ABPM Spotlight! Meet ABPM Director, Coleen Napolitano, DPM

Coleen Napolitano, DPM

Coleen Napolitano, DPM

The ABPM welcomes Dr. Coleen Napolitano as the newest member of the ABPM Board of Directors. Dr. Napolitano has been a Diplomate since 1994 and has been active with the ABPM for the past 15 years, primarily with the Examination Committee, where she is the current Chair of the certification exam (Part 2) sub-section.

“I am quite familiar with the ABPM’s past and present and have witnessed first-hand the significant strides it has made in the medical community, said Dr. Napolitano.  “I look forward to contributing to the future of ABPM and believe that ABPM certifies specialty skills that represent the majority and the best of podiatric care, witha focus on medicine and podiatric orthopedics.”

Dr. Napolitano did her undergraduate at Florida International University on a running scholarship.  She obtained her doctorate and Bachelor of Science from Dr. William Scholl College of Podiatric Medicine and completed her residency training at Hines Veterans Administration Hospital in Illinois.  Dr. Napolitano followed her certification with the ABPM by becoming ABFAS certified and encourages podiatry residents to recognize the benefits of dual certification.

She is currently an Associate Professor in the Department of Orthopaedic Surgery & Rehabilitation in the Section of Podiatry at Loyola University Medical Center and is the Program Director for the podiatry residency training.

Clinical Presentation Skills: Communication with your Patients

Faith A. Schick, DPM

Faith A. Schick, DPM

By: Faith A. Schick, DPM

The ability to communicate with your patients is integral to successful outcomes.   This is an important practice skill that should be developed and mastered prior to graduating residency.

As a resident, I recall spending time shadowing multiple physicians.  After a period of time, I was able to know what the physician was going to say before the words came out of his/her mouth.  This wasn’t because I was getting smarter at understanding how I was supposed to treat a specific condition,  but because I became familiar with the conversation the attending was going to have with the patient.  As time went by, and after many experiences, I was able to synthesize different versions of what I was hearing, and have specific treatment plans I would share with my patients when the time came.

Developing this organized thought process helped to ease the transition from resident to attending.  When the time came I was ready.  I knew how I wanted to treat my patients and what supplies I needed to perform an appropriate physical examination and render care.  Being board certified with ABPM and though my experiences I knew I could handle any situation. I was able to walk into the treatment room with confidence and explain to my patients what I thought their condition was, and how we were going to manage it without faltering.  I knew what I wanted to say before I said it, similar to the physicians I had observed.    This confidence reassured my patients.

Realize that just because what you are saying makes sense to you, it doesn’t necessarily mean that it is going to make sense to your patients.  During residency you are surrounded by peers who easily communicate using medical terminology.  Once in practice this changes, and your audience becomes your patient population.  Language needs to become more simple; you need to still speak intelligently, but use words that your patient will understand.  For example, instead of saying “calcaneus”, explain by saying “heel bone”.  While it may make sense to you that a patient should sleep in their CAM boot, you need to very clear with patients giving them instructions.  Make sure to ask if your patient has any questions before leaving the room.

Think about the message you are trying to convey.  How do you sound?  What does your posture look like?  Are you making good eye contact?  As time has gone by, I have come to appreciate the value this has on my office workflow.  I am able to review my chart notes with ease knowing that there is an organized thought process as to how I treated my patient during their last visit, and depending upon their outcome how I plan to proceed with care.  My staff is able to anticipate my needs and the needs of my patients.  Appointments are scheduled in an organized fashion based upon the diagnosis.  With the advent of electronic health records, I have been able to develop templates that facilitate my documentation process.  Patients are able to leave the office with organized instructions explaining their diagnosis and plan of care.

This level of organization assures that I do not miss any step in my patient’s treatment.  By the time the patient has completed their visit to the office they have an established diagnosis with plan of care, all questions have been answered, necessary studies having been ordered, medical supplies have been dispensed, and a follow up appointment has been made as needed.  This limits my liability and the chance that something gets overlooked or forgotten.  All too often physicians are multi-tasking throughout the day and a simple distraction can lead to error.  Having an organized treatment algorithm keeps things on track to make sure nothing gets missed, and communication with your patients is of utmost importance.

 

Congrats to Western University, CPM’s Class of 2019!

Western University, CPM

Message from ABPM Past President, Lester Jones, DPM:

I want to send congratulations to the members of the WesternU College of Podiatric Medicine Class of 2019 who recently learned that they achieved a 100% pass rate on both the APMLE Part 2 written exam and the Clinical Skills Performance Exam. This stellar outcome represents the diligence and hard work that are hallmarks of the students at CPM. You are a class apart!

This is the second year in a row that the fourth-year class has scored 100% on both of these board examinations. The College leads the nation in residency placement as well as with a five-year history of 100% placement of all graduates into some of the best hospitals in America for their three-year residency programs.

I also want to thank the WesternU community of faculty and staff who work hard to make this College and University such an outstanding place for learning. Strong work all.

Lester Jones, DPM, Interim Dean, WesternU College of Podiatric Medicine

Source: PM News, Online

Meet ABPM President, Dr. Gina Painter

Dr. Gina Painter, ABPM President

Dr. Gina Painter, ABPM President

Current ABPM President Dr. Gina Painter has been a diplomate of the ABPM since 1998 and a member of the Board of Directors for the past five years. She currently serves on the Examination Committee and the Speaker’s Bureau. Past committee involvement has included  Credentials, Budget, Bylaws and Case Review.  Dr. Painter also represents the ABPM as a site-evaluator for the Council on Podiatric Medical Education and is the Board’s liaison to the APMAIn November she was inducted into the Royal College of Physicians and Surgeons of Glasgow. Dr. Painter is a graduate of the Temple School of Podiatric Medicine and practices in Great Falls, Montana.  Her practice experience is extensive and has included solo practice, partnership in a multi-specialty group, where she served as Chair of the Executive Governing Board and, most recently, as a hospital-based physician.

From Dr. Painter:

Podiatric Medicine has evolved as a whole, with increased integration into hospitals and health networks. Along the pathway toward parity within the framework of the health care delivery system the role of podiatric medicine will rely increasingly on the medical aspect of podiatric care and care of the diabetic foot.

ABPM has a strong presence in the podiatric community.  We have recently escalated our informational efforts to hospitals and insurance panels regarding the value of ABPM certification.  Within the next month new documentation will be provided on the website to members.

The ABPM will continue to act as a staunch advocate for our current and future members.  We hope to be a unifying force within the Podiatric Medical community.  The practice of Podiatry is “diagnose and treat the diseases, disabilities, and deformities of the foot by physical therapy special shoes and other mechanical devices, pharmaceuticals and surgery.”  Let us all excel at it!

Clinical Presentation Skills: Owning and Operating a Successful Private Practice in Today’s Healthcare Climate

By: Daniel T. Hall IV, DPM

With the ever-mounting changes in healthcare and how physicians practice, I wanted to share my experience as a young owner of a private practice. While this may seem like a distant goal, you may be contemplating this type of practice structure. In today’s day to day work environment, it is imperative to know the obstacles you may face. The number of today’s solo practitioners are dwindling in favor of hospital-based employment, multi-specialty groups and/or larger podiatry groups. This could be due to the vast amount of responsibility put upon the doctor. Choosing your electronic medical record subscription, obtaining insurance prior authorizations before office and hospital procedures, navigating treatments around high patient deductibles, and increased in-office overhead expenses could all become daunting tasks. It is no wonder we are seeing reports of physician burn-out at an all-time high. So how does one successfully manage all of these variables and still provide the highest quality of medical care to our patients as a solo practitioner? The answer is simple. Evolve.

Let me explain a bit further. As my father used to tell me, “You can’t know where you are going, until you know where you have been.” As with any practitioner who is seeking advice on how to successfully own a private practice, I always begin with a few questions.

1. How are you generating new patient referrals? Furthermore, how are you keeping your current referring physicians?

There has never been a more competitive time to practice medicine, most notably as a specialist such as podiatry. And many other fields, namely family medicine and internal medicine are feeling a similar burden. The number of hospital-based physician employees and hospital-owned practices are at an all-time high. As a result, some of our best referral sources eventually may no longer be sending us patients if a podiatrist is employed within the same healthcare system. Nurturing referral sources is an important aspect of private practice.

2. Do you have a strong online web presence with positive physician reviews?

Let me give you an example. You are traveling to New Orleans for a conference and a friend recommends a great restaurant in the French Quarter. How many of us are going to search that restaurant on our phones or tablet before making a reservation? Nearly all of us. What if the restaurant had several bad reviews? Would we still go? Some of us probably would not despite our friend’s glowing recommendation. And today’s healthcare climate is no different. In fact, according to Practice Builders, nearly 80% of patients will change their mind about a medical practice after reading a bad review. Patients today are having to pay more money out of pocket for their medical treatment as deductibles rise. It is understandable for patients to be more selective with their physicians moving forward.

3. Do you have active social media engagement (i.e. Facebook, Instagram, Twitter) that is highlighting the strengths of your practice?

The internet has changed the way we all experience healthcare both as physicians and patients. We must evolve and adapt to keep pace with the current digital world. Without a strong online web presence, your practice is going to suffer the consequences. Being active in social media will strengthen the presence of your practice.

4. What criteria are you using to hire your staff, and how are they trained?

“Behind every great physician, there is a great staff.” How is your office staff greeting patients? How are they handling uncomfortable patient situations? Are they courteous and empathetic? Is your software “staff-friendly” regarding scheduling appointments and handling balances?

These are all important questions that every solo practitioner and their staff should be able to answer. Attending podiatry conferences and utilizing the multitude of online resources available will help one stay abreast to the changes that directly affect the practicing podiatrist. The American Board of Podiatric Medicine also serves as a excellent resource and offers access to a vast network of board certified podiatrists that are dedicated to uplifting our profession and offering guidance for private practitioners.

 

ABPM Directors Inducted into the Royal College of Physicians and Surgeons of Glasgow

(L-R) Drs. Lee Rogers, W.E. Chagares, Gina Painter and Jim Stavosky

(L-R) Drs. Lee Rogers, W.E. Chagares, Gina Painter and Jim Stavosky

American Board of Podiatric Medicine Directors, Drs. W.E. Chagares, Gina Painter and James Stavosky, were inducted into the Royal College of Physicians and Surgeons of Glasgow (RCPSG) in a ceremony on November 22, 2018. Also in attendance were Drs. Matt Garoufalis and Lee Rogers, both currently Fellow Faculty in Podiatric Medicine of the Royal College which sponsored the new inductees.

The RCPSG was founded in 1599 by surgeon Peter Lowe, and its membership has contained notable figures in the history of medicine, such as Joseph Lister who first described the principles of aseptic surgery 150 years ago.

Source: PM News, Online

ABPM Director Advocates for Podiatry Specialty in Romania

Stefan Minovici (CEO of the Romanian American Business Council), Dr. Andrew Pavelescu, Daniel Kline, and Dr. Lee Rogers, November 5, 2018.

Stefan Minovici (CEO of the Romanian American Business Council), Dr. Andrew Pavelescu, Daniel Kline, and Dr. Lee Rogers

November 5, 2018 – Dr. Lee Rogers, ABPM Director and Chair of the CAQ in Amputation Prevention and Wound Care Sub-Committee, spoke at the United Nations Millennium Hilton for the Romanian American Business Council about the wave of diabetes and amputations in Romania and the need to establish the specialty of podiatry to address this growing problem.  He cited American data on the success of podiatrists and teams in preventing limb losses and reducing costs in diabetes.

The audience consisted of the Romanian Secretary of State, Minister of Health, Ambassador to the UN, Ambassador to the US, and other government and healthcare leaders from Romania.  US Surgeon General Dr. Jerome Adams also spoke to the Council.

ABPM Board of Directors Announces Additional Pathway for Certificate of Added Qualification in Amputation Prevention and Wound Care!

The American Board of Podiatric Medicine has announced a third pathway for its diplomates to achieve a Certificate of Added Qualification (CAQ) in Amputation Prevention and Wound Care.  Now ABPM diplomates who have an office-based practice can be eligible to sit for the CAQ exam by submitting 10 wound care cases for review by the committee.  Previously, the only way to be eligible to sit for the CAQ exam was to either have completed a CPME-approved fellowship in limb salvage or wound care, or have documented 1000 hours of wound care experience in a hospital setting.

Lee Rogers, DPM and Chair of the CAQ Sub-Committee, stated “This new pathway gives ABPM Diplomates the opportunity to demonstrate their limb salvage and wound care knowledge by obtaining a CAQ”.

Diplomates should be mindful of specific deadlines associated with the third pathway.  To allow for the full case submission process, those diplomates interested in testing in this cycle using the case review pathway should submit their applications and cases no later than November 20, 2018. For those not submitting cases, the application deadline is December 14, 2018. 

For more information regarding the ABPM CAQ in Wound Care and for all deadlines, examination dates and applications, please visit https://www.abpmed.org/pages/exam-info/caq-amputation-prevention.

Note: The CAQ in amputation prevention and wound care is issued solely by the ABPM to its diplomates.  The Joint Committee on Recognition of Specialty Boards (JCRSB) of the Council on Podiatric Medical Education recognizes the certification process of the ABPM but has not developed a recognition process for certificates of added qualification.  Therefore, at this time the ABPM’s recognition by the JCRSB does not extend specifically to the CAQ

The American Board of Podiatric Medicine (ABPM) offers a comprehensive board qualification and certification process in podiatric medicine and orthopedics. Increasingly hospitals, surgical centers, managed care organizations and insurance carriers require board certification. ABPM is the only board recognized by the Joint Committee on the Recognition of Specialty Boards, under the authority of the American Podiatric Medical Association to certify in podiatric orthopedics and primary podiatric medicine.

ABPM Diplomate, Dr. Stephanie Hook, Elected to the NYSPMA Board of Trustees

Stephanie Hook, DPM

Stephanie Hook, DPM

“I have always had a heart for moving our profession forward. Being elected to the NY State Podiatric Medical Association Board of Trustees is a huge honor and opportunity,” said the newly elected Board of Trustees member, Stephanie Hook, DPM.

As a member of the Board, Dr. Hook will help their mission of supporting excellence in the practice of podiatric medicine and surgery by creating awareness of the profession’s role and value.  This includes supporting lobbying efforts for podiatric related bills, particularly those striving for parity in the medical community, and ongoing work to promote public understanding of podiatry, the level of training required, and specific expertise podiatrists can provide in overall health. She will also serve on the Insurance and Legislative Affairs committees and chair the Awards committee.

Dr. Hook has known since she was a teenager that she wanted to be a podiatrist. “I always knew I wanted to be a doctor, but after having a podiatric procedure when I was in high school and in observing what they did and learning about the profession, I knew then and there that I wanted to be a podiatrist. I know that is pretty young, but I just knew.”

She attended the Ohio College of Podiatric Medicine (now called Kent State University College of Podiatric Medicine) and did her residency at Sisters of Charity Hospital/Catholic Health System in Buffalo.  “I picked my residency pretty much based on the informal conversation I had with the residency director at the reception during the more formal interview weekend. I was the only one at the reception, which ended up being a great way for me to learn a lot about the residency led by Dr. Joseph Anian.  “I remember liking what he said both about the program and life outside the residency.”   For Dr. Hook it ended up being “a great experience.”   “We were part of the program for all residents and were not singled out as the ‘podiatry residents,’ which I have heard can sometimes happen at some institutions.”

Both in school and during residency Dr. Hook was involved in the State Associations and advocating for the profession.  “I think achieving parity and continuing to establish standards for all states is an ongoing process,” stated Dr. Hook, “but one that also needs ongoing attention and support.”

Dr. Hook worked in a podiatric practice for eight years before moving to Syracuse Orthopedic Specialists (SOS), an orthopedic practice near her home in Nelson, NY.   “I love my job,” she says.  “This is exactly the kind of practice I wanted to be part of.  It is collaborative, ethical, we provide our patients comprehensive care, and we treat our patients like they are family.  I love that I can refer cases to other in-house orthopedists and vis versa.”  One of the things Dr. Hook loves best is that this practice has opened her up to a variety of different cases ranging from sports medicine to diabetic foot care to being a part of the Acute Limb Salvage team at St. Joseph’s Hospital.  SOS is comprised of 31 orthopedic physicians and podiatrists, Dr. Hook was the first woman to become part of this practice.  “While I am proud to be part of the group, I don’t like to single out the gender piece, because I am just one of the team.”

Dr. Hook explains that her group is very active in the community providing trainers for local high school sporting events and tournaments, participating in local health fairs where she has been able to lecture about foot health, as well as sponsoring several community events and charities. “It was important to me to be part of an active and caring group,” she explains.

Shortly after completing her residency, Dr. Hook became ABPM certified. “I think it is really important that podiatrists get certified as early as possible because patients and practices are looking for that credential,” said Dr. Hook.  “Nearly every day I hear patients say, ‘I looked you up online and saw that you had your board certification, etc.’ – it’s not just a nice-to-have anymore.”  Dr. Hook selected the ABPM certification because she felt it was the most comprehensive. “In my opinion, it is much more well-rounded and demonstrates your understanding of biomechanics, medicine and surgery – not just biomechanics and medicine as it relates to surgery.”

While Dr. Hook sees the future of podiatry as very promising, she says she also knows there are pockets within all healthcare professions where financial gain can compromise integrity and optimum patient care. She wants to remind all those entering the field that if you do what you love (as cliché as it may sound) the financial rewards will be there – and be there honestly.   This is something she is very passionate about.   “Follow your heart, do what you love, and you will end up doing the right thing for yourself, your patients, your family and your lifestyle,” she shared.  “We are lucky to be in a profession where we can make choices about our day and the kind of life we want to lead.”

Dr. Hook enjoys sports, photography, travel and spending time with her husband, stepdaughter, and three dogs.  She is also proud to be a part of the DPM Mentors Network.  Enjoy more about Dr. Hook in one of the Syracuse Orthopedic Specialist videos.

Clinical Presentation Series: Forming a Differential Diagnosis

By: Dr. Nicole DeLauro, Director, ABPM

A healthy 30 year old male presents with right forefoot pain present for two weeks. The patient is an avid runner, and runs approximately 3 to 5 miles a day. He describes the pain as aching and throbbing. The pain continues throughout the day. He does have relief when resting. He has tried to abstain from running and admits to changing his shoes. He has had minimal improvement. He denies any other treatments.

What is your diagnosis?

As physicians we are forced to be investigators. We have to ask the correct questions regarding the complaint, form a diagnosis, and provide a treatment plan. To do this, we need to formulate a “differential diagnosis.”

The differential is a list of potential diagnoses compiled based on the complaint. It is important not only to determine the best treatment plan but also to treat patients in a timely fashion. The differential helps to narrow down more than one probable cause for the patient’s pain. Your differential can be based on the well known acronym, “NLDOCAT.” What is the nature and characteristic of the pain? Is it burning, shooting, aching, dull, etc? This helps you determine if it’s arthritic, neurological, vascular or musculoskeletal in nature. Once we know which system in involved, focus on the location. What structures are in the area? What nerves, tendons, ligaments, bones, and/or joints are located there? Does it radiate to any surrounding area? The duration of the pain helps decipher if it is an acute complaint secondary to potential trauma or chronic in nature. What makes the pain better or worse? Is it aggravated by activity or rest? Better in or out of shoes? Worse at the beginning or end of day? Does shoe gear alleviate or aggravate the pain? What treatments has the patient tried and has there been any improvement?

Once you have the answers to these questions, the differential is easy to devise. This methodical approach will help you avoid pitfalls and provide better care for your patients. Based on this approach, what differentials do you have in mind? You should be thinking about stress vs. occult fractures, bursitis, metatarsalgia, tendonitis, sprain, and even neuroma. The symptoms can also be aggravated by the patient’s foot type, biomechanical gait pattern,  and even improper shoe gear.  Further questioning, clinical examination, and diagnostic studies will help to lessen the amount of differentials and ultimately attain a definitive diagnosis.

As a young physician, you have the tools to alleviate complaints based on your final diagnosis and gain a patient’s trust and confidence in your care. Your patients will have done their own research before they walk through your door, and expect a certain quality of care. In order to constantly exceed these expectations, you must maintain the highest level of expertise and excellence within the profession. Having  a methodological approach towards your evaluations, and being board qualified and/or certified upholds this level, and informs your patients that you have been tested and challenged extensively within your specialty. This message, when conveyed to patients will solidify their confidence in you as their physician and create a lasting doctor-patient relationship.

 

 

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