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06/23/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Advertising “Standard of Care”


From: Allen Jacobs, DPM


 


Increasingly, corporations are advertising the utilization of their products or services as “standard of care.” I believe this to be an inappropriate, even dangerous behavior. The concept of standard of care in not defined by corporations nor their spokespeople. It is defined by podiatry healthcare providers. It is the degree of knowledge and skill expected of the average practitioner, not the use of a particular product or diagnostic service.


 


Corporations seeking increased podiatry utilization must discontinue suggesting that they have the authority to define the standard of care. Standard of care varies from state to state, and varies from the particulars of each individual patient. Standard of care changes over time.


 


Advertising and CME programs suggesting “standard of care” should, in my opinion, be prohibited. We are seeing this claim of “standard of care “with increasing frequency. This is a potentially dangerous road upon which to travel.


 


Allen Jacobs, DPM, St. Louis, MO

Other messages in this thread:


09/13/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: "My Feet Are Killing Me"


FFrom: Joel Lang, DPM


 


I think the program "My Feet Are Killing Me" (The Learning Channel) is a great public relations entity for the profession. However, am I the only one who thinks that the doctor taking off the shoes and socks of an able-bodied patient is "weird"? My doctor does not help me undress. For one thing, the touching of shoes, which are inherently dirty, with or without gloves, contaminates anything else that might be touched.


 


When I was in practice, upon entering a room, the patient had already shed his/her footwear, but the feet were covered with a towel, so that the feet were not the first thing I met when entering the room. I was able to first focus on....


 


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

09/06/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Letter from Ben Walner of APMA


From: Jeffrey Kass, DPM


 


Point of reference: in the event anyone gets an email from Ben Wallner, FYI, he is the Director of Legislative Action for the APMA. The email contains links to call your Congress people to help pass the HELLPP act which is included in the reconciliation package. This is important as it would help recognize us as physicians under Medicaid.


 


I don’t know Mr. Wallner but I think it would be prudent that the email come indicating in the subject line that it is from APMA. I think colleagues who don’t recognize his name might not open the mail. I think the message is important and it is more likely the email would be opened from APMA vs. Ben Wallner. Having said that, I applaud both Mr. Wallner and the APMA on this advocacy.


 


Jeffrey Kass, DPM, Forest Hills, NY 

08/20/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Slip and Fall Prevention


From: Keith L. Gurnick, DPM


 


Podiatry has taken such an interest in slip and fall prevention for our patients and the public, with the implementation of gait training, physical therapy, muscle strengthening, shoes, orthotics, and AFOs, when indicated and medically necessary. Every one of our patients who sustains falls does not suffer from pre-existing conditions such as drop foot, peripheral neuropathy, or flexible forefoot valgus.


       


Here is a link to a site that includes other ideas we should incorporate into our discussions with patients and family members to help prevent slips and falls. This is even more relevant, especially for otherwise healthy elderly patients, but also for our patients who are suffering or recovering from strokes, hip or knee replacements, or have conditions that affect stability and gait issues like ALS, MS, and more.   


 


Disclosure: I have no affiliation with EMC Insurance Company.


                                                        


Keith L. Gurnick, DPM,  Los Angeles, CA

07/23/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: David Secord, DPM


 


I have a brother-in-law who did a dental residency in Richmond, VA to specialize in endodontics. During an interesting conversation with him some years back, he explained that if you are trained in endodontics, you are not allowed to do general dentistry and could be disciplined if caught doing so.


 


I don't know how this is legal, as it seems like restriction of trade to me, as someone who does a root canal can certainly fill a cavity or make braces. As such, if his claim is true, that is NOT the model we want for our profession.


 


The humorist Will Rogers had a quip he would share, which goes as follows: "The World of medicine has become absurdly specialized. I went into the office of an eye doctor and told him 'doctor, I have something in my right eye. You have to help me'. The doctor responded 'I'm sorry, but I'm a left-eye doctor.'"


 


David Secord, DPM, McAllen, TX 

07/19/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Zocdoc’s Portrayal of Podiatry 


From: Alan Sherman, DPM


 


It’s always interesting to see how popular culture is portraying your medical specialty. Podiatry has, for the last two decades, been the specialty that people are at ease talking about. Is that because they find it funny or just, accessible? Imagine this Zocdoc commercial with general surgery, oncology, or ENT as the consumer focus.


 













Click on photo to watch Zocdoc ad



 


BTW, Zocdoc also has ads targeting conditions like migraines and back pain, without mentioning the specialty that you need to treat them. Should we be pleased that they mentioned us by name? You bet we should!


 


Alan Sherman, DPM, Boca Raton, FL

07/06/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Be Aware of the Cancelled Check Scam 


From: Elliot Udell, DPM


 


Recently,  I reviewed my checking account and lo and behold, the check I used to pay my rent had been fraudulently stolen. What the crooks did was gain access to the check by raiding a mailbox and then writing their name over the name of the rent company and then cashing it via a cell phone. Even though the forgery was obvious, the bank did not catch it.


 


I had to spend hours filling out forms at the bank and then had to do the same at the police station. A friend of mine had the same thing happen to her a month ago. She paid a bill and the thieves took the check and added on their names to the person she was paying and then cashed her check. Bottom line - check your cancelled checks carefully, this racket is spreading. 


 


Elliot Udell, DPM, Hicksville, NY

06/25/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Include Podiatric Medical Students in Bill to Vaccinate During Public Health Emergencies 


From: Leonard A. Levy, DPM, MPH


 


To extend existing emergency provisions and make permanent the ability of qualified health professions students to vaccinate during federally declared public health emergencies, Senator Mark Kelly (D-AZ) and Senator Susan Collins (R-ME) introduced S. 2114, the Student Assisted Vaccination Effort (SAVE) Act. S. 2114; this ensures that more than one million qualified health professions students are able to administer vaccines with supervision at the outset of a federally declared public health emergency. This bill also enables schools to put in place procedures for rapid deployment. It is important that podiatric medical students be included in this initiative. 


 


Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL 

06/24/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1B



From: Lawrence Rubin, DPM


 


Once again, Dr. Jacobs hits the nail on the head. No corporate entity, especially with special interest, or CME seminar should dictate what is the “Standard of Care." This would be an extremely dangerous precedent leading not only to easy misinterpretation, but misinformation. Remember, we are dealing with a "Forensic" definition that can carry a lot of consequence.


 


Gary Dorfman, DPM  Dana Point, CA

06/24/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Lawrence Rubin, DPM


 


I agree with Dr. Allen Jacobs who objects to advertising and CME programs suggesting a product or service is a "standard of care" without backing up that claim with statistical or other valid evidence. The claim implies that those podiatrists not using or prescribing the product or service for a particular condition are providing substandard care. Obviously, this advertising could have serious legal repercussions.


 


Lawrence Rubin, DPM, Las Vegas, NV

06/21/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Avi Kornbluth


 


Henry Schein has 10% sodium hydroxide in stock.


 


Disclosure: Mr. Kornbluth is a field sales and podiatry specialist at Henry Schein.


 


Avi Kornbluth, Spring Valley, NY

06/18/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Todd O'Brien, DPM


 


I agree that our biomechanics training differentiates podiatrists from most if not all of our allopathic colleagues. I also believe that this training can provide a foundation for entrepreneurship and engineering-related pursuits. I actually wrote a short book about this topic (Caesar’s Guide for Innovators). My early experiences with biomechanics while in school and then under the mentorship of Dr. Tom Sgarlato more than prepared me for my secondary career developing medical devices. I am often asked if I have an engineering background by contacts in the medical and business worlds. I tell them that although I have no formal engineering degree, I did have a solid education in lower extremity biomechanics. 


 


Todd O'Brien, DPM, Orono, ME 

06/14/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: The Practice of Medicine vs. Podiatry


From: W. David Herbert, DPM, JD


 


My perspective regarding the practice of medicine and the practice of podiatry began being formed in the fall of 1972. Dr. Abe Rubin, the then president of OCPM, told us that many MDs did not consider us real doctors because we had never delivered a baby. In the fall of 1975, I spent six weeks at an osteopathic hospital in Texas assisting in OB deliveries (27 exactly) and assisting in all podiatric surgeries that were performed there. Did this make me a better podiatrist? 40 years later, I still do not think so. 


 


As foot specialists, we are as competent as any physician who treats foot problems and more competent than most doing it! We must remember to limit our practice to what we know we are trained and able to do at any particular time. 


 


W. David Herbert DPM, JD, Billings, MT

06/10/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1B


RE: Scope of Practice of Nurse Practitioners 


From: W. David Herbert, DPM, JD


 


I first became involved with nurse practitioners about 30 years ago in Wyoming. The several that I knew were RNs who had completed a two-year RN program and I believe had an additional 18 months of training to become a certified nurse practitioner. They did not even have a bachelors degree at least at that time. At that time, my wife, who has a masters degree in nursing, was teaching in one of those two-year RN programs. If I had a cardiac, GI or allergy problem, I would not expect anyone providing primary care to treat me for it. I would expect a primary care provider to refer me to a specialist in that case.


 


The era of the plenary medical degree is over. Physicians should be providing specialty medical or surgical care. Most of the time, primary care, if done properly, simply means determining if a specialist referral is necessary. Podiatrists should be able to assess a surgical patient that they are licensed to perform surgery on. This would theoretically mean doing a complete body and systems assessment and determining if the patient has any problems that would preclude the intended surgery. If podiatrists cannot accomplish this type of whole body assessment, they should not be practicing!


 


W. David Herbert DPM, JD, Billings, MT

06/10/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A



From: David Secord, DPM


 


"I believe there are at least a dozen states which allow nurse practitioners to practice independently, which also includes full rights to write prescriptions. I believe changing a state’s practice act to allow podiatrists to treat the foot and ankle medically and surgically and also provide primary care may be politically feasible in some states." - Herbert


 


If you look at the infographic, the cause is being pushed that an NP is just as capable as a doctor or PA. Whether we, as physicians, agreed with this or not appears to have no bearing on the future of the NP and healthcare.


 


David Secord, DPM, McAllen, TX

06/09/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Johanna S. Youner, DPM, Brian Kiel, DPM


 


I recommend McCoys Upholstery in Woodside, NY to reupholster podiatry chairs. They did a great job for my office and are well priced also.


 


Johanna S. Youner, DPM, NY, NY


 


We have used a local car seat upholstering company for our chairs. They are used to vinyl seats and do a good job.


 


Brian Kiel, DPM, Memphis, TN

05/13/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1D



From: Gary S Smith, DPM


 




My son is a DO student and his school requires him to take the USMLE exam in addition to the DO exam. This is a stress they don't need and a financial burden that is unnecessary. They do it to "prove their parity" to a body that does not care. Everything the Project 2000 experiment has tried has only hurt our profession. Podiatry should quit trying to be "transmedical". If you want to be an MD, be an MD. Leave podiatry to the rest of us who want to be podiatrists. Thank you Dr. Jacobs for the solid information on the issue.


 


Gary S Smith, DPM, Bradford, PA



03/26/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Scott Herbert, DPM, Jay Seidel, DPM


 


Use Physician Claim Corporation in Onalaska, WI. I am very happy with their service. They are a podiatry billing specialist company.


 


Scott Herbert, DPM, Freeport, NY


 


I have been using Ontime Medical Billing Solutions and have been VERY satisfied. David is very competent, transparent, and available for questions or concerns at any time. I know he provides services for practices located in FL, MD, and NY.


 


Jay Seidel, DPM, Deerfield Beach, FL

03/25/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Greg Caringi, DPM


 


There is a very simple solution that we have been using for years with good success. We set up a separate phone and phone number for our "on-call phone." I think the add-on cost is like $10/month. When a patient calls our office number when we are not there, they are directed by the voice mail to call the "on-call phone" number with any emergencies (except 911 emergencies, of course). Depending on which doctor is on-call, these calls are call-forwarded to his/her personal cell phone (*73). 


 


The patient is then directly speaking to the on-call doctor. The patient doesn't see the doctor's personal number. The doctor knows it is a patient because he sees the "on-call phone" number. Every Monday morning, I cancel the call-forwarding (*72) and reassign the call-forwarding to the on-call doctor's personal phone number (*73). It is extremely simple and inexpensive and works great. 


 


Greg Caringi, DPM, Lansdale, PA

03/22/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Stephen Musser, DPM


 


This can be a difficult situation, but sometimes you have to be politely rude and tell the patient, "Mr./Ms./Mrs., if I have answered all your medical questions, I need to excuse myself and go on to my next patient so I don't get too far behind. If you think of any more questions, please send me a message through the EHR portal."


 


Stephen Musser, DPM, Cleveland, OH

03/19/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: By the Year 2025: A Commentary on Podiatric Medicine in the Foreseeable Future


From: Leonard A. Levy, DPM, MPH


 


By the year 2025, when currently enrolled podiatric medical students will be at the beginning of their residency, the need for podiatric physicians will be ultra-acute with one of every five Americans being 65 years of age and older. Each of these people has an average of five chronic diseases, most with disorders having pedal manifestations, stressing podiatric medicine as well as the entire healthcare system. The current epidemic of diabetes, for example, with its devastating complications in the foot will be paled by the much wider distribution of that disease in 2025. Degenerative arthritis, especially prevalent among the elderly, will run rampant, so frequently a prime cause of podiatric medical problems.


 


In addition, any suggestion to shorten the required period of residency will be retrogressive, the antithesis of achieving parity with allopathic and...


 


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

03/17/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: There Needs to be a Health Insurance Revolution


From: Peter J. Bregman, DPM


 


I have been telling all of my patients for the last few years that unless there is some sort of revolution or revolt against the so-called health insurance companies, both doctors and patients will continue to get abused financially. Every year, premiums go up, co-pays go up and doctors often get paid less for doing more. The insurance companies keep increasing their revenues. UnitedHealthcare made about $15 billion in revenue. I now refer to insurance companies as money transferring entities. They take money from people and then keep most of it, and then give a little bit to the healthcare providers who actually help people.


 


The reason they get away with it is because no one is making it a big enough public issue. This is likely because of lobbyists. If we were to have a revolution similar to... 


 


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

03/15/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1B




From: Paul Kesselman, DPM



 


I understand this has recently been discontinued due to an overwhelming amount of protest.


 


When I was in practice, I used to download the PDF to a folder in my computer and then could do anything I wanted with the file. Are those who are faced with this now also being charged simply to download the file? If so, that too is outrageous. I have only one Yiddish word to describe UHC (which owns Optum) and this is chazer (pig!). This brings to mind the old southern expression: Pigs get fed, but hogs get slaughtered.


 


If Optum thinks they are going to take over healthcare, I believe they will be faced with overwhelming protests (this recent one was just the tip of the iceberg), which could ultimately lead to their own destruction.


 


Paul Kesselman, DPM, Woodside, NY 

03/15/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A



From: Al Musella, DPM


 


We just ran into this. It looks like we can still download the 835 response file for free. The Medicare website has a free program that can print reports from these files.    


 


Al Musella, DPM, Hewlett, NY

03/08/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Barrett Sachs, DPM


 


No matter what the cost is here in Florida, we are only allowed to get 50% of our credits online or virtually. This was currently raised from 8 credits for 2 years. According to my research, Florida is one of the few states to severely limit our ability to get credits in this pandemic environment. I certainly don't want to attend any conferences where being exposed to COVID-19 is a distinct possibility. I have been vaccinated for 2 months. Florida needs to make changes!


 


Barrett Sachs, DPM, Plantation, FL

03/05/2021    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Different Diabetes Devices


From: Jean T Chen-Vitulli, DPM, MS and Anastasios Manessis, MD 


 


The management of diabetes today has many options. There are now insulin pens, continuous glucose monitors, insulin pumps, and closed loop systems that act similar to an artificial pancreas. Not everyone is familiar with all these options a person living with diabetes may have in improving glycemic control. To learn more and familiarize yourself with the various options that your patient may utilize, click here.


 


This website is also excellent to refer patients to when they ask for your opinion on different devices to help with diabetes control.


 


Jean T Chen-Vitulli, DPM, MS, Fishkill, NY and Anastasios Manessis, MD, Endocrinologist, West Village, NY
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