The Voice of Podiatrists

Serving Over 10,000 Podiatrists Daily

December 27, 2007 #3,127 Editor-Barry Block, DPM, JD

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PM News Subscribers Invited to Vote in Poll on New ACFAS Membership Policy

In the past week PM News has published a representative sample of letters that we have received on ACFAS' new membership policy. We are temporarily closing this topic for public discussion. If you still wish to voice your opinion on this matter, we invite you to take our poll at: www.surveymonkey.com/s.aspx?sm=pFcQKhw8XPkJI_2btWM7MjQA_3d_3d

This poll will close on 12/31/07.

PA Podiatrist Uses New Total Ankle Implant

A new procedure, the INBONE Total Ankle, being performed by Pottstown Memorial Medical Center foot and ankle surgeon Dr. Benjamin Overley, enables patients unable to enjoy daily activities due to pain, to live life to the fullest. There are a number of conservative non-surgical treatments for ankle arthritis, such as pain medications, steroid injections, physical therapy, and orthotic shoes/inserts.

Dr. Benjamin Overley

Until recently, the surgical choice for disabling ankle arthritis was joint fusion or arthrodesis. But fusion severely limits mobility and doesn’t always eliminate pain. Ankle fusion can also stress other joints in the affected extremity.

After the procedure, patients will remain in the hospital for a few days and then go home with a splint. Physical therapy is also recommended following the replacement.

Source: Pottstown Mercury (PA) [12/24/07]

New Push for Greater E-Prescribing Accelerates at the Federal Level

The effort to increase electronic prescribing is gaining momentum on Capitol Hill, as bipartisan groups of lawmakers push legislation that would require doctors to use e-prescribing under Medicare Part D, and request changes to federal regulations that prohibit the e-prescribing of controlled substances.

The legislation would provide a one-time payment bonus to physicians for the initial cost of purchasing e-prescribing technology, according to Porter. The bill also provides an extra 1% bonus for the administrative costs attached to every Medicare prescription a doctor writes electronically. On the other hand, E-MEDS would establish financial penalties for physicians who do not begin using e-prescribing by 2011. The bill would cut payments by 10% on each prescription not sent electronically, beginning that year.

Source: Drug Benefit News [12/14/07]

Query: Soapware Virtual Hosting

Does anyone have experience with using Soapware virtual hosting as their EMR? I am interested in good and bad experiences.

Brett Roeder DPM, Phoenix, AZ

RE: Biopro Memory Staple (Wayne C. Gould, DPM)
From: Jeffrey Kass, DPM, Marc Greenberg, DPM

I have used it for fixation of mini-Austins on tailor's bunionectomies and like it a lot. It is rather easy to use and have not had any problems with it. My concern in a toe would be to ensure it is not palpable beneath the skin. With the tailor's bunion you have the capsule that "pads" the staple whereas in a toe there is less soft tissue. Other than that, I find it an easy way of fixating bone cuts.

Jeffrey Kass, DPM, Forest Hills, NY, Jeffckass@aol.com

In 2007 I started using staples for a specific type of case (1st and 2nd MPJ arthrodesis). I have seen the choices on the market and I have played with each either at a seminar or in an office setting (sawbones). The Biopro staple was really the only staple design that I decided I would not use, specifically because of the design. The Biopro staple compresses when heated with as little as body heat. This includes yours when handling intra-operatively or the patient's when implanted. The important thing for me was that I wanted my staples to compress when I wanted them to and not sooner and not later. I don't want premature contracture of the staple to prevent fixation and I want to have a stable arthrodesis site prior to closure of the surgical wound.

Many of my peers in town use staples for other procedures that I still use K-wires or screws. They have been pretty satisfied with their results with these, which includes the Akin. I still use the other techniques partly due to the cost of staple fixation. I do most of my elective surgery at a local surgery center, of which I am a shareholder, and they can't bill the insurance carriers for the staples, or any other implants, like hospitals can.

If it matters, I have been using the OsStaple (BME) and I'm pretty happy with the results and technique simplicity. I would advise you to contact several companies that make surgical staples and have their rep's bring the equipment and sawbones to your office so you can play with the stuff. You might have better luck deciding which way to go after that. Scrubbing a case or two with somebody in your area who uses staples would be a good idea. I had a local DPM who was experienced with staples scrub my first staple case to help me out.

Marc Greenberg, DPM, Dayton, OH, tripperdpm@yahoo.com

RE: ACFAS Drops APMA Membership As Renewal Requirement
From: Multiple Respondents

Let's state the facts as they are. Dr. Graziano stated an inaccuracy when he stated that ACFAS has finally listened to its membership and severed its ties with APMA. The fact is, according to my regional rep of ACFAS, that TWO consensus of membership by ACFAS showed that membership DID NOT want to sever this relationship.

While some colleagues are dissatisfied with APMA policy, decisions, and action, fact is that APMA is our profession's leader in fighting our fights, representing our interests, and spearheading our profession to the levels it has attained. I thank APMA for much of the success I have achieved. Individuals are powerless to deal with the major political and turf battles that constantly go on. We need, as a profession, APMA to represent most of our interests. APMA has done a good job in responding to the majority positions.

Let's all grow up a little, and realize that not everyone will agree all of the time with the decisions made by any group leadership. It is supposed to represent its membership. We all can't always have our ways all of the time. Over a long period of time, APMA has done a great job in seeking input from membership, including new people into its hierarchy, and trying to represent podiatry for the betterment of the profession as its members determine it.

I have has the privilege to know several of our APMA leaders personally, and can tell you that these are the people I want to go to battle with at my side. At a time when we have accomplished so much together, we need to remain together, united, to continue our achievements. Therefore, I am dismayed by ACFAS's decision, but even more dismayed by its leadership ignoring the majority of membership in making that decision.

Brian Kashan. DPM, Baltimore, MD, drbkas@worldnet.att.net

Are we so desperate to achieve parity with our allopathic colleagues that we will repeat one of their greatest mistakes? The AMA's decreasing influence can surely be traced to their dwindling membership as their specialty societies no longer required AMA membership. Our profession is far too small and too inconsequential to main stream medicine be able to afford repeating this same tragic mistake.

As a member of both organizations, I am truly saddened by the events that lead to this. Perhaps we should all learn from these two famous quotes:
1) Those who cannot learn from history are doomed to repeat it; and
2) History repeats itself, first as tragedy, second as farce.

Both the APMA and ACFAS need to wake up to the realities of practicing medicine in 2007, or both may find themselves without anything to influence.

Paul Kesselman, DPM, Woodside, NY pkesselmanb@pol.net

I am a member of the ACFAS and the APMA. Can you please tell me what it is that you're applauding? It sounds to me like the profession is being needlessly split and destroyed from within. I support APMA President Chris Robertozzi's suggestion that the two organizations work out their differences. Also, I always thought that ABPS membership was dependent on APMA membership and in turn, ACFAS membership mandated APBS membership. Did somebody sneak through some legalese bylaws that bypassed this time-honored relationship?

I suggest everyone pay their dues to all of these organizations, support all of them, and pull our profession together, not apart. Some of the cheapest people I have ever met in my entire life are podiatrists. We have not achieved parity in the Title IX definition of "physician" and need to be a unified force to achieve the status we deserve and are entitled to. There are podiatrists in some states who have achieved a political victory by being allowed to do surgery on the ankle and leg while podiatrists of equal training in other states have been denied such privileges.

In my own state, there are a handful of podiatrist who achieved a recent victory of being allowed to perform reconstructive ankle surgery - and I support them gladly in their new-found legislative rights. Meanwhile, the rest of podiatrists in our state are not legally allowed to biopsy a suspicious mole or dermatological lesion at or above the ankle joint. The schism created by micro-politics is destroying our profession and our trust/mistrust in one another. I am asking ACFAS to revoke their exclusionist agenda, especially if it is based on money and the refusal to pay a couple of thousand dollars to support the inclusive politics practiced by the APMA.

Richard Grayson, DPM, Avon, CT, rjg2002@hotmail.com

Everyone has given very clear reasonable responses as to not making it mandated to belong to the APMA as a requirement for ACFAS membership. Now to the meat of this situation. What would happen if 100%, 50%, 25% 10% of the ACFAS membership leaves APMA membership. Will it shut down the APMA? Will APMA increase dues because of the need for money to keep the APMA doors and functions open? I estimate that the APMA will lose at the very Minimum, $250,000.

Sure we want freedom to chose but at what cost? The last time I looked, 15,000 podiatrists are all we have to work with. Please help me out with this one. Is the ACFAS eliminating the APMA? Maybe they might be a better job? What is important is that the members realize there will be no APMA in a few years and it will be replaced with ACFAS and state societies will be replaced with ACFAS divisions.

Is this good or is this bad? I think this MUST be placed on the table because this is what appears to all about. I want to point out I am a member of both organizations and will stay a member. We are at the our crossroads as members and we need to demand a fact finding committee to see exactly what the APMA does and what the ACAFS. Let's look at this as a positive situation and take a look at our representation and just well it has been functioning or poorly it has been functioning. A organization always survives when its interests and services are in the best interests of its membership. We need facts and more information and soon.

David Zuckerman, DPM, Woodbury, NJ, footcare@comcast.net

Editor's Note: This topic has been temporarily closed. Those wishing to voice their opinions are invited to take our poll (which will be open until 12/31/07] at:

www.surveymonkey.com/s.aspx?sm=pFcQKhw8XPkJI_2btWM7MjQA_3d_3d

ASSOCIATE-TO-PARTNERSHIP OPPORTUNITY NEW HAMPSHIRE

Established practice located 1 hour north of Boston in tax-free New Hampshire is seeking a well-trained graduate of a 24-month surgical/general podiatry residency. This is a practice with a nice mix of surgery, biomechanics, injuries, diabetic and general care. No nursing homes. Very modern office with EMR, US, excellent referral base, and a well-trained staff. E-mail inquiries howardbon@aol.com

ASSOCIATE POSITION/ BUY-IN -COASTAL SE NC

Excellent opportunity for well trained, articulate, hardworking individual competent in all phases of practice. Long term position available with buy-in also an option. Strong salary and benefits. Gorgeous coastal area. Don't miss this one! Contact kinggy@atmc.net

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

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

PRACTICE FOR SALE - MINNESOTA

Minnesota practice for sale in upscale suburban location with turnkey absentee-ownership opportunity. This owner let's this practice run on auto-pilot while collecting $700's and associates treat all patients. This is a very well established practice and staff is willing to stay. Financing is available OAC. Contact American Doctor Sales 614-918-3000 or email us at sell_my_practice@yahoo.com

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