The Voice of Podiatrists

Serving Over 10,000 Podiatrists Daily

November 10, 2007 #3,089 Editor-Barry Block, DPM, JD

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Some Pronation is Natural: MD Podiatrist

When you run, some pronation is natural, says Dr. James Christina, director of Scientific Affairs for the American Podiatric Medical Association. In fact, pronation serves as a cushioning system for the feet. It's when the feet roll toward each other too much (overpronation) or not enough that problems arise.

Dr. James Christina

The amount of pronation is directly related to the type of arches one has. A quick and easy way to determine your arch type is to wet your feet and step on concrete, says Dr. Christina. Look at the imprint. If you see all the toes, some of the ball of the feet and heel and some of the middle portion, then you have a normal arch. If you see just the toes and heel, you have a high arch. If you see the whole foot, then you have flat arches. These type of arches cause the foot to overpronate, which can lead to foot conditions like plantar fasciitis, a painful inflation in the foot. Look for "motion control" shoes, says Dr. Christina.

Source: Erlina Tulabut, Squeezeoc.com [11/7/07]

PA Podiatrist Defeats Pathologist For Coroners Position

In the race for coroner, incumbent Joseph Campbell defeated his challenger by a margin of 7,257 votes. Campbell touted his oversight of the county's newly opened $7.5 million morgue and crime lab, which began operations just a week before the election.

Dr. Joseph Campbell

Democrat Dr. Polly Beere, who holds a doctorate in pathology, said that compared to Campbell's training as a podiatrist, she would have far better expertise for the coroner's job.

Sources: Scoot Kraus, The Morning Call [11/7/07]

Insurers to Launch “Medutainment” Video Games

Video games aren't just for fun, say some health plans: They can also teach you healthy habits.

Both Kaiser Permanente Health Plan and Humana Inc. said in recent weeks that they are launching video games focused on such topics as obesity and diabetes. Humana is in the early stages of developing a series of video games entitled Games for Health, and Kaiser is distributing an obesity-focused game online (accessible at www.kp.org/amazingfooddetective) and at schools to children.

The two insurers join a movement toward using educational yet entertaining methods to inform and engage consumers about their health. The efforts are referred to in some circles as "medutainment," meaning entertainment designed primarily to convey medical information. The format involves everything from computer and video games, to movies and television shows.

Source: Health Plan Week [11/2/07]

Query: HIPAA-Compliant Disability Form

I am in the process of revising my office forms. I note that my patient "disability" form for both school and work may have a problem. They both advise either the employer or the school that the patient is being treated for a specific pathology that would either require an absence or a restriction from school or work. Since HIPAA doesn't allow discussion of a patient's problem with anyone not authorized to the information, I am reluctant to use these forms anymore.

Does anyone have a source for a good HIPAA-acceptable work or school "disability" form?

Barry A. Wertheimer, DPM, Redondo Beach, CA

Respose: My form has sections to insert the patient's name, today's date, and date range for any disability/work/gym/activity restrictions.

The rest of the form is blank where I simply write in that the patient was seen in my office today at [time] for the evaluation and care of his/her foot. I do not provide the patient's specific problem or condition. I do, however, list any work/school restrictions.

If this is a Workers' Comp patient, then I tend to be more specific. If the school or employer needs more information, I have the patient sign a formal release of information form so I can give it (or not) to the employer or school.

Tony Poggio, DPM, Alameda, CA

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RE: The Coming 10% Medicare Cut
From: Robert D. Teitelbaum. DPM

A travesty is about to occur. As I posted about one year ago in PM News , we are employees of the Federal Government. When almost all private insurers peg their payments to podiatrists on percentages of the Medicare Fee Schedule---we are employees of the federal government.

A ten percent decrease translates to a reduction (depending on your gross income) of anywhere between 20 and 80 thousand dollars, all things being equal. And unfortunately they won't be equal because of increases in cost of supplies, etc. Our vendors may be hit hard. Thinking about leasing/buying a new $12,000 ultrasound? I think not. In fact, you may be forced to reduce your work force. This won't make practice happier nor your care better.

Do you think it's just the federal government who has an interest in this? Guess again. The crucial problem for our lobbyists in the Senate will be the United Healthcares and Great Westerns of the world who are salivating at an instant decrease of ten percent of their outlays for physician fees.

I grew up in a time when totalitarianism, propaganda, mind control, and anti-Semitism, and racism were the evils that threatened freedom. Now, we are curtailing our own freedoms without any help, and with the presence of a presumably free press. And hate him for being a "fat slob", Michael Moore in his films has done a masterful job at revealing that corporate power is maybe the biggest threat to our future, as citizens and doctors. The questions I pose now, and don't have answers for are: "How free are we?" and "Has the coup d'etat already happened, and we're just finding out about it?" I think I can safely say that this is the precipice. We may dodge it now, but for how long?

Robert D. Teitelbaum. DPM, Naples, FL, mfvandange@aol.com

RE: Employee Theft (Name Withheld)
From: Multiple Respondents

Anyone who handled money in my office was bonded.

Jerome Levine, DPM Scottsdale, AZ, levipod@cox.net

I would never give any employee access to my accounts. I make all deposits and withdrawals. If you are giving an employee check-writing privileges, make sure a dual signature is required over a certain amount. Make sure 2 people handle the mail - one opens and logs on a day sheet of some sort, and the billing agent reconciles from the EOB. I have as many insurance companies direct deposit – e.g: Medicare. These are some suggestions which work well in a small office environment.

Trusted employees will inevitably figure out your weaknesses and try to exploit them. As Donald Trump states “surround yourself with the best people, but don't trust them, and be smarter than them.”

Simon Young, New York, NY, Simonyoung@juno.com

I would propose that all checks get sent to one PO Box were only the doctor has the key. I would also make sure that all the insurance companies are sending the checks to that PO Box. The insurance companies should have one or two contact persons from the office to change an address. This way if something does not jive, you can catch it quickly.

As far as cash you need to keep your eyes open and make sure that all patients get a receipt after all transactions and that you balance the cash out at the end of the day, every day. This will keep you and the people who collect money on their toes. Now, once the cash comes up short, you need to make a decision to let that person go. Secret security cameras can also help. Make sure of one thing, I have heard of this type of theft since my residency and what I have come up with is to trust in God, everyone else check out thoroughly.

Stephen Kinard, DPM, Rocky Mount, NC, sgkinard@aol.com

DPM-PT POSITION AVAILABLE - NEW JERSEY

Podiatrist/Physical Therapist dual-degree (DPM-PT) needed to join expanding 2 DPM practice and develop an internal Physical Therapy department with strong emphasis to all phases of Podiatric PT; including foot/ankle surgery, sports medicine, peripheral neuropathy and advanced wound care. Will hold position for right candidate. CV/Questions: pat_caputo@alumni.rutgers.edu

ASSOCIATE POSITION - ILLINOIS

Excellent opportunity for ethical & personable hard-working individuals to join a busy multi-office two physician practice. Looking for one podiatrist with interest in conservative care, including sports medicine and one podiatrist trained in rearfoot surgery. Rearfoot surgeon must be board eligible and working toward board certification. Competitive salaries, 401-K, health insurance, paid vacation and more. Please forward CV with references to nrussell@neondsl.com

PRACTICE FOR SALE - MISSISSIPPI GULF COAST

Near Casino's and beaches. Busy Practice with no HMO's and good insurance coverage. Hospital and Surgical Center privileges available. Call (228) 762-9531 or email me at jwbenus@yahoo.com

M.R.I FACILITY FOR RENT - NYC and LI

Extremity machine, reads are performed by board certified radiologist, global billing performed by D.P.M location; 121 East 60th street, NYC (Manhattan) 459 South Oyster Bay Road Plainview NY. Call for information and questions. 516 476-1815

PART-TIME LONG-TERM CARE OPPORTUNITIES- Chicago, Peoria, & East St Louis areas

We specialize in providing conservative care to residents in long-term care settings. Immediate part-time positions available. Very flexible scheduling. Competitive compensation and expenses. Contact Dr. Brian Aronson. Phone-773-775-0300, or Fax resume to 773-775-0883

PRACTICE FOR SALE -VENTURA, CA

Satellite office in Ventura, CA. Located very close to the hospitals and referral sources. Potential for further future growth. Nice coastal community and nice weather all year around. Inquire at tkhk@sbcglobal.net

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