The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

November 11, 2008 #3,397 Editor-Barry Block, DPM, JD

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Wear-ability Doesn’t Mean Shoe Safety: CA Podiatrist

Making ultra-high shoes more wearable doesn't necessarily make them any safer. Joshua Kaye, a Los Angeles podiatrist, describes what happens to the feet in high-heeled platform shoes.

Dr. Joshua Kaye

"It's like you're walking on stilts," he said. "The ball of your foot is up a couple of inches off the ground in platform shoes. That puts more pressure on the ligaments and soft tissue, instead of the bones."

Elevating the heel more than 3 inches off the ground, he said, increases the odds of suffering a sprained or broken ankle.

Source: Teri Agins, The Wall Street Journal, [11/9/08]

AAPPM Presents Inaugural B.C. Egerter Award

The American Academy of Podiatric Practice Management (AAPPM) has presented its inaugural B.C. Egerter Award of Excellence to Dr. Barry H. Block at its Annual Ft. Lauderdale Practice Management Meeting. This award is named after Bernhardt C. Egerter, DPM, the founder of AACPM.

Gary Adams, Drs. Mary Beth Crane, Hal Ornstein, Barry Block, Jeff Fredericks, Craig Conti, and Bill McCann

“Dr. Egerter selflessly devoted his life to the promotion of practice management,” said Hal Ornstein, Chairman of AAPPM, “and similarly Barry Block epitomizes that spirit. The AAPPM Board unanimously selected Dr. Block as the first recipient of this prestigious honor.

AAPPM Ft. Lauderdale Meeting Another SUNsational Sellout

Another year, another sellout. That has been the recurring theme of the American Academy of Podiatric Practice Management’s annual practice management meeting. There’s no mystery as to why. Combine top practice management experts, a luxury resort hotel, and a tropical climate, adds up to an unbeatbale and inspiring practice-building experience.

Dr. Ben Weaver (Center) conducts workshop at AAPPM Meeting

Attendees, ranging from new practitioners to seasoned veterans participated in lectures, roundtables, and workshops. In the small roundtable discussions, they shared their pearls as well as their problems.

Those who missed this unique opportunity are advised to register early for AAPPM’s Pittsburgh seminar on March 5-8, 2009 (aappm.org) That meeting is also a traditional sell-out.

Advice: Should You Take it? - Part 1

Everywhere you turn, people are willing to hand you some advice. However, not all advice is good advice. Use the following pointers as you decide which advice to take and which to leave on the table.

• Is the person giving advice qualified to do so? If you respect the person giving advice, you may not question whether the advice is good or bad. Yet, even people who care about your success can offer bad advice in some situations. Key: Question the adviser's expertise in that particular area, not only general integrity or good intentions.
• Is the advice univerally accepted? Is the person recommending something that works for everyone, something that works sometimes for some people or something that just happened to work for the person giving the advice? Rely on your common sense. If the recommendation doesn't sound right, don't follow it.

Source: Adapted from Year to Success by Bo Bennett

Query: Unexplained Bruising

I saw a healthy 53 y/o wf c/o unexplained bruising on her right foot. She states that this first happened 3 years ago. She appears to have bruising around the 5th MPJ area extending proximally about 3-4 cm. on the plantar aspect of her foot.

Unexplained Bruising

There is slight edema, but no pain or unusual sensation. Skin temperature is 2-3 degrees cooler than the contralateral side. She does not use alcohol or illegal drugs, and wears tennis shoes most of the time. X-rays were normal. Any suggestions as to what may be happening?

Neil A Burrell, DPM, Beaumont, TX

Query: Help for Divorced Practitioners

Help! With declining revenues and procedures no longer covered (all of which factored into child support/maintenance figures at time of divorce), does anyone have suggestions on requesting a downward modification, as these income reductions are "not due to the actions" of the individual?

Is there a podiatric support site for those in the same situation? If not, why? Other professions have instituted support structures for their members, why not ours?

Alan Cantor, DPM, East Meadow, NY

Query: Second Office Biling

I am considering having an office day in a nearby town from my primary office. I would have space in an office suite that is also used by another physician on his off days.

How would I bill these office visits? Would they all still be billed under my primary office address? Or do I need to submit the claims under the second office address?

Amy Jelinek, DPM, Greensburg, IN

Response: You need to show the correct location (address) where services are provided. If your new office is in the same state as your current office, you will only need to register the new locations with Medicare, Medicaid, TriCare, Railroad Medicare and all other insurers with which you participate.

When you bill, you will show the address of the second office.

Richard Papperman, MBA, CHBME, Cape May Court House, NJ

Codingline subscription information can be found here

RE: Painful Callused Heels (Shari Kaminsky DPM)
From: R.D. Teitelbaum, DPM, Joel Lang, DPM

How about considering that the Methotrexate pills she is taking every day are causing a peripheral neuropathy showing primarily in the heels. Are there other areas involved, fingers, etc?

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

"When you hear hoof beats, think horses, not zebras." It has been my observation that whatever the other etiological possibilities, mechanically there is a generally overweight person walking with a round heel on a flat surface with no lateral compression of the heel -in other words - a sandal, flip-flop or (most often) barefoot.

This squeezes the soft tissue outward at the rim of the heel, compromising the skin circulation, resulting in callus formation. This is usually associated with deep painful fissuring because the callus does not have the flexibility of normal skin and it cracks. The fissures frequently extend down to the lower skin layers, causing pain and sometimes bleeding.

The hyperkeratosis needs to be extensively and frequently debrided. Most important, the fissure sides need thorough wall debridement as well. This is often uncomfortable for the patient, but necessary for long-term relief.

Then a plastic M-F Cup should be worn at all times, restoring the lateral compression at the heel rim - this is very important. Topical medications of your choice can be used, but I found that Vaseline worked as well as anything, and better than most. Over time, this will improve (if not resolve) the problem - the callus will diminish, skin flexibility will be restored and the fissures will disappear. Shoes need to be closed, well-fitted, and with firm counters. Weight loss will be very helpful as well.

Joel Lang, DPM (retired), Cheverly, MD, langfinancial@verizon.net

PRACTICE FOR SALE - CALIFORNIA

Podiatry practice for sale, including all equipment. Doctor has spent 46 years building this successful practice in the wonderful community of Redlands, California. This is an incredible bargain for a young podiatrist. Come continue the legacy that the doctor has spent decades building. Email: syzygydoc1@yahoo.com.

ASSOCIATE POSITION AVAILABLE-MIDTOWN MANHATTAN

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

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

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

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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