The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

December 30, 2011 #4,345 Publisher-Barry Block, DPM, JD

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Death of Grandpa Inspires IN Podiatrist to Specialize in Diabetic Wound Care

Greensburg podiatrist Dr. Amy Jelinek was inspired to specialize in diabetic foot wounds by her grandmother. "During my last year of podiatry school," she explained, "my grandma told me she felt terribly guilty about my grandpa's death." Jelinek's grandpa was a diabetic who suffered from severe diabetic foot ulcers. "At some point," Jelinek said, "my grandpa's situation became progressively unsalvageable, and they started amputating a little at a time." After a number of below-the-knee amputations, however, Jelinek's grandfather refused to allow doctors to remove any more of his leg. Infection set in, and he eventually died from his wounds. 

Dr. Amy Jelinek

"Grandma went to her own death feeling guilty for not doing enough to help save grandpa's foot and leg, and thus, his life," Jelinek said. She continued, "She needlessly blamed herself; it wasn't her fault she hadn't been properly educated and informed." Jelinek's desire to prevent other families from feeling needlessly guilty blossomed into a career specialization.

Source: Robert Cox, Jr., Greenburg Daily News [12/28/11]

TN Podiatrists Invent Artistic Way to Teach Anatomy

Playing doctor is taking on a whole new meaning through a new product which Mountain Top Toys is the first store in the area to carry. Signal Mountain podiatrist Dr. Bob Spalding, vice president of marketing for Scalpel Art Supply, said the program uses painting to teach anatomy to students as young as kindergartners up to the college level. 

(L-R) Drs. Bob Spalding and David Velarde with Scalpel Art

The kit includes scalpel-shaped paint brushes, which the student uses to color in anatomical drawings from textbooks and other sources. The program is already being used by several schools, including Lincoln Memorial University and J. Frank White Academy in Harrogate, TN, and St. Nicholas School in Louisville, KY, said program developer Dr. David Velarde, also a podiatrist.

Source: Emily Crisman, Weekly Community News [12/28/11]

 FDA Issues Off-Label Information Guidelines for Industry

Query: Stark Law Question

Are there any restrictions as far as Stark laws are concerned with a DPM being hired and paid a salary or percentage by an MD?

Asher Rudowsky, DPM, Brooklyn, NY

Editor's comment: PM News does not provide legal advice. The answer depends on the exact circumstances of the arrangement. Thus, a healthcare attorney skilled in Stark Law should be consulted before entering into any arrangement involving referrals.

The physician referral law (section 1877 of the Social Security Act) prohibits a physician from referring patients to an entity for a designated health service (DHS), if the physician or a member of his or her immediate family has a financial relationship with the entity, unless an exception applies. (The exceptions are specified in 42 CFR Part 411, Subpart J.) The law also prohibits an entity from presenting a claim to Medicare or to any person or other entity for DHS provided under a prohibited referral. No Medicare payment may be made for DHS rendered as a result of a prohibited referral, and an entity must timely refund any amounts collected for DHS performed under a prohibited referral. Civil money penalties and other remedies may also apply under some circumstances.

Query: AEDs in Podiatry Offices

Do any of your offices have automated external defibrillators (AEDs) -- and if so, have you at any time had to use them on patients?

Bob Levoy, Great Neck, NY

RE: Orthotic Therapy For Hallux Rigidus (Elliot Udell, DPM)
From: James Clough, DPM

Dr. Udell's suggestion of a Morton's extension for hallux rigidus is a good one, as this will limit motion of the first MTPJ, a primary cause of pain in this deformity. The Cluffy Wedge will improve motion of the joint and, as you know, plantarflexion of the first metatarsal is a necessary component of this motion. I am the inventor of the Cluffy Wedge and have had experience with hallux rigidus. The Cluffy Wedge does not have a primary indication for hallux rigidus, however, I have seen this be an effective orthotic modification. I will tell you why I think this is the case in some situations.

As you bring the hallux to maximal dorsiflexion, you are bringing...

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

RE: Compatible Billing Program or Billing Service with Practice Fusion (John Scholl, DPM)
From:  Richard A. Simmons, DPM
 
My office uses Practice Fusion, and we continue to use American Health Care Billing Service out of Dallas, Texas. The owner is Mona Mellon, and she can be emailed for questions at ahcbs@tx.rr.com. Personally, I prefer to outsource billing. A consideration is that we will be converting to ICD-10 within two years, which means there could be an inordinate software expense as well as the expense of training your in-office billing person.

Richard A. Simmons, DPM  Rockledge, FL  RASDPM32955@gmail.com

RE: Hiring an In-House Biller (Darryl J Martins, DPM)
From: Steven J. Kaniadakis, DPM

Ask for podiatry-specific education (attended seminars, read articles, etc.), background, and experience. Be certain that the person is not over-confident, since sometimes the best answer is "it depends." Be sure there's a willingness to go to Codingline experts, if necessary. Be sure the person is open to a scheduled routine of "in-house" audits, to be certain that your business practices are straight. Use experts to perform audits. 

In-house billers can be just as reliable as using what might be represented as the biggest and best out-sourced "biller." There's no short answer or right answer. Use your clinical intuition. Remember, you are still responsible for what is billed, so keep a close eye on whomever bills for you..

Steven J. Kaniadakis, DPM, Saint Petersburg, FL, stevenkdpm@yahoo.com

RE: CMS Proposes Sunshine Rules on Industry Payments, Gifts to Doctors
From: Peter Smith, DPM

It seems to me that every time I turn around, there is more talk/legislation revolving around controlling, squashing, or hampering doctors from practicing medicine. When did medicine become such a reviled profession that we are constantly being slammed? I have never once awakened in the morning and thought, “How can I screw people today?” Frankly, I am growing weary of this day-to-day battle, just trying to make ends meet doing something that benefits others. I can say with all honesty that I could never recommend a career in healthcare to  my children, or anyone else. Enough is enough!
 
Peter Smith, DPM, Stony Brook, NY, ps84@bc.edu

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 NEEDED - NORTHERN CINCINNATI, OHIO (FAIRFIELD)

Lead to partnership &/or buy practice. Well-established, reputable & successful (700K collection annual) 25+ year practice. Newer 2k sq.ft office condo & w/5 tx rooms, Aver.80 new patients monthly, full hospital privileges, DME, Padnet, digital x-rays. Inquires to email: gsherwood1@cinci.rr.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." toDrgordon@gulfcoastfootcare.com

PART-TIME PODIATRIST NEEDED - LOS ANGELES, CALIFORNIA 

ASSOCIATE POSITION - CENTRAL VALLEY/SOUTHERN CA

Seeking associate with partnership availability. Must be highly motivated and have good patient skills and personality. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Compassionate and well-trained for immediate position. Surgery Center and hospital-based with no HMOs/no rest homes. Bilingual in English and Spanish preferred. Offering a permanent position/partnership in a multi-million dollar hi-tech practice with Partnership also in Surgery center. Please e-mail CV and short bio to: Tonya@wetreatyourfeet.com

ASSOCIATE POSITION - ALBANY/CAPITAL DISTRICT AREA

Immediate position available with generous salary, fringe benefits and percentage. All phases of Podiatry. For more information please contact Dawn at (518) 828-6516 or fax your resume to(518) 828-9510.

ASSOCIATE POSITION - HAWAII (OAHU) 

Full-time position available. Join this fantastic practice in paradise. Diagnostic ultrasound, Digital X-Ray, EHR, Surgical Privileges, Competitive Salary plus benefits package. Send CV toyoleven316@yahoo.com.

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

SPACE AVAILABLE - NYC & LI

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