Gout is a type of arthritis that causes sudden, severe attacks of pain with redness, warmth, and swelling mainly in the big toe. It is a condition that occurs during middle age and is 10 times more common in men than women. "You usually find the swelling in the big toe, I don't know why," said Podiatrist Owen Bernard from the Diabetes Association of Jamaica.
"Gout is one of those conditions out there that persons need to be aware of. In the past they used to say only rich people got it because they ate rich food with all that wine and red meat and all those things, but it's uric acid in the blood. And it can get very chronic, because obviously the foot is a weight-bearing area, so when you are walking, you get a lot of pain in that big toe from the swelling."
Source: Donna Hussey-White, Jamaica Observer [11/18/13]
PODIATRISTS AND OBAMACARE
MI Podiatrist Suffers Sticker Shock From Obamacare
Under the healthcare law, all plans must carry essential benefits. That’s going to raise the cost for some, but it also means better coverage. However, many consumers might not get past the sticker shock. Dr. Jeffrey B. Klein is a longtime podiatrist who said his premium to insure himself and his 18-year-old son increased from $460 to $760 a month.
Dr. Jeffrey Klein
What aggravates him even more is that his $2,500 maximum out-of-pocket costs jump to $10,200. So, in a year with lots of medical needs, he’d have to spend $10,200 in addition to premiums before insurance would kick in. He said: “That’s $19,000 plus change in a bad year.”
Source: Robin Erb, Livingston Daily [11/18/13]
PODIATRIC PRODUCTS IN THE NEWS
Web-Based Consumer Biofreeze® Sample Referral Program Announced
"Performance health has introduced the newest element of its Biofreeze sampling program, the extremely successful program that supports clinicians in bringing new patients and clients through their door,” stated Ethan Pochman, Vice President of U.S .Clinical, Performance Health.
“With our new online sampling application, we accept consumer requests for free Biofreeze samples and provide those requests to practitioners in the consumer’s area. This creates an opportunity for the practitioner to introduce both Biofreeze and their practice to someone looking for pain relief; someone who may likely become a new patient or client.”
Query: Hyperkeratosis Plantaris et Palmaris
The pictures attached are interesting and unique in that this 53 year old patient who has had hyperkeratosis of the palmar hands and plantar feet (focal/diffuse PPK) since childhood had a stroke in 2010 which resulted in a right-sided partial paralysis below the knee. During her convalescence from the stroke, she stated that the lesions on her feet and hands went completely away, but since she has returned to walking and more normal activity, they have recurred.
Hyperkeratosis Plantaris et Palmaris
Please note that the presentation of this is now much worse on the left non-paralyzed side. This has never...
Editor's note: This extended-length query can be read here.
Query: Coding a Medial Malleous Osteotomy
I'm looking for advice on how to code a medial malleous osteotomy for exposure to the talus for repair of an osteochondral lesion with graft.
Chad Knutsen, DPM, Fort Collins, CO
Response: The procedure performed was to correct an osteochondral lesion. The access to the lesion is included in the allowance for the principle procedure. Hence, the osteotomy is not separately reimbursable.
Tony Poggio, DPM, Alameda, CA
Codingline subscription information can befound here
APMA Members: Click here for your free Codingline Silver subscription
RE: The Passing of John Marlette, DPM
Dr. John Marlette
Dr. John Marlette of Sunberry PA passed away on Nov.14th. John was a past president of the Pennsylvania Podiatric Medical Society and was very active in many of its functions. Among them was the Surgical Seminar which was started during his term as president. His sense of humor was contagious.
It continues to befuddle me how the world gets cost-of-living increases, insurance companies pay dividends to stockholders, yet doctors who are among the most highly educated and hardest working continue to get stuck with reductions year after year simply because we have no recourse. Our lack of power vs. the mighty dollar insurance companies hold to control politicians and public sentiment has to be stopped or there will be a tragic physician shortage in the near future.
I am the podiatry ICD-10 champion of my hospital network. Don't confuse the word champion to mean any proficiency at the moment. I am just the interface person between hospital administration and the podiatrists and residents who must learn, adapt, and implement the new system. They "train" me, I train "them."
The ICD-10 system is a more exacting detailed description, that among other things must include severity, laterality, and, general health of the patient. Anyone who thinks that a drop-down menu with 35 more choices to scan through will not be...
Editor's note: Dr. Markinson's extended-length letter can be read here.
Jim Scales, DPM may certainly be correct that in his state, the BC/BS plan will put the word 'pathway' on the ID cards of those buying exchange ACA insurance. I am not clear how that is important. I agree that it is very important that some doctors will not be selected as providers for these plans. I suspect that BC/BS did not choose randomly, but established participation based on the hospital-based affiliations of those doctors.
I think that this could be derived by two separate items that Dr. Scales mentions: 1. not one podiatrist in his area is on the plan. 2. the two hospitals that his daughter uses - I presume they are the hospitals in the area - are not on the plan. Insurance companies have always established networks of participating hospitals and affiliated doctors based on contracts they negotiate with the hospitals, including employer-sponsored plans, and they will be doing this more and more, regardless of ACA. That is called the free market, a tenet of conservatism. I am not clear if the protesting doctors are against "Obamacare" or upset because they are not allowed to participate!
The Traumatic & Reconstructive Foot and Ankle Surgical Fellowship Program sponsored by the Southeast Permanente Medical Group in Atlanta, Georgia, is now accepting applications for the 2014-2015 training year.
Our fellowship program has recently been granted candidate status by the American College of Foot & Ankle Surgeons and offers an exemplary opportunity for advanced lower extremity surgical training. The Southeast Permanente Medical Group (TSMPG) is one of the largest multi-specialty medical groups in Georgia, working with the Kaiser Foundation Health Plan to provide medical care to members in metropolitan Atlanta. The foot & ankle fellow will be provided a broad-based clinical experience focused on adult reconstructive surgery, including sports-related injuries, Charcot reconstruction, total ankle replacement, and traumatic injuries of the lower leg, ankle and foot.
Interested senior residents can find a program application and other information on line at: www.acfas.org/fellowshiptucker/ Daniel J. Tucker, DPM, FACFAS, Director, Traumatic and Reconstructive Foot & Ankle Surgical Fellowship, The Southeast Permanente Medical Group, 770-677-6021 Daniel.J.Tucker@kp.org
We have podiatrists worried that that they have to accept these patients, yet I just received a letter from Empire Blue of New York telling me that they will not let me accept exchange patients. They let me know in no uncertain words that "according to the terms of my contract," I will not be participating in the exchange plans that they are coming out with. I'm not really sure what to think.
After performing a Lapidus/Reverdin/Akin bunionectomy on the wife of a Korean War Vet, I had to make a couple of extra phone calls to secure a leg caddy as I wanted her to remain off-weight-bearing. They had known about it beforehand, but had failed to make the arrangements. I was able to get one dropped off at the hospital before she went home, and her husband was very appreciative of my additional effort. He asked me to accept a token of his appreciation. I knew it would be an insult to refuse. Below is a picture of his "tip." I told him that it was my honor to accept it.
The Purple Heart
Paul Hilbert, DPM, Navarre, FL, firstname.lastname@example.org
MEETING NOTICES - PART 2
PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
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Choose any or ALL (50 CME Contact Hours) from the30+ CMECategory-1 articles posted
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
HOUSE CALL DOCTORS WANTED - NYC
A well-established practice with an elaborate house call service is seeking responsible, ethical and compassionate doctors to treat patients in Manhattan, Bronx, Queens and Brooklyn. Create your own schedule, full support, excellent compensation. Send CV to WPerez1000@aol.com or call Dr. Perez 917-757-1921 for more information.
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 - 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: firstname.lastname@example.org.
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: 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- 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: email@example.com.
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
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.
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
PM News Classified Ads Reach over 15,500 DPMs 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 15,500 DPMs. for details, click here or write to:email@example.com or call (718) 897-9700 for details. Weekly ad rates start as low as $119 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.
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management Magazine and Podiatry Management Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
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