The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

October 27, 2010 #3,994 Publisher-Barry Block, DPM, JD

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Plantar Fasciitis Often Mimicks Other Foot Conditions: MD Podiatrist

As if the first steps out of bed in the morning aren't torturous enough already, many people suffer stabbing pains in their feet as they limp their way to the bathroom. That morning symptom is a hallmark of plantar fasciitis, a common source of heel pain, but it could be other things: It could be a stress fracture, a broken bone, a tumor, compression of a nerve or tarsal tunnel syndrome," said Neil Scheffler, president of the Baltimore Podiatry Group. If it is plantar fasciitis, treatment options range from stretching to surgery.

Dr. Neil Scheffler

Scheffler said he advises his patients not to go barefoot at all, and to put running shoes on even to walk to the bathroom in the morning. If that doesn't help, patients might wear a night splint to gently stretch their calf and Achilles tendon while they sleep, or custom orthotics to correct any biomechanical problems. Physical therapy also helps to get more blood to the tissue to promote healing.

Source: Alexia Elejalde-Ruiz, Tribune Newspapers [10/22/10]

TUSPM Professor Recommends RIICE for Winter Ankle Sprains & Fractures

Serious wintertime injuries are not problems solely for athletes. “Ankle sprains and ankle fractures are much more prevalent this time of year for everyone. Ice and snow create the impetus for injury by allowing the foot to twist on the leg in such a way that ligaments and bone are damaged,” said Howard Palamarchuk, assistant professor of podiatric surgery.

Dr. Howard Palamarchuk

According to Palamarchuk, initial treatment for these injuries should include rest, ice, immobilization, compressive wraps, and elevation (commonly known as RIICE). He advises that any ankle or foot injury with pain and swelling beyond 48 hours be checked out by a podiatric physician.

CPMA Well-Represented in the First Modern House Call for Women

From October 22-October 24, 2010, podiatric medicine played an integral part in a ground-breaking event entitled 'Modern House Call for Women' in Long Beach, CA. The event, an innovative project of the first lady of California, Maria Shriver, was designed to provide medical, dental, podiatric medical, chiropractic, vision, financial and educational services to underserved women in the Southern California area. The Los Angeles (LACPMS) and Orange County (OCPMS) Podiatric Medical Societies, under the direction of Jan Winter, executive director for LACPMS, supplied podiatric physicians, residents and students to provide foot and ankle screenings, education about lower extremity health, including diabetic precautions, and when necessary, performed minor surgical procedures on the women.

(L-R) Dr. Ed Oghoorian, Natalie Nevins, DO, the Medical Director of the Modern House Call for Women, and Dr. Franklin Kase.

Dr. Franklin Kase, the podiatric medical director for the event and Chairman of the Health Policy Committee for the California Podiatric Medical Association, stated that "the goal of the project is to provide women with necessary medical and non-medical education so that they can have some of the tools needed to become active participants in their own health and well-being and improve their and their families' lives. This is an opportunity for podiatric medical physicians to give back to their community." 

Never Say "Try"

Never say “try” when you coach employees or issue instructions. That word gives them an excuse to fail to deliver. You will see better results if you simply express what you want. “Proofread every memo” is a stronger statement than “Please try to proofread every memo.”

Source:  Adapted from The Confidence Course, Walter Anderson, HarperCollins via Communication Briefings

Social Media Can Help a Podiatry Practice

Set up a practice Facebook and Twitter account. Ask your webmaster to link to your Facebook and Twitter pages directly from your practice website. Be sure to "tweet" each time you post a new blog. Also upload your web videos to your Facebook page.

Source: Adapted from "Social Media Can Help Your Medical Practice," (www) ezinearticles.com

Query: Getting Paid for L4360

Does anyone have a list of ICD-9 (diagnoses) that are covered when billing L4360 (pneumatic walking boot)? According to the NGS DMAC LCD, if I am reading it correctly, only ICD-9 718.47 (contracture of joint, ankle/foot) and ICD-9 728.71 (plantar fasciitis) are indicated for payment. We typically dispense them to patients who have broken their foot and/or ankle. That doesn't seem to be working anymore.

Michael Carroll, DPM, Greenwood, IN

Response: You are definitely misreading the policy. Night splints (L4396) have the requirements you listed.

For walking boots, either L4360 and L4386, there is no specific ICD-9 inclusion. There are orthopedic and neurological requirements with an exclusion for use of walking boots to off-load an ulcer. Under these latter circumstances, the walking boot should be billed as a non-covered service, A9270, with a "GY" modifier (non-covered service). No ABN is required.

For the L4360 and L4386, you must use both the "KX" modifier and then either the "RT" or "LT" modifier. Also be sure your name (in upper case) and NPI are in boxes 17 and 17B (or their electronic equivalent).

Paul Kesselman, DPM, Woodside, NY

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RE: WebMD Survey

I want to inform the readership that I just participated in an invited on-line market research survey from WebMD. Because I do a great deal of wound care, I was asked to comment in detail regarding particular wound care items and spent about 25 minutes doing so for a promised $45 honorarium.  At the final screen, I was informed that the survey was closed. Of course, they now have my entire survey completed for free.

This seems to be fraudulent and unethical.  I wouldn't recommend that anybody take WebMD surveys in the future if this is their typical behavior. Has anybody else had this happen to them?

Neil H Hecht, DPM, Sherman Oaks, CA. drhecht@sbcglobal.net

RE: The Future of Medicine
From: Bob Kornfeld, DPM

I am truly overwhelmed at how many of you wrote to me regarding my post about orthopedists opting out of Medicare. It is apparent to me that there is a lot of dissatisfaction in our profession. Quite a few of you told me that I have a unique situation and that you could never do what I did. Many of you wrote and said that you are at your breaking point and cannot stand the way you are being "forced" to practice but are afraid to drop your insurance contracts for fear of losing patients. And some of you just offered kudos for what I, and others, have done.

May I say that what I and many other doctors who have dropped out of insurance participation have done is not out of reach of any practitioner. The only thing keeping you stuck is...

Editor's note: Dr. Kornfeld's extended-length letter can be read here.

RE: FDA Laser Clearance For Treatment Of Onychomycosis (H. David Gottlieb, DPM)
From: Paul Kesselman, DPM

I had a meeting over 2.5 years ago with the manufacturer of the nail laser promising big profits and a zone monopoly. This was the first part of the sales pitch to me at a large national conference attended by podiatrists from across the country. My first question was to ask for...

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

RE: Ridiculous Shoes - Part 2

These shoes give new meaning to "walking the dogs."

Source: Submitted by Dr. David Secord

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Immediate opening for the right candidate. Join a well-established podiatric group in Southwest Florida. We are a multi-office practice with EMR, Digital x-ray, and more. Seeking full-time associate that is PSR-36 trained, personable, and highly motivated individual. Must be BC/BS in rearfoot and ankle. Please respond to JLH459@aol.com

ASSOCIATE POSITION – NORTH, CENTRAL & SOUTHERN ILLINOIS

Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings are available. If interested, fax curriculum vitae to 847-674-2113 or e-mail to feetwork@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

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

ASSOCIATE POSITION - PHILADELPHIA, SOUTHERN NEW JERSEY

Seeking motivated, independent foot & ankle surgeon to join large practice. Our multi-office practice covers all aspects of foot and ankle pathology, including heavy hospital volume. Offering competitive salary and benefit package. Send CV and two references to bleich5252@yahoo.com

ASSOCIATE POSITION - NASSAU COUNTY, NY

Experienced board certified podiatrist wanted for busy diversified practice located in Nassau County, New York. Energetic DPM, please send CV to JELLA810@GMAIL.COM

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

ASSOCIATE POSITION - CALIFORNIA

Busy, surgically-oriented practice in Bakersfield, CA seeks ABPS qualified/certified surgeon to join our existing two surgeons. Must be hard-working and honest. Strong reconstructive surgical practice with trauma privileges and wound care center/diabetic limb salvage center. Starting in December or January. E-mail CV to aghams2@aol.com

ASSOCIATE POSITION - BROOKLYN, NY

Podiatrist needed Part-time: Established practice in Bay Ridge, Brooklyn. Practice encompasses all aspects of podiatry. Please send resume to: hfasdpm@gmail.com

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 - 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

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

EQUIPMENT FOR SALE -  WHIRLPOOL AND WHIRLPOOL CHAIR

Professional, Whitehall brand 15 gallon Podiatry Whirlpool and Whirlpool Chair. In excellent condition. $2000.00. Please contact fergusondpm@aol.com

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

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

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

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.

PRACTICE FOR SALE - WEST VIRGINIA

Immediate opportunity for podiatrist to have your own practice without a loan. I have an 8 y.o. primary care practice with two offices that avg. between 110-135 pts/week. CPED on staff, established diabetic shoe business as well as braces, orthotics, etc. We do CDFE, PADNET(ABI with PVR) exams, and have Traknet DPM EMR system. Both offices are nicely equipped. Ample space for surgery suite, physical therapy, etc. You are set up and ready to go with a full patient load. You can pay me 7% of your gross for 10 years and its all yours. (304)523-3338, (304)453-5458, (304)617-7665, jmfeltner@yahoo.com

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