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					      TEXAS
     Podiatric Medicine
2nd Annual 2009             Journal of the Texas Podiatric Medical Association




In This Issue...

Legislative Report
Young Members Committee
Executive Director Report
TSBPME Rule Revisions
Medicare Corner
TPMF News
                                                 Register Now!
                                        TPMA Southwest Foot & Ankle Conference
                                                    September 11-13, 2009
                                                          Frisco, Texas
                                      Sports Medicine Lectures, Conflict Management,
                                       Hands On Workshops and Assistant Program
                                                     TEXAS
        2009-2010 TPMA
      BOARD OF DIRECTORS
President:      Martin Sloan, DPM
                Abilene, TX         325-695-1890
President Elect:Samuel Nava, Jr., DPM


                                                    Podiatric Medicine
                Irving, TX           972.432.9191
Vice President: Damien Dauphinee, DPM
                Lewisville, TX       972.219.3338
Vice President: Steven Brancheau, DPM
                Greenville, TX       903.455.2383
Past President: Robert Taylor, DPM
                                                    Journal of the Texas Podiatric Medical Association
                 Frisco, TX          972.712.4161                    2nd Annual 2009
Region I:       Tim Abigail, DPM
                Richardson, TX       214.217.3668
Region I:        Leslie Campbell, DPM                                            This Issue Features:
                 Allen, TX           972.747.5800
Region I:        Nicole Hancock, DPM                       President’s Message.................................................................         4
                 Denton, TX          940.300.3054
Region II:      Marque Allen, DPM
                                                           Letter From the Editor................................................................ 5
                San Antonio, TX 210.699.8326               Executive Director Report.......................................................... 6
Region II:       Maureen Caldwell, DPM
                Victoria, TX        361-578-2777           TSBPME Rules.......................................................................... 7
Region II:       James Miller, DPM
                San Antonio, TX 210.650.0314               Legislative Report.....................................................................      8
Region IV:      Cory Brown, DPM
                Abilene, TX          325.695.8990          TEX-PAC Contribution Form..................................................... 10
Region IV:      Bradford Glass, DPM
                Midland, TX         432.685-3650
                                                           Southwest Foot and Ankle Conference..................................... 10
Region V:        Jonathan Hosch, DPM                       Southwest Foot and Ankle Conference Registration Form....... 14
                Tyler, TX            903.596.9173
Region VI:      Jeffrey Bowman, DPM                        Young Members Committee...................................................... 15
                 Houston, TX        713.467.8886
Region VI:      Maria Buitrago, DPM                        TPMF - Treating Indigent Patients............................................. 17
                Houston, TX         713.680.3668
Region VI:      James Kutchback, DPM                       TPMF - Annual Meeting Recap................................................. 19
                Kingwood, TX         281.348.2166
Region VI:      Scott McKinney, DPM
                                                           TPMF Updates.......................................................................... 21
                 Pasadena, TX       713.946-1500           Medicare Corner........................................................................ 23
Region VI:      Jason Miller
                Kingwood, TX         281.348.2166          Classifieds.................................................................................. 25
Region VII:     Angel Lopez, DPM
                Fort Worth, TX       817.625.1103          TPMA Website Updated........................................................... 27
Region VII:     Ed Singleton, DPM
                Watauga, TX          817.656.0303
Region VIII:    Carlton Newman, DPM
                 Austin, TX          512.451.7929
Region VIII:     Jonathan Smedley, DPM
                Round Rock, TX 512.255.0125                                               2009-2010
Region VIII:     Steve Sterriker, DPM
                 Waco, TX            254.776.6995                 TPMA CORPORATE PARTNERS
Foundation:     Bill Van Pelt, DPM
                Canyon Lake, TX 830.935.3631
                                                                            TPMA gives special thanks to our
              TPMA STAFF                                             2009-2010 Corporate Sponsors for their support of
 918 Congress Ave., Ste. 200, Austin, TX 78701                                    Podiatric medicine.
    800.TEX.FOOT phone, 512.494.1129 fax
Executive Director: Don Canada
                                 don@txpma.org
                                                                                        Platinum Sponsors:
Association Manager:Shana Spring
                                                                                           eppointments plus
                              shana@txpma.org                                                    PICA
Membership Manager: Melinda Daise
                            melinda@txpma.org
                                                                                            Gold Sponsors:
Financial Manager: Tammy Ybarra
                                                                                             Synthes Trauma
                             tammy@txpma.org
                                                                                           Silver Sponsors:
TPM Foundation:     Krista Richter
                                                                                     Wright Medical Technology
                               krista@txpma.org
Legal Counsel:      Mark Hanna, JD                                                Link to them at www.txpma.org
                     mhanna@markjhanna.com
 900 Congress Ave., Ste. 250, Austin, TX 78701
    512.477.6200 phone, 512.477.1188 fax


2                                                     Texas Podiatric Medicine                                                                           TPMA
TPMA   Texas Podiatric Medicine   3
                                           President’s Message
                                                           Martin Sloan, DPM
                                Colleagues,                                   conflict and agreed-upon legislation, publishing a new rule mir-
                                                                              roring said legislation while in the long term securing legislation
                               In the four short weeks since making           in 2011 which will again, without ambiguity, define scope of
                               my opening remarks as the incoming             practice for podiatrists in the state of Texas. The mediation task
                               president of the Texas Podiatric Medi-         force comprised of podiatrists geographically representative of
                               cal Association (TPMA) for 2009-2010,          Texas while at the same time utilizing the talent of those who
                               the staff and leadership of TPMA have          have been instrumental in the process for the past eight years,
                               hit the ground running. You may recall         will meet in Austin on August 15, 2009. The mediation format
                               some of the goals I outlined for our           and personnel, which has been agreed upon by all parties, will
                               members. My primary goal is for the            take place in Austin on August 18, 2009.
                               podiatrists of the state of Texas to retain
                               the right to practice podiatric medicine       In my goals outlined at the Annual Meeting, I urged the utiliza-
    and surgery in the manner in which they were educated, trained,           tion of a professional public relations team with a proven track
    credentialed and have practiced throughout their careers. I               record to help navigate us through the waters of the current crisis
    stressed the importance of maintaining unity as one body as               and to get the message out to the public, the legislature and the
    we move forward in the scope of practice battle. We at TPMA               medical profession that we ARE the best-educated, best-trained
    are committed to fight the good fight to ensure that no further           and comprehensively the most proficient specialists in foot and
    revocation of surgical privileges takes place. We are committed           ankle care. Don Canada has put his heart and soul into TPMA in
    to ultimately having a rule or law in place that defines without          recent weeks and we have contracted with The Vollmer Group.
    ambiguity the scope of practice of podiatry in the state of Texas.        This state-wide PR firm headquartered in Austin with offices in
                                                                              Houston, Dallas and New York is committed to help us attain
    To that end TPMA requested approval of a new rule by Texas                our goals. On July 14, 2009, we had a teleconference between
    State Board of Podiatric Medical Examiners (TSBPME) at their              the Vollmer Group, Don Canada, Shana Spring and Drs. Angel
    July 6, 2009 meeting. (Interestingly, a proposed rule expires in          Lopez, Leslie Campbell, Scott McKinney, Robert Taylor, Jeff Bow-
    six months if not adopted, and the original rule was published on         man and Martin Sloan. They clearly understand the urgency of
    January 2, 2009 so we barely missed the deadline.) The TSBPME             our message. In our discussions great strides were made in key
    graciously agreed to discuss repeal of the definition of “foot” and       message development, strategic planning and crisis communi-
    to consider resubmission of a new rule (to replace the one which          cation. We are contracted with Vollmer through November and
    had initially been submitted in January.)                                 beyond as necessary. Further, they will assist us in our public
                                                                              awareness campaign, our manpower study showing future health
    Representatives of TPMA and Texas Orthopaedic Association                 care shortages and our advocacy program. As we establish our
    (TOA) met with the TSBPME on July 6, 2009 to testify as to their          grassroots effort toward successful legislation in 2011 (essential
    respective positions. TPMA was represented by Judge Tom Phillips,         if we are to succeed) The Vollmer Group will prove invaluable.
    Mark Hanna, Don Canada, Drs. Sloan, Nava, Taylor, Dauphinee, and
    Bowman. TOA was represented by Dr. John Early, TOA President,             On another front we are moving forward in the establishment
    TOA legal counsel, Susan Henricks, and TOA Executive Director,            of a Young Members Committee and the addition of a Young
    Donna Parker. After extensive testimony a closed door “Execu-             Member to the Board of Directors. You may read more on that
    tive Session” was held, after which the parties were then invited         elsewhere in this publication. 
    in for more discussion. The votes were then taken. The TSBPME
    voted 5 to 1 to repeal the old rule defining “foot” and 5 to 1 to         Before closing we at TPMA must extend a congratulatory hand to
    propose new rules.                                                        Dr. Paul Kinberg. This gentleman works tirelessly for all podiatrists
                                                                              in Texas, largely unrecognized. On July 16th, I had the pleasure
    The intent of this rule is to clarify that treatment may include          of meeting with Dr. Kinberg and Debra Patterson, MD, Medical
    surgical and non-surgical procedures performed on soft tissue             Director, Trailblazer Health Enterprises, LLC. The purpose of the
    structures distal to the tibial tuberosity that affect the foot and       meeting was to discuss proposed guidelines to wound care
    ankle. The net effect of this is for the time being podiatrists           debridement codes and reimbursement. At issue were prepay-
    who are credentialed to perform procedures should be able to              ment audits and the difficulties some practitioners have had with
    continue performing those procedures. The Board voted to hold             reimbursement from Medicare. I will defer to Dr. Kinberg for that
    their next meeting on November 16, 2009 at which time they                report. But suffice it to say the interchange and the dynamics
    will consider final adoption of the proposed rules.                       were cordial, professional and educational.

    At the same time we have been in extensive discussion with TOA
    and our legal team on the matter of how best to resolve this                  Classifieds are available online at
    ongoing battle. We have been encouraged by TSBPME, TOA and                  www.txpma.org. Send your Classifieds to
    others to attempt to resolve the issue with mediation. A mediation                   melinda@txpma.org.
    task force has been established to formulate a proposal, which if
    successful, will in the short term result in resolution of the current


4                                                                Texas Podiatric Medicine                                                       TPMA
                                            Letter from the Editor
                                                           Ken Dennis, DPM
                               IT IS HOT! No matter
                               if you talk about the
                               weather or the politics
                               of Health Care – It Is
                               Hot. It might be scope
                               of practice issues
                               across the state or
                               single payor consider-
                               ations on the national
                               front, but health care is
                               a hot topic right now. I
                               know that I am glad to
have the Texas Podiatric Medical Association (TPMA)
and the American Podiatric Medical Association
(APMA) representing my (and my patient’s ) best
interests. As you will see in almost every article in
                                                                            N A F T I N
                                                                                                            ®
this issue of Texas Podiatric Medicine, the politics of
health care is HOT.

Talk about hot - were you able to be in South Padre                         NAFTIFINE HCI 1% CREAM
for the TPMA Annual Meeting in June? That was
a fantastic meeting (I thought there was no place
hotter than Houston, but I think it was hotter down                                   PUMP
there – sorry Region II members). Between golf,
fishing, beach, lectures, ethics, business meetings,
awards luncheons, and the list goes on; what was
there not to like. We can always count on our TPMA
staff to provide meetings second to none, and this
year was no exception. If you were not able to at-
tend, you owe it to yourself and your family to put
June 4-6, 2010 on your calendar – I promise you
will be glad you scheduled it into your summer.                           Available in 30g and 90g sizes.

Back to hot topics - how often does someone ask
you, “how’s business?” If you are like me, you are
almost afraid to say that business is really pretty
good right now. Considering the economic times,
I feel pretty darn lucky to have my “day job” – es-
pecially considering the fact that all my retirement
dreams are in the basement right now. The more
I listen to the news, the more depressed I get, and
then I try the ignorance is bliss approach – all to no
avail. We really have no other choice but to keep
plugging away and make the most of our situation.
I still feel blessed to have the fellowship of my peers
and the support of a truly wonderful profession!

So between air conditioning bills and water ration-
ing and summer vacations we are already more
than half way through the summer of 2009. And
yes there will be a cold front (probably with a hur-
ricane or two mixed in) to cool us down into the
80’s sometime in the next 6 weeks. I hope to see
you in Frisco on September 11-13, 2009, because
as I said before, the fellowship developed by the
Texas Podiatric Medical Association is “Priceless”!
Please take care, and continue all you do for the
citizens of our great state.

 TPMA                                                      Texas Podiatric Medicine                             5
                               Executive Director’s Report
                                                               Don Canada
                             Just to review the situation with the Texas     If we can jointly agree on legislation, then there will need to be
                             State Board of Podiatric Medical Examin-        an interim TSBPME rule to govern until that legislation becomes
                             ers (TSBPME) and the proposed rules, the        effective, and decisions will have to be made on how and when
                             TSBPME met on December 15, 2008 and             to take the “foot rule” down which would make the Supreme
                             voted to publish rules that would delete        Court case moot, and hopefully get the Court of Appeals opinion
                             the definition of foot and added new            off the books as well.
                             language that better identified what a
                             podiatrist is able to do regarding scope        Although we have been through this before, I am optimistic
                             of practice. Those rules changes were           that we have an opportunity to work together with TOA/TMA
                             published on January 2, 2009 and a Public       to resolve this issue outside the courtroom. Time will tell.
                             Hearing was held on February 27, 2009.

                            Those rules could have been adopted
    at their next meeting on March 30, 2009 but after much discus-
    sion, the TSBPME left the rules pending and did not take action
    at that time.

    They met again on July 6,2009 and the significance of that date
    is that the rules process allows for published rules to expire if not
    adopted within 6 months. So TSBPME missed the opportunity
    to act on those rules by the 6 month rule and if they wanted to
    proceed, they would have to republish the rules.

    On July 6th, the Texas Orthopaedic Association (TOA) and the Texas                 Future TPMA
    Podiatric Medical Association (TPMA) made presentations to the
    Board under public comments. That went about as you would
    expect: TOA opposed the rules on their same premise, that the
                                                                                         Meetings...
    rule exceeded their authority and TOA considered it as “legislat-
    ing by rule”. Afterwards, TSBPME went into a lengthy Executive
    Session to consider what to do, which gave the parties (TOA/              Southwest Foot & Ankle Conference
    TMA and TPMA) to sit outside in the “bull-pen” an opportunity
    to discuss the situation.                                                      September 11-13, 2009
    TOA asked if TPMA would be interested in trying mediation                           Frisco, Texas
    again, to which I responded, absolutely! And we had a lot of
    the major players there (John Early, MD, Susan Henricks (TOA
    attorney), Judge Phillips, Mark Hanna, Drs. Martin Sloan, Robert
                                                                                  TPMA & Dallas County Winter
    Taylor, Damien Dauphinee and Jeff Bowman (and me) so the                            Conference
                                                                                     January 22-24, 2010
    conversation went to what does each side see as the sticking
    points, and how can we work out something that can be taken
    to the legislature in 2011 to once and for all, resolve this issue.
                                                                                        Dallas, Texas
    Both sides agreed on a Mediation date and a mediator (Patrick
    Keel – former District Judge and professional mediator) so                             TPMA Annual Meeting
    the mediation will be held at the offices of Baker and Botts on
    Saturday, August 18,2009. Prior to that (this coming Saturday)                            June 4-6, 2010
    we have assembled a TPMA Mediation Task Force to meet at
    the TPMA office to prepare for the mediation. That task force                            Houston, Texas
    includes, Drs. Sloan, Nava, Dauphinee, Brancheau, Taylor, Carpen-
    ter, Bowman, Lifshen, Mendicino, Falknor, Jason Miller, Marque            Southwest Foot & Ankle Conference
    Allen, and Leslie Campbell. At the actual mediation, TPMA will
    be represented by the Executive Committee (Drs. Sloan, Nava,                   September 24-26, 2010
                                                                                        Frisco, Texas
    Dauphinee, Brancheau, and Taylor).




6                                                               Texas Podiatric Medicine                                                    TPMA
      Proposed Changes to TSBPME Rules pursuant to Board approval to
       publish in the Texas Register at the July 6, 2009 TSBPME meeting:
§375.1. Definitions amended to provide that:                                  (6) Condition means any disease, disorder, physical injury, deformity or
                                                                              ailment of the human foot.
The following words and terms, when used in this chapter, shall have
the following meanings, unless the context indicates otherwise:               The proposed change for §375.3 implements Texas Occupations Code
                                                                              §202.001(a)(4) and Texas Health and Safety Code §241.101.
(1) Board--The Texas State Board of Podiatric Medical Examiners.
                                                                              §375.3. General. Amended to provide that:
[(2) Foot--The foot is the tibia and fibula in their articulation with the
talus, and all bones to the toes, inclusive of all soft tissues (muscles,     (a) - (b) (No change.)
nerves, vascular structures, tendons, ligaments and any other
anatomical structures) that insert into the tibia and fibula in their         (c) A licensed podiatric physician may treat that portion of the body at
articulation with the talus and all bones to the toes.]                       or below the ankle by any system or method.

(2) [3] Medical Records--Any records, reports, notes, charts, x-rays, or      (d) The intent §375.3(c) is to clarify that treatment may also include
statements pertaining to the history, diagnosis, evaluation, treatment        procedures performed on soft tissue structures distal to the tibial
or prognosis of the patient including copes of medical records of other       tuberosity that treat conditions on that portion of the body at or
health care practitioners contained in the records of the podiatric           below the ankle.
physician to whom a request for release of records has been made. (3)
                                                                              (e) The intent of §375.3(c) is to clarify that this includes fractures that
(3) [(4)] Office--In the singular, includes the plural.                       extend into the ankle joint.

(4) [(5)] Public communication--Any written, printed, visual, or oral         (f ) Complex surgical procedures of the ankle by a podiatric physician
statement or other communication made or distributed, or intended             shall be performed only in a JCAHO approved hospital or a licensed
for distribution, to a member of the general public or the general            ambulatory surgical center.
public at large.
                                                                              (g) The Texas State Board of Podiatric Medical Examiners recommends
(5) [(6)] Solicitation--A private communication to a person concerning        individual privileging based on an individual practitioner’s level of
the performance of a podiatric service for such person.                       documented experience, documented training or board certification/
                                                                              eligibility.




    TPMA                                                     Texas Podiatric Medicine                                                            7
               Legislative Report - 81st Legislature
                                                          Mark Hanna, JD
                                More than 7000 bills were filed during     by a podiatrist rather than a physician (MD or DO). HB 1570 (Rep.
                                the 81st Session of the Texas Legis-       Thompson) provides that a preferred provider contract between an
                                lature which adjourned Sine Die on         insurer and a podiatrist must provide that the methodology used to
                                June 1, 2009. Many good bills failed       compute the amount of payment or reimbursement for services or
                                to pass this Session due primarily to      procedures covered by the contract is the same as the methodology
                                the log jam in the House triggered by      used to compute the amount of payment or reimbursement when
                                the delay tactics put forth by many        the same services are provided by a physician. HB 1570 passed the
                                House Democrats to kill the voter ID       House, was heard by the State Affairs Committee in the Senate, and
                                legislation. The following is a sum-       left pending. Opposition by the health insurance industry caused
                                mary regarding the bills of significant    the bill to die late in the Session. TPMA supported. Did not pass.
                                interest to the Texas Podiatric Medical
                                Association (TPMA).                        Expedited Credentialing – SB 779 (Sen. Watson) provided for expe-
                                                                           dited credentialing for health care providers under a managed health
Medicaid – SB 1 (Sen. Ogden), the Appropriations Bill, includes full       care plan. Passed the Senate. Died in the House. TPMA supported.
funding for podiatric medical services for both children and adults.       Did not pass.
TPMA supported. Passed.
                                                                           The Healthy Texas Program – SB 6 (Sen. Duncan) created a new
Franchise Tax Exemption – HB 4765 (Rep. Oliveira) increased the            health insurance program for small employers. TPMA supported an
State franchise tax exemption from $300,000 to $1,000,000. TPMA            amendment to include all health care providers (not just “physician
supported. Passed.                                                         services”). Passed the Senate. Died in the House. Did not pass.

Insurance Coverage For Orthotics – HB 806 (Rep. Gallego) man-              Children’s Health Insurance Program – HB 2962 (Rep. Coleman)
dates insurance coverage for prosthetic devices, orthotic devices,         amended CHIP so as to allow 80,000 children above the current income
and related services. TPMA supported. Passed.                              limit to join the Program. TPMA supported. Passed the House. Died
                                                                           in the Senate. Did not pass.
Agency Consolidation – No legislation was introduced this Session
which would have consolidated the health licensing agencies under          Student Loan Forgiveness – HB 1876 (Rep. Chisum) as introduced,
an “umbrella” regulatory framework.                                        would have provided student loan forgiveness for physicians, dentists,
                                                                           and social workers who practice in certain underserved areas. TPMA
Scope of Practice – No legislation was introduced this Session             supported an amendment that would have added podiatrists. Did
regarding the DPM’s scope of practice.                                     not pass.

Regulation of Lasers – HB 449 (Rep. Jackson) provides that a person        Medicaid – HB 1541 (Rep. Turner) would have added 258,000 children
may not operate a laser or pulsed light device with the intent to treat    to the Medicaid Program by expanding the enrollment period for
an illness, disease, injury, or physical defect or deformity unless the    the Program from six months to twelve months. TPMA supported.
person is authorized by law to treat the illness, disease, injury, or      Did not pass.
physical defect or deformity in that manner. TPMA supported as
amended. Passed.                                                           Health Education Programs – SB 706 (Sen. Nelson) provided incen-
                                                                           tives to recruit health education program faculty, including podiatric
Diabetes Mellitus Registry – HB 1363 (Rep. Gutierrez) establishes          medical education faculty. TPMA supported. Did not pass.
a diabetes mellitus registry pilot program. Passed.
                                                                           Loan Repayment – HB 2154 (Rep. Edwards) revamps the Texas Physi-
Diabetic Equipment and Supplies – HB 1487 (Rep. Pitts) relates             cian Education Loan Repayment Program. Currently, the state forgives
to the alignment of certain Medicaid procedures regarding written          up to $45,000 of a medical graduate’s loans if he or she practices in a
orders for diabetic equipment and supplies with comparable Medi-           shortage area. Most physicians graduate with more than $160,000
care written order procedures. Passed.                                     in school loans, however in order to qualify family practitioners
                                                                           would have to serve in areas designated as medically underserved
Discount Health Care Programs – HB 4341 (Rep. Truitt) provides             for a minimum of four years, and in turn would qualify for more than
for the regulation of discount health care programs by the Texas           $150,000 in loan repayment. TPMA and the Patient Choice Alliance
Department of Insurance. Passed.                                           supported an amendment that would have added other health care
                                                                           providers, but the effort was unsuccessful due to the additional fiscal
Parity – Section 1451.104, Insurance, prohibits the discriminatory         implications. The funding for the bill will come from an increase in
payment or reimbursement of providers based solely on the type of          taxes on smokeless tobacco. Passed.
health care practitioner selected by the insured. However, several
insurers doing business in Texas have issued preferred provider            Out-of-Network Providers – SB 586 (Sen. Carona) would have
contracts to participating podiatrists which arbitrarily provide a         prevented insurers from retaliating against participating health
lower level of reimbursement if the covered service is provided            care providers who refer patients to out-of-network facilities. TPMA


  8                                                           Texas Podiatric Medicine                                                    TPMA
       Legislative Report - 81st Legislature - continued
                                                             Mark Hanna, JD
supported. Passed the Senate. Died in the House. Did not pass.
                                                                            HB 4171 (Rep. Christian) relating to procedures to help ensure that
Other Legislation of interest which did not pass is listed below.           certain state agency rules are consistent with the meaning and intent
                                                                            of applicable legislative enactments.
HB 40 (Rep. Corte) relating to regulations on certain complementary
and alternative health care services.                                       HB 4349 (Rep. Tracy King) relating to certification of a person as eligible
                                                                            for disabled parking privileges.
HB 223 (Rep. Eiland) relating to regulation of the secondary market
in certain physician and health care provider discounts.                    HB 4455 (Reps. Martinez and Fischer) relating to prompt payment
                                                                            of insurance claims.
HB 531 (Rep. Anchia) relating to medical loss ratios of certain health
benefit plan issuers.                                                       HB 4519 (Reps. Homer and Deuell) relating to standards for indepen-
                                                                            dent review organizations.
HB 698 (Rep. Zerwas) relating to the designated doctor’s examination
under the workers’ compensation system.                                                                HB 4572 (Rep. Zerwas) relating to insurance
                                                                                                       coverage for certain devices that facilitate
HB 1166 (Rep. Leibowitz) relating to cer-                                                              insulin therapy and enhance glucose control
tain requirements for doctors providing                                                                in the treatment of diabetes.
professional services under the workers’
compensation system.                                                                                   SB 556 (Sen. Hinojosa) relating to require-
                                                                                                       ments for certain contracts with physicians
HB 1369 (Rep. Rodriguez) relating to unfair                                                            and health care providers.
claim settlement practices by an insurer
that issues a preferred provider benefit plan.                                                         SB 793 (Sen. Hegar) relating to certification
                                                                                                       of a person as eligible for disabled parking
HB 1442 (Rep. Hancock) relating to the                                                                 privileges.
operation of certain managed care plans
regarding out-of-network health care                                                                   SB 821 (Sen. Shapiro) relating to the regula-
providers.                                                                                             tion of medical radiological technology.

HB 1929 (Rep. Jim Jackson) relating to payment of claims of certain         SB 1461 (Sen. Duncan) relating to the registration of diagnostic imag-
out-of-network physicians and health care providers.                        ing equipment, the accreditation of diagnostic imaging facilities, and
                                                                            the regulation of diagnostic imaging providers.
HB 1930 (Rep. Jim Jackson relating to health services provided to
health benefit plan enrollees by certain out-of-network health care         SB 1527 (Sen. Shapleigh) relating to the creation of an electronic
providers.                                                                  medical record for certain individuals enrolled in the Medicaid or
                                                                            child health plan program.
HB 2029 (Rep. Zerwas) relating to the establishment of a laser and
intense pulsed light device registry.                                       SB 2332 (Sen. Duncan) relating to the regulation of preferred pro-
                                                                            vider benefit plans regarding network adequacy, contracting and
HB 2203 (Rep. Isett) relating to the continuation and operation of          reimbursement activities.
the Texas Department OF Insurance and the operation of certain
insurance programs.                                                         SB 2383 (Sen. Shapleigh) relating to universal health coverage for
                                                                            Texans.
HB 2279 (Rep. Thompson) relating to the provision of and billing for
certain diagnostic imaging services.                                        SB 2426 (Sen. Deuell) relating to the establishment of a laser and
                                                                            intense pulsed light device registry; providing a civil penalty.
HB 2599 (Rep. Thompson) relating to the registration of diagnostic
imaging equipment, the accreditation of diagnostic imaging facilities,      SB 2441 (Sen. Uresti) relating to the enforceability of covenants not
and the regulation of diagnostic imaging providers.                         to compete and to certain procedures and remedies in actions to
                                                                            enforce those covenants.
HB 2938 (Rep. Truitt) relating to the conduct of investigations, prepay-
ment reviews, and payment holds in cases of suspected fraud, waste,         If you have questions or require additional information regarding bills
or abuse in the provision of health and human services.                     passed during the 81st Regular Session of the Texas Legislature, please
                                                                            contact TPMA Legal/Legislative Counsel, Mark J. Hanna, 900 Congress
HB 3507 (Rep. Fletcher) relating to specialized license plates and          Avenue, Suite 250, Austin, Texas 78701; telephone: (512) 477-6200;
parking placards for vehicles of persons with disabilities.                 facsimile: (512) 477-1188; email: mhanna@markjhanna.com.


 TPMA                                                      Texas Podiatric Medicine                                                              9
                                 I want to support the podiatric medical health and care for
                                citizens of the State of Texas, and pledge my support to the
                                              TPMA Political Action Committee!

 My Contribution:         President’s Council ($1,000)     Platinum ($500)      Silver ($250)   Bronze ($100)   Other
 Name:                                                         Address:
 City, State, Zip:                                             Phone/Fax:
 Payment:                 AMEX          VISA        MC           Check          Bill Me     Total Enclosed: $
 Card Number:                                       Exp:              Signature:
                     Return to TEX-PAC: 918 Congress Ave., Ste. 200, Austin, TX 78701, 512.494.1129 fax




              Southwest Foot & Ankle Conference

                                 September 11-13, 2009




10                                                   Texas Podiatric Medicine                                      TPMA
       Southwest Foot and Ankle Conference




TPMA            Texas Podiatric Medicine     11
     Southwest Foot and Ankle Conference




12               Texas Podiatric Medicine   TPMA
         Southwest Foot and Ankle Conference




       Program Sponsors:
                                                      Contributing Organizations:




TPMA                       Texas Podiatric Medicine                                 13
 Southwest Foot & Ankle Conference
         September 11-13, 2009




14             Texas Podiatric Medicine   TPMA
                         Young Members Committee
                Maureen Caldwell, DPM, Co-Chair Young Members Committee

 The American Podiatric Medical Association (APMA) Young Members’ Program was established in August 1997, and exists to serve the
 needs and interests of APMA young members (students, residents, fellows, postgraduate, and associate members) and to encourage
 membership.

 And I am happy to report that the Texas Podiatric Medical Association (TPMA) has developed and is implementing the TPMA Young
 Members Committee recognizing that students, residents, and new practitioners have unique concerns deserving special attention.

 The TPMA Young Members’ Committee will focus on the needs and interests of members with five years or less of experience in the
 practice of podiatric medicine, as well as resident and student members. The Committee also leads recruiting efforts of young prac-
 titioners into TPMA and assists with development of CME programming for TPMA’s young members.

 At our recent Board meeting, TPMA voted to develop a Young Members Committee and at the Annual Meeting, we passed a bylaws
 change that puts one designated Young Member on the TPMA Board as a voting member and that position this year will be held by
 Scott MacTavish, DPM. In addition, we added a position on the CME committee for a young member to help with programs that will
 specifically benefit the young practitioner. That position will be held by Linnie Rabjon, DPM. These are very good steps forward to
 provide benefits and integrate the members with less than five years in practice into the mainstream of TPMA.

 The TPMA Young Members Committee appointments were made by Martin V. Sloan, DPM, TPMA President and include:

                            YOUNG MEMBERS COMMITTEE
                            Maureen Caldwell, D.P.M.              Co-Chair
                            Young Member TBD                      Co-Chair
                            Jason Hancock, D.P.M.
                            James Kutchback, D.P.M.
                            Scott MacTavish, D.P.M.               (To also serve on TPMA Board)
                            David Pytowski, D.P.M.
                            Linnie Rabjohn, D.P.M.                (To also serve on TPMA CME Committee)
                            Nealand Willingham, D.P.M
                            Kary Ann Shebetka , D.P.M.            Emerging Leaders Program Co-Chair
                            Jonathan Hosch, D.P.M.                Emerging Leaders Program Co-Chair

                                              Young Members Committee Meeting
                                                 Saturday, September 12, 2009
                                                      2:00 pm – 3:00 pm
                                           Embassy Suites, Frisco, Texas during the
                                            Southwest Foot & Ankle Conference



                 Blue Cross/Blue Shield of Texas/HMO Blue Texas
                 Professional Multiple Surgery Pricing Guidelines
 Blue Cross/Blue Shield of Texas has published its June 2007 multiple surgery reimbursement
 policy, and can be found at:

                            http://bcbstx.com/provider/pdf/multiplesurgerylogic.pdf

 This includes payment provisions for multiple procedures performed unilaterally or bilaterally at
 the same operative session. If you have received payment from BCBSTX that is not consistent with
 its stated policy.




TPMA                                                Texas Podiatric Medicine                                                           15
                                                                                                                       A
                                                                                                                       AO Screw


                                                                                                                       LPS Screw
                                                                                                                       L




                                         Smaller Heads - Taller Threads
                                         Designed specifically for use in the lower extremity,
                                         the resulting Arthrex design lowers head profile by
                                         1 mm and increases pull-out strength by 30% over
                                         standard AO screws.


                                         5.5 MM JONES FRACTURE SCREWS, 5.5 MM X 40 - 65 MM
                                             The 5.5 mm Jones Fracture Low Profile Screw
                                               is designed with an increased shaft diameter,
                                               cortical thread design and a low profile head
                                                to provide ideal fixation and stability for the
                                                stresses found at the base of the 5th metatarsal.
                                                Whether used for acute fractures or chronic
                                               nonunions, this solid titanium screw is designed
                                              to provide stout IM fixation for healing this
                                                   difficult sports injury.




                                                                                                    4.5 mm


                                                                                                    4.5 mm
Pull-Out
Strength Comparison*                                                                                5.5 mm

                 6.7
          1200                                                                                      6.5 mm
                                                                                                    (18 mm Thread Length)
                                                                                                                  L
                                                                                                                  Length)

          1000
                       6.5                                                                          6.5 mm
Newtons




                                                                                                    (28 mm Thread Length)
          800


          600
                             4.5
                                   4.5
          400


          200                                Arthrex,
                                             6.7, 4.5 mm LPS Screw

           0                                 6.5, 4.5 mm AO Screw
                                            *data on file
                                                                                                         For more information go to:
          16                                                      Texas Podiatric Medicine
                                                                     a Podi tr
                                                                          d         dicin
                                                                  Texas Podiatric Medi ne                                              A
                                                                                                                                    TPMA
                     Texas Podiatric Medical Foundation
             TPMF ADDS RESOURCES FOR TREATING INDIGENT PATIENTS OF TEXAS
Indigent Care Liaison for Greater Houston Area:                                Houston area.  Doctors must donate their time, but TPMF will provide
The TPMF is committed to coordinating resources to serve the indigent          Gateway funds to reimburse as possible for hard goods, ie DME,
patients of Texas.  The first step of this project has been completed          Medicines, etc.  This will make it easier to care for those that need it.
and includes a liaison with Gateway To Care of Greater Houston.  Dr.
Don Falknor of Houston has worked with Gateway for over a year and             How do I become involved?
shares his experience: “Most Podiatrist have a desire to give back to the      1. Pledge Card can be downloaded at www.txpmf.org/pdfs/
community and provide help to those that need help but can’t afford it.           ind_pledge_card.pdf. Mail this to Gateway.
I want to help others but I want to know if the patient I am helping really    2. Refer indigent patients that show up at your office to Gateway
needs help.    I also don’t have time to spend traveling to outlying clinics      or participating clinics or Gateway will refer patients to you
to treat the indigent.  Gateway To Care of Greater Houston provides the           with your permission.  Patient Consent for Charitable Services
ability to provide charity work without a lot of hassle.  They screen the         is required and can be downloaded at www.txpmf.org/pdfs/
patients, refer them to your office, re-evaluates them and the best part          ind_pat_consent.pdf.
is they work with your schedule.  It is your choice how many indigent          3. Read the FAQ questions in working with Gateway of Houston.
patients you want to treat. “                                                     Contact TPMF with any questions.
                                                                               4. Take advantage of Gateway as a resource for indigent care though
Gateway To Care Provider Health Network is based on a national                    their hotline and website. www.gatewaytocare.org
model called Project Access where a network of physicians and health
care providers have agreed to see low income, uninsured patients               What about other areas besides Houston?
who are pre-screened and determined eligible for the program, on               The TPMF is working on creating partnerships with other indigent
a charity basis.  Patients eligibility is based on not having any insur-       networks in Dallas, Austin and San Antonio.  Watch for further details
ance coverage, being at 150% or below the federal poverty level                for these areas. For rural areas where there are no networks in place,
and must be referred by a Gateway physician or participating clinic.           as a TPMA member, you can contact the TPM Foundation Indigent
Currently, Gateway has over 800 participating physicians and 34                Patient Committee and request assistance or funding for hard goods. 
hospitals/ clinics.  They are a non -profit entity and have provided           All requests are based on current donations available.   
over 8 million people charity care since 2005.
                                                                               Other Indigent Supplies Available:
The TPMF Indigent Patient Program for Houston will be a liaison with           Currently as of June 2009, the TPMF has access to 50 pairs of diabetic
Gateway To Care PHN. The TPMF is approved as a partner with Gate-              shoes donated by Dr. Comfort, some Oxistat supplies, and 1000 pairs
way and any of our physician members can refer indigent patients to            Croc-type shoes that can be provided to indigent patients or clinics
Gateway.  The only commitment is to provide services based on the              based on availability.  To request aid, volunteer or donate for the
number of patients you want to see annually, 1 - 100.  It is your choice.      indigent patient project, contact any Foundation Board member or
                                                                               krista@txpma.org
TPMF has begun work to raise grant monies to reimburse our par-
ticipating DPMs for their expenses in caring for the indigent of the




                Check the TPMA Website for Current Information & Meeting Registration:
                                           www.txpma.org
                Have you visited the TPMA website? You need your APMA membership number to access
                  “members only section” but there is an abundance of resource information and links
                                                  available to you.

                 If you have suggestions or edits for the website, please send them to staff@txpma.org.



 TPMA                                                         Texas Podiatric Medicine                                                             17
18   Texas Podiatric Medicine   TPMA
                   Texas Podiatric Medical Foundation
                                   William L. Van Pelt, DPM - TPMF President
TPMF EVENTS AT TPMA ANNUAL MEETING RAISE OVER $18,000 !
The Texas Podiatric Medical Foundation would like to thank EVERYONE who helped make the Annual Meeting Events a success! These events
are the biggest fundraiser of the year and it is vital to the continuation of TPMF projects. With the support of all the participants, auction donors
and sponsors – the TPMF raised over $18,000 in funds.

A special thank you to our Annual Meeting Sponsors: Bako Podiatric Pathology, Mile High Orthotics and Gulf Coast Surgical of Houston. Also
a special thank you to our Golf & Fishing chairman, Dr. Larry Mactavish of Houston, the Poker Tournament Chairs – Dr. Jason Miller of Houston
and Dr. Bill Van Pelt of Canyon Lake and the Auction Chair – Nelda Falknor of Houston. Thank you to all of the Foundation volunteers who
donated their time and money to make these events successful: Dr. Scott & Sandy McKinney, Dr. Jim & Elizabeth Kutchback, Cyndi Lara and Dr.
Caporusso’s staff, Dr. Bill & Judy Van Pelt, Dr. Jim & Kris Miller, Dr. Don & Nelda Falknor and Dr. Maria & William Buitrago.

Congratulations to the following winners:
TPMF Golf Tournament – Greg Armstrong, Mile High Orthotics
TPMF Fishing Tournament - Dr. Larry Cohen – Largest Redfish &
Dr. Charlie Hartley – Largest Trout
TPMF Poker Tournament – Vic Caldwell (Dr. Maureen Caldwell’s Husband)
TPMF Raffle Grand Prizes – Dr. Robert Vranes – Tv & Dr. Tom Garrison- laptop




 TPMA                                                     Texas Podiatric Medicine                                                             19
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                                       You Have A Choice When It Comes To Premier
                                             Professional Liability Insurance

                                   Each podiatric practice is different and the Podiatry PLUS program was created to
 Competitive Pricing               respond to those differences. Qualified podiatrists will benefit from competitive
                                   premiums and discounts based upon their practice exposure.
  Superior Coverage
                                   Our coverage was crafted specifically for the podiatric practice with enhanced coverage
 Integrity, Financial              features including: Consent to Settle; Disciplinary Hearings or Other Regulatory Actions
                                   Defense Coverage included within your professional liability limit; Medical Waste Legal
Strength and Stability             Expense Coverage of $50,000 per incident/$50,000 aggregate and an optional $30,000
       of ACE                      per incident/$30,000 aggregate Medicare/Medicaid Legal Expense Coverage.
The Forbes-Troxel Insurance        All backed by Ace rated A+ (Superior)* for financial stability through AM Best Rating
Agency has been assisting          Service, one of the most respected and recognized financial rating agencies available.
Texas Podiatrists with their       The Podiatry PLUS program has been insuring podiatrists for nearly a decade. Find out
insurance needs for over 25        why more and more Texas podiatrists are choosing professional liability with the
years. Give Zack Troxel a call     Podiatry PLUS program.
to see how the Podiatry
PLUS program can help you.

      Forbes-Troxel
 Insurance Agency, Inc.
(800) 356-0131                     The above is a product summary listing of some of the coverage afforded under the Podiatry PLUS policy. The descriptions do not
                                   include all terms, conditions or exclusions found in the policy. Please refer to the actual policy and endorsements for complete details of
                                   coverage. Coverage may not be available in all states. *As of June 1, 2007




 20                                                            Texas Podiatric Medicine                                                                                 TPMA
               Texas Podiatric Medical Foundation
                              William L. Van Pelt, DPM - TPMF President
 TPMF UPDATES:
 2009-2011 Foundation Board Elected
                                                                         YES,
 TPMF welcomes the new 2009-2011 Foundation Board of Direc-              I would like to support
 tors including:                                                         the TPMF with my fully
 President- Bill Van Pelt, DPM                                           tax deductible gift.
 Vice–President – Jason Miller, DPM
 Secretary/Treasurer – Javier LaFontaine, DPM
 Directors:                                                                     Visionary Donor          $3,500
 Steven Brancheau, DPM                                                          Principal Donor          $1,500
 Cory Brown, DPM
                                                                                Supporter                $ 500
 Brian Carpenter, DPM
 Damien Dauphinee, DPM                                                          Memorial Contribution:
 Don Falknor, DPM
                                                                                In Memory of:
 James Kutchback, DPM
 Scott McKinney, DPM                                                            Donation Amount: $
 Karry Ann Shebetka, DPM
 Tim Abigail, DPM                                                               Honorary Contribution:

                                                                                In Honor of:
 To volunteer for TPMF committees or projects, contact any TPMF
 Board member or krista@txpma.org                                               Donation Amount: $
                                                                                I am interested in including TPMF in my estate
 New TPMF Website Launched in June                                              planning.
 Take a few minutes to check out the new and improved TPMF
 website at www.txpmf.org. Thank you to eppointments plus and                   I am interested in volunteering for TPMF mission
 Physician Web Pages for their donation of web page services.                   projects.

 All our new projects are listed on the website including:               Donor:
 NEW TPMF Marketplace
 Therapeutic Shoe Fitter Course Information                              Address:
 Indigent Patient Resources
 Holiday Shoe Drive – December 11, 2009
                                                                         City, State, Zip:
 San Miguel Mission Information
 Volunteer & Donor Information
                                                                         Phone:
  
 TPMF CO-SPONSORS THE PODIATRIC ASSISTANT TRACK AT                       Fax:
 THE TPMA FALL CONFERENCE
 Don’t miss the great Assistant Program offered at the TPMA Fall
                                                                         Email:
 Conference, September 11-12, 2009 at the Embassy Suites in
 Frisco.  A percent of the proceeds from the Assistant Program
 will benefit Foundation projects. The Assistant Program offers
 Medical Spanish, Coding, DME, Conflict Management and more!             Donation Amount Enclosed: $
                                                                         Form of Payment:
                                                                                    Check         MC        VISA      AMEX
       TPMA/APMA DUES REMINDER:                                          Acct.#:                                   Exp.:
                                                                         Signature:
       If your TPMA/APMA Membership dues
        aren’t paid in full by August 31, 2009                           Please make all checks payable to:
                                                                                Texas Podiatric Medical Foundation
         you will need to contact the TPMA
                                                                                          TPMF 501 C3 Tax ID #74-2952209
        office at 800-TEX-FOOT for balance/
                payment plan options.




TPMA                                                 Texas Podiatric Medicine                                                    21
      COMPLETE
     SITES FROM
       $895




22   Texas Podiatric Medicine   TPMA
                                                     Medicare Corner
                                                              Paul Kinberg, DPM
Trailblazer Health Enterprises (THE), the J4 Medicare Administrative            wanted the grafts “fixed” via suture or staples. The final LCD reverts to
Carrier (MAC), has announced the final Local Coverage Determination             the CPT statement that it is the surgeon’s choice as to the fixation device
(LCD) for Bioengineered Skin Substitutes. The LCD has, at the time this         with sutures, staples, Steri-Strips™ or by other appropriate techniques.
article is written, has not yet been published. So its effective date has
not yet been set and there could be other changes written into the              Another issue podiatry had questioned was the use of these products
policy. Watch for the LCD publication on the THE internet site and you          on small wounds. Again we were heard. The final LCD states these
will know when it will become effective. There were several changes             grafts can be “applied to wounds of reasonable size given the clinical
to the draft LCD podiatry requested and we have been successful in              circumstances. For instance, Medicare would not expect routine use of
getting those into the final version.                                           graft material in treating small wounds (smaller than 1.0 cm2 or 1 cm in
                                                                                smallest diameter) unless the medical record clearly demonstrates the
Of course Dermagraft and Apligraf remain a part of the LCD. Their in-           wound to be refractory to conservative treatment but otherwise heal-
dications for use and documentation guidelines and limitations remain           able. Use on small wounds that have demonstrated adequate healing
unchanged from the prior version. But there are several new additions           by conservative means is not covered.”
that will enhance our ability to treat wound.
                                                                                But with one victory comes another issue. TPMA has been the first
The first is the addition of GraftJacket, but not GraftJacket Express to the    organization to met with the THE Carrier Medical Director (CMD). The
list of bioengineered skin substitutes that can be used for a one-time          issue, revisiting the Wound Care LCD. Specifically the debridement
application to a full-thickness or deeper diabetic wound. It seems the          codes (11040 -11044) and the pre-payment audits podiatrists have had
peer-reviewed, on-line article showing data from a prospective, random-         to undergo on codes 11042 and 11043 since the fall 2007. The CMD
ized, controlled, multicenter level-1 study showed data to confirm the          wants to rewrite the LCD so these audits can be suspended. It was a
effectiveness of GraftJacket for the treatment of diabetic foot ulcers.         very good exchange and we were promised that podiatry would be in
David G. Armstrong, DPM, PhD, Professor of Surgery and Director of              the loop as the LCD is rewritten. The revised LCD will be brought up
Southern Arizona Limb Salvage Alliance (SALSA) at the University Of             at the October CAC meeting for discussion. Podiatry again made sure
Arizona College Of Medicine led the study entitled, “Clinical Effective-        THE understood that debridement is the “gold standard” from which all
ness of an Acellular Dermal Regenerative Tissue Matrix Compared to              other wound care extends.
Standard Wound Management in Healing Diabetic Foot Ulcers.” The
study did not include GraftJacket Express and THE is waiting to see a           We were told that the review of the 200+ claims by the CMD showed
similar article on the effectiveness of GraftJacket Express.                    that many, if not most, of those debridements did not meet the docu-
                                                                                mentation requirements of the LCD. One concession we got was for
Oasis, originally excluded from the initial draft of the LCD, but included      THE to give physicians the specific documentation requirements they
in the prior LCD, remains in the final LCD. Again the reason was the            need so the codes would be paid without problems. We were told that
articles published on use of this product for diabetic ulcers. Another          once a new LCD is put in place, THE will again audit the codes to be sure
issue in the draft revolved around the fixation of these graft products.        they are being paid correctly and the documentation is appropriate.
The final LCD has sided with organized podiatry’s statement that the CPT        Until then plan on THE continuing to audit CPT codes 11042 and 11043.
verbiage took precedence over what THE had written in the draft. THE




                                                                 In Memory
                                                 Ronald Wuntch, DPM, 56, of Dallas, TX

     Dr. Ronald J. Wuntch, 56, unexpectedly passed away on Friday, April 3, 2009. He leaves behind his beloved
     wife, Katie of 35 years, sons Marcus and Zev and daughter, Rachel, his parents, Israel and Beverly, younger
     brother, Barry and wife Judy and their son Brandon. His brother, David and his grandparents preceded him in
     death. Ron was born on January 8, 1953 in Houston, TX. He loved the many adventures they shared which
     included travel, golfing, skiing, tennis, scouting and games. He was a Board Certified Podiatrist who practiced
     for 30 years. Ron’s office was at RHD and was on staff at many local hospitals. He was a member of the
     American Podiatric Association, past president, and served on the State Board. As much as Ron enjoyed his
     patients, his family was closest to his heart. He was always willing to become personally involved in the
     activities and interests of his wife and children.



    TPMA                                                       Texas Podiatric Medicine                                                            23
     Achieve optimal repair of diabetic feet and ankles
     using the most current
     surgical approaches.



                                                                                           As incidence of diabetes grows, so does the
                                                                                           demand for state-of-the-art therapies to resolve
                                                                                           peripheral limb damage. Now, put your practice
                                                                                           on the leading edge of surgical advances and
                                                                                           expand your expertise to address this escalating,
                                                                                           critical need.
                                                                                           You’ll join a stand-out team of
                                                                                           specialists as they lead you through …
                                                                                                  • surgical reconstruction of the acute
                                                                                                    and chronic Charcot foot and ankle
                                                                                                  • prophylactic, elective, trauma,
                                                                                                    and revisional surgery for the patient
                                                                                                    with diabetes mellitus
                                                                                                  • the fine points of expert,
                                                                                                    soft-tissue reconstruction.
                                                                                             You’ll benefit from a stepwise
                                                                                             approach to diabetic limb salvage …
                                                                                             including initial actions and guidelines.
                                                                                             You’ll engage in broad-view,
                                                                                             multidisciplinary considerations as
                                                                                              evidenced in today’s most highly-
                                                                                              respected academic institutions so you can
                                                                                              fully understand the role and importance
                                                                                              of each team member. And you’ll explore
                                                                                               especially complex case scenarios to
                                                                                                                 prepare yourself for
                                                                                                                 unexpected outcomes.
                                                                                                                 More than 1,200
                                                                                                                 images bring you
                                                                                                                 in close to observe
                                                                                                                 critical details.
                                                                                                                 Convenient charts
                                                                                                                 summarize important
                                                                                                                 facts. And multiple
                                                                                                                 contributors ensure
                                                     Brand New                                                   discrete expertise within
                                                                                                                 each, crucial topic.

Surgical Reconstruction of the Diabetic Foot and Ankle
                 Thomas Zgonis, DPM, FACFAS
      400 pages · 1,208 images and illustrations · 30 tables and charts
                         8 3/8” x 1 0 5/8” · Hardbound




24                                                              Texas Podiatric Medicine                                                       TPMA
                                                             Classifieds
        Fax Classifieds to 512-494-1129. Free for Members, $25/Issue for Non-Members

Open Positions In Fort Worth and Central Texas                               Podiatrists Wanted in Dallas Area
Flexible schedule. Instant patient base with none of the headaches           American Physician Housecalls is a Dallas based, Physician housecall
of running an office. Unlimited income potential. Interested in pro-         practice providing primary health care services to Medicare patients
viding quality podiatric care to residents of long-term care facilities?     in the comfort and convenience of the patient’s home.
Positions available in Ft. Worth and Central Texas. To learn more,
please fax your CV to 1-866-950-3627 or email to resumes@health-             Here are just a few of our services that we provide to our patients:
sync.org. (1/3)
                                                                             Primary Care and Hospital Transition Care Examinations and As-
Texas- 30 miles south of Dallas- Ellis County- Immediate availabil-          sessments:
ity. Fulltime practice, steady office based patient flow, with surgery       Comprehensive Review of Medical History, Thorough Physical Ex-
and nursing home component. Priced to sell. Contact mcrosby@                 amination, Medication Evaluation and Management, Geriatric Psy-
providerresources.com                                                        chology Assessment, Neuro-Psychological Assessment, Fall Risk As-
                                                                             sessment, Home Safety Evaluation
Texas- DFW Airport Area- Immediate availability. Practice located
15 minutes from DFW airport at RHD. Broad based referrals. Full              Specialized Services and Diagnostic Testing Available:
service practice with privileges at hospital. Contact mcrosby@pro-           Podiatry, In-home Ventilator, In-home Infusion Therapy, Advanced
viderresources.com                                                           Wound Care including Debridement and Wound Vac, X-ray, EKG,
                                                                             Holter Monitor, Echocardiogram, Pulse Oximeter Testing, Pulmonary
                                                                             Function Test, Comprehensive Laboratory Services, and In-home
Austin, Texas: The Austin Diagnostic Clinic, a 120-physician multi-          Sleep Study
specialty clinic located in the heart of the Texas hill country, is seek-
ing a board eligible/board certified podiatrist to join our 2-physician      Benefits:
section. Imaging services available in office. Clinic owned Outpa-           Group Malpractice coverage, Paid Federal Holidays, Paid Vacation
tient Surgery Center close by. Competitive salary and benefits. Re-          Time, Excellent base + bonuses, incentives, Paid CME, Car allowance
location stipend provided. Texas medical license is a plus. Send CV          of $500.00 per month, Cell phone reimbursement, 100% employer
to scarnelly@adclinic.com. No Visa sponsorships available.                   paid Health benefits, No weekends, evenings, hospital rounds or ER,
                                                                             Physicians see six patients per day
Full-Time Podiatrist needed in Austin and San Antonio to join
our Austin and Alamo area mobile Podiatry Groups. Current Texas               APH is seeking multi-talented Podiatrist for the Fort Worth area who
License required. Unique mobile podiatry practice. Better pay, fine          is ready to play a lead decision making role with a company that is
working conditions, with excellent support staff. Check out our              redefining senior healthcare. I just wanted to see if you know any-
website www.footmobile.com. Email CV and letter of interest to               one that would be interested. For more information please contact
footcenter1@sbcglobal.net.                                                   Eric Butler – Director of Professional Recruitment at eric@aphouse-
                                                                             calls.com or call us at 214-754-8700 ext: 222.

Full Time/ Part Time Podiatry Associate Needed. Practice located
in the greater Houston area. Please Fax resume to 281-376-4545 or
e-mail to rday3@comcast.net

“Foot Specialist” illuminated store front sign. 18” lettering. $1,250.
Email katyfootdr@aol.com
                                                                                                 www.txpma.org
                                                                                                 www.apma.org
       LEGAL COUNSEL CONTACT INFORMATION:
     If you have questions or require any additional
     information regarding the matters listed above,
     please contact:

           TPMA Legal Counsel, Mark J. Hanna
         900 Congress Avenue, Suite 250, Austin, TX
                           78701
                 telephone: 512.477.6200
                     Fax: 512.477.1188
              email: mhanna@markjhanna.com



 TPMA                                                       Texas Podiatric Medicine                                                        25
                                            2.4 mm and 3.0 mm Headless Compression Screws

                                                          The 2.4 mm and 3.0 mm Headless Compression Screws work like lag screws,
                                                          providing interfragmentary compression and absolute stability. The instrumenta-
                                                          tion allows the surgeon to directly control the amount of compression, using the
                                                          compression sleeve to compress the fracture prior to fully inserting the screw.
                                                          The proximal and distal thread leads are equal, which allows the screw head and
                                                          shaft to advance at the same rate, maintaining compression. The screws are can-
                                                          nulated for 1.1 mm guide wires and have self drilling and self tapping flutes. The
                                                          threaded StarDrive head sits flush with or recessed below the cortex.

                                                          2.4 mm and 3.0 mm Headless Compression Screws are indicated for fixation of
                                                          fractures and nonunions of small bones and small bone fragments. For complete
                                                          indications, refer to 2.4 mm and 3.0 mm Headless Compression Screws Technique
                                                          Guide (J6512).



 Image from cover of J6512D (MediaBin file name: 2.4-3.0 HCS)




Synthes is the leader in orthopaedic
internal fixation devices.
Synthes develops, manufactures, and markets the
AO system of orthopaedic implants and instruments.
Our goal is to provide the most advanced implants,
biomaterials, instruments, and technologies that
meet or exceed the highest expectations in safety
and quality. Our products are designed to ensure
reliable operating procedures, rapid recovery, and
optimal patient outcomes.

Synthes has committed significant resources in
conducting the most comprehensive postgraduate
training programs available for podiatry surgeons.
With emphasis on practical work in a laboratory
setting, these courses enable the surgeon to learn
how to use AO implants and instruments for a wide
range of fracture types and surgical techniques
related to the foot and ankle.




Synthes, 1302 Wrights Lane East, West Chester, PA 19380
www.synthes.com




26                                                                Texas Podiatric Medicine                                                TPMA
Check out our new website to better serve you!
TPMA Website Updated and Live!

We have been working on simplifying and streamlining the TPMA website to make it more user friendly and
efficient. I am happy to announce that the new site is up and running. Check it out at www.txpma.org. My
thanks to Linda Koepsel at Eppointments Plus who handles our site for her diligent work with our staff to make
the changeover.




                                                                         The TPMA E-News from the Texas
                                                                      Podiatric Medical Association has been
                                                                       instituted as a way of communication
                                                                        and to keep the TPMA members in-
                                                                      formed on current issues affecting the
                                                                      practice of podiatric medicine in Texas!

                                                                      TPMA E-News is emailed monthly to all
                                                                       TPMA Members. Members can also
                                                                          find it on the TPMA website,
                                                                             www.txpma.org under
                                                                          Members/News and Events.




 TPMA                                      Texas Podiatric Medicine                                        27
Texas Podiatric Medical Association                                           First Class Mail
918 Congress Ave., Ste. 200                                                     US Postage
                                                                                    PAID
Austin, TX 78701                                                                 Austin, TX
                                                                               Permit #272




                                      Peers
                                      What we were. What we are.
                                      What we always will be.
                                      We were founded by the APMA to ensure
                                      that podiatrists would have access to quality
                                      insurance without prejudice.

                                      We give podiatrists a voice by staffing our
                                      Risk Management, Claims, and Underwriting
                                      committees with practicing podiatrists.

                                      We utilize only podiatric physicians in our
                                      claim review process.


                                      That’s why you pick PICA.

                                      For more information or a no-obligation
                                      quote, visit us online at www.picagroup.com
                                      or call us at (800) 251-5727.

				
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