News reports this week reminded us that the creators of computer viruses and worms rarely take time off.  The latest version to get attention is the "Beagle" (early reports said it was also sometimes called "Bagel"), more formally known as  W32.Beagle.A@mm .  The description sounds much like the Klez32 worm that was so prevalent a couple of years ago.  It obtains email addresses as it invades web sites and systems, and uses them to send itself all over again.  You'll find more specifics about the "Beagle" here:
http://securityresponse.symantec.com/avcenter/venc/data/w32.beagle.a@mm.html

There are more details about other viruses and worms, as well as links to worm-removal tools, at the Symantec (Norton) Security Response page: http://securityresponse.symantec.com/avcenter/vinfodb.html

It's true, "You can't be too careful!"

~  Gayle

From:  Dianne Sain
re:     Marketing Products in the Office

Gayle,

Several of your issues in December talked about marketing products in the podiatrist office.  I am trying to sell my doctor on this, and we had started exploring the idea.  He was looking forward to the next issue of the Footzine to give us suggestions for the products and a supplier.  We just want to see the types of products others are carrying and hear more about how they sell the products, and if there are other suppliers with different product lines that we don't know about.  So if others have suggestions, we would like to hear them.

Thanks,

Dianne Sain
Hickory, NC

*_* Editor's Note *_*

Dianne, Dr. Ornstein says:  "For me to respond to which products I use, why and how would result in a book. To help address her question, I suggest that you give her my e-mail in the upcoming FootZine letting her know that she can contact me and I will set up a call with her and her doctor to provide the answers."   You can reach him at:  hornstein@aappm.com

 ~  Gayle

*_*    *_*    *_*

From:  Jamie Ancich, PMAC
re:     Washington State Meeting

We are working hard planning the WSPMAA 2004 Annual Meeting and Scientific
Seminar.  I want to make sure we make this the best seminar you've ever been
to.  Last year the biggest complaint was there just wasn't enough for the
front office.  So please let me know what would you like to polish up on, or
learn about in the front office?  Your ideas would be greatly appreciated.

And is anyone looking to take the ASPMA Certification Examination?  We need
at least 10 people who are interested, to include it in the seminar.  Please
let me know by Feb. 29, 2004.  I can be reached by email at
jdancich27@techline.com

I hope to see all of Region 7 attend.  We have some really great lectures to
present to you, a talent show and an elegant reception planned for Saturday
night.  It is April 16-18 at the beautiful Davenport Hotel in Spokane WA.

Thank you,

Jamie Ancich, PMAC
Vice President WSPMAA
jdancich27@techline.com

*_*    *_*    *_*

From:  Krissy
re:      Surgical Code Needed

Hello Gayle,

I'm needing some help on getting a CPT code for a surgery?  Do you know
anyone who can help on my search for: Evans Calcaneal navicular bar!!
Please Help or help me in the right direction.
Thank you for your help in my search :-)

Krissy
Hillsboro, OR
HFC@ARACNET.COM



*_*

"Change has a considerable psychological impact on the human mind.  To the fearful it is threatening because it means that things may get worse.  To the hopeful it is encouraging because things may get better.  To the confident it is inspiring because the challenge exists to make things better."  -  King Whitney Jr.

*_*

Your in-office dispensing program will not be successful without your staff becoming involved in the process.  One of the exciting elements of your in-office dispensing program will be the ability of your staff to contribute to practice income.  While the staff is critical to the success of your in-office dispensing program, the doctor must be the initiator of the process.  It is the podiatrist’s recommendation that will ultimately sell the product.  The program process should include self-analysis, product selection, product integration and staff training, patient introduction to the product, inventory control and handling repeat business. 

When your office decides to embark on the in-office dispensing journey, the doctor must critically evaluate his or her own thoughts on the entire process.  Basically, psychological overviews of the podiatric physician’s feelings as well as the staff need to be positive about offering products to patients in the office.  Otherwise, negative feelings will subvert the whole process and the staff will fail to make meaningful contributions to the process as a result.  This is not to say that the doctor and staff will not be slightly “uncomfortable” at first.  This is natural and during the early phases will accompany the positive feelings that you have about starting.

To begin your in-office dispensing program the doctor will need to select some products.  What to choose is extensively covered in later sections, but according to Richard Levin, DPM, “dispense what you know.”  Your staff will need to know the products as well, so let them sample with themselves, their friends and their families.  Samples can be obtained from your local company representative before placing an order.  The staff will then be able to offer first (or second) person testimonials that will be heartfelt and appreciated by your patients.  As the program progresses, the staff will offer recommendations for new product additions and the whole office will start to be “on the lookout” for applicable products. 

Once the products are selected, integration and staff training will take place.  This is the critical step in being able to effectively communicate the features and benefits of your in-office dispensing offerings to the patients.  The staff will need to know the pertinent information on how to use the products and the potential side effects.  This is important for insuring compliance.  Pre-printed instruction sheets enhance patient compliance documentation as well as staff understanding.  By doing this work on the front end of the program, the doctor can now turn over the actual discussion about the product to a well-trained staff member.  

Now that you and your staff have made the decision to dispense products in your office, have selected your products, and trained, you are now ready to actually start to dispense to your patients!  Again, the doctor will present the appropriate product to the patient during the encounter.  The staff can actually give the patient the product, the pre-printed instructions if applicable, and answer any questions.  The patients will find it helpful to hear the staff testimonials. 

As with any consumable, inventory control will need to be worked out as your program progresses.  The staff will be very involved in this part of the process and may incorporate it into the ordering of other items (i.e. gauze).  Inventory in the fledgling in-office dispensing program can simply be controlled visually.  When you see it is low, order more.  It is not as simple as one adds more items and possibly expands into prefabricated DME.  The use of a checklist for typically-ordered items could be used at this point.  Some practices use bar codes and electronic means to reorder.  Whatever method is used, organization is the key.  Many offices have found that keeping a supply of the items dispensed in a cabinet in each room to hand to patients works the best.  The item would be put on the patient’s billing sheet along with services delivered at the visit.  The patient would then pay for the item at checkout.  Conversely, a central supply area may work best if you have no space in your treatment rooms.  Consideration can be given to coordinating the entire transaction in the front office.  Whichever way you choose, staff involvement will be the critical factor in keeping the shelves full.

Repeat business will usually be handled by the staff at the front desk.  Both doctor and staff should encourage the patient to come to the office if more products are needed.  Let them know that they do not need to see the doctor or have an appointment to do so.  Many patients will actually tell family and friends about the effective products that they have received from you and soon they will be coming in as well. 

In-office dispensing is fun and stimulating for your well-trained staff.  The staff will be crucial in the success of this undertaking.  Make the process fun and informative.  Consider offering incentive bonuses to them for reaching certain goals with the program.  By following this orderly recipe, your office and especially your patients will enjoy the many positive benefits of in-office dispensing.

We would like to thank Bill McCann, DPM, President-Elect of the American Academy of Podiatric Practice Management, for his assistance with writing this Gem.

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


*_*

"The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn."   -    Alvin Toffler

*_*

A friend recently told me that the FootZine publication and web site, and our subscribers, have become "a real community, instead of just individuals all going it on their own".  Thanks to the writers of questions, and answers, and the Gems and other articles, whose contributions reinforce that concept.  That's the way we like it, so do keep on writing!

  ~ Gayle