July 13, 2012 #4,513 Publisher-Barry Block, DPM, JD
A service of Podiatry Management http://www.podiatrym.com E-mail us by hitting the reply key. COPYRIGHT 2012- No part of PM News can be reproduced without the express written permission of Kane Communications, Inc.
The winner of this week's contest is Dr. Brenna Steinbergof Frederick, MD. There has been an overwhelming response to our new Facebook page, so we are giving away another prize this week. Simply "like us" and be eligible to win a free registration for theGreenbrier Coding and Practice Management Workshop (Value $395). Enter now. The contest ends July 15th, 2012. No Purchase necessary.
PODIATRISTS IN THE NEWS - PART 1
NY Podiatrist Performs Cosmetic Surgery on Fat Toes
When patients seek out cosmetic surgery from New York-based Dr. Oliver Zong, they're often looking to remove fat, but not from their bellies or thighs. Zong is a podiatrist, and one of his specialties is slimming down people's fat toes -- "toe-besity," he calls it. He's been in practice for about a decade, and when he started, toe reshaping was unheard of.
Dr. Oliver Zong
"When people first started asking, I said 'What?'" said Zong, who is surgical director at NYC FootCare. "We were mostly doing toe shortenings in the begining." Now, he said, more and more people are zoning in on the smaller details of their feet, like the width of their toes. This type of surgery is considered entirely elective, so insurance companies will not cover the costs, which can range from a few hundred dollars to a few thousand dollars, depending on how complicated the procedure is.
Source: Kim Carolla, Good Morning America (ABC) [7/11/12]
PODIATRISTS IN THE NEWS - PART 2
Flip-Flops Never Safe: FL Podiatrist
Flip-flops, a favorite footwear for many South Floridians, are “never safe,” says Dr. Scott Strolla, a West Palm Beach podiatrist. Yes, he actually said, “never safe.” Strolla practices at Good Samaritan and St. Mary’s medical centers in West Palm Beach, at Palm Beach Gardens Medical Center, and Jupiter Medical Center. Over the years, he has seen many foot injuries when patients wear flip-flops, including footwear that costs several hundred dollars. He defines flip-flops as a thong sandal with only a V-strap.
Dr. Scott Strolla
For diabetics, wearing flip-flops can be problematic for those with neuropathy. They don’t feel or don’t heal as well as healthy people, Strolla says. Consequently, when the V of a flip-flop cuts into the space between their big and index toes, they can’t feel it rubbing. He talks about one of his diabetic patients who insisted on wearing flip-flops despite being warned against doing so. That patient, who had neuropathy, developed a deep-space infection that led to the amputation of the big toe and part of his foot, he says and sighs.
Source: Jane Smith, Palm Beach Post [7/11/12]
PA Podiatrist Receives Dr. G. Dock Dockery Special Achievement Award
The International Foot & Ankle Foundation (IFAF) recently presented Dr. Guido LaPorta with the Dr. G. Dock Dockery Special Achievement Award. This special ahievement award provides special recognition to individuals who have demonstrated notable singular or multiple achievements in medicine, surgery, research, or education. This award honors living individuals who have made a positive and substantial impact on the education and advancement of the profession.
Dr. Guido LaPorta (R) is presented with the Dr. G. Dock Dockery Special Achievement Award by Dr. Bryon Hutchinson, last year's recipient.
This award was developed by the IFAF Board of Directors (BOD) in Dr. Dockery's Honor, and the BOD selects the recipient each year. The award is presented each year at the IFAF Seattle Summer Seminar or the Annual Residency Graduation Ceremony. Dr. LaPorta is a ledgendary podiatric surgeon and residency director.
PODIATRISTS AND POLITICS
CA Podiatrist Demands That Opponent Repay Preferred Countrywide Mortgage
The Democratic challenger to Rep. Howard "Buck" McKeon (R-CA) said Monday that the high-ranking House member should "pay back" the spoils from a sweetheart deal he allegedly received from former mortgage juggernaut Countrywide Financial. Last week, the House Oversight and Government Reform Committee, following a three-year investigation, released a report that confirmed existing allegations that McKeon received preferential treatment from Countrywide when obtaining a $315,000 mortgage loan in October 1998.
Dr. Lee Rogers
"It shows that, at the very minimum, he has poor judgment," said Dr. Lee Rogers, McKeon's opponent in the contest for California's 25th District. "I think the Oversight Committee's report showed that McKeon isn't being honest," Rogers argued. "If McKeon truly didn't know about the discount and fee waivers, he could just pay back the benefit he received."
Source: Greg Rosalsky, The Huffington Post [7/11/12]
VA Tests Teleconference Training for Primary-Care Docs
The U.S. Veterans Affairs Department is testing a new take on telemedicine at 11 sites across the country. The three-year, $15 million pilot program, called Specialty Care Access Network-Extension for Community Healthcare Outcomes, aims to train VA primary-care physicians to provide specialty medical care to veterans living in rural settings where specialists are scarce. If successful, such Internet-based specialty training for primary-care physicians could be rolled out throughout the VA system, according to VA officials.
The program uses one-and-a-half hour weekly video conference training sessions for primary-care physicians. Sessions are led by panels of medical specialists in select areas of medicine. The training uses specific cases to simulate the training that physician specialists receive. The aim of the program is to serve as a "force multiplier" that allows the same number of physicians to treat a larger number of patients by expanding primary-care physicians' knowledge of select specialty areas of medicine.
Rich Daly, Modern Healthcare [7/11/12]
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 2648.
I always use a tourniquet when doing a chemical matrixectomy. I used phenol successfully for ten years but switched to sodium hydroxide a few years ago. Sodium hydroxide is less expensive and does not incur a hazardous material shipping fee. A single 5 to 10 second application is all that's needed followed by a vinegar flush. Keep an eye on the expiration date as the solution does weaken with time. The healing time is the same as with phenol.
I think the key to this procedure is to reduce the variables. One variable is the amount of bleeding that neutralizes the phenol, the second is not controllable - which is the patient's genetics. To control the bleeding, I use a touniquet, and then apply Monsel's solution, and then clean the excess with 2 or more cotton tipped applicators. After this, I apply the phenol.
Stanley Beekman, DPM, Cleveland, OH,firstname.lastname@example.org
I have been using 99% (crystalline) phenol for the 33 years I’ve been in practice and never use a tourniquet. It’s hard to say what my recurrence rate is since I have no way of knowing if a dissatisfied patient with a recurrence went to a colleague. I also don’t use an elevator or a nail splitter, but rather a Steven’s tenotomy scissor, which is far less traumatic. I can’t say whether it’s the pure phenol or the technique, but hardly anyone has any post-operative pain whatsoever. What I particularly like about using 99% phenol is if it’s crystalline, I know it’s pure and free of contaminates (otherwise it turns to liquid). It’s a bit of a bother heating it up into solution to make it available for an applicator tip (I use the Micro-tip applicators), and I can’t imagine that the 0.004 picograms that gets discarded on the tip of the applicator is a major source of global warming.
You need to purchase this from a chemical supply house, as medical supply houses don’t have the 99% stuff. I get mine, well, I GOT mine (since 1 bottle will last you the life of your practice) from Ward’s Natural Science in Rochester, NY: (wardsci.com)
Unfortunately, Dr. Jaffe's question is far too generic to accurately answer at this time. A myriad of parameters exist that affect bone healing. For instance, what type of bunionectomy is contemplated? Will an osteotomy be performed? If so, which bone (metatarsal? phalanx? both?), how many, and where within the anatomy of that bone will the osteotomy be performed (distal metaphysis, proximal metaphysis, midshaft)? How will it be fixated? Is your patient's physiologic age commensurate with her chronological age? Just because she is a karate expert, can we automatically assume 100% health with no co-morbid fracture healing factors such as post-menopausal osteoporosis, etc.? ALL of these parameters affect bone healing rates.
As one example, a healthy 50 year old female, with no co-morbid fracture healing factors, who undergoes a distal metaphyseal 1st metatarsal osteotomy with AO fixation, should heal that osteotomy via primary bone healing between 4-6 weeks. At 8 weeks, assuming no setbacks occur, and radiographic evidence confirms primary fracture healing, then I'd likely have little qualm about allowing this patient to re-stress the forefoot. Keep in mind that following any immobilization (for me, in this example, typically 3-4 weeks in a pneumatic cam walker), patients will experience some disuse atrophy and regional, pedal osteoporosis. So, I'd want her back in flexible shoes, propelling off her forefoot and re-establishing full blood flow throughout her operated foot for several weeks prior to allowing the stress of board-breaking.
Dr. Stone's article/recommendation is sensible, but overstated as a warning. If you have cold feet and can't sleep or be comfortable, just make a bowl of warm water, feel it with your hand to make sure it isn't too hot, and soak the feet. This gives tremendous relief.
I read the posting on PM News about Dr. Janis. In reading the article excerpt, the assumption is that this doctor is guilty of malpractice. After reading the entire article, I got a better picture of the story but I find it irresponsible for PM News to post only a portion of the article. In addition, we should be cautious posting articles or news stories from a media outlet that may be biased. We all remember the skewed report from ABC’s 20/20 back in the ‘90s that painted podiatrists as not being well trained and even inferred that there was a danger to the public.
I recommend reposting “In the Courts” stories where the podiatrist was actually found guilty or not guilty of malpractice or fraud and stop catering to the “court of public opinion.” We should set a higher standard within our profession in delivering negative stories of podiatrists. I’m sure not one of us would be happy if a malpractice lawsuit were published and republished online, tarnishing our reputation, while later the lawsuit was found to be frivolous and thrown out.
Editor's note: We believe that the excerpt was objective and balanced, and there was no assumption of guilt implied. We generally run short excerpts of longer stories. Readers are invited to read the entire article and decide for themselves. PM News policy is not to run a story about a single alleged case of malpractice.
MEETING NOTICES - PART 2
Codingline&PM NewsIn conjunction with AAPPM Present The Greenbrier Coding & Practice Management Workshop -August 20-22
(Following the 2012 APMA Annual Scientific Meeting in Washington, DC)
The Infinity Pool at the Greenbrier
Coming to Washington D.C. for the National? Don't miss out on being treated like a President and First Family. Enjoy world class amenities including golf, tennis, spa, casino and children's programs.
Speakers: Harry Goldsmith, John Guiliana, Barry Block, Michael Brody, Paul Kesselman, Jonathan Moore, Rem Jackson, Chad Schwarz, and other nationally-known authorities in morning-only presentations.
All required credits can be taken online for AL, AK, AR, CA, CO, CT, DE, GA, HI, IN, KS, KY, LA, ME, MD, MI, MN, MI, NV, NJ, NM, ND, OH, OR, RI, SC, SD, VA, WV, WI, & WY
Partial required credits can be taken online for AZ, FL, ID, IL, IA, MO, MT, NH, NY, NC, OK, PA, PR, TN, TX, UT, VT, WA, and DC
Choose any or ALL (50 CME Contact Hours) from the30+ CMECategory-1 articles posted
PRACTICE FOR SALE– KANSAS SOUTHWEST
For sale multi-location practice in beautiful Southwest Kansas. Practice has 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Recently added new office space with digital x-ray. Only surgical podiatrist in 2 of 3 locations. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice, a great location and opportunity for the right email@example.com
PRACTICE FOR SALE- SOUTHWEST FL
multilocation multidoctor practice in beautiful Southwest Florida . Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email firstname.lastname@example.org.
PRACTICE FOR SALE- BALTIMORE, MARYLAND
Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact:email@example.com
ASSOCIATE POSITION - NASSAU COUNTY, NEW YORK
Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to: Podiatryoffice@doctor.com
ASSOCIATE POSITION - NEW YORK CITY & QUEENS
High Income Potential. One of the fastest growing podiatry practices in New York City and Queens seeks a hard-working podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Contact me at Podocare@aol.com
ASSOCIATE POSITION- LOUISVILLE, KY
Immediate position for established practice in excellent location with option to buy. All phases of podiatry with good mix of patients. Two local residency programs with foot and ankle and trauma privileges. Office has EMR qualifying for meaningful use in the first year. PADnet vascular testing. Send resume to:firstname.lastname@example.org.
ASSOCIATE POSITION- SEATTLE, WA AREA
Established podiatric clinic looking for an associate to join our team, 5 offices located around the greater Seattle, WA area. Great base salary, benefits and friendly work environment. Please send resume to:email@example.com
ASSOCIATE POSITION-WEST COAST, FLORIDA
Outstanding opportunity for PSR-36 graduate to join successful group podiatry practice. Seeking a sociable, articulate graduate who is confident in rearfoot and ankle reconstructive cases but also enjoys all phases of podiatry. Long-term opportunity for the right candidate with generous pay and benefits. Reply to:firstname.lastname@example.org
ASSOCIATE POSITION - CENTRAL FLORIDA
Associate position leading to partnership. Busy two doctor, two office practice. Good balance of surgical and general podiatry, diabetic foot and wound care, limb salvage. Looking for the right person to transition into vacancy that will be left by retiring physician. Well-established practice with large referral base. Privileges at two hospitals and surgery center. About an hour to each coast and close to attractions. Interested persons please forward CV and summary of surgical log to:email@example.com
ASSOCIATE POSITION- BIRMINGHAM, ALABAMA
Immediate opening. Strong established group practice. 30-40 office patients per day to start. Surgery available, but not required. Base salary, production bonus, benefit package, relocation assistance. Aggressive work ethic amust. Email resume and cover letter to:firstname.lastname@example.org
ASSOCIATE POSITION - NJ
Service Nursing Homes throughout NJ, perform house calls in Passaic County and others. Recent Residency Graduates welcome. A team player who is reliable, hard working, loyal, and skilled. Send resume before calling to:email@example.comPhone 516-375-9224
ASSOCIATE POSITION- QUEENS AND NYC
Part-time position PSR 24 min. Must have friendly, confident personality with great communication skills and training to back it up! All phases of podiatry. Hosp, office, and surgery center priv's. Experience helpful, but willing to train the right person. This position has definite full-time, partnership a/o buy-out potential. It is a meritocracy! You will keep 25-35% of your net revenues. No base salary or benefits until you are a proven entity. You build it, you will keep it! If this sounds like something you really want, please email:firstname.lastname@example.org
ASSOCIATE POSITION – WILMINGTON, DELAWARE
Seeking full time associate, PSR 24/36 Board Qualified/Certified that is personable, highly motivated, ethical and hard working. Established 25 years old, well rounded, and busy practice. In large primary care based medical building with lab, X-ray, CT, ASC and medical aid unit. Multilingual is beneficial. Offering competitive salary with bonus opportunities and wide range of benefits. Partnership potential. Cover letter / CV to:Del.DPM@gmail.com
ASSOCIATE POSITION- HUDSON VALLEY REGION, NY
Unique opportunity for the right person! We’re looking for a personable, motivated individual who seeks opportunity and security in a high-end, multi-office group practice. An incredible position for the right person. Please forward CV and cover letter to:email@example.com
ASSOCIATE POSITION- SOUTHERN WESTCHESTER, NY
Practice opportunity Flexible terms, work with an option to buy. Stable location, 24 year practice with a stable established patient base. Great opportunity for a self motivated podiatrist wanting immediate income and future stability. Send letter and CV to:Billfeet@aol.comor call 551-574-0776 for details.
ASSOCIATE POSITION- OHIO
Ohio practice with excellent reputation and patient base seeks to hire a Podiatric Surgeon. The offices are state of the art including Digital X-Ray, EMR, Diagnostic ultrasound, Padnet Vascular Testing, CO- 2 Lasers all aspects of DME. The base salary is $120,000 with a bonus structure and benefits also would like to have this individual buy into the practice eventually. Please send CV to:Ohiopodiatrist@aol.com
ASSOCIATE POSITION- BOSTON/CAPE AREA
Boston/Cape Area Practice looking for physician experienced in surgical and medical care in office, clinical, and nursing home settings. Practice will provide opportunity to utilize training immediately. Both surgical and non-surgical applicants. Email CV to:firstname.lastname@example.org
ASSOCIATE POSITION- DAYTON, OHIO
Seeking motivated PSR 24/36 trained Podiatrist for busy established practice; EMR established; Good surgical opportunity; Competitive salary and benefits. Send CV to:email@example.com
EQUIPMENT FOR SALE
Retiring from practice. Equipment For sale. Mini x-ray. One year old Ultrasound with MS arterial/venous X-ray plates. Great condition Ritter chairs. Drills, surgical tools. So much. Just ask, I probably have it:Footcare@comcast.net
EQUIPMENT FOR SALE-USED PODIATRIC LASERS
Great price, great outcome. Stop wasting money on expense lasers. Personally owned and used few hours in my office,. 10 and 30 watts lasers. Two handpieces in one. First one for plantar fasciitis, Achilles tendonitis, arthritis, pain, inflammation. 2nd handpiece for surgical ablation and fungus toenail conditions. Portable fast and very firstname.lastname@example.org
WANTED TO PURCHASE-PINPOINTE LASER
Seeking to purchase Pinpointe used laser. Willing to pay top dollar. Please contact us at:email@example.com (1) 713-541-3764. Product Information: Product: PinPointe (Patholase) Company: Cynosure / PinPointe Type: Nd:YAG Options: Podiatry/Toenail
SPACE AVAILABLE- NYC & LI
Office to sublet and share - 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. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM
PM News Classified Ads Reach over 13,500 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 13,500 DPM's. Write to:firstname.lastname@example.org call (718) 897-9700 for details. Weekly ad rates start as low as $115 for a 50-word ad. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.
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