California Podiatric Physician July/Aug/Sept 2013

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California Podiatric Physician The

J u ly | Au g u s t | S e p t e m b e r | 2013

THE

PRESIDENT’S MESSAGE P r e s id e n t M c A l o o n ’ s I n a u g u r a l A dd r e s s Friends, Delegates, Board of Directors, and honored guests:

our school of podiatric medicine, the CPMA is our Association and our professional family.

I am embraced by your trust, confidence and enthusiastic support. I am uplifted by your passionate and committed Board of Directors and staff, and I am guided by those of you among us who have been where I am going. I am looking forward to a challenging and fulfilling term as CPMA President which may very well stand out to be the highlight of my career as a doctor of podiatric medicine.

As we have heard here today, none of us can meet the challenges of this complex and transformative healthcare environment alone. It is our duty to prepare and assist CPMA members so that they may thrive in the changing healthcare environment. It is together, with all of the experience, innovation, passion, and skill that each of us can contribute that we will ensure that the practice of our specialty continues to be rewarding and fulfilling.

This to me is very clear: the California Podiatric Medical Association is THE association for every student, resident, and doctor of podiatric medicine in California. It is our obligation to provide resources and value for ALL. Private practice or medical group; owner or associate; employee or independent contractor; federal service or faculty; clinician or administrator; new practitioner or approaching retirement; regardless of our residency training, our board status, or

See PRESIDENT’S MESSAGE on Page 7

WESTERN WOWS AGAIN! over 150 vendors displaying the latest technologies, tools and techniques in modern surgery, medicine and management.

The nearly 1,100 attendees of The 2013 Western Foot and Ankle Conference (The Western) were enthusiastic, enthralled and excited by the vast variety of fresh, dynamic lectures, innovative instructional courses, cutting-edge hands-on workshops, and the world class exhibit hall that featured

While attendees’ days were filled with numerous educational and networking opportunities, there was time in the afternoon and evening for fun with family and friends to stroll, shop and dine at the Disneyland Resort’s vibrant Downtown Disney district, or head over to check out the latest rides and entertainment at Disneyland and Disney’s California Adventure theme parks, for which Western

conference attendees received deep discounts on park passes. Plans are already on the drawing board to make the 2014 Western BIGGER and BETTER than ever. Mark your calendar and plan to attend THE podiatric surgery, medicine and management meeting of the year June 19-22, 2014.

- In This Issue Lessons from Disney Employment Laws: Forget Me Not 21 Management 25 T D B , PMAC, XT C. K G , E . ina

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Essentials of Practice Management Saturday, November 16, 2013 • 8:30 am - 5 pm California School of Podiatric Medicine at Samuel Merritt University Health Education Center 400 Hawthorne Avenue • Oakland, California 94609 Co-sponsored by: California Podiatric Medical Association California School of Podiatric Medicine at Samuel Merritt University

Announcing Essentials of Practice Management, a one-day seminar for doctors of podiatric medicine and medical assistants. Specialists will present topics of interest to podiatric physicians, office managers, staff, and technicians to help you enhance, build, and earn from your practice. Bring your questions and get answers from the experts!

Plus, visit exhibits and stay for a complimentary wine and cheese reception after the meeting for more time with the speakers and exhibitors.

Program Keynote Address Jon A. Hultman, DPM, MBA The Impact of ObamaCare on Your Practice Harley Schultz, MD, MBA How to Get Paid for Professional Services in the Changing Landscape of Healthcare Reform Franklin Kase, DPM Clinical Scenarios – Coding Solutions Q&A Harry Goldsmith, DPM Building a Specialty Focused Practice Timothy G. Dutra, DPM, MS Marketing Your Practice Rem Jackson Tina C. Del Buono, PMAC, XT

Registration All communication regarding Essentials of Practice Management coming from CPMA or exhibitors who purchase registrant data will be sent to the contact information given below. CPMA Member pricing is for CPMA members and podiatric medical assistants or office managers working for CPMA members. Non-Member pricing is for all other registrants. Regular Late 8/31-10/11 10/12-11/8 __________________________________________ m CPMA Member $199 $229 Last Name First Name m Non-Member $399 $429 __________________________________________ Name of Company/Office ________________________________________________________________________________ Mailing Address ________________________________________________________________________________ City, State Zip ________________________________________________________________________________ Daytime Phone Email Additional office staff Discount of $50 applies to each additional staff member from the same office if registering at the same time. __________________________________________ (Subtract $50 from rate above) $______________ Last Name First Name __________________________________________ (Subtract $50 from rate above) $______________ Last Name First Name __________________________________________ (Subtract $50 from rate above) $______________ Last Name First Name Payment Total: $______________ m Check enclosed payable to CPMA m Visa / Master Card / Discover m American Express _______________________________________________________________________________ Credit Card Number Exp. Date (mm/yy) Security Code _______________________________________________________________________________ Cardholder’s Name Cardholder’s Signature Date _______________________________________________________________________________ Credit Card Billing Address if Different from above Mailing Address

Mail CPMA, 2430 K Street Suite 200, Sacramento, CA 95816 Fax (916) 448-0258 Email jsteed@calpma.org Cancellation Policy All registration cancellations must be supplied in writing by mail, fax, or email (jsteed@calpma.org) and received by Friday, October 11, 2013 to receive a full refund. No refunds will be issued on or after Friday, October 11. Refunds are not granted to no-shows. Additional Notes Registration policy is first come, first served. Late fee begins Saturday, October 12. Pre-registration ends Friday, November 8, 2013. Payment must be received to secure registration. No onsite registration will be available. Returned checks may incur service charges. If written confirmation is not received, please call CPMA at (800) 794-8988 to confirm registration.

Hotel Info

A block of rooms is reserved for exhibitors and attendees of Essentials of Practice Management. These rooms will be available at the special rate or $99 Single or Double until October 25, 2013. Please refer to Essentials of Practice Management when making a reservation. Hilton Garden Inn • 1800 Powell Street • Emeryville, CA 94608 • 510.658.9300


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October 9th is National Walk to School Day

NOVEMBER IS NATIONAL DIABETES Awareness MONTH Diabetes is a Family Affair Diabetes is a challenging disease that affects the entire family in many ways. If you are living with diabetes or have a loved one with the disease, family support is very important when it comes to managing diabetes and preventing serious health problems. It’s also important to know that if you have a family history of diabetes – such as a mother, father, brother, or sister – you are at risk for developing type 2 diabetes. “Because diabetes can run in the family, it’s important that families discuss the disease and its warning signs,” said Dr. Carolyn McAloon, President of the California Podiatric Medical Association. “Family members can also ensure a person with diabetes maintains a proper diet, increases exercise, performs daily foot inspections and keeps a positive outlook.” The number of people that have diabetes continues to grow. Over 6 million people are afflicted with the disease and don’t even know they have it! An early diagnosis is critical to help control this epidemic. The warning signs of the disease can often appear first in the feet. Check your feet regularly for the following diabetes signs and symptoms: • Numbness

• Redness

• Tingling sensations

• Burning sensations

• Loss of hair

• Cuts and scrapes that are slow to heal

J u ly | Au g u s t | S e p t e m b e r | 2013

If any of these symptoms are present, CPMA recommends visiting a podiatric physician immediately. Podiatric Physicians are foot and ankle specialist and are more readily able to detect abnormalities in the foot that may be a precursor to systemic diseases like diabetes. Diabetes is not a disease to face alone. Talk with your family members to learn about their history with the disease. By working together, you can stay a step ahead of diabetes. | 5


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PRESIDENT’S MESSAGE from Page 1

I have the incredible good fortune of succeeding my friend, Dr. Karen Wrubel, as president. I have not witnessed a more gracious leader. I have seen no president do more to mentor and encourage her successor than Karen has done for me. And not just for me. Karen has given every Board member opportunities to do more than we knew we could. She has held the bar high for all of us, herself included. She has made sure that, as Ben Franklin said, “Well done is better than well said.” She taught us to take ownership of our own good ideas and see them through to completion, not giving up just because it was difficult or there were obstacles. She made sure that we did what we said and said what we did. And when we did, she would take a step back and let us have the spotlight all to ourselves, even though we would have not been there without her. This entire Board of Directors is rowing in the same direction. As Karen and I trade seats today, we will know that we have done well if the boat hardly rocks at all as we continue forward with our efforts. So what are those efforts by which we will achieve our vision to be THE association for all California podiatrists? 1) We are committed to ensuring value in membership for every California podiatrist. The 3 Muses of CPMA, Andrea, Althea, and Jeannette, are committed to the members of our association. These 3 women are an incredibly hard working team lead by our multi-talented Executive Director, Dr. Jon Hultman, who moves us ahead while always watching our back. No matter how busy they are on our behalf, they find a way to get one more thing done before an impending deadline. They are committed to providing value for all of us 24/7, not 9 to 5. We will be led in this effort to provide valuable member services by incoming Member Services Committee Chair Dr. Diane Koshimune and Board Member Dr. Rebecca Moellmer who have today laid out their vision and strategies for the upcoming year to provide even more value to better serve our current members and recruit new ones. 2) We will continue to promote our members and our specialty with engaging, innovative, and informative media placements and the increased use of social media. Our incoming Communications Committee chair Dr. Jay Sung and Board Member Dr. Jonathan Uy have been incredibly prolific these last few months in writing press releases and posting to our website and Facebook page. [If you haven’t already, be sure to “like us” on Facebook www.facebook.com/calpma.] I am sure that you have been, as I have, impressed with the diversity and depth of the topics of our articles and posts. The Committee is producing both outstanding clinical and political press releases to profile our members involved in both patient care and advocacy. 3) We will remain vigilant in protecting and advancing our specialty with the implementation of the Affordable Care Act here in California. Monitoring the incredible volume of healthcare legislation is the impressive charge of our Governmental Affairs Committee led by Chair Dr. Tom Tanaka and Board Liaison Dr. Ami Sheth. Yes, when the rest of us are sound asleep, these 2 and their tireless Committee are combing through bills to keep the world safe for J u ly | Au g u s t | S e p t e m b e r | 2013

podiatry! These superheroes are writing position statements for the bills that most affect us and are looking for opportunities to be proactive rather than reactive as our state moves ahead as the poster child for the implementation of the Affordable Care Act. We are committed to advocating for both our members and the patients we serve. We each have a duty to serve the greater good by making sure our voice is heard by our own legislators, so that collectively we can make a difference. Each of us is called to contact our elected representatives via e-advocacy, and I am looking forward to all of us gathering together in Sacramento on March 5th for our Legislative Leadership Conference. 4) We will work to increase our non-dues revenue so that we can provide greater value without raising our dues. Nurturing our corporate relationships and developing new opportunities is what gets our President-Elect Dr. Tom Elardo and Board member Dr. Devon Glazer excited. They are committed to making sure that we can provide extensive member resources without raising our dues! The Western Foot and Ankle Conference is our largest source of non-dues income. Conference Chair Dr. Jon Labovitz and Science and Education Committee Chair Dr. Shannon Rush ensure that The Western is both a financial and educational success every year. This event is an amazing member benefit as we can earn all 25 of our annual CECH and our 10 Radiology CECH hours at this one conference. Shannon has been a oneman membership drive as he recruits our best and brightest to renew their CPMA membership and lecture at this prestigious conference. 5) We will continue to work to ensure that all Californians, especially the most vulnerable among us, have access to our services. This has been the commitment of Director Dr. John Chisholm even before he joined the Board. As chair of our Medi-Cal Committee, he is ever vigilant that CPMA remain mindful of protecting all of our patients’ rights to healthcare access. We will continue to advocate on behalf of our patients for the sensible expansion of Medi-Cal. We will also continue to create and provide resources to help members thrive in an environment of an expanded Medi-Cal population. We are working at both the state and federal level to reinstate podiatry services in Medi-Cal and we are also working to ensure that our members who provide emergency care for these patients are not required to do so without reimbursement. 6) The implementation of Vision 2015 here in California is the Physician and Surgeon Joint Task Force. Our goal is to achieve parity with our MD and DO colleagues. Our past presidents Drs. Steve Wan and Mike Cornelison are not only visionaries, but incredibly willing and able to do the hard work necessary to see that this vision becomes a reality. Fulfillment of this objective will need the participation of many of us, particularly those of us employed at multi-specialty medical groups where we have the same responsibilities as other physicians and surgeons without all of the benefits. I would argue that obtaining the physician and surgeon See PRESIDENT’S MESSAGE on Page 9

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PRESIDENT’S MESSAGE from Page 7

certificate will do more to improve the daily working conditions and income of those who work side by side with physician partners in medical groups than it will for those of us in private practice. Our state’s other medical associations have leaders from large medical groups. The president of the California Medical Association, Dr. Paul Phinney, who addressed us earlier today, is a Kaiser Permanente pediatrician, for example. I would like to see more of our own doctors from these groups provide leadership for our association as well. CPMA has the vision to be THE association that serves and enhances the professional life of ALL California podiatrists, and we have developed the strategies and aligned the right people to make this vision our reality. We are responsible not only for helping our members cope with the inevitable changes that affect our specialty, but also to set the direction of where those changes will take us. The only way to predict our future in healthcare is to create it ourselves. Our relationships with others who are aligned with us are critical, as together we build our future. Collaborating with my fellow Presidents has been particularly rewarding and fruitful. At both our leadership dinner meeting last night and during his address to us here today, California Medical Association President Dr. Paul Phinney emphasized that our differences are less than our similarities and that he is committed to our joint task force collaboration during his term and beyond. Two weeks before this House gathered, the President of the California Orthopaedic Association Dr. Leslie Kim and I met and shared our vision on how our associations can forge a more collaborative relationship. We plan to meet several more times this year, and I hope that he may be able to join us all at the HOD next year. In February, I met with ACFAS President Dr. Jordan Grossman and his Board of Directors. He is very excited about what we are doing here in California, and his Board recognizes the national implication of our efforts with their financial support. Of course as a state component president, my relationship with our APMA President Dr. Matt Garoufalis, who is here with us today, is one that is particularly close. Matt and I met last year here at The Western when we were both President-Elect, and we have communicated throughout this past year. Matt has been committed to supporting us here in California. He has made more than a few trips out here in the last 12 months! Thank you, Matt. I am grateful for both your friendship and your leadership. The President of Samuel Merritt University, Dr. Sharon Diaz, has joined us today, which reveals the depth of her engagement with our specialty. Our ongoing collaboration with and support of both of our schools is critical to our vision. Here in California, we are the only state to be the home of 2 schools of podiatric medicine. I have spoken with both of our distinguished Deans, Drs. John Venson and Larry Harkless, to renew our commitment of being a valuable resource to them as they carry out their mission of educating our students of podiatric medicine and preparing them for residency training. Our ongoing relationship with the Teamsters provides value for our members. It was due to our alignment that we were able to obtain a non discrimination clause in the ACA implementation J u ly | Au g u s t | S e p t e m b e r | 2013

regulations here in California. The Teamsters have also made significant annual contributions to our Physician and Surgeon Task Force fund. Of course our most vital relationship is the one we have with each other. The highlight of my year as President-Elect has been the opportunity to begin my society visits. Thank you to those societies I have visited so far on my listening tour where I was so warmly received. I am looking forward to visiting the rest before the end of this year. As every president before me has surely appreciated, you have a duty to do as much as you can with the 12 months that you have been given AND a duty to identify and mentor those who will lead us from here. It is this that I hope will be my legacy - that I leave the association in the hands of well prepared leaders so that when it is time for me to step off this dais graciously that I leave you well. They do not know it yet, but… I do have some plans for engaging your Board in leadership training at our next meeting and throughout the year. I am grateful to this hard working Board, and I am looking forward to a successful year together. So this is the time in every new President’s speech when you must indulge us as we thank the ones we love for the sacrifices that they have made that allow each of us to stand here before you - and so as not to disappoint you, I will be no exception… My family: my husband, Mike Smith, who is an incredibly hands-on Dad - dinner, homework, baseball, and dance class - he does it all, so that I can do this. Our children, Andrew and Megan, who think all of this is normal and will never be able to come back to Disneyland as regular people again! I am blessed. Having Mike as a husband allows me to be everything that I was meant to be: wife, mother, podiatrist, and now your president. Thank you, my love. My practice: You all know my partner, Dr. Alex Reyzelman, who is a member of the Committee that brings us the outstanding educational content at this meeting. I must thank him and also our associates back home holding down the fort - Drs. Naleen Prasad and Ciaran Jacka and our dedicated, hardworking staff at Bay Area Foot Care - for allowing me the time away from the office to do the work of the association. My friends and classmates - it means so much to have you here today. My home society: Alameda/Contra Costa where it all started. Your constant support and encouragement over these past 14 years has brought me here today, and I hope to make you all proud. And so many of you here have played an important role in me being here today, and I thank you from my heart. Delegates: thank you for electing this incredibly smart, passionate, capable, and committed Board of Directors. It is an honor and a privilege to serve you with them. Along with your society presidents, please bring home all that you have seen and heard today and share it with your members. Thank you for allowing me to serve our specialty in this incredibly meaningful way. In closing I would like to say to you all the same thing that I say to my pre-operative patients: I cannot guarantee you a result, but I can guarantee that I will give you my very best. Thank you.

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Congratulations

2013 Awards

Society President of the Year Vladimir Zeester, DPM President’s Award C. Keith Greer, Esq. Executive Director Award Bradley Bakotic, DO, DPM Humanitarian Award Holly Spohn-Gross, DPM Step-Up Award Diane Koshimune, DPM

CalPPAC Awards Society with Highest Total Contribution Los Angeles County Podiatric Medical Society Societies with Highest Number of Members Contributing Alameda Contra Costa Podiatric Medical Society Society with Highest Contribution per Member Santa Clara Valley Podiatric Medical Society Honorable Mention Orange County Podiatric Medical Society

Communication Awards Service-Above-Self Karen Wrubel, DPM

GOLD – Orange County SILVER – LA County Bronze – San Diego

western sponsors diamond Bako Integrated Physician Solutions Wright Medical Technology, Inc.

gold DermaTran Health Solutions, LLC Formula 3 Shire Regenerative Medicine, Inc.

silver Anacor Pharmaceuticals, Inc. Arthrex, Inc.

bronze Amerx Arthrosurface Bard Peripheral Vascular KCI Matrix Biosurgical ProLab Orthotics, USA Stryker Orthopaedics Vilex

copper Bioventus, LLC Solana Surgical, LLC

program Performance Materials Podiatry Insurance Company of America Smith & Nephew Wound Management J u ly | Au g u s t | S e p t e m b e r | 2013

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McAloon Elected CPMA President Carolyn E. McAloon, DPM was installed as the 2013-2014 president of the California Podiatric Medical Association (CPMA) during the organization’s annual House of Delegates held in Anaheim in June. A podiatric physician, Dr. McAloon is in private practitioner with offices in Castro Valley and Dublin, California. In addition to her private practice, Dr. McAloon is also an adjunct clinical assistant professor in the Department of Podiatric Medicine at the California School of Podiatric Medicine at Samuel Merritt University, Oakland, California. A member of CPMA since 1997, Dr. McAloon has served in a number of leadership roles, including President-Elect, Vice President, Secretary/Treasurer, and Director-at-Large of CPMA. A member of the California delegation to the American Podiatric Medical Association Annual House of Delegates and Leadership Conference, Dr. McAloon travels to Washington, DC annually to proactively support podiatric physicians and their patients on the national level. Before being elected to the CPMA Board of Directors in 2007, Dr. McAloon served as president of the Alameda/Contra Costa County Podiatric Medical Society from 2002-2004 and received the Association’s 2004 Society President of the Year for her outstanding leadership. In 2007 she was the recipient of the Dr. Milton Wolfson Memorial Scholar of the Year, in recognition of contributions to primary care podiatric medicine. In 2009 Dr. McAloon was appointed to California’s Legislative Task Force on Peripheral Neuropathy, and in 2010 she was awarded The Gary P. Bianchi, DPM Award for her Outstanding Dedication to the California School of Podiatric Medicine (CSPM), its students, graduates and friends. In addressing the nearly 200 podiatric physicians, residents, students, and guests present at the 2013 CPMA House of Delegates, Dr. McAloon called on her colleagues to “take hold of the reins” and lead change rather than merely follow. “We owe it to our patients, the public, and our profession to be leaders in health care reform, not merely followers, and to create a better future that we help design and implement,” she said to the attentive, enthusiastic crowd.

Dr. McAloon earned her Bachelor of Arts degree in Psychology from the University of California at Berkeley. She received her medical training at the California College of Podiatric Medicine (CCPM) in San Francisco, where she earned her Doctor of Podiatric Medicine (DPM) degree. After receiving her DPM degree, Dr. McAloon completed both her primary podiatric medicine and surgical residencies at the Veterans Affairs Palo Alto Healthcare System in Palo Alto, California. A Fellow of the American College of Foot and Ankle Surgeons (ACFAS); A Fellow of the American Professional Wound Care Association (APWCA) and a Diplomate of the American Board of Podiatric Surgery (ABPS), Dr. McAloon is board certified in foot and ankle surgery. “A unique aspect of my profession is that you practice both medicine and surgery. Podiatric physicians (podiatrists) are the foot and ankle specialists, so on any given day I practice sports medicine, diabetic medicine, radiology, dermatology, neurology, infectious disease, surgery, pediatrics, and geriatrics,” said Dr. McAloon, who is a highly sought after lecturer and spokesperson for both the American and California Podiatric Medical Associations, and is frequently selected by the media for information, articles and programs pertaining to foot health and well being. Dr. McAloon resides in the East Bay with her husband Michael and their two children Andrew and Megan. Also serving on the 2013-2014 CPMA Board of Directors: President-Elect, Thomas J. Elardo, DPM, Los Gatos Vice President, Ami A. Sheth, DPM, Los Gatos Immediate Past President , Karen L. Wrubel, DPM, Hawthorne Secretary/Treasurer, Rebecca A. Moellmer, DPM, Pomona Director-at-Large, John A. Chisholm, DPM, Chula Vista Director-at-Large, Devon N. Glazer, DPM, Mission Viejo Director-at-Large, Thomas J. Tanaka, DPM, Ontario Director-at-Large, Jonathan J. Uy, DPM, Hercules Director-at-Large, Mark A. Warford, DPM, Fair Oaks

WARFORD STEPS UP TO CPMA DIRECTORSHIP Mark A. Warford, DPM, of Fair Oaks, California, was elected as a Director-at-Large to the Board of Directors of the California Podiatric Medical Association (CPMA) during the organization’s Annual House of Delegates this past June in Anaheim, California. A Past President of the Sacramento Valley Podiatric Medical Society, for which he received CPMA’s 2012 Society President of the Year, Dr. Warford is active in the podiatric medical community having served on a number of the Association’s committees, and volunteered in numerous capacities, including the Western States 100 Footrace podiatric aid station, where he volunteered for nearly a decade. Warford received an Associates of Arts degree in Liberal Arts and J u ly | Au g u s t | S e p t e m b e r | 2013

Science from the College of Marin. He received a Bachelor of Arts in Biology from San Francisco State University. He received his medical training and Doctor of Podiatric Medicine (DPM) Degree from the California College of Podiatric Medicine (CCPM) in San Francisco, California. He completed his residency training at Pacific Coast Hospital. Dr. Warford is a private practitioner with offices in Fair Oaks and Sacramento, California. He resides in West Sacramento with his wife Suzanne and a number of 4-legged dependents. | 13

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CPMA Celebrates Women in Medicine Month CPMA salutes September’s Women in Medicine Month to recognize and celebrate the growing number and influence of women doctors in the profession and their communities

Carolyn E. McAloon, DPM President

Karen L. Wrubel, DPM Immediate Past President

Ami A. Sheth, DPM Rebecca A. Moellmer, DPM Vice President Secretary-Treasurer

The California Podiatric Medical Association (CPMA) is a leader in the recognition of the important role of women in medicine.

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excellence!

CPMA Executive Director Jon Hultman, DPM, MBA (r) presents the 2013 Executive Director Award to Bradley Bakotic, DPM, DO

Director Rebecca Moellmer, DPM presents Diane Koshimune, DPM (l) with the 2013 Step Up Award

Daniel Fulmer, DPM (l) presents James Stavosky, DPM with the CSPM Alumni and Associates’ Past President’s Award 16 |

President Carolyn McAloon presents Immediate Past President Karen Wrubel, DPM (l) with the 2013 CPMA Service-Above-Self Award

President Wrubel presents Vladimir Zeester, DPM, President of the Los Angeles County Podiatric Medical Society, with the 2013 Society President of the Year Award

CPMA Society Newsletter Awards were presented by Director Rebecca Moellmer, DPM (far right) Gold: Orange County accepted by Cheryl Strich, DPM; Bronze: San Diego County accepted by Kenneth Charp, DPM; and Silver: Los Angeles County accepted by Gabriel Halperin, DPM C PM A | C a l if o r n ia P o diat r ic M e dica l A s s o ciat i o n


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James Christman (center) receives the CSPM Alumni and Associates’ Philip Gardner, DPM Award from Daniel Fulmer, DPM (r) and James Stavosky, DPM (l)

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Director Ami Sheth, DPM presents Holly Spohn-Gross, DPM with the 2013 CPMA Humanitarian Award.

CalPPAC Chair Derick Ball, DPM (far right) presents the 2013 CalPPAC Awards: Valdmir Zeester, DPM accepts for Los Angeles County (Highest Total Contribution); Adam Howard, DPM accepts for Santa Clara Valley (Highest Contribution per Member); Timothy Dutra, DPM accepts for Alameda/Contra Costa, (Highest Percentage of Members Contributing) and Cheryl Strich, DPM accepts for Orange County (Honorable Mention)

Bradley Bakotic, DPM (center) is presented CSPM Alumni and Associates’ Heather P. Barton, JD Award by Dr. Daniel Fulmer, DPM (r) and James Stavosky, DPM

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C. Keith Greer, Esq. is presented the 2013 President’s Award by President Wrubel

Ronald Jensen, DPM (center) is presented CSPM Alumni and Associates’ Gary P. Bianchi, DPM Award from Daniel Fullmer, DPM (r) and James Stavosky, DPM (l) | 17



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CPMA Members Get More For Their Money: Get Your $avings On!

Save 15% on AT&T wireless services and products

Save up to 30% off Dell computers

Save up to 25% off Alamo, Avis, Hertz, National, Budget and Enterprise Rental cars

Save on theme parks, sporting events and movie tickets

Save on vacation travel, flowers, books and MORE!

For details visit the Member Benefits page at CalPMA.org J u ly | Au g u s t | S e p t e m b e r | 2013

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Management Lessons from Walt Disney The Western is a great conference that we look forward to each year. Not only do we have the opportunity to continue our education as physicians and assistants, but we also have the opportunity to gain wisdom from the great management lessons of Walt Disney as we watch his employees in action. If you have never had the opportunity to read any of the management books about Walt Disney, you might want to do so. The Disney properties have excelled in guest service from the day they opened. Walt Disney believed that every detail of each project he did was important. It is the details that catch the interest of its guests. Walt Disney was an amazing person and his insight into what people wanted and what it would take to keep them coming back is above any other. Let’s take a look at a few of Disney’s lessons that he has perfected to see how we might apply them to our practices to keep our “guests” happy and wanting to come back to see us. These lessons being shared come from the book “Inside the Magic Kingdom: Seven Keys to Disney’s Success” by Tom Connellan. No matter what type of business you work in, you will have competition for customers, clients or patients. The competition is anyone that the customer compares your business with. The key to winning customers to your business over others is service.

Lesson 1: Understanding your competition • Recall a situation where you were very impressed with the level of service you received. How did it raise your expectations of other company’s service? • How does your practice’s service compare to the best service you have received from businesses you patronize? • Do you know who your direct competitors are? • Who else might your patients compare your business with? • What do the answers to the above questions suggest about how you might change the way you do business? Take the time to thoroughly evaluate the above questions and your answers. Doing this as a team will give you many different points of view, so you may begin seeking how to change the way you serve your patients. Knowing who and how your competitors serve their patients will give you an edge to begin with. The key is your practice needs to exceed the service that patients get from your competitors. Lesson 2: Pay fantastic attention to detail • What details get in the way of your practice being easy to do business with? • What details could be improved to keep your patients coming back? • Ask your patients what details they like or do not like when they use a business like yours. • What unexpected details could you add to your practice to attract customers? Put together a group of your own “Imagineers” and see what new details you can come up with to wow your patients so they will want to keep coming back. There is a mural outside of the Cinderella Castle at Walt Disney World illustrating scenes from Cinderella. The details are simply amazing and most guests never see all of them because there are so many. See walt disney on Page 23

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walt disney from Page 21

In one of the scenes there is a picture of Cinderella’s stepsisters, which most people do see, but what they do not notice is that the stepsister who was “green with envy” has light green blush on her cheeks and the other stepsister who was “red with rage” has red cheeks. It is little details like this that make the Disney properties so amazingly wonderful. Ask yourself: Is Disney-like attention to detail part of your company’s culture? If you knew that increased attention to some detail would improve customer loyalty, how much more attention would you be willing to give it? Lesson 3: Customers are best heard through many ears • How can the people of your workplace “put on their ears” to track patient satisfaction? • How could you make the process of gathering feedback more creative and fun? • Impact of immediate action is important, how can you quicken your response time to your patient’s needs? • What listening posts can you use to hear your customers? • How can you become more responsive to your patient’s needs? The Disney Resorts survey guests on a continual basis. They have several ways they do this. They feel that “guests are best heard through many ears”. Disney has what they call “super greeters” that roam the parks and ask guests to take surveys. Now since they all are trained to “walk the talk” they never have problems with guests not wanting to help out. The computer program for the survey uses Tinkerbell and other Disney characters to liven up the process. They have found that guests really enjoy participating in the surveys. They also use cast members in various positions throughout the park to keep their ears open to what guests are saying and report daily with any issues they may hear, such as a popcorn vendor who is asked for a grounds map and does not have them at his stand. If this request happens more than a few times, they make sure maps are made available.

Lesson 4: Everyone walks the talk • Think about the way people at your place of employment do their jobs. Could you adapt the “aggressively friendly” concept of Disney to your office environment? • How might you expand patient service from a chore to a wonderful tradition? • What does “walking the talk” mean at your place of employment? • How could you individually do an even better job of “walking the talk” at work? • How would a patient’s experience be different if everyone at your work “walked the talk”? Walt Disney had a dream to build a place for people to come and forget about the outside world. He accomplished that very dream. We can build practices for our patients that will make them forget about doing business anywhere else and enjoy the time they are in our offices. It just takes the time to listen to them and then acting upon what you hear. “You can design and create, and build the most wonderful place in the world. But it takes people to make the dream a reality.” ~ Walt Disney The Magic Kingdom is about fun and magic. It is every cast member’s job to make that happen with each guest encounter that they have. The average guest will have approximately 60 opportunities for these encounters with cast members during the day they are at the Magic Kingdom. Cast members are trained well to “walk the talk,” which means that they do not just talk about the magic. They help create it. It was Walt Disney’s idea that every cast member ensures that the magical experience happens for each guest when they visit the Kingdom. Cast members seek out opportunities to create those moments with their guests whenever they can. The culture of the Magic Kingdom is that everyone “walks the talk”, from accountants to Tinkerbell. It is the “magic” that connects Disney to its guests and keeps them coming back.

Disney also will send follow-up surveys to guests after they have returned home from vacationing at one of their resorts to get feedback, which is very valuable.

The Magic Kingdom is a unique, special place. Think about your practice; every time a patient comes in contact with your office there is an opportunity to create value. Take advantage of each opportunity and you cannot help but create a win with your patients.

It takes listening to your patients and documenting their feedback in order to see what they are looking for in your business.

“Do what you do so well that they will want to see it again and bring their friends.” ~ Walt Disney

Find Us on Facebook Like our Page: www.facebook.com/calpma Join or Group (CPMA Members Only): www.facebook.com/groups/calpma J u ly | Au g u s t | S e p t e m b e r | 2013

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EMPLOYMENT LAWS: FORGET-ME-NOT Under California law, employees are subject to mandatory break time and overtime regulations unless they are “managers,” and thus exempt. Failure to follow these regulations, even if unintentional, can result in severe penalties. Thus, it is important that you determine which of your employees are truly “managers,” and make sure that those who aren’t management comply with the break and overtime laws. In order to be considered a “manager,” an employee must: 1. Have primary responsibilities that involve managing the business; 2. Regularly direct the work of two or more other employees; 3. Have the authority to hire or fire other employees, or make suggestions regarding hiring practices that are given substantial consideration;4. Regularly exercise discretionary authority over job responsibilities; 5. Spend more than 50 percent of their time engaged in managerial duties; and 6. Earn a monthly salary equivalent to at least two times the $8.00 State minimum wage for full-time employment (i.e., make more than $2, 774 a month).

a “working lunch.” If an employer fails to give a proper meal break, the employee can recover one hour of pay at their regular rate of pay for each day they are not provided a proper meal break. There are exceptions to the rules regarding meal breaks. If the work day is less than six hours, the employee can waive the break. In some cases, an “on duty” meal break can be provided when job duties prevent the employee from being relieved of duty and if there is a written waiver agreement. The written agreement must state that the employee may revoke the agreement at any time.

If the employee does not meet each of these criteria, you must make sure that they are given the following benefits and privileges. Mandatory Overtime: Employees who work more than eight hours in any workday, more than forty hours in a work week or more than six days in a workweek, must be paid overtime. Specifically, wages one and one-half times the employee’s hourly rate must be paid for all hours worked up to 12 hours per day, beyond forty hours per week, or for the first eight hours on a seventh consecutive day in a workweek. The rate for overtime is double the hourly rate for hours above those hours. It is also important to note that employees must be paid overtime rates even if the overtime was not authorized. The policy behind this law is that an employer cannot accept the fruits of the employee’s labor without fairly compensating the employee. Thus, even express policies such as “employees will not be paid for unapproved overtime” are unlikely to withstand challenges in court if the employee worked overtime without permission. Mandatory Lunch and Meal Breaks: California law provides that employees must receive a 30 minute meal break if they work over five hours. During this break, the employee must be relieved of all duties. The law does not recognize J u ly | Au g u s t | S e p t e m b e r | 2013

Mandatory Rest Breaks: Employees must also get rest breaks if they work more than three and a half hours per day. These mandatory breaks must be in the middle of each work period and must be 10 minutes for every four hours worked or fraction thereof. Rest breaks are work time and the employee must be paid for them. If an employer fails to provide an employee a rest period, the employee can recover one hour of pay for each work day that the rest period is not provided. The obligation is on you, the employer, to make sure that these laws are complied with. And you will be the one penalized if you don’t. Thus, although well wishing employees may volunteer to forgo these privileges in an effort to “help the team,” in the long run their efforts may cause more harm than good.

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house of

DELEGATES A Gathering of Leaders

CPMA Executive Director Jon Hultman, DPM, MBA with CMA President Paul Phinney, MD, MSC

Members of the Los Angeles County Delegation: Robert Lee, DPM; Derick Ball, DPM; J. Scott Rosenthal, DPM

William Tarran, DPM, Immediate Past President

CPMA Past President s Roderick Farley, DPM and Lyman Wilson, DPM (l)

Derick A. Ball, DPM, Chair, CalPpac

Ami A. Sheth, DPM, Secretary-Treasurer

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Karen L. Wrubel, DPM, President

Members of LA Delegation: Erick Hubbard, DPM and Gabriel Halperin, DPM casting ballots

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San Francisco/San Mateo Delegation

Harry Goldsmith, DPM and Richard Green, DPM

Franklin Kase, DPM

Past President Stephen S. Wan, DPM

Philip Ward, DPM, Vice President APMA with CPMA Past Presidents Oliver Foster, DPM and Erick Hubbard, DPM J u ly | Au g u s t | S e p t e m b e r | 2013

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Michael J. Cornelison, DPM, CPMA Past President

Scott Tafuri, DPM, CPMA Past President ; Douglas Taylor, DPM and CPMA Past President Randall Sarte, DPM

Daniel Altchuler, DPM, CPMA Past President with Nedra Farley, CPMA Recording Secretary

Jon Hultman, DPM, MBA, Executive Director; Roderick Farley, DPM, JD, Parliamentarian and Karen Wrubel, DPM, President

Paul Phinney, MD, President, California Medical Association 28 |

2013 House Credentialing Committee: Adam Howard, DPM; Diane Koshimune, DPM and Neil Mansdorf, DPM

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Lawrence B. Harkless, DPM, Dean, College of Podiatric Medicine at Western University

Michael Zapf, DPM and Gabriel Halperin, DPM (l)

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Ronald Jensen, DPM, APMA and CPMA Past President with Philip Ward, DPM, APMA Vice President

CPMA Past Presidents: Stephen Wan, DPM and Lyman Wilson, DPM (r)

2013-2014 CPMA Board of Directors: Roderick Farley, DPM, JD, Parliamentarian; Rebecca Moellmer, DPM, Secretary-Treasurer; Ami Sheth, DPM, Vice President; Jon Hultman, DPM, MBA, Executive Director; Carolyn McAloon, DPM, President; John Chisholm, DPM, Director; Karen Wrubel, DPM, Immediate Past President; Jonathan Uy, DPM, Director; Devon Glazer, DPM, Director; Thomas Elardo, DPM, President-Elect; Thomas Tanaka, DPM, Director and Mark Warford, DPM, Director J u ly | Au g u s t | S e p t e m b e r | 2013

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Past Presidents Oliver Foster, DPM; Eric Hubbard, DPM with House Sergeant-at-Arms Donald Kuzyk, DPM

Dustin Corcoran, Executive Officer, California Medical Association

Nedra Farley with Bako representative Mandi McGill

Glenn Gastwirth, DPM, Executive Director, American Podiatric Medical Association

San Francisco/San Mateo delegates Maureen Lee, DPM and David Tran, DPM 30 |

Karen L. Wrubel, DPM, President (2012-2013)

CPMA Directors Devon Glazer, DPM and Rebecca Moellmer, DPM

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President Wrubel pins Immediate Past President William Tarran, DPM with Association’s Past President Pin

David Mullens, DPM, Chair, Foundation for Excellence in Podiatric Medicine presents Sharon Diaz, President of Samuel Merritt University, a check for $48,000 for the California School of Podiatric Medicine

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CMA President Paul Phinney, MD, MSC and CPMA Executive Director Jon Hultman, DPM, MBA

Members of CPMA Board of Directors: Carolyn McAloon, DPM; Jonathan Uy, DPM and John Chisholm, DPM

Carolyn E. McAloon, DPM, CPMA President 2013-2014

Oliver Foster, DPM; Joseph Hughes, DPM; Stephen Wan, DPM and Michael Cornelison, DPM

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Thomas Elardo, DPM, President-Elect (2013-2014) and Ernest Hook, DPM, CPMA Past President

CPMA General Counsel Keith Greer, Esq., chatting with Suzette Lee, DPM and CPMA Director Thomas Tanaka, DPM

John N. Venson, DPM, Dean, California School of Podiatric Medicine at Samuel Merritt University

Jon Hultman, DPM, MBA, Executive Director; Karen Wrubel, DPM, President; Thomas Elardo, DPM, President-Elect

Matthew G. Garoufalis, DPM, President, American Podiatric Medical Association

Neil B. Mansdorf, DPM, President, Board of Podiatric Medicine

C. Keith Greer, Esq., CPMA General Counsel 32 |

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Rockard J. Delgadillo, Chief Executive Officer, Los Angeles County Medical Association

John Chisholm, DPM, Director; Thomas Tanaka, DPM, Director, and Thomas Elardo, DPM, President-Elect

Philip Ward, DPM, Vice President, American Medical Association

CPMA Immediate Past President William Tarran, DPM is greeted by his fellow past presidents

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CPMA Thanks Bako for Its Generous Support of the 2013 House of Delegates William Henning, DO, Immediate Past President , Osteopathic Physicians and Surgeons of California J u ly | Au g u s t | S e p t e m b e r | 2013

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2013-2014 CPMA Board of Direc tors

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Carolyn E. McAloon, DPM, President

Thomas J. Elardo, DPM, President-Elect

Ami A. Sheth, DPM, Vice President

Karen L. Wrubel, DPM, Immediate Past President

Rebecca A. Moellmer, DPM, Secretary-Treasurer

John A. Chisholm, DPM, Director

Devon N. Glazer, DPM, Director

Thomas J. Tanaka, DPM, Director

Jonathan J. Uy, DPM, Director

Mark A. Warford, DPM, Director

Roderick D. Farley, DPM, JD, Parliamentarian

Jon A. Hultman, DPM, MBA, Executive Director

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2013 CPMA HOUSE OF DELEGATES SET GOALS AND SELECTED LEADERS FOR 2013-2014

Well over100 leaders of California’s podiatric medical profession gathered at the Disneyland Hotel in Anaheim this past June for the California Podiatric Medical Association’s (CPMA) Annual House of Delegates (HOD) where they discussed and debated a myriad of medical practice, public health and CPMA governance issues.

term, and Mark A. Warford, DPM (Fair Oaks) was elected to the Board as a two-year Director-at-Large.

Delegates and alternates representing CPMA’s eighteen (18) local component societies (stretching from the Oregon to Mexican borders) received in-depth briefing on CPMA’s Joint Physician and Surgeon Taskforce; important healthcare policy issues impacting podiatric physicians and their patients; legislative affairs, regulatory issues; podiatric medical education, and legal matters.

Eric Hubbard, DPM was elected to the four-year delegate position joining CPMA’s three other four-year delegates Franklin Kase, DPM; Jon Hultman, DPM, MBA and Stephen Wan, DPM.

Speakers included representatives from the: American Podiatric Medical Association; California Medical Association (CMA); Osteopathic Physicians and Surgeons of California (OPSC); Board of Podiatric Medicine (BPM); California School of Podiatric Medicine (CSPM) at Samuel Merritt University; and the College of Podiatric Medicine (CPM) at Western University of Health Sciences.

Elections The delegates were also tasked with choosing the Association’s Board of Directors for the coming year. The 2013-2014 Board of Directors as voted by the 2013 CPMA House of Delegates are as follows: Carolyn McAloon, DPM (Castro Valley) was elected President; Thomas Elardo, DPM (Los Gatos) was elected PresidentElect, Ami Sheth, DPM (Los Gatos) was elected Vice President; and Rebecca Moellmer was elected Secretary/Treasurer. Director-atLarge Thomas Tanaka, DPM (Ontario) was re-elected for a two-year J u ly | Au g u s t | S e p t e m b e r | 2013

The 2013 House also selected the delegation that would represent California at the 2014 American Podiatric Medical Association (APMA) House of Delegates next spring in Washington, D. C.

Those elected as one-year delegates and alternates to the 2014 APMA House of Delegates are: Derick Ball, DPM; Michael Cornelison, DPM; Thomas Elardo, DPM; Ronald Jensen, DPM; Carolyn McAloon, DPM; Ami Sheth, DPM and Karen Wrubel, DPM. The three elected Alternates are David Mazza, DPM; Rebecca Moellmer, DPM and William Tarran, DPM.

Awards During the meeting, the House honored a number of members of the podiatric medical community for their efforts to promote and advance the medical specialty of podiatric medicine. Award recipients included: Vladimir Zeester, DPM, President of the Los Angeles County Podiatric Medical Society, who was named the 2013 Society President of the Year. Holly Spohn-Gross, DPM received the 2013 Humanitarian Award. Diane Koshimune, DPM was awarded the 2013 Set Up Award. Bako Principal Partner Bradley Bakotic DPM, DO received the 2013 Executive Director’s Award. CPMA General Counsel C. Keith Greer, Esq. was the recipient of the 2013 President’s Award. | 35


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CPMA Executive Director Jon Hultman, DPM, MBA with spouse Patti

The Western is a family affair

Catching up 36 |

Sharon Diaz, PhD and Jon Hultman, DPM, MBA C PM A | C a l if o r n ia P o diat r ic M e dica l A s s o ciat i o n


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At The 2013 Western Animated discussions

Test drive

Gateway to Downtown Disney and the Disneyland theme parks J u ly | Au g u s t | S e p t e m b e r | 2013

Daniel Altchuler, DPM with Arlene Hoffman, DPM

Lawrence Harkless, DPM in lively conversation with colleague

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out & about

Western University Reception

Western traffic was brisk throughout the Disneyland Convention Center

Lester Jones, DPM and Mark Warford, DPM

Alumni catching up

CPMA President-Elect Thomas Elardo, DPM and Daniel Fulmer, DPM 38 |

Timothy Dutra, DPM and Derick Ball, DPM

CPMA Past President Barry Scurran, DPM with his spouse Hope

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Goofing around with Goofy

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CPMA Past Presidents Jon Hultman, DPM, MBA and Fred Youngswick, DPM

More Smiles

Eileen Haworth, DC with CPMA Past President Ernest Hook, DPM and her spouse CPMA Past President Daniel Altchuler, DPM J u ly | Au g u s t | S e p t e m b e r | 2013

CPMA Past President Oliver Foster, DPM embraces Immediate Past President Karen Wrubel, DPM | 39


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out & about

The Hultman-Levi family: Aimee, Eli, Sasha, and Jeff

Dr. and Mrs. Lester Jones

Lots of smiles

Past President s Michael Cornelison, DPM; Karen Wrubel, DPM and William Tarran, DPM 40 |

Devon Glazer, DPM; Adam Howard, DPM; Rebecca Moellmer, DPM; Thomas Elardo, DPM and Diane Koshimune, DPM C PM A | C a l if o r n ia P o diat r ic M e dica l A s s o ciat i o n


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Say what?

Having a good time

Keith Greer, Esq. and Eric Hubbard, DPM

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Say “cheese”

Glad to be here

CPMA Executive Director Jon Hultman, DPM with son Luke, CSPM student (center) and daughter Aimee

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out & about

Disneyland Hotel Pool

Fellow Past Presidents Karen Wrubel, DPM and Ronald Jensen, DPM

Yummy 42 |

Past Presidents William Tarran, DPM and Ernest Hook, DPM

Ami Sheth, DPM and Ross Taubman, DPM

CPMA Past Presidents Michael Cornelison, DPM and Stephen Wan, DPM with APMA President Matthew Garoufalis, DPM

CPMA Past President and Parliamentarian Roderick Farley, DPM with spouse Nedra

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Group hug

Eric Hubbard, DPM and Ross Taubman, DPM

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CPMA Secretary/Treasurer Rebecca Mollmer, DPM chatting with students

CSPM Alumni and Associates Reception

CPMA Directors: (seated) Thomas Tanaka, DPM and John Chisholm, DPM. (standing) Jonathan Uy, DPM and Devon Glazer, DPM J u ly | Au g u s t | S e p t e m b e r | 2013

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SMU President Sharon Diaz, CPMA Past President Ronald Jensen, DPM with President Carolyn McAloon, DPM

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2013/2014 board of directors President Carolyn E. McAloon, DPM Castro Valley, CA 94546 P: (510) 581-1484 drmcaloon@bayareafootcare.com President-Elect Thomas J. Elardo, DPM Los Gatos, CA 95032 P: (408) 358-6234 painfulfeet1@gmail.com Vice President Ami A. Sheth, DPM Los Gatos, CA 95032 P: (408) 358-6234 amishethdpm@gmail.com Immediate Past President Karen L. Wrubel, DPM Hawthorne, CA 90205 P: (310) 675-0900 drkw@cox.net Secretary-Treasurer Rebecca A. Moellmer, DPM San Bernardino, CA 92404 P: (909) 886-3668 rebeccamoellmer@hotmail.com

Directors John A. Chisholm, DPM 345 F Street, Suite 100 Chula Vista, CA. 91910 P: (619) 427-3481 F: (619) 420-7807 dr_triguy@yahoo.com Devon Glazer, DPM Newport Beach, CA 92660 P: (949) 272-0007 drdev01@yahoo.com Thomas J. Tanaka, DPM Ontario, CA 91761 P: (909) 724-5052 drtanaka@doctor.com Jonathan J. Uy, DPM Hercules, CA 94547 P: (510) 724-4674 flipdpm@sbcglobal.net Mark A. Warford, DPM Fair Oaks, CA 95628 P: (916) 548-0218 markwarforddpm@att.net

Executive Director Jon A. Hultman, DPM 2430 K St Ste 200 Sacramento, CA 95816 P: (916) 448-0248 (800) 794-8988 jhultman@calpma.org jonhultman@gmail.com General Counsel C. Keith Greer, Esq. San Diego, CA 92128 P: (858) 613-6677 greerkeith@aol.com Governmental Representative Jodi Hicks Sacramento, CA 95814

2014 CPMA House of Delegates will convene

Wednesday, June 18, 2014 Disneyland Hotel Anaheim, CA

Parliamentarian/ Recording Secretary Roderick Farley, DPM/ Nedra L. Farley Albuquerque, NM 87122 drrodfarley@gmail.com

Student Representatives Kevin Grenier (CSPM) Oakland CA 94601 Kevin.grenier@samuelmerritt.edu Dayna Chang (Western U) Walnut CA, 91789 changd@westernued.org

2013/2014 COMPONENT SOCIETY PRESIDENTs ALAMEDA/CONTRA COSTA COUNTY Timothy Dutra, DPM P: (510) 869-6511 x7564 tdutra@samuelmerritt.edu docpod85@yahoo.com CENTRAL VALLEY Matthew Takeuchi, DPM Stockton, CA 95204 P: (209) 948-3333 mjtakeuchi@gmail.com COACHELLA VALLEY Harvey Danciger, DPM Palm Desert, CA 92260 P: (760) 568-0108 docofeet@gmail.com INLAND Diane Koshimune, DPM Pomona, CA 91766 P: (909) 706-3778 ISCPMA@gmail.com LOS ANGELES COUNTY Gabriel Halperin, DPM Los Angeles, CA 90063 P: (323) 264-6157 ghalp@earthlink.net MID-STATE Richard Motos, DPM Visalia, CA 93291 P: (559) 734-1171 moetoes@hotmail.com

MONTEREY BAY AREA Vittorio Lagana, DPM Monterey, CA 93940 P: (831) 375-5634 vlagana@gmail.com

SAN FRANCISCO/SAN MATEO Bill Metaxas, DPM San Francisco, CA 94108 P: (415) 433-3668 bjm@faisf.com

NORTHERN CALIFORNIA KAISER Thomas DaSilva, DPM Walnut Creek, CA 94596 P: (925) 295-7099 thomasdasilva@hotmail.com

SAN LUIS OBISPO/SANTA BARBARA David Sterling, DPM Santa Maria, CA 93455 P: (805) 928-5645 sterlingfamily4@gmail.com

ORANGE COUNTY Gregory Eirich, DPM Tustin, CA 9 92780 P: (714) 669-1780 eirichdpm@sbcglobal.net REDWOOD EMPIRE Paul Weiner, DPM Vallejo, CA 94590 P: (707) 643-3687 mdweiner@scrserv.com SACRAMENTO VALLEY Mark Warford, DPM (liaison) Fair Oaks, CA 95825 P: (916) 488-8750 markwarforddpm@att.net SAN DIEGO/IMPERIAL Nicholas DeSantis, DPM San Diego, CA 92101 P: (619) 239-3286 footdoc5@pacbell.net

SANTA CLARA VALLEY Adam Howard, DPM Cupertino, CA 95014 P: (408) 446-5811 footdoc4u@gmail.com SHASTA REGION Gordon Shumate, DPM Redding, CA 96001 P: (530) 246-4800 g.shumate.dpm@frontiernet.net SOUTHERN CALIFORNIA HMO Anthony Cannizzaro, DPM South Pasadena, CA 91031 P: (323) 857-2000) anthony.x.cannizzaro@kp.org doctoracann@aol.com VENTURA COUNTY Heather McGuire, DPM Ventura, CA 93003 P: (805) 648-2016 drhmcguire@me.com

The California Podiatric Physician is the official publication of the California Podiatric Medical Association. CPMA and the California Podiatric Physician assume no responsibility for the statements, opinions and/ or treatments appearing in the articles under an authors’s name. For editorial or business information and advertising, contact California Podiatric Medical Association, 2430 K Street, Suite 200, Sacramento, California 95816; telephone, (916) 448-0248; facsimile; (916) 448-0258; e-mail; calpma.org.

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June 19-22, 2014

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DHCS Announces yet another Delay in Implementation of Dual- eligible Project The California Department of Health Care Services (DHCS) announced that it would delay the implementation of the state’s “pilot project” to redesign healthcare for Medicare/ Medi-Cal dual eligibles. The program, now called Cal MediConnect, is expected to begin no earlier than April 2014. Most recently, implementation had been scheduled for October 2013. The California Podiatric Medical Association (CPMA) along with the California Medical Association (CMA) and other stakeholders has continuously urged DHCS to withdraw the overly-ambitious project proposal in order to take more time to develop a scaled-down project that gives seniors and the healthcare professionals that provide care for this fragile population, information and feedback mechanisms to assure continuity of care and improved care coordination.

Give to CalPPAC, the only PAC that supports YOU! Send your contribution today to 2430 K Street, Suite 200, Sacramento Ca, 95816 To use your VISA, MasterCard or American Express call 800-794-8988

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On your toes Are YOU Ready for the Next HIPAA Compliance Deadline?

Meaningful Use Penalties Just Around the Corner

The Department of Health and Human Services (HHS) released new regulations in January 2013 that made important changes to the privacy and security requirements under the Health Insurance Portability and Accountability Act (HIPAA). These new regulations, known as the HIPAA Omnibus Rule, implement many of the provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Covered entities have until September 23 to comply with these changes.

The American Recovery and Reinvestment Act of 2009 (ARRA), requires penalties for Medicare eligible professionals (EPs) who are not meaningful users of Certified EHR Technology under the Medicare EHR Incentive Programs beginning in 2015. The reporting period for avoiding this penalty will vary based on when the EP began successfully attesting in the program according to the following guidelines:

Practices will, at minimum, need to review and update their business associate agreements, office privacy and security policies and notice of privacy practices. Some of the key changes made by the HIPAA Omnibus Rule include, but are not limited to, an updated definition of a business associate, new rules surrounding certain permitted uses and disclosures of protected health information (PHI), such as the sale of PHI and the use of PHI for fundraising and marketing, and rules controlling how patients can obtain medical records that are kept by a physician electronically. It also made significant changes to the breach notification rule. CPMA Members can find materials to help them comply with the new regulations and requirement in the Compliance Center under HIPAA in the Members’ area of the CPMA website at www.calpma. org/desk/practiceresources/compliance

CPMA Announces New Chief Lobbyist

Dear CPMA Members: I am pleased to announce that Jodi Hicks of DiMare, Van Vleck & Brown, LLC (DVB) has been engaged as our new state legislative advocate. Ms. Hicks is the previous chief lobbyist and former Vice President for Government Relations of the California Medical Association (CMA).

• EPs who first attested to meaningful use in 2011 or 2012 must demonstrate meaningful use by successfully attesting for a full calendar year in 2013 to avoid payment adjustments in 2015; • EPs who first attested to meaningful use in 2013 must demonstrate meaningful use by successfully attesting for a 90-day reporting period in 2013 to avoid payment adjustments in 2015; • EPs who first attested to meaningful use in 2014 must demonstrate meaningful use by successfully attesting for a 90-day reporting period in 2014 to avoid payment adjustments in 2015. This reporting period must occur in the first 9 months of calendar year 2014, and EPs must attest no later than Oct. 1, 2014, in order to avoid the payment adjustments. Providers subject to the EHR Incentive Program penalties must continue to demonstrate meaningful use each year to avoid penalties in future years. (Source: Health Management Solutions 5/9/2013)

LCDs Under Noridian

Dear CPMA Members:

As you know Noridian will soon be taking over as the fiscal Medicare intermediary for California. Posted today on their website is their LCD notification which will be implemented as of September 16, 2013.

DVB provides an array of bipartisan government services and currently represents a number of clients involved in health care policy areas, including the California Academy of Family Physicians (CAFP), California Association of Eye Physicians and Surgeons (CAEPS), Saba University School of Medicine, Safeway, Equality California, the Transgender Law Center, and the Partnership to End Domestic Violence. DVB maintains excellent working relationships with not only legislators and legislative staff, but with the Health and Human Services Agency, the Department of Health Care Services, the Department of Insurance, the California Medical Board, Covered California, and other key departments. They are uniquely positioned with the right blend of skills and relationships to assist CPMA in meeting its overall objectives in the upcoming legislative year.

Noridian has adopted Palmetto’s existing LCDs without any changes. The LCD identification numbers have changed but the policy is unchanged. Below is a partial list of the LCD policies and their new numbers if you wish to check Noridian website which is www.NoridianMedicare.com

This change in representation will more closely align CPMA and CMA’s legislative agenda which will be of great benefit to our members. CPMA is grateful to Broad & Gusman for many years of dedicated service and looks forward to a smooth transition to our new lobbying firm.

Symptomatic pathological nail and it’s treatment L33493

Thank you for your support, Carolyn McAloon, DPM, President California Podiatric Medical Association 46 |

Injections-- tendon, ligament, ganglion cyst, tunnel syndromes and Morton’s neuroma L33716 Noninvasive peripheral arterial studies L33478 Noninvasive peripheral venous studies L33479 Physical medicine and rehabilitation policy L33741 Skin lesion(non-melanoma) removal L33488 Treatment of ulcers and symptomatic hyperkeratosis L33496 Trigger point injection L33498 We will continue to keep you updated as to new information regarding our transition to Noridian. Sincerely, Tony Poggio DPM, Chair, Medicare Committee C PM A | C a l if o r n ia P o diat r ic M e dica l A s s o ciat i o n


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New CMS 1500 Claim Form on the Way The Office of Management and Budget (OMB) has approved the revised Centers for Medicare & Medicaid Services (CMS) 1500 claim form, version 02/12, OMB control number 0938-1197. The CMS 1500 claim form is the required format for submitting paper claims to Medicare. The revised form, among other changes, adds the following functionality: • Indicators for differentiating between ICD-9 and ICD-10 diagnosis codes. • Expansion of the number of possible diagnosis codes to 12. • Qualifiers to identify the following provider roles (on item 17): • Ordering • Referring • Supervising CMS is updating the Medicare Claims Processing Internet Only Manual (IOM, Pub. 100-04) Chapter 26 with instructions on how to complete the revised form. This information will be posted on the CMS website when it is available. Medicare anticipates implementing the revised CMS 1500 claim form (version 02/12) as follows: • January 6, 2014: Medicare begins accepting paper clams submitted on revised CMS 1500 claim form (version 02/12) • January 6 - March 31, 2014: Medicare continues to accept paper claims submitted on the old CMS 1500 claim form (version 08/05). • April 1, 2014: Medicare no longer accepts paper claims on the old for and will only receive and process claims submitted only on the revised CMS 1500 claim form (version 02/12). These dates are tentative and subject to change. CMS will provide more information as it is available. (CMANet.org 9/3/2013)

DHCS Announces Dates for Implementation of 10 percent Cut to Medi-Cal Reimbursement Rates

The Department of Health Care Services (DHCS) has announced that it would begin to implement the 10 percent Medi-Cal physician payment rate reduction on October 1, 2013, for Medi-Cal managed care and on January 9, 2014, for fee-for-service. DHCS also announced that it would be retroactively implementing the cuts for FFS providers to June 1, 2011, when the law authorizing the cuts went into effect. DHCS has said it will recoup a percentage of provider payments to recover overpaid funds during the retroactive period. These retroactive payment recoveries will not occur until after the prospective 10 percent payment reductions are implemented. Additional details were not provided, but assuming the retroactive See on your toes on Page 61

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Mary Hudson-McKinney, PT, MS, DPT, NCS and Lawrence Z. Huppin, DPM

Learning proper technique

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Attentive Attendees

Tina Del Bouno, PMAC, XT

Happy Assistants

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Welcome to The Western

The dynamic duo of billing and coding Tony Poggio, DPM and Harry Goldsmith, DPM

Learning is fun at The Western

Real hands-on

Western Workshop Team: Brett Shahabi, DPM; Roman Paulus, Workshop Coordinator; Neil Mansdorf, DPM and Rodmehr Ajdari, DPM

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Interactive Assistants

Studious Assistants

Excited to learn

Alexander M. Reyzelman, DPM

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Thomas J. Chang, DPM (standing) checking technique

Nothing beats hands-on learning

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Lots of learning opportunities

Team work

Diane M. Koshimune, DPM, MS

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Mary Hudson-McKinney, PT, MS, DPT, NCS

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Lectures were full

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Tony Poggio, DPM

The latest technology

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Gary “Dock” Dockery, DPM

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Ronald J. Belczyk, DPM

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Dynamic Displays, Demonstrations, HAnds-on instruction, Networking, Shopping, Games, Food and Fun madE the 2013 Western Exhibit Hall the PLACE TO BE!

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period ends as of the date the prospective cuts begin, the entire portion for which there would be a “clawback” cut would be June 1, 2011, until January 9, 2014, or over 29 months. CPMA is supporting Senate Bill 640, which would stop both the cuts and “clawback” from being implemented.

Sunshine Law Now in Effect

On August 1 manufacturers of drugs, medical devices and biologics that participate in federal health care programs began tracking and reporting certain payments and items of value including consulting fees, travel reimbursements, research grants and other gifts - given to doctors and teaching hospitals. The new law, known as the Sunshine Act, also requires manufacturers and group purchasing organizations to report certain ownership interests held by doctors and their close family members. The intention of the law is to increase transparency and reduce the potential for conflicts of interest that can influence research, education and clinical decision making. The reports will be submitted to the Centers for Medicare and Medicaid Services (CMS) on an annual basis. The majority of the information contained in the reports will be made available on a public, searchable website beginning in September 2014. Doctors have no legal duty to keep a tally of industry payments and gifts, but they may want to in order to ensure accurate reporting. Doctors will have the right to review their reports and to challenge any information that is false, inaccurate or misleading. By statute, physicians are provided, at a minimum, 45 days to review the transparency reports and make corrections before they are made public. The Sunshine Act covers all doctors who have an active state license, even if they do not participate in federal health care programs, but excludes residents and medical students. Payments of less than $10 do not need to be reported unless the aggregate amount exceeds $100 annually. The $10 threshold will increase every year, based on the Consumer Price Index. CMS has released a free mobile app that doctors can use to record cash and in-kind payments from industry.

CMS Conducts Meaningful Use Audits in California The Centers for Medicare & Medicaid Services (CMS) has begun auditing California doctors who attested through the federal electronic health record (EHR) incentive programs. Doctors selected for the audit have received letters from CMS contractor Figliozzi and Co., with requests for documentation to support their stage 1 meaningful use attestation. Figliozzi is an accounting firm that specializes in auditing health care facilities for Medicare cost compliance. Under the 2009 federal economic stimulus package, health care providers can qualify for Medicaid and Medicare incentive payments by demonstrating meaningful use of certified EHR systems. The law also requires CMS to audit health care providers attesting to meaningful use. According to CMS, the audits will J u ly | Au g u s t | S e p t e m b e r | 2013

impact 5 to 10 percent of doctors who have received incentive payments. The letters generally request that doctors provide the following information: • Evidence that they are using certified EHR technology • Their method of reporting emergency department admissions • Documentation that the physician completed the attestation module for the core set and menu set objectives and measures. Practices that receive such a letter should consider contacting a Regional Extension Center such as CalHIPSO (www.calhipso.org), their EHR vendor or a consultant for assistance.

Medical Board to Suspend Licenses of Doctors with Delinquent Taxes

The Medical Board of California will soon be sending notices to physicians who have outstanding tax obligations, warning that their medical licenses may be suspended if they do not pay their tax obligation or enter into a payment plan within 90 days. A new state law, passed in 2011, authorizes the medical board to deny an application for licensure and to suspend the license of any licensee who has outstanding tax obligations due to the Franchise Tax Board (FTB) or the State Board of Equalization (BOE) and appears on either the FTB or BOE’s certified lists of top 500 tax delinquencies over $100,000. Doctors who fail to either pay the taxes owed or enter into a payment installment plan with the relevant agencies will have their licenses denied or suspended until the Medical Board of California receives a release from the FTB or BOE. The form for requesting a release will be included with the preliminary notice of suspension. Suspensions will be posted on the medical board’s website and publicly distributed through its electronic notification system. The law prohibits the Medical Board of California from refunding any money paid for the issuance or renewal of a license where the license is denied or suspended. Names of those owing money to that state are published by the FTB and BOE on their websites. Doctors can check if they are currently on the FTB’s list at https://www.ftb.ca.gov/aboutFTB/ Delinquent_Taxpayers.shtml or the BOE list at http://www.boe. ca.gov/cgi-bin/deliq.cgi If you believe you are on either list in error, please call the FTB at (866) 418-3702 or the BOE at (916) 445-5167.

Samuel Merritt University Opens New Motion Analysis Research Center Oakland, Calif. (Sept. 3, 2013) - Samuel Merritt University (SMU) announces the opening of its new Motion Analysis Research Center (MARC), a state-of-the art laboratory designed to advance the study of human movement in education, research and patient care. See on your toes on Page 67

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PICA: Tamara Jackson; Ross Taubman, DPM; CPMA President Carolyn McAloon, DPM; Western Chair Jonathan Labovitz, DPM; CPMA Executive Director Jon Hultman, DPM, MBA

THANK YOU!

AMERX: Jon Hultman, DPM, MBA; Hunter Christian; Carolyn McAloon, DPM; Ann Dosen; Jonathan Labovitz, DPM

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STRYKER: Aaron Cohen; Carolyn McAloon, DPM; Mark Strong; Jonathan Labovitz, DPM; Jon Hultman, DPM, MBA

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BAKO: Aaron McKenzie; Rob Riker; Jon Hultman, DPM, MBA; Mandi McGill; Jeff Zaba; Carolyn McAloon, DPM; John Garrigan; Justin Marcello; Jonathan Labovitz, DPM; Michael Hausler; Angela Lochmann

THANK YOU!

SHIRE: Laine Dyess; Jon Hultman, DPM; Gayle Bashe; Jerem Sutherland; Carolyn McAloon, DPM; Jonathan Labovitz, DPM

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ARTHREX: Jonathan Labovitz, DPM; Roman Ledman; Mark Kimitsuka; Carolyn McAloon, DPM; Sean Vandenboss; Donnie Carter; Jon Hultman, DPM, MBA

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WRIGHT: Jon Hultman, DPM; Carolyn McAloon, DPM; Jonathan Labovitz, DPM; Adam Yoder; Nathan Polzin; Nathan Moore; Kevin McGuire; Michelle Gibson; Aron McKim

THANK YOU!

BARD PERIPHERAL: Jonathan Labovitz, DPM; Tyler Wilkins; Carolyn McAloon, DPM; Nick Boggs; Jon Hultman, DPM

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MATRIX BIOSURGICAL: Carolyn McAloon, DPM; Dave Wessels; Kevin Obrien; Jonathan Labovitz, DPM; Jon Hultman, DPM, MBA

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FORMULA 3: Jonathan Labovitz, DPM; John Yelick; Paula Pitts; Jennifer Painter; Brian Penrose; George A. Cioe; Carolyn McAloon, DPM; Jon Hultman, DPM; Terry Zach; Patrick Reichel

THANK YOU!

ARTHROSURFACE: Jon Hultman, DPM; MBA; Carolyn McAloon, DPM; Steve Petlansky; Jonathan Labovitz, DPM

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KCI: Jon Hultmna, DPM, MBA; Steve Wooldridge; Jeremy Wedemeyer; Carolyn McAloon, DPM; Eric Scanlan; Jonathan Labovitz, DPM

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DERMATRAN: Jonathan Labovitz, DPM; Jon Hultman, DPM; Vlad Shapiro; Carolyn McAloon, DPM; Smyth Six

THANK YOU!

PROLAB: Jonathan Labovitz, DPM; Lori Waters; Coleen Severson; Paul Scherer, DPM; Carolyn McAloon, DPM; Jon Hultman, DPM, MBA

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Vilex: Carolyn McAloon, DPM; Jonathan Labovitz, DPM; Victor Lavi; David Behmer; Jon Hultman, DPM, MBA

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The laboratory will serve as a teaching center on motion analysis for faculty and students from SMU’s California School of Podiatric Medicine (CSPM), Department of Occupational Therapy, and Department of Physical Therapy. Located in the SMU Health Education Center on the University’s Oakland campus, the center is equipped with the latest technology to study movement including three-dimensional motion-capture cameras, in-floor devices to measure forces, and other equipment to evaluate muscle function and range of motion. “The MARC will provide valuable opportunities for collaborative, interprofessional teaching and research to Samuel Merritt University,” said Assistant Academic Vice President Terry Nordstrom. Healthcare practitioners across several fields will use the center to study biomechanics, gait, upper and lower body movement, and the effect of treatment modalities, and apply what they learn in clinical practice for the benefit of patients. The MARC will also be used for clinical trials of new products to treat movement disorders. Drew Smith, PhD, the director of the center, has more than 35 years of experience in the field of movement analysis and

kinesiology, and has worked internationally in academic settings, clinical settings, and research labs. His primary area of research is in gait and balance, in particular neuromuscular control of motion across a wide spectrum of movements. Before coming to SMU, Smith was an associate professor and associate head of the Department of Health and Physical Education at the Hong Kong Institute of Education. A Biomechanics and Sports Medicine Symposium, co-sponsored by CSPM and the Department of Physical Therapy, will be held at the MARC on September 28. The MARC was funded entirely by philanthropic support. Foundations, corporations, employees, alumni, board members and friends of Samuel Merritt University contributed more than $600,000 to renovate the space and purchase the equipment. For more information, contact the SMU Office of the President at 510.869.1528 or officeofthepresident@samuelmerritt.edu.

You’ve Got Mail CPMA is increasingly utilizing Email and the Association’s website (CalPMA.org) to get important information to members in a rapid, efficient and cost-effective manner. To make sure that CPMA has your correct email please go to CalPMA.org and log-in. Once you are logged in, click on Physicians’ Desk and then on Member Directory. Put in your name and view your contact information. If the Association does not have your email, or if it or any of your information is incorrect call 800-794-8988 or email jsteed@calpma.org. Members are also encouraged to check the CPMA website regularly.

Don’t miss important information that impacts your patients, practice and profession! J u ly | Au g u s t | S e p t e m b e r | 2013

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Presidential Corporate members

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BAKO

STRYKER

PICA

CSPM

FORMULA 3 (Tetra)

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Presidential Corporate members

nsight

PEDiNOL (VALEANT)

Vilex

BLAINE LABS

Thank You for Your Support! WRIGHT J u ly | Au g u s t | S e p t e m b e r | 2013

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western foot and ankle conference june 19 – 22, 2014

disneyland hotel & convention center anaheim, california

visit www.TheWestern.org

for more information.

get more for your money: • Economically conscious registration rates • 25 CE contact hours • 10 radiology CE contact hours • Dynamic lecture tracks • Distinguished faculty • Innovative instructional courses

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2430 k street • suite 200 • sacramento, ca 95816 • (800) 794-8988


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California Podiatric Medical Association 2430 K Street Sacramento, CA 95816

Essentials of Practice Management Saturday, November 16, 2013 8:30 am - 5 pm

California School of Podiatric Medicine at Samuel Merritt University Health Education Center 400 Hawthorne Avenue • Oakland, California 94609 Co-sponsored by: California Podiatric Medical Association California School of Podiatric Medicine at Samuel Merritt University

Announcing

Program

Essentials of Practice Management, a one-day seminar for doctors of podiatric medicine and medical assistants. Specialists will present topics of interest to podiatric physicians, office managers, staff, and technicians to help you enhance, build, and earn from your practice.

Keynote Address Jon A. Hultman, DPM, MBA

Bring your questions and get answers from the experts!

Clinical Scenarios – Coding Solutions Q&A Harry Goldsmith, DPM

Plus, visit exhibits and stay for a complimentary wine and cheese networking reception after the meeting for more time with the speakers and exhibitors.

The Impact of ObamaCare on Your Practice Harley Schultz, MD, MBA How to Get Paid for Professional Services in the Changing Landscape of Healthcare Reform Franklin Kase, DPM

Building a Specialty Focused Practice Timothy G. Dutra, DPM, MS Marketing Your Practice Rem Jackson Tina C. Del Buono, PMAC, XT


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