The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

December 05, 2011 #4,323 Publisher-Barry Block, DPM, JD

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MD Podiatrist Uses Moore Brace to Help Prevent Falls in Seniors

Most people don't think of falling as something deadly, but for seniors it's a common cause. "Several studies have been done on falls and out of all the injury-related deaths to seniors, half of them are due to falls," says Dr. Dan Michaels, a podiatrist at the Reconstructive Foot and Ankle Institute. For Mildred Reese, it was something she feared every day after never fully recovering from her knee surgery. "I used to walk around the house doing what I had to do but I always had to hold on to the railing to go upstairs," says Reese. 

Dr. Dan Michaels

However, falling is one less worry on her mind now. "We take a fiberglass mold of the patients foot, ankle, and lower leg to capture the exact contour, and that produces a device that fits perfectly," says Dr. Michaels. A Moore leg brace specifically designed to help prevent falls offered Reese renewed mobility.

Source: Jessica Reyes, WHAG-TV (Hagerstown, MD)

CMS Develops New EHR Guide for Docs

The CMS has developed what it describes as a "comprehensive tool" to help guide physicians and other eligible professionals through all phases of the Medicare electronic health-record incentive payment program. The Web-based interactive resource, called "An Introduction to the Medicare EHR Incentive Program for Eligible Professionals" includes chapters on program basics, eligibility and registration. It also has a description of all of the Stage 1 meaningful-use criteria and advises practitioners on how to choose the optional measures they will use as part of the attestation phase of the program.

Physicians and other eligible professionals have until Dec. 31 to complete 90 consecutive days of meaningful use of a certified EHR, and until Feb. 28, 2012, to report their data and attest that they have met the criteria to be deemed meaningful users in the Medicare portion of the program.

Source: Joseph Conn, Modern Physician [12/1/11]

Medicare Now Pays for Intensive Obesity Counseling

CMS, which first floated the obesity coverage plan last September, said it expects more than 30% of the Medicare population to qualify for the new benefit. Beneficiaries with body mass index values of 30 or more can receive weekly in-person intensive behavioral therapy visits for one month, followed by visits every two weeks for an additional five months, fully paid by Medicare with no co-payment.

Additional monthly sessions will be covered for up to six months afterward if the beneficiary has lost at least 6.6 pounds (3 kg) during the first six months. The sessions should also include dietary counseling, the agency said. Medicare patients who fail to lose the 6.6 pounds in six months may be re-evaluated at the one-year mark after the initial screening. Those showing "readiness to change" and a BMI value still at 30 or more may receive another round of counseling paid by Medicare.

Source: Obesity (Issue 602) via Diabetes in Control [12/2/11]

TX Podiatrist Sentenced For Tampering With a Government Record

Dr. Donald E. Robinson, a podiatrist described by law officers as a sovereign citizen extremist, was sentenced this week to 14 days in jail at one of Kendall County's quickest trials in memory. Robinson, 67, said from jail Thursday that he has been wrongly painted as an extremist for merely asserting his rights. “I don't belong to the Republic of Texas, and I'm not in any sovereign group,” he said. Representing himself in the two-hour proceeding, Robinson called no witnesses and didn't dispute writing on an indictment issued against him in a separate case, which prosecutors claimed constituted tampering with a government record.

He was arrested here in June after finishing four months of federal incarceration when he was charged with filing false income tax returns in 2003, 2004, 2005 and 2006. Representing himself in that case, he said he merely followed the advice of lawyers and accountants in a bid to avoid taxes, not illegally evade them.

Source: Zeke MacCormack, San Antonio Express-News [12/2/11]

Query: Hair Loss and Lamisil

I am curious if anyone has seen a side-effect of extreme hair loss after use of Lamisil? My patient is a healthy 52 year old female on no other medications. She has been on Lamisil for a little more than six weeks and presented for follow-up today with hair loss. Her hair is breaking off in clumps, not at the scalp. She has long, thick, dark hair. I advised her to immediately stop taking the medication.

Brian W. Fullem, DPM, Tampa, FL

Query: Return Shipping Charges for Shoes

Who pays the return shipping charges for shoes that are ordered under the Medicare Therapeutic Shoe Program if the shoes do not fit? What if the patient just does not like the shoes? Is the policy different for patients with private pay insurance?

Alan Berman, DPM, Carmel, NY

RE: Terbinafine Overdose (Eric Edelman, DPM)
From: Kenneth Meisler, DPM
 
I have been giving patients a one month Rx. for Lamisil with NO refills after I check their baseline CBC with diff and liver function tests. At the same time, they get slips for 3 additional blood test dates (3 weeks after starting Lamisil, 7 weeks after starting, and after they finish the three months of Lamisil). I do not give a second month's Rx. for Lamisil until after I have checked the blood work done after 3 weeks on Lamisil.  I do the same for the third month by checking the 7-week blood test.

I worry that if you give a patient an Rx. for 3 months of Lamisil, they will just take the entire 3 months without going for the blood work in the middle. I have had it happen. I assume you wrote on the Rx "One tablet, twice a day." The patient has to read the bottle. You could have avoided some of it if you had only given one month's supply. Then the patient could have at most taken 10 days of two pills a day.

It is a little extra work to have to write another Rx each month or e-prescribe it, but it's worth avoiding someone developing a liver problem you could have avoided.

Kenneth Meisler, DPM, NY, NY, kenmeisler@gmail.com

RE: Life-Long Maintenance Regimen for Onychomycosis (Evan Meltzer, DPM)
From: Barbara Hirsch, DPM

I am interested in knowing if this use of Lysol spray has actually been proven to disinfect footgear in regard to fungal organisms and wart viruses? As far as I know and understand, Lysol only disinfects on non-porous surfaces. If it is true, then it would make sense that one would need to do this daily, or the shoes would be re-infecting the nails and feet during the Lamisil treatment.

Barbara Hirsch, DPM, Chevy Chase, MD, davis44@gmail.com

RE: Insurance Verification
From: William Tenney, DPM

I believe that one of the best practice management tools one can have is the ability to know exactly what benefits and limitations a patient’s insurance provides prior to treatment. How best to make this happen is the question? As one of our colleagues has suggested, yes indeed, it is possible to do everything “in- house.”

In fact, this was the focus of a discussion that a group of us pods had at one for our jam session dinners. One option discussed was for each of us to utilize an already employed staff member to make the calls to insurance companies or search the appropriate websites for the needed, up-to-date information. This information would, of course, include unmet deductibles, co-pays, co-insurance, coverage limitations, and DME coverage.

We all agreed that...

Editor's note: Dr. Tenney's extended-length letter can be read here.

RE: Who Gets to Cast (Robert Scott Steinberg, DPM)
From: Barry Mullen, DPM

Dr. Steinberg is entitled to his opinion, however off-base it is. My hope is that my colleagues appreciate the difference between foot positioning ability versus the performance of a thorough biomechanical examination, and what role that actually plays in the casting process. Unfortunately, Dr. Steinberg doesn't! These are two completely different issues.

Nowhere in my post did I intimate that my staff performs my biomechanical examinations. They don't because they don't have the training; plus, it would be too time-consuming to teach them the entire podiatric biomechanical curriculum taught in our schools. They also don't perform my gait analyses either, which frankly, is MUCH more important than...

Editor's note: Dr. Mullen's extended-length letter can be read here.

RE: Why This Country is Going Broke

A patient presents to my office with a complaint of painful flatfeet. An examination and x-rays confirm pronation syndrome, moderate, decreased calcaneal inclination angle, increased talor declination angle; external appearance of the foot is essentially normal with a slight decrease in the medial longitudinal arch. Palpation of the medial tuberosity of the navicular shows no sign of discomfort. There is no reduction in activity, and the patient is able to function normally. The patient is fitted for a functional balanced inlay.

Two months later, I received a letter from the Illinois Department Of Human Services, Disability Determination. This patient is applying for permanent disability, lifelong disability payments, and will be eligible for Medicare in two years as a disabled person. They're doing so because several of the cousins and relations of the family have been accepted under similar circumstances. As if our system of social welfare isn't already overtaxed, this patient is eight years old.
 
Dale M Smith, DPM, Chicago, IL

RESEARCH AND SURGICAL FELLOWSHIP PROGRAM: BOSTON UNIVERSITY MEDICAL CENTER
 
Join our team and become an expert in limb preservation, tissue repair, and wound healing. This is a unique accredited multidiscipline fellowship program at a major teaching hospital. Fellows will be expected to significantly contribute to clinical research, surgical procedures, teaching and innovation with a world renowned expert team. Requirements: Completion of a two or three-year surgical residency; ACLS certified. Candidate must possess a commitment to an academic career in podiatric medicine and surgery. Program begins 7/1/12. Submit a CV and letter of interest to: Erin Springhetti erin.springhetti@bmc.org and the Director Dr. Vickie Driver,Vickie.driver@bmc.org. If questions call 617-414 6821.

EQUIPMENT FOR SALE - SUPERPULSE 45 WATT PEAK POWER LASER (LUMIX2)

Superpulse 45 watt peak power Laser (lumix2) used once or twice. This is a real superpulse 910nw up to 100,000 HZ. Great Laser Used in the super bowl by the Green Bay Packer Why am I selling? I have too many lasers in my office now ( six) This is a great laser for plantar fasciitis. Achilles tendonitis. Lightweight portable. easy to use, fully programmable Sold to first person under $$12,000 You will NEVER get a laser like this at this price. Enjoy. it I just have too many lasers. David Zuckerman DPM  footcare@comcast.net

EQUIPMENT FOR SALE - CLASS FOUR LASER- USED K-LASERS

I have used K-laser for sale. Still in Warranty. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargeable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

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 - TEXAS

We are looking for a reliable and enterprising podiatrist who will assist in growing our practice. People skills, clinical/surgical skills and good behavior will be a plus also Texas license required. forward your CV to "divinefootcarecenter@yahoo.com or you can also contact us at 972-790-2800, fax number 972-790-2803. 

PART TIME PODIATRIST NEEDED- LOS ANGELES, CALIFORNIA
 
Busy podiatrist looking for assistance with treating home-bound patients. Flexible hours, independence, and great compensation. If interested, email CV to homefootcare@hotmail.com

ASSOCIATE POSITION - SOUTHEAST GEORGIA - SAVANNAH

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking associate or new residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

ASSOCIATE POSITION - DAYTON, OH

Join a well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and to Ohiodoctors@aol.com

ASSOCIATE POSITION - EAST TENNESSEE

30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. $160,000 base salary with bonus incentives and benefits. Post-residency experience a plus. Please send resume to ddavidphawk@yahoo.com

ASSOCIATE POSITION - TEXAS

Well established, expanding podiatric medical and surgical practice with multiple locations Northeast of Dallas, Texas. Modern offices with EHR, digital radiography, Padnet vascular studies and laser. We offer a competitive salary and benefits package for a motivated, ethical, personable and well trained PSR/36 or board equivalent. This individual will also assist managing the residency program. Send resume (CV)to northtexaspodiatry@yahoo.com along with a letter of intent

ASSOCIATE POSITION - MARYLAND

Multi-office group seeks highly trained surgical associate to join us. Prefer person with frame and trauma experience. Our practice is state-of-the-art and has all modalities: EMR, PadNnet, on-site billing, diagnostic US, PRP, digital x-ray, etc. Excellent salary, bonus structure and benefits with partnership available. Please forward CV and letter of intent to docsbnb@aol.com

ASSOCIATE POSITION - TAMPA BAY AREA

Excellent opportunity to join a well-established multi-office group practice in the beautiful Tampa Bay area starting July 1, 2012. We are seeking a highly motivated, ethical and personable physician with a Florida license. Competitive salary, excellent benefits and partnership track. Please email or fax CV to  thesykeshome@aol.com (813) 254-8262

ASSOCIATE POSITION - MARYLAND

Looking for 3rd associate. Must be personable, well trained and highly motivated. Great locations in Southern Maryland, including an Ambulatory Surgical Center. We currently have EHR, digital radiography, dispensing center and PADNet. Looking for immediate hire! Please send CV to: myfeetfeet@aol.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 24-36 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 Diane Coulter, Office Manager.

ASSOCIATE POSITION – NORTHERN CALIFORNIA / BAY AREA

We’re looking for someone entrepreneurial who can help grow our practice. Must have great people skills, clinical/surgical skills, and positive demeanor. California license required. Send your CV and cover letter to cvpodiatrist@gmail.com

PODIATRY OFFICE TO SHARE - SEATTLE, WASHINGTON

Fully equipped podiatry office in North Gate area of Seattle. Office located in medical professional building near I-5. Office has 3 treatment rooms, 3 physical therapy rooms, direct digital x-ray, PAD- net, NCV testing equipment, physical therapy equipment. Please contact us: website Tel. 425-643-8901 isbinc2006@gmail.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 516 476-1815 PODO2345@AOL.COM

PRACTICE FOR SALE – NANAIMO, BRITISH COLUMBIA, CANADA

Have you ever dreamed of owning a practice where...you can see 0-50 patients daily * average 100 new patients monthly * have zero accounts receivable * gross $480K per year * live in a beautiful community with skiing, hiking, fishing, and boating on your doorstep. This could be yours! If interested contact pistone@telus.net or call 250-754-4192.

PM News Classified Ads Reach over 13,500 DPM's 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 13,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 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.

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