The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

October 26, 2011 #4,289 Publisher-Barry Block, DPM, JD

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NJ Podiatrist Offers Foot Safety Tip for Gym Workouts

Now that the weather is getting colder, many people will be spending more time at the gym, keeping their bodies in shape. Dr. Gerald Mauriello, Jr., a podiatric surgeon at AOSMI (Advanced Orthopedics and Sports Medicine Institute), Freehold, says sweaty shoes, public showers, exercise equipment and the pool deck at the gym are breeding grounds for fungus, viruses and bacteria, including drug-resistant strains like MRSA (methicillin-resistant Staphylococcus aureus), which has become increasingly more common. Dr. Mauriello advises to never go barefoot in public areas; water shoes can provide a great barrier between your feet and the wet surfaces. 

Dr. Gerald Mauriello, Jr

“It’s also best to cover cuts and cracks in the skin or ingrown toenails since these minor tears in the skin’s surface can act as entry points for bacteria,” says Dr. Mauriello. “If you have a cut or scrape that becomes red or swollen and is not healing in a timely manner, don’t hesitate to see a foot and ankle surgeon.” Dr. Mauriello cautions, “Above all, never ignore any pain or injury. Listen to your body!”

Source: NJTODAY.net [10/22/11]

Prompt Attention to Diabetic Foot Problems Reduces Costs: Aussie Podiatrist 

The Australasian Podiatry Council has dubbed October Foot Health Month to reiterate the importance of taking care of your feet. Gladstone Podiatry & Footwear podiatrist Peter Charles said the month was aimed at educating people about the problems associated with diabetes with this year's theme for the month: Diabetes: Counting the Costs. 

Peter Charles

"Many foot and lower limb problems can progress to become chronic problems that can be quite debilitating and costly to try and treat," Charles said. He said that any pains or discomfort with your lower limbs is a warning sign that something is wrong, and they should not be ignored. "Treating signs of problems early always results in better recovery and with less effort and cost for the patient," he said.

Source: The Observer [10/24/11]

NJ Podiatrist Buys Back Candy for Needy Children

Peter Wishnie, DPM, a podiatrist in Hillsborough and Piscataway, NJ, is helping to put smiles on the faces of children in need this Halloween season by buying candy from local Trick or Treaters. A friend and patient of Dr. Wishnies personally designs and sews clothes for children in need, and to sweeten the deal, she adds a piece of candy to each article of clothing.

Dr. Peter Wishnie

"We developed the Candy-Buy Back Program to help children in need, and The Candy-Buy-Back program is rewarding for everyone involved," says Dr. Wishnie. Trick or Treaters save their teeth and make cash for their candy while those enduring tough economical times get new clothes and some sweets too. Last year alone, Family Foot & Ankle Specialists  collected over 50 pounds of candy.

Source: mycentraljersey.com [10/24/11]

Editor's Note: PM News is proud to present excerpts from Meet the Masters

Bret Ribotsky: How can new or experienced DPMs increase the number of wound care patients they see?

Dr. Robert Snyder

Robert Snyder: I suggest they consider making rounds at the hospital at different times on different days. For example, Monday at 6 AM, Tuesday at noon, and Wednesday at 6 PM. Talk to all the doctors you see and tell them what you do.

Drs. Warren Joseph and Susan Saxe

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's guests are infectious disease specialists Warren Joseph, DPM and Susan Saxe, MD. You can register for future events by clicking here

Medical School Applications Hit New Record

U.S. medical schools officials saw a record number of applicants in 2011, with applicant ranks increasing by 1,178, or 2.8%, according to the Association of American Medical Colleges.

The Washington-based AAMC on Monday released its annual report on medical school applications and enrollment. A total of 43,919 individuals applied to U.S. medical schools in 2011, including 32,654 first-time applicants, according to the AAMC. First-year enrollment grew by 3% to 19,230, up from 18,665 in 2010

Source: Ashok Selvam, Modern Healthcare [10/24/11]

Query: Office Phone Systems

I am moving to a new office in a few months and am looking for a dependable office phone system. I would prefer to go VOIP, if that is practical, or a reasonably-priced digital phone system. Does anyone have any experience with the VOIP system offered through COSTCO?

David Kahan, DPM, Sacramento CA

Query: Discounting Orthotics

Does anyone discount the charge regarding orthotics for 'self pay' patients, or for patients who have insurance which does not cover orthotic devices?  Is it legal (and/or advisable) to discount the charges?

Lani Smith, Office of Kash Siepert, DPM, Roseburg, OR

Response: If you advertise discounts on orthotics, then you could very well be in violation of your insurance contracts.

As for "special" circumstances, on an occasional as-needed basis, you could lower the price. Only you can decide on how much of a discount you feel is warranted for a "special" case. No one here is going to suggest a dollar amount, as that could be construed as price fixing.

Robert Steinberg, DPM, Schaumburg, IL

Codingline subscription information can be found here
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RE: Vital Signs
From: A.L. Green, DPM

We have been taking vitals in our office for many years. I vividly remember one case in point: A patient had a systolic reading of over 200. Our office immediately called her internist, who saw her on the same day. The patient called the next day to thank me for "saving her life."  Vitals provide important information and should be a part of every podiatric office visit. Do it!

A.L. Green, DPM, Jacksonville FL, dgreen1433@aol.com

RE: SuperGroup Formation In Maryland (M. W. Aiken, DPM)
From: Hal Ornstein, DPM

I proudly serve as founder and co-chair of the New Jersey Podiatric and Physicians and Surgeons Group, LLC, and have assisted in forming SuperGroups with a similar model in Texas, Michigan, Ohio, and North Carolina. I will be directing the Maryland meeting mentioned in the post on Wednesday evening to help get their group started. The primary features of a Group Practice Without Walls (SuperGroup) are as follows: centralized management/administration; centralized billing under a single billing number (NPI/EIN); centralized payer/vendor contracting; and centralized employee benefits.

That being said, individual physicians and/or offices may retain autonomy over: treatment, billing, collections, staffing, and equipment. So while each practice/office will be run as a separate cost-center under the umbrella of the overall group, that autonomy will be counter-balanced by the legal requirement that each SuperGroup itself be both financially and clinically “integrated.” 

The numbers mentioned in the post (7–7.5% administrative fee and 20–25% increase in fees from private payors) are simply relative numbers extrapolated from the SuperGroup that has very successfully operated in the Chicago area, led by Neal Frankel, DPM. He has also worked with me in forming subsequent groups. None of the five groups have yet gone live with insurers, so I cannot give an answer as far as increased reimbursement, but much research across all medical disciplines shows increased payments for SuperGroups based on better outcomes and quality delivered to their insureds. All these groups are being led by a passionate and dedicated group of podiatrists in each state, receiving no financial benefit. Our mantra is “For podiatrists, by podiatrists.” 

Hal Ornstein, DPM, Howell NJ, Toetoe@optonline.net

RE: Stay Away from Trimming Toenails (Peter Vannucchi, DPM)
From: Paul Busman DPM, RN

A most elegant and touching testimony to the value of the humble act of toenail cutting is found in the short story "Toenails" by Dr. Richard Selzer in his collection "Letters To A Young Doctor." He's an M.D. but he gets it. I heartily recommend any and all of his books.

Paul Busman DPM, RN, Clifton Park, NY, paul@busmanwhistles.com

RE: Alleged Unnecessary Surgery (New Jersey)
From: Pete Harvey, DPM
 
ALL podiatric defense experts should receive the podiatric equivalent of The Medal of Honor. They save millions of dollars in legal costs and verdicts, force plaintiff attorneys to think twice before going to war, and preserve the honor of the entire profession of podiatry. The exact opposite is true of their counterparts.
 
Pete Harvey, DPM, Wichita Falls, TX, pmh@wffeet.com

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