September 17, 2019 #6,507 Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com E-mail us by hitting the reply key. COPYRIGHT 2019- No part of PM News can be reproduced without the written permission of Barry Block
ANNUAL SURVEY NOW ONLINE - WIN VALUABLE PRIZES
Congratulations to David Cauthon, DPM of San Antonio, TX, winner of last week's prize ... a $100 Macys Gift Card. We encourage you to participate in this year's important annual survey. Completing this anonymous survey provides us with valuable data, which we will publish in the February 2020 issue of Podiatry Management. It also makes you eligible to win thousands of dollars worth of valuable prizes. Enter by completing this confidential survey and providing your e-mail address in the comments section on the last page of the survey. The earlier you enter, the more chances you have to win.
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***This is also your opportunity to vote for the next DPM and non-DPM inductees into the PM Podiatry Hall of Fame.
PODIATRISTS IN THE NEWS
MA Podiatrist Discusses Plantar Fasciitis
Don't let foot problems hobble your autumn activities, a foot surgeon says. "Foot health contributes to your overall health," said John Giurini, DPM, chief of podiatric surgery at Beth Israel Deaconess Medical Center in Boston. One of the most common foot problems among active people is plantar fasciitis. "Under normal circumstances, your plantar fascia helps absorb the shock of pounding on pavement," Dr. Giurini said. "But repetitive stretching can lead to inflammation and irritation, and even small tears."
Dr. John Giurini
Along with overuse, other risk factors for plantar fasciitis include being flat-footed or having a high arch, being overweight, or doing activities in worn-out or inappropriate footwear. "When caught early, mild cases can be treated conservatively with rest, ice, and stretching to give the inflammation time to heal," Giurini said. "In some cases, physical therapy and orthotic devices can be helpful. In more severe or resistant cases, steroid injections and surgical procedures may be necessary to alleviate this pain."
Source: Robert Preidt, HealthDay [9/14/19]
PODIATRISTS IN THE COMMUNITY
GA Podiatrist Named Sam Poole Volunteer of The Year
Good News Clinics is thankful for its volunteers every day. But the non-profit honors volunteers each year who have gone above and beyond. Jeannette Velazquez, DPM said being honored as the Sam Poole volunteer of the year was a way to show her parents she is making a difference in her community. “For me, it’s a way to make them proud,” Velazquez said of her parents. “I am who I am because of them.”
Dr. Jeannette Velazquez
Velazquez owns Bare Foot Care Specialist in Flowery Branch but volunteers a full day once every month at Good News Clinics. It’s work she isn’t required to do — and with a full schedule of patients, probably doesn’t have a lot of spare time to do — but she does it because she finds it rewarding. Good News Clinics isn’t the first place Velazquez has volunteered. After podiatry school in Miami, the Puerto Rico native went to New York for her residency. She made her way back to Miami to work and volunteered at a homeless shelter there.
Source: Layne Saliba, The Times [9/14/19]
UPMA Holds Annual Fall Conference
The Utah Podiatric Medical Association (UPMA) held its Annual Fall Conference at the Zermatt Resort in Midway, Utah Sept. 6th-7th. The meeting covered a wide variety of topics including surgical, vascular, wound care, rehabilitation, and non-invasive imaging.
Attendees at Imaging workshop
20/20 Imaging sponsored a lecture and workshop on diagnostic ultrasound where MartyWendelken, DPM conducted hands-on imaging training for a number of attendees. “Ultrasound today has greatly advanced in image quality and work flow,” said Dr. Wendelken. His talk compared ultrasound to MRI imaging of ligaments, tendons, and soft tissue masses.
IN THE COURTS
Milwaukee Surgery Center files for Bankruptcy
Milwaukee Surgery Center has filed for Chapter 7 liquidation in Wisconsin Eastern Bankruptcy Court. Milwaukee Surgery Center is a podiatry clinic in West Allis, WI, according to Milwaukee Business Journal, which first reported the news.
Several times a week, PM News posts an entire article from a recent issue of our partner, Podiatry Management Magazine. Please note that the views expressed in Podiatry Management Magazine do not necessarily reflect the views of PM News or Barry Block.
Here are some strategies to help you re-focus and enhance your patient interactions:
8. Ensure buy-in through shared decision-making - Buy-in is a critical element of shared decision-making. It’s an invitation to the patient to collaborate in decision-making around the goals, options and plans for treatment. Patients who are consulted and engaged in their care report enhanced satisfaction, understanding, and confidence in their physicians’ decisions.
Developing shared goals for treatment will also help motivate patients to adhere to the treatment plan. Through education and shared decision-making, patient anxiety decreases, there’s a stronger physician-patient partnership, and more satisfying relationships for both parties.
Source: Rohit Uppal, Physicians Practice [8/29/19]
Query: The Value of the Initial E/M
I need some clarification on the hot topic of billing an E&M with a procedure. It used to be that the new visit (charge) or E&M included the opening of a “chart” and all the information gathering necessary along with the complete evaluation of the complaint and all the exam data. Now add a procedure to that initial visit, let’s say a nail debridement (CPT 11720). This patient returns at some latter date for routine nail debridement (CPT 11720). I understand that in the return visit there would certainly not be the same depth of evaluation for routine foot care as they are now established and the E&M is nearly non-existent. My question is regarding the value of the initial evaluation of the new patient. If we are only to charge the CPT 11720 on both the new visit and on the established return visits, then of what value was the extended evaluation and information gathering on the patient's initial new visit? This certainly takes more time and is more involved than the return visits.
Kevin Brattain, DPM, Peoria, IL
Response: This an area of confusion as some insurance companies want to lump everything into the procedure and not pay for any E/M service performed on the same day as any procedure. It all depends on the scenario. In a hospital or SNF, you might get a referral to cut a patient's nails or trim a callus. The diagnosis has been established so there may not be any E/M, if that’s all you did. On the other hand, if while caring for the nail or callus you find some underlying problem such as an ulcer, then absolutely a work-up is required and payable.
In the office, I generally do not get this type of referral; rather it is more of a referral for a foot evaluation. Wording is important. If you do the work-up whether it is for a systemic or “pain” diagnosis, you should be paid for that work-up on the initial visit. The nail or callus care may not be covered depending on what you find! On the follow-up visit for regular nail/callus care, the E/M may not be payable unless there is some other issue to be addressed. Just verifying the “at-risk” status is not enough to qualify for the E/M service.
Tony Poggio, DPM, Alameda, CA
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RESPONSES/COMMENTS (RELEVANT RESEARCH)
RE: Evidenced-based Guidelines on Foot Care in Epidermolysis Bullosa
From: Leonard A. Levy, DPM
A systemic literature review relating to podiatric care of patients with epidermolysis bullosa (EB) was undertaken and reported by Khan, MT, et al. in the British Journal of Dermatology (August 9, 2019). The outcomes of an EB community international survey indicated that priorities to foot care included blistering, wound management, exploring the most suitable footwear and hosiery, management of dystrophic nails, hyperkeratosis, maintaining mobility, and pseudosyndactyly. While evidence is limited, several interventions currently practiced by podiatrists show positive outcomes.
I just switched to Sammy EHR. My old company is sunsetting and I had to get a new one fast. They are excellent with transition and if I knew the trainer was excellent, I would have switched earlier. Any worthwhile EHR is not, however, simple and fast. Feel free to contact me if needed.
Dr. Udell suggests that orthotic labs should subsidize lectures at podiatry meetings and at the podiatry schools. This proposal underscores exactly why teaching the science of biomechanics has disappeared from all of the major educational symposia available to the podiatry profession. The content and speakers at these meetings have become heavily dependent upon corporate sponsorship and most of this comes from the wound care and surgical technologies industries.
Foot orthotic labs with their meager profits and budgets cannot and should not be called upon to fund the teaching of an essential element of the podiatric curriculum. To assume that foot orthotic therapy represents the major delivery of skill and knowledge of biomechanics of the lower extremity is a sad conclusion. No student or resident should enter the operating room and be allowed to make an incision before mastering this subject. Biomechanics is an essential pillar of podiatric medicine AND surgery and should not rely on funding from commercial interests in order to maintain priority in our educational process.
Doug Richie, DPM, Long Beach, CA
YOU CAN'T MAKE THESE THINGS UP
RE: Outrageous Shoe of the Day
Perfect for a Goth fishing trip?
Source: SHOISE via Virtual Shoe Museum
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CLASSIFIED ADS - ASSOCIATE POSITIONS AND FELLOWSHIPS
ASSOCIATE POSITION– FLORIDA
Join a podiatric team whose work positively impacts the lives of seniors every day! KG Health Partners, the largest podiatric practice in Florida, is seeking full and part-time podiatrists who will provide mobile-based foot, ankle, and lower leg care to residents living in long-term facilities throughout Florida. Achieve work-life balance with a Monday through Friday schedule, competitive wages, malpractice insurance, and exceptional benefits for full-time employees (health, paid time off, 401K retirement plan with company match). You must maintain active Medicare and Florida licenses. Email CV to firstname.lastname@example.org
ASSOCIATE POSITION – WESTERN, NY
Full-time, residency-trained associate podiatrist wanted for a busy two-doctor practice in Western New York. Practice involves surgery, routine footcare, wound care, and sports medicine. Please send CV to email@example.com.
PODIATRY POSITION – BROOKLYN
Well rounded podiatrist needed for private office, competent in all aspects of podiatry including surgery. Competitive rates, negotiable. Please email resume to firstname.lastname@example.org
ASSOCIATE POSITION- BERGEN COUNTY, NJ
Part-time podiatric physician needed in the Bergen County NJ area. Must have NJ license and be a Medicare provider. Must have reliable transportation to travel from office to facilities. Email Myfootdoctor2@aol.com also Podiatry X-ray Unit for sale, best offer.
EMPLOYMENT/INDEPENDENT CONTRACTOR - FL
Mobile podiatrist wanted to cover long-term care facilities throughout Florida. Travel is required however we do offer Flexible schedule, flexible hours, no call. Office days available if candidate wishes to keep that aspect of practice. Full-time preferred but part time will certainly be considered. Looking for a personable and dependable doctor to join our team. Very competitive salary with benefits and buy-in options. We are not a big corporation and want a doctor who will grow with us. Contact: DrGatCare@gmail.com
ASSOCIATE POSITION – MANHATTAN
Part time position: Well-established Park Avenue podiatric practice seeks associate for office coverage Mondays and Wednesdays. All aspects of podiatry including diagnostic ultrasound, lasers, fluoroscopy and digital x-ray along with office-based procedures. Excellent opportunity for ethical, energetic and skilled individual. Please send CV to Healthyfeetny@gmail.com
ASSOCIATE POSITION – LOS ANGELES, CA
Multi-specialty wound care and reconstructive surgery group hiring podiatrists to our growing family. Our practice treats wounds within inpatient and outpatient settings. Opportunity for general podiatry cases in brand new surgery center. Benefits include health insurance, 401k plan, and paid vacation time. $140k salary plus bonus . E-mail email@example.com with CV
ASSOCIATE POSITION - S. E. PENNSYLVANIA
Seeking full time associate for growing, multifaceted practice in SE Pennsylvania. Must be ABPS Qualified/Certified, motivated, personable, compassionate and dedicated. Competitive salary + bonus. Forward CVs to firstname.lastname@example.org.
ASSOCIATE POSITION- SOUTHWEST FL
Immediate Position. Associate for busy practice. ABFAS or ABPM BC or BQ. Great interpersonal skills and willingness to work as a team a must. EMR, dig x-rays, Ultrasound, DME. Base salary, bonus, health, 401K, etc. DrLam@NaplesPodiatrist.com
MOBILE PODIATRIST NEEDED - NEW JERSEY
Well-established and fast growing House-call podiatry practice (www.homefootcareservices.com) is looking for Full-Time or Part time podiatrist (at least 2 weekdays) to provide services to home-bound patients in New Jersey. Full-time position salary 100K+ bonuses, paid time off, gas/health insurance/car/malpractice compensation and administrative support . Lana.Raginsky@homefootcareservices.com
POSITIONS AVAILABLE - MINNESOTA AND PENNSYLVANIA
Rapidly expanding company serving Skilled Nursing Facilities, Nursing Homes, and Assisted Living Centers is looking for doctors for full or part time positions. Openings include, but are not limited to, Minnesota and Eastern Pennsylvania. Positions available immediately. Send inquiries and CV to: email@example.com
PM NEWS CLASSIFIED ADS REACH OVER 18,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 18,000 subscribers. For details, click here or write to: firstname.lastname@example.org or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at email@example.com or call (215) 808-0770
CLASSIFIED ADS - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE
PRACTICE FOR SALE – MARYLAND
Established 22+ year. Grossing over 450K 3 days a week all palliative. Digital x-rays, diagnostic ultrasound, EMR. Turn-key set up, ideal for a new practitioner, can easily increase revenue with surgery and wound care. Priced for immediate sale, owner is retiring and will help with transition. Send inquiries to firstname.lastname@example.org
PRACTICE FOR SALE- EAST BAY OF SAN FRANCISCO
Energetic practice with completely updated technology and ready made patient base. Owner looking to relocate out-of-state. - Full service practice with ancillary services. Practice operated on a part-time basis. Employment option available. Priced to sell. Contact MCrosby518@gmail.com
PRACTICE FOR SALE - PITTSBURGH, PA
Southern Suburb - Established practice with motivated seller offering practice for sale. Key opportunity to grow existing business or enter practice with established and educated patient base. Full range of services. Primarily office based. Contact: SWPADPM224@gmail.com
PRACTICE FOR SALE - EAST CENTRAL ILLINOIS (JUST SOUTH OF CHAMPAIGN)
Highly motivated to sell practice. Great demand for a residency trained podiatrist to take over busy practice located in Charleston/Mattoon. Buy on contract for $2,000 a month with an upfront deposit and secure mortgage on building after 24 mos. Purchase practice for $130K includes building all equipment, computers, EHR, billing software and receivables. Staff will stay. Revenues are $350K gross/yr. Established in 1992. Contact 217-549-1887 or email@example.com
PM NEWS CLASSIFIED ADS REACH OVER 18,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 18,000 subscribers. For details, click here or write to: firstname.lastname@example.org or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at email@example.com or call (215) 808-0770.
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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