LETTERS TO THE EDITOR
***Clinic Attire***
I agree that clinic attire: business attire + white coat, should be maintained as much as possible.
Roodabeh Samimi, DPM, PGY-1
[email protected]
***Journal Reviews***
Thanks Jarrod for that insightful article on the new peer review journal "Foot and Ankle Specialist." I also found it horrifying to note that the anatomy picture was mislabeled. There is another peer reviewed journal available to all of us for free online called "The Foot & Ankle Journal." I have found some interesting articles available through this journal… I thought that you may also want to check this one out.
Sincerely,
Maxime Savard,
South Miami Hospital
[email protected]
EDITOR’S RESPONSE
Here´s the web address for the Foot and Ankle Journal: www.faoj.org. It appears to be a new online journal that started in January 2008. The majority of content so far are case studies.
—Jarrod Shapiro, DPM
You mention that the journal is free. I only find a $30.00 fee. Could you elaborate?
Thanks,
Bruce N. Block, DPM
[email protected]
EDITOR’S RESPONSE
I have to extend my apologies for my error regarding the Foot and Ankle Specialist subscription price. I reviewed the journal´s website, and it appears it does in fact require a subscription. I´m not sure how I managed to obtain this journal for free now that I´m looking back. Again, my most sincere apologies. If I hear anything new along these lines I´ll let you know.
—Jarrod Shapiro, DPM
***Nail regeneration question***
I wanted to ask you about recalcitrant nail regeneration and what you would do in the following
situation. I have a patient who presented with a pincer hallux nail right foot. She elected to have the nail removed - no exostosis to the distal phalanx. We first did a total chemical matrixectomy in the office. Sometime later, the nail grew back. The next step we took was a Winograd procedure at our outpatient hospital. Now, the nail had still returned, partially any ways. Currently, she is satisfied and not bothered with the remnant nail. However, I'd like to know what you would suggest at this point should she want to pursue a procedure further down the road.
Laurence Cane, DPM
[email protected]
EDITOR’S RESPONSE
Let´s open this question up to the community. With all those fabulous residents and practitioners out there I´m sure we´ll get a boatload of suggestions. I´ll start this off with one comment. A Winograd procedure is actually a partial matricectomy which leaves the rest of the nail intact. Let´s assume for the discussion that Dr Cane had in mind a surgical total matricectomy.
—Jarrod Shapiro, DPM
***Apligraf***
I completely support your viewpoints, but just to clarify your last statement. It's not fraud if you use a piece of apligraf on 2 – 3 patients. It's fraud if you bill for it on 2-3 patients. Given that, I still think the system is a bunch of BS , i.e. cigna, health net, and aetna can tell us that orthotics are only authorized for pts who are diabetic because those are the ones that really need them right? Note sarcastic tone of last statement...
Sincerely,
ara kelekian, dpm
4th Year Practitioner, Montebello, CA
[email protected]
If you cut up apligraf, apply to multiple patients & bill for them, it's a fraud...no question about it.... however, if you do not bill for it, in my view, it is perfectly acceptable and legal.
Sincerely,
Kazu Suzuki, DPM CWS
Los Angeles, CA
[email protected]
EDITOR’S RESPONSE
Drs Suzuki and Kelekian are correct. If I led anyone to believe I´m billing multiple patients for one Apligraf then I apologize. I meant to argue that even if I bill one patient and use the remainder of the graft for other patients I am committing fraud. I have been forced at my wound clinic to dispose of the unused portion and document that amount of Apligraf I used. What a waste. By the way, Dr Suzuki has an excellent PRESENT lecture on PAD evaluation. If you´ve ever ordered an arterial Doppler you should watch this!
— Jarrod Shapiro, DPM |
