Podiatry Management Online


Podiatry Management Online
Podiatry Management Online



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Query: Supplemental Oxygen in the Office


Is anyone using or supplying supplemental oxygen for themselves or for their patients in the office? I have noticed my personal pulsioximeter readings are dropping in the low 90s while I am wearing a regular mask. It seems to be much worse in the afternoons than mornings. I am 64, so my age may exacerbate this. Is anyone else experiencing this?


Richard A. Simmons, DPM, Rockledge, FL

Other messages in this thread:



Query: Oral Surgeon Model for Podiatry?


In reviewing posts about our profession’s future, I have not noticed a post on the possibility of a DPM/MD using the oral surgeon model. Could this be a possibility for parity that uses several of our schools that share campuses with existing medical schools? 


Phil Culliton, DPM, Tonawanda, NY 



Query: Recommendation for Inexpensive Voice Recognition Software


Are there any suggestions for voice recognition for office note dictation? We have been using Dragon and are happy with the product but it is getting very costly. Are there any comparable systems that aren't as expensive?  


Jeff Worman, DPM, Largo, FL



Query: Upgrading to a Cloud-Based Digital X-Ray System


We have a CR digital x-ray system. We are told the support is no longer available and now have to upgrade to a cloud-based system. The price quoted is around 25K per office. I would like to hear from my colleagues as to their experience with this.


Ed DosRemedios, DPM, Providence, RI



Query: Revised Notice of Reporting to HRSA


I recently received an email from HRSA (Health Resources and Services Administration) about new reporting requirements for recipients of provider relief payments. Does anyone know what this is about? Is this for PPP loans, SBA grants, or any other monies received due to the pandemic?


Edward S. Orman, DPM, Perry Hall, MD



Query: Availability of 10% NaOH for Matrixectomies


What is the current availability of 10% NaOH for matrixectomies? I have been buying this from two suppliers. Neither source has the product available and there is no timeline for availability.


Greg Caringi, DPM, Lansdale, PA



Query: Source to Reupholster Podiatry Chairs


Can anyone recommend somebody or a company that recovers podiatry chairs in Bergen county NJ?  


Wayne Feldman, DPM, Fair Lawn, NJ



Query: Recommendation for Podiatry Chairs and Hydrotherapy Units


Can anyone recommend someone who fixes podiatry equipment such as podiatry chairs and hydrotherapy units in the NYC/Long Island area?


Elliot Udell, DPM, Hicksville, NY



Query: Acupuncture Certification


I have a few patients who have chronic arthritic pain of the lower extremities respond well to acupuncture performed by a local non-MD acupuncturist trained in the U.S. Has any podiatrist incorporated acupuncture into their practice successfully? Where trained? If so, would certification allow a wider scope of practice, i.e. smoke cessation, weight loss, back pain, and other non-foot related painful conditions. It seems odd that a non-MD can treat such a wide variety of medical problems without supervision or a medical exam.


John Moglia, DPM, Berkeley Hts., NJ



Query: Recommendation for Efficient and Trustworthy Billing Company


Can anyone recommend a billing company that is efficient and trustworthy?


Jerome Reeves, DPM, Hollis, NY



Query: Alcohol Injections for Neuroma 


I would like some guidance from those practitioners who use alcohol injections for neuroma treatments. The answers to the following questions would be appreciated:


1. What is the cocktail injection using alcohol and the amounts per substance?

2. What is the amount of the cocktail injected per treatment?

3 When do you increase the % of alcohol from 4% to a higher amount—and what is that higher amount?

4. What, if any, are the side-effects with alcohol injections and how are they treated?

5. What are the total number of injections given and over how long a period?

6. What results are expected and when?

7. Is the series of injections repeated and if so when?

8. Where in relationship to the neuroma mass is the injection given? 


Kel Sherkin, DPM, Toronto, Ontario



Query: Changes to Board Certification ABFAS Requirements


I recently received an email from the ABFAS that seemed to suggest that continued board certification will require additional testing requirements in foot surgery. Does anybody know what these requirements are?


Also, I do not understand how the ABFAS can change the rules on current board certified foot surgeons. In the past, I would assume grandfathering was done. The email I read would suggest that current ABFAS diplomats will be subject to continued exams, etc. Can anyone shed light on this development if my understanding of it is correct.


Don Peacock, DPM, MS, Whiteville, NC



Query: HealthSmart Complete PPO


My office is fielding calls from Centene about a new PPO in our area called “HealthSmart Complete.” I am curious if any of you are part of their network and what your experience is as far as fair market reimbursement, timely payments, and handling of appeals.


Dave Williams, DPM, El Paso, TX



Query: Recommendation for Collection Agency


Can anyone recommend a good collection agency that works on a contingency basis? 


Ian Klein, DPM, St. Petersburg, FL



Query: In-office Physical Therapy 


We are looking to add physical therapy to our office. I know there are different state laws regarding how physicians handle these arrangements and we are looking for some feedback about how others have done it. We have two ideas: either set up an independent office or hire the physical therapist and have a multi-specialty group. The one issue that may complicate it is the physical therapist is a sibling of one of the doctors.  


James Hirt, DPM, Fenton, MI



Query: Source for Dehydrated Alcohol


I am looking for sources to purchase the dehydrated alcohol that is used as a sclerosing agent for neuromas. Currently, we purchase 5ml vials for about $250/ bottle. Their price is going up at the end of year to $800-$900 per bottle. 


Ed DosRemedios, DPM, Providence, RI



Query: Formula for Valuing a Practice


What is the current method in 2021 to value a practice for sale? Is it still based on one year’s net or a multiple or percentage of that? Is there any difference between a C-Corp vs. solo practitioner?


Mark Ross, DPM, Yardley, PA


Editor's Comment: Note that any formula would just be a potential starting point for the valuation of a practice. There are multiple factors which go into any valuation including, but not limited to, type of practice, age of equipment, lease terms, accounts receivable, type of insurances accpted, and location and demographics of the area.



Query: What do Podiatrists Keep in Crash Carts? 


I am curious about what podiatrists keep in their clinical “crash cart.”  I also wonder how many podiatrists have AEDs in their clinics. What would be a sensible approach to this type of emergency care and preparation?


Dave Williams, DPM, El Paso, TX



Query: Fluid Flow Amniotic Liquid Allograph Injection - Results and Reimbursements


I have been approached by BioLab Sciences concerning their product Fluid Flow. Does anyone have experience with this product, results, and reimbursements? The company clearly says there is Medicare reimbursement. Has anyone had refund requests for past payments?


Elliot Diamond, DPM, Philadelphia, PA



Query: Vendor of Diagnostic Ultrasound


Can I have a recommendation for a vendor for diagnostic ultrasound for use in the office?


Denise A. Levy, DPM, Bronx, NY



Query: Podiatry Coding & Billing Training


I am interested to know if there is a recommended training and educational facility for the podiatry billing and coder. I have searched online but do not see a specific training recommendation.


Dieter J Fellner DPM, NY, NY



Query: Recommendation for Transcription Company


I am nearing retirement and do not use an EMR. My current transcriptionist is retiring. I need a reasonably priced replacement company, preferably with podiatry dictation. I currently use an encrypted voice recorder that we download and receive encrypted notes back. Any recommendations?


Ian Klein, DPM, St. Petersburg, FL



Query: Functional Movement Specialist


Does anyone know of a course a DPM can take to become a functional movement specialist?


Robert Scott Steinberg, DPM, Schaumburg, IL 



Query: Source for Marcaine


My office reports they are having trouble finding 0.5% Marcaine with epinephrine. Does anyone know of a reliable source? We use this for our sclerosing injections for neuromas and we are down to our last bottle.  


Jane Graebner, DPM, Delaware, OH



Query: Sanexas Neuropathy Treatment


I just heard from a patient about a clinic in my area that is using a new neuropathy treatment called Sanexas. This treatment uses "electric cell signaling-therapeutic pulsed energy waves that are comfortably and non-invasively delivered directly into the body's desired anatomical region". According to the clinic brochure and the company website, patients require 3 treatments a week for 3-4 months and that "Medicare and most major PPO insurance plans typically reimburse up to 24-36 treatments". They also claim it will increase circulation.


Is anyone familiar with Sanexas? If so, what results have you seen? If it is in fact covered by Medicare and most insurance plans, then what code is being used for this and what is typical reimbursement?  


Tom Silver, DPM, Minneapolis, MN



Query: Collecting Annual Medicare Deductibles


I am watching this 800-pound gorilla rear its ugly head once again. Being retired (from a solo Florida practice), I am no longer aggravated by the pain of collecting Medicare deductibles. But I can certainly empathize with anyone who is still involved. I am curious as to how much of a problem this presents in other parts of the country. 


Howard Lepolstat, DPM, Coconut Creek, FL

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