The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

November 22, 2012 #4,619 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2012- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Errata

1) The correct e-mail addres for Dr. Paul Scollo regarding Hurricane Sandy relief efforts is  pscollo@aol.com

2) The correct URL link to the story misquoting Dr. James Christina is found here.

Cosmetic Foot Surgery on the Rise: TN Podiatrist

These days, some women will do just about anything to fit into their favorite pair of high heels – including surgery. Shortening toes is just one of the many surgical procedures that can make wearing heels less painful. Others range from simply removing bunions to injecting collagen into the balls of the feet for added cushion. It’s as if they’re walking on pillows when they wear their high heel shoes,” says Dr. Nathan Lucas, a podiatrist in Memphis, TN with 15 years of experience performing such procedures.

Dr. Nathan Lucas

And for even narrower feet, Lucas said some women come into his office requesting removal of their pinky toe. “For me, that’s a bit extreme,” said Lucas. “I wouldn’t take anyone’s toes off unless it has to come off.” But, Lucas added, he has referred patients to doctors who will perform the removal procedure. Lucas has seen a steady increase in the number of women interested in surgical options to help take away the pain of wearing high heels, as many as 30 patients a month in the last year.

Source: Garrett Tenney, Fox News [11/20/12}

Orthotics May Relieve Chronick Back Pain for Some: FL Podiatrist

Bradenton attorney Dave Dietrich was prescribed orthotics to cure his plantar fasciitis, a painful foot problem that causes the heel to throb. The custom shoe inserts that cushion and align the feet worked quickly to squelch his foot pain. After several months of wearing them, he noticed his chronically sore back had stopped hurting as much, too.

Dr. Ronald Hadam (Photo: Paul Videl)

Dr. Ronald Hadam, the podiatrist who fitted Deitrich for orthotics, is no longer surprised that wearing shoe inserts does more than solve foot problems. He now routinely examines the mechanics of people's feet and how small imbalances affect their knees, hips, and back.

Source: Susan Hemmingway, Bradenton Herald  [11/20/12]

Dance Helps NY Podiatrist With Parkinson's Disease

Sharon Epstein and Dr. Beth Hochstein, both from Great Neck, Long Island believe that it was fate that they met at a 3-day training course for The Mark Morris Dance for PD® program three years ago. Beth Hochstein, diagnosed with Young-Onset Parkinson’s Disease (YOPD) at age 36, went back to her dance roots as a form of exercise which was recommended by her physician. Sharon Epstein, a registered yoga instructor and dance therapist had already been teaching a Dance for Parkinson’s disease class. Beth decided to work with Sharon after retiring from her career as a podiatrist.

Dr. Beth Hochstein

“Dance has helped me in so many ways - both physically and mentally - to cope with having Parkinson's disease,” stated Hochstein. “I wanted to share my positive experiences with dance and PD in the hopes of helping others cope with the daily challenges that people with Parkinson's disease face.”

Source: Reuters via Yahoo [11/20/12]

E-visits Could Lead to Overprescribing: Study

In the short run, electronic visits with a physician appear to produce the same level of clinical care as in-person patient encounters, based on a study involving two medical conditions and one outcomes measure, researchers in Pittsburgh report. But the researchers' study, which looked at two medical conditions and one outcomes measure, found that down the road, e-visits via a personal health record may lead to problems with increased use of antibiotics.

The study, “A Comparison of Care at E-visits and Physician Office Visits for Sinusitis and Urinary Tract Infection,” published online in the Archives of Internal Medicine, examined the results of more than 8,100 patient visits to four primary-care practices at the University of Pittsburgh Medical Center Health System between Jan. 1, 2010, and May 1, 2011. The study cohort consisted of 5,165 visits for sinusitis, including 465 e-visits, or 9%; and 2,954 visits for urinary tract infections, including 99 e-visits, or 3%.

Source: Joseph Conn, Modern Healthcare [11/19/12]

Query: HIPAA and House Calls

On a recent house call to a senior citizen apartment building, I was asked by the front desk to write down in their incoming non-resident book where I was going. This book is open and available for anyone to see. I stated that this is a HIPAA violation and objected to telling anyone who my patient was. Am I wrong?

Myron Bergman, DPM, Bridgewater, NJ

Editor's Comment: PM News does not provide legal advice: When one signs into an apartment building, there is no requirement to state your occupation or the purpose of the visit. Signing in is simply a security measure taken by the building. Simply signing your name in a log book, by itself, would not constitute a HIPAA violation.

RE: Pea-Sized Plantar Fibroma (David Kahan, DPM)
From: Joan Schiller, DPM

You could consider accommodating it to off-load the pressure. I like the Burns Lab Nusoft orthotics for removal of hyperkeratotic lesions.

Joan Schiller, DPM, Euclid, OH, Joan.Schiller@UHhospitals.org

RE: EMR Auditing (James Breedlove, DPM)
From: David E. Gurvis, DPM

I have done a basic security self-audit. I am "secure" by any standards that a "normal" person would consider. That is my way of saying if you wanted to get into my computer system, there is no way in hell anyone but the best of hackers would be able to. I seriously doubt I would pass some CMS bureaucrats' idea of security. Actually, I doubt the bureaucrat office could pass it either.
 
The Government giveth, and the government taketh.
 
David E. Gurvis, DPM, Avon, IN deg1@comcast.net

RE: EMR Auditing (James Breedlove, DPM)
From: Robert Kornfeld, DPM

Dr. Breedlove only discusses the "tip of the iceberg". Medicare's implementation of EMR was NOT designed to create better communication systems between doctors' offices and hospitals. It was designed to have easy access to patient records for the purpose of auditing and recouping money. Here you see that the government will be taking back stimulus money by making it very difficult to "comply". Not surprising. They will also be auditing all of your patient care records and there is going to be an enormous recoupment of Medicare reimbursement at your expense. Is this surprising? I think not. We have a government that simply can't pay its bills. Even if you dot all the i's and cross all the t's, they will find guideline violations. If this isn't BIG BROTHER, I don't know what is. But Dr. Breedlove beware. You will not be able to "go back to paper." Your claims will not be processed. You have willingly walked into the lion's den.
 
The moral of this story is...when you give away your power and freedom (cooperate with imposed regulations) to any governmental beauracracy, you will either become a slave (participating doctor) or an inmate. Free enterprise medicine has every right to exist. This is a democracy. You choose or you lose.
 
Robert Kornfeld, DPM, Manhasset, NY, Holfoot153@aol.com

RE: Podiatry-Specific Coding (Podiatry-Specific Coding (Paul Galluzzo, DPM)
From: Harry Goldsmith, DPM
 
The American Podiatric Medical Association, several years ago, developed the APMA Coding Resource Center (apmacodingrc.org) which was designed for foot/ankle specialists.  The Coding Resource Center is a subscription online CPT, ICD-9, HCPCS, Medicare LCD, DMEPOS LCD, CCI edit, CPT to ICD-9 proposed links, Medicare information center: global days, whether an assistant surgeon is allowed, RVUs (including separate work RVUs), documents library…as well as, in the future, ICD-10 and a podiatry-specific electronic ICD-9 to ICD-10 crosswalk.
 
The CRC is only available online which allows it to be accessed anywhere you – doctors, staff – have a computer and an Internet connection. It is meant to be logged onto in the AM and left logged on all day. The APMA Coding Resource Center is updated automatically so there are no disks to load, no need to get online to download anything. The cost? For APMA members, it is $189 a year (365 day subscription) – cheaper than buying CPT, ICD-9, and HCPCS manuals.  [NOTE: A portion of the proceeds goes to the APMA Educational Foundation Student Scholarship Fund]
 
Want to check it out before you subscribe for real? Take advantage of the 7-day free trial subscription – apmacodingrc.org. 
 
Harry Goldsmith, DPM, Cerritos, CA, hgfca@verizon.net

RE: NJ Podiatrist Warns of Universal Life Insurance Danger (Jon Purdy, DPM)
From: Michael M. Rosenblatt, DPM

Dr. Purdy is correct about whole life insurance. It is highly expensive and a failure as an investment for most people. But there are some exceptions. There are some policies that offer single premium payment options to help finance extended care when we get old enough to consider that need. 
 
Only a very small number of companies offer these policies, and you have to qualify for their underwriting, which is usually based upon considerations of dementia or pre-dementia. Every time I walk into a room and forget why, I calculate that this is one less decision away from my stepping into the nursing home. That said, whole-life policies benefit insurers mostly.
 
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

RE: NJ Podiatrist Warns of Universal Life Insurance Danger
From: Joel Lang, DPM

As a financial planner, I do not know all the details of this particular situation, but this scenario occurs way too often in my practice. This article points up the truth that real financial planners know - no one (with rare exception) should ever buy anything other than term life insurance. Insurance salespeople (who often masquerade as financial planners) make large commissions on the sale of these fancy policies and often mislead the client about the rewards projected down the line. Meanwhile, the reward for the salesperson are immediate!

To add insult to injury, it seems that the client was advised to purchase more life insurance with the proceeds of prior policies. Why would a 66 years old need more life insurance? As people grow older their need for life insurance decreases, not increases. It appears what they need is cash flow to cover their current expenses. This insurance salesperson was only looking out for him-/herself, obligating this couple to a never-ending course of increasing premium payments.

Term life insurance fits the needs of 99.9% of everyone when properly structured and is very inexpensive and never increases in cost. The artificial mix of life insurance with savings, investments, and annuities only makes the product unnecessarily expensive, and rarely does it deliver on what is promised.

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

ASSOCIATE POSITION – NORTHERN CALIFORNIA/SF BAY AREA
 
We’re looking for someone entrepreneurial to join our growing practice. Must have great people skills, clinical/surgical skills, and positive demeanor. California license required. No nursing home visits. Send your CV and cover letter to: cvpodiatrist@gmail.com

ASSOCIATE POSITION - CT (GREENWICH, FAIRFIELD, AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to Dr.Kassaris@yahoo.com

ASSOCIATE POSITION - PORTLAND, OREGON

Busy office with good steady referral sources looking to expand. Areas of expertise wanted: wound care, surgery of all aspects, knowledge of running an office. Please come with good personality and hard work ethic. New main and satellite offices. Email: office.pfac@gmail.com

ASSOCIATE POSITION NEW JERSEY - PASSAIC COUNTY

Associate Position Available leading to Practice Purchase. 25 year old well established general, well rounded practice seeking residency trained, ABPS eligible/certified podiatrist. Must be able to perform general foot procedures/surgeries without assistance. Well equipped office with digital x-ray, ultrasound, Doppler, 3 treatment rooms. Hospital Privileges available. Must be logical, Ethical and hard working. Pay commensurate with performance. Call 201 986-1900   ToeBizCenter@Yahoo.Com

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Welcome to paradise! Immediate opening in a busy, multi-location practice. Six figure income potential possible for the motivated individual in the first year. Surgical training a plus. Hospital privileges available, depending on training. Must be Florida licensed. Great benefit package. Send CV and cover letter to 1foot.ankle@gmail.com.

ASSOCIATE POSITION - KANSAS CITY

Kansas City may be the perfect move for you and your family. I am looking for an entrepreneurial minded associate who wants to grow and then own part of an already successful practice. If you are the right candidate for this associate position, you will enjoy a competitive compensation package and you will be working with a doctor who is as committed to your success as he is to his own. Go to: www.YourFutureInPodiatry.com for full details.

ASSOCIATE POSITION - NAPLES, FLORIDA

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. Candidate should have the skills and desire to perform rearfoot/ankle surgery. Florida has a great scope of practice law and we rotate for ER call. Candidate needs to be ethical and motivated. Established practitioner or new practitioner. In a cover letter tell me why you should be selected for the team. Email cover letter and CV with subject line "I am your new team member." to: Drgordon@gulfcoastfootcare.com

ASSOCIATE POSITION - NC PIEDMONT

Excellent opportunity for highly motivated, ethical, and personable PSR 24/36. This well established, 3-physician practice has excellent rapport with physician community, multiple office locations, and hospital privileges. Intent is an associate leading to partnership for the right individual. Competitive salary & benefits. Email CV to dpmassociatenc@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 12/24 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

ASSOCIATE POSITION - NASSAU COUNTY, NEW YORK

Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to: Podiatryoffice@doctor.com

ASSOCIATE POSITION LEADING TO PARTNER - NJ HAMILTON SQ

Looking for a 2/3 year surgically trained podiatrist for a position in my well balanced practice. A full schedule of patients is waiting. The practice incorporates surgery, wound care and clinic, general podiatry and sportsmedicine. Starting salary is $90,000 plus bonus +health+401K+paid vacation and seminars+all dues. Starting immediately send resume to Drj4foot2012@aol.com.

PRACTICE FOR SALE - SOUTHWEST FL

Multilocation multidoctor practice in beautiful Southwest Florida . Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to : practiceforsaleswfla@gmail.com.

EQUIPMENT FOR SALE - USED Q-CLEAR LASER

Still under warranty . New laser head just added. First Best Offer. Marketing and training included. Dr. Zuckerman will train you. e-mail with questions to mook863@comcast.net

PEDORTHIST WANTED – NEW JERSEY

Certified pedorthist interested in part owning-working in a therapeutic shoe store in busy podiatrist's office. Please email to advancedfoot1@aol.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 PODO2345@AOL.COM 516-476-1815.

PM News Classified Ads Reach over 14,000 DPMs 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 14,000 DPMs. Write to:bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 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.

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.