The Voice of Podiatrists

Serving Over 10,000 Podiatrists Daily

December 04, 2007 #3,108 Editor-Barry Block, DPM, JD

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AAPPM and Powerstep® Team Up to Establish Student Practice Management Clubs

Thanks in large measure to a $15,000 grant from Les Appel, DPM and his prefab orthotic company, Powerstep®, the American Academy of Podiatric Practice Management (AAPPM) is now working with students from the podiatric medical colleges to help fund and manage student AAPPM Practice Management Clubs.

Pictured left to right are AAPPM Scholl Chapter students Brian Damitz, First Vice President, P.J. Constantino, VP Social, Trina Monis, President, Kirsten Grau, Treasurer and Jennifer Fong, Secretary

AAPPM and Powerstep® are providing the Practice Management Clubs with a recommended governance structure and bylaws, speakers and partial sponsorship for meetings, regular conference calls for club presidents to share ideas and address management issues, membership literature, lapel pins for club members and a special section just for Practice Management Clubs member students on the AAPPM web site - www.AAPPM.org.

The Powerstep® grant also funds all of the presidents of the student AAPPM Practice Management Clubs to attend the AAPPM Midwinter Practice Management Workshop, March 6-9, 2008 in Pittsburgh, and three student winners of a practice management essay contest to make all expense paid, one week visits to AAPPM member top practices in 2008.

IL Podiatrist Charged With Medicare Fraud

A West Peoria podiatrist appeared in federal court Friday afternoon, charged with bilking Medicare out of more than $270,000 over a decade. Dr. Ernest Nwani was released on bond. The doctor sat through a brief hearing, wearing civilian clothing but in shackles.

A federal grand jury sitting in Springfield indicted Nwani, 56, on 15 counts of mail fraud and one count of health care fraud. If convicted, he faces up to 20 years on each of the mail fraud charges and up to five years on the healthcare fraud charge. The time frame covered by the indictment begins in 1997 and ends this year. The 15 counts of mail fraud detail specific instances where he allegedly committed fraud.

In January, a company hired by the U.S. Department of Health and Human Services to combat fraud noted some irregular billing practices by the doctor, according to recently unsealed court records. An investigation revealed that patients told agents they did not have procedures or even surgeries for which Nwani had billed Medicare. Medicare paid $171,760 for the surgeries and $100,180 for the toenail removals. Thirty-three patients were interviewed and of those, "none of the surgeries billed for these 33 patients and for which Medicare paid, could be verified as having been performed."

Source: Andy Kravetz, Peoria Journal Star [12/1/07]

Medicare and Medicaid Spending Growth Unsustainable: CBO

Medicare and Medicaid spending would -- if unaddressed -- continue to grow faster than the economy over the next 75 years, but don't blame it all on the baby boomers. Instead, look at the way physicians and hospitals are paid and how technology and new treatments drive costs, according to a first-ever Congressional Budget Office analysis of long-term health spending.

"The main message of this study is that, without changes in federal law, federal spending on Medicare and Medicaid is on a path that cannot be sustained," stated the report, released Nov. 13.

In 2030, federal Medicare and Medicaid spending will consume about 8% of the gross domestic product, a measure of the total value of goods and services produced in the U.S., the report predicts. Of that, 0.8 percentage points would be from the effect of aging. By 2082, federal Medicare and Medicaid spending would eat up 18.5% of the gross domestic product, with the effect of aging representing just 1.7 percentage points.

Source: Doug Trapp, AM News [12/3/07]

Query: Board Certification in Primary Care Podiatry

What is the best board certification for primary care podiatry and what is their weblink? What is the best study guide for a primary care board?

Juliet Burk, DPM, Tahlequah, OK

RE: Medical Marijuana (Michael Zapf, DPM)
From: Jon Purdy, DPM, David E. Gurvis, DPM

Let me put forth this scenario. A patient walks into my office and would like surgery for an ingrown nail. The patient says; “The best thing for my pain is Mepergan.” Now, what do you think I would say? Of course I don’t feel this drug is standard or appropriate for this type procedure and I think the same is true for any other type elective surgery in the case of marijuana.

Medical marijuana, of which I am a proponent, may be necessary as an antiemetic, in the case of glaucoma, or as an ancillary drug for spasticity. It’s certainly not a drug used for routine pain management. The answer to this question is very simple. It makes no difference what a person looks like, always base your medical judgment on what your training and experience tells you. And, by all means, do not let a patient talk you into prescribing treatments outside your medical knowledge or intuition. My intuition tells me Dr. Zapf already knows the answer to his question.

Jon Purdy, DPM, New Iberia, LA, jpurdy@mindspring.com

I am not a California resident, so I have no first hand knowledge of the laws there, but it was my understanding the medical marijuana law was intended for tings such as chronic situations i.e., those associated with terminal illnesses, pos-chemotherapy nausea & vomiting, and so on. I somehow think you would be remiss to prescribe this medication for an acute post-operative course of pain management.

In fact, you would probably be putting your license in jeopardy by even trying to prescribe this, not to mention I feel your patient may be scamming you for a few legal hits. I would refuse to prescribe marijuana and inform the patient that acute pain is not the proper indication for this drug.

David E. Gurvis, DPM, Avon, IN, deg1@comcast.net

RE: Digital Imaging (Josh Prero, DPM)
From: Kathy Riffe, DPM, David J. Freedman, DPM

My office has been using a digital imaging system for about a year. I use the Reina - 20/20 Extreme1012. On the whole. I am very happy with the system and my return on investment. There have been some "speed bumps" along the way, but the company has always been quick to resolve any problems. There was no problem when the company transitioned from Reina to 20/20. Support is available at the time of your call and you do not have to wait for a callback. I have broadband Internet into my unit and the wireless carries it to my two laptops, they come into the system and fix software problems quickly and talk you through any minor problems at anytime. My only regret is I did not wait a bit as the new direct image system, which eliminates the scanner, looks like the way to go. I may convert in the near future.

Kathy Riffe, DPM, Trenton, TN KRiffeDPM@GibsonCountyPodiatry.com

I researched this issue five years ago and ultimately purchased the ScanX from Stone Podiatry 4 years ago and have not looked back. Digital X-rays have integrated well with my Medinotes EHR and I purchased additionally from Tigerview their module that allows me to bring any other images into the patient's file, including Ultrasound images. Also, I have purchased annually the software maintenance from Tigerview which is definitely worthwhile.

I had a mechanical issue one day with my ScanX and Stone Podiatry responded favorably such that my unit was fixed by the next business day. When purchasing any electronic equipment such as digital x-ray which you will depend on, requires a company that is committed to your practice and I can state that Stone has been there for my practice.
Being part of a purchasing group here in the DC area, we put Reina (20/20), ScanX and Naomi head to head in a competitive face off side by side one evening this past Spring. Although some of our group purchased the 20/20-Reina system, more purchased and have been happier with the ScanX. Based on this side-by-side demonstration, the Naomi system (purchased by 20/20) was not at all something we would recommend.

David J. Freedman, DPM, Silver Spring, MD, DJFREEDMAN@aol.com

RE: Office Dictation Systems (Syed Ahmed DPM)
From: Mark K. Johnson DPM, David Gurvis, DPM

I have been using Dragon (currently 9.1 Professional) for 5 years with success for office notes; no experience with the digital recorder source. Shop around on cost. Use a "good" mike (handheld/headset/lapel- do your homework!) and with patience the results are good. I'm transitioning to the PodMed EMR for more point-and-click at this time.

Mark K. Johnson DPM, White Plains, MO, DDR004@centurytel.net

I also use Dragon Naturally Speaking and wanted to add to the previous comments. One of the more powerful features of this type of voice recognition program is the use of macros. For example, if I say “Lodine macro: The system will type: Etodolac 500 mg, #60, I tablet PO BID with food. No refills.

For Marcaine, it types Marcaine 0.5%, I say past medical history and it types PMH: …and so on

I have macro’s ranging from as simple as the above, up to some that will produce a near complete note with a few blanks to be filled in for the variable aspects of a note. How complex you can be depends only on your imagination.

David Gurvis, DPM, Avon, IN, deg1@comcast.net

PART-TIME PRACTICE FOR SALE - FLUSHING, NY

40 year old part time practice for sale. Priced for quick sale. Please contact me at footdoc60@gmail.com. Serious inquires only please

PRACTICE FOR SALE - SOUTH CAROLINA

Upstate SC practice of 25 years. Retiring. High Volume. 65% routine foot care, 35% surgery. Several nursing homes. Plenty of opportunity for growth. Grosses over $450,000.00 yearly. Hospital and Surgery Center privileges. Financials available upon request. Serious inquiries only! Beautiful area. Contact: Carolinafootdoctor@yahoo.com

ASSOCIATE POSITION - SOUTHERN ILLINOIS

Tired of Nursing Home Care? Ready to join a well-established practice with 2 Board Certified Foot Surgeons? If you are a personable, ethical and responsible, hard-working podiatrist with interest in conservative care, including sports medicine, this may be the position for you. Competitive salaries, 401-K, health insurance, paid vacation and more. Please forward CV with references to nrussell@neondsl.com

ISO SOUTH JERSEY AREA OPPORTUNITIES

ABPS Certified with 20 years of experience looking to relocate to South Jersey/South Central Jersey. I am looking for a practice that appreciates and understands the value of experience and integrity. I am willing to discuss ALL options, including employment, partnerships, buy-ins, practice purchases, etc. All info will be kept confidential. E-mail panel32@comcast.net

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City . Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

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