November 16, 2013 #4,917 Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
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AT THE COLLEGES
NYCPM Honors 3 Women Podiatrists
Last night, with pomp and circumstance, the New York College of Podiatric Medicine (NYCPM) held a Convocation honoring Women in Podiatry. Drs. Susheel Bathla, Kathleen Reilly Fallon, and Halina M. Semla-Pulaski, all graduates and Board of Trustees members of NYCPM, received honorary doctorates in humane letters.
Drs. Susheel Bathla, Kathleen Reilly Fallon, and Halina Semla-Pulaski
These highly accomplished women were recognized by President Louis L. Levine and the Board of Trustees both for their professional and personal contributions to podiatric medicine, and for their community service. The ceremony, gala dinner, and silent auction were held at the Grand Hyatt Hotel in Manhattan and raised money for student scholarships.
The Pennsylvania Podiatric Medical Association (PPMA) presented nine awards at the Annual House of Delegates Banquet, held at the Valley Forge Casino Resort in King of Prussia, PA. This was in addition to the installation of Joseph C. Smith, DPM, as the new PPMA President.
(L-R) John Mattiacci, DPM; Robert Herpen, DPM; Dennis Santoli; Cynthia Booth; Jason Miller, DPM; Ed Hart, DPM; Thomas Rocchio, DPM; and Stephen Schleicher, MD.
The award winners were:
Podiatrist of the Year - Robert W. Herpen, DPM
McQuaid Distinguished Service Award - Edwin S. Hart, III, DPM
Special Recognition Award (Podiatrist) - Jason R. Miller, DPM
Special Recognition—Health Practitioner Stephen M. Schleicher, MD
Special Recognition Award for a Layperson - Dennis R. Santoli and Cynthia Booth
Award of Excellence - John A. Mattiacci, DPM
The Rising Star Award - Thomas M. Rocchio, DPM
The Annual Residency Program Recognition Award - Philip Richardson, DPM
PODIATRY AND DIABETES - PART 1
Ontario Podiatry Association Promotes World Diabetes Day
The Ontario Podiatric Medical Association (OPMA) and Ontario's podiatrists join in recognizing World Diabetes Day today with a plea to improve awareness of the impact diabetes has on overall health and particularly on the foot health of the 2.4 million Canadians living with diabetes. According to the OPMA, podiatrists identify and treat wounds that could otherwise go unnoticed and, if left untreated, become seriously infected and detrimental to the individual's health.
Dr. Bruce Ramsden
The prevalence of diagnosed diabetes has increased by 70% from 1999 to 2009 according to government reports. Podiatrists, as primary healthcare providers, are on the front line coping with the increased demand for care of diabetic foot conditions. "Public health sources claim that diabetic foot ulcers cost more than $150 million annually," stated Dr. Bruce Ramsden, President of the OPMA. "Diabetic foot wounds left untreated or treated too late led to over 2,000 amputations in Canada in 2011-2012," added Ramsden. Diabetes is a call to action to all health professionals.
PODIATRISTS AND DIABETES - PART 2
UK Podiatrist Discusses Diabetic Peripheral Neuropathy
Solent NHS Trust runs a podiatry service in Portsmouth, including clinics at the Turner Centre, in St James’ Hospital, in Locksway Road, Milton. Mathew King is a pathway lead podiatrist, and explains why diabetes can lead to amputation of the lower limbs. He says, "With diabetes, people can lose the feeling in their feet. Diabetes affects the nerves, which leads to a loss of sensation, so people cannot feel pain. This means they don’t know if they have done any damage."
Source: Portsmouth News [11/14/13]
PODIATRISTS IN THE COMMUNITY
NJ Podiatrist Collects Shoes for Needy
In any given week, Dr. Daniel Margolin might see 200 patients or more in his office at New Jersey Foot and Ankle Centers in Oradell. Podiatry is his passion, but what feeds his soul is helping the less fortunate get back on their feet, literally. “Everybody is depending on the government to do something. And you know what, why don’t we just do it ourselves. We must work together to build a community,” says Margolin.
Dr. Daniel Margolin
The doctor has collected more shoes over the years than he can count, and what does he do with them? Well, he donates them by the hundreds to organizations like the Red Cross and the Salvation Army.
Source: Pat Battle, WNBC-TV [11/7/13]
HOSPITAL PODIATRISTS IN THE NEWS
MI Podiatrist Joins Botsford Hospital Medical Staff
Sophia C. Barnett, DPM, has joined the medical staff at Botsford Hospital in Farmington Hills. This podiatric surgeon practices at Foot Healthcare Associates with locations in Livonia, Novi, and Southfield.
Dr. Sophie Barnett
Dr. Barnett graduated from Temple University School of Podiatric Medicine in Philadelphia, PA. She then completed the three-year podiatric medicine and surgical residency at Botsford where Dr. Barnett managed patients' dermatological conditions and diabetic ulcers at Botsford's Wound Care Clinic.
Source: Farmington Patch [11/14/13]
Query: Office Design and Set-up
I am currently looking for resources on designing a new office. Layout, ways to improve exam room efficiency, upgrades, new must haves, floor plans, etc. If anyone knows of good resources or has some good ideas please post them on PM News.
Martha Holzworth, DPM, Boca Raton FL
Query: Selective Debridement vs Excisional Debridement
I have recently started having issues with a hospital coder. She requires that all documentation on any debridement have the word "excisional" in addition to whatever type of debridement was done. This means that my terminology - "into subcutaneous tissue" - from CPT describing debridement must say "excisional debridement into subcutaneous tissue."
If I debride down to and include bone, and say debridement of wound including (a specific) bone, I must change the wording to say excisional debridement of wound including (a specific) bone. My progress notes I write say that I am performing a sharp, surgical debridement, but that is not good enough. I even have to have my operative reports from other facilities changed if the patient is transferred into this one hospital. Please advise me on the proper terminology of wound debridements and if I have to acquiesce to her way of wording.
Matthew Babich, DPM, Dallas, TX
Response: Selective debridement involves the removal of superficial slough versus excisional or surgical debridement which involves removal of deeper-than-superficial (i.e., subcutaneous tissue or deeper levels) nonviable tissue. This is how CPT views these terms. This is how the profession uses these terms.
You should document what type of tissue you removed, the post-debridement size of the wound, if you use any anesthesia, etc. From a claim processing perspective, if the claim requires review, that review is typically done by either a nurse or professional coder...not a doctor. Those reviewers are trained to look for certain key words. They can infer things but if they are not well trained, then documentation details that seem to be blatantly obvious to you may not be to this person... and the claim gets denied.
It is not typical or necessary to include the word, "excisional" when you are using the surgical debridement codes. The key term is "debridement" that is defined by level of tissue removed.
Tony Poggio, DPM, Alameda, CA
Codingline subscription information can befound here
APMA Members: Click here for your free Codingline Silver subscription
I have tried Juvederm and most of the HAs over the past few years. When you study/learn about the rheology of the injectables, you will find that Radiesse is a winner when it comes to the forces that the bones of the feet exert on the skin. I have 7.5 years of follow-up, and so far the results have not changed since I first wrote about PSTTA (Pedal Soft Tissue Temporary Augmentation) in PM News in 2007.
My results for Radiesse injections are as follows:
1. For Interdigital HMs in young patients (under 60), average of 2.2 years pain-free from one injection.
2. For Interdigital HMs in the 60+ y.o. patient. Zero recurrence in 5 years.
3. For IPKs in 20-40 yo, Average of 8.3 months pain-free.
4. For IPKs in 41-60 yo, Average of 14.1 months pain-free.
5. For IPKs in 60-70, Average of 11.7 months pain-free
We all know that ESWT is an effective modality to treat plantar fasciitis and Achilles tendonitis. That was never the issue.
Clearly, Horizon's (and every other insurance company's) issue is their bottom line. How many patients have we all had who have come in years later praising the result of ESWT? The problem, which we all know, is that...
Editor's note: Dr. Sach's extended-length letter can be read here.
I received a fax asking me to be an investigator in a study of compounded pain medication approved by "the IRB". Apparently, my qualification as an investigator for this study is that I have a license and a working fax machine. They are paying the investigator $125 per month for each patient enrolled. The patient must not be on Medicare or Medical Assistance. It is certainly an 'odd' study in that there are no controls, and the patient's insurance company is billed for these compounded medications. But not to worry, it says right in the study contract that both the investigator and the research company "acknowledge that any scheme of “pay-per-script” is strictly prohibited and forbidden and shall not constitute any part of this agreement." I guess that makes it legit!
Our (podiatry) offices are professional locations, not restaurants. Our employees are paid a salary and do not need "tips" to live as do waiters. If someone wants to thank the practice by giving a box of candy or cookies to the entire office, okay. But never is a cash to an individual acceptable or professional. If someone offers it, then it is up to the doctor to politely explain that it is against office policy.
I heard on the radio last night that there is a bill before Congress right now that will compel doctors to accept Obamacare exchange patients. They said they expect all Democrats and a few Republicans to vote for it.
Is there authority, documentation that states the doctor cannot opt out of a plan? With the plans now, one can select the PPO, HMO, and/or the POS plan without issue. I have not seen anything that says we must accept or anything that says we do not have to accept "health exchange" plans. The insurance cards will have initials to indicate that the patient is part of the health exchange.
Now, assuming you are correct, the issue will come up that there are deductibles and co-pays in the least expensive plan. It could have a $5,000 deductible and 50% coverage. We are not, at least as I understand it, required to treat patients (exception might be in the ER) without collecting the deductibles and co-pays at time of service, either before or after. If one waits until after treatment, I feel that payment might be difficult.
LOOKING TO PURCHASE A PRACTICE IN PALM BEACH COUNTY, FL
Obamacare!? Looking to get out...or stay? I am looking to purchase a practice in Palm Beach County, FL. Contact Ian S. Goldbaum DPM at (561) 702-5637.
PRACTICE FOR SALE - NASSAU COUNTY, NEW YORK
60 year old practice currently operating only 16 hours per week. Plenty of room for growth. Stable lease. Grossing 100k priced for quick sale at 65k. Three complete treatment rooms plus O.R. staff in place. Turn-key operation. Respond to email@example.com
LOCUM TENENS POSITION - VIRGINIA
Short term position available. 3-4 days per week, two offices. Reply by submitting a letter of interest and CV to our Practice Administrator at firstname.lastname@example.org
EQUIPMENT FOR SALE - PADNET
Padnet vascular testing machine with updated security software (purchased in 2012). Perfect condition only used for training. We do not have the patient population to provide this valuable diagnostic tool. Purchased for 20K, asking 12K (and we will pay for shipping costs). Please contact email@example.com
FOR SALE - STORZ ERGO ELECTRIC SAGITTAL SAW HANDPIECE AND CHUCK
Storz Ergo Electric Sagittal Saw Handpiece and Chuck, also 1 power cord for same set In Excellent Condition $1200 for Handpiece $1000 for power-cord Separate or together-buyer pays for postage & insurance Pictures available Contact firstname.lastname@example.org
EQUIPMENT FOR SALE– USED PINPOINTE LASER AND 2 USED Q-CLEAR LASERS
Used Pinpointe Laser for Sale! $17,500. 2 Used Q-Clear Lasers for sale $9,000 each. Please call 202-255-6236 or email: email@example.com
ASSOCIATE POSITION - ARKANSAS
Ethical, highly motivated, enthusiastic associate needed to join successful, well-established practice located in Northwest Arkansas. Certified/qualified by ABPS with rearfoot training preferred. The practice has an excellent working relationship with a high referral base from local PCPs and other specialists. Well-rounded practice incorporates general podiatry, surgery, wound care, and sports medicine. Salary plus excellent bonus potential for the right individual. Send CV to: firstname.lastname@example.org.
PART-TIME ASSOCIATE POSITION – CHICAGO, IL
part-time opportunity in Chicago to provide treatment to homebound patients. You can create your schedule- logistical support provided. Reimbursement is 40% of collection. If interested, please call 312-375-6430.
ASSOCIATE POSITION- DAYTON, OHIO
Join an established group practice in Dayton, Ohio excellent reputation, large referral base. Base Salary$120,000, benefits and bonus structure. EMR;diagnostic ultrasound; Padnet; CO2 and Cutera Laser for nails, all aspects of DME. We need well trained personable PSR24/36 surgeon. Future Buy-in available. Please send CV to: Ohiomedical@aol.com
PART-TIME ASSOCIATE POSITION- ILLINOIS
Part-time podiatrist wanted for Franklin Park, IL office to begin December 2013. Please contact Dr. Ballard at 630-307-7463 and fax vitae to 630-529-0087 to apply.
ASSOCIATE POSITION - WESTERN PHILADELPHIA SUBURBS
Here’s the practice opportunity you’ve been looking for! Wanted: One well-rounded, PSR-36 trained, podiatrist to join “our family”. Exposure and great patient mix for ALL aspects of podiatry. Recently, 2 partners became 4 partners! You could be next! We are growing and want the right person to grow with us. Please send an email, with CV and/or resume as an attachment to: Teegee46@gmail.com and title it- “Wanted: One well-rounded podiatrist”.
PODIATRIST WANTED - SOUTHERN CALIFORNIA
Podiatrist for practice in long-term care facilities. Facilities include Skilled Nursing, Assisted Living and Board and Care homes. Professionally managed. Email interest and CV to: ZbubblesZ@aol.com
ASSOCIATE POSITION - EASTERN SHORE OF MARYLAND
Seeking highly motivated, ethical, enthusiastic associate to join successful, well-established practice located in close proximity to Maryland and Delaware beaches. Certified/qualified by ABPS with rearfoot experience preferred. The practice incorporates surgery, wound care, sports medicine and general podiatry. Fully equipped office with diagnostic ultrasound, fluoroscopy, vascular testing, radio frequency ablation, six treatment rooms and three satellite offices. Main office has accredited ambulatory surgery center. This opportunity has excellent salary potential with benefits for the right individual. Send CV to: email@example.com.
ASSOCIATE POSITION –DALLAS/FT WORTH, TX
Dynamic, busy practice in Dallas/Fort Worth area, seeking surgically trained, Board Certified/Board Qualified podiatrist, PSR-36 preferred. Excellent salary and benefits compensation package, for the right candidate, who is motivated to work hard. Contact/Send resume to: firstname.lastname@example.org
ASSOCIATE POSITION- CENTRAL FLORIDA
Looking for a motivated individual to join a busy two office practice. Diverse patient population from general podiatry, wound care and surgical. Two hospitals and surgical center coverage. Competitive salary with incentives. Malpractice, health insurance, all fees and dues covered. Must have active Florida license. Please forward CV and surgical log to: email@example.com.
ASSOCIATE POSITION - CT (GREENWICH, FAIRFIELD AND NORTH HAVEN)
Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to: Dr.Kassaris@yahoo.com
ASSOCIATE POSITION– BROOKLYN
Podiatrist needed for busy Brooklyn practice. Must be at least Board Qualified. Surgical background, personable and able to travel to different offices in Brooklyn. Part-time to start, with the potential for full time and partnership. Please email CV to firstname.lastname@example.org or fax to 718-840-0653.
ASSOCIATE POSITION - CENTRAL FLORIDA
Associate wanted for well-established practice in central Florida. Experienced support staff, malpractice coverage and health insurance provided. Excellent opportunity for a promising future. To apply please go to www.yourcareerinpodiatry.com
ASSOCIATE POSITION - ST. LOUIS
Group practice seeking motivated DPM with initiative & leadership skills. Must have the ability to lead your own clinic. Group is fully automated, utilizes EMR, digital x-ray, etc. Base salary starts at $125k, with incentives to grow income to $200k+, includes malpractice coverage, health insurance, 401k. Please send CV to email@example.com.
DIABETES MANAGEMENT FELLOWSHIP - CENTRAL KENTUCKY
CVs and letters of interest are being accepted now for the most unique and well-rounded fellowship in podiatric medicine. This non-accredited, 1-year fellowship starts in July of 2014 and offers a wide variety of training opportunities that focus on diabetes, including diverse pathologies and unique medical and surgical opportunities. Regular surgical case load, intensive practice management, and the best prep for real world practice. Work with our on-staff certified orthotist, physical therapist, shoe store staff, MRI director, etc. Generous stipend, benefits, and free housing. Learn more at www.myhappyfoot.com (click the Fellowship Tab). Send CVs to firstname.lastname@example.org.
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