The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

November 15, 2006 #2,741 Editor-Barry Block, DPM, JD

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Bert Brosky, D.P.M., 96

Bert Brosky, a podiatrist who died Thursday at his Elyria home at age 96, put his profession's best foot forward. Brosky, who began taking care of his patients' feet when a foot doctor was called a chiropodist, worked with other podiatrists to educate the public about their field and about good foot health.

Dr. Bert Brosky

In the 1940s, he helped put together an exhibit for the Health Museum of Cleveland that included plaster of Paris mock-ups depicting foot disorders. He later lent them to programs in other American cities and as far away as New Zealand. He was a past president of the Northeast Ohio Podiatry Association, which named him most outstanding podiatrist in the state in 1945, and the Academy of Lorain County Podiatrists, which gave him its distinguished-service award in 1976. He chaired the Ohio College of Podiatric Medicine's scholarship program.

PM News policy is recommend that memorial donations be made to the APMA Educational Foundation Student Endowment Fund, 9312 Old Georgetown Rd., Bethesda, MD 20814 or to the Bert Bernard Brosky D.P.M. Endowment Fund, c/o Ohio College of Podiatry, 10515 Carnegie Road, Cleveland 44106

Source: Alana Baranick, Cleveland Plain Dealer [11/14/06]

Barry University’s Yucatan Project Celebrates its 10-Year Anniversary

Fifty-two flights have been made and more than 5,000 crippled children in the Yucatan Peninsula of Mexico have received medical treatment, including life-altering surgeries as a result of the Yucatan Project at Barry University. In addition, more than 75 physicians and 50 residents have volunteered over 20,000 hours to the project, which marks its 10th year of operation at a celebration in Merida, Mexico Nov.18.

The Yucatan Project is the brainchild of Dr. Charles Southerland, a podiatric surgeon at Barry’s School of Graduate Medical Sciences. Inspired by the Baja Project for Crippled Children in Baja, Mexico, Southerland and the physicians from Barry first made contact with officials in Yucatan in 1992 but it wasn’t until 1996 that the first surgeries were performed.

Dr. Charles Southerland, director of the Yucatan Crippled Children’s Project, shown here with Dr. Pedro Abrantes and Dr. Nelson Gonzalez, graduates of BU's School of Podiatric Medicine, treat a 5-year-old girl with cerebral palsy Jan. 23, 2004, in Progreso, Mexico. Three months after surgery she was able to put both of her heels flat on the floor for the first time in her life

“Anyone who goes down and comes backs, never comes back disappointed,” said Southerland, who noted the podiatric residents who go on the Yucatan trips often get a chance to observe and treat deformities, such as, club feet that are usually screened at birth in the United States. As for Southerland, himself, he says he would like to keep making trips to the Yucatan “as long as he can” or until he is “forced to retire.”

Query: Open Book Management

Has anyone used "Open Book Management" (i.e., opening the books to employees)?.
If so, were the results positive or negative?

Bob Levoy, Great Neck, NY

Query: CAQH and Confidentiality

Many insurance carriers are using Council for Affordable Quality Health Care (CAQH) for credentialing purposes. My billing mgr received a call from a carrier indicating they needing a print out of specific credentialing information. With one simple telephone call to CAQH (and without my knowledge) my billing manager was given access to this information after having been provided a change in user ID and password to access the CAQH website account. Just because my billing mgr called CAQH doesn't verify I have given them authorization to discuss any of these issues with anyone other than me.

Another experience, an insurance carrier called requesting more information than what was provided by CAQH. The insurance credentialing representative proceeded to give specific, detailed information to my staff regarding a past case, again without my knowledge. Aren't there some confidentiality issues with this?

Name Withheld

Editor's Comment: PM News does not provide legal advice. Before jumping to conclusions, you should first read the agreement you signed (or clicked) when you signed up with CAQH. A relevant legal concept known as agency usually applies. This means that if your employees are acting within the scope of employment, they are considered your agents, and therefore are granted the same rights, privileges, and responsibilities that you have.

Query: HCPCS Code for a Heel Lift

What is the most appropriate HCPCS code for a "heel lift" made of leather or cork placed inside the shoe?

Charles Perry, DPM, Cambridge, OH

Response: Here are your code choices for "shoe modifications: lifts":

L3300 Lift, elevation, heel, tapered to metatarsals, per inch
L3310 Lift, elevation, heel and sole, neoprene, per inch
L3320 Lift, elevation, heel and sole, cork, per inch
L3334 Lift, elevation, heel, per inch
L3330 Lift, elevation, metal extension (skate)
L3332 Lift, elevation, inside shoe, tapered, up to one-half inch

It looks like L3320 is for cork. Note the unit is "per inch."

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

Codingline subscription information can be found at
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RE: Grafted Jones Fracture (Frank Graham, DPM)
From: Marque A. Allen, DPM, Robert Schwartz, C.Ped.,

To date, I have dealt with nearly 150 Jones fractures from a surgical perspective with the great majority being in competitive athletes from high school to professional level of participation. Your description is unclear as to the use of fixation if any. Also the evaluation of the healing needs to be addressed via a CT scan. In short answer to your question, no re-fracture is not inevitable. I would also be interested to know if the patient has any meta-adductus foot structure. If you can provide some more information, I would be glad to lend my experience with the fracture in this specific setting and demand.

Marque A. Allen, DPM, San Antonio, TX, FtAnkldoc1@aol.com

We have successfully helped professional basketball players who have had multiple Jones fx's. In both cases we changed the foundation under the lateral column of the shoe to return the athletes to long and successful careers. We simply changed the forces under the lateral side of the foot by making their shoes wider than the their feet. This was accomplished by opening up the sole of the shoe approximately 1" from the lateral border and extending it so that the lateral side of the foot was no longer directly above the high pressure area of the shoe where the upper and outsole come together. An orthosis with dispersion under the base of the fifth metatarsal was also provided to reduce vertical forces.

Robert Schwartz, C.Ped., NY, NY, rss@eneslow.com

RE: HPV and Cervical Cancer (Dale Smith, DPM)
From: Bryan C. Markinson, DPM

The discussion over the past few days regarding the HPV virus is not very flattering to our profession. We really should have a much broader knowledge about it than the discussion is indicating. The following link gives an excellent summary on the subject, and will enlighten all on the more than 100 types of HPV virus that exist and which ones cause which diseases. Indeed, the common plantar wart is caused by a HPV virus, as is cervical cancer (though not the same virus), and many other conditions in between. Some HPV infections are meaningless, others important.

http://en.wikipedia.org/wiki/Human_papillomavirus

Bryan C. Markinson, DPM, NY, NY, Bryan.Markinson@msnyuhealth.org

ASSOCIATE POSITION - CENTRAL CALIFORNIA

Central California multilocation practice looking for PSR-36 associate leading to partnership. PSR-36 trained podiatrist with great opportunity for reconstructive surgical practice. Practice has Medicare-approved surgery center. Must have excellent interpersonal skills. Excellent salary and incentive. Respond to: westsidefoot@yahoo.com

PRACTICE FOR SALE – CENTRAL FLORIDA

Well established surgical podiatry practice and a state of the art Medicare-certified outpatient surgical center. Gross for 2005 - 1.6 million. Modest down payment. percentage ownership possible. Located in Central Florida. Contact Camille Todd/Transworld Business 321 217 3625 cell or office 407 226-7171

ASSOCIATE POSITION - NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

PSR-24 RESIDENCY POSITION SOUTHEASTERN MI

Available for recent graduates or former PPMR/RPR or PSR-12 residents. this is a major teaching affiliate of Michigan State University college of Osteopathic Medicine and serves 17 residency and fellowship programs. Active podiatric clinics in wound care, limb salvage, foot and ankle surgery, medicine and orthopedics. competitive salary and benefit package. meded@pohmedical.org

PRACTICE FOR SALE - BOCA RATON/DELRAY BEACH FLORIDA

Solo practice in large medical building. Near hospital and surgical center. Gross average 520 k for three years. 80% Medicare, no HMOs or nursing homes. Seasonal. Further growth potential. Large patient base. Well equipped for clinical/management needs, over 90 K cost of assets. Owner relocating. Serious inquires only. Contact FeetInFlorida@Yahoo.com

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