-rule compliance remains low among health care providers, finds a study sponsored by Phoenix Health Systems and the Healthcare Information and Management Systems Society (HIMSS).

Although the deadline for compliance with the HIPAA security rule passed 545 days ago, 80% of payers and only 56% of providers that responded to the US Healthcare Industry HIPAA Summer 2006 Survey have implemented the security standards, according to HIMSS. Of those claiming full compliance with the security rule, the study finds, gaps remain. Many "compliant" providers and payers could not confirm that they had implemented all key security standards. "

Source: Today in E-Health Business [10/17/06]

Query: Problem With Candida Skin Antigen

I’ve been using injections of Candida skin antigen 0.1 cc. of 1:10 strength for plantar warts for about a year now. I’ve had minimal problems with post-injection reactions. Recently I got a new supply of three separate vials for my satellite offices, all the same lot number. I’ve given two injections with the new vials. Both people have gotten sick with fever of 100-101 F and body aches within 12 hours. The feet appeared cellutic.

The first patient was seen by his family doctor, diagnosed with pneumonia and bronchitis. He started him on Keflex with no improvement in 48 hours and worsened cellulitis of the foot He improved on Ancef within 24 hours. I injected the second patient yesterday, and she is having the same symptoms today. I’ve started her on Clindamycin 300mg 3X daily. The antigen lab has not been helpful. Has anyone else had similar problems? Any suggestions?

Sylvia Trotter, DPM, Riverton, WY, jefsyl@wyoming.com

Query: Repair MTPJ Coding

An MRI result shows a 2 mm. partial tear of distal lateral aspect of the 2nd metatarsal-phalangeal joint plantar plate, not significantly displaced. Surgery has been scheduled but I don't know how to code this. I would greatly appreciate any assistance that you could provide.

Aimee Judy, PMAC, Office of Brian Shwer, DPM, Bartlett, TN

Response: Finding a 2 mm. tear in the plantar flexor plate is an interesting finding, but I'm not sure this requires any surgery. I would recommend trying conservative avenues with immobilization of the second metatarsal-phalangeal joint with the toe held in a neutral or slightly plantarflexed position for a few weeks which will allow this tear to heal. In the case of conservative treatment, the coding would be an E/M service.

In the event that conservative avenues fail, and there is still pathology and symptoms that require surgery, I would recommend using code CPT 28200, repair tendon, flexor, single. While this is not the actual flexor tendon, I do feel this closely approximates the same techique and surgical management.

Howard Zlotoff, DPM, Camp Hill, PA

Codingline subscription information can be found at http://www.codingline.com/subscribe.htm

RE: Tips for Dealing with Difficult Patients
From: Doug Milch, DPM

We all get that patient once in a while who is extremely opinionated about the podiatric care they are receiving from us. I'm pretty patient with these types of patients. One might come in telling me that they have plantar fasciitis and they want a cortisone injection, and if I think it is reasonable for them, I'll do one. But now and then, a patient will cross the line about "telling me what to do." I usually just say, "I'm sorry. I didn't catch the name of the medical school you went to." It stops them in their tracks, and they get the message. My method of delivery of that line is not obnoxious, and the patient doesn't take it that way.

Often times I will explain to a patient what their problem is and what the treatment options are only to have them say, "Well, you're the doctor." What they are doing is absolving themselves of any decision-making responsibility which I think is wrong, so when they say, "You're the doctor," I reply, "Well, you're the patient. Now we know who we each are. Let's both figure out what we are going to do about your problem here."

Doug Milch, DPM, Asheville, NC, ldmilch@charter.net

PRACTICE FOR SALE – FLORIDA

Miami-Dade and SW Ft. Lauderdale, well established surgical practice for sale. This one has everything. Surgery, Orthopedics, Pediatrics, Trauma, ER, General Podiatry. Participates in all local and national managed care plans. $850,000 but will discount depending on amount up front. Mature, serious inquires with business experience preferred. email response to podfootdocs@aol.com

HOUSE CALL PRACTICE OPPORTUNITY- CHICAGO / NORTHWEST INDIANA

Chicago-Home Physicians specializes in house calls to the elderly homebound. Full and part-time positions available in Chicago/Northwest IN. Competitive Compensation, including malpractice. Contact Scott Schneider. Phone-773-292-4800. Fax-773-486-3548. E-mail sschneider@homephysicians.com www.homephysicians.com

WELL ESTABLISHED PODIATRY PRACTICE IN MT. AIRY, NC

Dr. John H. Hodges had a well established podiatry practice in Mt. Airy, North Carolina that is either for sale or in need of an associate/partner to come on board to take over patient care. Dr. Hodges unexpectedly passed away in January 2006, leaving approximately 3,500 patients without a podiatrist to care for them. This is a unique opportunity to be able to begin work in an extremely busy podiatric practice. If interested, contact Carolyn McMackin at (336)577-2886 or cmcmackin@triad.rr.com

ASSOCIATE POSITION - NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

ASSOCIATE POSITION - BRONX, NY

Podiatrist wanted two days a week(with full-time growth potential). One day working in a busy Bronx office, one day making house calls. Base salary + incentives. Golden opportunity for a podiatrist to join up with a very ethical, hard-working and successful DPM. Please email CV to: Scottdeis@aol.com

ASSOCIATE POSITION – ARIZONA

Excellent opportunity for an experienced looking for a change or young podiatrist looking to jump start their practice. Podiatry practice is well established over 25 years, successful and a large volume in the Phoenix metro area. A current AZ License preferred as the position is available immediately. The right person will join as a salary associate leading to partial ownership in the group practice. Position available immediately. Email CV and inquiries to:scfcs@cox.net

PODIATRY POSITION IN ALABAMA

Excellent opportunity for immediate opening with AL licensee. Practice is very busy, 2 locations in West AL. Opportunity of six figures first year with contract for stock ownership. Great place to practice and raise a family. Get started with no hassles of a start-up practice. Very modern offices with ongoing management. Fax resume to (205) 330-9920 and visit our website at www.myfeethurt.com

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