The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

November 29, 2006 #2,753 Editor-Barry Block, DPM, JD

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James A. Busey, DPM, Age 57

Dr. Jim A. Busey of Vienna, VA, lost his battle with cancer on November 20th. He is lovingly remembered by his family, friends and colleagues as living a full and rewarding though brief life.

Dr. Jim A. Busey

Dr. Busey earned his DPM degree from the Ohio College of Podiatric Medicine. He completed in residency training in Dallas, TX where he later opened a successful private practice. In 1988, Dr. Busey joined the United States Army as a Captain and relocated back to Washington with a medical assignment at Walter Reed where he was stationed until his discharge from active duty in 1992. He remained in the active reserves until 1996 and was in the inactive reserve, volunteering at Fort Meade, with the rank of Lieutenant Colonel at the time of his death.

From 1992 and until his death, Dr. Busey worked with distinction as the first board certified podiatric physician for the Kaiser Permanente Mid-Atlantic facility where he cared for his patients at the Kensington, MD site. Known for his quality patient care and for his rapport with patients, Dr. Busey was also instrumental in the growth of its podiatry department for the Mid-Atlantic division.

PM News policy is to request that memorial donations by made to the APMA Educational Foundation Student Scholarship Program 9312 Old Georgetown Rd. Bethesda, MD 20814

APMA Scores Historic CMS H & P Victory

In yet another huge step towards parity with other medical specialties, The Centers for Medicare & Medicaid Services (CMS) on November 27th published regulations granting podiatrists the right to perform histories and physicals (H&P’s) on patients. This monumental achievement was made possible through the exhaustive efforts of the American Podiatric Medical Association (APMA).

Title 42, Chapter IV, Part 482.22(c)(5) of the U.S. Code of Federal Regulations will now require hospital bylaws to ensure that “medical history and physical examination must be completed no more than 30 days before or 24 hours after admission for each patient by a physician (as defined in section 1861(r) of the [Social Security] Act), an oromaxillofacial surgeon, or other qualified individual in accordance with state law and hospital policy.”

Read the Federal Register at:
http://a257.g.akamaitech.net/7/257/2422/01jan20061800/edocket.access.gpo.gov/2006/pdf/E6-19957.pdf

Source: APMA Daily E-News

Obesity Affects Kids' Foot Structure: Study

Obesity during childhood changes the structure of a child's foot and results in instability when walking, a new study has shown. The findings were presented at a conference of the UK Society of Chiropodists and Podiatrists. The study involved 200 children aged nine to 12.

It found that obese children had feet that were up to 15 mm longer and 7 mm wider than the feet of normal weight children. Another study of nine to 11-year-olds meanwhile found that excessive body mass led to instability when walking. In fact, obese children spent significantly more time balancing on two feet when walking and less time on one foot than normal weight children. They also walked at a slower pace.

Gordon Watt, a consultant pediatric podiatrist, pointed out that from a clinical point of view, this research is very important as it 'flags up to the podiatrist the 'at risk' nature of the foot in the child who is overweight or obese'. "Clinicians have been aware for some time of particular problems associated with these children, but this research provides evidence that obesity and being overweight has an effect, not only on the development of the foot, but also on the way the foot and lower limb functions during walking", Mr Watt said.

Source: Irish Health, Ireland – [11/24/06]

Query: Post-op Nail Care

I am wondering what medications other practitioners are using to dry a post-op nail wound. We are currently using silver nitrate but it is not very user-friendly.

Gene Graham, DPM, Columbus, OH

Query: Altering Billing Statistics

I am a podiatrist employed by another podiatrist. I have discovered that he has been altering the billing statistics in order to pay me less. Besides pursuing legal action, is this a complaint that I could bring to the state board of podiatry? Also, if I believe that he is fraudulently billing insurance companies by upcoding visits, am I liable for that?,

Name Withheld

Editor’s comment: PM News does not provide legal advice. The first issue is whether the employer altered the billings submitted to insurance companies or altered the EOMBs after s/he received them. The next issue is under whose tax ID the employer is billing. Hopefully, the billing is not being done under your tax ID.

In any event, if fraud is being committed, you have an ethical and possible legal responsibility to report your findings to both the insurance companies involved (if the fraud is being committed in the billing itself) and/or the state licensing agency if the fraud is being perpetuated on you.

RE: Buying Used C-Arms
From: Kathleen Neuhoff , DPM

I bought a used Fluoroscan unit from a reputable dealer 13 years ago. I had to have one repair done in that time to the monitor which was reasonably performed in less than 3 days. We had two other minor repairs to the arm which my staff was able to accomplish while being "talked through" the repair by the original salesperson who also sent us the part that was needed. I have performed well over 3,000 surgeries using the unit and have used it for multiple other purposes. So I can testify that purchasing used equipment can be a very good option if you are careful to check out the supplier including the length of time he has been selling C-arms, how he provides service for them, and references from those who have purchased from him.

Kathleen Neuhoff , DPM, South Bend, IN, VETPOD@aol.com

RE: Diabetic as a Descriptor
From: Shay Fish, DPM

This debate over how to describe one with diabetes has been going on for at least 10 years. It's interesting that the describers are more concerned about these semantics than those with the disease. For instance, many of my patients with diabetes proudly announce to me that, "I am a diabetic" without any idea that they've just offended themselves (nor should they). None has ever questioned my genuine concern for their health, regardless of vocabulary. But I have heard lecturers dwell on this topic at seminars as if it would produce better outcomes in disease management. The energy arguing over denotation versus connotation could be better utilized, and we could all be a little less paranoid.

Shay Fish, DPM, San Antonio, TX , fishdpm@aol.com

RE: Certified Diabetic Educators
From: Paul Kesselman, DPM

It has been my privilege to work with many of these individuals. I also had an opportunity in the fall of 2005 to attend their annual meeting in Washington DC. This meeting was by the far the single largest medical meeting I have ever attended. With thousands of attendees along with hundreds of pharmaceutical, health food and main stream food companies to even list. One could literally attend hundreds of lectures and eat healthy diabetic alternative foods from sunrise to sunset over the course of their meeting. Getting your patients involved with one of these individuals is a wonderful experience for your patients, and an untapped source for new patients for your practice.

Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net

RE: Benfotiamine (Jeffrey Kass, DPM)
From: Richard H. Mann, DPM

Benfotiamine (also known as benfothiamine) is a lipid soluble, highly bioactive form of thiamine, vitamin B1. It is has been used in Germany with great success since 1978 in the treatment of diabetic neuropathy, sciatica and nerve pain. Additionally, it has been used in Japan since the 1960's. Benfothiamine is very safe. According to the German equivalent of the FDA, millions of doses have been dispensed since 1978 with no significant adverse effects reported.

I first became interested in benfothiamine about one year ago after reading a number of well done European studies. In these studies subjects who were given benfothiamine experienced statistically significant improvement in multiple types of neuropathies, including diabetic and alcoholic neuropathies.

In the past year I have used benfothiamine in the treatment of over 200 patients with peripheral neuropathy. I dispense it to patients with all types of neuropathies and radiculopathies. When used properly, I find that 20% to 30% of these patients get some benefit. I dispense 150 mgs bid for 2 weeks and follow up with the patient at that point. If they have experienced any relief of symptoms I keep them on benfothiamine long term. Improvement is often gradual and plateaus in a few months. Benefits that I have observed in this population include lessening of pain and restoration of sensation in hypesthetic feet. I have observed no significant adverse effects. I would caution you to use a well formulated benfothiamine product. Dietary supplements are not as well regulated as pharmaceuticals.

Richard H. Mann, DPM, Delray Beach, FL, rhm123@gmail.com

ASSOCIATE POSITION--PHOENIX SUBURB

Attractive opportunity for enthusiastic, proficient, and personable associate. Well-established modern practice with multiple newer spacious offices, technology and equipment. Solid referral base, close to hospitals, knowledgeable certified staff. 22% MCR. Practice and surgical center partnership potential opportunity. Prefer 24-36+ PSR. Send CV: AZpodassociate@aol.com

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

ASSOCIATE POSITION – VANCOUVER CANADA

Associate superb opportunity- beautiful Victoria, BC, Canada- multi office ,future buy-in. Full scope Podiatry Write Dr.Cole@shaw.ca.for further details. Exam given in June 2007.

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

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