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| PM News | |
The Voice of Podiatrists
Serving Over 20,000 Subscribers Daily
December 31, 2020 #6,844  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management https://podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2020- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL |
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Have you received your COVID-19 vaccination yet?
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| AT THE COLLEGES | |
NYCPM Sports Medicine Club Provides Community Care
On December 12, three members of the New York College of Podiatry Medicine's (NYCPM) Sports Medicine Club joined with members of Graffiti 2 Community Ministries, which is based at St. Paul Evangelical Reformed Church on East 141st Street in the Bronx, to distribute winter clothes, food, and fresh breakfast sandwiches to the community.
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(L-R holding banner) Anthony Castronova, Will Stallings, and Paul Jicman flanked by members of Graffiti 2. |
The “Stop and Care Volunteers” event included members of the Sports Medicine Club: Anthony Castronova (2024; Class Representative), Will Stallings (2023; President-elect of Student Association), Paul Jicman (2023; Research Coordinator). Kim Abrams (2023; Club Treasurer) assisted in organizing the event.
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| PODIATRISTS IN THE NEWS | |
NY Podiatrist Discuses Causes of Flat Feet
When you’re working up a sweat, your feet likely get less attention than larger muscle groups but when you have flat feet—which, according to some estimates, as much as 30 percent of people do—targeted flat feet exercises are crucial for preventing injury and pain. Nelya Lobkova, DPM, a board-certified podiatrist based in New York City, says some of the main causes of flat feet include genetics (the alignment of the foot’s bone structure from birth), injuries, obesity, aging, and pregnancy, which increases laxity (or looseness) in the foot’s ligaments.
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Dr. Nelya Lobkova |
Over time, flat feet can also develop into posterior tibial tendon dysfunction (PTTD), a condition caused by a tear of the tendon that connects the calf muscle to the bones on the inside of the foot. “The tendons and ligaments located on the inside of the foot begin to weaken and stretch out, causing deformity of the joints that the tendons and ligaments normally stabilize,” says Dr. Lobkova. “The foot arch appears collapsed, and the foot becomes unstable, which leads to the foot turning out and knee and back pain. It is important to identify this condition and control and stabilize the integrity of the foot and ankle tendons and ligaments before chronic pain and deformity results.”
Source: Jessica Estrada, Well + Good [12/29/20]
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| PODIATRISTS IN THE COMMUNITY | |
NY Podiatrist Receives Healthcare Hero Award
Samantha Landau, DPM was recently presented with the Healthcare Hero Award at the Schneps Media Awards show which was held virtually this year due to COVID-19. This award was given to frontline workers who went above and beyond the call of duty helping and healing COVID-19 patients. Dr. Landau is the chief resident of NYCPM/Metropolitan Hospital surgical residency program.
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Dr. Samantha Landau |
Dr. Landau was the only resident recipient to receive this award. In attendance for this award were many prominent people in the medical field and many influential business leaders alike including her father Laurence D. Landau, DPM and stepmother Corrine E. Renne Landau, DPM.
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| FROM PM's CURRENT ISSUE | |
Several times a week, PM News posts an entire article from a recent issue of our partner, Podiatry Management Magazine. Please note that the views expressed in Podiatry Management Magazine do not necessarily reflect the views of PM News or Barry Block.
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Today's Featured Article |
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| PRACTICE MANAGEMENT TIP OF THE DAY | |
Year-End Financial Planning Checklist - Part 3
Year-end provides the perfect opportunity to review your financial life and make sure you are on track towards your goals. The above checklist is just a few of the financial items you may need to address.
3. Max Out Your Retirement Accounts
The 2020 maximum contribution amount for 401(k)s and 403(b)s is $19,500 if you are under age 50 and $25,500 if over age 50. Check your contribution history for the year to ensure you are on track to max out by year-end. If you are not on track, you may want to consider increasing your withholding percentage in the final month to ensure you are maximizing this tax-advantaged account. 401(k) & 403(b) contributions need to be made by year-end. IRAs, on the other hand, can be funded up until the tax filing deadline. The maximum IRA contribution in 2020 if you are under age 50 is $6,000 and $7,000 if over age 50.
Source: Jeff Witz, CFP®, Logan Lutton, Physicians Practice [12/18/20]
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| CODINGLINE CORNER |
Query: KX Modifier and My Billing Company
Very recently, I’ve learned that our billing company has been attaching KX modifier to Medicare claims for patients receiving orthotics billed as L3000, without our knowledge or consent. I know from prior posts that this is improper. I’m wondering what the best course of action would be to remedy this: Should I contact Noridian and tell them the situation and have them request recoupment? Have the billing company handle it? (I’m not sure how much to trust them to do this properly). We will obviously need to refund the money. How should we handle billing the patients that don’t have Medicaid? They were all told Medicare doesn’t cover foot orthotics but in our state, Medicaid will cover them even with Medicare as primary.
Name Withheld
Response: This is a very loaded question and I know that many of you may not be happy with this response. Let me first preface this that I am not an attorney, in a position to offer legal advice, nor am I representing any liability carrier as an expert witness. I have offered the latter in several other cases and of course cannot provide that information here. I am not going to use this forum to simply cite chapter and verse from the orthopedic LCD policy, why the billing of L3000-L3060 with the KX modifier is mostly fraudulent or abusive when billed with the KX modifier. It is apparent that from your question, that is not needed.
But you have a potential significant problem on your hands. Suffice it is to say that the use of the KX modifier should be restricted only to the very rare circumstance where the shoe has a brace attached to it and the orthotic is placed into that shoe. You are going to need a healthcare attorney to guide you in how you proceed and communicate with the DME MAC.
Paul Kesselman, DPM, Woodside, NY
For information on Codingline subscriptions, click here
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| QUERIES (MEDICAL-LEGAL) | |
Query: Are Gloves Necessary to Administer COVID-19 Vaccine?
I have noticed some people receiving the COVID-19 vaccine by people who are not gloved. All podiatrists giving injections for whatever have always worn gloves. Glove wearing for all procedures including routine foot care became the norm sometimes in the 1990s. What are your thoughts?
Steven Finer, DPM, Philadelphia, PA
Editor's comment: PM News does not provide legal advice. According to CDC guidelines, "gloves are not recommended for most vaccination administrations and are optional for the COVID-19 vaccine unless the person administering the vaccine is likely to come into contact with potentially infectious body fluids or has open lesions on their hands.
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| QUERIES (NON-CLINICAL) - PART 1 | |
From: Steve E Abraham, DPM
I purchased squaric acid from ScienceLab.com. I bought a 5g bottle; it seemed small but lasted several years. I mix some in sterile water. How much? Enough to make a supersaturated solution. After thorough shaking, some settles to the bottom. That's okay. I apply a "50 cent size" liberal application on the patient's forearm. I circle the area with a black magic marker. It is not necessary to cover, but sometimes we cover it. The patient keeps it dry for at least 24 hours.
They return in 2-3 days, and I repeat the process. They must wait for about 2-3 weeks before beginning to apply the squaric acid solution, allowing time for antibodies to build. The patient then shakes the bottle, uses a cotton-tipped applicator, and applies the squaric acid to the wart liberally. This is done twice a day for 3-4 weeks. We find that after a week, the color of the wart changes. Sometimes it is grey, sometimes silvery; it begins to look different. After about 4 weeks the wart shrivels, dies, and falls off.
There is NO pain with this procedure. I have used this on 6 patients, 3 of them with recalcitrant warts, and 3 with new warts. All resolved without any incident or issues. There are several sources for this treatment protocol. It works really nicely on young children.
Steve E Abraham, DPM, NY, NY
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 2A | |
From: Howard Osterman, DPM
I will just say not all joints are equal. Not all sports are equivalent. 30 years of treating athletes has provided insight into this. Fusing a first metatarsal-phalangeal joint can be a damned if you do/damned if you don't scenario, but fusing a 1st met-cuneiform joint is another matter. I suspect this is where the controversy lies. Tennis, golf, basketball are really inhibited with fusion here. This is under-appreciated in mechanics. Sports medicine physicians have many patients who had to stop their desired sport because of this. These are the types of panel discussions at all of our AAPSM Stand Alone meetings.
Dr. Jacobs, as always, makes some valid points, but those of us who treat mostly patients trying to maintain their continued level of sport are often left disappointed with the surgical result. I have many patients very pleased with a 1st met osteotomy and Akin that wasn't 'perfect' but left a much more desirable result than a 'perfect' Lapidus that stopped them from doing their sport.
Howard Osterman, DPM, Washington, DC
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 2B | |
From: Douglas Grimm, DPM
I think is a timely case study with the current discussion of fusions versus non-fusions. I also am finding colleagues who are performing Lapidus procedures on almost every patient. I recently had a 15 year old boy in the office who had a bunionectomy in February 2020 and he wanted the other foot done. As you can see for reference, the right foot shows he does have a very large bunion for a 15 year old. He was pleased with the appearance of the left foot after surgery as the first ray was straight but he wanted to know why the big toe joint has no motion and why he can't play basketball 10 months after surgery.
I have subsequently done a MICA MIS bunionectomy on the right foot which was completely pain-free in five weeks. The patient is now...
Editor's note: Dr. Grimm's extended-length letter can be read here.
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| RESPONSES/COMMENTS (PM NEWS QUICK POLLS) | |
From: Allen Jacobs, DPM
There is no dispute that a PT block provides anesthesia and thereby pain relief in the management of PAIN associated with any painful acute monarticular disorders, including gout. However, to conclude that the PT block alters the pathophysiology of gout is without any scientific evidence. The so-called sympathectomy effect may or may not be true. However, your suggestion that a PT block alters the natural history of this disorder (other than pain relief and theoretically vasodilation) is without evidence. If you have such studies to the contrary, “show me the money”.
A PT block will reduce pain from septic arthritis, pseudogout, fracture, malignancy. Pain relief and “sympathectomy” do not alter the disease process. Is the administration of a PT block associated with a shortened course of the disease? Less need for steroids, NSAIDs, colchicine, or irate lowering therapy? Is there evidence that a PT block reduces the intra-articular urate burden, inflammatory cytokines, joint pH, or leukocyte/macrophage? The answer is no, you have no such evidence. There is a difference between theory and proven fact. It is called the scientific method. Absent confirmatory studies, the suggestion that a PT block “dilutes out” the uric acid (which effect would be expected to last only for the duration of the anesthetic used) is mumbo-jumbo until proven otherwise.
Allen Jacobs, DPM, St. Louis, MO
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoe of the Day
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Bottoms up for the New Year? |
Source: Submitted by Dr. Joseph Borreggine
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MEETING NOTICES
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NEED CME CREDITS FAST?
PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
You can Earn up to 50 Continuing Education Contact Hours (CECH) Online
Earn 15 CECH only $249 (less than $17 per CECH)
podiatrym.com/cme.cfm
All required credits can be taken online for AL, AK, AR, CA, CO, DE, HI, IN, KS, LA, MA, ME, MI, MI, MS, NV, NJ, NM, ND, OH, OR, RI, SC, SD, UT, VA, VT, WV, and WI
Partial required credits can be taken online for AZ, FL, GA, ID, KY, IL, ID, IA, MD, MN, MO, MT, NE, NH, NY, NC, OK, PA, PR, TN, TX, WA, and DC
Choose any or ALL from 25+ CECH Category-1 articles posted
* NY podiatrists whose licenses expire from 3/2/20-5/1/21 may take all credits online
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| CLASSIFIED ADS - ASSOCIATE POSITIONS AND FELLOWSHIPS |
WOUND CARE FELLOWSHIP - NEW YORK
CPME APPROVED 12 month fellowship beginning July 1st, 2021. Hospital and clinic environment, with onsite hyperbaric medicine. Working with infectious disease, dermatology, as well as, general, vascular, and podiatric surgeons. Must have completed a PMSR residency. Please contact drarnoldhertz@aol.com or jtfootcare@gmail.com. EOE employer.
WOUND CARE/RECONSTRUCTIVE SURGERY FELLOWSHIP - LOS ANGELES, CA
Attention graduating residents! Multi-specialty surgical group adding wound care and reconstructive surgery podiatry fellowship for 2021-2022 academic year. Will train in multiple settings alongside plastic surgery and general surgery in new facility. Full salary, health insurance, housing stipend, with more opportunities after completing program. Send CV to: woundcaredocs@gmail.com
PODIATRIST POSITIONS - PHOENIX, ARIZONA
Established practice hiring both full-time and part-time physicians. If you are an energetic physician and would like to practice in an upbeat, well-equipped, modern and conveniently located facility please email CV to HealthyFeetAZ@Gmail.com. Candidates holding Arizona State License preferred.
ASSOCIATE POSITION - SOUTHERN CALIFORNIA
A well established practice is looking to add a third podiatrist. We are looking for a candidate with wound care training as well as experience in foot and ankle reconstruction. The Palm Springs area boasts year round resort activities with close proximity to LA and San Diego beaches. Full benefits/CME/Malpractice and salary offered. Potential surgery center buy in. Please contact 515-556-5316 /Email CV to asnelsonbean@gmail.com
FULL-TIME or PART-TIME PODIATRIST - DALLAS/FORT WORTH AREA
PSR 24-36 Trained with a current Texas podiatry license. Multi-dimensional, Multi-office group treating a wide range of conditions. A great opportunity for driven personable individual. Please e-mail CV, References Letters, Short Video Introduction Email: cnunez1940@gmail.com
POSITION AVAILABLE - ALBANY, NEW YORK
Immediate opening and opportunity to join a busy growing practice in the capital region of NY. We have a growing practice that offers all aspects of podiatric care - both surgical and non-surgical. We pride ourselves on being state-the-art with EMR, digital x-ray, ECSWT and MLS laser therapy. We have the necessary support staff and have privileges with local hospitals and participate with all of the local insurance panels. We enjoy what we do and are looking for an ethical, reliable and motivated podiatrist to join our team. Please submit CV and cover letter to Albanypodiatry1@gmail.com
ASSOCIATE POSITION - MIDWEST
ONCE IN LIFETIME OPPORTUNITY to join a thriving practice with instant patient volume. State-of-the-art practice with Advanced Derm, Limb Salvage, Sports Med, Pediatrics, in-office-lasers, formulary. Seeking ambitious DPM with surgical and patient management skills. Early board-certification with the ability to outpace your peers financially. Buy-in anticipated after initial contract. Starting six-figure salary with generous bonuses. No nursing homes. Perks include Paid Med-Mal, Vacation & CME days. Hospital & Medical Organizational Dues, Health & Disability Insurance, Phone & Car Allowances, 401k, and $5,000 Signing Bonus. DPMPROFESSIONAL2021@GMAIL.COM
MOBILE PODIATRIST NEEDED - SAN DIEGO AREA
Fast growing housecall practice is looking for a podiatrist to see patients in their homes &/or an assisted living facility. We offer a flexible schedule (Part-Time/Full-time), excellent monthly compensation, dedicated support staff. We are looking to add a third podiatrist. July 2021 associates are welcome. If interested, email CV to: barefeetpodiatry1@gmail.com
FULL TIME PODIATRIST - NORTHERN NEW JERSEY
We are a fast-growing podiatry practice in North Jersey with multiple locations and Doctors. We are currently looking for a full-time motivated and caring Doctor to join our busy practice. Some benefits include: competitive six-figure salary, generous bonus structure, health insurance (including vision & dental), paid vacation time off, paid malpractice insurance and CME time off. Great prospects for experienced Doctors as well as new Associates. This is an excellent opportunity to expand your Podiatric medical and surgical experience in an office-based practice! If interested, please submit your CV to DrSamofal@PodiatryCenterNJ.com
POSITIONS AVAILABLE - RHODE ISLAND and UPSTATE NEW YORK
Looking for reliable and ethical podiatrists to service Nursing Homes and Skilled Nursing Facilities in Rhode Island and Upstate New York. Send inquiries and CV to: phasetwopodiatry@gmail.com
ASSOCIATE POSITION WITH OPTION TO BUY – BRONX, NY
Full time or part time with option to purchase. Co-Op City, Bronx New York. Established in 1969. Full scope of podiatry. Must participate in insurance plans. Pleasant office; great patients; Great opportunity. Call or text 914-772-3842 or email: Lwolstein@aol.com
ASSOCIATE POSITION - NW FLORIDA/COASTAL ALABAMA
Busy, well-established practice, EHR, digital x-ray, diagnostic ultrasound. Offering competitive six-figure salary w/bonus structure, health/malpractice insurance, and PTO. PSR-36 required. Partnership path to motivated and compassionate associate. Must obtain Florida and Alabama licenses. Send CV: Brentmharwood@gmail.com
ASSOCIATE POSITIONS - DE, OH, MO, TN, PA, CT, FL
PediRite, a company that provides care to nursing home residents has excellent opportunities providing services to our contracted facilities. Flexible scheduling, set your own hours, very lucrative commissions! This is a great match for podiatrists with open days/hours in their schedule. Work available in DE, OH, MO, TN, PA, CT send resume to sara@sightrite.com (submit for any other state as well as we have ongoing opportunities)
ASSOCIATE POSITION - TAMPA/ST PETERSBURG BEACHES AREA, FL
Due to demand we are seeking a well trained associate. Great hours, no call, office based practice, surgery all included in this practice. Great location. Competitive salary and benefits. Opportunity to grow with this busy practice. Contact: Yourpracticenow@gmail.com
ASSOCIATE POSITIONS - AVAILABLE IMMEDIATELY
Podiatrist positions available for immediate hire to treat patients in Nursing Facilities in FLORIDA, UPSTATE NEW YORK, TEXAS, KENTUCKY, and ARKANSAS. A unique opportunity with flexible schedules and an unmatched potential for growth. Send CV and Cover letter to office@easternpodiatrypllc.com
ASSOCIATE POSITION - ALBUQUERQUE, NM
Busy, growing, 3 location, Podiatry group in Albuquerque, NM seeking full-time associate. Must be ABPM BQ/BE. Competitive salary and full benefit package. Qualified applicant will join a value based, protocol driven state of the art practice addressing all aspects of Podiatric care to include limb salvage, sports medicine, trauma and reconstructive foot and ankle surgery and hospital call. If interested please send CV and cover letter to hiring@nmfootandankle.com
ASSOCIATE POSITION WITH BUYOUT OPTION - FREDERICK, MD
Located in beautiful western Maryland, less than an hour from Baltimore/Washington, DC. Enjoy skiing, hiking, kayaking, hunting, fishing outside your back door. Excellent opportunity for well trained individual who is ready to become an owner after only one year. I will teach you how to become a top earner in the field. Full time offices also in Hagerstown, MD and Gettysburg, PA. Full benefits package. drhenrock@yahoo.com
FULL-TIME ASSOCIATE POSITION – FLORIDA PANHANDLE
Immediate position available for hard-working, motivated individual in a well-established practice. Equal mix of primary care and surgery. Excellent opportunity to get on all insurance panels. Board qualified/Certified with ABPS preferred. Competitive salary and benefit package. Please email CV and letter of interest to recruiting@feetareneat.com.
ASSOCIATE POSITION - SOUTHWEST, FL
Immediate position for busy practice in Sunny Southwest, FL. ABFAS RRA BC/BQ. EMR, E x-rays, US, DME. Base salary + bonus w, PTO, 401K, fees, health benefits. Also 1 ACFAS credentialed fellowship avail, must be BQ ACFAS by start of program 8/2021: DrLam@NaplesPodiatrist.com
PM NEWS CLASSIFIED ADS REACH OVER 20,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 20,000 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com or call (215) 808-0770
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| CLASSIFIED ADS - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICES FOR SALE - HUDSON VALLEY, NY
Long established in two Hudson Valley, NY counties. 4 employed podiatrists, experienced staff. Full hospital admitting, surgical privileges. Participation in most commercial, advantage, Medicare & Medicaid. Custom built Office #1 = 1900 sq ft 3-4 tx rms FOR SALE in deal. Office#2 = 1400 sq ft rental 3 tx rms. Contact: podiatrypracticeny@yahoo.com
PRACTICE FOR SALE - WHITE PLAINS, NY
This established practice has been operating for more than 25 years in key market location. Full range of office services and surgery. Opportunity to grow practice and have outstanding return on investment. Priced to sale. Contact: Yourpracticenow@gmail.com
PRACTICE FOR SALE - BOSTON, MA
High volume surgical practice. Based on hospital campus, serves as referral center for cases. Established relationships. Key success factors include: outstanding interpersonal skills, well trained in all aspects of surgery, willingness to work weekends and take call. Well trained staff in place and willing to transition. Great hands are not enough, superior interpersonal skills required. Contact: YourPracticeNow@gmail.com
PRACTICE FOR SALE - WESTCHESTER COUNTY, NY
This well-established practice needs a new owner. Current owner seeking to retire. Busy office practice built on sports medicine and general podiatric care. Established referral sources. Priced to sell. Owner will transition. Fully equipped. Contact: MCrosby518@gmail.com
PRACTICE FOR SALE - CT - BRANFORD
Solo practice for sale. Practice positioned for future growth. Owner has busy practice with full schedule and privileges available at local hospitals and surgery centers. Owner relocating out of state. Contact: MCrosby518@gmail.com
PRACTICE FOR SALE - VAN NUYS, CALIFORNIA
Motivated Seller. General podiatric 53 year old practice for sale in Van Nuys California, next to hospital.
Great growth potential. Will stay to help transition. Call Ron Miller at 310-980-1822
PRACTICES WANTED TO BUY – TRI-STATE AREA (NY, NJ, CT)
Building out a network of podiatry practices throughout the Tri-State area (NY, NJ, CT). We are looking to buy podiatry practices large, small, rural or urban. Podiatrists who are looking to join a larger group to manage business operations, or retire, can contact us at podiatrymanagementinc@gmail.com. Competitive compensation and benefits package for those who would like to sell and work within the larger company.
PM NEWS CLASSIFIED ADS REACH OVER 20,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 20,000 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details.
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| Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management® Magazine and Podiatry Management® Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
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ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
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distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
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