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11/29/2013    Jim Shipley, DPM

Time for a Universal Insurance Form (Robert Kornfeld, DPM)

Dr. Kornfeld, you recently posted a thread in PM
online that once again stated the need for all
podiatrists to move toward a cash payment
situation. Even though I don't disagree with your
assessment of our nationwide current standings in
the medical community, with insurance companies,
and with our scope of practice, I do believe some
things need to be put into perspective. Assuming
that not all podiatrists will convert to your cash
model in one unified motion, what do you think
will happen in my situation?

(I took the liberty of researching the
demographics of the area in which you practice
compared to mine.)

Manhasset, NY
According to a 2009 estimate,[4] the median income
for a household in the CDP was $105,938, and the
median income for a family was $130,909. The per
capita income in the CDP was $51,698. 5.7% of the
population and 3.9% of families were below the
poverty line. Out of the total people living in
poverty, 5.4% are under the age of 18 and 6.9% are
65 or older. (per

Surry County, NC
The median income for a household in the county
was $33,046, and the median income for a family
was $38,902. Males had a median income of $27,854
versus $20,556 for females. The per capita income
for the county was $17,722. About 9.10% of
families and 12.40% of the population were below
the poverty line, including 15.00% of those under
age 18 and 17.40% of those age 65 or over. (per

People in my community barely have enough money to
pay their co-pays and most are very grateful just
to have a job that provides some insurance
coverage. I'm sure you wouldn't suggest that I
pack up and move my family (we all can't practice
in Manhasset, NY).

Jim Shipley, DPM, Mount Airy, NC,

Other messages in this thread:

12/05/2013    Jim Shipley, DPM

Time for a Universal Insurance Form (Robert Kornfeld, DPM)

Dr. Kornfeld, I in no way fault your inaccurate
assessment of me. I have given you no information
about myself except for the income of the county I
live in. I had honestly hoped that you would give
some other advice besides uprooting my family to
move to a different area. The fact that you didn't
is not a big deal, I'm glad it has turned out so
well for you.

I, however, can offer PM News readers another
suggestion that was given to me two years ago.

If you're not a part of one already, it is time to
form a super group in your state. It is time to
find like-minded individuals in your area and band
together to increase your bottom line. Like all
group formations there is a loss of autonomy, but
the minor loss of autonomy is nothing compared to
the benefits.

As of January 1, 2014 the North Carolina Podiatric
Physicians and Surgeons Group (NCPPSG) will have
been incorporated and fully functioning for one
year. I can sum up my experience with this group
using one word: awesome.

What have we accomplished in this formation?
1) We have successfully negotiated higher rates
from multiple insurance companies. A mutually
beneficial agreement on our side because we get
paid more, and on their side because of our
quality control and treatment protocols.
2) We have successfully negotiated lower
malpractice insurance.
3) We have successfully negotiated greater vendor
rates and services including, but not limited to,
DME products, office supplies, orthotic
manufacturing, pathology services, HIPAA and OSHA
training services etc.
4) We now have approximately one-third of the
podiatrists in our state within NCPPSG, including
members in state society positions. We also cover
every area of our state which is beneficial to
large, self-insured corporations and hospital
systems looking to refer patients.
5) With over 350 employees in NCPPSG we've been
able to negotiate private health insurance rates
for our group.
6) Because we are such a large group we have our
own lawyer, accountant, insurance negotiator,

So what's the bottom line?

Doctors looking to better their position as
podiatrists have a few options. One, you can pack
up your family and move to a more affluent area.
Two, you can negotiate being bought out by a
hospital system. (I was given this option and
turned it down.) Three, find like-minded
individuals, learn as much as you can from current
state super groups, and help form one in your

Regardless of what you readers choose, I certainly
feel no woe-is-me mentality about the position I
am in, and I'm excited for the future of podiatry
in my state.

Jim Shipley, DPM, Mt. Airy, NC,

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