The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

December 31, 2012 #4,652 Publisher-Barry Block, DPM, JD

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TX Podiatrist Discusses Wound Care

Persistent, non-healing wounds may result from a variety of causes, such as medical illness, trauma, injury, burns or pressure sores. “Non-healing wounds are often associated with inadequate circulation, neuropathy, immobility, and ineffective wound management,” says Nicholas Desai, DPM, Medical Director of the Advanced Wound Care Clinic.

Dr. Nicholas Desai

“Wounds and ulcers are being seen more frequently in populations with metabolic conditions such as diabetes, and are affecting a variety of age groups from children to geriatrics. In order to develop successful treatment plans, we must take into consideration each patient’s underlying condition and unique medical needs,” Dr. Desai comments.

Source: Sugarland Sun [12/28/12]

Medicare Pay Struggle a Familiar Year-end Cliffhanger

Physician organizations are working toward a permanent plan to bring payment stability and higher quality to Medicare, but they have run into a familiar roadblock on Capitol Hill — impending deep payment cuts and no immediate relief in sight. Doctors participating in Medicare again found themselves just days away from a large decrease in pay rates, with Congress working against the clock to craft another temporary solution. So far, no deal had been reached to stop a 26.5% cut under the sustainable growth rate formula even as lawmakers pledged to prevent the decrease before it hits on Jan. 1, 2013.

Congress has enacted stopgap legislation to prevent statutory reductions since the last cut took place in 2002. Some pay patches lasting a matter of weeks or a few months have been enacted — and applied retroactively — days or weeks after the cuts technically had taken effect. Virtually no one believes Congress will allow the SGR to lower pay in 2013, but doctors have sent a strong message to lawmakers that the annual ritual of enacting a last-minute, transitory solution needs to end.

Source: Charles Fiegel, amednews [12/24/12]

How to Time and Pace Your Speech

Pace yourself when writing your first draft of a speech. Aim for 135 words for every minute of your presentation and you will be close to the right length.

Source: Adapted from Fletcher Dean,  "Do You Follow the 135 Rule When Writing a Speech?" via Communication Briefings [January 2013]

Query: ABMSP Certication Exam Course

I am taking the American Board of Multiple Specialties in Podiatry (ABMSP) exam. Does anyone know of a course review or anything that will help?

Ronnie Bateh, DPM, Jacksonville, FL

RE: AOS Incompatibility Problem with Windows 8 (Elliot Udell, DPM)
From: Elliot Udell, DPM
 
I want to thank all of you for your help in resolving my problem with the AOS practice management program. As a result of posting this and your comments, AOS went out of their way and bought a system with Windows 8, and their techs made sure that their program became compatible with Windows 8. Anyone with a computer with Windows 8, who needs a practice management program, can now consider AOS because they fixed the problems.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Strapping Denial When Injection Given (Robert Kornfeld, DPM)
From: Kathleen Neuhoff, DPM

I agree with Dr. Kornfield - patients WILL pay for procedures not covered by insurance as long as the costs and benefits are explained to them ahead of time. Of course, it is important to be sure you are not separately billing for a procedure which is already bundled in a fee for which insurance is paying. If these fees are bundled, and you have a contract with a company agreeing to accept their payments, it is my understanding that you cannot also bill a patient.

The choices appear to be to decline to accept an insurance whose fees appear unfair, negotiate an exception to a specific code, or live with their payments. However, for services which are NOT covered, it is appropriate to charge patients and, in my experiece, they are willing to pay. Examples in my practice include cryosurgery for neuromas, physical therapy, Class 4 therapeutic laser, non-covered nail/callous care, orthotics, evoked nerve/QST testing, and bunionectomy (specifically excluded by one of our large local  carriers for both DPMs and MDs).

If you believe you are providing the best care, and your patients trust you, they will find a way to pay.

Kathleen Neuhoff, DPM, South Bend, IB, vetpod@aol.com

RE: Combination Drug for Xerosis (Jay Wenig, DPM)
From: John J. Brummer, DPM

Often, my patients who are suffering from chronic dry skin (xerosis) complain more about the excessive itch they're experiencing. In the past, I'd prescribe a moisturizer like urea or lactic acid to address the excessively dry skin, as well as a low potency steroid to reduce the itch. I've found the combination to be very successful, but costly. Medical moisturizers are hardly covered by insurance anymore these days!

Not convinced that compounding pharmacies were the answer, I was told about a product called KERA-HC by a colleague. The product is manufactured by Clinical Therapeutic Solutions, and is physician-dispensed only. KERA-HC is 1% hydrocortisone in a 20% urea vehicle. What a great combo! You're addressing both aspects of the condition with every application. I generally Rx bid. My patients have responded very well to the therapy, as well as the cost!

John J. Brummer, DPM, NY, NY jjbrummer@hotmail.com

Disclosure: I am a potential investor and sell their products in my office.

RE: Rising Patient Deductibles Spell Trouble for Doctors (Allen Jacobs, DPM)
From: Jon Purdy, DPM
 
I’m not sure how Dr. Jacobs “knows” the answer to a future event. I certainly take care of my share of patients that have let painful conditions go unresolved for extended periods of time when they have no out-of-pocket costs. I also know that more people are spending money on cosmetic procedures than ever before, and this is a complete out-of-pocket expense. The sales of on-line quick-fix treatments and over-the-counter remedies continue to rise every year. Since I can’t predict the future, I would say the trends indicate otherwise. 
 
I’m also not sure what “real problems” are. In my practice, the patient concerned over the appearance of a fungal nail is just as important as is the patient with the painful bunion.
 
What I guess would happen in the future, if out-of-pocket expenses rise, will be better educated patients concerned about their medical condition as well as medical costs. As a result, I predict they will stop allowing their primary doctors to tinker with them, and seek out the specialist sooner.
 
Jon Purdy, DPM, New Iberia, LA, jpurdy@mindspring.com

RE: Rising Patient Deductibles Spell Trouble for Doctors (Allen Jacobs, DPM)
From: Elliot Udell, DPM
 
Allen, I pray that your prediction comes true, and people will not allow high  insurance company deductibles to deter them from having serious diagnostic procedures. Neither one of us can see into the future; however, a local oncologist in my area has a sign in his office saying that he worked out a deal with a local radiology practice to offer mammograms to uninsured or underinsured people for 40 dollars. This deal would not have been worked out if people were not putting off potentially life-saving tests because of monetary considerations.

I am due for my next colonscopy in three years. My last one was totally covered by insurance, but the next one will force me to pay up to two thousand dollars out-of-pocket. I'll go because I know the risk of not going, but I am hearing from some of my staff members who have the same insurance that they might put it off when the time comes.
 
As for whether people will pay for laser treatments for nails, speak to some of your friends who are cosmetic surgeons. The person who will bark about an office co-payment for a painful condition or life saving test will not blink an eye at paying ten thousand dollars for a facelift or tummy tuck.
 
Elliot Udell, DPM, Hickville, NY, Elliotu@aol.com

ASSOCIATE POSITION - KANSAS CITY

Kansas City may be the perfect move for you and your family. I am looking for an entrepreneurial minded associate who wants to grow and then own part of an already successful practice. If you are the right candidate for this associate position, you will enjoy a competitive compensation package and you will be working with a doctor who is as committed to your success as he is to his own. Go to: www.YourFutureInPodiatry.com for full details.

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 - NASSAU COUNTY, NEW YORK

Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to: Podiatryoffice@doctor.com

ASSOCIATE POSITION – NORTHERN CALIFORNIA/SF BAY AREA

We’re looking for someone entrepreneurial to join our growing practice. Must have great people skills, clinical/surgical skills, and positive demeanor. California license required. No nursing home visits. Send your CV and cover letter to: cvpodiatrist@gmail.com

PODIATRISTS WANTED - NORTHERN AND SOUTHERN CALIFORNIA

Excellent opportunity for independent, professionally managed practice in skilled nursing facilities. E-mail interest and CV to ZBUBBLESZ@aol.com

ASSOCIATE POSITION - FLORIDA

Associate wanted for well-established practice in central Florida. Experienced support staff, six figure salary, malpractice coverage and health insurance provided. Excellent opportunity for a promising future, this position will provide for the possibility of partnership in the future. To apply please go to www.yourcareerinpodiatry.com

ASSOCIATE POSITION - GRAPEVINE, TEXAS

Do you want to practice in a fast paced office environment? Do you like all aspects of podiatric medicine? Very busy 2 office practice looking for associate to add to our group of 5. If you are a forward thinking, surgically trained podiatrist send your CV to giacalone@faant.com

ASSOCIATE POSITION - MARYLAND

If you are a graduating resident, in July, or an established practitioner (available now) and you are enthusiastic, personable, motivated and well-trained, we would be delighted to discuss an associate position in our group with you. We are a 17-doctor group, with 12 locations. Significant patient flow already in place to keep you busy from the start! All the bells and whistles-EMR, digital x-rays, ultrasound, computerized scheduling, certified ambulatory surgical centers, hospital and physician referral base. Please send cover letter and resume to newdpm@footandankle-usa.com. We look forward to hearing from you.

ASSOCIATE POSITION - ORANGE COUNTY, NY

Full-Time or part-time. Looking for a highly motivated, surgical trained podiatrist in Orange County, NY (West Point). Hospital, wound center and surgical center affiliated. A busy practice that covers hospital in-patients, wound center, and ER calls. Must be trained in all foot surgery and be able to handle advanced diabetic wound care. 1 hour car ride from NYC and close to hiking, fishing, skiing and state parks. Email CV and contact info to: clsp4@yahoo.com

ASSOCIATE POSITION - NEW YORK

Established and modern podiatry practice seeking well trained podiatrist for our two offices located in the Hudson Valley. Individuals must be highly motivated, ethical, and have PM & S-36 training. Partnership potential! Please see our recruitment video (845) 471-2243, esims@simspodiatry.com

ASSOCIATE POSITION - CT - (FAIRFIELD AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to Dr.Kassaris@yahoo.com

ASSOCIATE POSITION - MICHIGAN

Multi-doctor practice looking to add associate for two offices in Flint, MI. Partnership opportunity for right person. Needs to be proficient in forefoot surgery. Two docs already proficient in rearfoot/ankle surgery. Competitive salary, paid vacation and seminars. Patient schedule available “now” from retiring associate. Email resume flintfootdocneeded@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 PODO2345@AOL.COM 516-476-1815.

ASTORIA PODIATRY OFFICE FOR RENT/SHARE

BEST ASTORIA location. 30TH AVE./32nd ST. Turn-key operation with 4 fully equipped, built-out exam rooms, private Drs.' Office/Consult room, X-ray, cryo-therapy, beautiful waiting area, large staff area, Shockwave, Multiple Lasers etc. Perfect for NEW PODIATRIST or SATELLITE location. ALL you need is a PHONE and COMPUTER! RENT includes all other standard expenses (utilities, cleaning, waste disposal etc.) P/T, $2500. F/T., $3500. Please send inquiries to hansfeet2@gmail.com.

EQUIPMENT FOR SALE - USED Q-CLEAR LASER

Still under warranty. New laser head just added. First Best Offer. Marketing and training included. Dr. Zuckerman will train you. e-mail with questions to mook863@comcast.net

PM News Classified Ads Reach over 14,000 DPMs and Students

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