The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

March 28, 2009 #3,504 Publisher-Barry Block, DPM, JD

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Get Your Feet Ready Before Going on Vacation: MD Podiatrist

Before you go on vacation, make sure that your feet are in good condition. Everyone has saved and worked hard for that vacation. Why would you want to take a painful, pre-existing condition on a trip with you? Identify what’s bothering you and seek attention from a podiatrist before you go.” says Ira Gottlieb, DPM, head of the Chesapeake Foot and Ankle Center.

Megan Pringle interviews Dr. Ira Gottlieb

“When you get ready to travel, you want to ready for the amount of walking you will be doing,” says Gottlieb. “We suggest that you start an exercise program 3-4 weeks before leaving. This will get your bones, joints, and ligaments ready. 

Source: Tia Craddock, Good Morning Maryland (ABC News) [3/24/09]

CSPM Holds 13th Annual White Coat Ceremony

On March 13, 2009 the California School of Podiatric Medicine (CSPM), Samuel Merritt University (SMU), held its thirteenth annual White Coat Ceremony for the class of 2012. Thirty nine first-year podiatry students in the Doctor of Podiatric Medicine (DPM) program gathered at the Health Education Center on the Oakland Campus.  In the presence of families, guests, faculty members and CSPM leaders the students formally received the symbolic white coat. 

CSPM Students at White Coat Ceremony

“This year’s White Coat Ceremony gave our class the opportunity to thank our families and faculty for all the support and guidance they have given to lead us to this remarkable point in our lives,” said Mark Razzante, first-year podiatric student. “The ceremony not only signified the transition of classroom to clinical education, but it provided a moment where our class exhibited unity and maturity.”

Dr. Sandra and Arnold Gold

The keynote address was delivered by Drs. Arnold Gold and Sandra Gold, the co-founders of the Arnold P. Gold Foundation, a public organization dedicated to fostering humanism in medicine.  The White Coat Ceremony was originated in 1993 at Columbia University by Dr. Arnold Gold.
 

Health IT Seen as Key to Long-Term-Care Reform

Health information technology is a key tool in improving the quality of long-term-care services, witnesses testified before the Senate Finance Healthcare Subcommittee. Upcoming reform efforts to overhaul the healthcare system provide an opportunity to improve the quality of long-term-care services, said Ray Scheppach, executive director of the National Governors Association. “Standards are needed to enhance quality measurement,” he said, adding that measurements, standards and processes to coordinate care could lead to the development of different reimbursement models that would more effectively reward long-term-care providers and customize care for patients.

Cost-effective proposals to improve quality in long-term-care services do exist, said Joshua Wiener, senior fellow and program director for aging, disability and long-term care at RTI International. These include establishing a Medicaid pay-for-performance demonstration for nursing homes, and increasing support for integrated data systems that cut across provider settings, he suggested. Sen. Jay Rockefeller (D-WV), who chairs the subcommittee, held the hearing to underscore the lack of progress made over the past 20 years in reforming long-term-care benefits and services. 

Source: Jennifer Lubell, Modern Healthcare [3/26/09]

Give Yourself a Career Checkup

Do you sometimes wonder why you are not moving ahead as fast as you would like to? Follow these simple improvement strategies to move your career in the right direction:

• Listen more than you speak. You will find it hard to gain input, buy-in and commitment when you operate only in “talk” mode.
• Plan time to plan. Start each day with a 15-minute meeting with yourself. Identify priority tasks so you stay focused on them. Spend time writing and revising your long-term goals too. That keeps you from engaging in frantic firefighting as your deadlines sneak up on you.
• Learn to debrief. Build on your experience and knowledge—and that of your team members—by forming the “post-mortem” habit. Following each project, meeting or presentation, ask two questions: “What can I/we learn from that?” and “How can I/we improve the next time?”
• Increase your self-awareness. Discover how others perceive you, by  asking how your words and actions affect others. Seek feedback from all around you: your employees, patients, and peers.

Source: Adapted from “Use a Review of Last Year to Help Guide Career Resolutions for 2009,” Maureen Moriarty, The Seattle Post-Intelligencer, via Communication Briefings

HAV Surgery, Type-3 Ehlers-Danlos Syndrome

My patient requires a Youngswick-type procedure for hallux limitus. She is a 35 year old, black, with Type-3 EDS and no other medical issues. She is not taking any prescribed or OTC medications. Any feedback on potential risks and complications would be appreciated.

David Cohen, DPM, Baltimore, MD

Query: Extra-Depth Scuba/Swim Fins

I have a patient who is looking for swim fins that would have room for his hammertoes/MTP contractures. He has not had luck at the major sporting goods stores. He is going to investigate this at a diving specialty shop, but I would also appreciate any info. this group could share.

John P. McLoughlin, DPM, Boston, MA

Query: Qualified Routine Foot Care Revisits

When I see a patient and debride mycotic nails and calluses (qualified foot care), can I get reimbursed seeing/treating that patient on the 61st day, or have to wait until the 62nd day?

When I see a patient and debride mycotic nails and calluses (qualified foot care), but another podiatrist sees them for routine foot care (and bills Medicare) one month after I do, does the 61 day global period begin when I originally billed it as routine foot care, or does the 61 day global period get reset at the time the other podiatrist billed it? Example: I saw and cared for a patient on January 1. I plan on seeing that patient again 61 days from January 1 (approximately the beginning of March). If another podiatrist sees the patient and performs (and bills for) routine foot care on February 1st, when can one expect Medicare to reimburse another debridement - March 1st or April 1st?

Mark Gasparini, DPM, Massapequa, NY

Response:The LCD for routine foot care and nail debridement published by NGS, the carrier for New York, clearly states that care will be paid for only once every 60 days. "More frequent services will be denied." A patient can only receive covered routine foot care every sixty-one days.

Mark Schilansky, DPM, Catskill NY

Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm

RE: Recurrent Verruca, Possible Carcinoma [Zacharia Facaros, DPM]
From: Multiple Respondents

Here’s a photo of a similar case of mine. This was diagnosed as a verrucous carcinoma.

Verrucous Carcinoma

I referred the patient to a surgical oncologist who performed a forefoot amputation. The patient is doing well after ten years.

Pete Harvey, DPM, Wichita Falls TX, pmh@wffeet.com

I have seen this reaction a couple of times with TMA patients. I have tried everything from banana peels to papain urea mixtures. I acknowledge that the biopsy returns verruca. Carcinoma is a real concern, but I have never seen one convert. On one patient, it just went away a year or so after the wound was resolved. It may just be me, but I would ignore the verruca (do a a biopsy and watch for the development or conversion to carcinoma of course) and just work to get the wound well. Make sure your osteomylitis has been properly addressed.
 
Please avoid Bleomycin. It can make general anesthesia and hyperbaric oxygen therapy very dangerous. If you treat this patient with Bleomycin, he may never be able to undergo hyperbaric therapy. If it is not too much trouble, I would like to know what you end up doing and how it works out.

Wm. Barry Turner, DPM, Royston, GA, claret32853@gmail.com

I wrote some articles that may help regarding hyperplasic changes in a diabetic ulcer from insufficient off-loading, see: Dermatol Surg. 2005 Oct;31(10):1376 J Foot Ankle Surg. 2004 Nov-Dec;43(6):441
 
Regarding verrucous carcinoma, see: J Foot Ankle Surg. 2001 Jul-Aug;40(4):225-31

Steven Miller, DPM, Chicago, IL, miller613@hotmail.com

RE: PM News Marks Issue #3,500 & 15th Anniversary [Marlene Reid, DPM]
From: Lynn Homisak, Richard Mann, DPM

Add me to the list of people who appreciate what Barry Block has done to connect all of us within our profession! I can't think of a better way to honor him than as Marlene Reid suggested in her post...by giving to the APMA Educational Foundation (9312 Old Georgetown Rd., Bethesda, MD 20814). If everyone who subscribes to PM News gave even $1 (a drop in the bucket!!!), it would amount to an $11,000 donation! Now, imagine if we donated $1 for every Anniversary year? $15 x 11,000 = $165,000! Imagine if...? I think we should stop imagining and make it happen...who will join me?
 
Lynn Homisak, Seattle, WA

I just wanted to add my name to the chorus of congratulatory wishes to Barry Block, David Kagan, and the rest of the staff at PM News on their 3,500th issue. Thank you for creating this extremely informative, useful, entertaining and engaging tool. It makes us better doctors. The profession has benefited greatly from your efforts. Well done gentlemen.

Richard Mann, DPM, Delray Beach, FL

ASSOCIATE NEEDED - MIAMI DADE FLORIDA

Partnership/buy out opportunity for the right candidate. Well-established modern practice. EMR , digital x-rays, gait scan etc. Excellent hospital privileges. SALARY...two options. $50,000 starting, 40% of everything you generate over $120,000, 50% over $200,000, 55% over 250,000 and 60% of everything you generate over $350,000. Want a fixed salary instead? $80,000 a year. I feed you patients and provide an excellent well-trained staff. Contact doctorinhialeah@aol.com

PRACTICE FOR SALE - CENTRAL FL

Practice sale, in beautiful, high quality of life, growing area; 2000 sf bldg. fully equipped/ designed for podiatry; excellent location, features & exposure; near hospital, wound and HBO center. Great opportunity for expansion; good insurance climate. 352-357-7499 / E-mail: windnwave@earthlink.net

PRACTICE FOR SALE-SOUTHEAST MICHIGAN-BRIGHTON

Great opportunity. Established 11 years. Excellent location. Large illuminated sign on busy main road. Mid to high income growth area.  Supplies, furniture, and equipment included: X-Cell X-Ray w Hope Autoprocessor, Pelton-Crane Autoclave, Parks Lab, Bircher, Burton Floor Light, OR with Lighting, bone instruments and power equipment, Midmark Chairs. Quality 1,350 sf build-out. convenient parking. Must sacrifice. Call (248) 565-5266. Docpod@aol.com

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

PODIATRIST NEEDED FOR MIAMI-DADE COUNTY

Multi office practice needs doctor of podiatry for full time and/or part time for private office, clinics, and nursing homes. Great opportunity to grow with and unlimited income potential. Offices in Miami, Hialeah, Westchester, and Cutler Ridge. Email to feetdoctor@aol.com

ASSOCIATE POSITION – VICTORIA, CANADA

Beautiful Victoria, B.C. Canada on the ocean, fast growing area. Associate for multi-office full scope practice. Licenser exam to be given in June 2009. Reply to dr.cole@shaw.ca

ASSOCIATE POSITION NEW YORK

Podiatrist needed for private clinic setting in N.Y.C.  All RFC, no stress, $40+/hr. Great opportunity to earn some easy extra money. For more info. And details call (917) 880-6639 or e-mail: hansfeet@aol.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

ASSOCIATE WANTED - FLORIDA

Associate needed for a dynamic multi-doctor practice in the Tampa Bay area. Partnership opportunity for the right candidate. Preference given to a PSR 24+ resident completing their education this spring/summer, and must have a Florida license. Well-established practice, high tech with EMR and digital x-rays, with specialties in sports medicine, surgery and wound care. No nursing homes or HMO's. Excellent hospital privileges available. Choose an area of practice concentration that you are passionate about and enjoy a lifestyle for yourself and your family that is second to none. E-mail: kimvelez@tampabay.rr.com

ASSOCIATE NEEDED - MIAMI DADE FLORIDA

Partnership/buy out opportunity for the right candidate. Well-established modern practice. EMR , digital x-rays, gait scan etc. Excellent hospital privileges. SALARY...two options. $50,000 starting, 40% of everything you generate over $120,000, 50% over $200,000, 55% over 250,000 and 60% of everything you generate over $350,000. Want a fixed salary instead? $80,000 a year. I feed you patients and provide an excellent well-trained staff. Contact doctorinhialeah@aol.com

ASSOCIATE POSITION - CHANDLER/GILBERT/PHOENIX, ARIZONA

Seeking a well-trained, ethical and hard working graduate of a PSR 24+/36 Residency to join our growing multi-location practice. This is a practice with a nice mix of 35% surgery/trauma, 20% diabetic/wounds, 25% biomechanics, 20% pediatric. ER Call. Opportunity for partnership at 2 surgery centers. Very modern offices with EMR, U/S, Digital X-Ray, ESWT, Vascular Testing Machine. Excellent referral base, and a well-trained staff. Board eligible/certified a plus. Competitive salary, bonus structure, benefits. Please e-mail CV and references to FootAnkleAZ@aol.com

OFFICE SPACE/ MRI RENTAL – NYC, LI   
 
Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, and Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

PM Classified Ads Reach over 11,500 DPM's and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 11,500 DPM's. Write to  bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 Ext 110.

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