The Voice of Podiatrists

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November 08, 2008 #3,395 Editor-Barry Block, DPM, JD

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We’ve just posted a November CME titled:

By Robert G. Smith, DPM, MSc, RPh

You can Earn 30 CPME-Approved CME Contact Hours Online

Foot Health Vital in Tough Economy: TN Podiatrist

With so much financial uncertainty in the air, businesses large and small need to take special care to avoid lost productivity, business interruptions, and employee absenteeism. These days profit margins run thin, and all businesses need their key people at work, productive and happy.

Dr. Christopher Segler

According to Dr. Christopher Segler, a member of the Chattanooga Chamber of Commerce, “it seems people are more likely than ever to come into my office to have their foot pain treated. When times get tough, it seems that people develop a sense of urgency to treat minor complaints such as heel pain, bunions, ingrown toenails, and ankle pain. Often patients will complain that they cannot "afford to miss work." With so much corporate downsizing, lay-offs, and business shut downs, people are nervous. Working folks seemed concerned that if they start to miss days of work, this might place their jobs in jeopardy.”

Source: mycontentbuilder.com [11/6/08]

The Orthotic Group Buys Langer

Langer, Inc. sold substantially all of the operating assets related to its Langer-branded custom orthotics and related products business to an affiliate of The Orthotic Group, a manufacturer of prescription custom foot orthotics, orthotic footwear and gait analysis equipment headquartered in Markham, Ontario.

The company's Deer Park, NY facility, as well as its sales office in Markham, Ontario are included in the transaction. The purchase price was approximately $4.7 million paid in cash at closing, including $475,000 to be placed in escrow to satisfy potential indemnification claims. The purchase price will be subject to a post-closing working capital adjustment within approximately 90 days

Source: SportsOneSource Media via The Pedorthic News

OIG Criticizes CMS for Limited Enforcement of HIPAA Security Rule

Before it began compliance reviews of covered entities in early 2008, CMS was taking only limited and insufficient action to ensure that CEs adequately implemented the HIPAA security rule and was not encouraging CEs to enforce it on their own, the HHS Office of Inspector General (OIG) said in an audit report released Oct. 30. CMS enforces the security rule (the HHS Office for Civil Rights handles the privacy rule) and is authorized to do compliance audits of CEs. But until recently, CMS has "relied on complaints to identify any non-compliant covered entities that it might investigate," the report says.

Although CMS has an effective process for resolving the complaints, OIG says there was no effective way to ensure that CEs were complying with the security rule or that patient information was being protected. OIG recommends that CMS establish policies and procedures for conducting the reviews. In comments included in the report, CMS said it disagreed with OIG's views on complaint-driven enforcement, saying it has "furthered the goal of voluntary compliance" that was set out in HIPAA. CMS agreed that reviews are a good enforcement tool and agreed with the suggestion that it establish policies and procedures for the audits.

Source: Report on Medicare Compliance [11/3/08]

Why We Don't Hear Others - Part 1

If you want to listen so you really hear what others say, make sure that you're not a:

• Mind reader. You'll hear little or nothing as you think "What is this person really thinking or feeling?
• Rehearser. Your mental tryouts for "Here's what I'll say next" tune out the speaker.
• Filterer. Some call this selective listening - hearing only what you want to hear.
• Dreamer. Drifting off during a face-to-face conversation can lead to an embarrassing "What did you say?" or "Could you repeat that?"

Source: The Writing Lab, Department of English, Purdue University Press

Query: Painful Callused Heels

A 50 year old African-American woman presented with severely painful callused heels (rim). She states that the callus builds up and feels like she is walking on a rock. She has used Kerol 40 and econazole (Rx’d by her dermatologist) without any help. She has had her calluses removed by pedicure which she states takes away the "rock" feeling, but the heels are still very sore after that. She must be careful how she positions her feet at night because if she touches them to something, she will awaken with severe pain. The morning is not bad, but as the day progresses the pain worsens. At the end of the day, she is walking on tip toes. She presents today complaining of severe pain. This has been going on for 9 months and is gradually worsening. The callus really is not impressive, but the skin of the rims of the heels is hard and has a funny mix of whitish hue mixed with darkening of the skin.

X-rays are normal, except for some mild symmetrical narrowing of the joints of the rearfoot. She has polymyalgia rheumatica and she is on Methotrexate 3 pills per day. She works on her feet all day and she smokes. Is there anyone out there who might be able to help me with this case?

Shari Kaminsky DPM, St Louis, MO

RE: Digital Scanning Systems
From: Marc G. Mittleman, DPM

Our three-physician practice has had the Pedalign orthotic scanning system, from Max Med Technologies, in our Southern California office for just over four years now. We have been quite pleased with it. It has improved our orthotic production and efficiency dramatically. I have been making custom foot orthoses for 25 years with numerous labs. I was "Root trained" at CCPM in the later 70's. I have been impressed with the fit, contour, comfort, and control afforded by this incredibly easy-to-use high technology system.

The turn-around time is quite fast and our orthotic volume pretty much tripled since we went digital. We also have never had a higher re-order rate for additional pairs of orthoses from very satisfied return patients. We are quite pleased to have taken the orthotic portion of our practice into the digital age. Patients are impressed with the system and it fits in very well with our high-tech oriented practice.

Marc G. Mittleman, DPM, Torrance, CA, drmgm@verizon.net

RE: Non-Payment of Associate
From: Michael M. Rosenblatt, DPM

Non-payment of an employee podiatrist is just one of many problems faced by employees. As long as you are an associate, you are an employee. In a soon to be published article on the subject of associateships, I posit the question: "Has associateship damaged the profession?"

The high cost of going into private practice, mixed with stratospheric student loan balances have "forced" new graduates into these contracts. It was not always like this. We have a proud history of self-employment and entrepreneurship. New podiatrists miss a great opportunity if they refuse to recognize practice purchase. Their primary concern is adding more debt to their loan balances.

It's really about income stream. Employed podiatrists learn a painful lesson when they are not paid for work done. Legal recourses are limited. In most cases, a suit against their employer is the best option among a small list of alternatives. Rather than engaging the legal system based upon "more fees to more lawyers," they are far better off directing those funds to purchasing a practice and getting up on their own feet.

The recession, combined with a record number of podiatrists looking to retire, has provided a once-in-a-lifetime chance to wave goodbye to ex-employers and bid against a multitude of hungry practice sellers. This is a "perfect storm" of opportunity that will not soon recur.

Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

PODIATRISTS NEEDED - CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC

PRACTICE / BUILDING FOR SALE - CENTRAL ILLINOIS

Practice and office building for sale. Full-time very busy practice with well built stand-alone office building. Podiatrist wishes to retire. High patient volume. No need for second office. Midsize town with University and Industry. Call 217-778-4465 for more details.

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for full-time podiatrist in a multi practice location in the Chicagoland and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

POSITION - NORTHERN VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes.Top hospitals. Fax CV with references to 703-491-9994

ASSOCIATE POSITION –GEORGIA

A well-established practice in South Georgia seeks a full time PSR-24/36 trained podiatrist. Excellent benefit package. Please send CV to agriffin@southernpodiatry.com. For more information, visit our website

EQUIPMENT FOR RENT - EXTREMITY MRI

Now you can rent an extremity MRI, have the scan performed, read by a board-certified radiologist and derive all the income. two convenient locations, Manhattan East 60th street between Park and Lexington, and Plainview, Long Island. Conforms to the Stark amendment; call for information (516) 476-1815.

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