The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

November 19, 2011 #4,310 Publisher-Barry Block, DPM, JD

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MN Podiatrist Discusses Cold Weather Boots

With the deer season upon us, many will soon find themselves a long way from the fire or heater with feet that feel less than toasty. "Every year, cold-related injuries (frostbite or chilblains) occur frequently for those in the field and for those simply standing and waiting for the bus," says podiatrist Dr. Barry Butler. Prevention of such injuries should be common knowledge where we live, but all too often may get overlooked.

Dr. Barry Butler

Boots that fit with one pair of socks may not fit with two. Tight-fitting boots prevent airflow and restrict movement and circulation. They may cause injury quite quickly in people with poor circulation at temperatures as high as 50 degrees. A good rule of thumb for cold weather boot fit is: “If you can’t fit another pair of wool socks inside them, they are probably too tight,” says Butler

Source: Faribault Daily News [11/11/11]

MPMA and AAPPM Co-Sponsor Diabetes Expo

The American Academy of Podiatric Practice Management (AAPPM) and the Michigan Podiatric Medical Association (MPMA) sponsored a free diabetes expo at the prestigious Oakland Regional Hospital (ORH)) in Southfield, Michigan. Held in one of the largest media markets in the country—Metro Detroit—the event was covered by Fox News and other regional media outlets.

Dr. Jodie Sengstock at Diabetes Expo

Dr. Jodie Sengstock, President of MPMA, Dr. Jeffrey Frederick, President of AAPPM, and Dr. Lee Hoffman (who runs the podiatry cliinic at ORH with Dr. Frederick) gave insightful talks on the role podiatrists have in the medical team that care for our nation’s diabetic patients.

LA County Society Holds 4th Annual CPPAC Fundraiser

"One Voice" 4th annual gala event was held on November 12, 2011 at the Peninsula Hotel in Beverly Hills. Jack Morgan, DPM, chairman, says that this event raised significant funds for CPPAC and the LA County Podiatric Medical Association in support of CPMA's physicians and surgeons directive.

Dr. Jack Morgan

One Voice provides an opportunity for the podiatric community to support political action on behalf of our association. The event was made possible by generous contributions by sponsors Bako Labs, Dr. Comfort, Arthrex, Applied Biologic, and TLC.

CMS to Delay Enforcing 5010 Compliance

The CMS has backed off—a bit—from its Jan. 1, 2012 deadline for enforcement of a rule requiring adoption of a more-robust set of claims transmission standards. The CMS announced today it will hold off until March 31, 2012, on enforcing its rule requiring hospitals, physician practices, health plans, and claims clearinghouses to switch to using the ASC X12 Version 5010 standards for the electronic transmission of healthcare claims and other administrative communications.

The agency said its decision to bend a little on enforcement was "based on industry feedback revealing that, with only about 45 days remaining before the Jan. 1, 2012 compliance date, testing between some covered entities and their trading partners has not yet reached a threshold whereby a majority of covered entities would be able to be in compliance by January 1."

Joseph Conn, Modern Healthcare [11/17/11]

Have Your Patients Register On-Line

To improve efficiency in our office, we used to e-mail new patients forms for them to complete and bring at their initial visit. We found this helpful with getting more complete information and no delay due to filling out paperwork on their first visit. For the past several months, we have taken this process a step further using a service through registerpatient.com.

You give a patient a link on the phone or via e-mail to a site where they fill out patient forms on-line. The completed forms are then faxed to your office. You can use their templates of forms or customize them to mirror yours for a small fee. A significant discount is given for those who use Officite for their website. Of course, a patient portal to your computer system is the most ideal method.
 
Source: Hal Ornstein, DPM, Howell, NJ

Query: Sesamoid Pain Right Foot

This is a 35 year old female marathon runner with a six-month history of sesamoid pain right foot. This x-ray was taken one week ago, soon after the NYC Marathon. Clinically, there is pain on palpation of both the tibial and fibular sesamoid areas. I am thinking of an old fracture or AVN of the fibular sesamoid and a bipartite/fracture of the tibial sesamoid.

Sesamoid Pain Right Foot

I feel that the fibular sesamoid changes preceded the mararthon; I'm not sure about  the tibial. I feel comfortable with some type of orthotic, but I am slightly concerned about possibly overlooking a process that is not traumatic/biomechanical. Does anyone recommend therapy or  surgery?

Bryan C. Markinson, DPM, NY, NY

Query: Taking a Deposit in the Diabetic Shoe Process

We are finding that, in numerous cases, patients who request Medicare diabetic shoes are non-compliant. For whatever reason, after they ask us to file the necessary paperwork and chase their MD/DO for the authorization, they decide not to come back to complete the measuring and ordering process. Obviously, this requires a lot of time and effort on the part of our staff, as well as cost to the practice.

Can we request a minimal deposit of $25, in the form of a check, that would not be deposited, just held by us to encourage them to complete the transaction? It would be returned to them upon placement of the order. If that is okay, if they did not return after the paperwork was done, are we legally allowed to deposit the $25 check as a fee for filing the paperwork?

Marc Hudes, DPM, Monticello, NY

Response: Medicare regulations precludes providers from charging patients for a claims-related issue. In a similar fashion, Medicare precludes physicians from charging suppliers for processing paperwork. Whether or not you intend to cash the check is likely irrelevant as having the patient writing you a check for $25 is a financial transaction precluded by Medicare.

I do agree that the paperwork has become unduly burdensome, and our patients don't care about how much time we spend on this thankless task. Perhaps it would be better not to promote this aspect of your practice until you have had an opportunity to better establish your practice with the patient (not on an initial office visit). Better yet, limit it to those patients (or their families) who can engage their primary care physicians directly. I have found that many PCPs are just simply overwhelmed with DME requests and other thankless paperwork tasks - a financial drain to their practices. While your practice supplier side may be overwhelmed by the requirements, at least there is some potential reward for getting the paperwork; for the PCP there is none other than the satisfaction of knowing that the patient has diabetic shoes.

Patients (or their families) who tend to have longer-lasting relationships with their PCPs or are willing advocates for themselves tend to get the paperwork issues resolved the fastest.

Paul Kesselman, DPM, Woodside, NY

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RE: Wavelengths for Laser Treatment of Onychomycosis (Jeff Kass, DPM)
From Elliot Udell, DPM
 
We are seeing corporate-sponsored research studies which tend to study small numbers of patients for short periods of time. There are many different companies promoting lasers for onychomycosis and each one will hand you a packet of information showing that their machine and its wavelength is the best. Some have studies backing their devices and others do not.

These machines are very expensive and the treatments are not covered by insurance. As clinicians who have a responsibility to properly inform and advise our patients, we should know if there are any good studies out there showing that the results are long-lasting. To charge a patient a lot of out-of-pocket money for a treatment only to have the problem recur in a year creates a very unhappy patient. Hopefully, there will be some long-term studies on all of these modalities which will address some of these concerns.
 
Elliot Udell, DPM, Hicksville, NY, Elliotiu@aol.com

RE: Chronic Wound in Type 1 Diabetic
From: Robert S. Schwartz, C. Ped.
 
An open wound over the styloid process is often the result of repetitive stress caused by the foot shearing against the lateral aspect of the shoe. A broad shank shoe may provide long-term relief after the wound has healed.

Robert S. Schwartz, CPed, NY, NY rss@eneslow.com

RE: NY Podiatrist Performs Sinus Tarsi Implant Surgery on Ecuadorian (Arnold Wolf, DPM)
From: Martin M Pressman, DPM

I could not agree more with Dr Wolf. I had a sales representative for the HyProCure implant company tell me they had their own "approved" CPT code - 28585. It turns out to be a code for open treatment of talotarsal dislocation, which includes internal fixation, when performed (2011 CPT Professional edition).

The sudden use of non-standard nomenclature (talotarsal dislocation) as a description of pes valgus, or flexible flatfoot is, in my opinion, an obvious attempt to obscure the truth and will clearly not stand up to the scrutiny of professional review. This is not an indictment of the procedure per se, but rather the attempt to parse words and use a code that was clearly meant for correction of an acute traumatic event.
 
Martin M Pressman, DPM, New Haven, CT, pressmandpm@gmail.com

RE: Early Diagnosis Of Bunions Can Prevent Foot Surgery (Robert Bijak, DPM)
From: John F. Swaim, DPM

Cynicism is a powerful tool when applied to extending one's own understanding of any particular academic or philosophical subject. One would think the two mutually exclusive in the barest sense, academic based in scientific fact and philosophical based in faith, in belief. Yet these two camps are interdependent in that academic research and objective findings on physical exam both require faith in the guidelines and teachings we all undertook as medical students.

You have to believe in something to get to the other side, eternally and in biomechanics. In geometry, what occurs with an applied force vector acts upon a... 
 
Editor's note: Dr. Swaim's extended-length letter can be read here.

ASSOCIATE POSITION - SOUTH/CENTRAL PENNSYLVANIA

PSR-24/36 trained individual for busy practice in family-friendly college town. Seeking personable, ethical, motivated individual to join our well established practice providing all aspects of podiatric care. Competitive salary and benefits package. Reply with letter, CV and photo to Jagerone@aol.com.

ASSOCIATE POSITION - DAYTON, OH

Join a well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and to Ohiodoctors@aol.com

ASSOCIATE POSITION - MARYLAND

Looking for 3rd associate. Must be personable, well trained and highly motivated. Great locations in Southern Maryland, including an Ambulatory Surgical Center. We currently have EHR, digital radiography, dispensing center and PADNet. Looking for immediate hire! Please send CV to: myfeetfeet@aol.com

ASSOCIATE POSITION - EAST TENNESSEE

30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. $160,000 base salary with bonus incentives and benefits. Post-residency experience a plus. Please send resume to ddavidphawk@yahoo.com

ASSOCIATE POSITION - TEXAS

Well established, expanding podiatric medical and surgical practice with multiple locations Northeast of Dallas, Texas. Modern offices with EHR, digital radiography, Padnet vascular studies and laser. We offer a competitive salary and benefits package for a motivated, ethical, personable and well trained PSR/36 or board equivalent. This individual will also assist managing the residency program. Send resume (CV) tonorthtexaspodiatry@yahoo.com along with a letter of intent

ASSOCIATE POSITION - MARYLAND

Multi-office group seeks highly trained surgical associate to join us. Prefer person with frame and trauma experience. Our practice is state-of-the-art and has all modalities: EMR, PadNnet, on-site billing, diagnostic US, PRP, digital x-ray, etc. Excellent salary, bonus structure and benefits with partnership available. Please forward CV and letter of intent to docsbnb@aol.com

ASSOCIATE POSITION - SOUTH CAROLINA

Upstate practice seeking PSR-24/36 trained associate. Full-time position with partnership opportunity. Must be ethical, highly-motivated with strong surgical and medical skills. Please send CV topalpodiatry@att.net

ASSOCIATE POSITION – NORTHERN CALIFORNIA / BAY AREA

We’re looking for someone entrepreneurial who can help grow our practice. Must have great people skills, clinical/surgical skills, and positive demeanor. California license required. Send your CV and cover letter to cvpodiatrist@gmail.com

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 24-36 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977 Diane Coulter, Office Manager

ASSOCIATE POSITION – NEW YORK CITY/ LONG ISLAND

Seeking an ethical, competent, and responsible associate with a minimum of board qualification, who is proficient in all facets of podiatric medicine, surgery, and biomechanics for a multi-doctor and interdisciplinary medical practice in NYC with suburban NJ/NY satellite offices. Must be able to practice independently with excellent management skills. PT/FT with potential forpartnership.ambulatewell@aol.com

ASSOCIATE POSITION - BAKERSFIELD, CA

Busy surgically-oriented group in Bakersfield, CA searching for 4th doctor. Wound care center privileges. All 3 current surgeons have 3+ years post-graduate training. Send letter of interest with CV to: aghams2@aol.com

ASSOCIATE POSITION - UPSTATE NEW YORK

Outstanding Opportunity. Our medical surgical group is recruiting a well-trained licensed podiatric physician. Located in Beautiful upstate NY. Full hospital privileges, as well as working with two residency programs. Must be highly motivated and great with patients. Opportunity for growth. Competitive salary and benefit package. Please send CV to associateinfoot@yahoo.com

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Immediate position for associate to potential partnership available for a surgeon that is BQ/BC by ABPS. Must be a PSR 24 or PM&S 36 graduate. Salary with bonus. Must be ethical, self starter, hard worker and a team player. Willingness to learn and work as part of a great team is a must. Great ancillaries and surgery facility. Email CV to: susmitad86@yahoo.com

ASSOCIATE POSITION - NORTHERN, NJ

Well-rounded practice. No Nursing Homes or House Calls. All phases of foot and ankle care. Must have good surgical skills and like treating patients. Applicants must take care when doing both Surgery and/or Routine Foot Care. Must be ethical, logical and thoughtful when treating patients. This position can lead to purchase of practice. Send CV to ToeBizCenter@Yahoo.com  

PODIATRY OFFICE TO SHARE - SEATTLE, WASHINGTON

Fully equipped podiatry office in North Gate area of Seattle. Office located in medical professional building near I-5. Office has 3 treatment rooms, 3 physical therapy rooms, direct digital x-ray, PAD- net, NCV testing equipment, physical therapy equipment. Please contact us: website Tel. 425-643-8901isbinc2006@gmail.com

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

SUB LEASING TIME on MRI (NYC)

Don't refer out $$ when they can go into your pocket. Beautiful state-of-the-art 5th Avenue medical office is offering lease time on a .31 tesla Esaote extremity MRI, complaint with Stark laws. This particular magnet is the only one accepted by insurances and Medicare as of 2012. For more information email dri@myfcny.com

CPME-CERTIFIED WOUND CARE FELLOWSHIP

Open position available Jan.31, 2012. St. John`s Episcopal Hospital, Far Rockaway New York. State-of-the-art wound care center. All aspects of wound care including hyperbaric oxygen & reconstructive surgery. One year, excellent salary & benefits. Must have completed approved residency and passed boards. Contact Mariann (718) 869-7256

EQUIPMENT FOR SALE - SUPERPULSE 45 WATT PEAK POWER LASER ( LUMIX2)

Superpulse 45 watt peak power Laser ( lumix2) used once or twice. This is a real superpulse 910nw up to 100,000 HZ. Great Laser Used in the super bowl by the Green Bay Packer Why am I selling? I have too many lasers in my office now ( six) This is a great laser for plantar fasciitis. Achilles tendonitis. Lightweight portable. easy to use, fully programmable Sold to first person under $$12,000 You will NEVER get a laser like this at this price. Enjoy. it I just have too many lasers. David Zuckerman DPMfootcare@comcast.net

EQUIPMENT FOR SALE - CLASS FOUR LASER- USED K-LASERS

I have used K-laser for sale. Still in Warranty. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargeable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

PRACTICE FOR SALE – NANAIMO, BRITISH COLUMBIA, CANADA

Have you ever dreamed of owning a practice where...you can see 0-50 patients daily * average 100 new patients monthly * have zero accounts receivable * gross $480K per year * live in a beautiful community with skiing, hiking, fishing, and boating on your doorstep. This could be yours! If interested contact  pistone@telus.net or call 250-754-4192.

PRACTICE FOR SALE - ARKANSAS
 
Busy, well established practice of 13 years grosses 160K/year for the past 5 years, while working 3.5 days/week. Nursing homes available. 50% Medicare, average of 15 new patients/week. Doctor retiring. Please call 800-983-4194 for more details, or e-mail contactus@podiatrypracticeconsultants.com

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 13,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 for a 50-word ad 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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