The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

November 06, 2010 #4,003 Publisher-Barry Block, DPM, JD

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NY Podiatrist Uses HemiCap Implants to Resurface Cartilage

Dr. Ernest Isaacson is using a new, minimally invasive technology, the HemiCAP toe resurfacing system to treat pain and lack of motion caused by damage to the articular cartilage - the smooth, shiny membrane that covers the bones of a joint and lets them slide smoothly against each other. The HemiCAP implant is a cobalt chrome implant that restores the articular surface, allowing the bones to slide freely against each other once again.

Dr. Ernest Isaacson

Localized damage to the cartilage in an otherwise intact joint is a common problem for many patients of all ages and activity levels, explains Dr. Isaacson, a Manhattan podiatrist and Board certified podiatric surgeon. "Repeated impact from decades of playing sports, normal daily activity, or even hereditary factors can weaken or damage the articular cartilage," he says. "When this happens, the bones grate against each other during movement, causing pain, swelling and limiting the range of motion. People with articular cartilage damage may eventually require fusion or rigid fixation of the bones, but resurfacing the joint with the HemiCAP implant is a viable option for active patients."

Eastern Academy of OPMA Elects Officers

The Eastern Academy of the Ohio Podiatric Medical Association has elected Dr. Mitchell Dalvin president. Dr. Dalvin, who is certified in foot and ankle surgery, serves as chief of the podiatry department at Northside Hospital. He teaches surgery to podiatry residents and is on the staff at Northside Medical Center, St. Elizabeth Health Center in Youngstown and St. Elizabeth Boardman Health Center. He is a member and past president of Austintown Rotary Club and is in private practice in Austintown.

Dr. Mitchell Dalvin

Chosen as associate officers were Dr. Edward Constantino, vice president; Dr. James Tavolario, treasurer; Dr. Thomas Groner, secretary; and Dr. Derrick Jackson, trustee.

Source: Vindy.com [11/4/10]

PPMA Presents Awards at HOD

During the Pennsylvania Podiatric Medical Association House of Delegates Awards Banquet on Saturday, October 30, the following received awards:

Dr. John Fawcett

Podiatrist of the Year went to John Fawcett, DPM, Past President, 2007-2008.

Karen Campbell, DPM, Judy DeRose, DPM (Past President 1989-1990), and Bruce Ganey, DPM, received Special Recognition awards for a Podiatrist(s); Stevan Anselmi, DPM, received the Award of Excellence.
The Rising Star Award (now in its third year) went to L. Jolene Moyer, DPM.
For the first time, Dawn Stein, DPM, received the Goldfarb Foundation’s newest award, the Annual Residency Program Recognition Award.
The Edward L. McQuaid Award went to Harry Burke, DPM.
Special Recognition for a Health Practitioner went to Bridget Scott, PMAC, posthumously.
Special Recognition for a Layperson went to Carolyn Miller, PPMA’s former Membership Director, who retired at the end of last year.
Edward Rosboschil, DPM, received the Pioneer of Podiatry award, posthumously.

Surgeons from Afghanistan, Pakistan, and India Simultaneously Spice SALSA

The Southern Arizona Limb Salvage Alliance (SALSA), as part of its mission to educate clinicians, worldwide, regularly hosts visiting scholars from around the world. This week, however, signaled something unique. The core service, which consists of University of Arizona vascular and podiatric surgeons, was joined by three different surgeons hailing from three South Asian nations: Afghanistan, Pakistan and India. 

(L-R) Vascular surgeon Iram Naz (Pakistan), podiatric resident Lida Farouqi (Afghanistan), Prof. David G. Armstrong, and orthopaedic surgeon Amit Burande (India)

David G. Armstrong, Professor of Surgery and SALSA's Director noted, "We can't recall having an entire region so well represented at one time. I think it signals the interdisciplinary and multinational nature of what we do. This problem transcends borders and disciplines. This type of sharing invariably reaps benefits not just for us practitioners, but for the patients we serve. It is just a wonderful time to be working in this field."

FL Podiatrist Broadcasts From Thailand

Podiatric Success’ Meet the Masters hosted its first show from out of the country. Dr. Harold Vogler was the guest from his home in  Sarasota, Florida at 9 pm while Dr. Bret Ribotsky was hosting the show from South East Asia at 8 am the next day. Dr. Ribotsky said, “Technology has allowed listeners throughout the world to join Meet the Masters for free via Skype, and today, I used the technology to host the show live from Bangkok.”

Dr. Bret Ribotsky at Floating Market Bangkok

Listeners from throughout the USA, Asia and Australia often listen in live, and Europe tends to download the interview the next day (due to time differences) “The world is much smaller today as podiatric leaders are no longer confined anywhere in the world” says Ribotsky.

Senate Minority Leader Takes Aim at Healthcare Reform

Senate Minority Leader Mitch McConnell (R-KY) sent a clear message Thursday when he said Republicans “can and should propose and vote on straight repeal, repeatedly” on this year's healthcare reform bill.  “But we can't expect the president to sign it,” McConnell said in prepared remarks for a speech he gave at the Heritage Foundation, a conservative think tank on Capitol Hill. “So we'll also have to work, in the House, on denying funds for implementation, and, in the Senate, on votes against its most egregious provisions. At the same time, we'll need to continue educating the public about the ill-effects of this bill on individuals young and old, families, and small businesses.”

McConnell also pledged what he called “smart, aggressive oversight” of the administration and its agencies, which includes HHS. “Through oversight, we'll also keep a spotlight on the various agencies the administration will now use to advance through regulation what it can't through legislation,” McConnell said.

Source: Jessica Zigmond, Modern Healthcare [11/4/10]

TX Podiatrist Accused of Tax Evasion Tries to Cancel His Own Hearing

A federal judge has issued an arrest warrant for an area podiatrist after he failed to show up for a hearing Thursday on charges of cheating on his taxes. Donald E. Robinson, 66, faxed papers to the federal courthouse in San Antonio stating that his hearing had been “canceled,” and that he had issued a $300 million warrant naming himself as the surety, though he has no authority, Chief U.S. District Judge Fred Biery said at the hearing.

A federal grand jury indicted Robinson in August on four counts of subscribing to a false income tax return or statement. The indictment said he signed off on tax returns that significantly underreported his income for 2003, 2004, 2005 and 2006. It also alleges he denied having any interest in or signatory authority over financial accounts in foreign countries when he actually did.

Source: Guillermo Contreras, Express-News [11/4/10]

Query: Prolotherapy for Achilles Paratendosis

I am interested in utilizing prolotherapy for Achilles paratendosis. I wonder how often to inject the area, how much solution to use, what type of solution works the best, and where to purchase it. 

Brent Rubin, DPM Bradenton, FL

Query: Reporting PQRI

Can we bill an E/M code (e.g., CPT 99213) each time we report the PQRI codes? Can we follow the Risk Classification Guidelines listed in Diabetes Care, Volume 31, number 8, August 2008? Essentially, a diabetic with history of foot ulcers is Risk Category 3, and it is recommended that they are evaluated every 1-2 months. Does this mean we can evaluate them every one to two months, and bill an E/M code with the PQRI codes?

If the above is correct, can we bill for routine foot care on qualifying patients as long as it has been at least 62 days between visits, along with the CPT 99213 code, a "-25" modifier, and doctor's last visit?

Melissa Hill, DPM, Concord, NC 

Response: Reporting PQRI codes is not justification for an E/M service. In other words, a patient can't come to the office specifically to have a PQRI measure checked off. You can report PQRI measures while the patient is being seen for a variety of medically necessary conditions for services including E/M and others. For the comprehensive diabetic foot examination, in addition to, say the E/M service the patient came in for, you could be doing all of the items in measures 126, 127 and 163, so that is a good time to report for PQRI.

Michael Brody, DPM, Commack, NY

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RE: Three Strikes and You're Out? (Arden Smith, DPM)
From: Multiple Respondents

There is no bible, just some common sense here. If you've given three steroid injections and you find yourself needing a fourth, rethink your diagnosis, your technique, and possibly the choice of steroid. Are you using soluble (Dex), insoluble (Depo), or something in-between (Celestone).

Also, what else are you doing? PT, orthotics, night splint, NSAIDs, and orthotripsy? What's the contributing medical history? Are they on oral steroids or other immunosuppressive meds? Obesity? Cavus foot type, etc.? The bottom line is don't rely on a bible, rely on good solid podiatric medicine.

Frank Lattarulo, DPM, NY, NY, DOCLATT@aol.com

With regard to the often quoted number of three steroid injections - I do not believe it is written anywhere. Having said that, it is prudent to be aware of potential problems with skin atrophy, possible weakening of soft tissue structures, etc.
 
Jeffrey Kass, DPM, Forest Hills, NY jeffckass@aol.com

In response to Dr. Smith's tongue and cheek biblical steroid reference, the answer is it doesn't; however, then the question begs, why didn't the patient respond to the prior two injections?! When something doesn't work, aren't clinicians obligated to ascertain why? So, could there be an issue with...

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

RE: Web-Based EMR Systems (Michael Tran, DPM)
From: Alan L. Bass, DPM, Marc Katz, DPM

TRAKnet DPM is, in fact, certified by CCHIT. If you go to cchit.org/products/onc-atcb, you will   see that listed under the certified EHR technology, TRAKnet DPM is listed there. I understand the confusion. There is a delay between the postings of the certifying bodies and ONC. Therefore ONC’s information is somewhat delayed. The listing on the ONC website referenced by Dr. Tran in the PM-News posting of November 5, 2010 is dated. As stated above, TRAKnet DPM is certified as a COMPLETE EHR system and not MODULAR. TRAKnet DPM was certified as a complete EHR system on October 29, 2010. Please click on the link above to confirm. I would be happy to discuss this with any of my colleagues who wish to contact me. And yes, the purchase of TRAKnet DPM would allow you to qualify for meaningful use and the incentive money offered by the government.

Disclaimer: Dr. Bass is a consultant for Biomedix.

Alan L. Bass, DPM, Manalapan, NJ, abassdpm@optonline.net

I have looked at and done demo sessions on many EHR/PM products. I would not take anybody's word that they will become certified. Some of these companies are going to have significant financial problems trying to meet the criteria, if not now, then in other phases.
What I recommend is to watch your favorites and wait until they actually have full certification. Many companies are saying they are certified and if you look at their current status, they have only fulfilled several items. Look out for yourself.

Many docs are running scared due to pressure from companies and their 44K has already been spent and then some. Sit back, relax, and see how it all plays out. Also, take pity on your friends who have already spent their 44K and are now paying monthly fees! Their practice revenues are going to go down just because of their EMR.  Forget the promises that you will finish your note after each patient, make more money, etc. And the real kicker is that some offices are less efficient and need extra staff to help the through hundreds of clicks.

Marc Katz, DPM, Tampa, FL,dr_mkatz@yahoo.com

RE: Setting the Goldfarb "Record" Straight
From: Lara Beer-Caulfield

Mathematicians, we are not! The Goldfarb Foundation incorrectly reported the number of attendees at our 38th Annual Clinical Conference in yesterday's PM News. We had a record breaking 372 DPMs which included 29 faculty who were joined by more than 50 podiatric assistants. With the record-breaking number of attendees and an exhibit hall housing 71 booths, this  was the best attended Clinical Conference in more than 12 years!
 
Lara Beer-Caulfield, Director of Education & Meeting Planning,
Goldfarb Foundation/PPMA

RE: OH Podiatrist Appointed as President and CEO of Hospital
From: Frank Lattarulo, DPM, Ivar E. Roth DPM, MPH

Congratulations to Dr. Suppan. Her credentials are quite impressive. I must say, as a practicing podiatrist in New York since 1983, I can't imagine a podiatrist, (and we have so many qualified podiatrists out there), being named president and CEO of a hospital. While I enjoy virtually all privileges that I apply for involving the foot and ankle, I could never see a podiatrist as president and CEO of my hospital nor at any hospital in the New York City/Westchester County area. I had to read the posting twice. What an honor!

I wish Dr. Suppan great luck in her new positions. This is a feel good story right here for all podiatrists.

Frank Lattarulo, DPM, NY, NY, DOCLATT@aol.com

Congratulations to Dr. Suppan.  What a great accomplishment and another move forward for our great profession of podiatry. Surely, one by one, this upward advancement of our profession helps us in the long run. Who would have thought this was possible?

Ivar E. Roth DPM, MPH, Newport Beach, CA, ifabs@earthlink.net

RE: Wrong-Patient, Wrong-Site Procedures Persist Despite Safety Protocol (Henry Slomowitz, DPM)
From: Samantha Bark, DPM

Many people have thought to write "NO" on the non-operative extremity. The issue with this is that when the "NO" is seen from upside down, it appears to say "ON." This can get confusing and so writing "NO" on the non-operative extremity has not caught on. An interesting study would be to check how many of the wrong site surgeries happen on prone patients. We typically sign the anterior aspect of the foot or leg, then the patient is flipped. I've seen some surgeons sign both anterior and posterior to prevent this error.

Samantha Bark, DPM, Mountain View, CA, krabmas@yahoo.com

RE: NY Podiatrist Evaluates "Revolutionary" Golf Shoe
From: Joseph Menn, DPM

I admit that I haven't yet tried the new Ecco golf shoe, but based on their other footwear, I'm sure it is a good product. I'm not too sure if the biomechanics of gait and stance and their interaction with the shoe has a lot to do with the game of golf. One fine Myrtle Beach afternoon, I met a friend and SC colleague for a round of golf at one of our tougher courses. We both strapped into our Foot-Joys, complete with the requisite...

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

RE: PM News Publishes 4,000th Issue
From: Art Gudeon, DPM, Richard H. Mann, DPM

From all of us who rarely submit, but so enjoy having something great to read daily, congratulations on # 4000!

Art Gudeon,  DPM, Rego Park, NY

I would like to add my name to the chorus of congratulatory wishes to Barry Block and the staff at PM News for their impressive achievement.  PM News has reshaped the way we communicate as a profession. Thank you, Barry, for 4,000 interesting issues. Keep up the good work.

Richard H. Mann, DPM, Founder and CEO, Realm Labs, LLC

SEEKING EMPLOYMENT OPPORTUNITY - NORTHERN, NJ

Looking to relocate my current position closer to home. I am honest, ethical, punctual and hard-working. PM and S-36 trained with over four years of work experience. Seeking a full-time employment opportunity starting as an associate with the potential for partnership in the future. If interested, please contact  footdoctor36@gmail.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 - 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.

ASSOCIATE POSITION - MARYLAND AND DC

Immediate opportunity to join our group in Maryland and DC. Will consider full or part-time. Our practice is general podiatric care with a heavy slant on sports medicine/orthotics. In-office ASC. Must be PSR 24-36. Send cover letter and CV to hgodpm@verizon.net

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 - MICHIGAN - (OAKLAND COUNTY)

Outstanding opportunity for associate in well established practice, general & surgical podiatry forefoot, rearfoot & ankle (full or part-time). Well-trained, responsible, motivated with good communication skills, ABPS qualified or better. Send CV & letter of interest to: PodiatristWanted@AOL.com. All replies kept strictly confidential

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.

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 - 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

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 PM and S-36 trained, personable, independent and highly motivated individual. Must be BC/BS in rearfoot and ankle with confidence in complex reconstructive cases. Full benefits package, competitive salary, excellent lifestyle. Please respond to JLH459@aol.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 - 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 Ohiodoctors@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

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

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

PRACTICE FOR SALE - CONNECTICUT

Outstanding solo practice for sale in northern Fairfield county, CT. Shared space with other medical professionals. Very low overhead. Grossing almost $300K on 30 hours per week. Referrals from three different primary care physician offices. If interested e-mail CTPodiatry@gmail.com

PRACTICE FOR SALE - MARYLAND, DC SUBURB

Own your own practice and be your own boss.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.  Owner will stay on as needed for easy transition. dpmpracticeforsale@yahoo.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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