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PM News |
The Voice of Podiatrists
Serving Over 18,389 Subscribers Daily
November 15, 2018 #6,309 Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com E-mail us by hitting the reply key. COPYRIGHT 2018- No part of PM News can be reproduced without the written permission of Barry Block
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PM NEWS QUICK POLL |
Quick Poll
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What percentage of your patients use your portal to access their medical records?
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![](http://podiatrym.com/vote.jpg) |
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AT THE COLLEGES |
The Kiss That Helped Avoid CMS' Proposed E/M Changes
This Summer, CMS proposed changes to the E/M codes, which would adversely affect podiatry. In August, Rock G. Positano, DPM, MSc, MPH, the Founder and Director of the Non-Surgical Foot and Ankle Service and the Joe DiMaggio Sports Medicine Center at the Hospital for Special Surgery in New York, and Deputy Board Chairman of the New York College of Podiatric Medicine took podiatrists’ grave concerns directly to Washington.
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(L-R) Dr. Rock Positano presents Larry Kudlow with APMA fact sheet. |
Dr. Positano was able to make the case for retaining podiatry’s status at CMS with his contacts, presenting the APMA fact sheet about the threat posed by the proposal to Larry Kudlow, the chief White House economic advisor. Mr. Kudlow told Dr. Positano he would bring the issue to the attention of Alex Azar, Secretary of HHS, and he did -- he made a direct personal call to the Secretary to exclusively discuss the matter.
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PODIATRISTS IN THE COMMUNITY - PART 1 |
NY Podiatrist Heads St. Ann's Podiatry Clinic
A new podiatry clinic at St. Ann’s Community is open to the public for the treatment of acute and chronic diseases of the foot. Located on St. Ann’s Irondequoit campus, the clinic operates on an out-patient basis, treating a variety of complex medical and surgical foot pathologies. “As podiatric foot and ankle surgeons, we can medically and surgically treat a variety of foot and ankle illnesses,” said John Ellie, DPM, head of St. Ann’s Podiatry Clinic.
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Dr. John Ellie |
"We focus on acute and chronic diseases of the foot to minimize transfers to the emergency department and eliminate unnecessary hospital stays for our patients." A native of Greece, Ellie is a board-certified podiatrist with extensive training in foot and ankle surgery. He attended the New York College of Podiatric Medicine and completed his residency in foot and ankle surgery at SUNY Downstate Medical Center in Brooklyn, and was chief resident in his final year.
Source: Monroe County Post [11/12/18]
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PODIATRISTS IN THE COMMUNITY - PART 2 |
LA Podiatrist Receives Newspaper's Healthcare Heroes Award
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Dr. Jon Purdy |
The local Daily Iberian newspaper held a contest to honor the “2018 Healthcare Heroes”. Subscribers were asked to vote for doctors in the various medical disciplines within the parish of Iberia. An awards ceremony was held to honor the winners of the contest. Podiatrist Jon Purdy, DPM was selected "Best Podiatrist" by the readers of Daily Iberian.
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IN THE COURTS - PART 1 |
Hospital Fired NY Podiatrist for Reporting Workplace Harassment: Suit
God-awful medicine isn’t the only thing that flourishes at Coney Island Hospital. The Brooklyn medical center, which consistently ranks among the nation’s worst, also allows harassment to thrive there, a new lawsuit charges. The union for podiatry resident Bella Mednik, 33, says in the suit that its member was canned in August after a three-year stint at the hospital because she complained about the harassment. The court papers cite a series of off-color text messages allegedly shared among the hospital’s podiatry team.
An arbitrator had ruled that Mednik violated nearly a dozen hospital protocols, including failing to correctly document the vital signs of a patient with gangrene in July 2016, leading up to her firing. The union says Mednik was actually fired in retaliation for blowing the whistle on the workplace harassment back in February 2017.
Source: Julia Marsh, NY Post [11/12/18]
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IN THE COURTS - PART 2 |
NY Jury Determines that Floppy Toes Outcome is Not Podiatric Malpractice
Patricia Seabrook claimed that six arthroplasty surgeries performed from 2006 to 2010 to address her painful recurrent hammertoe condition were performed improperly, causing increased bilateral pain and subsequent deformity to her feet. Expert witness Dr. David Plotkin testified that failure to use a K-wire, which is a type of stabilization wire used in orthopedic surgery, was a departure from good and accepted standards of podiatric medical malpractice, and that too much bone was removed, resulting in toes that were floppy and lax.
The jury was not charged with the allegation of lack of informed consent but was asked whether the defendant doctor had removed too much bone and whether he should have used a K-wire in two of the surgeries. The jury deliberated an hour before determining that no medical malpractice was committed in the trial that resolved in Kings County Civil Term.
Source: Alba Acevedo, Brooklyn Daily Eagle [11/14/18]
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FROM PM's CURRENT ISSUE |
Several times a week, PM News posts an entire article from a recent issue of our partner, Podiatry Management Magazine. Please note that the views expressed in Podiatry Management Magazine do not necessarily reflect the views of PM News or Barry Block.
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Today's Featured Article |
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PRACTICE MANAGEMENT TIP OF THE DAY |
CMS Finalizes 2019 Rules - Part 4
4. One proposal that did not make it in the 2019 final rule involved the collapsing of E/M codes. CMS proposed paying a single rate for E/M office/outpatient visits with levels two through four while maintaining the payment rate for level five, among other changes. These E/M changes have been deferred to 2021.
CMS estimates that, once the new payment policies are implemented in 2021, it will disproportionally benefit specialties that report lower-level visits, such as podiatry (+10 percent), as well as specialties that report E/M visits in conjunction with minor procedures, such as in dermatology (+4 percent).
Source: Todd Shryock, Medical Economics [11/2/18], JD Supra [11/7/18]
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RESPONSES/COMMENTS (NON-CLINICAL) |
RE: Marcaine/Bupivacaine Strategies
From: Robert D. Teitelbaum, DPM
We are all having difficulty getting these drugs in our offices. A rep at Moore Medical stated in a decisive way that Marcaine will not be available until nearly 2020. Henry Schein currently does not have it either, but they are selling a package of ten 1ml ampules of epinephrine, 1:1000, for $138. That's about $7 per half an ampule, which is all you need to add to a 0.25% bupivacaine multi-dose 50ml bottle. It turns out to be 10 micrograms of epinephrine per ml of bupivacaine.
Where can you get that? Clint Pharmaceuticals. They sell a rack of 25, 50ml bottles for a good price with a limit of one rack per doctor. Now, I'd rather use 0.5% bupivacaine, so I am using 0.25% which is something new. I will listen closely for patient feedback on duration and effectiveness. But I also have personal experience with dermatologists who think nothing of using 1% lidocaine--and it works just fine--so that tempers my anxiety about the lesser strength.
Robert D. Teitelbaum, DPM, Naples, FL
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RESPONSES/COMMENTS (NEWS STORIES) - PART 1A |
From: Joshua Kaye, DPM
I would appreciate authentication and the sources of information in the Forbes' article written about Dr. Dananberg. Did Dr. Dananberg make the statements or is he in agreement with them?
1. Who has determined him to be a “world-renowned” podiatrist?
2. Who has determined that orthotics may be our best bet for back pain?
3. In what specific manner does foot architecture apply the most stress to the muscles of the back?
4. In what specific manner does the swinging of the leg strain the back musculature and how has that exactly been determined? Are there any scientific studies that have shown that?
5. What data is present that shows that 84% of those with incurable (whatever that means) lower back pain, orthotics improve or relieve their back pain? To what extent have those 84% been relieved?
6. What scientifically-based data demonstrates that there is 50% less low back pain with those who use orthotics, compared to those that don’t?
7. Low back pain is caused by a variety of different problems, such as disc degeneration, stenosis and nerve impingement. What types of back problems are involved in this broad classification?
Joshua Kaye, DPM, Los Angeles, CA
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RESPONSES/COMMENTS (NEWS STORIES) - PART 1B |
From: Howard J. Dananberg, DPM
Joshua, the answers to the posed questions are easily available on the Internet. Had even minimal time been spent researching my background, your letter would never have been written in the first place. But since you chose to write to PM News without doing your homework, I’ll do it instead.
Here are some of my accomplishments in the field of gait style and chronic back and postural pain. I am a contributing editor to JAPMA and have been for decades. I am a long-term consultant to Tekscan, the makers of the F-scan in-shoe pressure analysis system. I received the Astra award in 1986 for my original work on "Functional Hallux Limitus and its Relationship to Gait Efficiency."
I won the Scholl’s Award in...
Editor's note: Dr. Dananberg's extended-length letter can be read here.
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YOU CAN'T MAKE THESE THINGS UP |
RE: Outrageous Shoes of the Day
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Peculiar pink AFO? |
Source: Submitted by Dr. Arnold Ross
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MEETING NOTICES
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CLASSIFIED ADS PART 1 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PODIATRY PRACTICE WANTED - SOUTHERN CALIFORNIA
Looking to purchase Southern California podiatry practice from podiatrist willing to stay for transition. Please reply to socalpod12@gmail.com.
EQUIPMENT FOR SALE - NORTHERN INDIANA
Closing satellite office. Selling misc medical and office equipment including Xanar 15 watt laser, 3 treatment chairs, x-ray machine. Email for complete list of items available. Fwfeet7@gmail.com
SURGICAL INSTRUMENTS FOR SALE
Have retired. Selling surgical instruments and Ellman Surgitron For pictures and prices. Contact. Ksherkin@gmail.com
PRACTICE FOR SALE – BLOOMINGTON, IN
A well-established, profitable 47 year-old podiatry practice is for sale in Bloomington, Indiana. All office equipment and inventory is separately for sale, including but not limited to a digital x-ray, c-arm, laser, and power chairs. Inquires can be made to blmpodiatry@gmail.com
SPACE AVAILABLE – NY AND LONG ISLAND
Offices available to sublet and share, Manhattan and North Shore Long Island. Offices fully equipped with state-of-the-art equipment extremity MRI, foot/ankle CT scanner, diagnostic ultrasound and the availability to become a staff member of a certified ambulatory surgical center. Call 1516 476-1815 podo2345@aol.com
PM NEWS CLASSIFIED ADS REACH OVER 16,500 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 16,500 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com or call (215) 808-0770
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CLASSIFIED ADS PART 2 - ASSOCIATE POSITIONS AND FELLOWSHIPS |
POSITIONS AVAILABLE – ROCHESTER, NY
Looking for podiatrists to see residents in nursing homes and skilled nursing facilities in and around Rochester, NY. Great opportunity for part-time income. Positions available immediately! Send inquiries to: phasetwopodiatry@gmail.com
ASSOCIATE POSITION – NORTH CAROLINA
Great opportunity in rural Northeastern NC! 20 year, well established practice with multiple locations, ready to continue to grow, seeking hard working podiatrist/s just entering practice or with experience, to join us. North Carolina license a must, Send questions and/or CV to iiicms@aol.com
FULL-TIME or PART-TIME PODIATRIST - DALLAS/FORT WORTH AREA
PSR 24-36 Trained Multi-dimensional, Multi-office group treating a wide range of patients to include: forefoot, rearfoot, diabetic wound care, sports medicine and work-related injuries. A great opportunity for driven personable individual. Please e-mail CV, Letter of references, 1 minute Video Introduction Email: cnunez1940@gmail.com
ASSOCIATE POSITION – MARYLAND
Established practice looking for a full-time podiatrist for our three Maryland locations. The ideal candidate will have strong clinical skills including ulcer care, diabetes, surgery and general foot care. Must have a strong office personality with the ability to maintain and attract patients. Must be willing to merge into an already established protocol based office. Please send C/V to podiatristsmd@gmail.com
ASSOCIATE POSITION - NASSAU COUNTY, NY
Exciting opportunity! Busy Nassau County, NY office seeks full time podiatrist. State-of-the-art facility. Complete EMR, digital radiograph and diagnostic ultrasound. Excellent salary and benefits. Must be board qualified. Please e-mail resume to: Medicalofficeinquiry@gmail.com, or call: 516-902-1073
ASSOCIATE POSITION – HOUSTON, TEXAS
Busy podiatry practice seeks motivated DPM to join our team. Amazing opportunity for someone looking to grow with us. Incredible company culture. Suburban outpatient practice in an active part of town. Sports medicine and lots of kids. No weekends or hospital call. Interested applicants invited to send CV's to: HoustonDPMJob@gmail.com
ASSOCIATE POSITION - LOS ANGELES CA
Excellent opportunity for hard working, ethical rearfoot and ankle trained foot & ankle surgeon. Full scope practice including fore/rearfoot surgery, trauma, biomechanics. Located across the street from a major hospital. Associateship leading to partnership. Email CV to lafootanklesurgeon@gmail.com
MULTI-LOCATION GROUP - CHICAGO/NEAR WEST SUBURBS
Seeking F.T. ABFAS Board Certified/Eligible associate- P.T. available. MINIMUM 2 year practice experience required. Surgical/ortho patients. Great staff. DME, MIS, EMR, ultrasound, PRP, shockwave, digital x-ray, laser, sx center & Physical Therapy- Top pay, associateship & practice equity available for experienced candidates. Contact podiatryoffer@gmail.com
ASSOCIATE POSITION - UPSTATE NY
Excellent opportunity to start your career in a fresh practice! Seeking an associate to join, grow, and become partner. Key attributes: Board Qualified/Certified, self-starter, willingness to build practice. Looking for a motivated individual to contribute to our growth through all aspects of podiatry. Please send CV to: docryanlee@gmail.com
ASSOCIATE POSITION - LOUISVILLE, KY
Immediate opportunity to walk into a busy three doctor practice to take over for an established podiatrist moving back to his home town for family reasons. Multifaceted well-equipped office centrally located with a local residency. Send resume and letter of interest to benfeet@yahoo.com.
POSITIONS AVAILABLE – BROOKLYN, NY
Looking for podiatrists to see residents in nursing homes and skilled nursing facilities in Brooklyn, NY. Great opportunity for part-time income. Position available immediately! Send inquiries to: phasetwopodiatry@gmail.com
ASSOCIATE POSITION – WESTERN PA
Well-established podiatry practice in Western, PA looking for a full-time Podiatrist to join their team. Position will involve seeing patients at multiple hospitals, wound care centers and satellite offices. Basic qualification: Graduation from an accredited medical school and completed accredited residency program. Board Certified/Qualified. Certificate/license medical license to practice in State of Pennsylvania. We offer a competitive compensation and benefits package to our team members. email CV to: dysteindpm@gmail.com
ASSOCIATE POSITIONS – PHOENIX
Phoenix office seeking the services of podiatrists. Practice offers a great opportunity to the right physicians to establish and grow. Physicians holding an Arizona State license preferred. IMMEDIATE full and part-time openings available. Please email your CV and cover letter to FootAnkleRescue@gmail.com
ASSOCIATE POSITION - WASHINGTON, DC
Growing, well-established practice seeking well-trained, hard-working surgical trained podiatrist. Practice with concentration in foot & ankle surgery as well as sports medicine. Excellent referral base. Downtown location. Full benefits package. Please send CV to WDCDPM@gmail.com
ASSOCIATE POSITION - UPSTATE SOUTH CAROLINA
Busy two physician practice in Upstate South Carolina seeking highly motivated, ethical associate. PSR-36 trained. High surgery case load. Competitive benefits & salary. Send CV to upstatescpodiatry@gmail.com
PM NEWS CLASSIFIED ADS REACH OVER 18,500 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 18,500 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com or call (215) 808-0770.
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Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management Magazine and Podiatry Management Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.
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- Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.
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