The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

February 26, 2011 #4,094 Publisher-Barry Block, DPM, JD

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NY Podiatrist Provides Salon Safety Tips

A pedicure may be relaxing - and a great way to get winter feet looking presentable again -- but an ingrown toenail will certainly stress you out. Germs picked up during a pedicure can lead to an ingrown toenail or an infection. If that happens, don't go back to the salon, says Dr. Johanna Youner – see a podiatrist before it gets worse. A good rule of thumb is to choose a salon where the foot-soaking tub is either disposable or removable, says Dr. Youner, because a lot of infections may originate in the plumbing.

Dr. Johanna Youner

It can't hurt to bring your own tools, either – and even if they're yours, clean them before you head out. And when in doubt, apply some Bacitracin to your feet when you get home.

Source: Melanie Lefkowitz, Stylist [2/19/11]

NY and PA Podiatrists Return to Nicaragua with Temple Students

For the last seven years, Drs. Charles Morelli and Jeffrey Siegel have been providing both surgical and medical humanitarian aid to the people of Leon, Nicaragua at HEODRA hospital. This year, they brought with them two 3rd year students from Temple University (James Morrow and Morgan Houston, standing right rear) as well as a 4th year surgical resident Kate Paskey (right front). Brother and sister Josh and Juanita Ramlall, an ultrasound tech and nurse practitioner respectively, rounded out the team (left rear). Maine podiatrist Dr. Sharmilia Das-Wattley also joined this year's team.

Drs. Charles Morelli (left) and Jeffrey Siegel (center) and their surgical team in Nicaragua

In addition to performing 30 surgical procedures in four days, Drs. Morelli and Siegel were also able to provide an educational experience for these individuals that they have all said they will never forget. It is Drs. Morelli's and Siegel's plan to invite students and residents every year to join them on this annual pilgrimage.

New Zealand Podiatrist and Patient Survive Earthquake

Catherine McHerron's Christchurch home is still standing after Tuesday's devastating earthquake; however, she says the inside looks as if Cyclone Yasi had ripped through it. The building was structurally sound but objects in the room became missiles as it shook violently. 

Catherine McHerron in front of home after the earthquake.

“I am a podiatrist and I had an elderly patient with me, so my first thoughts were to make sure nothing was going to hit her,” McHerron said. “I secured a light, made sure she was stable, then took shelter. It was hard to stay on my feet as the room was shaking violently, things were flying around.”

Source: Melissa Grant, Daily Mercury [2/25/11]

Many Errors Result of Physicians Not Listening: Study

Great effort goes into stopping preventable errors such as wrong-site surgeries, but authors of a study on unwanted variation in elective procedures say that many more errors are taking place because physicians are not listening to their patients. The latest report from the Dartmouth Atlas Project—Improving Patient Decision-Making in Health Care, which was conducted in conjunction with the Foundation for Informed Medical Decision Making—concludes that if physicians educated and listened to their patients more thoroughly, unwanted variation would decline.

Researchers took an in-depth look at medical conditions involving decisions for elective care in cases where the statistics don't recommend a single course of action. The study found that much of the difference is attributable to physicians' preferences, not differences in patient populations. But in cases of elective procedures, giving a patient a treatment he doesn't want is as much an error as wrong-site surgery, said Michael Barry, a co-author and president of the decision-making foundation.

Source: Joe Carlson, Modern Physician, [2/24/11]

Keep Your Website Dynamic with Fresh Content

Two of the most important things you can do to help achieve and maintain the highest Google ranking is to add new links or content to your website  on at least a weekly basis. This content can be in the form of a blog, links to your website from referring doctors, Facebook and Twitter postings, online press releases (introducing new associates or technology) and of course, new content directly to your website. A great way to increase your web presence and create new links to your website is by producing and posting videos about your practice on YouTube and other search engines. Videos will not only drive more traffic to your website, they will ultimately help increase your Google ranking.

Source: Gary Ignotofsky

Query: MD-Logic

I just completed a 1.5 hour computer introduction to an EMR company called MD-Logic. It was very informative and  actually eased some of the fear I think most of us have about converting to EMR. Does anyone have knowledge of this company or use them for EMR?

Jack Ressler DPM, Lauderhill, FL

Query: Partial Ray Amputation

How would I bill a partial 2nd ray amputation? The toe and distal 1/3 of the 2nd metatarsal were removed for a diagnosis of osteomyelitis.

Adam Silverman, DPM, Baltimore, MD
 
Response: CPT 28810 - amputation, metatarsal, with toe, single - I believe, is the most appropriate code in this example.

David J. Freedman, DPM, CPC, Silver Spring, MD

Codingline subscription information can be found here APMA Members: Click here for your free Codingline Silver subscription

RE: High Price of Medical Equipment (Tip Sullivan, DPM)
From: Jeffrey Kass, DPM

Dr. Sullivan reveals a prime example of "high-priced, medical-related expenses." In his posting, he states expected reimbursement for surgery about six grand. For real? Six grand? Dr. Sullivan would you be so kind as to share with us if you are in or out-of-network with that particular plan? There seems to be an epidemic nationwide where participating providers performing surguries are paid less than the anesthesiologist on the case, and less than the hospital collects. This fee additionally is usually "below par."

On the other hand, an out-of-network provider, can receive five times the amount. There is something wrong with this equation.

Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

RE: Transition to Practice Fusion (George F. Jacobson, DPM)
From: Richard A. Simmons, DPM

The changeover to Practice Fusion will simply depend on how fast you want to make the conversion. I am a Medinotes user. My conversion has consisted of IT at Practice Fusion, moving all of my patients' basic demographics into the Practice Fusion database (no charge!), followed by my office signing up for e-Prescribe and deciding how to create the patient note. Since Medinotes creates a great note already, my office creates the note using Medinotes and simply copy/pastes that note into Practice Fusion for the time being.

Why? Because Medinotes is...

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

RE: A Call for Unity and Action Against Insurance Companies (Denis LeBlang, DPM)
From: Michael E. Munson, DPM

The need for all physicians (MD, DO, DPM) to organize and bargain collectively is an absolute necessity. The stories that have been shared in our journals and newsletters are really no different than in primary care. I have worked with internists for about 4 years, and they are every bit as mad as we are. The part that frustrates me to no end is the notion that we don't have an answer! There is only one - organize. That's how groups of workers get what they need.

Sure, sometimes unions overreach, but let's not...

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

RE: EHR/EMR Gouging (Alan Bass, DPM, Michael Brody)
From: Jeffrey Kass, DPM

Over the past few days, there has been a debate on whether or not EMR prices are excessive/costly. We have heard from Drs. Bass and Brody, both who acknowledge they are paid consultants, hence, I would expect them to explain the worth of the systems. I do not know the price of the Biomedix program, but I believe most systems are approximately 15 - 20 thousand dollars if not more, and this is for the program, with monthly carrying charges. I am curious how a new graduate, with loans up the whazoo, who can't get on any insurance plans because the panels are "closed", is going to survive. When you do get on plans - often you are paid at rates below Medicare, and you have to jump through hoops to get paid (modifiers, pre-authorizations, etc.).

We are not simply in the midst of a residency crisis; we are in the middle of a profession crisis. $400 for a bunion with a 90-day global period is simply not going to pay for a 20 grand EMR. The insurance companies will have us convinced that with EMR, your efficiency will increase so you'll be able to do three more $400 bunions. Please, do not fall for it. If you calculate out your $400 bunion, based on office visits and travel time to the hospital, you are probably getting paid minimum wage.

Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

RE: H&P for Podiatrists (Sam Mendicino, DPM)
From: Robert Bijak, DPM

I take exception to Dr. Mendicino's comment Re: "Senior" podiatrists and their "aging eyes." It's bad enough that we have to deal with MD discrimination, now we have a podiatrist against us. I don't know how old Dr. Mendicinio is, but I'm sick of this one upsmanship in podiatry. "Oh, you had only 1 year, 2 year residency. I had 3 years!" "I do surgery on the leg, you can't treat the ankle." "You've been in practice 20 years, you're out of the loop." This is pure podiatric insecurity. This is age discrimination and I would think Drs. Weil, Kalish, Volger, et al. who are in their 60's and leaders in the profession, demonstrate the inaccuracy of  Dr. Mendicino. Young people think they know more than their elders. Maybe we should put all podiatrists in practice over 20 years on an ice flow like the Eskimos do!
 
I reverse the observation and say, "younger" podiatrists are too puerile and should be required to work with an experienced podiatrist. And to all you H&P experts, you are still a limited licensed, non-systemic treating (by law)  podiatrist.  Wait until a lawyer's expert cardiologist starts asking you about heart sounds and the number of hours in podiatry school you spent learning about systemic diseases (which you are supposed to be ruling out!).  It's obvious to me that podiatrists are trying to be MDs by "association" instead of by actual education.  If the education IS equivalent, why doesn't the state grant an equivalent license?  Maybe because the state licensing board is composed of "old people with aging eyes."

Robert Bijak, DPM, Clarence Center, NY rbijak@aol.com

Part-time full-time podiatrist needed for our Indiana offices. Must have Indiana license. Must have completed two years of surgical residency. If qualified email to f-massuda@footexperts.com

PART-TIME / FULL-TIME PODIATRIST NEEDED ASAP - CHICAGO

Part-time podiatrist needed for 2 offices in Chicago with an average of 20 hours/week. Must have Illinois license. Must have completed 2 years of surgical residency. If qualified, email to:     A-Storjohann@footexperts.com

ASSOCIATE POSITION - NE GEORGIA SUBURB

Immediate opening for PSR24/36, ABPS Qualified or Certified individual. Hosp/Amb. Surg. Ctn privileges available. Good chance of partnership or practice purchase in foreseeable future. Send resume/CV to gramps395@yahoo.com

TWO ASSOCIATE POSITIONS - WEST CENTRAL FLORIDA

One in general podiatry, second with surgical residency. Good diagnostician, compassionate, hard-working individuals needed for high-tech group practice. flpodiatrist@tampabay.rr.com

ASSOCIATE POSITION - KENTUCKY
 
Very well-established podiatry practice in Louisville, KY seeks a motivated, ethical practitioner trained in all phases of podiatry including routine care, surgery and wound care to join 2 other podiatrists. By joining our practice you will receive a competitive salary with a bonus structure and benefits. Our practice is equipped with DME, PadNet, Gait Scanner and on site retail store. There is a huge potential to grow your practice with our ideally located facility that has strong affiliation with leading area hospitals as well as 2 local residency programs. For immediate consideration, please forward CV to Samuel10530@yahoo.com

ASSOCIATE POSITION AVAILABLE - NY

Busy Midtown Manhattan state-of-the-art practice with 2 locations seeking part time/full time associate. Must be in-network Empire BC/BS. Looking for a personable doctor with immediate availability. Residents Need not apply. DrB@myfcny.com

ASSOCIATE POSITION - WEST CENTRAL FLORIDA

A great opportunity to join a very busy, well-established, diversified practice in Clearwater, FL. Seeking an associate who has the drive and desire to work hard, has strong work ethics, and is very personable. BC/BE and minimum PSR24 +. We offer competitive salary and benefits. Send resume to Jaye@fdn.com

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION - DAYTON, OHIO

Join a well-established modern practice with an excellent reputation and referral base. Base salary $100,000 and benefits with a bonus structure. EMR, diagnostic ultrasound, all aspects of DME, Padnet vascular studies, and CO2 lasers. We seek a surgeon that is well trained, personable and motivated to join our group of 3 Podiatric Surgeons. Would like this individual to buy in the practice eventually. Please send resume to ohiodoctors@aol.com

ASSOCIATE POSITION/PARTNERSHIP - CHICAGO

Chicago Podiatric Surgeons, one of Chicago’s leading podiatric practices, is searching for a FT podiatric surgeon. Applicant must be a personable and confident surgeon with ability to manage surgical patients independently and be at least board qualified. High compensation. Will be working in new 7000 sf state of the art office in AN upscale Chicago neighborhood. Ownership/partnership opportunities. Send letter of intent and CV to drcarr@chicagopodiaty.com

FELLOWSHIP OPPORTUNITY
 
Applications are being accepted for the Central Kentucky Diabetes Management Fellowship. Dr. Jonathan Moore, former UTHSC Diabetes Fellow, OCPM adjunct faculty, AAPPM board member and national lecturer and author on diabetes and practice management related topics is director and founder. Don't miss out on the most unique, dynamic fellowship in Podiatric medicine. Learn latest advances in Diabetes management/surgery along with knowledge to run and grow a successful practice. Generous stipend, full benefits and free housing in resort setting. Email CV and letter of interest to: jmoore@aappm.org  Visit our website

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Great opportunity. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K. dpmpracticeforsale@yahoo.com

PRACTICE FOR SALE - BOSTON SUBURB

A 12+ year practice, including all equipment is for immediate sale. Average gross is $100K while being open only one day weekly. The ability for increased growth potential is obviously excellent with increased hours. Doctor is looking for serious offers only. Reply to shop@thefootdoctor.com

SPACE AVAILABLE- NYC & LI

Office to sublet and share with DPM and chiropractor, East 60th Manhattan, and Plainview long island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

PM News Classified Ads Reach over 12,500 DPM's and Students

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