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PM News

The Voice of Podiatrists

Serving Over 17,786 Subscribers Daily


December 05, 2016 #5,811 Publisher-Barry Block, DPM, JD

A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2016- No part of PM News can be reproduced without the
written permission of Barry Block

OHIMBB117


PM NEWS QUICK POLL RESULTS
Results of last week's poll

Clearanail125


AMERXL5

PM NEWS QUICK POLL

Quick Poll

How familiar are you with MACRA?

Blaine1003B


AT THE COLLEGES
Kent State Students and Professor Invent Insole for Diabetic Patients
 
Kent State University students Nilin Rao, PhD and Craig Verdin, and Exercise Science and Physiology Professor Ellen Glickman, PhD are the co-founders of TheraPod Medical LLC, a wound-care company that is looking to transform the field of podiatric medicine. Rao, a fourth-year podiatric student who completed his master’s and doctorate degrees in exercise physiology from Kent State, and Verdin, a second-year podiatric student in Kent State’s College of Podiatric Medicine, have been working with Glickman to research and develop products geared toward helping those with diabetes.
 
(L-R) Drs. Nilin Rao and Ellen Glickman; Craig Verdin
 
They developed and patented a product called the Puncture-Pedic insole to help people with ulcerations on their feet, which affects people with diabetes, and can be very painful without assistance. If the ulcerations don’t heal properly, they can cause infections and lead to possible amputations on the toes and feet. The insole made of a soft, durable fabric fits into a normal shoe and allows certain spots to be punched out so that the person can walk without pressure on the ulceration. This allows the person to easily and comfortably walk without the need for a walking boot until they can recover.

Neurogenix1128D


PODIATRISTS IN THE NEWS
GA Podiatrist Discusses Bunions
 
For many people, bunions are hereditary, but for others, the problem can occur because of years of ill-fitting shoes. Whatever the cause, it’s a painful condition for several reasons.
 
Dr. Michael Schreck
 
“Because of the deformity, it starts to make the foot wider; that’s number one so that makes for a lot of shoe gearing problems. Then the big toe, when it starts to push on the smaller toes. It can cause those toes to draw up and become hammertoes. So again, you get a wider foot, which then makes all sorts of shoe-gearing problems,” said Dr. Michael  Schreck, a podiatrist at Foot and Ankle of West Georgia.
 
Source: Teresa Whitaker, WRBL-TV [12/1/16]

toerific1031


E-HEALTH NEWS
AHA Asks Trump to Cancel Meaningful Use Stage 3
 
The American Hospital Association has asked President-elect Donald Trump and his emerging administration to cancel Stage 3 of the Meaningful Use program. Currently, the mandatory start of Stage 3 is 2018, as established by the Centers for Medicare and Medicaid Services in a final rule released this fall.
 
In a November 30 letter addressing a variety of regulatory pressures faced by the nation’s hospitals, AHA asked Trump to cancel the final Meaningful Use stage “so that hospitals will not be forced to spend large sums of money upgrading their electronic health records solely for the purpose of meeting regulatory requirements.”
 
Source: Greg Slabodkin, Health Data Management [12/2/16]

pedicis59b


HEALTHCARE NEWS
Healthcare Spending Hits $3.2 Trillion in 2015
 
Healthcare spending in 2015 increased at a rate of 5.8%, the fastest in eight years, as more people obtained health insurance and prescription drug costs continued to rise, according to a CMS report published Friday by Health Affairs. For the first time, the federal government accounted for the largest share of healthcare spending at 29%, mainly because of Medicaid expansion. Household spending made up 28%, private businesses were 20% and state and local governments were 17%. Federal government spending grew at a rate of 8.9% in 2015 after an 11% increase in 2014.
 
The 2015 increase follows a 5.3% spending increase in 2014, which came after five years of historically slow growth. National healthcare expenditures represented nearly 18% of the GDP in 2015. Spending in 2015 reached $3.2 trillion, or $9,990 per person. The report's authors predict continued growth in health spending over the next decade because of the aging population and continued medical price growth. The report "casts further doubt on the extent of a permanent slowdown in health cost growth," said economist Eugene Steuerle of the non-partisan Urban Institute.
 
Source: Shannon Muchmore, Modern Healthcare [12/2/16]

sigma


PRACTICE MANAGEMENT TIP OF THE DAY
The Basics of Incident-to Billing - Part 4 
 
Employing non-physician practitioners (physician assistants, nurse practitioners, clinical nurse specialists, etc.) is an effective way to increase productivity in a physician office. However, under Medicare rules, covered services provided by non-physician practitioners (NPPs) are reimbursed at a reduced rate (85 percent of the fee schedule amount). The “incident-to” billing rules provide an exception, allowing 100 percent reimbursement for non-physician services that meet the requirements detailed in the Medicare Benefit Policy Manual, Chapter 15, Section 60 (Services and Supplies Furnished Incident To a Physician’s/NPP’s Professional Service).
 
There are six basic requirements to meet the incident-to guidelines for Medicare payment:
 
4. A physician must actively participate in and manage the patient’s course of treatment. The exact requirement is usually defined by the state licensure rules for physician supervision of NPPs (e.g., the physician must see the patient every third visit).
 
Source: G. John Verhovshek, MA, CPC, Physicians Practice [11/23/16]

pica37joystick


MSI531


QUERIES (CLINICAL)
Query: Non-Healing Biopsy Site
 
I'm a 70 year old podiatrist in good health. Six weeks ago, during a regular skin exam, a suspicious lesion was noted on the plantar lateral border of my left foot. A shave biopsy revealed an acral compound nevis with some irregular cells. I was informed a future excision may be needed. The biopsy site has not healed after six weeks.
 
Non-Healing Biopsy Site
 
Treatment has included daily cleansing, dressed with Aquaphor, sterile padding and cushions to reduce shoe pressure. 10 day course of a cephalosporin, then 10 days of doxycycline did not reduce the surrounding erythema.  Any suggestions would be appreciated.

OHIMezzo66


QUERIES (NON-CLINICAL)
Query:  The Global Foot and Ankle Congress 2017
 
I've been receiving notices about a new conference group hosting a meeting in China called The Global Foot and Ankle Congress 2017. The meeting is supported by the Asia-Pacific Society for Foot and Ankle Surgery, Chinese Orthopaedic Foot & Ankle Society.  
 
They say that they held a meeting in Cleveland, OH last year with over 300 attendees from 27 countries. That's a big meeting. It's too big of a meeting not to have gotten some attention on online groups but I don't recall hearing about them. I wouldn't mind spending the money to visit China, but I don't want to find out that there is no meeting upon arrival. Has anyone heard of this group and/or gone to the Cleveland meeting last year? 
 
H. David Gottlieb, DPM, Baltimore, MD

Bakomacer


RESPONSES/COMMENTS (CLINICAL) - PART 1
From: Robert A. Boudreau, DPM
 
I encourage our colleague to obtain a biopsy of the periphery and central lesion ASAP. Many years ago, I saw a patient for "recurrent warts." His PCP had removed a lesion from his heel almost a year prior. The patient wanted to take the specimen home and show it to his wife, so the PCP put it in a jar of formalin and sent him home with it. He came to my office complaining that the original surgery had never healed, and that the warts were spreading to other places. You can see what's coming: malignant melanoma. I biopsied 2 lesions, and within 18 months, the patient had expired. Had the initial specimen been sent to the pathology lab rather than home to show his wife, the outcome may have been different. Please take a biopsy or two.
 
Robert A. Boudreau, DPM, Tyler, TX

Fabi125


RESPONSES/COMMENTS (CLINICAL) - PART 2
RE: Betadine® and Silvadine® on an Open Wound Long-Term
From: David Secord, DPM
 
I’m always curious about the recommendation of using either povidone iodine (Betadine®) or silver sulfadiazine (Silvadine®) on an open wound, long-term, to promote healing. As you can see from the chart enclosed (from “The In Vitro Antimicrobial Activity of Wound and Skin Cleansers at Nontoxic Concentrations”, Betadine® is toxic to fibroblasts and keratinocytes. The other article(s) cited questions about the usage of Silvadene® (as opposed to nanocrystalline silver) on wounds. 
 
From: Wound Cleansers and Toxicity. ADV SKIN WOUND CARE 2005;18:373-78: “Skin cleansers in the present study were most toxic to fibroblasts, showing toxicity indexes between...
 
Editor's note. Dr. Secord's extended-length letter can be read here.
Faculty Full-time Professional
College of Podiatric Medicine
[Job #988847]
Kent Campus – Independence, OH
 
Opportunity: The College of Podiatric Medicine has an immediate, full-time clinical faculty opening in our Department of Podiatric and General Medicine.
 
Qualifications: Successful candidates must possess current licensure (DPM) in the State of Ohio (preferred) or eligible for licensure in the State of Ohio; completion of a residency program; board qualification required (certification is preferred); ability to pass risk management and malpractice underwriting; ability to be fully credentialed on private and public health insurance plans.
 
For a complete description of this position and to apply online,
visit our jobsite at https://jobs.kent.edu and reference job number 988847
Equal Opportunity / Affirmative Action Employer / Disabled / Veterans

RESPONSES/COMMENTS (EMR)
From: Rich M. Cowin, DPM
 
I too have found Practice Fusion and Dragon to work very well together. When you set up Dragon medical on your computer, you can select podiatry as your specialty and the dictionary with many of our commonly used terms will load. There is a very nice hand-held microphone that I also purchased from HTH Engineering from whom I purchased Dragon Medical. It is manufactured by Nuance. You press the “T” button on the microphone and a text box opens on your computer screen. As you dictate, your text appears in that text box. When you finish dictating, you press another button on the microphone and the text transfers into the designated area of the Practice Fusion Program. HTH Engineering also offers free lifetime tech support which I have utilized several times with excellent experiences. 
 
Disclosure: I do not have any financial relationship with HTH Engineering, Dragon Medical, Nuance, or Practice Fusion.
 
Rich M. Cowin, DPM, Orlando, FL

ICS66


RESPONSES/COMMENTS (NEWS STORIES)
From: Donald R Blum, DPM, JD
 
It appears that the issue is that this one doctor testifies for plaintiffs against DPM defendants, not about the competency of the doctor. In most states, after the Governor (governor's appointment officer) makes an appointment, the appointee must be approved by the state senate. I'm not sure of the appointment process in New York, but podiatrists can express dissatisfaction with the appointment by writing to Thania Fernandez (thania.fernandez@nysed.gov) of the New York State Education Department. Perhaps if enough DPMs complain and express that it is felt that this appointee would not protect the citizens (not the licensees) of NY, then perhaps her appointment might be rescinded.
 
The purpose of a licensing board is to protect the citizens of the state and make sure that the practitioners meet minimum standards of competency.
 
Donald R Blum, DPM, JD, Dallas, TX

DrRem37


YOU CAN'T MAKE THESE THINGS UP

RE: Outrageous Shoe of the Day

What to do with leftover cherry Swizzlers?

Source: Safa Sahin via Virtual Shoe Museum

MEETING NOTICES

IFAFarthro125

IPED704


aafas1024


codingline1

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CLASSIFIED ADS PART 2- PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE
LOOKING TO BUY YOUR PRACTICE! 
 
We are an expanding, well-rounded, multi-site, state-of-the-art podiatric practice seeking to acquire another practice located anywhere in North Broward County or Palm Beach County, FL. If you are interested in selling, but still hope  to continue working part-time within the field, we are flexible and open to accommodating this request. If interested, please contact Dr. Ian S. Goldbaum at Podfather5@aol.com.
 
PRACTICES WANTED - NEW JERSEY 
 
Practice looking to expand through acquisition and/or merger. Ideal locations within one hour of NYC. Opportunity to receive cash for your practice. NJAssoc@comcast.net
 
PRACTICE FOR SALE  – REDUCED TO SELL-  WESTERN MASSACHUSETTS 
 
State-of-the-art medical suite renovated 4 years ago Modern equipment, prime location, large physician referral base, full hospital privileges. No house calls, nursing homes or hospital ER call. Established patient base and unique opportunity for surgically-oriented podiatrist in the Berkshires. Will transition, if desired.. Contact: drross@albany.twcbc.com or 413-443-2468.
 
PM NEWS CLASSIFIED  ADS REACH OVER 16,500 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 16,500 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com  or call (215) 808-0770.
CLASSIFIED ADS PART 1- ASSOCIATE POSITIONS AND FELLOWSHIPS
1 YEAR RECONSTRUCTIVE FELLOWSHIP  
 
Requirements graduate of PM&S36, CV, board scores, school transcript. in service exam scores for ABFAS. Common cases to expect, Rods, Illizarov, hindfoot & midfoot fusions. Adult/pediatric flat foot.  ACFAS poster to be done. Energetic, well spoken & efficient. BQ in RRA by end of residency. 55k / yr www.fflcreconfellowship.com  klamdpm@hotmail.com
 
F/T OR P/T PODIATRIST- PENNSYLVANIA
 
Expanding, well rounded, multi-site, state-of-the-art group with offices and Nursing homes throughout Lehigh County, Pennsylvania. We offer: Competitive salary Benefits, paid time off, partnership opportunity We're associated with hospitals, wound care centers, and a residency program.  Requirements:  Hard-working, self- motivated, Non-Surgical OK 2017 graduating residents welcome. Please email CV to:   recruiting@foi-solutions.com
 
PODIATRIST WANTED - NORTHERN NEW JERSEY
 
Graduating in 2017 or existing podiatrist looking for a change. Must be go getter and work well with others in great opportunity. Confident forefoot and rearfoot /ankle training a must. podiatrydocsnj@gmail.com
 
ASSOCIATE POSITION - EASTERN SHORE OF MARYLAND 
 
Seeking highly motivated, ethical, enthusiastic associate to join successful, well-established practice located in close proximity to Maryland and Delaware beaches. Certified/qualified by ABPS with rearfoot experience preferred. The practice incorporates surgery, wound care, sports medicine and general podiatry. Fully equipped office with diagnostic ultrasound, fluoroscopy, vascular testing, radio frequency ablation, six treatment rooms and three satellite offices. Main office has accredited ambulatory surgery center. This opportunity has excellent salary potential with benefits for the right individual. Send CV to dpmkthomas@gmail.com.
 
ASSOCIATE POSITION - SPRING HILL/CITRUS COUNTY AREA OF FLORIDA
 
Community Health Solutions of America (CHS) has a territory opening in the Spring Hill/Citrus County area of Florida for a mobile podiatric physician.  Physicians must maintain an active Medicare and Florida licenses.  Expenses including malpractice insurance, medical supplies, travel allowance, etc. are covered. Exceptional benefits include paid holidays, vacation, health insurance and 401K retirement plan with company match. First year six figure salary is guaranteed! Second year profit sharing. Most 2nd year doctors earn $150,000 and up. Email CV to psojobs@chsamerica.com
 
POSITION AVAILABLE - LOS ANGELES, CA
 
Multi office, multi physician foot and ankle surgical practice looking for highly trained foot and ankle surgeon to join our growing group. Practice emphasis on sports medicine, reconstructive foot and ankle surgery and revision surgery. Prospective candidate must have excellent personal skills and work well with a team. Competitive compensation and 401K, profit sharing, health insurance, dental and vision insurance. Surgical center partnership potential and full scope hospital privileges available. Facility is state-of-the-art with PT, CT, MRI, ultrasound and digital x-ray all in office. New graduates are welcome. Interviews prior to and at ACFAS in Las Vegas.  Contact us at: bbaravarian@mednet.ucla.edu
 
ASSOCIATE POSITION – NEW YORK  
 
Seeking motivated PMS-36 trained podiatric surgeon for full-time associateship in group with offices in Manhattan, Queens, LI, and and the Bronx.  Offering competitive salary with room for growth. Surgical-based practice - special emphasis on trauma, reconstruction, rearfoot and ankle surgery.  Please email resume to: nypodrecruit@gmail.com 
 
ASSOCIATE POSITION - UPSTATE NY 
 
Rapidly growing practice seeks associate to join and become partner. Key attributes: Board Qualified/Certified, self-starter, willingness to build practice. Partnership starts beginning year 2 based on per-established criteria. Contact: docryanlee@gmail.com
 
ASSOCIATE POSITION - NEW JERSEY 
 
Doctor needed in south Jersey for expanding practice. Multidisciplinary setting. Six figures. No weekends. Must be both conservative and surgically capable. ABFAS certified/qualified. jennberlin1@gmail.com
 
PM NEWS CLASSIFIED  ADS REACH OVER 16,500 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 16,500 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com  or call (215) 808-0770.
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.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify me and you are hereby instructed to delete all electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be either timely or free of viruses.
Guidelines
  • To Post a message, send it to:    bblock@podiatrym.com
  • Notes should be original and may not be submitted to other publications or listservs without our express written permission.
  • Notes must be in the following form:
    RE: (Topic)
    From: (your name, DPM)
    Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
    Your name, DPM City/State
  • Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.

Barry H. Block, DPM, JD
 
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