Spacer
PMbanA7-513.jpg
Spacer
PresentBannerCU418
Spacer
INGBannerE215
Podiatry Management Online


Facebook

Podiatry Management Online
Podiatry Management Online


PracticeEHRWebBannerGY218

Search

 
Search Results Details
Back To List Of Search Results

03/13/2018    

RESPONSES/COMMENTS (NON-CLINICAL)


RE: NJ Former Resident Meets Attending After Many Years 


From: David P. Luongo, DPM


 


Every year, kids play their last games of Little League baseball at a week-long tournament in Cooperstown, NY. On my team’s fourth game, to my amazement, while meeting at home with the umpires, the opposing coach was very familiar looking. He then introduced himself as Dr. Steve Lemberger, one of my residents at St Clare’s/St Vincent's Hospital from the late '90s.  


 


What a coincidence, so many years later, here we are, meeting on the Cooperstown ball field representing our kids' 12U baseball teams the Maywood Hawks vs. the Freehold Fusion. We both had an incredible week, an experience for our boys they will never forget. It truly is a small world!


 


David P. Luongo, DPM, NY, NY

Other messages in this thread:


06/19/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2


Re: Costco Selling "Custom" Insoles 


From: Robert Scott Steinberg, DPM


 


I posted this on Costco's Facebook page. If you feel the same, please post on your Facebook page and on Costco's page:


 


I was in Costco on Saturday, June 16, 2018, and realized they could save tons of money by getting rid of pharmacists and optometrists! Anyone can read a prescription, count pills, and make people better, right? Digital devices can scan the eye and come pretty close to correcting vision and improving eyesight, right? Of course, they are not going to do that, but they do invite into their stores, people with no licences to advise people that they can make their feet feel better by standing on a mat and have the bottom of the feet mapped. Then produce devices that may cause injury to the foot, ankle, knee, and low back.


 


So, what if it has a 90-day guarantee?  The damage from devices like these might not show up for months. If you want to try something quick and easy, and inexpensive for foot pain, pick up a pair of rather stiff insoles at a sporting goods store. If they don't work, you're only out $35-$40 bucks, not the $130 Costco charges for their ridiculous insoles. If you have foot or ankle pain, you deserve to be seen by a licensed expert, a doctor of podiatric medicine and surgery.


 


Robert Scott Steinberg, DPM, Schaumburg, IL

06/19/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Using an Orange Light to Better Visualize Lesions


From: Daniel Chaskin, DPM


 


Skin cancer on the feet can result in death. In some patients, a parallel ridge pattern on the dermatoglyphic areas of the feet indicates a high probability of skin cancer. Sometimes, examination under a polarized or non-polarized white light just might not provide a clear diagnosis.


 


I discovered that an orange light may be helpful in distinguishing between the parallel furrow and parallel ridge patterns. I believe other colors might also give similar, if not improved, ability to give a more accurate diagnosis. 


 


Daniel Chaskin, DPM, Ridgewood, NY

06/14/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 3



From: From: Charles M Lombardi, DPM


 


I applaud any advancement of podiatry and have always worked to advance the profession. That was not the point in my post. It should have been podiatric physician, not surgeon, since most positions in the VA (FULL TIME) require board certification as far as I am aware (I may be wrong, but would like to see the documents). I believe this new title may be a slippery slope as opposed to clean language "podiatric physician." .


 


That being said, I am presently considered a podiatric surgeon under NYS Medicaid and still don't get paid for my services, so please explain how this helps the majority of podiatrists in New York or other states that do not pay for podiatric services or surgery. I am just not sure how you make the jump to it helping the majority of podiatrists. 


 


Charles M Lombardi, DPM. Bayside, NY

06/14/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Michael L. Brody, DPM


 


Dr. Steinhauser is 100% correct in the reason for all of the chart reviews. The term is known as "Risk Adjustment", the amount of money the insurance company receives is modified by the risk status of the patient population. In chart reviews, they are looking for medical conditions that were not reported as an ICD-10 code on the bill.


 


Michael L. Brody, DPM, Commack, NY

06/14/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2



From: Jeffrey Kass, DPM 


 


Dr. Williams has pointed out there is an alternative to ABFAS. He mentions ABLES. However, unfortunately, ABLES is not according to state law, in some states, going to help you practice above the ankle. For example, here in New York, the law specifically singles out that  one needs to be Board Certified by ABFAS in order to be granted this privilege. One of the largest hospital networks in New York has also recently made ABFAS certification your ticket to OR privileges. 


 


Jeffrey Kass, DPM, Forest Hills, NY

06/13/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Change in ABFAS Rules Prevents Recertification


From: Michael Z. Metzger, DPM


 


I received my (ABPS) certification in 1992. I was required to be re-certified and thought I had done so in 2002. I passed the exam and then learned that under the rules, I could not be recertified unless I submitted cases.  Because I had changed my practice and was not doing surgery back then, I was not be able to get my new certification. 


 


I wrote to the board officers and never heard anything. I still have no idea how they had the authority to just change the requirements retroactively. The fact that I got my original certification under certain requirements and rules made no difference. By the way, they have since dropped the requirements for cases, but I was still “uncertifiable”. 


 


Michael Z. Metzger, DPM, Houston, TX

06/13/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2



From: Benjamin J. Wallner


 


I would like to address a few misconceptions that have appeared in the discussion of the VA MISSION Act over the past few days. Dr. Lombardi’s conclusion that only ABFAS-certified podiatric surgeons will receive an increase in pay as a result of the passage of the VA MISSION Act is fundamentally incorrect. Board certification is just one of many factors in determining market pay at the Veterans Health Administration. The section of the handbook that he has quoted refers to how the VA determines whether a physician or surgeon is board certified—not how the physician or surgeon is paid. 


 


The bureaucratic machine that is the VA looks at myriad sources to determine pay, including Sullivan and Cotter, MGMA, Bureau of Labor Statistics, among a whole host of other sources. The podiatry section at the VA now faces the formidable task of implementing this legislation and...


 


Editor's note: Mr. Wallner's extended-length letter can be read here.

06/12/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Unreasonable Chart Reviews 


From: Dave Williams, DPM, Gian Steinhauser, DPM


 


I have seen a big increase in chart requests as well. I submitted 30+ just last week. Dr. Rettig posted, “I, and most doctors, charge the plan for copying the charts and collect enough to make it worthwhile.” I didn’t even know that was an option. What is the process and how much do you charge?


 


Dave Williams, DPM, El Paso, TX


 


Our office has also been getting multiple requests for 50-100 charts at one time as well. We pride ourselves on having excellent documentation and an EHR system that makes chart retrieval “easy”, so we don’t worry about the chart reviews. In fact, we welcome them, as we charge the insurance companies $25/chart, to cover the labor and printing costs. Requests for insurance payment refunds are few and far between at our office.


 


I was informed by an industry insider that the reason the insurance companies are requesting these charts is ...


 


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

06/12/2018    

RESPONSES/COMMENTS (NON-CLINICAL) PART 3



From: Joseph Borreggine, DPM


 


I am surmising that according to this recently passed VA Mission Act, we are not defined as “physicians and surgeons” as it is for the MD/DOs; rather, we are just no longer defined as just  “podiatrists”. Now we are re-labeled as “podiatric surgeons”.


 


The question is how is it that this bill creates parity if we are not defined as “physicians”? Or was this just supposed to create parity in the pay scale for podiatrists as compared to our allopathic colleagues? Has the ADA been fighting the same battle as podiatry? And was that why the dentists were re-labeled as “dentists and oral surgeons”? 


 


If that was the case, then has the APMA thought of imploring the cooperative lobby power of the ADA for any other issues that we equally face? On another more important note: according to Title XIX, optometrists are not defined as “physicians”, just like podiatrists are not. So, should the APMA contact the AOA to see if they can help us do the same with Title XIX, just like we did with the VA Mission Act?


 


Joseph Borreggine, DPM, Charleston, IL

06/12/2018    

RESPONSES/COMMENTS (NON-CLINICAL) PART 2



From: Dave Williams, DPM


 


There is an alternative to ABFAS. The American Board of Lower Extremity Surgery (ABLES), is a multidisciplinary certifying board consisting of MDs, DOs, and DPMs who specialize in lower extremity surgery. The Board has been operating for more than thirty years and has certified many thousands of physicians who have gained privileges at hospitals in every state of the Union and Puerto Rico, based on their ABLES certification. The Board grants certification in both forefoot and rear foot surgery. If you are frustrated with ABFAS, ABLES is worth a look. 


 


Dave Williams, DPM, El Paso, TX

06/11/2018    

RESPONSES/COMMENTS (NON-CLINICAL) PART 2



From: Paul Clint Jones, DPM


 


Thank God for people like Dr. Robert Steinberg. I salute his candor. I agree with him wholeheartedly. This idea that a problem goes away just by shouting louder is ridiculous. The problem with the ABFAS Board Certification is it is an entity unto itself with no oversight other than participating constituency. No APMA, No state Board, No, I see a problem here. Does anyone else? Sure doctors should be well trained. I scored well on my written tests, but my cases were rejected because my Chevron bunionectomy had “no fixation.” Apparently, one cannot see absorbable pins on x-ray. I guess nobody told me that it did not qualify as the standard of care.  


 


Silly me. Of course, there is no challenge of such discrepancy. “Pay your bill next year and maybe you'll get through then.” But this is not about me. It doesn't have to be. It is very apparent that the stories are all the same; “Bad.” As for limiting my right to practice, forget about hospital privileges. I cannot even get onto insurances here without having the ABFAS Board Certification. Surely, we must have the best surgical track record there is in the U.S. We never have malpractice problems now that we're all Board Certified. At least our patients get the confidence of warm fuzzies they deserve. The system needs to stop trying to re-invent something that already has good models in the medical world to follow.


 


Paul Clint Jones, DPM, Portland, OR

06/11/2018    

RESPONSES/COMMENTS (NON-CLINICAL) PART 2



From: Charles Lombardi, DPM


 


I think this may have been a major misstep - calling us "podiatric surgeons" means the only ones getting the pay raise would be surgeons. It should have been physicians. This is out of the VA handbook. It seems that now to be full-time, you must be boarded by ABFAS since that is the only surgery board.


 


(1) Physicians. Board certification may be verified through the Compendium of Medical Specialists, published by the American Board of Medical Specialists, or the Directory of American Medical Specialists, published by Marquis’ Who’s Who, or by direct communication with officials of the appropriate board. A letter from the board is acceptable for those recently certified. (The address and telephone number of the board may be obtained from the latest Directory of Approved Residency Programs published by the Accreditation Council for Graduate Medical Education.) Copies of documents used to verify certification are to be filed in the [VHA credentialing file].


(2) Dentists. Board certification may be verified by the listings in the American Dental Directory published annually by the American Dental Association or by contacting the appropriate Dental Specialty Board. Addresses of these boards may be obtained from the American Dental Association.


(3) Podiatrists. Three specialties are currently recognized by the House of Delegates, American Podiatric Medical Association and VA: the American Board of Podiatric Surgery, American Board of Podiatric Orthopedics, and American Board of Podiatric Public Health. Addresses of these boards may be obtained from the latest American Podiatric Medical Association Directory.


 


Charles Lombardi, DPM, Bayside, NY

06/11/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Richard Rettig, DPM


 


Dr. Hofaker, I think you misunderstand the situation. Medicare Advantage plans get paid by CMS on a capitation basis per client. They get a higher payment if the patient has a lot of co-morbidities. They know a doctor may send in claims and place a single diagnosis for payment, but there may be many more diagnoses within the note that would allow them to collect more from CMS. So they audit charts to find those diagnoses. It has absolutely nothing to do with your care; you personally are not being audited. They would have no reason to get back to you. Further, I  and most doctors charge the plan for copying the charts and collect enough to make it worthwhile. I look forward to these requests!


 


Richard Rettig, DPM, Philadelphia, PA

06/09/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 3



From: Jeff Merrill, DPM


 


Just for clarification, I thought I understood the new VA Provider Equity Act as providing podiatrists with increased pay and an ability for leadership positions; however, it did not "RE-LABEL" podiatrists as "PHYSICIANS" but as "PODIATRIC SURGEONS". Is that correct? Would you be able to clarify? 


 


Jeff Merrill, DPM, Klamath Falls, OR 


 


Response from Dr. Robbins: The bill lists us under the definition of Physicians as below. To be clear, the orthopedic society wanted a distinction made in the paragraph that stated physician and surgeon (MD,DO) Podiatric Surgeon (DPM) and Dentist and Oral Surgeon (DDS, DMD). They are all included under the heading of Physician. 


 


SEC. 502. ROLE OF PODIATRISTS IN DEPARTMENT OF VETERANS AFFAIRS. 


(a) INCLUSION AS PHYSICIAN.— 


(1) IN GENERAL.—Subchapter I of chapter 74 is amended by adding...


 


Editor's note: Dr. Robbins extended-length response can be read here.

06/09/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Unreasonable Chart Reviews


From: Rich Hofacker, DPM


 


I am just wondering about all of these insurance company "chart review" requests and what other pods are doing about it. Medicare and Medicaid do not routinely request them. However, it all started years ago with Medicare Advantage Plan insurance companies. The insurance companies were requesting one or two charts at a time. Now we are seeing 50-70 chart requests at a time. The insurance companies never get back to you in regard to what you are doing right or wrong. They just request more and more charts. I am perplexed by all of this, primarily because I just no longer have the time to reply to all of these frivolous requests that have gone from a yearly time frame to a monthly time frame.


 


Rich Hofacker, DPM. Akron, OH

06/09/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2



From: Robert Scott Steinberg, DPM


 


Dr. Feldman, I find your post arrogant, smug, and condescending. I suggest you think about those who came before you. There is no reason board costs are so high. Let the boards charge more for re-certification, instead of extracting the "last ounce of blood" from the young DPMs. You owe your colleagues an apology.


 


Robert Scott Steinberg, DPM, Schaumburg, IL 

06/07/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2



From: Richard J. Manolian, DPM


 


Welcome to the opioid epidemic. You quickly will get used to the online Rx history requirement as we have had in Massachusetts for a few years, and it will be enlightening as to what your patients are up to. 


 


I had some patients that we pull up where they’ve had 50 to 100 Percocet or Vicodin just prescribed only a few days before surgery that we are about to perform. I simply tell them you will not be getting a controlled substance prescription following this procedure based on that, and they understand fully.


 


Richard J. Manolian, DPM, Cambridge, MA

06/07/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 3



From: Tayeb Hussain, DPM


 


Attaining board qualification status upon completion of residency should not be a pain-staking decision for any graduate coming into the "real" world. I have recently come upon residents who prefer to defer the board qualifying exam until fall or even the following year. This is in fear of not passing the exam as they are aware of the less than 50% passing rate and considering the expenditure of funds for this exam.


 


I also agree with Dr. Roth's explanation of not enough training available to all residents graduating from our so called parity resident format we came up with. This format does not work at all. There is no consistency of all graduates to have the same training as others do in our medical discipline. All general surgeons have the same core training performed at any institution that has that residency program. The board qualifying or certification process should not deter our future colleagues in fear or financial burden, but rather be looked forward to as a milestone they accomplish.


 


Tayeb Hussain, DPM, Evanston, IL

06/07/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: The Origins of Surgical Residencies


From: Rick Harris III, DPM


 


Halsted. Who cares? Well perhaps any physician who has trained at a surgical residency program. Dr. William Halsted played a vital role in the rise of surgery as a specialty as he helped to establish the first American surgical residency at The Johns Hopkins Hospital in 1889.


 


After attaining his medical degree from the Columbia University College of Physicians & Surgeons, Dr. Halsted spent 2 years training in Austria and Germany. Through his training in Europe, he became acquainted with the German system of graduate surgical education. He brought this paradigm to the United States thus having a profound impact on the American surgical residency system. Dr. Halsted described the purpose of his residency program as follows: “We need a system, and we shall surely have it, which will produce not only surgeons, but surgeons of the highest type, men and women who will stimulate the first youths of our country to study surgery and to devote their energy and their lives to raising the standard of surgical science.” Tip of the scrub cap to the Father of American Surgery for his contributions over a century ago that helped to get us where we are today. 


 


And of course, a tip of the cap to Dr. Earl Kaplan, for opening Civic Hospital in 1956, the first podiatric teaching hospital in the United States. Lastly, a tip of the cap to all podiatric surgery residency attendings as they continue to train the next generation of foot and ankle surgeons. 


 


Rick Harris III, DPM, Jacksonville, FL

06/06/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Florida’s New Law on Controlled Substance Prescribing


From: George Jacobson, DPM


 


H B 21, signed into law by Gov. Rick Scott on March 19, 2018, imposes a number of legal requirements on healthcare practitioners who prescribe controlled substances. A prescriber must consult "the database" to review a patient's controlled substance dispensing history before prescribing or dispensing a controlled substance. This requirement applies to all controlled substances, not just opioids. There is now a substance prescribing continued education requirement for each physician to be completed by Jan 31, 2019, and then prior to each subsequent licensure renewal. Details of this new law are outlined in this article:


 


George Jacobson, DPM, Hollywood, FL  

06/06/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2B



From: Ivar E. Roth DPM, MPH


 


I recently interviewed associates with three years of residency training. The spectrum of graduates training was from excellent to below average. One may ask how a graduate of three years of surgical training could be average or below average. The answer is that many programs just do not have the surgical load or variety that is necessary to come out as a fully trained “surgeon”. Many whom I interviewed felt they needed an additional year as a fellow to feel confident. Sadly, three years of training may NOT adequately prepare graduates for practice and or sitting for the boards. From what I saw from the current crop of residents is  that many were under-trained and not ready to become full scope podiatric “surgeons”.


 


Ivar E. Roth DPM, MPH, Newport Beach, CA

06/06/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2a



From: Len La Russa, DPM


 


We, as podiatrists, are all worried about the dwindling number of pre-med applicants applying to podiatry school. Could part of the problem have anything at all to do with the 50% passing rate for ABPS certification? Orthopods don't have that problem. Or is it possibly the chance that there might not be a position available for residency? The low passing rate is much easier to fix than the residency crisis, which is less of a crisis now. Another impediment to getting talent to apply to podiatry school could easily be addressed by increasing the pass rate so that it is no longer such an embarrassment. 


 


Len La Russa, DPM, Americus, GA

06/05/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A



From: Joseph Borreggine, DPM


 


I do not know if this individual is an outlier or is the typical norm for an ABFAS candidate, but it should raise eyebrows for the entire profession if this issue is a frequent problem. The facts are plain and simple... the cost and time involved to reach this pinnacle of certification may be in excess based on the supposed high quality education and training that every podiatric student receives prior to this achievement.


 


It is my understanding that podiatry is equal to allopathic and osteopathic medicine less a few educational courses and post-graduate rotations. And as a specialty requiring all DPMs to be trained as “foot and surgeons”, passing of said exam should be a piece of cake. Alas, it is not. The pass rate the first time a candidate takes this exam is much less than 50%. 


 


The second or third time it is taken, the results are appreciably higher, but these multiple attempts to pass an exam which should reflect the candidate’s aptitude is unnecessary. Our orthopedic colleagues seemingly take a similar exam and have a much higher first pass rate as compared to our comparative board exam. 


 


I find this disheartening in light of the fact that podiatry is and has been fighting for parity. This concern from this ABFAS Diplomate is valid and should be investigated. If not, then it should fe explained so that prospective ABFAS candidates can understand more thoroughly how this process really works.


 


Joseph Borreggine, DPM, Charleston, IL

06/05/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1B



From: Don Peacock, DPM


 



With ABFAS board certification discussions, we sometimes miss a very important point. The boards give credence to our surgical achievements and that’s all. Our greatest achievements will be in helping people, not in ABFAS certification. Lacking certification will not prevent a good podiatrist from making a great living. The huge effort to obtain and remain board-certified for the purpose of hospital privileges is becoming less important as well. I perform most of my surgeries in the office setting where hospital privileges or board certification is optional. 


 


Whether we're board-certified or not, our surgical income means little with respect to our financial health. The bulk of reimbursement for a successful foot surgeon remains non-surgical. With current cuts in procedure-based and fee-for-service models, it would behoove all of us to move more surgeries to the office setting where reimbursement is better and turnover quicker.


 


In the overall scheme of things, board certification is not as important as being a good doctor, having patients that like you, and doing a good job at treating those patients. That is how you will be successful. The board certification is the icing on the cake. It is not the cake.


 


Don Peacock, DPM, Whiteville, NC


06/03/2018    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A



From: Marshall Feldman, DPM


 


Are you kidding? You should thank your lucky stars that you can even sit for the Board. Because of the men and women that came before you, you are now able to provide the most  comprehensive treatment of foot and ankle disorders in our country. I am not going to waste my time by describing how practicing our profession was like prior to the advent of ABFAS.  Nor will I waste my time to explain how other medical professionals perceived our profession, again prior to the Board's creation.  However, I will say that you should count your lucky stars that the leaders of our profession determined that it was paramount to create a substantial and esteemed panel that would properly ascertain the qualifications of a potential applicant.


 


To that end, yes the cost is not cheap in order to be able to complete the required certificate. Yes, you were not able to buy into an out-patient surgical center of your choice nor attain hospital staff privileges or even retain them due to the fact that you were not "boarded". You should get down on your knees in order to thank those who came before you and opened the doors for you to enter these institutions with the knowledge and I hope ability that you have attained.


 


On another note, why the heck does it matter that the ABFAS headquarters are in California?


 


Marshall Feldman, DPM, Rahway, NJ
PALWebBanner?117
<-- Privacy pop up is at bottom of footer3. -->


Our privacy policy has changed.
Click HERE to read it!