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PM News

The Voice of Podiatrists

Serving Over 16,733 Podiatrists Daily


November 29, 2014 #5,230 Publisher-Barry Block, DPM, JD

A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2014- No part of PM News can be reproduced without the
written permission of Barry Block

abbyjenn


PM NEWS QUICK POLL

FINAL DAY TO VOTE

Quick Poll

Do you plan on participating in Meaningful UseĀ  in 2015?

Safestep


Gordon Labs


PODIATRISTS IN THE NEWS
NY Podiatrist Discusses Calluses
 
Calluses are often caused by how someone walks. Calluses can be treated with orthotics to correct a person's gait, says Manhattan podiatrist Dr. Hiillary Brenner. Some people don't mind the extra padding on their feet, she says. For everyone else, she advises having the calluses shaved down by a podiatrist every two to three months.
 
Dr. Hillary Brenner
 
Also, moisturize your feet with a good cream and seal it into your skin by wearing a sock for 40 minutes to an hour, she says. "The more you moisturize your feet, the stronger the integrity of the skin is, so it's harder to break down," says Brenner. Finally, you can help to scrub away calluses twice a week with an exfoliant, especially one that contains pumice, she says.
 
Source: Rachel Pomerance, US News and World Report

Spenco


Dr.Comfort


INTERNATIONAL PODIATRISTS IN THE COMMUNITY
Canadian Mission Opens Podiatry Clinic for Winnipeg's Homeless
 
Siloam Mission has taken an important step to help deal with an increasing foot-care demand. The downtown shelter officially opened a permanent podiatry room Thursday, in the hopes of alleviating the many foot problems homeless people suffer through on a daily basis. The permanent podiatry room, a $15,000 facility put together by Dr. Tejel Patel and funded through various donations, will provide patients and volunteers with a modern and well-equipped clinical setting for foot-care services.
 
Dr. Tejel Patel
 
Surprisingly, there’s little difference in demand on the podiatry department from summer to winter. "In the summer it’s hot, so there are friction and blister issues associated with the heat," Patel states, "while winter sees more insulation problems. No matter what season we’re in, though, this service and this new space will continue to help a lot of people."
 
Source: Winnipeg Free Press [11/27/14]

aetrex


QUERIES (CLINICAL)

Query: Medial and Lateral Ankle Pain

This 21 year old athletic male was born with a clubfoot deformity. He has had soft tissue correction (B/L posterior, medial, lateral, and plantar release) at two years of age. His chief complaint is medial and lateral ankle joint pain. His limbs are equal in length with >10 degrees of dorsiflexion. He has limited active supination. He has a decreased medial arch.
 
Medial and Lateral Ankle Pain
 
I made new semi-rigid orthotics with 0 degrees of rearfoot varus, a deep 1st metatarsal cut-out, and forefoot valgus extrinsic post of -3 degrees. The orthotics are comfortable and the left foot is now 99% pain-free, but there is no improvement in the right foot. Any suggestions would be helpful as to what corrections in the orthotics are needed to address the painful right foot without affecting the left foot. Also, what type of surgery should be considered to correct his problems?

optima5


CODINGLINE CORNER
Query: Co-Pay for F/U Avulsion/Matrixectomy
 
What is the rule, if any, on collecting co-pays for follow-up visits on an avulsion/matrixectomy? I know the global period for a matrixectomy is 10 days and for an avulsion is 0 days. So, if I am seeing follow-up visits at 14 days for both avulsion and matrixectomy, am I billing for an office visit and therefore collecting copays since I am out of the global period, or am I not billing and collecting anything since it is a follow-up for a procedure? 
 
Charles Baik, DPM, Tustin, CA
 
Response: First off, just in case there is any confusion, the avulsion would be part of the matrixectomy. The matrixectomy has a global period of ten days. After ten days, you can see the patient as medically necessary and charge a co-pay, per insurance plan. 
 
Tony Poggio, DPM, Alameda, CA
 
Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

Redi-thotics


RESPONSES/COMMENTS (CLINICAL) - PART 1A
From: Lisa Levick, DPM, H. David Gottlieb, DPM
 
The MPJ doesn't look terrible. Where is the person's pain? An MPJ fusion will just create more problems at the MC joint. If deep pain is present, I would put in a hemi implant like Arthrosurface. Keep the motion until it's a problem. You can always fuse in the future. 
 
Lisa Levick, DPM, Oxnard, CA
 
I have had tremendous success treating arthritic 1st MTPJs with amniotic fluid injections. I've found that 2 infiltrations 2 weeks apart works most of the time, with a few people needing three applications. The pain seems to resolve within a few days. I have done these with and without joint distraction via mini-rail, with no observable difference. I no longer recommend joint distraction. 
 
H. David Gottlieb, DPM, Baltimore, MD

Safestep


RESPONSES/COMMENTS (CLINICAL) - PART 1B
From: Eric M. Hart, DPM
 
Thank you for sharing this case. What does his weight-bearing lateral x-ray look like for the 1st ray position? Is it plantarflexed? What other conservative care has this patient had? Has he had a 1st ray cutout orthotic? Have you tried topical NSAIDs? Injections? Give him a series of diagnostic bIocks, first to the proximal side of the sesamoids with small volume lidocaine. Then have him walk this off and have him come back for a 1st MTPJ block. It will take time and be inconvenient, but he’s worth the extra time.
 
What are his hobbies and work physical demands? If he can’t function with a solid rod of a toe, don’t fuse it. Don’t fuse and remove the sesamoids. Do one or the other. The fusion allows you to fuse the sesamoid apparatus easily at the same time. I’ve fused a couple of 1st MTPJs with a prior HIPJ fusion and only did so in patients with low physical demands. It’s difficult to meet the patient's expectations—especially if they’re still pretty active in middle age. You can almost guarantee that he’s going to need some orthotic accommodation down the road, so tell him that pre-operatively.
 
Eric M. Hart, DPM, Bismarck, ND

certifiable


RESPONSES/COMMENTS (EMR)- PART 1A
RE: What's the Use of Meaningful Use? (Jeffrey Kass, DPM)
From: H. David Gottlieb, DPM
 
The government DOES make a great EHR available. It's the same one I and everyone else at the VA uses - CPRS. The VA's Computerized Patient Record System is available here
 
There are companies that have used CPRS as the framework for their systems. I don't know why it's not used by more people. 
 
H. David Gottlieb, DPM, Baltimore, MS

ACE USA and RPS Healthcare Expand Podiatrist Professional Liability Coverage

The Patient Protection and Affordable Care Act and Centers for Medicare & Medicaid guidelines and rules resulted in a record number of investigations and enforcement actions in 2011. ACE Medical Risk, a division of ACE USA, has responded through an endorsement that increases limits on Medicare/Medicaid legal expense reimbursements, raising coverage limits from $30,000 to $50,000 per action, with an annual aggregate of $50,000. This product is underwritten by companies within the ACE Group, an A.M. Best “A+” rated carrier, and is offered to podiatrists exclusively by RPS Healthcare, National Program Administrator of the Podiatry PLUS programs and one of the largest wholesalers and the largest Managing General Agent in the country. For more information Call 800-397-9697 ext 2646.


RESPONSES/COMMENTS (EMR) - PART 1B
RE: What's the Use of Meaningful Use? (Jeffrey Kass, DPM)
From:  Jengyu Lai, DPM
 
Not only have the systems not improved the communications, Meaningful Use did increase unnecessary financial burdens to healthcare. We switched out of one system last year because it couldn’t support all our specialties. Even though we had paid a large sum to purchase the software, we were denied access to the data unless we continued to pay the monthly “maintenance fees.” Our current system has not lived up to their promises but agreed to let us out of the contract without penalty. However, the company demanded a $20k “data transfer fee.” If the government mandates the use of electronic health systems, the providers should be guaranteed access to data. Otherwise, we are held hostage by the EHR companies. The only party benefited is the EHR industry.
 
Additionally, every EHR system has touted how easy charting would be with electronic systems. Regardless whether it is true, we are now being audited because encounters for the same patient look similar. We told insurance carriers that every note was created new, not copied from previous encounters. If they want, we’d produce the electronic record on how each chart was created.
 
Jengyu Lai, DPM, Rochester, MN

Bako


RESPONSES/COMMENTS (EMR) - PART 1C
RE: What's the Use of Meaningful Use? (Jeffrey Kass, DPM)
From:  Alan Sherman, DPM
 
Jeff Kass’s comments regarding the billions spent (19 billion in 2103 alone) on payment to doctors’ offices for accomplishing meaningful use was quite poignant and insightful. I have said again and again that we missed a huge, important opportunity when the ACA failed to establish interoperability and communications standards for EMRs. The network effect, whereby data gains enormous value when it is put on a network and made accessible, was totally missed in this legislation. 
 
It’s the 21st century, but we’ll still need to print and fax or, at best, send static PDF pages of our medical records when requested by another office, for a few years more. It's funny how we...
 
Editor's note: Dr. Sherman's extended-length letter can be read here.
MEETING NOTICES - PART 1

Fabi2

Gordon Labs


YOU CAN'T MAKE THESE THINGS UP

RE: Outrageous Shoes of the Day

What to do with Thanksgiving leftovers?

Source: soulthumpingblog.com

MEETING NOTICES - PART 2

Image Map

kent


CLASSIFIED ADS
LOCUM TENENS WANTED – LOS ANGELES AREA
 
Need podiatrist for 8-12 hours a week to cover Encino practice for 8 months (Dec-July 30, 2015). (Ex: Tues pm and Friday 9-5; flexible). Must have own malpractice ins. Urgent reply requested. O:(818)905-1000, C: (818)807-3200, send cv to email: gilmanpodiatry230@gmail.com.
 
ASSOCIATE  POSITION -  FREDERICK, MARYLAND
 
Exceptional opportunity for an associate Podiatrist who is trained in all aspects of trauma and podiatry. ER call is required.  Salary with bonus structure and benefits package is offered. Please send CV and case log with cover letter to drsteinberg@mynewfeet.com
 
PODIATRIC PHYSICIAN WANTED - CHICAGO/SUBURBS 
 
If you are working in private practice and have the time to see more patients; we can significantly increase your income. Chicago Podiatric Surgeons is looking for a minimum of two days per week commitment to work at one of our offices located in Chicago, Tinley Park or Lombard. Enjoy a full schedule and high compensation immediately. We would consider part or full time employment, independent contracting, partnership or merge. If interested or want more information contact, Thomas Carr, DPM at dr.tcarr@gmail.com.
 
ASSOCIATE POSITION, IMMEDIATE – NORTHERN CALIFORNIA/SF EAST BAY 
 
We are seeking podiatrists to join our multi-office practice, immediate opening. Must have great people skills, bedside manner, and positive demeanor. California license required. No nursing home visits. Prefer private practice experience, credentialed with insurance. Full and Part Time positions. Send CV and cover letter to: ebpod2008@gmail.com
 
ASSOCIATE POSITION - MULTI-SPECIALTY GROUP IN LOS ANGELES 
 
Looking for PMSR/RRA graduate to join the group and the residency training faculty. Must be well trained in limb preservation, trauma, and reconstructive foot and ankle surgery. Starting guaranteed base salary of 120,000/yr with incentives & benefits. Send CV with 3 references to podiatricri@yahoo.com attention Stan Mathis, DPM
 
ASSOCIATE POSITION - EASTERN SHORE OF MARYLAND 
 
Multiple office practice located on the Eastern Shore of MD near beaches.  Seeking motivated, energetic individual to join our three existing physicians.  We are an expanding practice with focus on all aspects of podiatric care.  Offices equipped with ultrasound, digital imaging, 3-D scanners, onsite ambulatory surgery center and many other state of the art amenities. Excellent salary with bonus and benefits package. Send CV to dpmkthomas@gmail.com
 
ASSOCIATE POSITION - SOUTH CAROLINA 
 
South Carolina's largest provider of foot care is a multi-doctor, multi-location practice currently seeking a highly skilled, personable, and hardworking physician to join our TEAM. South Carolina License is necessary. Salary range $120k-$140k (base + bonus) and benefits. Please send Letter of Interest and CV to scdpmjobs@gmail.com
 
IMMEDIATE OPENING FOR A DPM - DC METRO AREA
 
Foot and Ankle Specialists of the Mid-Atlantic, LLC  is in need of a replacement practitioner in our Downtown Silver Spring and DC offices. Come join our team of top docs.  If you are an established practitioner (available now), and you are enthusiastic, personable, motivated and well-trained, we would be delighted to discuss an associate position in our 33-doctor group with 21 locations with you. Significant patient flow, EMR, computerized scheduling, certified ambulatory surgical centers, hospital and physician referral base. Please send cover letter and resume to: newdpm@footandankle-usa.com.
 
BUSY PRACTICE SEEKING FULL TIME / PART-TIME ASSOCIATE - WASHINGTON, DC 
 
Active DC License required now. All facets of podiatry including office, ER, hospital surgery, and nursing homes. We are in three offices in the DC area. We treat you right. Applicants should be PSR-24/36. Competitive salary. You will be seeing 20 patients a day from the start. Opportunity to get cases for boards. Hospital based practice.. Come grow with us. Send CV and references to DCMDfootdoc@aol.com
 
ASSOCIATE POSITION - CALIFORNIA
 
We are a group practice based in Irvine (Orange County), with a second office in the high desert city of Victorville.  Currently, there are four doctors in the group and we are ready to bring on a fifth doctor. Both offices are attached to surgicenters. We have a high patient volume and very little C & C. Our compensation is competitive and negotiable. If you are interested in this opportunity, please feel free to reply via email or call me at your convenience. Michael Goddard 949-289-0685 Email: mgoddard@cafai.com
 
ASSOCIATE POSITION - NEW YORK
 
Well-rounded, hospital based podiatry practice. Large number of new patients monthly, digital x-rays, and EMR. Team podiatrist for Division 1 college sports program. Currently have 3 DPMs and 3 offices. Senior partner is Chair of Pod Dept.; Partner & Associate are involved in wound center. Offices located 75 miles north of New York City, in the beautiful Hudson Valley. More affordable cost of living; great place to live. Looking for a personable individual with strong ethics and high motivation. Seeking an associate leading to potential partnership. Must have PM & S-36 training. Please call (845) 471-2243 or email eriksims@hotmail.com.
 
ASSOCIATE POSITION – NORTHWEST INDIANA/CHICAGOLAND AREA
 
Busy established practice looking for a full time Associate with long term goal of partnership. Two to Three PSR trained. Modern office with EHR/Digital X-ray. Competitive salary, bonus and benefits. Please send cover letter, and CV to Pjames@cffaac.com
 
ASSOCIATE POSITION - DAYTONA BEACH, FLORIDA 
 
Associate wanted for well-established practice in central Florida. Experienced support staff, malpractice coverage and health insurance provided. Excellent opportunity for a promising future. To apply please  go to www.yourcareerinpodiatry.com
 
ASSOCIATE POSITION  - TAMPA FLORIDA
 
Beaches, great weather, great restaurants, culture, laid back lifestyle – all year! "old-style" work ethic, unique thriving practice. Associate to "Buy-In" Opportunity. Customer service, sense of humor detailed, driven, laid back personality. Market yourself and the practice, Good surgical skills, great practice management ability. Email, "I'm the ONE!", CV, docmkatz@gmail.com
 
EQUIPMENT FOR SALE - PADNET
 
PADNET - $12,000. Contact Jennifer at 817-467-1990 or e-mail to info@footanklecenters.com
 
PRACTICE FOR SALE – MARYLAND 
 
Well established, turn-key busy podiatry practice with accredited hospital-grade ASC is available for sale. Situated in a full service medical building located in a very desirable and convenient area of Northwest Baltimore County. Strong referral base and modern facility with EMR, digital x-rays, hi-def ultrasound and multi-use laser equipped. A great opportunity for a group to expand services into this area or for a very motivated and well trained individual. For more information contact Mr. Jesse Delanoy, attorney representative c/o Offit/Kurman Law Group: jDelanoy@offitkurman.com or at his office 301-575-0301.  
 
PRACTICE FOR SALE- ARIZONA
 
Central Arizona - between Phoenix and Tucson. Well established and very busy 35 year old solo-practice. High volume surgery and general practice with good cross-section of patients from pediatric to geriatric. Hospital, surgicenter and in-office surgery. Located in professional center. Contact E-mail: pmmpod@gmail.com
 
PM News Classified Ads Reach over 16,000 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 16,000 DPMs. For details, click here or write to:bblock@podiatrym.com or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at (800) 284-5451.
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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Barry H. Block, DPM, JD
 
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