The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

September 04, 2010 #3,949 Publisher-Barry Block, DPM, JD

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Congratulations to Richard A Simmons, DPM of Rockledge, FL, winner of a two-night stay at a Kimpton Hotel located in Atlanta, Aspen, Baltimore, Chicago, Denver, Los Angeles, New York, Portland, San Diego, San Francisco, Salt Lake City, San Francisco, Seattle,  Washington, DC, and Elsewhere (value $558).

We encourage you to participate in this important survey at www.podiatrym.com/survey Completing this anonymous survey provides us with valuable data, which we will publish in the February 2011 issue of PM. It also makes you eligible to win thousands of dollars of valuable prizes. Enter by sending Question #43 (no answer necessary) to bblock@podiatrym.com along with your name and address.

This week's prize is a copy of Reconstructive Foot and Ankle Surgery: Management of Complications: Expert Consult - Online, Print, and DVD by Mark S. Myerson, MD (Value $229).

This is also your opportunity to vote for the next DPM and Non-DPM inductees into the PM Podiatry Hall of Fame.

4th Annual OCPM Alumni Association BBQ Welcomes Over 300 Attendees!

The 4th Annual OCPM Alumni Association BBQ was held on Saturday, August 14, 2010 at the OCPM campus in Independence, Ohio.  

4th Annual OCPM Alumni Association BBQ

Source: Footsteps, September 2010

ACFAOM 2010 Covers All Clinical Bases

Doctors from 27 states gathered at Disney World last week for the Annual Clinical Conference of the American College of Foot & Ankle Orthopedics & Medicine (ACFAOM). The conference attracted 200 participants for very clinical and practical 8-hour tracks on chronic foot wounds, orthotic therapy, and essential surgical skills. The combination of four hours of twenty-minute plenary presentations and four hours of ‘hands-on’ workshops featured 20 faculty experts. Other 4-hour focus sessions of lectures and workshops covered punch biopsy and plastic surgery, reimbursement, HIPAA compliance, diagnostic ultrasound, and clinical and research papers 

Participants at diagnostic ultrasound workshop presented by the new ACFAOM Podiatric Imaging Council.

A scientific exhibition by 32 companies and several social events, including one with Mickey Mouse, rounded out another very successful annual clinical conference. ACFAOM 2011 will be held at the Hilton Orlando Bonnet Creek, Florida, October 27-30, 2011. Visit www.acfaom.org for details about the 2011 conference over the coming months.

How do you make sure you have the right people for the right positions?

It is advisable to use a tool such as The Physician DNA™ to benchmark your physicians and key management staff.  Here are some facts and “The real cost of a bad hire.”

1. Personality profiling increases accuracy of a successful hire. Studies were performed by John Hunter, PhD. at Michigan State University that showed that the interview process was only 14% accurate in predicting a successful hire, that background and reference checking has a 26% accuracy, the aptitude and personality profiling has a 53% accuracy, and that job profiling increases accuracy to 75%. The Physician DNA™ profiles have been done on over 25,000 individuals in all job categories and show an 87% accuracy rate.
2. A Harvard University study concluded that nearly 80% of turnover is due to mistakes made in hiring.
3. Talents are the key to organizational and personal success. Buckingham and Coffman point out that you cannot teach talents. You must select them. The key to excellent performance is finding the match between your talents and your role in the practice.  

Source: David Helfman, DPM, CEO, Village Podiatry Centers, PC, dhelfman@vpcenters.com

Query: Cortisone Injection in Second Trimester?

A female patient 5 months pregnant came into the office with heel pain. She stated that her Ob/Gyn MD said she could get a cortisone injection. Does anyone have input on this issue?

Mark Stempler, DPM, Staten Island, NY

Query: Problems with MTI 525 Chair?

Has anybody else had problems with the MTI 525 treatment chair? I have had two of my chairs burn out the tilt motor. Both chairs are about 5 years old and the tilt motors have gone out within about 5 months of each other. The manufacturer says that it hasn't been a problem with anybody else but me. Is it time to switch to another brand?
 
Arthur Weisman, DPM, Independence, MO

Query: Resection of Dorsal Bossing

What is the correct way to bill resection of dorsal bossing - 1st cuneiform, 1st metatarsal bones?

Donald Brann, DPM, Orland Park, IL

Response: I suggest billing a single CPT 28122 (partial excision [craterization, saucerization, sequestrectomy, or diaphysectomy] bone [e.g., osteomyelitis or bossing]; tarsal or metatarsal bone, except talus or calcaneus) for this procedure.

Tony Poggio, DPM, Alameda, CA

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

RE: Manipulation Videos (Howard Dananberg, DPM)
From: Robert Bijak, DPM

I found Dr. Dannenberg's videos frustrating and offensive. For many years, we have seen podiatrists claiming they are the kings of the foot. In Dr. Dannenberg’s video we see him working on the poplitieus and the leg. Not that I oppose podiatrists doing more, but the reality is most of us in the U.S. can't do this by law. I'm sick of  seeing treatments we can't do. On the other hand, we are  told to be proud that we are the specialists of the foot. It's obvious to me that foot treatment without a license to work on the leg makes us an inefficient practitioner. Podiatry has to decide where it stands. Just the foot, the foot and leg, or what? 

The laws in this country are non-standard and podiatrists don't know what they are. The profession is, excuse the truth, screwed up.  Licenses are different, residencies not available. This is what our leadership has given us. Dr. Dannenberg shows what chiropractors have been doing for years. We don't learn manipulations of the fibular head in school; and it's not legal for most of us. Podiatry has to address the main problem, our limited license and limited training. Try manipulating the fibular head and popliteus in New York. Bye, Bye license. Full scope answers all our problems, and that's all we should be addressing. 

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

Query: Keller with Chondroplasty (Jeffrey M. Kittay, DPM)
RE: Barry Mullen, DPM

Frankly, I've never understood the rationale why hemi-implants designed to replace phalangeal bases, are ever utilized in 1st MTP degenerative joint disease surgery. Other than joint destruction to phalangeal bases created from a) old intra-articular fractures, or b) inflammatory or infectious arthritis, when was the last time any of my colleagues witnessed significant destruction of a phalangeal base, especially when the degenerative arthritic changes are associated with a biomechanical etiology? Phalanx bases may "cup" around 1st metatarsal heads, and/or develop peri-articular osteophytes, but, by and large, the actual joint surface remains viable...so why do podiatrists replace it?! What is your rationale?

In addition, I would strongly disagree with Dr. Kittay's statement that phalangeal base hemi-implants are designed to articulate against damaged 1st metatarsal head articular surfaces. This is particularly inaccurate with respect to Silastic hemi-implants. Implant fracture, fatigue and subsequent detritic synovitis from uneven implant wear against compressed, irregular 1st metatarsal head joint surfaces are just a few of the well documented complications. Perhaps, metallic hemi-implants will hold up long-term; but, then one has to wonder what happens to the irregular, damaged 1st metatarsal head surface when now forced to articulate against an implant with much greater strength.

Wouldn't the logical conclusion be that unless the compression over the 1st MTP is completely eliminated, further 1st metatarsal head breakdown is inevitable? As such, I understand the rationale why one would try to improve the 1st metatarsal head's articular surface when choosing to perform phalangeal base implantation. I'm curious to learn if 1st metatarsal structural deformity was addressed. If not, surgery designed to create painless and full 1st MTP ROM is doomed to fail.
 
Logically, if one were to specifically address 1st MTP degenerative arthritis, it should be attacked at its source, the metatarsal head. From my perspective, the surgical choices are: 1) total implant arthroplasty  2) Hemi-implantation of the 1st metatarsal head in conjunction with plantarflexory and/or shortening 1st metatarsal osteotomy if applicable, or 3) 1st MTP fusion. Other than the previously cited specific indications of phalangeal base degeneration, can anyone explain a rationale for replacing the "healthy" side of a degenerating 1st MTP? Anyone? 
 
Barry Mullen, DPM, Hackettstown, NJ, yazy630@aol.com 

RE: Medicare Announces Availability of Internet Access
From: Paul Kesselman, DPM 

CMS is currently testing an Internet-based module which will allow providers and suppliers to perform most of the functions currently available on the IVR. I am currently undergoing training as a beta tester for this system. This will allow free 24-hour Internet accessibility to receive information which most other commercial insurance companies currently provide.

It will take some time before this is widely available to the general provider and supplier community.When available, it will be done on a carrier-by-carrier basis. Updates on this system's availability and its functions will be posted as warranted.

Paul Kesselman, DPM, Woodside, NY,pkesselman@pol.net

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

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION -CT (FAIRFIELD AND NORTH HAVEN)

Great opportunity. Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices. Electronic medical records, digital x-ray, diagnostic ultrasound, Padnet vascular studies, nerve conduction studies, pinpoint and CO2 lasers, electrical stimulation and ultrasound therapies. Seeking a well-trained, personable, and highly motivated individual. Please send resume and current photo to dr.kassaris@yahoo.com

ASSOCIATE POSITION - BLOOMFIELD, NEW JERSEY

Part-time office, part of larger practice looking for associate with well-rounded podiatric skills. Board qualified a must. Ground position leading to partnership. Please email CV to doccapo@yahoo.com

PODIATRY POSITION AVAILABLE – WISCONSIN

Affinity Medical Group, an integrated health care organization in East Central Wisconsin, is seeking a BC/BE Podiatrist for our Appleton location. This is a General Podiatric practice opportunity including routine care, sports medicine, and surgery. The Appleton area offers a unique quality of life, combining a family centered, university community with all season recreation, a nationally acclaimed educational system, and a diverse and growing economy and population. For information, contact or send your CV, to: Sara Roth, Affinity Medical Group, Physician Recruitment, Phone: 800-722-9989; Fax: 920-727-4350; E-mail: sroth@affinityhealth.org Visit our website at: www.affinityhealth.org EOE.

ASSOCIATE POSITION - SW FLORIDA GOLF, BOATING & BEACHES 
 
Great opportunity to join a well established podiatry practice.  Excellent mix office/surgery, motivated experienced staff. Seeking full-time Associate PSR 12-36. Salary $100 Thousand + bonus package with benefits, early buy-in available to right candidate. Email resume to capecoralpodiatry@live.com or fax to 239-573-9201

MANHATTAN - FULL-TIME POSITION

Available for a Board certified/qualified podiatrist (PSR-24, PM&S-36 ). Located in Downtown Manhattan in a multi-specialty Orthopaedic office. We have a high-volume practice that treats routine care, trauma, sports-related injuries, hospital consults, and ER Consults. Contact fscudese@seaportortho.com

ASSOCIATE POSITION - FREDERICK, MARYLAND

Fredericks premier group practice is located only 45 minutes from both DC and Baltimore. Immediate opening for a minimum PSR 36 Podiatrist for full time position. We have it all: EMR, digital x-ray, ultrasound, ASC, etc. Excellent salary with bonus structure and benefits. Please email resume to docsbnb@aol.com

FULL-TIME ASSOCIATE NEEDED FREDERICK/HAGERSTOWN, MARYLAND

Reconstructive Foot & Ankle Institute, LLC needs full-time DPM at least PMS 36 to join premier group in Frederick/Hagerstown, MD. ASC, EMR, DR-digital radiography and ultrasound, Vascular/nerve testing, DME, retail store, strong hospital affiliations, salary, bonus and benefits. Respond to drmichaels@rfainstitute.com

PRACTICE & STATE LICENSED ASC FOR SALE (MARYLAND, DC SUBURB)

Full-time 38 yr old podiatry practice with state licensed surgical center. Fully equipped with digital x-ray, diagnostic ultrasound, 2 orthotic scanners, computer network, and well-equipped surgical suite. Retiring owner will stay on as needed for transition. Email dpmpracticeforsale@yahoo.com

PRACTICE FOR SALE – MASSACHUSETTS

Solo Practice Grossing over $700K yearly 4 days a week. Mostly surgical with heavy emphasis on peripheral nerve patients and pediatrics. General bread and butter podiatry as well. No Medicaid very little Medicare. Very modern office. 30 minutes north of Boston. Modern new equipment (digital x-ray, ultrasound, computer network, etc.). Great referral network. Website included. Option to buy the condo 3500sq ft. Have PICA practice evaluation to show you. Call 978-944-7789 for details.

MEDICAL SPACE AVAILABLE- MANHATTAN

Multispecialty Medical Building with 24/7 doorman. Prime Luxury Building and Location, Gramercy, Stuyvesant, Peter Cooper Area. 305 Second Avenue (17th-18th). Prior tenants past 23 years; podiatrist, dentist (plumbing/electric intact), internist. Ideal for podiatry, co-share with dentist, MD, etc. (flexible lease terms). E-Mail; jbdrun@aol.com Phone; 480-951-2480.

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