Are we listening??  Recently, at least one new patient a week has told me that the podiatrist they had seen previously "just didn't listen to me".  Just as often, we hear of primary physicians who have told them that "It's no big deal" or "It will probably go away on its own", or perhaps referred them for treatment of "X", when their pain comes from "Y".  Each of them told me how their greatest concern about their foot condition was ignored or discounted by the previous practitioner.  While this is not a recent phenomenon, it seems that I have heard such complaints more often lately.  These patients were seeking not only resolution of their problem, but validation that their concern was warranted.

This is somewhat like paying a visit to the mechanic for some brake work, only to be told that you could use a new exhaust system or an alternator or something else that you hadn't noticed at all.  Your immediate concern and the cause of your distress is how your brakes are working, so you don't want that to be brushed aside. 

My experience has been that when the doctor doesn't have the time to fully hear them out, people truly appreciate when the staff will make a point of learning what the patient thinks is their primary issue.  They count on us to help convey that to the doctor, whether our job is gathering information on the phone at the time of scheduling or taking the initial history in the office.  I've learned the wisdom of an early employer's advice: "Never pre-judge a situation".  When there is pressure to act in haste, it is easy to make assumptions about   what seems obvious.  While we all recognize that we must strive for efficiency, we must also remain receptive to what the patients are trying to tell us.

Podiatric assistants serve as advocates for the patients and often as "translators" between them and the doctor.  We can understand what the patient is trying to express, and they will often open up to us with more details about their situation and expectations if they feel we are paying attention.  We need to be sure that the doctor gets the whole story ("She's leaving for a European walking tour next month" or "He's got a marathon coming up") as they consider a treatment plan.  Finally, we can paraphrase and reinforce the doctor's presentation and instructions to help the patient understand the more technical information.   We can add helpful information (pre-approved by the doctor, of course) about keeping dressings or strappings dry; ways to stay non-weight-bearing while performing daily tasks; what and when to eat (or not) while taking medication; placement and timing of heat or cold; and many other details that may otherwise be lost as they try to absorb what the doctor tells them.

In the end, it is all about communication.  Improving our listening skills will help the patients and the practice.

~ Gayle S. Johnson

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

From:  Paul Kesselman, DPM
re:      "Shoe Buddies"  (Volume 80)

I know that Dr Comfort shoes sells split sizes (that's actually what it's called when the left and rt foot are of diff size).  They either charge a minimal fee or no extra charge, but certainly one doesn't have to pay for two pairs.  As one of a handful of Podiatric DME advisors, I'll try and get tap my resources and report back in a few days w/more info.

Dr Paul Kesselman

*_*  A follow-up letter from Dr. Kesselman  *_*

It was actually easier than I thought:

http://www.amputee-coalition.org/fact_sheets/oddshoe.html
This is an excellent source it has many different commercially available shoes. I think you have planted a seed and I will gladly write an article about this for Podiatry Management in the near future.

Dr Paul Kesselman

*_*    *_*    *_*

From:  DB, Podiatric Medical Assistant
re:      Compensation Questions

Dear Gayle,
 
I know this question has been asked before, but no answer was ever truly given?  How does someone decide what the correct hourly rate of pay should be for a podiatric assistant?  Do you go by the amount of years you've been employed, or what?  Does becoming certified account for anything?  How about seniority, should that, or does that account for anything?  I would truly appreciate any input on this subject.  Please respond with whatever information you can!

Thanks,
DB, PMA  


*_*                                         

It is literally true that you can succeed best and quickest by helping others to succeed.
 -  Napoleon Hill

*_*

AAPPM/IPMA Summer Practice Management Workshop

Thursday to Sunday,  July 29 to August 1, 2004
Westin Chicago River North Hotel, Chicago, IL

The American Academy of Podiatric Practice Management (AAPPM) is partnering with the Illinois Podiatric Medical Association (IPMA) to offer a new summer practice management workshop in Chicago for podiatrists and their staff members.

A workshop highlight will be an all-new, one-day track for residents and new practitioners, “Practice Management A to Z”.   The meeting is expected to be the largest AAPPM has ever run with over 200 registrants projected to attend. We added it to the AAPPM conference calendar in response to the tremendous growth in membership of the Academy and demand for its meetings.

For more details, visit:  http://www.aappm.com/

Suzanne Adams
Director of Member Services
AAPPM


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

The Question: (from Volume 80)

Question: Is it necessary to use Q modifiers when billing for an initial or ongoing convalescent hospital or office visit?

Thanks again for your help.

Kate Prado
Dr. Mike Prado

The Answer:

Q modifiers are not required on the initial or subsequent convalescent visits if you are treating a covered podiatric medical condition.  If the sole purpose of that visit is to trim or debride nails or calluses, then the appropriate Q modifiers would apply to the procedure codes.  You should not bill both a visit code and the nail and/or callus debridement codes if the sole purpose of the visit was to perform the procedures.  If there is a separate identifiable diagnosis, then an E&M visit may be charged.  Make sure this is well documented that these are separate conditions.  To make it easier for reviewers I have dictated these as separate problems with a SOAP note for each.  I do this at in the office also.

Scott Schroeder, DPM
Wenatchee, WA


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

A "found Gem" from Napoleon Hill, author of Think and Grow Rich.  Additional information and other motivational quotes from Napoleon Hill can be found at this web site for The Napoleon Hill Foundation:  www.naphill.org

"Every time you influence another person to do a better job, you benefit that person and you increase your own value.  Someone once said that no one can really motivate anyone else; all we can do is motivate ourselves and hope it catches on.  You will probably never know how much you influence others with your behavior.  When you always go the extra mile, you will influence those in your circle of friends and acquaintances, your family, your co-workers, and even your bosses to do more and better than they have done before.  Your value to yourself and others is greatly enhanced by your ability to influence others to be happier, more productive people.  There are no salary caps or career limits for those who lead others to great heights of success. Such people are simply too valuable."

Thanks to Dr. Hal Ornstein for bringing us new motivational resources.

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

The FootZine publishing schedule will be slowed down a little over the summer.  Instead of a weekly issue, I anticipate sending out a new issue about every 2 weeks.  But the inbox will be open, as always, and I'd still love to hear from you!

  ~ Gayle

Copyright 2004 Gayle S. Johnson.  All Rights Reserved.
DISCLAIMER: Acceptance and publication of any letter, article, news item or advertisement does not necessarily constitute or imply approval or endorsement by myself of the product, idea, or content therein. I reserve the right to edit or to not publish any material received. Any letters published are the property of FootZine. Any health- or legal- and financial- related information is for educational purposes only and should not be construed as medical, legal or financial advice, or a substitute for the advice of a healthcare professional, attorney, financial advisor or any other consultant or professional. Information pertaining to legal matters should not perceived as legal advice, nor should discussion about such issues as Medicare, coding, and billing be considered as definitive. All content is presented as being only the opinions of the contributors and is for educational purposes only.

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