This issue of FootZine has a new Practice Management Gem, more Crystal-Clear Coding, feedback on the AAPPM/PPMAA meeting of last week, and some ideas about learning opportunities closer to home. 

In the last week we have been able to add several pages of photos to the FootZine web site from the WSPMA/WSPMAA seminar and the "Murder Mystery".  (All the photo pages link from the bottom of the main Picture Page: http://www.footzine.com/FZ_8.htm ) Many thanks to Lynn Homisak and Denis DeBoer, Ann Orminski, and Heather Schafer for sharing their perspectives on the event!

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X-rays are taken in our offices daily.  We take for granted the appearance of those black, white and gray images.  The link below goes to a site with work by an artist who takes X-ray images (including some feet) to a new artistic level. 
http://www.gustoimages.com/xray-homepage.htm

~  Gayle

From:  Gail Bennett, PMAC
re:      AAPPM Meeting ("The Ultimate Staff Meeting")

I wanted to let you know I attended the AAPPM this last weekend in Philadelphia.  What a great weekend.  I would like to personally put a plug in for that group.  Ray Posa was extremely helpful and has only good things to say about you, Gayle.  He even told the whole group about FootZine and how intelligent you are, etc.  What a great guy.

Then of course is Hal and all he does.  He makes everyone feel so welcome.  Hal goes out of his way to help everyone.  Bill McCann is extremely helpful as well. And of course Lynn, Phill Ward and John Guiliana are very nice and helpful. A personal thank you to each of them.

And let's not forget the hunk from Universal Footcare Products that was exhibiting, he was cute and very hot!  If you belong to AAPPM you get a discount with Universal and some of the other corporate sponsors.
I can promise that if you attend an AAPPM conference you will not be disappointed and your doctor will not be sorry for sending you.

Thanks,
Gail Bennett, PMAC

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From:  Linda Casella
re:      Contacting Hal Ornstein, DPM

Gayle,

I am trying to get in touch with Dr. Hal
Ornstein by email.  Can you give that out?

Thanks,
 Linda Casella

*_*  Reply  *_*

Linda,

My e-mail is hornstein@aappm.com

All the best always...
Hal Ornstein, DPM

A letter this week from a podiatric assistant in the Southwest expressed the hope that she would be able to attend a seminar someday soon.  She is relatively new to this field, and has heard about various programs but has not been able to attend one yet.  Based on correspondence and conversations with other assistants, I don't think her situation is unique.  There are many assistants who are in small or isolated communities, or in practices that cannot afford to send staff members to the big meetings.  But that doesn't mean that they can't have a valuable and enjoyable learning experience.

To use her case as an example, she is not in a big city, but is within an hour or two of some much bigger cities that have many podiatrists and podiatric residency programs.  In fact, within 100 miles of her town, there are two major cities and 17 smaller communities with at least 50 podiatric practices.  Using the doctor's state association directory, or the association's web site for their doctor-locator information, she and her co-workers could invite staff from those "nearby" offices to attend an informal day of lectures some Saturday.

If their own office has a large reception area, they might be able to accommodate everyone there.  Otherwise, a hospital cafeteria or meeting room, or even space at a community center or a civic organization, might be available at no charge for educational purposes.  If her doctor is supportive in this, she could ask him to speak, and perhaps he would encourage other doctors to do the same.  She could ask the directors of the residency programs if some of the residents would be available to give lectures or hands-on demonstrations to the group.   Between 9:00 am and 4:00 pm, they should be able to hear about 4-6 different topics.  For lunch, the possibilities range from brown-bagging to asking a pharmaceutical or other sales rep to provide pizza and soft drinks.

On an even smaller scale, if there are enough participants close by, a similar approach could work on a week-night, with a single speaker focusing in-depth on just one topic. Holding such a study session after work means that people have a chance to eat either on the way there, or on the way home, so meals are not a concern.  This worked for years for assistants in Dallas County, especially as we were all studying hard for Certification.  Every month we met in an office or even someone's home, and one of the doctors gave a comprehensive presentation about one subject that we anticipated might be covered on that exam.

When we got to "Instrumentation", we went to an office that had a very complete O.R. setup, and spread out all of the instruments and talked about what each one was and how it was used.  Being able to see the real thing instead of an illustration made a tremendous difference, especially to the assistants whose doctors might not use a particular instrument in their offices. The doctor who lectured about X-rays got books donated by Kodak for the group, and in addition to his slides, he showed actual films and explained how certain anomalies occurred.  In another office O.R., we had hospital scrub nurses demonstrate sterile technique, gowning, gloving, and more.

In Harris County (Houston), the hospitals that had podiatric residency programs were very willing to let us use their cafeterias or small conference rooms, and their A/V equipment was also available to us, so we had no expenses there, either.  Having an "official" organization with dues and elections isn't required to make educational opportunities available.  It does take time and some phone calls, and often a little innovation.  In this time of email communication, mailing costs for planning such things could be almost eliminated.  There are lots of possibilities if you can get a few folks interested.... small starts can grow into bigger things. 

With time, the commitment that is shown by such gatherings may reap more interest from potential sponsors.  In addition, I think the doctors would be pleased at the interest their employees show in wanting to become more knowledgeable and more competent in their work. There is also the "side" benefit of the camaraderie that develops, the networking to share resources and solutions, and the friendships that can last decades.

If you want to get such a study group started, write to me and I'll be happy to pass along your information to FootZine's subscribers.  If you have had such a program, send a note, and photos if you have them, for us to share.


 

At the recent AAPPM meeting in Philadelphia, one of the most common billing questions concerned the correct way to bill orthotics.  The answer to the question is to bill specifically for the device you are dispensing.  Many insurance companies will cover “orthotics” but not orthotics related to the feet.  When verifying insurance coverage for an orthotic, make sure you tell the company what code you plan on using.  Often an insurance company will cover a lesser device but not the type of device you want the patient to have.  The orthotic codes are listed below with their descriptors.

L3000    foot insert, removable, molded to patient model, UCB type, each
L3001    foot insert, removable, molded to patient model, spenco, each
L3002 foot insert, removable, molded to patient model, plastizote or equal, each
L3003    foot insert, removable, molded to patient model, silicone gel, each
L3010    foot insert, removable, molded to patient model, longitudinal arch support, each

L3020    foot insert, removable, molded to patient model, longitudinal/metatarsal support, each

L3030    foot insert, removable, formed to patient foot, each

The L3040-L3060 are premolded devices and the L3070-L3090 are nonremovable devices attached to the shoe.

If you are dispensing a device made from an impression of the patient’s foot, then the L3000-L3020 series is appropriate.  If the device is formed directly to the patient’s foot and no model of the foot is made, then the L3030 is the appropriate code.  The take-home lesson is not to allow the insurance companies pay you for a less expensive device than you are dispensing.

The AAPPM DME seminar will be held in Philadelphia in August. Watch for more info coming about this dynamic seminar.

Crystal-Clear Coding tips by Dr. Ward are posted on the FootZine web site on this page:
http://www.footzine.com/FZ_C.htm

It is not possible to reach a destination when driving if the destination is not known.  A football game without end zones would be quite amusing to watch.  Too often, managers and leaders set their employees up for failure by not spelling out simple expectations.  Children behave best when they know what their parents expect, and in a sense this does not change as adults.

Communicating expectations to staff is most important during the training period for new employees but it does need to be a continuous process.  The expectations should be communicated in writing and verbally, presented in specific and simple terms.  An office meeting is an excellent venue to discuss general expectations of all employees.  This should also be done one-on-one.

Patient care can be enhanced by telling them “For you to achieve the best results, it is expected that you are to follow the treatment plan.”  This is especially important when performing surgery.  Many lawsuits are a result of expectations not being specifically and clearly told to the patient relating to post-op pain, limitations of activities, what the foot will ultimately look like, and length of time before they can return to their normal shoe gear.

You will find that the staff greatly appreciates understanding expectations and how they can be met.  Provide any tools your employees need to not just meet but also exceed the expectations set forth.  We have an assignment for both doctor and staff.  It is due ten days after reading this.  Doctors, write down 5 -10 expectations for your staff in general.  Assistants, write down 5  10 individual expectations for your doctors and managers in your practice.  Begin each one with “I expect…”.  The staff should also meet as a group and make a list of 5 -1O expectations beginning with “We expect…”.

When all is said and done, we expect that you will soon have clear and concise expectations communicated throughout your office!

Previous "Gems" can be found on their own pages of the FootZine.com web site, at
http://www.footzine.com/FZ_90.htm

Here's a travel tip that I learned from my Ocean Shores seminar roommate, Phillis Pearson.  She suggested packing a self-addressed, stamped, padded mailing envelope in your carry-on bag. Airport security should allow you to mail back to yourself any "contraband sharps" that were inadvertently left in the bag using that envelope.  You'll have to get out of line to do it, but at least you won't have to spend months searching for replacements.  Too bad I didn't know that last year, when I forfeited forgotten items at each airport!  Thanks, Phillis!

When I go to the Oregon Podiatric Medical Association meeting next week, I'll remember that one.  Because it will be another one of those short weeks, FootZine will take a break next week.  But as always, feel free to write!

~ Gayle