The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

December 10, 2011 #4,328 Publisher-Barry Block, DPM, JD

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Claims By Toning Shoemakers are Exaggerated: Aussie Podiatrist 

The claims made about toning and wellness shoes are enticing: improve your leg and butt muscles simply by wearing them. But is firming up really as easy as putting on a pair of wobbly shoes?

Brenden Brown

Sydney podiatrist Brenden Brown, a spokesman for the Australian Podiatry Association, says claims made about these shoes are exaggerated. "I have had half-a-dozen patients who have gone on to have injuries because these shoes are based on being unstable. "I think they are an expensive fad."

Source: Bronwyn McNulty, stuff.co.nz [12/6/11]

IL Podiatrist is Medical Director of Hospital Wound Clinic

Dr. Brittany Crowhurst is a podiatrist with Ottawa Regional Hospital and Healthcare Center. She performs foot and ankle surgery at the hospital and does inpatient consults for patients who need foot care. She is also the medical director of the Wound Clinic, which will be opening soon in the Rehabilitation Department of the hospital. 

Dr. Brittany Crowhurst

"In the wound clinic, we will be able to treat patients with a variety of wound care products, perform testing for circulation problems, and evaluate wounds for infection using the laboratory and radiology departments, says Crowhurst.

Source: mywebtimes.com [12/4/11]

PA Podiatrist Keynotes German Association for Foot Surgery

Dr. Lee J. Sanders, presented the keynote address at the 19th International Symposium for Foot Surgery in Munich, Germany on December 3rd. The title of his invited lecture was "My Lifetime Experience with the Treatment of Charcot Arthropathy: Lessons Learned."  The meeting was attended by 400 orthopedic surgeons.  

Dr. Lee Sanders with Dr. Angela Simon, President of the German Association for Foot Surgery.

Dr. Sanders also presented the ADA/APMA Task Force Consensus Report on the Diabetic Charcot Foot, which was published in the September issue of Diabetes Care and the September/October issue of JAPMA. American podiatrists Drs. Brian DeYoe (Dallas, TX) and David S. Caminear (Hamden, CT) were also invited speakers and gave outstanding presentations on flatfoot surgery.

House GOP Agrees to Doc Pay-Rate Extension

House Republican leaders have agreed to include a two-year extension of the current Medicare physician pay rates, including a 1% increase, in a large legislative package primarily aimed at extending an expiring payroll tax cut, according to a Republican healthcare leader. The legislative package, including the SGR patch, would derive its funding through a variety of changes, including a provision limiting Medicare benefits for high-income beneficiaries.

Rep. Phil Gingrey (R-GA), co-chair of the GOP Doctors Caucus, said in an interview that the two-year $38 billion extension of current rates that were scheduled to drop 27.4% on Jan. 1 “was not ideal” but was better than the sometimes months-long extensions that have occurred over the past two years as Medicare's sustainable growth-rate funding formula has repeatedly called for steep physician payment cuts. Republican leaders had considered shorter cuts, he said, but the caucus urged two years as the shortest.

Source: Rich Daly, Modern Healthcare [12/8/11]

Query: Diabetic Shoe Referrals
 
I was approached by an executive director of a large assisted living company who owns a medical marketing company that builds websites, prints brochures, etc. for doctors and clinics. This individual wants to create a diabetic shoe program within her facilities and refer QUALIFIED individuals for diabetic examination and fitting of shoes. Is there any way to form a legal relationship with a multifaceted individual like her and benefit from marketing and referrals? How would she be paid for marketing such a program? Or is this a slippery slope?

Name Withheld

Editor's comment: PM News does not provide legal advice. In general, whenever a doctor is approached by anyone and presented with a scheme which involves referrals, it's time to consult with a healthcare attorney well-versed with the Stark laws. These statutes define which arrangements are legal and which are not.

Query: Slipper Cast Billing When Staff Does It

I know coverage for slipper casting varies widely in the U.S. For those doctors who do bill for orthotic casting but let their assistants do the casting, are you billing the insurance companies for the casting?

Robert Steinberg, DPM, Schaumburg, IL 
 
Response: You may want to check with your state's medical board to find out if there are any specific limitations on what medical assistants are allowed to do in your state. That said, there is no regulation that I am aware of that does not allow medical assistants to cast for orthotics as an "incidental to" service to the doctor. This means the doctor bills for the impression casting performed by an assistant after checking it.

You can check with specific payers/plans you deal with to be sure they have no requirements/limitations, but I doubt they do.

Tony Poggio, DPM, Alameda, CA

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RE: Traumatic Injury (David L. Kahan, DPM)
From: Clint Jones, DPM

I just had a similar case of a female with recalcitrant foot pain who received repeated injections, orthotic therapy, and major rearfoot surgery by several very competent doctors for over 2 years prior to presenting to my office. Her residual problem was the “ball” of her foot “feeling like it is being shot.” Her pain level was 4/10, and she complained that her gait was off as a result. She desperately wanted to avoid further surgery and needed to get back to work.  

I utilized a new product called Acell  Xenograft (acell.com). Using ultrasound guidance, I did an MPJ intra-articular and pericapsular injection of 60 mg of this product. I later addressed her biomechanical problems with a Sole Supports orthosis (solesupports.com), and after only one month, the patient was back to full activity. When injecting, it is very important to prescribe a  7-day Medrol dose pack, as this injection will incite an aggressive, sometimes painful, reparative response. I also use contrast soaks. This seems to slow down the response enough to maintain patient comfort. I have used this regimen for plantar fasciosis with the same success. About a week later, patients are well on their way to healing.

Disclaimer: I have no financial connections with either of these products. 

Paul Clint Jones, DPM  Spokane Valley, WA, instepfootandankle@gmail.com

RE: Life-long Maintenance Regimen for Onychomycosis
From: Carl Solomon, DPM

To prevent recurrence of onychomycosis in patients successfully treated with oral terbenafine, I guess Lysol disinfection of the shoes sounds reasonable...as does Mycomist, Fungusoap, bleach, etc. How about chewing Spearmint gum twice a day. After all, it produces a nice aromatic smell and it's reasonable to think it would repel fungus. But it has to be sugarless gum because some fungi thrive on sugar. As ridiculous as that sounds, I'm not aware that any good study has validated that...
 
Editor's note: Dr. Solomon's extended-length letter can be read here.

RE: Exchange of Health Information Test (David Weiss, DPM)
From: Pete Harvey, DPM

Part of Meaningful Use requires that you send the patient report of your findings to the referring doctor. Call a referring doctor and get the fax number if you don’t already have it. Enter that number in the proper field of your EMR which will be on the Sign and Complete page before you electronically sign the record. This will send the report. Then call the referring office to be sure they received the report. Or, create a patient record named “Test”, get a correct fax number from your EMR company, send the report to them, and then verify.
 
With Attestation, you can then truthfully state that portion of the program works. The support team of your EMR should guide you through the process.
 
Pete Harvey, DPM, Wichita Falls, TX, pmh@wffeet.com

RE: Starting a Practice (Nicole Rubackin-Hayward, DPM)
From: Joel Lang, DPM

Getting yourself known and seen are best. Consider one or more of the following:

Attend and participate in as many hospital meetings that you can. Let the other 'docs' see your face and hear an occasional intelligent comment. Send a formal report to every primary care physician about each new patient, regardless of how trivial the presenting complaint may be. Send follow-up reports when treatment is complete or when significant events occur (surgery, etc.). Send copies of labs and operative reports. If the patient was referred to you, send a separate thank-you note and include the clinical summary.

Join every HMO, PPO, IPA and other similar groups when you can, if you are so inclined. They may 'own' most of the patients in your area. 30% of something is better than 100% of nothing. Join one or more social, civic, religious or service organizations and be sure to let people know who you are and what you do. Dress well and professionally to these events. Offer to provide lectures or talks as are appropriate to these organizations.

Send a small gift to the 'docs' in your area such as a pocket notebook or appointment book with your name embossed on the cover. These can be purchased in bulk and mailed to each office in the area you think might be important to you. Shop locally whenever you can and introduce yourself and leave cards wherever you go. It takes time to become known in the community - be patient and persistent.

Joel Lang, DPM (retired) Cheverly, MD, langfinancial@verizon.net

RE: Starting a Practice (Nicole Rubackin-Hayward, DPM)
From: Susan Bartos

One of the best ideas I’ve heard was from a young podiatrist in PA, who built a strong referral network after relocating to a new community. He created a 4-up (4 forms to a page – about postcard size) checklist, listing the most common problems he treats, and some blank lines for comments. He put his name, title, phone, and “Hours by Appointment” at the bottom of the form.

At the top, he left a blank space for the referring physician’s name. He had them printed locally, cut in to 4s, and glued at the top to make notepads of 20 pages each. He then went to every potential referring practitioner – from primary care to endocrinologists, and even psychiatrists, to introduce himself. He left a note pad with each office manager, asking for the referral of patients who might benefit. He requested that they give their patients a completed sheet from the note pad to bring to the podiatrist at the first appointment. 

Each time a new patient came with a referral sheet, the podiatrist began communicating with the referring doctor with chart notes and progressive healing reports, concerning their shared patient. After the initial introduction, the podiatrist made monthly phone calls to each office manager, to develop and deepen his relationship with referring and potentially referring physicians.
 
Susan Bartos, Massillon, OH, eworthotics@neo.rr.com

RE: MN Podiatrist Supports Statewide Single-Payer Health Insurance System
From: Tip Sullivan, DPM

On the way to work today, I was listening to a public radio station. There was a discussion going on regarding housing, and one of the interviewees stated that housing should be a basic human right and implied that our government should provide this in some way. Many people have stated that having enough food to not be hungry is a basic human right and our government provides free food in the form of food stamps and other programs.

Now, we have one of our fellow podiatrists saying that he believes that healthcare is a basic human right and we all know the involvement of our government in healthcare. Where do basic human rights begin and end? Some apparently believe that...

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

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.

EQUIPMENT FOR SALE - LASERSCOPE LASER SYSTEM

Laserscope Model Lyra i YAG Laser system with 3 handpieces, eyewear  sets, calibration unit, complete manual, foot control and video information, for fungus nails, vein therapy and hair removal.  The unit has the attached cooling system and all accessories. flpodiatrist@tampabay.rr.com

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

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 - SOUTHWEST FLORIDA

Immediate position for associate to partnership for a surgeon that is BQ/BC by ABPS. Must be a PSR-24 or PM&S-36 trained. 100K start. Must be ethical, self-starter, hard worker ,team player. Willingness to learn / work as part of a team. Great ancillaries & surgery facility. Must be proficient in rearfoot/ankle surgery. Email CV and recent cases to: susmitad86@yahoo.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

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 - NAPLES, FLORIDA

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. Candidate should have the skills and desire to perform rearfoot/ankle surgery. Florida has a great scope of practice law and we rotate for ER call. Candidate needs to be ethical and motivated. Established practitioner or new practitioner. In a cover letter tell me why you should be selected for the team. Email cover letter and CV with subject line "I am your new team member." to  Drgordon@gulfcoastfootcare.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.

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

PM News Classified Ads Reach over 13,500 DPM's and Students

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