RE: Should We Dispense Products from Our Office?
From: Elliot Udell, DPM
At board meetings of the American Society of Podiatric Medicine, a specialty group dating back to the 1940s, there was constant arguing and finger-pointing at doctors who sold products from their offices. All of the board members were in podiatric academia. The argument against dispensing is that most doctors from all facets of medicine and dentistry do not sell products to their patients; I was the black sheep in the room.
Recently, I went to a new dental office for a cleaning. After cleaning my teeth and gums, the hygienist asked if I was using an electric toothbrush. I told her that mine broke six months ago and I never replaced it. She was quick on the draw and let me know that the office sells them to patients and I bought one for fifty dollars. I was happy for the service and do not think any less of any of the dentists or hygienists.
Elliot Udell, DPM, Hicksville, NY
Query: Duty to Report Changed Status When Employed by Practice Buyer
I recently sold my practice and I am now working for the purchaser who has a different NPI and Tax ID.
1) Do I have to notify the various insurance companies of the sale or is the fact that I won't be submitting claims any longer under my NPI/Tax ID sufficient?
2) I have to download the Electronic Remittance Advice (ERAs) from my EMR vendor. How many years of ERAs should I save?
Name Withheld
Query: Source for Jan-L Repairs
Jan-L is out of business. Does anyone have a guy who repairs these anywhere? I’m not looking for a new unit, but when it needs repairs, I'd like to have someone to fix it.
David Luongo, DPM, Paramus, NJ
Editor’s comment: RAM Products (732) 651-5500 now sells and services Jan-L products.
12/15/2025
QUERIES (EHRs)
Query: AthenaOne EHR and Billing
Is anyone using AthenaOne EHR and billing? I would really appreciate any opinions from my DPM colleagues.
Dawn Buratti, DPM, Tarzana, CA
12/09/2025
QUERIES (MEDICAL-LEGAL)
Query: Uploading Patients’ Charts into AI
Is it okay to upload patient chart info to Chat GPT if the name of the patient is removed? For example, if a podiatrist had a dermatoscopic image to upload or a chart to upload with the patient’s name redacted, can a podiatrist use a local language model on your local computer or Chat GPT? How does a podiatrist comply with HIPAA regarding this choice?
Daniel Chaskin, DPM, Ridgewood, NY
Editor’s comment: PM News does not provide legal advice. To best understand what is considered Protected Health Information (PHI) under HIPAA, it is necessary to review not only the definition of Protected Health Information under HIPAA in 45 CFR §160.103, but also the definitions of “health information”, “individually identifiable health information”, and “designated record set”.
Source: The HIPAA Journal
11/17/2025
QUERIES (MEDICAL-LEGAL)
Query: Insurance Request for Chart Notes
Recently, I received an email from Regence requesting 16 patient chart notes free of charge. I’m familiar with receiving similar requests from third-party vendors (ex. CIOX, Change Healthcare, etc.) and have successfully charged them for chart note access. However, this one reads differently to me, as it is directly from Regence demanding that I send chart notes to CIOX. They pull contract language as noted and state I am obligated to do so at no cost to them. Am I obligated or do I stand my ground and still demand payment? Have others experienced similar situations and what was the end result?
Medico-legal speaking, I will abide by what’s right, but it makes me wonder that if Regence is correct (i.e., I am under contract), then why have other insurances/vendors paid us physicians thousands of dollars for chart notes when they could have simply and legally enforced the same language Regence did? I imagine most, if not all, insurance contracts have similar language as Regence’s. Or is this just a game of calling each other’s bluff?
Chris Seuferling, DPM, Portland, OR
11/12/2025
QUERIES (NON-CLINICAL)
Query: Source for PDM Podiatry Chair Repair
Is there a highly recommended repair person to repair a PDM Chair in the Long Island area?
Dennis Fassman, DPM, Westbury, NY
11/10/2025
QUERIES (NON-CLINICAL)
Query: Compounding Pharmacy for Cantharone
Can anyone suggest a 503b compounding pharmacy that we can order Cantharone from?
Ed dos Remedios, Providence, RI
11/08/2025
QUERIES (NON-CLINICAL)
Query: Source for Dremel 3000 Nail Grinder
We bought this nail grinder somewhere almost 10 years ago. It’s a great grinder; the main benefits are the large dust intake and very flexible hose, as well as the affordability of the system, as the only custom part is the Dremel attachment and the air hose.
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Dremel 3000 Nail Grinder |
I’ve searched for hours and can’t find another one. Can anybody help me source another couple of these?
Daniel Jones, DPM, Casper, WY
11/06/2025
QUERIES (NON-CLINICAL)
Query: Unequal Salaries
Can someone explain to me why the ACFAS career center website is mostly populated with ads from employers seeking MD/DO only positions? Do you think you will EVER see a DPM employer being able to post an ad on the AOFAS career center website? And then look at the salaries being offering compared to the ones being offered by DPM employers? Is anyone awake at the wheel?
Chad Rappaport, DPM, Westwood, NJ
10/24/2025
QUERIES (NON-CLINICAL)
Query: RVU Conversion Rates for Employed DPMs
I’m trying to gather information on conversion rates for RVUs In NFP Health systems. First: Straight conversions vs. straight with decreased rates for bonuses. Second: conversion rates relative to orthopedics in the same system. Third: is anyone aware of potential avenues podiatry could take regarding potential discrimination in this situation?
Tim Vogler, DPM, Winston Salem, NC
09/25/2025
QUERIES (NON-CLINICAL)
Query: Alternative to the Gordabalm Lotion?
Does anyone have an alternative to the Gordabalm Lotion since the company went out of business?
Tom Debenedictis, DPM, Union City, NJ
09/23/2025
QUERIES (NON-CLINICAL)
Query: DEA MATE Training
I am in the process of renewing my DEA license. I noticed it only allows for courses that are accredited by AMA, even dentistry, but I see no podiatry accreditation courses. Is this correct?
Gary Friedlander DPM, Phoenix, AZ
09/13/2025
QUERIES (NON-CLINICAL)
Query: Sources for Spenco Products
Does anyone have any sources for Spenco products?
A James Fisher, DPM, Eureka, CA
09/11/2025
QUERIES (NON-CLINICAL)
Query: When an Orthopedist Tells Your Patient That Orthotics Are Bogus
I thought I had seen everything until today. A patient presented with plantar fasciitis, early bunions, and abnormal foot pronation. I cast him for custom orthotics. Today, he presented to the office all upset. He had gone to a local orthopedist for something else and ran past his foot history. The orthopedist told him that custom orthotics are bogus and he should get a refund from me and then go and buy Dr. Scholl’s at a kiosk at CVS.
I explained the differences between a Dr. Scholl’s OTC orthotic and what we made for him. How have others dealt with this problem? Would you give the patient a refund based on an orthopedist’s opinion on orthotics?
Elliot Udell, DPM, Hicksville, NY
08/29/2025
QUERIES (MEDICAL MALPRACTICE INSURANCE)
Query: Per Occurrence Malpractice Insurance in California
Just a quick note to all podiatrists regarding insurance coverage at California owned SNFs--PICA doesn't write "per occurrence" policies in California. I am losing an account/contract I've had for 7 years because of this issue. The State of California requires per occurrence coverage. I am going down the list of Med Mal insurers online and am receiving this negative response from them all. Has anyone else had to navigate this issue in California?
John F Swaim, DPM, Red Bluff, CA
08/26/2025
QUERIES (NON-CLINICAL)
Query: Jasper Colin Research
I received a solicitation from Jasper Colin Research regarding paid survey participation. I am looking for good and/or bad experiences from others who have worked with them. This would be helpful not only to me but for anyone else here who is approached by them.
H. David Gottlieb, DPM, Baltimore, MD
08/26/2025
QUERIES (CLINICAL)
Query: Recommended Time Period Between Neuroma Injections
What is the recommended time period between multiple (3) injections for treating neuromas? Each injection is 3cc containing equal parts of: 1% Xylocaine, Kenalog, and Vitamin B12. Orthotics, with the appropriate placed neuroma pads, are also dispensed.
Kel Sherkin, DPM, Toronto, Canada
08/21/2025
QUERIES (NON-CLINICAL)
Query: Source for Broken Springs on Nail Nippers
On four new nail nippers, the spring broke on two of them. When I called the podiatric equipment distributor, I was told that this is normal wear and tear and that they could send it to be fixed which would take 8-10 weeks.
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Broken Springs on Nail Nippers |
From what I can tell, I just need the spring and a screwdriver. Does anyone know where the springs can be purchased?
Richard A. Simmons, DPM Rockledge, FL
08/16/2025
QUERIES (NON-CLINICAL)
Query: Butterfly vs. Clarius Portable Ultrasound Machines
I am deciding between the Butterfly and Clarius portable ultrasound machines. I would appreciate feedback from any users of these particular brands. I have researched the pros, cons, and pricing of both and they are similar. I am now relying on actual user experience.
Anas Khoury, DPM, Passaic NJ
08/16/2025
QUERIES (CLINICAL)
Query: Infection Post-Repair of Ruptured Achilles Tendon
A 69 year old female with a PMH of RA ruptured her tibialis anterior tendon at the insertion. She takes methotrexate, plaquenil, and sulfasalazine, along with monthly Orencia infusions, but has held off on the infusions since her surgery 4 months ago. Repair was performed with Arthrex suture tape, anchoring it with a bioabsorbable Swivelock anchor. This was reinforced with a Wright GraftJacket wrap since the tendon was quite damaged. Unfortunately, she has developed a draining 2mm sinus tract at the incision and presumably has infection within either the graft, the suture, or both.
X-rays do not show any concern for bone erosion. Cultures have grown staph hominis and she has been on appropriate IV antibiotics directed by ID for 6 weeks with no resolution. I was contemplating doing a limited debridement of the sinus tract and an adjacent graft or visible suture fibers, possibly dropping some Vanco powder there in an attempt to eradicate this infection. I know there is no way to remove the entire graft and suture without compromising the tendon and giving her drop foot. I did a long Krackow suture to secure it, which is deeply buried within the tendon and bone anchor. She has minimal pain, is active, and is walking about 7 miles/day for exercise. I am just trying to do anything to avoid sacrificing the tendon and would appreciate any advice.
08/06/2025
QUERIES (BOARD CERTIFICATION)
Query: Board Re-Certification
I have been board certified in podiatry and podiatric surgery for 15 years with the American Board of Lower Extremity Surgery (ABLES). At the time of certification, they accepted my written board examination passing status through the American College of Foot and Ankle Surgery (ACFAS). I had to undergo re-certification every 5 years through case submission, discussion, and review. ABLES was acquired by another certifying board, who has provided verification of certification status for the past 2 years. With my certification expiring soon, this board has told me that I will have to sit for the board exam and submit 50 surgical cases.
I have been in private practice for 20 years and I never imagined I would be sitting for a board exam at this point in my career. As though running a busy solo practice and fighting with insurance companies was not enough already, this adds a bit of stress (not to mention the expense of the application and testing). Is there any advice from others? I have already spoken on the phone with the president of the new certifying board and have gotten nowhere. Another certifying board that I contacted also requires the same process.
Richard D Wolff, DPM, Oregon, OH
08/05/2025
QUERIES (CLINICAL)
Query: The Use of Injectable Hyluronidase Gel for Arthritis of the Feet
For decades, orthopedists and other medical specialists have been injecting hyluronidase gel into knees. There have been a few papers published suggesting that this can be helpful with arthritis of the foot and ankle. Question: How many of you have used this for foot and ankle arthritic conditions and does insurance cover it for foot and ankle osteoarthritic conditions?
Elliot Udell, DPM, Hicksville, NY
07/18/2025
QUERIES (FOOTWEAR)
Query: STAND+ Shoes
Being podiatrists, we are always looking for good shoe options to suggest to our patients, friends, and family. Recently, I came across a shoe called STAND+. Two models of most interest are the Antigrav1 and Antigrav2. Their website states their line of shoes have the American Podiatric Medical Association Seal of Approval. Has anyone tried on these shoes or know about this brand? Any input would be greatly appreciated.
Jack Ressler, DPM, Boca Raton, FL
