LETTERS TO THE EDITOR
***Board Review***
I am a resident at POH Medical Center in Pontiac, MI. I'm a first year in a PM&S 24 program.
First of all, I really enjoy your newsletters. I especially liked the one today about Board Reviews. My co-resident and I were coincidentally just talking about Boards today.
You answered one of our questions about ABPOPPM vs. ABPS. I take it that ABPS carries a lot more weight than ABPOPPM.
We don't have a board review set-up at our program, and I was wondering what we should be doing to prepare right now. We have a journal club twice a month.
How did you prepare for the written exam for ABPS? Did you take it directly out of residency?
Thanks a lot for your help. I look forward to more of your newsletters.
Sima Pandya, DPM
[email protected]
EDITOR’S RESPONSE
From my knowledge it is true that ABPS carries more weight than ABPOPPM, although I'm sure if you were to speak to those folks they may take exception to that.
When I was a resident we did a weekly McGlamry Jeopardy-style board review. The residents had to read a chapter the week prior, then answer questions created by one of the residents, and moderated by our residency director. We had two teams who competed. It was a great way to review for the boards. Clearly, at the very least you have to read McGlamry cover to cover. Many of the questions seemed to come out of this reading. There are board review texts such as the Hershey and Presby manuals which I did review a little. The PRESENT lectures are also good resources.
I took the qualification exam during residency. You should be able to easily pass this exam with the current level of residency training. Just remember one thing. As important as the exams are, the most important thing is that you become a quality physician who can think for yourself. Gain knowledge for this reason, not to pass a test. Good luck with your studies.
—Jarrod Shapiro, DPM
***Board Certification***
You forgot some things here.
1. You have to be qualified before you apply for your certification.
2. You have to be in practice for 3 yrs before you can apply for the certification.
3. The qualification only lasts 7 yrs. Seems like a long time, but I know a few people who have pretty successful practices who ran out of time and are retaking the qualification exam this year.
4. Remember that you will most probably not do any cases your first 6-12 mos., if you are lucky, because of credentialing in hospitals/surgery centers. And if you are looking to open up alone that might even take longer.
5. The worst part of the certification if the variety of cases. We don't usually get 15 calcaneal fractures, or pylon fractures that just walk into your office. Sometimes we start "subspecializing" and end up doing mostly soft tissue, or bunions, or hammertoes, etc. Just remember to try and keep your cases varied (even though we all know its very difficult to justify a base wedge with an IM of 12).
I hope that this sheds a little more light to what Jarrod said.
Hope everyone is well and Happy New Year!!!
Fernando L. Quirindongo, DPM
[email protected]
EDITOR’S RESPONSE
Hear hear!! All good and true points.
—Jarrod Shapiro, DPM
***Job Search***
I would like to personally thank you for all your contributions. You have been a big help.
I was wondering if you know of any good web sites to look at while trying to find a job.
Your help will be appreciated.
Thank you,
Armin Feradouni
[email protected]
EDITOR’S RESPONSE
I don't know specific websites any more. Let's open this one to the podiatric community to answer. What websites have you used or are using to look for jobs? For that matter, what methods in general are you using for your job search?
—Jarrod Shapiro, DPM
***Hospital Billing***
I am a new practicing podiatric physician in Grand Rapids, Michigan. I read your New Docs emails, and always get so much out of them. Thank you for doing that for our profession.
I have a billing question for you. I know you see a lot of in-patient consults, and I have seen a few myself since starting in G.R. My office staff is telling me they don't know how to bill these visits. They say in the past they haven't gotten paid for these in-pt consults. How do you bill for an in-pt consult, and do you ever have trouble getting paid?
Thank you in advance!
Marisha Stawiski, DPM
[email protected]
EDITOR’S RESPONSE
Yes, you do get paid for in-patient consultation work. If we didn't at all how many doctors would we see in the hospital? Whether you get paid a lot is a different story. Keep in mind these are often higher risk patients (or they probably wouldn't be in the hospital) so you should expect reimbursement. Also, a lot of these patients have Medicaid which doesn't pay doctors well. In my area almost no one accepts Medicaid patients. My boss does not, so as a new doc courtesy to the hospitalists, I will see Medicaid patients knowing I probably won't be paid.
When you first see a consult you'll use the E"M codes 99251-99255 based on the severity of condition and bullet points in your consult note. I tend to use the 99253 code most often. When you follow up that patient on subsequent rounds you'd use the 99231-99233 codes. If you've done a procedure then you have to follow the appropriate global period, etc. If you do palliative care then you can bill medicare for the palliative codes as you would in the office. Remember to append the appropriate modifiers. Surgery is billed with the same codes you'd use if they were an outpatient surgery. The payment may be different in some cases though. For example, if you like to apply Apligraf in the OR the reimbursement will be different from your office. Good luck with your hospital work
—Jarrod Shapiro, DPM
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