The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

November 11, 2009 #3,698 Publisher-Barry Block, DPM, JD

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Cosmetic Foot Surgery is on the Rise

If the Cinderella story were a modern-day reality show, the evil sisters might win the day by undergoing cosmetic foot surgery to fit into the dainty glass slipper. Nipping and tucking has now reached the nethermost region of the body, with procedures like laser spider-vein removal and surgical toe shortening becoming more prevalent.

Dr. Suzanne Levine

"The population is aging, and people are concerned about their feet looking good," says aesthetic podiatrist Dr. Suzanne Levine, Institute Beauté, New York. Today's shoe styles are open-toed or have cutouts that expose the feet. And heel heights have "gotten out of hand," Levine says. That's one reason she invented a trademarked procedure called "Pillows for Your Feet," which restores padding beneath the skin.

Our natural padding breaks down with age. "People complain about burning under the balls of their feet," says Levine, vice president of the International Aesthetic Foot Society. The procedure consists of injecting polylactic acid to plump up the foot, oftentimes so patients - mostly women - can wear "fabulous" footwear, Levine says.

Source: Dawn Klingensmith, Philly.com [10/30/09]

TUSPM Honors PA Podiatrist at Gallery of Success Awards

John Marty, MS, DPM, was named as one of the awardees at the recent Temple University Gallery of Success Awards. The Career Center's Gallery of Success portrays successful alumni from Temple University.

Dr. John Marty

Dr. Marty received his doctor of podiatric medicine degree from the Temple University School of Podiatric Medicine (formerly the Pennsylvania College of Podiatric Medicine) in 1983. He performed his surgical residency at Pittsburgh Podiatry Hospital, and opened his private practice in Kittanning.

Dr. Marty has held several offices within the PPMA, including President in 1996. He has published numerous articles and received the PPMA "Podiatrist of the Year" award in 1999. In 2001, he received the prestigious "Edward L. McQuaid Award" from PPMA for his endless hours of service for the continuing education of podiatrists. Also, he has been serving as president of the Goldfarb Foundation since 1998.

Source: Leader Times [11/9/09]

Derner Named Distinguished Podiatrist of the Year

Virginia’s Podiatrist of the Year practices in Prince William County. Dr. Richard Derner, surgeon and partner at Lake Ridge Foot and Ankle, which is located in both Prince William and Stafford counties, is the first podiatrist to receive the Distinguished Podiatrist of the Year award from the Virginia Podiatric Medical Association.
 

Dr. Richard Derner

This award is bestowed upon the podiatrist who delivers outstanding performance of service to the foot and ankle, the welfare of the public, and for services to and on behalf of the profession of podiatry.

Source: Stafford County Sun [11/5/09]

NJ Podiatrist/Photographer Wins Linnaeus Medal

He used lighting techniques learned from Dutch artists Rembrandt and Vermeer - his work has been described as a "highly successful fusion of science and art" and a "magnificent tribute" to Linnaeus by The Royal Swedish Academy.

Dr. Jonathan Singer in front of his photograph of a Hippeastrum Toscana, a new hybrid amaryllis. (Photograph by Howard Schatz).

Jonathan Singer, a podiatrist, is the first photographer in more than 100 years, and fourth American citizen to win the medal, which will be presented as a large memorial silver coin that is 66 millimeters in diameter. "To be the first of anything is amazing," he said at his Bayonne studio, surrounded by abstract printings of his work, along with prize-winning photographs of rare flowers that he describes as "ever so beautiful."

It was that "magnificence" that won Singer the medal. He was notified of the prize in October. Tulipae, a collection of his works, is now in the care of The Royal Swedish Academy of Sciences as the first book to ever be accepted by the academy. The medal will be presented to him in Washington at a later date. Singer is also a Hasselblad Laureate Award winner. The award is an international photography prize regarded as the most coveted award in the field today.

Source: Bayonne Weekly [11/5/09]

Disable Window's Autorun to Protect Your PC From Internet Worms

Easy to use tools to create self-spreading worms are readily available. Simply checking a box labeled "autorun," activates a code that corrupts USB ports, infecting any memory stick, camera, or music player that is subsequently plugged into the port. Those tainted devices then spread the infection when plugged into other PCs.

To protect yourself, keep anti-virus protection and Windows security up to date. In addition, disable the Windows autorun function. Instructions can be found here.

Source: Byron Acohido, USA Today [11/9/09]

Query: 1st MPJ Closed Reduction in 13 Year Old Boy

Below are pre- and post-reduction films from a 13 year old boy who is a great athlete. He is in excellent health. He jumped into a pile of leaves and jammed his toe. He went to the ER where the joint was reduced. He was not placed in a splint and was told he would be playing football by the weekend and his sesamoid bones were not important. He was on crutches one day post-injury and reduction when he presented to my office. He was not having much pain.

1st MPJ, Pre- and Post-Reduction

I placed him in a Jones compression splint and will send him for an MRI in a few days when the swelling is reduced. The joint is stable, but the sesamoid apparatus is displaced with disruption of the intersesamoidal ligament, and fracture of tibial sesamoid. This appears to be a type IIC injury. My concern is returning this young adolescent to normal function. Suggestions?

Michael Tritto, DPM, Rockville, MD

Query: Removal of Nail Plate + I&D Abscess

Can I bill procedure code, CPT 11730 (avulsion of nail plate, partial or complete, simple; single), with CPT 10060 (incision and drainage of abscess) on the same date of service for non-Medicare payers?

Charles Lombardi, DPM, Bayside, NY

Response: According to the latest version of the CCI, your claim could be coded as follows:  CPT 10060, CPT 11730-59-T_

Therefore, this combination could be billed, barring any medical policy that excludes it. However, as a coder, if I were reviewing your documentation for payment, I would consider the following:

(1) The toenail removal is considered a component of the I&D, which means I would look for there to be something significantly different, showing the need to bill the removal of the toenail as a possible cause for the I&D to be performed.

(2) I would review the documentation to see if the 2 services were performed on different body sites. [There are no body-site specific accepted modifiers for the CPT 10060.]

If, as a coder, I could not determine otherwise, it would be given to a clinician for review. For the clinician, (which I am not) - I would expect the reviewer to examine the documentation to determine if there were extenuating circumstances for the significant, additional payment for the I&D, once the toenail was removed. In a nutshell, can you bill this to any payer? Yes. Will your documentation support the need to be paid for an additional service of the I&D after the toenail is removed? That's where the answer lies.

Karen Hurley, CMM, CPC-I, Waldorf, MD

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RE: Painful Callus, Unresponsive to Conservative Care  (Megan Lawton, DPM)
From: Charles Morelli, DPM, Roody Samimi, DPM

In the very same issue of PM News, Dr. Demp presents a brief discussion on the "Theoretical Explanation of the Metatarsal Length Pattern." I look forward to his study and the results it provides.  That being said, I don’t believe there is anything theoretical about this case.  All I can go by is my patient base and the procedures performed for various pathologies. Whenever there is either an excessively long metatarsal, or hypertrophy of the plantar condyles, addressing that deformity will usually address the patient’s symptoms. 

From hallux limitis to the problem being discussed here by Dr. Lawton, I would be quite surprised if this patient's MLP is not a contributing factor. X-rays would be helpful, both AP and sesamoid view, but clinically, the second toe is up in the air and even though this photo is non-weight-bearing, one can presume that it is putting an additional retrograde pressure on the head of the second met, thereby increasing plantar pressure. I also believe the answer to Dr. Lawton's problem has already been suggested in her query. She states that this condition has been "unresponsive to conservative care," If that is the case, it is time to consider a surgical approach for both lesions.

My suggestion is to first consider a plantar condylectomy as it does not mess with the parabola. If you ruin the parabola, you will cause problems under 3, then 4 and then 5. If the condylectomy is not successful, then go ahead and perform your Weil osteotomy. Again, without seeing the x-rays, the Weil might be your first choice. The hallux lesion might be nothing more than an IP sesamoid. 
 
Charles Morelli, DPM, Mamaroneck, NY, podiodoc@gmail.com

An Achilles lengthening should heal them. One of our docs here has great success with TAL (right where the tendon starts fanning out) with forefoot ulcers, and even for bunions. Forefoot pressures are significantly decreased with this, as seen in the literature.

Roody Samimi, DPM Sacramento, CA, roody.samimi@gmail.com
 

RE: The Application of EBM to Orthotic Therapy
From: Mr. Jeff Root

The practice of evidence-based medicine (EBM) as it relates to foot orthotic therapy continues to be a topic of interest and debate. I appreciate PM News’s willingness to host this discussion. The question remains, how can EBM be applied by individual practitioners in the treatment of real patients in a clinical setting?

In order for EBM to be applicable in the treatment of real patients...

Editor's Note: Mr. Root's extended-length letter can be read at: http://www.podiatrym.com/letters2.cfm?id=30330&start=1
 

RE: Emergency Podiatric Practice in a Local Catastrophe
From: Michael M. Rosenblatt, DPM

Here in CA, podiatrists are actually licensed to assist medical and osteopathic physicians in surgery that (the podiatrist) is not actually licensed to treat by themselves. I believe that CA is the only state where this is in the DPM practice law. But there also remains the issue of "practicing" while being retired and not having an active license. We have that situation here in...

Editor's note: Dr. Rosenblatt's extended-length letter can be read at: http://www.podiatrym.com/letters2.cfm?id=30332&start=1

ASSOCIATE POSITION – BROOKLYN, NY

Busy medical office in Brooklyn seeking part-time podiatrist. Good conditions. (718) 259-6666 phone (718)259-7000 fax, email zg0109@yahoo.com

PODIATRISTS 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 Jake Shimansky, Director of Physician Recruitment. Phone-773-342-5221 FAX 773-486-3548-E-Mail jshimansky@homephysicians.com www.homephysicians.com

ASSOCIATE POSITION - MINEOLA, NEW YORK

Full-time associate position with future partnership potential available with busy multi-office practices on Long Island. Must be proficient in all phases of podiatry with emphasis on surgery, biomechanics and RFC. Minimum standards include either a three-year PSR, or board qualified/certified status with ABPS. Existing hospital privileges with a NY based facility helpful. Interested doctors are encouraged to e-mail their CV to mets724@gmail.com

ASSOCIATION POSITION – NORTH CAROLINA

Cornerstone Health Care, one of the largest physician-owned and managed multispecialty groups in the Southeast, is seeking two podiatrists for offices located in the Piedmont Triad of North Carolina. Cornerstone has over 280 providers in 60 locations. Physicians benefit from centralized billing, contracting, and human resource, while maintaining autonomy over office practices. A state-of-the-art EMR system by Allscripts provides instant access to all Cornerstone patient records. Send CV to page.redpath@cornerstonehealthcare.com

ASSOCIATE POSITION - EAST CENTRAL FLORIDA

Wanted podiatrist for well-established practice in East Central Florida. Fulltime position to perform routine foot care in the office and nursing homes. Competitive salary and full benefits available.  Reply to jrdpm@bellsouth.net

ASSOCIATE POSITION-SOUTHERN CALIFORNIA, INLAND EMPIRE

2-office multi-doctor practice looking for ethical, dependable doctor to work 3-4 days per week. State-of-the-art, long established practice. Needs a team player which may lead to buy-in for the right doctor. Must be ABPS BC/BE. High surgical volume. Send cover letter and CV to bkatzman2@earthlink.net

ASSOCIATE 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 - MISSOURI

Expanding multi-location practice seeks motivated individual to contribute to growth. Practice enjoys strong reputation and name recognition. Prefer candidates with interest in partnership opportunity. Established locations available for PSR 24+ and includes incentive comp with benefits/coverage. Please send CV to jmurray@foothealers.com or call John Murray at 314.842.3875.

ASSOCIATE POSITION – MINNESOTA

Well-established podiatry clinic located in the Twin Cities area has an immediate opening for a full-time podiatrist. The clinic is located just minutes from a surgery center as well as 2 major hospitals. Associate position is also open for partnership or purchase. Please email CV and inquires to rmccoy@associatedpodiatrists.com

ASSOCIATE POSITION - NW IOWA (SIOUX CITY AREA)

Well-established, diverse, growing practice. Excellent referral base. Seeking an ethical, hardworking, motivated, caring podiatrist to fill a full-time position. Multiple hospital affiliations. Generous income with room for growth, leading to partnership for the right candidate. See our community www.siouxlandchamber.com. Fax CV, resume, three references to 712-258-9977.

OFFICE SPACE/ MRI RENTAL – NYC, LI

Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, Hicksville and/or Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITIONS - INDIANA/OHIO

PrimeSource Healthcare is a leading provider of mobile, on-site healthcare services at long-term and skilled nursing facilities. Our exceptional growth has created an immediate need for traveling, independent contractors of podiatry services in Indiana/Ohio. Earn between $175k and $225k per year. E-mail CV to kwright@pshcs.com. Visit us at pshcs.com.

PRACTICE FOR SALE- SEATTLE, WA

Beautiful office for sale in the heart of Seattle, WA. Newly renovated, 2,500 sf, new digital x-ray, vascular lab, state of the art physical therapy equipment, paper-less system, all new podiatric furniture and equipment, popular podiatric products store and beautiful diabetic shoe display. Office is located in the medical building and open 3 days a week. Great opportunity for expansion to full-time. Please send us a letter of interest to the: podiatrygroup@yahoo.com

ASSOCIATE POSITION FULL-TIME - SUBURBS OF CHICAGO

PSR 36 - month-trained podiatrist needed for busy suburban Chicago practice. Office and diagnostic equipment state-of-the-art. Full benefit package included. If interested, please fax your curriculum vitae to 847.352.0270 or email to foot1st@yahoo.com

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 a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to fmassuda@footexperts.com

ASSOCIATE POSITION - PHOENIX, ARIZONA 
Part Time/Full Time well-trained, ethical and hard working graduate of a PSR 24+/36 Residency to join our growing multi-location practice. Good mix of Surgery/Pediatric/General Podiatry. ER/Hospital Call a must. Very modern offices with EMR, U/S, Digital X-Ray, ESWT, Vascular Testing. Excellent referral base, and a well-trained staff. Base salary, bonus structure, benefits. Current AZ License a Must. Please e-mail CV and references to azpodiatrists@hotmail.com

DIABETIC RURAL OUTREACH PROGRAM - FLORIDA AND GEORGIA

Seeking DPM to join our program due to a high demand for Podiatric Care to off-site settings in SNF, ALFs and House Calls. Applicants must be willing to travel and must have experience. Current State License, Medicare and Medicaid numbers required. Seeking highly motivated individuals who can be team players, yet work independently. Must have strong work ethic and excellent communication skills. APPLY: Fax CV to: 866-258-9993 include 3 professional references. Please provide the geographic area where you can provide services. Further information call 800-779-8551 or email: info@DROPInternational.org. Visit our website

ASSOCIATE POSITION – RESEDA, CA

Podiatrist needed in Reseda, CA office 2-3 days/wk, 6hrs/day @ $375/day to senior community. Please have an active Medicare #. Position starts immediately. Please email CVs to coasttocoastpodiatry@yahoo.com

ASSOCIATE POSITION - FREDERICK, MD

Well-established and growing 2 office state-of-the-art practice located in medical/professional buildings. EMR, Digital X-ray, Ultrasound, DME provider, etc. Competitive Base Salary plus bonus, malpractice, health insurance, etc. PSR 24 minimum/Board Qualified or Certified with ability and desire to take ER call. If interested, forward CV to DOCSBNB@aol.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

PM News Classified Ads Reach over 12,000 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 11,500 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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