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PM News

The Voice of Podiatrists

Serving Over 20,074 Subscribers Daily


November 20, 2020 #6,815 Publisher-Barry Block, DPM, JD

A partner of Podiatry Management https://podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2020- No part of PM News can be reproduced without the
written permission of Barry Block

PM NEWS QUICK POLL

Last Chance to Vote

Quick Poll


Since the onset of COVID-19 are you recommending more or less home remedies to patients?
 

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PODIATRISTS AND DIABETES
Telemedicine is as Effective as Office Visits for DFU Infections: CA Podiatrist
 
According to David Armstrong, DPM, PhD, “Half of all people with diabetes will develop diabetic neuropathy, which causes numbness as a result of dying nerves, usually in the feet. With this condition, people may develop a foot sore without knowing it. If the wound becomes infected, this may result in the foot having to be amputated. In fact, there is an amputation around the world every 20 seconds due to foot ulcers caused by diabetes.
 
Dr. David Armstrong
 
“During the pandemic, we are urging patients to seek regular checkups because foot sores can creep up silently and quickly. A recent study showed that telemedicine is just as effective as office visits in stopping diabetes-caused foot infections. In fact, telemedicine has worked so well for Keck Medicine that we have actually seen a downturn in hospitalizations for foot ulcers during the pandemic,” says Dr. Armstrong.
 
Source: Newswise.com [11/18/20]
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PODIATRIC SUPER GROUPS IN THE NEWS
IL Podiatrist Joins Ankle & Foot Centers of America 
 
Michael Ferrari, DPM has joined Ankle & Foot Centers of America – First Step Foot Care Division Chicago, IL.  After graduating from the University of Illinois at Urbana-Champaign, he spent time with First Step Foot Care as a medical assistant, learning more about the field of podiatric medicine and surgery, and it soon became his passion.   
 
Dr. Michael Ferrari
 
Dr. Ferrari earned his Doctor of Podiatric Medicine from the Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science. He then completed his residency training in Chicago at Rush University Medical Center, Department of Orthopedics. Ferrari is affiliated with Advocate Lutheran General Hospital, Advocate Good Shepherd Hospital, and Northwest Community Hospital.
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PODIATRISTS AND FOOTWEAR
Clunky Orthotics Can Cause Heel Blisters: NY Podiatrist 
 
Are you tired of your shoes giving you pain, blisters, and discomfort? According to Bruce Pinker, DPM, "Many thick and chunky old-school orthotics will sit very high inside of shoes. The foot is then not sitting flush into where it should be. The heel bone rubs against the wrong part of the lining which often causes blistering. Have orthotics assessed by a modern podiatrist to get the right fit."
 
Dr. Bruce Pinker
 
"Since most of the globe wears footwear, it is important for shoes to fit comfortably. Many individuals wear shoes all day long, and, in some cases, shoes can rub the back of the ankle, leading to significant discomfort. This can apply to women, as well as men," says Dr. Pinker.
 
Source: UP Journey [11/17/20]
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PODIATRIC ECONOMICS
Podiatrists Rank #2 in 25 Hot Jobs That Pay More Than $100,000 a Year List
 
Choosing a career can be an overwhelming decision thanks to the vast array of options available to you. So, aiming high and setting a six-figure salary goal could be a smart move — it narrows down your choices and might even help you secure a bright financial future. To find jobs where you can earn more than $100,000 a year, GOBankingRates analyzed occupations from the Bureau of Labor Statistics that paid a median salary between $100,000-$150,000 in 2018 (the most up-to-date BLS data). 
 
Podiatrists rank #2 on Hot Jobs List
 
To diagnose and treat complications with the human foot, you’ll need to earn a Doctor of Podiatric Medicine (DPM) degree and complete a three-year residency program to become licensed. However, investing in your education will certainly pay dividends in your career — especially if you work in the Charlotte, Concord, and Gastonia metropolitan area in North Carolina. Podiatrists in that region take home a staggering $256,950 per year, which is over $100,000 more than the U.S. average. Overall, these doctors can expect an increase of 1,100 positions in their field between 2016-26 — a growth rate of 10%.
 
Source: Daria Uhlig, MSN Money [11/16/30]
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PODIATRIC PRODUCTS AND SERVICES IN THE NEWS
Paragon 28 Launches Silverback™ Posterior Plating System
 
Paragon 28  has announced another addition to its hindfoot fusion portfolio in 2020 with the launch of the Silverback™ Posterior Plating System. The Silverback™ Ankle Fusion Plating System now offers three distinct approaches (anterior, lateral, or posterior). The Posterior Plating System includes 16 low profile anatomically contoured plates to address soft tissue closure and accommodate varied patient anatomies and deformities.
 
Dr. Byron Hutchinson
 
Paragon 28® credits significant contributions that Paul Fortin, MD, Todd Irwin, MD, Mark Myerson, MD, and Byron Hutchinson, DPM made in the design of this system.
 
Source: The Daily Sentinel [11/17/20]
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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.
 
Today's Featured Article
 
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PRACTICE MANAGEMENT TIP OF THE DAY
5 Ways to Improve Patient Experience – Part 3
 
The better you can be for your patients, the more patients you will have. Here we present a quick and simple guide as to how to improve the experience of your patients and make them feel as comfortable as possible. 
 
3. Make Communication with The Practice Simple & Easy
  • If someone has to get in contact, it's important to be accessible and easy to deal with when they do.
  • You could do worse than considering a medical answering service so that someone may speak to a real human being at any time of day or night. 
  • You could complement this system by having a facility to communicate via email, live text, or SMS, as many individuals may have anxiety about phone conversations and you wouldn't want to exclude them from medical treatment.
Source: John Moran, Logan Lutton, Physicians Practice [11/2/20] 
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CODINGLINE CORNER
Query: Diagnostic Nerve Block
 
I have a patient with sural nerve neuritis. I wish to perform a diagnostic block on this patient with or without steroids. What CPT code would you recommend I use? CPT 64450? CPT 64455? Would the code be the same if it was another nerve (saphenous nerve or common fibular nerve)?
 
Jeffrey Klein, DPM, Warren, MI
 
Response: If you know that the patient has sural nerve neuritis, I don’t think that it would be appropriate to describe the injection to be administered into the sural nerve as being diagnostic. I believe that it would be best to describe the injection as therapeutic. Nevertheless, CPT code 64455 would not be appropriate to bill for this encounter. It is defined as: Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (e.g. Morton’s neuroma). The appropriate CPT code to bill is 64450 which is defined as: Injection(s) anesthetic agent(s) and/or steroid; other peripheral nerve or branch.
 
With respect to the injection of other nerves with either local anesthetic and/or steroid, unless the nerve is specifically identified with a CPT code in the CPT Manual, for our purposes, CPT code 64450 would be the CPT code of choice.
 
Michael G. Warshaw, DPM, CPC, Lady Lake, FL
 
For information on Codingline subscriptions, click here
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RESPONSES/COMMENTS (CLINICAL) - PART 1A
From: Jordan DeHaven, DPM, Todd Lamster, DPM
 
I would consider a nerve entrapment or Baxter's neuritis. Often these are missed on MRI. I would revisit the MRI to assess for fat replacement to the abductor digiti minimi. I would also consider giving him a diagnostic injection at the branch of the lateral plantar nerve. If you have positive findings with MRI and/or diagnostic injection, then a Baxter's nerve release would be warranted.
 
Jordan DeHaven, DPM, Bristol, RI
 
I would look at nerve compression as the etiology of his pain. It is likely he traumatized Baxter's nerve with his initial injury, and is now suffering with a localized compression neuropathy. Try a nerve block of the tarsal tunnel or just directly underneath his heel and see how he responds and for how long. He may need a release of the distal tarsal tunnel and the abductor muscle/fascia. If the plantar fascia is significantly thickened or scarred on US or MRI, I would consider releasing that as well.
 
Todd Lamster, DPM, Scottsdale, AZ

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RESPONSES/COMMENTS (CLINICAL) - PART 1B
From: Don Steinfeld, DPM, Martin M Pressman, DPM
 
To me, an autologous transplant of fat under the heel is an exercise in futility. I recall, years ago, a new idea on the landscape. Collagen was injected to treat pressure spots and keratomas. We quickly learned that this material was pressed away with only a few steps. The only time it was of any use was interdigitally. The fat beneath the heel is held in place in honeycomb septae. You cannot replicate this situation. It sounds to me like there may be a nerve issue. The click may be a nerve which is now problematic due to the lack of fat. Consider that and take a fresh look.
 
Don Steinfeld, DPM, Farmingdale NJ
 
This is an interesting and difficult case. If you think this is a fat pad atrophy case and not the fascia and you can palpate the plantar tuberosity through the fat pad, you might take a lateral non-weight-bearing film to measure the fat pad thickness as compared to the contralateral side. If indeed there is atrophy, then a folded GraftJacket graft with plantar calcaneal condylectomy might be considered. This is from personal experience and not from EBM. I have done this only in select cases when I am sure the fat pad is damaged.
 
Martin M Pressman, DPM, Milford, CT

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RESPONSES/COMMENTS (CLINICAL) - PART 1C
From: Howard Dananberg, DPM
 
Considering that there is only minimal pain despite extensive palpation, but pain occurs with standing and/or walking, a herniated lumbar disk should be ruled out, particularly in light of the type of ski jump injury he incurred. A straight leg raise exam may reproduce symptoms. The other two problems may be 1) trigger points in the soleus which can cause referred pain to the inferior heel but would not exhibit symptoms on localized exam, and 2) a cuboid fixation, which can cause pain in the abductor hallucis muscle, often confused with plantar fascia pain.
 
In this situation, careful palpation shows limited to no pain with plantar fascia palpation, but when the abductor is palpated above the superior aspect of the plantar fascia, pain is acute. Manipulation of the cuboid creates spontaneous relief. I think that the disk herniation, considering the history of injury, is the most likely culprit.  
 
Howard Dananberg, DPM, Stowe, VT
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RESPONSES/COMMENTS (NON-CLINICAL)
From: James Stavosky, DPM, Nicole DeLauro, DPM
 
The ABPM Maintenance of Certification (MOC) is an ongoing learning process that is a required and critical component of maintaining ABPM board certification. The MOC is intended to strengthen a Diplomate’s practice and ultimately improve patient safety and clinical outcomes. This can be instilled by ensuring current licensing, maintaining continuing education credits on an annual basis, and demonstrating cognitive expertise in the specialty of podiatric medicine. There is data which correlates MOC with improved patient outcomes, higher physician compensation, and fewer disciplinary actions.
 
ABPM MOC pathways are on par with those of our osteopathic and allopathic medicine colleagues and their maintenance of certification processes. Time-limited Diplomates who were certified prior to 2011, who have not already enrolled into the MOC process, must re-credential and take a competency assessment exam prior to enrolling into the MOC process.
 
More information regarding the importance, value, and benefits of the MOC program, can be seen in this recently published article on the Board’s website. For any additional questions related to the MOC, please contact ABPM Headquarters.
 
James Stavosky, DPM, ABPM Executive Director, and Nicole DeLauro, DPM, ABPM MOC, chairperson.
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RESPONSES/COMMENTS (YOU CAN'T MAKR THESE THINGS UP)
From: Larry Aronberg, DPM
 
If my memory serves, there was an odd shoe exchange based in Arizona about 30 years ago, the National Odd Shoe Exchange. I believe if you Google it, this non-profit exchange still exists.
 
Larry Aronberg, DPM, Lake Worth, FL
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YOU CAN'T MAKE THESE THINGS UP

RE: Outrageous Shoes of the the Day

Pixelated shoes. Now we've seen everything!

Source: Kunihiko Morinaga via Virtual Shoe Museum

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MEETING NOTICES

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You can Earn up to 5Continuing Education Contact Hours (CECH) Online

Earn 15 CECH only $249 (less than $17 per CECH)

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All required credits can be taken online for AL, AK, AR, CA, CO, DE, HI, IN, KS, LA, MA, ME, MI, MI, MS, NV, NJ, NM, ND, OH, OR, RI, SC, SD, UT, VA, VT, WV, and WI

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Choose any or ALL from 25+ CECH Category-1 articles posted

NY podiatrists whose licenses expire from 3/2/20-5/1/21 may take all credits online


CLASSIFIED ADS - ASSOCIATE POSITIONS AND FELLOWSHIPS
SEEKING CLINICAL INSTRUCTOR - NYCPM, DEPARTMENT OF MEDICINE 

Looking for a motivated full-time podiatrist with excellent clinical and academic skills. Responsibilities: Providing high quality patient care, teaching students and residents in the diagnoses and treatments of foot and ankle diseases at the NY College of Podiatric Medicine as well as NYC Health and Hospital facilities. Qualifications: DPM Degree from an accredited College of Podiatric Medicine, NY State License. Board Certified/Board Eligible. Please send your CV to Mr. Joel Sturm, COO, New York College of Podiatric Medicine, JSTURM@NYCPM.EDU

PODIATRIST POSITION – F/T IN OCALA, FL TERRITORY AND P/T IN VARIOUS FL LOCATIONS 
 
Join a podiatric team whose work positively impacts the lives of seniors every day! KG Health Partners, the largest podiatric practice in Florida, is seeking full and part-time podiatrists who will provide mobile-based foot, ankle, and lower leg care to residents living in long-term facilities in the Orlando/Daytona Florida territory. Achieve work-life balance with a Monday through Friday schedule, competitive wages, malpractice insurance, and exceptional benefits for full-time employees (health, paid time off, 401K retirement plan with company match). You must maintain active Medicare and Florida licenses. Email CV to kgadmin@kghealthpartners.com
 
ASSOCIATE POSITION - SOUTHWEST, FL 
 
Immediate position for busy practice in Sunny Southwest, FL. ABFAS RRA BC/BQ. EMR, E x-rays, US, DME. Base salary + bonus w, PTO, 401K, fees, health benefits. Also 1 ACFAS credentialed fellowship avail, must be BQ ACFAS by start of program 8/2021: DrLam@NaplesPodiatrist.com
 
POSITION AVAILABLE - SYRACUSE, NY 
 
Great opportunity to join a growing podiatric medicine and surgical team in central New York.  Fast paced, fun environment with a variety of foot pathologies. You will meet your surgical case requirements for boards within the first year. For more information please email: docryanlee@gmail.com
 
ASSOCIATE POSITION – KENTUCKY 
 
Associate position available for well-trained, compassionate physician for busy, established office in Central Kentucky. Wide range of services to be offered with ancillary services onsite. Enormous potential for growth. Generous salary with incentive/full benefits and partnership opportunity. Email CV and cover letter to: Kyfootdr@gmail.com
 
ASSOCIATE POSITION – HOUSTON, TX 
 
Busy, growing, state of the art surgical, sports medicine office based group practice in Houston, TX currently looking for a full-time associate to start 8/1/21. Must be BQ/BE Competitive six-figure salary, generous bonus structure, health insurance (including vision & dental), paid vacation time off, paid malpractice insurance and CME time off. Opportunity to invest in surgery center and PT clinic. If interested, please submit your CV to mvargas@thefootpros.com
 
ASSOCIATE POSITION – PORTLAND SUBURB, OR
 
Busy, growing, group practice in Portland, OR currently looking for a full-time Associate/Graduate. Must be ABPM BQ/BE Competitive six-figure salary, paid malpractice insurance and CME, bonus, health insurance, paid vacation time off. Please submit your CV with references to: drwring@gmail.com
 
ASSOCIATE POSITION - SOUTHEAST PA 
 
Looking to hire summer 2021. We are a free-standing large office with surgery center on site searching for new surgeon to join our high volume practice. Located in a thriving, affluent community with growing patient base. Partnership opportunity for an individual where significant surgical productivity exists in one's own office. Email inquiries/CV to ascpractice018@gmail.com
 
ASSOCIATE POSITION - ST PETERSBURG/CLEARWATER, FL
 
Rapidly growing two location practice looking for a full-time associate. General podiatry, wound care, sports medicine, DME, surgery, inpatient. Competitive salary, malpractice, paid time off, CME included. Applicant must be highly personable, caring, and self-motivated. New graduate or experienced provider. Submit letter of interest and CV to precisionfootandankleFL@gmail.com.
 
FULL TIME PODIATRIST- NORTHERN NEW JERSEY

We are a fast-growing podiatry practice in North Jersey with multiple locations and Doctors.  We are currently looking for a full-time motivated and caring Doctor to join our busy practice. Some benefits include: competitive six-figure salary, generous bonus structure, health insurance (including vision & dental), paid vacation time off, paid malpractice insurance and CME time off. Great prospects for experienced Doctors as well as new Associates. This is an excellent opportunity to expand your Podiatric medical and surgical experience in an office-based practice! If interested, please submit your CV to DrSamofal@PodiatryCenterNJ.com

ASSOCIATE POSITION - PODIATRY GROUP IN SAN BERNARDINO/ ORANGE /LOS ANGELES COUNTIES 

Position starting august 2021. Must be well trained in limb preservation, trauma and reconstructive foot and ankle surgery. Send CV to podiatricri@yahoo.com.

PM NEWS CLASSIFIED  ADS REACH OVER 19,000 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 19,000 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
CLASSIFIED ADS - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE
PRACTICE FOR SALE - WHITE PLAINS, NY 
 
 This established practice has been operating for more than 25 years in key market location. Full range of office services and surgery. Opportunity to grow practice and have outstanding return on investment. Priced to sale. Contact: Yourpracticenow@gmail.com
 
PRACTICE FOR SALE - BOSTON, MA 
 
 High volume surgical practice.  Based on hospital campus, serves as referral center for cases.  Established relationships.  Key success factors include: outstanding interpersonal skills, well trained in all aspects of surgery, willingness to work weekends and take call. Well trained staff in place and willing to transition.  Great hands are not enough, superior interpersonal skills required. Contact: YourPracticeNow@gmail.com
 
PRACTICE FOR SALE - WESTCHESTER COUNTY, NY 
 
This well-established practice needs a new owner. Current owner seeking to retire. Busy office practice built on sports medicine and general podiatric care. Established referral sources. Priced to sell. Owner will transition.  Fully equipped. Contact: Yourpracticenow@gmail.com
 
PRACTICES FOR SALE - HUDSON VALLEY, NY
 
Long established in two Hudson Valley, NY counties. 4 employed podiatrists, experienced staff. Full hospital admitting, surgical privileges. Participation in most commercial, advantage, Medicare & Medicaid. Custom built Office #1 = 1900 sq ft 3-4 tx rms FOR SALE in deal. Office#2 = 1400 sq ft rental 3 tx rms. Contact: podiatrypracticeny@yahoo.com
 
PRACTICE FOR SALE - TUCSON, AZ 
 
Established two doctor podiatry practice, Principal retiring, other physician contractor will stay. Three-year average $1.4MM gross, $322,682 owner net in a three-and-a-half-day week and with no product sales (yet).  ~250 new patients per month. Principal will assist transition. Email peter@mcmil.com or call Peter at 860-912-0800.
 
PM NEWS CLASSIFIED  ADS REACH OVER 18,000 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 19,000 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details.
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.
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