The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

November 30, 2006 #2,753 Editor-Barry Block, DPM, JD

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AZ Podiatrist Dies After His Plane Runs Out of Fuel

The Flagstaff podiatrist involved in a Nov. 17 plane crash has died. Preliminary indications from the investigation into the crash show that The reserve fuel tank being used at the time of landing ran out of fuel, but the cause of the crash remains under investigation.

Dr. Levitt's Plane

Flagstaff police officials said Monday that Dr. James Levitt died Sunday at Barrow Neurological Institute in Phoenix. Levitt was the only person on the single-engine Beechcraft Bonanza when it crashed short of Flagstaff Pulliam Airport at about 7:30 p.m. Nov. 17. The plane hit a tree, sheared off a wing and crashed about 400 yards short of the runway on approach to land.

Levitt was taken to Flagstaff Medical Center before being transferred to Barrow in Phoenix. A podiatrist, Levitt flew daily to Chinle on the Navajo Nation about 150 miles northeast of Flagstaff. He had worked at the Chinle hospital since June 2002, according to a hospital spokesperson.

Source: Larry Hendricks, Arizona Sun [11/28/06]

CA Podiatrist Charged With Lying About Credentials

In October 2006 the California Podiatric Medical Board charged Brandon J. Hawkins, an applicant to practice as a podiatric physician in Washington (CA00000300), with unprofessional conduct.

Dr. Brandon J. Hawkins

While a podiatry resident in California, Hawkins lied about being credentialed to use a machine and lied about how long he had attended the residency program.

Source: Washington State Department of Health [11/27/06]

Three NY Podiatrists Accused of Writing Out of Scope Rx’s

A healthcare provider whose foot doctors were accused of prescribing drugs for schizophrenia and other conditions unrelated to feet has been barred from the state's Medicaid system after overbilling 1-point-3 (m) million dollars.

That's according to an audit by state Comptroller Alan Hevesi. The three podiatrists, Raymond G Ferguson Jr, DPM, Rafael Tabari, DPM, and Sheila A Omapas, DPM worked for Signature Health Center of New York City and Long Island.

The audit found they violated state law by prescribing 156 drugs used for acid reflux, high cholesterol, depression, erectile dysfunction, schizophrenia, sleep disorders and other complaints.

Source: Associated Press [11/27/06] Office of NY State Comptroller

Query: Closing 1st MP Pressure Ulcers

I have had difficulty closing the last centimeter of sub 1st MPJ pressure ulcers. I end up with a clean, granulated bed, but no final closure. Short of total contact casting and/or skin grafting with no weight-bearing for an extended period, what are some other options?

Robert Teitelbaum, DPM, Naples, FL

CMS Announces New DMERC Reconsideration Procedure

Reconsideration requests for DMERC claims with a date of service on or after Dec. 1, 2006, will be processed by RiverTrust Solutions, according to a recent announcement by CMS. Reconsideration has replaced the second level of claim appeals, formerly known as Fair Hearing.

Requests should be sent to RiverTrust Solutions via either:
USPS mail: PO Box 80208 Chattanooga, TN 37401 or
Courier Service: (Fed-Ex, UPS, etc.) 801 Pine Street, Chattanooga, TN 37402

Rivertrust Solutions replaces the original contractor selected by CMS for this process, Q2 Administrators, based in Columbia, South Carolina. Q2 Administrators will continue to process reconsideration requests for dates of service from Jan. 1, 2006 through Nov. 30, 2006.

Source: CMS via Paul Kesselman, DPM

RE: APMA Scores Historic CMS H & P Victory
From: Multiple Respondents

What a great victory this is for podiatry. I know I am sick of podiatry getting looked down upon by our counterparts. Any the bottom line, this benefits EVERYONE in podiatry, not just the ones that are in the APMA. So let’s use this as a lesson that there is strength in numbers. Our APMA dues and PPAC contributions help us all.

Eugene A. Batelli, DPM, Naples, FL, ebatelli2001@yahoo.com

This is a victory that we all should celebrate! Kudos to the APMA for the fine work that they do and for fighting for the privileges that we are due. I graduated CCPM in 1981 and have seen the medical training delivered by our colleges and residency programs step up again and again. You spend a lot of time one on one with a book, journal or in a lecture hall....and now we even have Internet CME. We all have pushed our way to the top and should congratulate each other. Tell the next five colleagues whom you speak with how proud you are of our profession.

Alan Sherman, DPM, CEO, PRESENT e-Learning Systems, asherman@podiatry.com

The recent decision by CMS to allow DPMs to independently perform histories and physicals is a seminal event in the history of our profession. As someone who has spent over 10 years fighting for this change, it is gratifying and well-deserved. As with all these decisions, APMA was the prime mover and this change would never have occurred without the efforts of many, many APMA members. Many APMA past and future presidents were instrumental in making this happen. I personally met with CMS officials in Baltimore and elsewhere to advocate for our position on about 10 different occasions. Numerous letters, email, and phone calls were made.

These efforts with CMS began early in the 1990s. We would have had victory in the late 1990s but the changes were held up for a variety of political reasons unrelated to the issue itself. In fact, based on language we saw, the issue would have been solved at that time. There is a component to this decision which advances the concept that podiatrists are defined as physicians. I encourage everyone to read the Federal Register decision which mentions APMA and AMA in the same paragraph. Yet again, this is a giant step forward for us all.

I want to thank all the members of the APMA Board, current and past, many APMA staff members and many other APMA members and component organizations who advocated for this change. We are the premier foot and ankle physicians and surgeons in this country and continue to prove our value to the patients we serve.

Lloyd S. Smith, DPM, Newton, MA, lloydpod@yahoo.com

RE: Post-op Nail Care (Gene Graham, DPM)
From: Multiple Respondents

Providone iodine ointment (Betadine) gives a great combination of topical antibiosis and drying, it is reasonable in cost. The recent caveat against using it in ulcers in the elderly is overstressed. I have found it works great in all wounds that are wet and you want to dry-out.
Laurence C. Rogers, DPM, Rochester, IN, larrydpm@rtcol.com

Phenol or NaOH destroy nail bed/root tissue but leave it in place. The wound will not dry up until that tissue has been liquefied and sloughed off. Silver nitrate is caustic and destroys MORE tissue. I've been using the NaOH/acetic acid regimen for years, and find that they dry up much faster than phenol/alcohol procedures. I'm surprised more practitioners are not using this.

Paul Busman, DPM, Troy, NY, BREWERPAUL@aol.com

I have used Castellani paint to great effect in those lingering, mucky, nail border phenol burn-type conditions. It seems to be a very penetrating topical antiseptic as well as a drying agent for these often macerated conditions. Maybe it’s visually overly dramatic, but it does the job.

Robert Teitelbaum, DPM, Naples, FL, Mfvandange@aol.com

We use a 1% gentian violet solution to dry post-op nail sites.

Brian Kiel, DPM, Memphis, TN, footdok4@gmail.com

RE: Using Nutrients as Drugs
From: Bob Kornfeld, DPM

I am gratified to read posts on PM News giving credit to natural therapies. Just recently, discussions about homocysteine control via B vitamin therapy as well as the discussion regarding benfotiamine and its benefits for diabetic neuropathy. While it pleases me to see some of these therapies being embraced by the profession, I would like to caution practitioners against using nutrients as drugs. One will find a much higher rate of success when all of the mechanisms of pathology are addressed. Natural therapies are protocol based and are patient specific, unlike drugs which are single agent based and condition specific. Much gets overlooked when a nutrient is used to affect relief of a symptom when it is prescribed without regard to the patient receiving it.

After studying and using natural medicines for over 20 years, I can attest to the fact that the biggest failures in holistic therapies are when they are applied in a "non-holistic" way (i.e. - diabetic neuropathy is not simply caused by a shortage of benfotiamine in the body). Functional medicine teaches a paradigm where first, we understand all of the mechanisms and causes of pathology in a given individual and then we apply protocols that assist that body in healing.

Bob Kornfeld, DPM, Lake Success, NY, Holfoot153@aol.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.

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