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04/21/2010
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Radiology Lab Performing Neuroma Injections (Alan Kalker, DPM)
From: Michael Turlik, DPM I am a blinded neuroma injector. I found Dr. Kalker’s post interesting. After a cursory search of the literature, I found articles comparing guided and unguided plantar fascia injections, but no trials comparing guided and unguided neuroma injections. I would appreciate a reference which demonstrates improved patient outcomes for guided neuroma injections. Michael Turlik, DPM, Cleveland, OH, mmturlik@aol.com
Other messages in this thread:
03/12/2012
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: ABPS Name Change (M. W. Aiken, DPM)
From: Michael M Cohen, DPM
I admire Dr. Aiken's pride in the podiatry profession as we all should. Those before us have worked tirelessly to ensure that our schools and residency programs produced physicians who provide top-notch foot and ankle care. In just a few decades, we have been elevated from storefront chiropody to a profession treating complex foot and ankle deformities. Dr. Aiken should rest assured, however, that the name change isn’t as much about ego as it is access.
Isn’t it a shame that our residents completing excellent programs which provide the skills necessary to perform foot and ankle surgery are unable to harness these skills in their home states and local hospitals? Insurance companies, including Medicare, continually question the competency of a podiatrist to perform these complex procedures, and if approved are reimbursed at an inferior level than their orthopedic counterparts. Some of this is due to the common misconception that podiatric surgery refers to the surgical removal of bunions, corns, and calluses.
We have morphed from the American College of “Foot” Surgeons to the American College of “Foot and Ankle” Surgeons and are proud to showcase our achievements in the Journal of “Foot and Ankle” Surgery. Take a look at the surgical textbooks we’re publishing. Isn’t it time to be proud of the fact that we are foot and ankle surgeons?
I am in favor of the name change and urge my colleagues to celebrate our achievements and consider doing the same.
Michael M Cohen, DPM, Miami, FL, Michael.Cohen1@va.gov
01/07/2012
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Insurance Company Controls (Larry Lavery, DPM, MPH)
From: Elliot Udell, DPM
Dr. Lavery makes a good point when he writes that there is not enough research being conducted in biomechanics. The fact that our schools, even with experts in biomechanics on staff, publish very little is also deplorable. The problem in a nutshell is that institutions, including our own podiatry colleges, use a business rather than a "society needs it" model to decide on what topics to conduct research. This means that, unless a corporation with deep pockets is willing to fund any given research project, the likelihood of such a project seeing the light of day is nil. Since evidence-based medicine has given birth to a "prove it to me" mentality, unless there is research on the table that proves that orthotics work, many insurance companies will take the path of not paying for them.
Since we are not going to change the business model on which most of our research institutions are based, the only solution to this is for podiatry labs to team together and contribute the money so that quality research can be paid for, performed, and published. Only then will our profession be able to force the insurance industry to pay for what we as practitioners already know is a big help to our patients.
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com
01/06/2012
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Insurance Company Controls (Robert Kornfeld, DPM, Lawrence Lavery, DPM)
From: Dennis Shavelson, DPM
This topic reflects the polarity in our profession. Dr. Kornfeld, is a podiatry/patient advocate, and Dr. Lavery a Blue Cross/Insurance one.
If I were the CEO of BCBS and forced to fly in smaller helicopters, I would be quick to use Dr. Lavery’s models that “the problem is simply that we have not done extensive research to demonstrate the benefit of _________” and demand podiatry to “approach BCBS with randomized clinical trials that were peer-reviewed and published in high level journals to argue (their) case” in order to justify eliminating payment for most covered services.
Can podiatry provide high level evidence for injection therapy (i.e., trigger injections), surgical procedures (i.e., Austin bunionectomy), physical therapy (i.e., stretching), and pharmacology (i.e., Metanx) in addition to orthotics. As a biomechanics guru, I find that Dr. Lavery and others denigrate biomechanics with “the evidence argument” but have blinders on when sitting in their glass houses.
I’m so pleased to see Robert, who has been a champion for “dropping out of the insurance company cesspool” and promoting “integrative medicine”, adding “the orthotic” to his list of thankless causes that I believe will make him more influential in podiatry over time. Larry’s call for a “growing influence of evidence” to determine how and when and by whom we get paid. On the other hand, IMHO, is calling for bigger helicopters and the extinction of podiatry as a respected profession.
Dennis Shavelson, DPM, NY, NY, drsha@lifestylepodiatry.com
01/05/2012
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Medicaid Change for Orthotics in NY (Alan Silverstein, DPM)
From: Lloyd Nesbitt, DPM
The NY State Podiatry Association has to fight this one! Medicaid has to be made to understand the importance of the podiatrist being the provider of orthotics. Podiatrists are not “vendors” -- they are not selling “insoles.” When orthotics are required, it is in the best interest of all patients that podiatrists diagnose the foot problem, write the biomechanical prescription, perform the proper neutral position casting technique, use a proper orthotics lab, and then subsequently dispense the devices, plus provide follow-up visits.
DPM are the most qualified providers; plus they can evaluate the efficacy of the devices to assure that they are working properly and that the patient is comfortable. If the orthotics are problematic in any way, the podiatrist is again the best person qualified to rectify the problem and make adjustments or modifications.
This problem occasionally had surfaced in Canada, yet insurers came to realize that it is in their clients’ best interests that when it comes to orthotics, that they should have the gold standard of foot care (podiatry). As a result, many major national carriers such as Manulife Financial (who bought John Hancock in the U.S.) now stipulate that they will cover orthotics only when prescribed and dispensed by DPMs (and chiropodists in Ontario), and not retailers and other providers. As a result, several insurers have saved millions of dollars over the years by avoiding repeat claims that followed orthotic failures by unqualified providers.
Lloyd Nesbitt, DPM, Toronto, ONT, lloydn@rogers.com
01/03/2012
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Selling Old X-Rays for Silver (Michael J Felicetta, DPM)
From: Walter Perez, DPM
I used Two Brothers Scrap Metal before, and I had a good experience with them. Their number is 631-845-8188. They cover the tri-state area.
Walter Perez, DPM, Brooklyn, NY, WPerez1000@aol.com
09/22/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Demeaning Invesco Ad
From: Joan Williams, DPM
I find the attached ad published in The Wall Street Journal demeaning and insulting to podiatry.
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Invesco Ad |
In at least two other incidents in television or other media, I have noticed podiatry being the butt of jokes.
Joan Williams, DPM, Seattle, WA, joan.williams@comcast.net
08/26/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4 (CLOSED)
RE: Doughnut Tourniquet (Andrew Cassidy, DPM)
From: Greg Caringi, DPM
Rather than waste materials, I bring back to the office the "used" latex-free Esmarch bandages from the O.R. My assistants cut the Esmarch bandages into small strips and place them in Cidex until we use them for our nail avulsions or matrixectomies. They are secured with a curved Kelly. This is never a problem. You get lots of small digital tourniquets from each roll. In our O.R., we place the Esmarch bandage over the sterile impervious stockinette for exsanguination. It never comes in direct contact with the patient's skin.
Greg Caringi, DPM, Lansdale, PA, drgregc@msn.com
06/02/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4 (CLOSED)
RE: Rem Jackson's Top Practices (Peter Wishnie, DPM, Jennifer Feeny, DPM)
From: Sloan Gordon, DPM, Misty McNeill, DPM
I agree wholeheartedly with the comments of Drs. Wishnie and Feeny. Rem is the best for public relations/marketing. However, the caveat with Rem is that he will only take two clients per city. So, for those of us who would love to have Rem's advice and services and private meetings, it is not available to the general population of podiatrists.
You can come to his public meetings; you just can't use his ideas one-on-one due to his client policy. I think the world of Rem and respect him, but I think this should be a fair-and-balanced discussion.
Sloan Gordon, DPM, Houston, TX, sgordondoc@sbcglobal.net
I have been working with Rem for over four years now, and without hesitation, it's the best money I have ever spent on my practice and myself. I opened my practice six years ago in an area already saturated by podiatrists, and since beginning work with Rem, I have had huge success. What I think is best about Rem is that there isn't a magic solution (nor does he claim there is one) for everyone. He treats each practice uniquely and helps you find what the right answers are for your practice.
Misty McNeill, DPM, Elmhurst, IL, mistydpm@yahoo.com
Editor's note: We have received many positive letters about Rem Jackson's Top Practices. Since they all say substantially the same things as previously published letters, we have closed this topic.
05/19/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Attaining Parity in California (Ira M. Baum, DPM)
From: Jack Morgan, DPM, Michael Cornelison,, DPM
I wish to clarify the excerpt attributed to me here on PM News. First of all, it is important for me to be clear that I was not representing CPMA in my response. What I meant to say was that it was my understanding that CPMA, CMA, and COA have been working diligently to launch a task force to evaluate the education and training of future graduates of the California podiatric medical schools. What was printed was only my personal thoughts on a potential outcome of such an evaluation. I did not mean to imply that this work had already been done or that the outcome would be an MD degree. I deeply regret any misunderstanding that may have been inadvertently caused by the posting of this excerpt.
Jack Morgan, DPM, Los Angeles, CA, JMDPM@aol.com
In light of two recent postings on PM News, (Dr. Morgan’s answer to Dr. Ribotsky’s question, “How is the issue of parity with MDs playing out in California?” and Dr. Baum’s posting “RE: Attaining Parity in California (Jon Hultman, DPM, MBA),” I feel it is imperative to clarify the subject of both postings, because they are inherently intertwined.
Specifically, I need to be clear that the goal of the California Podiatric Medical Association is for all new graduates of podiatric medical schools who then meet the criteria to practice in California to be awarded California’s “Physicians and Surgeons Certificate,” which is an unrestricted license and the same license as MDs and DOs receive in California. This is quite different than pursuing the MD degree itself. APMA's goal for Vision 2015 and ACFAS's goal for project parity is an unrestricted license, which is consistent with CPMA's goal. At the same time, there needs to be a state model, and it is this area in which CPMA is focused.
The leadership of the California Medical Association and the California Orthopaedic Association met with that of CPMA and agreed to...
Editor's Note: Dr. Cornelison's extended-length letter can be read here.
05/18/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Bench-Top Orthotic Grinder Finishers (Rich Rusche)
From: Trudi Traister
In addition to the other tools and equipment we carry to produce custom foot orthotics, we carry a very suitable bench grinder for finishing work. Additional information can be found on our website or contact us via email or phone 800.356.3668 x264.
Trudi Traister, Amfit, Inc., ttraister@amfit.com
05/05/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Duty to See Patients in Isolation (J M Cortez, DPM)
From: Harry A. Harbison, DPM
Dr. Cortez is concerned about "cross-contamination" from isolated patients and does not see them due to that concern. I must point out that all patients must be equally treated via universal precautions, such that cross-contamination should not be a concern. As to seeing a specific patient "because social services insists," that would appear to fail the definition of medically necessary services under Medicare guidelines. The solution is to ethically treat patients who require the services of a physician in your specialty, when specifically consulted by the primary care physician for a medical problem. Be aware that OIG has targeted SNF services for scrutiny in their work plan.
Harry A. Harbison, DPM, Long Beach, CA, harbih@verizon.net
04/28/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Exogen Bone Healing System (Tip Sullivan, DPM)
From: Dan Michaels, DPM, MS
I have used the Exogen system for all fractures/osteotomies for six years (except PIP or DIPJ arthrodesis). I have had zero non-unions and only one delayed union due to the patient walking on the foot and fracturing the osteotomy post-op one week. Then after this was repaired, he did the same thing again. I didn't do a third surgery but got him an Exogen, and within a month, there was osseous bridging. It simply works by increasing integrin activity (little hairs on the surface of the bone). 20 minutes of ultrasound stimulate these integrins to release a host of good chemicals like NO2 which increases osteoblast activity for 24 hours, thus the 20 minutes per day recommendation.
I always tell patients to...
Editor's note: Dr. Michaels' extended-length letter can be read here.
04/23/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Routinely Taking Patients' Blood Pressures in a Podiatric Setting (David Finkelstein, DPM)
From: Leonard A. Levy, DPM, MPH
Accolades to David Finkelstein, DPM for taking the blood pressure of a patient who was sitting in a car outside his office but too ill to enter. Indeed, he probably saved her life. However, taking the blood pressure of patients only if they were about to have nail or wart surgery is not nearly enough. Podiatric physicians should do this relatively simple procedure on virtually every new and follow-up patient. If time is an issue, the office assistant can be taught to do it. This often is the protocol in many other physicians’ offices.
Most patients with abnormal blood pressures are completely asymptomatic and, before tragedies occur, could be referred for care prior to developing the sometimes life-threatening or morbidity-producing complications of such findings. What a simple and effective way to demonstrate the role of our profession as one that truly can be categorized as being part of the physician community with a major role in comprehensive healthcare.
Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL, levyleon@nova.edu
04/23/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Exogen Bone Healing System (Tip Sullivan, DPM)
From: Russell F. Trahan, DPM
I am surprised at the degree of negative reaction to Dr. Sullivan's desire to utilize the Exogen bone healing system on most, if not all, of his fractures/osteotomies. While I understand that, as doctors, we should take a role to police the use of healthcare dollars, the thought of the use of the Exogen on all fractures is certainly not unreasonable: It indeed has an FDA indication for fresh fractures. What may appear as "exotic", "wasteful", or "unnecessary" today, could be standard of care tomorrow.
I am sure that the same argument was used about the use of MRIs vs x-rays 20 years ago when MRIs became widely available. Besides, if the device can get a patient healed 38% faster, the argument could be made that it can ultimately save healthcare dollars by having fewer patient encounters and the expense that goes along with that as well as reducing other costs (e.g., disability insurance costs).
Russell F. Trahan, DPM, NY, NY, dr.trahan@att.net
04/22/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Clarification Lympha Press USA
From: Marv Boren, DPM
I would like to correct an earlier post that I submitted, which in my disclaimer, I mistakenly stated that I was an independent sales representative of Lympha Press USA. I am rather an independent rep of American Compression and Wound Care, LLC which is a distributor of Lympha Press Systems. Lympha Press USA does not have independent reps, nor do they sell directly to physicians or consumers.
Marv Boren, DPM, Canton, OH drboren@smartdrs.com
03/23/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4 (CLOSED)
RE: The Affordable Healthcare Act of 2010 /Obamacare
From: George Jacobson, DPM,
Our founding fathers were such seers... It's amazing that some believe that they anticipated our state of healthcare in 2011, with what some interpret as a "General Welfare Clause." You may say it is inferred, but it is not written. I wrote about and studied the "Privacy Rights" issues when I was in college. Abortion, gambling, drug/alcohol use, and prostitution can be argued as individual rights of choice based on "privacy rights" and therefore they should not be crimes (Text book "Crimes Without Victims." 1965). Nowhere in the Constitution are privacy rights guaranteed, yet the public think they are. They may be inferred.
You can say the same for healthcare being guaranteed or a right but it is a greater leap, especially when you consider the concept of healthcare and the language of the 1700's. The Constitution can be amended to specify inferred rights, yet it hasn't happened nor are there movements to do so. We can't even get a common sense balanced budget amendment. Ambiguity is the rule of politics. Specificity is common sense which doesn't mix well with politics.
George Jacobson, DPM, Hollywood, FL, fl1sun@msn.com
03/17/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Homeopathy is a Safe Way to Complement Treatment Choices: IL Podiatrist (Al Musella, DPM)
From: Marc Katz, DPM
I don't really find the need to hate anything. That's counter-productive. You certainly have the right to practice with what you believe to be superior. And the physician in the article has the same right. You are so correct when you state that podiatry is on the fringe. This is the only profession not embracing alternative and functional medicine. So, as with many other treatments, we will be left behind once again, and it will kick us in the behind one day.
Notice how everyone is whining that we are no longer seen as the experts on orthotics. So we missed that boat. Let's not miss the next big boat and watch the MDs, DOs, DCs, NPs, PAs, etc. run the show.
Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com
Editor's note: The results of our poll (based on 167 responses) are as follows:
Is homeopathy a legitimate treatment option for podiatrists? Yes 19%, No 74%, Not Sure 7%
03/03/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Practice Fusion (Donald Brann,DPM)
From: Joe DeTrano
Practice Fusion is very clear about our ad-supported business model. Information about our ad program is posted on the website for anyone to see. They do not share information about providers or patients with the insurance industry. Not only would it violate company privacy policy but also HIPAA regulations. Any questions can be happily answered at support@practicefusion.com
Disclaimer: My firm is a licensed partner of Practice Fusion.
Joe DeTrano, CPC Medical/Medical Data Resource, joe@medical-billing.com
03/02/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: MD Logic (Jack Ressler, DPM)
From: Paul G. Yungst, DPM
I was first introduced to MD Logic Touch Screen Solutions in early 1996 by Tim McKenna, VP of sales. At the time, the EMR industry was in its infancy and the MD Logic knowledge base was a blank canvas without any information relating to podiatry. There was no government mandate or incentive for me to purchase MD Logic other than my own curiosity about electronic medical records and a strong desire to automate and streamline the documentation process. This was an effort to improve the quality of my notes, increase workflow efficiency in the office, and ultimately improve the quality of my life as I was often spending hours after work on dictation.
After researching other documentation input devices, I found that...
Editor's note: Dr. Yungst's extended-length letter can be read here.
03/01/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4 (CLOSED)
RE: H&P's for Podiatrists (Robert Bijak, DPM)
From: Jon Purdy, DPM, Elliot Udell, DPM
There is a saying, "Be careful what you wish for." Can you imagine what the practice of podiatry would be like if Medicare and insurance companies were to take a 180 degree turn and insist that in order for a podiatrist to get paid for treating a case of onychomycosis, plantar fasciitis, or even a verruca, he or she has to perform a complete physical exam on the patient? Could you imagine what a busy practice would be like, if in order to be paid for treating a minor foot problem, you had to listen to a patient's chest, take their blood pressures, palpate their bellies, examine their throats and ears, do a breast exam or prostate exam, take an EKG, etc. We would all become as adept at doing these tests as the family practitioner down the block, but after the novelty would wear off, the time consumed in doing these tests would send the best of our practices to hell in a handbag.
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com
At one time, I felt very qualified to perform H&P’s. In school, I went through our H&P course and was tested with “actors” faking symptoms. In residency, I rotated through many months of neurology, ER, and other specialties where I performed H&P’s. I did three months of internal medicine where we podiatrists did the full admission, presented cases in morning rounds, and followed and managed patients through discharge.
While a resident, I witnessed other specialties (orthopedics comes to mind) that did their own pre-operative H&P’s which were a fraction as good as mine. I recall rounding in the ICU with the attending orthopod who looked at his consult and asked the nurse what all the wires and tubes coming out of the guy were about. Dumbfounded, she had to inform him that his patient was in the ICU which should be self-explanatory.
I guess the point is that we take risks every day and operate within our comfort zones of training. Doing an H&P on an otherwise healthy patient, and being sued for missing that one in a million this or that, is no more risky than not biopsying that little melanoma or having the infection go bad. We are multi-system clinicians and surgeons. There’s always going to be that “expert” to tear you apart. Although I don’t do my own H&Ps anymore, and not because I don’t have my IM friend to pay $20 to do the rectal exam for me, I just lost my touch. I certainly don’t begrudge those competent to do them.
Jon Purdy, DPM, New Iberia, LA, podiatrist@mindspring.com
02/26/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: EHR/EMR Gouging (Alan Bass, DPM, Michael Brody)
From: Jeffrey Kass, DPM
Over the past few days, there has been a debate on whether or not EMR prices are excessive/costly. We have heard from Drs. Bass and Brody, both who acknowledge they are paid consultants, hence, I would expect them to explain the worth of the systems. I do not know the price of the Biomedix program, but I believe most systems are approximately 15 - 20 thousand dollars if not more, and this is for the program, with monthly carrying charges. I am curious how a new graduate, with loans up the whazoo, who can't get on any insurance plans because the panels are "closed", is going to survive. When you do get on plans - often you are paid at rates below Medicare, and you have to jump through hoops to get paid (modifiers, pre-authorizations, etc.).
We are not simply in the midst of a residency crisis; we are in the middle of a profession crisis. $400 for a bunion with a 90-day global period is simply not going to pay for a 20 grand EMR. The insurance companies will have us convinced that with EMR, your efficiency will increase so you'll be able to do three more $400 bunions. Please, do not fall for it. If you calculate out your $400 bunion, based on office visits and travel time to the hospital, you are probably getting paid minimum wage.
Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com
02/25/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: H&Ps for Podiatrists (Barry Mullen, DPM)
From: Robert Bijak, DPM
Dr. Mullen differentiates between an H&P and "clearing" a patient. If a DPM H&P isn't sufficiently competent and comprehensive to "clear" a patient, why do them, only to have the service duplicated by an MD? Or, are we taking about a PODIATRIC H&P? As for the opinion that MDs that aren't cardiologists, internists, or PCPs can't do a competent H&P, I say, tell that to the medical schools. I guess they are wasting their time teaching it to ALL medical students because according to Dr. Mullen, only internists, etc. should be doing them.
Maybe, courses in physical diagnosis and USMLE Clinical Skills II should be dropped from the MD license exam. I'm sure the MDs will appreciate podiatrists advising them on their curriculum. Perhaps with the new extra time the MDs could take a course in biomechanics. Can't podiatrists see it's all or none? Be schooled, licensed and expected to do the job right the first time. MDs start doing history and physicals in hospitals actively in their second year of medical school, not residency.
Robert Bijak, DPM, Clarence Center, NY, rbijak@aol.com
02/24/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: EHR/EMR Gouging (Michael Brody, DPM)
From: JM Cortez, DPM, Alan Bass, DPM
You have to be kidding me? We are now comparing a software program to the automobile. Whether I drive a Kia or Mercedes does not matter to anyone, except maybe my neighbors. The big difference being no one is going to penalize me for driving the economy car over the luxury car. No one has written a bill that you have to drive a luxury car or you will be deducted 2% in reimbursement. And this year's car model has not seen a price increase ranging anywhere from 300% to 400%, just because the Federal Government will reimburse you if you use the program. But like the automobile salesman, we are being swindled and this system is being made mandatory. I am talking about the EMR companies lining their pockets at the expense of our fellow podiatrists.
I have programmed computers and do my own IT support. I have also consulted for a local vendor coming out with their own EHR/EMR program. I put their program through the paces and gave them my input. I did not benefit in any way nor receive any compensation. I have worked as a programmer. I know the time it takes to write the program, implement it, test it and fix any bugs. This is nothing new to me, but it still does not justify the sudden huge increase in price.
JM Cortez, DPM, Simi Valley, CA, jmcdoc@roadrunner.com
Let me start out by saying yes, I am a paid consultant for Biomedix Vascular Solutions, the makers of TRAKnet DPM, a certified EHR/Practice management program, eligible to receive the stimulus money.
I have been following the conversation on PM News, and while people may not agree with me, the one thing the conversation is missing is that EMR has been around for quite some time now. This is not something new. I consider myself an early adopter, implementing EMR into my practice almost...
Editor's note: Dr. Bass' extended-length letter can be read here.
02/23/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: EHR/EMR Gouging
From: Jon Purdy, DPM
If there is really gouging occurring, and it seems to stem from recent changes in the market place, only two things are possible. Either the EMR companies are violating anti-trust laws and price fixing (which they are not), or they are responding to a trend in the free market.
Put yourself in their shoes for a moment, and let’s say you own an EMR company. You feel you'd be best positioned in the market by investing a lot of money to meet meaningful use. You next ask yourself “How do I recoup my investment?” You do that in one of two ways. You either pass along the costs directly to your customers, or you make it up on the backend over time, by keeping your prices low and recouping it through greater market share.
Your company has to size up the competition, and weigh the advantages and disadvantages of capital investment, product price, and market trends. After you place your bets, your private company will either thrive or falter. People will either like your product and price or they won’t. Simple market forces determine what will and what will not work. I don’t begrudge a company for seeing how much profit they can make ethically. YOU, the consumer, dictate the success of the company and no one else.
Jon Purdy, DPM, New Iberia, LA, podiatrist@mindspring.com
02/10/2011
RESPONSES / COMMENTS (NON-CLINICAL) - PART 4
RE: Employee Embezzlement (Daniel D. Michaels, DPM, MS)
From: Michael Forman, DPM The best method that I know of to prevent employees from opening up their own accounts to deposit your checks is to keep track of all adjustments made in the office. Once the charge is put into the computer, the only way to reconcile this amount to "get it off the books" is to either pay it, or adjust it. If adjustments are not looked at, your employees can take the money, adjust the amount so that it does not show up in accounts receivable.
Dr. Michaels' suggestion of using a receipt book is excellent.
Michael Forman, DPM, Cleveland, OH, im4man@aol.com
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