The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

January 17, 2007 #2,791 Editor-Barry Block, DPM, JD

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Regular Exercise of Feet Prevents Problems: CA Podiatrist

Regularly exercising your southernmost appendages can strengthen muscles of the foot and ankle, warding off tendonitis, plantar fasciitis and good old-fashioned foot pain, says Dr. Douglas Richie, a podiatrist in Seal Beach, California, and past president of the American Academy of Podiatric Sports Medicine.

Dr. Douglas Richie, Jr.

A toned, strengthened foot, furthermore, can reduce the occurrence of “sore, aching feet,” which are often the result of muscle fatigue. Regular exercise can also improve flexibility, thus boosting mobility.

Source: Janet Cromley, The Peninsular [1/14/07]

Two TUSPM Faculty Members In Print

The following faculty members of the Temple University School of Podoatric Medicine (TUSPM) have been in the news.

Dr. Vincent Muscarella, DPM

Vincent Muscarella, DPM, assistant professor in the department of podiatric surgery, published an article titled “The Use of Patient Simulators in Podiatric Medical/Surgical Education” in the January issue of Clinics in Podiatric Medicine and Surgery.

Dr. Howard Palamarchuk

Howard Palamarchuk, DPM, director of the sports medicine program, will be featured in an upcoming article in Smart Money entitled “"Walking for Exercise: How to Get the Most out of Your Walking Routine."

Superbones/Superskin Another Supersuccess

Dr. Stanley Kalish and his conference committee did it again. A capacity crowd was treated to world-class lectures in a weather-perfect tropical paradise. One of the highlights of this year's meeting was a keynote address by former Sen. Max Cleland. This disabled war hero, in an emotionally-charged speech, related how his loss of feet changed the path of his life, and stressed how important podiatrists are in maintaining the lifestyles of Americans.

Louis Levine

Honored at Superbones were Louis Levine, President of the New York College of Podiatric Medicine and Daniel Glassman, President of Doak Dermatologics for their work in advancing the profession of podiatry.

Daniel Glassman

Next year's Superbones conference will be held January 17-20, 2008 at Atlantis Resort on Paradise Island, The Bahamas.

Query: Quinine Sulphate

I have been using quinine sulphate for treatment of nocturnal recumbency cramps. The cramps resolve at close to a 100 % rate. In twenty-five years I have no more than a handful of patients with any reaction at all to the quinine sulphate.

I have received letters lately from mail order pharmacies stating the FDA will not longer allow quinine suphate to be used for nocturnal recumbency cramps. These letters state that the FDA has ordered production of quinine sulphate to stop. Is there something we can do to continue using a tried and tested treatment option for our patients?

Gary Lieber, DPM, Delray Beach, FL

Query: Semmes-Weinstein Test

Is there a code to be used in billing insurance companies when the Semmes-Weinstein sensitivity test is performed?

Thomas Nolen, DPM, Salem, IL

Response: It is my understanding that Semmes-Weinstein is not billable for two reasons. First, it is a screening test that is not diagnostic in and of itself. Second, this test is usually considered to be part of an E/M service. You may get a higher level E/M for having done the test, but it is not separately billable.

J. Kevin West, Esq, Boise, ID

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RE: H&P Precedents (Rick Burnell, DPM)
From: Ken Malkin, DPM

When I was a resident in the dark ages (1984), a busy podiatry group was responsible for over a million dollars of billings for limb preservation and elective foot surgery. I wonder what the PM readers think would happen if DPMs like Dr. Burnell responded by bringing all possible cases to unaffiliated institutions (like surgi-centers) or another local hospital that would consider granting H&P privileges to podiatrists that were qualified?

One other possibility, less dramatic, is to request H&Ps for class I patients only - have them see your work and then request an expansion.

In NJ we are lucky that forward thinking podiatrists, such as Dr. Harvey Roter, when serving as a podiatrist on the NJ State Medical Board cleared the way for DPMs to perform H&Ps and hospitals with residencies were comfortable allowing privileges to staff DPMs.

Ken Malkin DPM, Caldwell, NJ, drmedicare@aol.com

I’m in the unique situation of my hospital system having taken my H&P for 3½ years before deciding they couldn’t take it anymore about 3 years ago—based upon the CMS CoPS at the time. Once I informed them of the new CoPS, they are telling me that “the bylaws don’t allow it” and for some reason they think that is the end of it. I plan on seeing what APMA comes up with and if I don’t think its sufficient, my plan is to see if we can organize a listing of non-compliant hospitals, get a suit against them started and certified as a class.

If this is successful, not only would monetary compensation be desirous, but those who remain unimpressed should face exclusion from CMS from being reimbursed for seeing Medicare/Medicaid patients and decertified by JCAHO for blatant non-compliance with the new CoPS rule and the standing guideline by JCAHO. I guess it was näive of me to think that my hospital would revert to allowing me to doing my H&P’s once the new CoPS was issued. I can’t help but wonder why they insist on doing things the hard way? Why does it always take a lawsuit to get people to comply with the law?

David Secord, DPM, Corpus Christi, TX, David5603@pol.net

There has been much discussion and recent news about podiatrists performing H&Ps. I still don't understand why this is such a big deal. Could I do an H&P or could my residents do it? Sure. Can we do them better than an internist, no. Do I want that responsibility? No. We admit several patients a week with diabetic infections, trauma, etc. We consult an internist to manage their medical care as we manage their surgical care. Am I missing something? What is wrong with this scenario? Is this going to now impact our malpractice rates? Sorry.

We are functioning quite well, getting better surgical privileges across the country. I am not sure how doing H&Ps will benefit us in any way. I suspect that admitting privileges may be limited in some hospital systems, if you can't admit directly. We are fortunate to have full admitting privileges and we just have to consult medicine for medical management. Is this the reason such a big deal has been made of this issue?

Dave Samuel, DPM, Springfield, PA, desamuel@pol.net

Editor’s comment: Dr. Samuel misses the true significance of podiatry’s inclusion in the class of physicians allowed to perform H&Ps. Prior to 2007 if a podiatrist wanted to perform an H&P, he or she could be excluded because DPM’s were not authorized to do so, implying that we were not trained to perform this task. Whether an individual podiatrist ever performs an H&P is totally irrelevant.

RE: Iatrogenic Calcaneal Fractures (Art Hatfield, DPM)
From: Allen Jacobs, DPM

With reference to the two patients reported with calcaneal fractures discovered following ECSWT, one wonders whether an occult stress fracture was present prior to treatment. With the increasing prevalence of obesity associated heel pain in our society, as well as ironically increasing enthusiasm for athletic activity, I have never diagnosed as many stress fractures causing heel pain as I have in recent years. In the regard, I have found MRI or diagnostic ultrasound have been most helpful in the evaluation of any patient with ATYPICAL signs or symptoms.

Allen Jacobs, DPM, St. Louis, MO, allenthepod@sbcglobal.net

EQUIPMENT FOR SALE - METTLER SONICATOR 715 ULTRASOUND

Mettler Sonicator 715 Ultrasound with 5cm2 with delivery head, great in any podiatry office for multiple uses. The cheapest I am able to price this machine new, is on Esurg at $1396.77. My unit was used about 20 times, and is about 2 years old. I will let it go for $650.00 plus shipping. Like new condition. If interested, write deg1@comcast.net

EXCELLENT ASSOCIATE OPPORTUNITY – SOUTHERN CALIFORNIA

Established 25 year well-rounded biomechanical and surgical practice seeking energetic, enthusiastic, personable and proficiently-trained PSR-24 or PSR-36 foot and ankle surgeon for associate with ultimate partnership opportunity in LA area. Excellent position for an individual interested in all aspects of podiatric medicine with emphasis on reconstructive foot and ankle surgery. Only 8% Medicare with No HMO. Email CV to dr4feet@sbcglobal.net

ASSOCIATE POSITION - CINCINNATI, OHIO

One of the largest podiatry practices in the United States is again in need of a PSR 24-36 Associate. All present doctors are in their thirties with similar training. Everyone is treated equally and there is definitely no limit to your success. Please submit resume or contact Karen Roesch via email or phone. Kroesch4poh@aol.com (513) 729-4455

POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

ASSOCIATE POSITION - CENTRAL CALIFORNIA

Central California multi-location practice looking for PSR-36 associate leading to partnership. PSR-36 trained podiatrist with great opportunity for reconstructive surgical practice. Practice has Medicare-approved surgery center. Must have excellent interpersonal skills. Excellent salary and incentive. Respond to: westsidefoot@yahoo.com

ASSOCIATE WANTED FOR SOUTH MIAMI AREA

Large group, busy, multi-office, partner potential. Motivated applicants only. Mail resumes and letters of intent to 999 N. Krome Avenue, Homestead, FL 33030. July start time OK, sooner preferable. E-mail lianadpm2@aol.com. I can also be reached at 305-331-4501.

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

ASSOCIATE POSITION - NORTHERN VIRGINIA

Well-established, busy, diversified, multioffice/multidoctor practice seeking associate with opportunity for partnership. Must be highly motivated and ethical with strong interpersonal and patient skills. Excellent opportunity for PSR 24 or higher trained individual to complement a full-scope podiatric medical and surgical practice. Competitive salary and benefits package. Please send CV and references to saglag2@aol.com or fax to (703) 368-5103.

ASSOCIATE POSITION--PHOENIX SUBURB

Attractive opportunity for enthusiastic, proficient, and personable associate. Well-established modern practice with multiple newer spacious offices, technology and equipment. Solid referral base, close to hospitals, knowledgeable certified staff. 22% MCR. Practice and surgical center partnership potential opportunity. Prefer 24-36+ PSR. Send CV: AZpodassociate@aol.com

ASSOCIATE POSITION – ST. LOUIS, MISSOURI

Immediate Opening. Busy practice in prime suburban St. Louis location looking for a surgically trained associate, possible partner. Must be honest, ethical and hardworking. ABPS preferred, but not required. Please reply with CV and requirements to mdwrtw@aol.com

ASSOCIATE POSITION—NORTH COASTAL CALIFORNIA

Two fully staffed rural offices with continually growing patient load. We take care of all aspects of podiatry: assisted-living centers, palliative care, wound care, biomechanics, surgery, diabetic care. Hospital privileges are available to those properly qualified. If you are interested in challenging and hard work leading to partnership, send your CV to jimf@humboldt1.com

PODIATRIST WANTED - MARYLAND / WASHINGTON D.C.

Mid-Atlantic Permanente Medical Group (MAPMG) has a full-time position for a board eligible/certified podiatrist to join our team. PSR 24 or PSR 36 preferred. The practice includes all aspects of podiatric medicine, including forefoot surgery, rearfoot and reconstructive surgery, diabetic foot care, limb salvage, sports medicine and general podiatry. Operating under the Kaiser Permanente umbrella, MAPMG is a family of over 800 physicians who proudly serve 500,000 health plan members. We offer an excellent starting salary and full benefits, including professional liability coverage, shareholder opportunities and bonuses based on group performance.

To apply online, go to http://physiciancareers.kp.org or send C.V. to: Pattie Dascenzo at MAPMG, 2101 East Jefferson Street, 3rd Floor East, Rockville, MD 20852. EOE

ASSOCIATE POSITION - LOS ANGELES/SOUTH BAY AREA

Multi-office, multi-doctor, well-established practice near the beach cities. Seeking a board eligible/certified PSR-24 or PSR-36 trained foot and ankle surgeon. Well-rounded practice requiring knowledge in biomechanics, pediatrics, sports medicine, diabetic wound care, trauma, and reconstructive foot and ankle surgery. Full-time position available immediately with generous compensation and benefits, including malpractice, and health insurance. Two-year commitment required with partnership opportunity. Send CV to akemfoot@sbcglobal.net or fax to (310) 838-0227

POSITION AVAILABLE-SOUTH FLORIDA/BROWARD COUNTY

Needs 2 or 3-year post surgical training in forefoot and rearfoot
Salary plus incentives Email responses to office email: advfoot@bellsouth.net

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