Thanks to our wonderful contributors, we have practically a double issue this week.  Here it is, then.....

  ~ Gayle

From:  Joan Gordon, PMAC
re:      ASPMA Study Manual (Yolanda R., Volume 38)

Gayle,

This answer is in response to Yolanda R.'s request regarding the ASPMA study manual:
Yolanda, the order form for the manual can be downloaded from our website,
www.aspma.org. You DO NOT have to be a member of ASPMA, or registered to take the exam to order the manual.

Joan Gordon, P.M.A.C., Chair, ASPMA Qualifying and Examining

*_*     *_*    *_*

From:  Sandra Lohrentz, MAC
re:      ASPMA Study Manual (Yolanda R., Volume 38)

The "Comprehensive Study Guide to Podiatric Medical Assisting" is always available for any podiatric medical assistant. While the ASPMA encourages everyone to become certified, there are no restrictions on buying the manual. It is a wealth of information for the new assistant as well as a review for anyone in the profession for awhile. It can be ordered for $75.00 from Joan Gordon, PMAC.
44 Spring Run Road
P.O. Box 254
Lamar, PA 16848
(570) 726-3215
e-mail jgordon@cub.kcnet.org

Thanks for your interest.

Sandra Lohrentz, PMAC
Executive Director, ASPMA

*_*    *_*    *_*

From:  Joan A. Cox
re:      ASPMA Study Manual (Yolanda R., Volume 38)

Hi Gayle,

I was wondering if Yolanda would be interested in just the "Manual of Basic X-Ray Techniques for Podiatry" to help in taking x-rays. The doctor would perhaps pay for it for his office, it is $41 total including S/H.

There sure are a lot of things for a new assistant to learn.
It must seem reassuring for assistants to be able to use your web site "out there" for help in so many ways; what a wonderful concept....team work in action.. sharing knowledge..
Talk about "Random Acts of kindness" !!
Have a Great Day !

Joan

*_*  Editor's note *_*

An additional note was received from Joan Gordon, PMAC, regarding the purchase of the Study Manual alone, versus buying the "Certification Exam Study Kit":

Gayle,

Yes, only the manual can be purchased at a cost of $50. We do not advertise it as such, because we prefer to sell the entire kit that contains valuable information AND an exam study guide.
Thanks!

Joan

*_*    *_*    *_*

From:  Karen Merriman
re:     Tourniquets (Kelly Lasswell, Volume 38)

Gayle,
Good Morning,

The letter from Kelly Lasswell from Dr. Schroeder's office struck home
with me.  Everyone is looking for a tourniquet.  Kidde discontinued the
tourniquet.  There is a manufacturer in Canada, Delfi Medical, and Zimmer is also a manufacturer of a tourniquet.  Zimmer as I understand is used in all hospitals and clinics.  Moore Medical is checking both products to offer to our customers.
Have a great weekend.

Karen
Karen Merriman
Moore Medical

*_*    *_*    *_*

From:  Mike Moscow
re:      Tourniquets (Kelly Lasswell, Volume 38)

Hello Gayle,

There is a new tourniquet that we should have in stock next week.  E-mail your fax number or the subscribers fax number and I will get you the information as it becomes available.

Mike Moscow
Universal Footcare Products
MikeUFP@aol.com

*_*    *_*    *_*

From:  Tommy Santos
re:       Texas X-ray Certification

Hello Gayle,

My name is Tommy Santos, I live in Houston and work for Dr. Lynnelle Gabriel and Dr. Robert E. Neville.  I need to get my X-ray cert. but I don't know who to call to get it set up.  Can you help me?  I need to make more money so anything I can do to make more money I will do.  Let me know.

Thanks in advance,
Tommy Santos

August 22-24, 2003
American Academy of Podiatric Practice Management
DME Meeting
Marriott Philadelphia Hotel
Philadelphia, PA

"Join us for this interactive seminar and workshop presented by the practice management experts from AAPPM and a faculty comprised of leading DME, AFO and In-Office Dispensing experts. If you attend this seminar and apply even some of what you learn, we unconditionally guarantee that your patient satisfaction and practice income will increase over the next six months or we will refund your entire registration fee."
Contact AAPPM at 978-686-6185 or e-mail info@aappm.com  or go to
http://www.aappm.com/upcconferences.html

November 14-16, 2003
American Academy of Podiatric Practice Management
Fall Practice Management Workshop
Lago Mar Resort, Ft. Lauderdale, FL
Friday, November 14th -Sunday, November 16th, 2003
Winning Practice Enhancement Strategies from Podiatry’s Leading Experts Featuring the Academy’s Unique, Highly Interactive Small Group Discussion and Workshop Format.
Lago Mar Beach Resort, Ft. Lauderdale, FL, 800-524-6627 for hotel reservations;
Contact AAPPM at 978-686-6185 or e-mail info@aappm.com.
Program details to be announced

FootZine's "Calendar" page is found at http://www.footzine.com/FZ_4.htm

“The most effective executive is one who hires good people and then has the good sense to stand back and watch them do their work”. 

Many owners of small businesses often fall into the trap of micromanaging their employees.  Since most of these owners were, at one time, the ONLY employee of the business, they have usually performed every job within the business and know exactly what needs to be done and how to do it.  It is easy to understand (yet not to accept) the criticism that micro-managers often deliver to their employees in response to doing something in a slightly different manner.  After all, their way has worked since the “beginning of time”.…why should they let someone try something new?
 
Physicians, like other business owners, often micromanage their staff.  If you find yourself frequently suffering from any of the following symptoms, you may be a micro-manager:

* You often look over your employees’ shoulders and offer “advice”.
* You often listen to your employees discuss a problem and feel compelled to voice an opinion or suggest a solution.
* You often succumb to the urge to finish a task that was started by an employee.
* You often delegate some tasks within the project but never the whole project.
* Your employees relate that they feel unfulfilled in their job.
* Your practice suffers from a high employee turn over rate.

If you are the unfortunate “victim” of a micromanager, these symptoms are unmistakable.  Perhaps it is not only the doctor’s act of interfering that concerns you, but the inevitable criticism that micromanagement often leads to. 

Micromanagement is certainly not taught within the core curriculum of any business schools.  Practicing it will ultimately limit the growth of any business.  Particularly true in the challenging environment of medicine, constant innovation, thoughts, and ideas must infuse your practice in order to thrive.  These can only come from people.  These critical innovations, thoughts and ideas will only be extracted from people who feel “empowered”.

Empowerment may be considered the polar opposite of micromanagement.  It involves choosing your employees well, considering who is best for each task, setting goals and objectives and finally, giving them each the authority and the responsibility to make their own decisions that effect their work.  Eventually, this will not only translate into complete employee fulfillment, but you may soon find yourself surrounded by a team of creative self-thinkers who have the means of creating unlimited business growth.  Watch their full potential come alive!

As the leader of the team, you have the responsibility of providing feedback along the way so that the employee has the opportunity to change course or fine-tune their strategies.  Feedback is NOT the same as criticism however.  Feedback is merely dynamic, up-to-date insight on how close they are to the mutually agreed upon goals and objectives.  Positive reinforcement is a key ingredient of feedback.

So your boss is a micromanager…

If you find yourself under the wrath of a micromanager, consider your options.  The easiest (but perhaps not the most practical) thing to do is to quit.  I would certainly never recommend quitting anything as a first-line option.  The second easiest thing to do (although not very easy) is to simply change your response to micromanagement.  Recognize and understand your boss’s reason for micromanaging and separate out the good constructive feedback from the unrealistic criticism.  Unfortunately, as your valuable input diminishes in response to your normal defense mechanisms, you may eventually feel a great deal of apathy toward the practice.   Finally, the last option (and perhaps the most difficult) is to actually change your boss.  This option, while difficult, is the only one with real, long- standing potential.  It is the only option in which the practice itself will benefit.

Changing the behavior of another individual is a slow and tedious process.  Like all creatures, (I don’t recommend calling your boss a creature to his or her face), we gravitate to that which makes us feel good.  With that in mind, you need to give your boss the same positive reinforcement that he or she is giving you during this change of habit (changing from micromanaging you to empowering you).  Acknowledge any acts of empowerment that comes your way.  Make your boss feel good about it.  Slowly, you will see that behavior “stick”.    

Unfortunately, you will not change the behavior of your boss by simply providing him or her with information about empowerment, its rationale, scientific evidence of its effectiveness, or even this article.  You must make them want to change through slow and steady positive reinforcement...make them feel good about it!   An old but true proverb states “change a man against his will, he’s of the same opinion still”.

Dr. Guiliana is a nationally recognized speaker and author on topics pertaining to practice management. He holds a Master’s Degree in Health Care Management and is a Trustee and Fellow of the American Academy of Podiatric Practice Management. He practices in Hackettstown, New Jersey.    

Dr. Guiliana's articles and Pearls can be found on the FootZine web site on the "Feeture Article" page: http://www.footzine.com/FZ_P.htm

Medicare Coding

The Question:

If Medicare is primary are you not suppose to fill in 11 A-D on the HCFA 1500 form? We do paper claims in our office. Medicare said this has been in effect for I year now. They say no, only put the word NONE in box 11. Now if Medicare is not their primary then you fill in the boxes 11 A-D. Have you heard of this?
Thank you,

Phyllis

The Answer:

No, you do not need to put anything in box 11 except "NONE" if Medicare is primary.


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

With the dynamic nature of today’s health care environment, decisions need to be made faster.  Successful practices are confronted with a large number of decisions on a daily basis.  If not dealt with in a timely fashion, a backlog is created, resulting in frustrated staff and an inefficient office.  Decisions are made quicker and more effectively by empowering your staff to deal with what’s on the plate.  Today’s consumer does not want to hear that an employee needs to speak with their supervisor before a decision is made on an issue.  Too often we do not empower our staff out of concern that a mistake will be made or that they will fail.  Rest assured that if your staff is not failing, then there’s no growth or positive change being made within your practice.

Results are best achieved by setting goals.  It’s difficult to hit a target if one does not know where to aim.  The focus on results makes performing tasks that much easier.  “Tasks” sounds too much like work, which we often procrastinate to avoid.  Focusing on the goal and appreciating what it will bring results in the task being part of the process of success.  An example is working to build gatekeeper referrals by setting up a meeting to discuss your practice.  Rather than dwelling on the time and energy of this process, look at the increase to your bottom line with another ten referrals a week.  The task at hand is short and the return is an annuity for your practice.

Holding yourself accountable for actions taken within your practice(s) results in respect from staff.  When confronted with problems or issues with an employee, one’s tendency is often to point blame.  In our practice we have learned that quality management does not blame our staff for poor production.  Instead we look at the system to see how the system is failing the employees.  A simple illustration of this is complaining to your receptionist that the phone typically rings eight times before it’s picked up in your four-doctor and ten-room office.  As the only employee who answers the phone and makes appointments she was set up for failure.  We continue to be amazed that when we take a step back from an employee issue we usually find it’s our lack of support and effective listening that has caused the problem.  As the leader of our office, our personality is adopted by the staff.  We determine the environment within our office through being responsible and accountable, two key traits of a good leader.

Patients have a keen sense of your commitment to your profession and staff.  Beyond patients’ basic expectation of having their foot problem resolved, what makes your practice unique is your commitment to the community within and outside the office.  Patients enjoy supporting businesses (and yes, we are a business) that deliver the message they care about others and practice the old adage that “the best service is service to humanity”.  The more our practice gives, whether it is volunteering time or through donations, the better we feel.  This good feeling is then sensed by patients, who feel that they’re part of a winning team.  A commitment to podiatry through mentoring students, residents and new practitioners is one of the most rewarding feelings.  Our staff also thoroughly enjoys helping and guiding these young physicians.  Employees are more committed to a practice that cares and will mirror its values.

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

The inquiries and responses of the last couple of weeks prompted me to go in search of study materials for podiatric assistants.   Good ol' Google led me to a few sources, and reminded me that we shouldn't overlook reduced-price and other used books stores, or public and college libraries, especially those where medical assisting courses are taught.

I learned that ebay has a "half.com" division, and found that there is a copy of Podiatric Medical Assisting, edited by Levy &Thompson, for $39.95.  It is described as "Brand-new - never been used".  The link to check into that one is:
http://half.ebay.com/cat/buy/prod.cgi?cpid=830548&meta_id=null

Amazon.com had the most entries, both in their new and used sections.  They did have a (new) copy of Levy & Thompson's  Podiatric Medical Assisting listed for $67.95, although it seems to have been sold in the last few days.  It might be worth checking on again.
The used section of Amazon has (as of this broadcast) two copies of
Podiatry for the Assistant by Irvin I. Donick , DPM.  This is the book which, after being out of print for several years, was revised and evolved into the current ASPMA Study Manual.  Check the link below for availability:
http://www.amazon.com/exec/obidos/tg/stores/offering/list/-/0683026143/all/ref=sr_pb_a/103-1936188-9122200

Also listed in Amazon's used section was Auxiliary Personnel in Podiatry (no author given).  I am not familiar with this title, but it is listed for $18.50 at this link:
http://www.amazon.com/exec/obidos/tg/detail/-/0879931035/qid=1058044227/sr=1-5/ref=sr_1_5/103-1936188-9122200?v=glance&s=books#product-details

The last entry I found in Amazon "used" was another book that I didn't recognize, but which might be helpful for someone with an particular interest in podiatric surgery.  It is Assisting at Podiatric Surgery: A Guide for Podiatric Surgical Students and Podiatric Theatre Assistants  by Telford Thomson and Ian Wilkinson.  That page is located at:
http://www.amazon.com/exec/obidos/tg/detail/-/0443072264/qid=1058044227/sr=1-1/ref=sr_1_1/103-1936188-9122200?v=glance&s=books#product-details

Podiatry, and podiatric assisting, are certainly changing and evolving continually.  Even so, there are many basics which have remained the same for the 30-plus years that I have been in this profession, and are not likely to change soon.   We might use the newest X-ray machines and processors, but the views we take remain the same.  K-wires and metal fixation give way to absorbable pins and screws, but I'd venture that most podiatry ORs still have osteotomes, mallets, hemostats and Rongeurs.  HIPAA is the law now, but we've always been careful to protect our patients' privacy.  For every high-tech concept that is introduced, there is an old technique or an old truth which will be constant.  We need to stay current with all the latest developments, but we shouldn't forget a good foundation of practice management and patient care that have set podiatry apart for so long.  Some of the books mentioned above may not be brand-new, but they will prove valuable for someone wanting to learn about this field.  An older edition of Gray's Anatomy, for example, serves us just as well as new.  These older texts can make a worthwhile investment for our professional libraries.

It's great when you write - please continue!

~ Gayle