The Voice of Podiatrists

Serving Over 10,000 Podiatrists Daily

December 08, 2007 #3,112 Editor-Barry Block, DPM, JD

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Podiatrists Meet With Sen. Clinton in IA

Following Senator Clinton’s September televised reference to podiatry, Dr. John Mattiacci worked with President Michael Goodwin of the OPEIU to arrange a meeting with Presidential candidate Hillary Clinton, during her recent campaign trip in Iowa. The Senator’s healthcare proposal lists failures of the country’s current healthcare system. Among those failures she cites the system’s refusal to pay a podiatrist for preventive diabetic treatment, while paying for surgical correction of diabetic conditions that could have been avoided.

From Left to right, Dr. Freschi, Dr. Mattiacci, Dr. Yoho, Senator Clinton, Dr. Rogers, Kate Banasiak, IPMS, Dr. Bevilacqua, Dr. Herpen

At the meeting, Dr. John Mattiacci, Dean of Temple University School of Podiatric Medicine, Dr. Robert Yoho, Dean of the Des Moines College of Podiatric Medicine and Surgery, Dr. Robert Herpen, trustee of the First National Guild. Drs. Lee Rogers, Nicholas Bevilacqua, and Scott Freschi from Iowa presented a position paper to Senator Clinton, requesting legislative additions to her American Health Choices Plan.

Dr. Rogers, Director of the Amputation Prevention Center at Broadlawns Medical Center told Sen. Clinton, “it astonishes me that an insurance company won’t cover simple preventative measures, like a $150 foot thermometer which has been shown to prevent diabetic foot ulcers and, thus, amputations.” Senator Clinton replied, “it will be covered under my plan.”

NY Podiatrist Lectures at Third International Summit of the Experts

Dr. Marc Brenner of Glendale, NY lectured last weekend on “Diabetic Foot Salvage and Limb Preservation” at the Third International Summit of the Experts in Fajardo, Puerto Rico.

(From L-R) Dr. Julio Rodriguez (vascular surgeon) and Dr. Edward B. Diethrich (thoracic and cardiovascular surgeon) of the Arizona Heart Institute, Dr. Marc Brenner and Dr. Javier Ruiz, president of the Sociedad deCirugia Vascular and Endovascular

This congress was a multidisciplinary meeting for education for health professionals who save limbs and prevent amputations.

Previously Sanctioned IA Podiatrist Sued Again For Alleged Malpractice

An IA foot doctor who was stripped of his surgery license for eight years after a patient lost a leg due to his alleged negligence now faces another claim of botched surgery from an Indianola woman who says she lost permanent function in her left foot after two surgeries. Dr. Navin Gupta, 50, an Indianola podiatrist, mishandled two surgeries in June 2005 on Alana Jo Knudson, 34, of Indianola, a lawsuit filed in Warren County District Court alleges.

The Iowa Board of Podiatry Examiners revoked Gupta's license to perform surgery in 1995 after finding him negligent in a 1991 surgery which caused the amputation of a 90-year-old woman's right leg. The board called the surgery "classic, definitional negligence in the literal sense ... in flagrant and wanton disregard of the obvious, foreseeable consequences: failure to heal, ultimately resulting in gangrene." Gupta, who was practicing in Denison at the time, was restricted from performing surgery until Oct. 1, 2003, when he was deemed to have completed a series of board requirements, said Don McCormick, spokesman for the Iowa Department of Public Health.

In 1996, Gupta was ordered to complete at least a 32-hour continuing education course on surgery before performing any podiatric surgeries and obtain certification by the American Podiatric Medical Association within two years of becoming eligible. Gupta failed the certification exam in 1999 and again in 2000.

Source: Aaron W. Jaco, Record-Herald [12/5/07]

Query: Screening Employees for Drug Abuse

I have an employee of the practice that we suspect is abusing drugs. When confronted, she denies and states that she is not feeling well. Is it legal to ask the employee to undergo a drug screen test? She has been working with the practice for 4 months, are there any legal ramifications to let her go? Any suggestions are welcome.

Name Withheld (NY)

Response: Written drug screening policies and procedures are generally permissible, but testing on an ad hoc basis without a pre–established written policy is risky. Employers should take care to document behaviors giving rise to a suspicion of substance abuse in the first instance. If there is a voluntary disclosure by the employee of substance abuse, applicable law may require providing reasonable accommodation to the employee and a drug test may be permissible. Further, legal requirements on the employer change once a suspicion of substance abuse is disclosed, including by posing a question to the employee as to substance abuse.

Generally, an employer’s inquiries should not introduce the substance abuse question and focus instead on the underlying conduct and its cause. It is not inappropriate, where the employee does not disclose any substance abuse, to indicate that a continuation of the specific conduct (absences, mistakes, sleeping on the job, etc…) could result in disciplinary action. This response is informational only and not to be relied upon as legal advice. Situations vary based on facts and qualified counsel should be consulted in each instance.

Joseph J. LaBarbera, Esq, Brooklyn, NY, jlb@NYhealthlawyers.com

Query: Broken Strap on CAM Boot

I dispensed a CAM boot to a patient in my office, L4386. The patient called, and said that the "strap was broken."

I purchased the boot from a large medical supply company, so would I send the boot back to them or to the specific manufacturer of the boot? In this situation, can I re-bill the insurance if I dispense the patient another CAM boot?

Amy Jelinek, DPM, Greensburg, IN

Response: This problem is not common. I have had straps break, and foam liners tear or fall apart during laundering. The best thing to do is to call the manufacturer, explain the situation, and see how they wish to resolve this. In the past, I have resolved these minor manufacturing defects in the following manner:

If it is a case where the strap is easily removable, then simply swap another strap from another boot. The manufacturer would then simply ship you a replacement strap. If it is not easily removable, I would just re-dispense another boot, and have the manufacturer ship you a new replacement boot free of charge. The manufacturer may want to see the defective boot and strap. If so, they should send you a pre-paid shipping label in order to ship it to them. In either case the manufacturer's warranty should cover you.

The above scenario are true regardless of whether you ordered the CAM walker directly from the manufacturer or from a medical supply house. Regardless of the defect, the patient should be instructed not to use the CAM walker in its current state, no matter how they may temporarily choose to modify it. Should the patient fall, and become injured, once you have been notified about this, you could be held liable. Your delivery confirmation slip should have some instructions on daily inspections for defects prior to use and the patient's needs to notify you.

Paul Kesselman, DPM, Woodside, NY

Editor's note: Dr. Kesselman will be a speaker at the upcoming Codingline New York Meeting on January 24, 2008. (See www.codingline.com) and the 2008 Hawaii Coding and Practice Management Seminar (see www.podiatrym.com/hawaii)

Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm

RE: Repairs for Osada Surgical Hand Pieces (Paul Galluzzo, DPM)
From: David Cutler, DPM

Osada repairs their own hand pieces. They can be found at www.osadausa.com

David Cutler, DPM, Bellingham, WA, mdavidm@aol.com

RE: Video on Developing the Perfect Robotic Foot
From: Bret M. Ribotsky, DPM

UC Berkeley biologist Robert Full shares his fascination with spiny cockroach legs that allow them to scuttle at full-speed across loose mesh and gecko feet that have billions of nano-bristles to run straight up walls. His talk, complete with wonderful slow-mo video of cockroach, crab, and gecko gaits, explains his goal of creating the perfect robotic "distributed foot." http://www.ted.com/index.php/talks/view/id/195

Bret M. Ribotsky, DPM, Boca Raton, FL, Ribotsky@Doctorbret.com

RE: Medent or Pragnocis EMR (Atta J. Asef DPM)
From: Alan L. Bass, DPM, RPh

I have been using POD Med EMR for the last 1 and 1/2 years and have been extremely happy. Templates pre-installed are great and it is easy to build your own. I have no interest in this company; I’m just a happy user.

Alan L. Bass, DPM, RPh, Manalapan, NJ, abassdpm@optonline.net

RE: Educating The Medical Community About Podiatry (Mike Boxer, DPM)
From: Multiple Respondents

While there are many sources of podiatric literature, APMA is at the forefront of education utilizing among many entities, the Public Education and Information Committee. APMA Public Relations staff Amie Hornbaker and Erin Wendell and the PE& I committee currently has a nationwide program designed to help all state components and their members to educate their patients. For more info, call the Public Relations dept at 1-800-ASK-APMA

Cary M Zinkin, DPM, Public Education and Information Committee, APMA, CZinkin@aol.com

The comments of Dr. Boxer regarding a complete report to the PCP is the same advice given to students in the EARLY 1970's by the great scientist and teacher James Ganley DPM. In my opinion there is no better advertisement for you and your profession than to submit a well done (not overstated) progress note to the PCP. It serves as an attestation to your competency, and places you on an equal footing with other health care practitioners.

Lecturing to MD's, DO's, NP's, PA-C's is also VERY effective if properly done. Teaching in non-DPM student, resident, fellowship programs can also prove to be quite helpful in demonstrating your superiority to other foot care providers.

When sending progress notes or presenting a lecture, consider the specialty of the referring health care provider, or the audience to whom you are speaking. Utilize the opportunity to subtly but effectively demonstrate your knowledge of THEIR specialty. For example, a rheumatologist may not know who does a better bunionectomy, a podiatrist or orthopedist, but they can recognize your familiarity with arthritic disorders and will frequently feel more comfortable referring to you rather than the local bone mechanic. Participation in hospital committees can also be quite helpful.

Allen Mark Jacobs, DPM, St. Louis, MO, allenthepod@sbcglobal.net

Editor’s Note: An extended-length from Dr. Rosenblatt note can be read at:

http://www.podiatrym.com/letters2.cfm?id=16921&start=1

ASSOCIATE POSITION (OR SALE)– QUEENS, NEW YORK

Associate position available. Work towards partnership or ownership of practice. Or terms to buy practice available. Busy practice grossing $400K, not including surgery. Medicare 65%. Surgically trained podiatrists can significantly increase income. Close to hospitals and transportation. Call (646) 373-8921.

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

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

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

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

ASSOCIATE POSITION - VIRGINIA

Immediate opening. Multi-office practice, EMR, digital x-rays, sonography. Great opportunity for mature, well trained new or established surgeon. Hospital and surgery center privileges. ABPS eligible/certified. Full scope of foot and ankle care. Base salary, incentive, and benefits. Email CV to practice administrator at: mtrevor41@yahoo.com

ASSOCIATE POSITION - WEST COAST, FL

Outstanding opportunity for PSR-36 graduate to join highly successful group podiatry practice in Summer 2008. Seeking a sociable, articulate graduate who is confident in rearfoot and ankle reconstructive cases but also enjoys all phases of podiatry. Long-term opportunity for the right candidate with generous pay and benefits. Reply to jwicks@ips-med.com

ASSOCIATE POSITION - NORTHWEST PENNSYLVANIA

Multi-specialty group is looking to add another Podiatric Surgeon or General Podiatrist to our well-established group. Office locations in northwestern Pennsylvania. Unlimited opportunities exist for the right Associate, wound care experience is a plus. Please forward your CV to adminsec@ips-mso.com

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com -- www.homephysicians.com

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