Query: Pay Structure for New Associate
I am a solo podiatrist of 21 years. I have been blessed with a very busy and growing practice. I am currently building a new office large enough to accommodate two doctors. My question is in regard to how to pay the new associate. I know there are so many variables to consider so even just some general rules or formulas would be appreciated. For the sake of argument, let us assume this is a fresh 3-year trained resident graduating from their program and I would be paying their malpractice, CME, health insurance, and any other "normal" benefits.
What range of base salary is considered normal for a smaller southern city of a population around 100,000 people? For example would a $100K base salary based of a 40% split based off gross collections be a good starting point? (In this example, the new associate would have to collect $250K to break even, and then would keep 40% of the gross collections above $250K.) I am open for all suggestions. I would like to pay associates fairly, yet incentivize them to produce.
Query: Using a DPM Degree Outside of Podiatry
What else can I do with a “DPM” degree besides practice clinical medicine? Where else is the DPM recognized outside of our community? I have a bachelors degree in biology and then I went to podiatry school right out of undergrad. I’m feeling that practicing and seeing patients is perhaps not for me—at least full time. One of my true passions is to teach. I’m interested in seeking teaching opportunities at some of my local colleges and universities. Anyone else care to share their experience?
Editor's comment: You only go through life once, so you should always pursue your passion. Many academic institutions from high school level (NYC Public Schools, for example) on accept the DPM as post-graduate training.
Query: Creating a Facebook Page
I have had a website for several years, but I am considering creating a presence on Facebook. I would like to know if my colleagues who have Facebook pages have any tips or suggestions on setting up a practice Facebook page. Does it consume a lot of time adding content regularly? Has it proved to be a significant source of new patients (compared to print or other advertising)?
Mark Aldrich, DPM, Antigo, WI
Query: Source for Carbocaine
Can any reader direct me to a supply source for carbocaine 2% Plain 50ml bottle? All my supply sources say it is on backorder of unknown time.
Pete Harvey, DPM, Wichita Falls, TX
Query: Custom Shoes for Patients with Gout
I have a very unique diabetic patient who has the most severe case of tophaceous gout I have ever seen. The patient's hands are affected as well, so the use of laces is out. My question is: Are there any other custom shoe makers that can make a shoe for a really, really deformed foot in constant danger of ulceration, especially around the tophi?
A. James Fischer, DPM, Eureka, CA
Query: User-Friendly Billing Software
I am looking for billing software that can submit electronic claims to insurance companies, track accounts receivable, and print monthly statements for patients that need to be billed. It needs to be able to receive electronic EOBs and, if possible, have a function to check insurance benefits. I prefer to have software I can purchase and install on an office computer as opposed to a cloud-based platform. I am not interested in an EMR package. Does such a program exist that is reasonably priced?
Judd Davis, DPM, Colorado Springs, CO
Query: SMB Podiatry Services Billing
Can anyone give either positive or negative feedback as to their experience with SMB Podiatry Services Billing out of the Kansas City, MO area? I’m considering signing on to their company in the very near future.
Allan Freiberg, DPM, Metairie, LA
Query: Podiatry-Specific Insurance Billing and Collection Services
I would like to get recommendations from the profession on podiatry-specific insurance billing and collection services, specifically the pro and cons. Also I’d like to know what percentage of procedure codes are being rejected and has this gone up in the past few years?
Allan Freiberg, DPM, Metairie, LA
Query: Axolotl Biologics
I have to assume that many of you have clicked on the PM News advertisement for Regenerative Treatment. The company is based out of Arizona. Have any of you had any experience with the injectable form of this product including results, using with or without PRP, with or without ultrasound guidance, patient interest, etc.? This is a very intriguing time for all of us and a modality such as this, if successful, could change the way we treat many injuries, acute and mostly chronic. I curiously await your feedback.
David Kahan, DPM, Sacramento, CA
Query: Yearly Diabetic Foot Exams
I've been in solo practice just under 6 years, and I was hoping for some clarity on the issue of yearly diabetic foot exams for people with diabetes but no concurrent foot issues. I have heard back and forth from different voices in the podiatry world giving conflicting opinions. What is the answer?
I have read Dr. Jacobs recent post about the 2019 ADA guidelines but would still appreciate further advice and direction as it relates to scheduling diabetic patients on a yearly basis with no foot complaints/problems; they just have diabetes.
Jeff Merrill, DPM, Klamath Falls, OR
Query: How to Check Patients’ Deductible Status
Is there a free or inexpensive way to check patient deductibles before services rendered (especially Medicare and Horizon)?
John Moglia, DPM, Berkeley Hts, NJ
Query: Wound Care Clinics
I'm looking for advice regarding out-patient wound care clinics, specifically: type of procedures performed; which types of products/biologics make the most sense to have on hand; the most common modalities utilized; and protocol recommendations.
S. Jeffrey Siegel, DPM, Bradenton, FL
Query: Sterilization Testing System
What is a good testing system to assure that sterilization of instruments by steam autoclave has been accomplished and documented for state inspection requirements?
John Moglia, DPM, Berkeley Hts., NJ
Query: National Shortage of Meperidine
I have used Demerol for my post-op patients for years to control acute pain for the first 3 days or so. There are several reasons that I prefer it over other narcotic pain meds, and I have prescribed most all of them over the years. Recently, I have been informed by a local pharmacy that there is a national shortage of meperidine and I was wondering if I was told the truth. FDA did have a warning about a shortage of IV meperidine for PCA use, but I did not find any info on the oral form. Is anyone else aware of this?
Tip Sullivan, DPM, Jackson, MS
Query: Custom Hallux-Toe Latex Shields
Are there any companies that still make custom hallux-toe latex shields?
Joe Boylan, DPM, Ridgefield, NJ
Query: Lamisil Discontinuation
The FDA Drug Shortage List has Lamisil 250mg as being discontinued by Novartis. It will be available until the end of April 2019. We have already had one pharmacy unable to fill a Lamisil prescription. Is anyone else feeling the impact of the discontinuation of Lamisil?
Catherine Yack, DPM, Huntsville, AL
Query: Government Shutdown and Medicare Payments
Does anyone know if the shutdown will delay Medicare payments?
Larry Aronberg, DPM, Lake Worth, FL
Query: Digital Camera to Upload to EHR
I'm looking for a digital camera that will transmit in a HIPAA-compliant manner via Wi-Fi or cable to my EHR. Any suggestions?
Richard Willner, DPM, New Orleans, LA
Query: TayCo External Ankle Brace
Does anyone have experience with the TayCo external ankle brace for treating posterior tibial dysfunction?
Frank DiPalma, DPM, Athens, GA
Query: Source for Quality Disposable Nail Clippers
Does anyone have information on suppliers of quality disposable nail clippers?
Mark Hinkes, DPM, Nashville, TN
RE: Source for Shoe Horns
I am hoping that your readers may assist in my search for a supply of 20-50 shoe horns. I am currently serving the veterans in Springfield, MA and always have a shoe horn handy to assist in helping put shoes on their feet. There are many requests from them and I only have my one remaining shoe horn. I have been unable to locate any store where I could purchase a supply to provide at no charge to these veterans.
Charles F. Ross, DPM, Pittsfield, MA
Query: Podiatric Cancer Registry
Are all DPMs in a risk group? Almost every week, we learn of a fellow DPM who has passed on due to some type of cancer. I wonder if there is something we are all exposed to that might be increasing the risk of specific cancers among DPMs. Many have been reported with lymphoma and pancreatic CA which makes me wonder.
My request is that one of our researchers, schools, or the APMA consider developing a registry so that real data can be generated. When I started podiatry school in the '80s, there was a thought that testicular cancer incidence was higher among DPMs and the thought at the time was that the use and grinding of Rhoadur (that we all used in orthotics) was responsible, causing this material to be removed from the market.
Bret M. Ribotsky, DPM, Boca Raton, FL
Query: Affordable Ultrasound Machine
My old ultrasound machine finally died. As much as I would love to get a $16,000 machine, it is impractical at this time. There are a number of lower level machines in the $6,000 range that are probably more technically advanced than my old one. What can my colleagues who use US regularly suggest for a new machine?
Ron Werter, DPM, NY, NY
Query: Billing Service for Small Practice
I am need of a billing service that is willing to work with a small solo practice in IL. Any recommendations would be appreciated.
Gary Trent, DPM, Chicago, IL
Query: Recommendations for X-Ray Systems
We are a busy surgical practice in need of a new x-ray system. Can anyone recommend a system with which they’ve been satisfied? (No rep responses please).
Christopher Stewart, DPM, Charlottesville, VA