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PMNews
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| PM News | |
The Voice of Podiatrists
Serving Over 17,260 Subscribers Daily
October 31, 2015 #5,512  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2015- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL | |
FINAL DAY TO VOTE
Quick Poll
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Are you in favor of mandatory flu shots for medical personnel? |
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| EDITOR'S NOTE | |
Call for Nominations - Podiatry Management's 2016 VIP List
Every five years, Podiatry Management Magazine publishes its "Most Influential Podiatrists" list. This list is compiled by the editorial board of PM. We invite nominations of individuals for this prestigious honor. Please send nominations along with a brief statement of why this podiatrist belongs on the VIP list to bblock@podiatrym.com. Self-nominations will be accepted. The deadline for nominations is December 1, 2015.
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| PODIATRISTS IN THE COMMUNITY | |
DC Podiatrists Volunteer at Homeless Project
Dr. Howard Osterman of Foot and Ankle Specialists of the Mid-Atlantic participated in Project Homeless Connect. The event served as a one-day resource fair for participants to access legal services, employment services, podiatry, medical and dental checkups, housing services and more - services that might normally take weeks or months to obtain. This was the first Project Homeless Connect event in the District of Columbia, organized by United Way NCA and held at Central Union Mission in Washington, DC.
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Dr. Howard Osterman (far right) and his staff |
The doctors (Howard Osterman, DPM, Saylee Tulpule, DPM, Jennifer Gerres, DPM, and Vinay Matai, DPM) and staff had a wonderful day giving back to the community. Sheila Somashekhar, the event coordinator, gave a special thank you to the FASMA team for their professionalism and quality of service. She said, “In speaking with participants and reviewing the participant evaluation forms, podiatry was among the most popular and well-received services, and I believe your services and medical expertise may have saved some lives."
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| QUERIES (CLINICAL) | |
Query: Becker's Nevus
This 12 year old African American female presented to my office with pigmented streaks on three of her toe nails. Her younger brother presented the same day with the same condition. The 12 year old has a large pigmented lesion on the right upper back and shoulder. It was biopsied and the diagnosis was Becker's nevus.
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Becker's nevus on shoulder, pigmented streaks on toenails |
Is there any correlation between Becker's nevus and pigmented streaks on the toenails? Above are photos of the affected foot as well as her shoulder. Because she has this on multiple toes as well as a familial history of this, I opted not to do a biopsy on the toes.
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| QUERIES (MEDICAL-LEGAL) | |
Query: New Requirement for MRI Request?
Every day brings something new. Today, I was denied approval for an MRI of my patient because I was told I did not have an x-ray report from a board certified radiologist requesting further diagnostic studies. What kind of joke is that? I asked the reviewing doctor what difference it made whom it was from. He avoided answering me and told me my request was denied. Is that even legal?
Jeffrey Kass, DPM, Forest Hills, NY
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| CODINGLINE CORNER | |
Query: Bilateral L3000 & Unilateral Diagnosis Coding
With the new ICD-10, often the codes are now for one limb (as opposed to bilateral). We, however, prescribe orthotics bilaterally unless the patient has only one limb. Does anyone have a recommendation on what to do for the coding? For example, a patient has posterior tibial tendinitis, right; no symptoms on the left. How do you bill for orthotic(s) as a pair?
Cheryl Christensen, Everett, WA
Response: I would bill:
L3000-RT with pointers to: M76.821, Q66.51, M21.6x1
L3000-LT with pointers to: Q66.52, M21.6x2
Paul Kinberg, DPM, Dallas, TX
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| RESPONSES/COMMENTS (CLINICAL) - PART 1A | |
From: Jeff Kittay, DPM, Tip Sullivan, DPM, Jackson, MS
I see a poor cosmetic result and an awful looking x-ray of an osteotomy with screw fixation that was apparently over-aggressive, but what is the patient's complaint? It was stated that she is fairly active, but there was no mention of pain or inability to find proper shoes. Could she cope with the1st MPJ fusion. That seems the most likely resolution? How long ago was the original surgery, and what conservative treatments were exhausted?
Jeff Kittay, DPM, Boston, MA
Fuse it!! Also check the lateral collateral at the second MTPJ. You may need to offset the fusion slightly. Regarding opiate addiction — your patient is at high risk for relapse. Make sure you discuss this frankly with her and even request to speak to whomever is helping her with this problem (i.e. - N.A. sponsor). I have found opioids are really only needed for about 48-72 hours if the patient will be compliant.
Tip Sullivan, DPM, Jackson, MS
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| RESPONSES/COMMENTS (CLINICAL) - PART 1B | |
From: Peter Caldwell, DPM, David Weiss, DPM
I would address this by removing the hardware. Do a wedge osteotomy at the center of rotation of angulation (CORA) of the first metatarsal to re-align the capital fragment. Do a 1st MTP fusion, followed by a shortening second metatarsal osteotomy, if needed.
Peter Caldwell, DPM, Cedar Rapids, IA
I suggest an arthrodesis using autogenous bone graft (from the iliac crest or calcaneous) with locking plate. This is your best option for good LONG-TERM results. Make sure you check her Vit D level and 24-hour calcium.
Regarding the opiate dependency, try to get a pain management doc to help you, or try using non-opiates such as Lyrica (450-600mg QD) to help with the pain, and Celebrex (200-400mg QD). If you consider an opiate, it is always helpful to have a family member or close friend to “monitor” the narcotic to ensure it is not being overused.
David Weiss, DPM, Richmond, VA
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| RESPONSES/COMMENTS (PM ARTICLES) | |
From: Susan Bartos
I have done considerable research in 3-D printing as it relates to medical applications, and found Dr. Hochstein's article very concise and informative. Its application in custom orthotic fabricating will require the coordinating software to not just replicate the model, but to add the appropriate correction to the device to address the patent's deformity. Software developers will need to adapt their CAD-CAM software to conform to 3-D printers. The two most significant issues in adopting 3-D printing for orthotics in its present technological stage are 1.) having quality software available from established developers such as Sharp Shape, Oretek, and/or Delcam and 2.) reducing the manufacturing time, which is much longer than current machining methods.
Currently, the CAD-CAM software used by many orthotic labs functions by merging prescription information with the negative model to create an electronic, corrected positive model. It is very sophisticated software and requires exacting technical precision, just as the precision required to create a manually-corrected plaster positive. But its patient-specific capacity to balance gait and to integrate and apply patho-mechanical accommodations, goes beyond what can be done manually. Most DPMs who prescribe orthoses have become accustomed to dispensing this type of high-quality device over the last 20 years.
I think that there is little doubt that 3-D printing has enormous potential in fabrication of medical appliances in the very near future. It will give orthotic laboratories an additional process to offer their customers and give doctors more choices as to how they want their orthotics fabricated. Keep in mind that there is no one right way to make a prescription orthotic, just several alternative options in the processes used to create it. The art lies in the skills of the technician, rather than the process.
Susan Bartos, President, Earthwalk Orthotics, Inc.
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| RESPONSES/COMMENTS (OBITUARIES) - PART 1A | |
From: Joan E. Williams, DPM, JD
Dr. Gibley was the dean of Pennsylvania College of Podiatric Medicine (now Temple University) until 1984. Under his leadership, PCPM was the top podiatry College academically, and in residency placement. That year, he became Dean of the University of Health Sciences (USciences) in Philadelphia. About a month later, he slipped on an icy sidewalk while Christmas shopping, broke his neck, and was in a coma for months. After a long recovery, he continued as Dean of USciences until his retirement.
His love for podiatry and his commitment to academic excellence continued, and after his retirement from USciences, he remained Executive Director of the National Board of Podiatric Medical Examiners for several more years. Dr. Gibley, although not a podiatrist, was one of the great men who helped make podiatry what it is today. He was predeceased by his wife and college sweetheart, Jean. He has 4 adult children. It is my honor to call him my mentor and my friend.
Joan E. Williams, DPM, JD, Seattle, WA
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| RESPONSES/COMMENTS (OBITUARIES) - PART 1B | |
From: Les Jones, DPM
It was very sad to read about the passing of a great champion for the profession of podiatric medicine, Charles W. Gibley, PhD. I met Dr. Gibley in 1972, while he served in various capacities at PCPM, and as I was completing my second year as a student at the California College of Podiatric Medicine. His commitment to podiatric medical education covered nearly 50 years of dedicated service. We all realized his commitment by his unwavering service to the NBPME (currently the APMLE) as the Executive Director. He was one of the finest gentlemen that I had the pleasure to work with.
I had the pleasure to speak to Dr. Gibley in August. I'm so glad that I had an opportunity to speak with him for that brief moment. His voice was very weak, but as cheerful as ever, and the very pleasant gentleman I knew him to be at all times. Little did I know that would prove to be my final opportunity to speak with him. Dr. Gibley was among the few people who had a tremendous impact on my professional and personal life.
To the Family of Charles W. Gibley, PhD, my family and I send our deepest condolences. To my colleagues in this great profession, please don't hesitate to contact those who have touched your life in a special way; and let them know how you feel about them.
Les Jones, DPM, Pomona, CA
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WEBINARS
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoes of the Day
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Perfect for Halloween! |
Source: nichance
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MEETING NOTICES
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| CLASSIFIED ADS - PART 1 - ASSOCIATE POSITIONS AND FELLOWSHIPS |
PODIATRIST WANTED - NORTHERN NEW JERSEY
Looking for a podiatrist who is either in the process of or is Board certified by ABPS. Must participate with all Blue Cross Blue Shield plans including Horizon NJ health. Amerigroup, Americhoice, Wellcare and Republic a plus. Must be energetic and able to handle large volume. Spanish speaking a plus but not required. Excellent forefoot and rearfoot training. Salary negotiable. Retirement, health and malpractice. laoshih5@gmail.com
POSITIONS AVAILABLE - FULL TIME/ PART TIME IN MISSOURI AND OKLAHOMA
Opportunities are available to serve residents of long-term care facilities in central Missouri and in Oklahoma. High earning potential with competitive benefits as part of a 40 year old ethical company for the right candidates. Contact ckestner@preferredpodiatry for additional information
ASSOCIATE POSITION – NEW YORK CITY
Highly ethical and motivated practitioner sought. Experienced, assertive, podiatric surgeon wanted. All aspects of forefoot, rearfoot, and ankle surgery. Board qualified or certified.please send C.V. to bunioncenter135@yahoo.com
ASSOCIATE POSITION - WESTERN PHILADELPHIA SUBURBS
Wanted: One well-rounded, PMSR36 with RRA trained podiatrist to join “our family”. Your Benefit: A growing practice and exposure for treatment of ALL aspects of podiatry. Special Attraction: Our Associates actually become partners! You could be next! Please send an email with a cover letter and CV to: Teegee46@gmail.com
IMMEDIATE PART TIME ASSOCIATE OPPORTUNITY - CHICAGO
Multi-location group - Opening for ABFAS Board Certified associate for Chicago. Large surgical/ortho patient load. Must hit the door running! EMR, digital x-ray, laser, ultrasound, surgery center & amazing support staff. Benefits available, Full-time available for the right doc. Send CV to chicagopodwork@gmail.com
IMMEDIATE ASSOCIATE POSITION - INDIANAPOLIS, INDIANA
Available in busy three office practice Leading to Partnership. Position available for graduate in 2016. Two locations in Indianapolis and 1 location outside of Metro area Competitive salary and benefit package including 401, profit sharing, Health insurance. Surgery Center Ownership Available If interested forward letter and resume to Imalament1@comcast.net
ASSOCIATE POSITION - SOUTHERN MICHIGAN
Associate wanted for rapidly growing 5 physician practice. Salary plus incentive. Great opportunity and partnership potential for right person. Have an opportunity in controlling your own destiny….which you will not have working for a hospital or multi-specialty group. Send CV and contact information to: PaulaPMAC@me.com
ASSOCIATE POSITION – LONG ISLAND, NY
Seeking Full Time Podiatrist for two upscale practices located at the Americana Manhasset and Huntington. Excellent work environment with digital x-ray, laser, EHR, Ultrasound, the latest apple software and iPads. Must be surgically trained, motivated, with a great work ethic. Very competitive salary with significant upside. Email phendizadeh@gmail.com.
ASSOCIATE POSITION - CHICAGO AND SUBURBS - HOUSECALLS 3 DAYS A WEEK
We provide logistical support, malpractice, and mileage allowance; another half day at the office is possible if interested; physician will make $140-150k; salary plus bonus structure ; benefits are available. Schedule can be tailored to your need. If you are interested to fill out your schedule, contact chipod12@yahoo.com
ASSOCIATE POSITION - LOUISVILLE, KENTUCKY
Available immediately in a busy high visibility office with digital x-ray, diabetic shoe store, and 5 years experience in EMR. Good patient volume and potential for partnership or purchase. Contact samuel10530@yahoo.com.
ASSOCIATE POSITION - CENTRAL FLORIDA
Associate wanted for well-established practice in central Florida. Experienced support staff, great benefits including malpractice coverage . Excellent opportunity for a promising future. To apply, go to www.yourcareerinpodiatry.com
PM NEWS CLASSIFIED ADS REACH OVER 16,500 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 16,500 subscribers. For details,click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at (800) 284-5451.
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| CLASSIFIED ADS PART 2- PRACTICE FOR SALE OR WANTED, EQUIPMENT FOR SALE |
DESIRABLE LOCATIONS TO SUBLET AND SHARE - NEW YORK / NEW JERSEY
Midtown, Gramercy, Financial District and Plainview (North shore of Long Island) turn-key. Extremity MRI, Extremity CT scanner, diagnostic ultrasound, digital xray in selected offices. Fair Lawn ASC,LLC a dedicated certified ambulatory surgical center for foot and ankle surgery accepting applications for staff privileges 516 476-1815 PODO2345@AOL.COM
PRACTICES WANTED - GEORGIA, TENNESSEE & OTHER SOUTHEASTERN STATES
If you are serious about selling or merging your practice into our model, the EHI Equity Based Supergroup Model, then we are interested in a conversation. We are looking mainly in Georgia and the Atlanta area but we will be ready for scaling in early 2016. Our practice top 3 criteria are; successful, must have a high volume of patients and Physicians who stay must be willing to utilize EHI's in-house ancillaries. If you meet these criteria, send us an e-mail to dhelfman@extremityhealthcare.com and tbrzezicki@extremityhealthcare.com.
PRACTICE FOR SALE - NEW JERSEY
Eestablished practice in Mercer County. Average volume 130 patients / week with room for growth. Annual gross revenue of practice approaches $500K. Well trained staff. Current doctor willing to stay to ensure smooth transition. footfixer17@gmail.com.
PRACTICE FOR SALE – BONITA SPRINGS, FLORIDA
15 year old well established satellite podiatry practice for sale immediately. Well-equipped treatment rooms, digital x-ray. Located in busy multispecialty medical building with very busy Urgent Care Clinic, Outpatient Surgical Center, pharmacy, CT and MRI imaging center. Email bonitaspringspodiatry4sale@gmail.com
PRACTICE FOR SALE - BRITISH COLUMBIA, CANADA
Have you ever dreamed of owning a practice where you can see 0-50 patients daily, average 100 new patients monthly, have zero accounts receivable, gross $440K per year, live in a beautiful community with skiing, hiking, fishing and boating on your doorstep? Contact pistone@telus.net or call 250-754-4192.
PRACTICE FOR SALE - KANSAS CITY METRO CITY
Well established, successful practice in prime Kansas community. Full array adult, pediatric services. RFC less than 10 percent. Strong commercial mix. High level of patient, physician referrals. TRAKNET EHR. Equipment purchased- no leasing. Owner would assist buyer in transition. Contact Mike Crosby @ MCrosby518@gmail.com
PRACTICE FOR SALE – CENTRAL NEW JERSEY
Perfect opportunity to purchase a practice in an ideal location. Office is located in a busy town center shopping and dining complex. Modern and fully equipped office in a building with other medical professionals. Easily accessible to major roadways and highways with visible signage at busy intersection. Excellent potential for increased revenue in a great town to own a practice. Owner financing may be available to qualified buyer. Serious inquiries only to healthnet708@gmail.com
PM NEWS CLASSIFIED ADS REACH OVER 16,500 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 16,500 subscribers. For details, click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at (800) 284-5451.
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| Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management® Magazine and Podiatry Management® Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.
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- Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.
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