The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

January 03, 2011 #4,053 Publisher-Barry Block, DPM, JD

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Childhood Obesity Affects The Feet: PA Podiatrist

Excess weight is hard on the body, even for children, and it doesn't just lead to heart problems and diabetes; it can also affect kids' feet. Podiatrist Dr. Eric Ricefield says as more Americans become overweight, he's seeing more patients, including children, complaining of foot problems, "Arch pain, heel pain, fatigue or 'my legs are tired.'" 

Dr. Eric Ricefield

And because kids are still growing, the extra weight can cause permanent damage. But fixing it creates a catch-22. You want kids to be active so they lose weight, but oftentimes, the pain makes it difficult. Dr. Ricefield also says for all kids, if they're wearing their sneakers or any shoe every day, they should replace shoes every three to six months.

Source: WPVI-TV (ABC) Philadelphia, PA [12/30/10]

MI Podiatrist Leads 6th Mercy Mission to Guatemala

Dr. Vicki Athens, a podiatrist from Grosse Ile, MI has been participating in medical mission trips to Guatemala for six years. Athens, whose office is in Brownstown Township, has been a practicing podiatrist and podiatric surgeon for more than 28 years. “Podiatry is a passion as well as my work,” she said. This passion for podiatry led Athens to seek out a way to help people in areas of the world who don’t have access to basic healthcare, let alone specialty care.

Drs. Vicki Athens and Dr. Trevor Whiting examine a Guatemalan child to assess her condition.

The podiatric mission team that went to Guatemala recently included Athens on her sixth mission, Dr. Guy Pupp on his second mission, Dr. James Hill on his first mission, Dr. Chris Olenech on his second mission, and Dr. Julie Fraser on her first mission. Four podiatric residents from Henry Ford Wyan­dotte and Providence hospitals accompanied them. “Healing the children coordinates the missions for us,” Athens said.

Source: Shannon Rossi, The News Herald [12/30/10]

UK Podiatrist Gets $300 Grant to Study if Fish Oil Can Aid Diabetics

A new Southampton-based medical study is to investigate whether fish oils can help diabetics avoid blindness, heart disease, and having their limbs amputated. A city podiatrist is launching the 18-month clinical trial to discover if purified fish oil medication can protect against serious health complications triggered by Type-2 diabetes

Keith McCormick

Keith McCormick, who also works as a University of Southampton lecturer, will study 100 people at risk of developing Type-2 diabetes to determine whether taking high doses of a fish oil-based medication can improve the function of nerves and small blood vessels in the feet.
The £197,000 ($307,000) research study is being funded by Diabetes UK and will focus on a fish oil called OMACOR, found in Norwegian sardines.

Source: Madeline Adams, The Daily Echo [12/30/10]

How Well Does Your Staff Deal with Conflict?

If you suspect that their attitudes are adversely affecting productivity, use this survey to find out. Ask each person to choose from the following examples the style that best describes the staff’s current approach to conflict.

• Denial. Typical reaction: “Problems? We have no problems.”
• Smoothing. Typical reaction: “We disagree sometimes, but it’s no big deal.”
• Power plays. Typical reaction: “We’re doing it this way; end of discussion.”
• Compromise. Typical reaction: “Let’s split the difference so we each have something we like in the solution we choose.”
• Problem solving. Typical reaction: “Let’s examine the issue and figure out what is best for the practice.” Discuss your staff’s answers, and ask staffers to list ways the group can improve its approach to solving problems.

   Source Adapted from Team Depot, Glenn Parker, Jossey-Bass via Communication Briefings

Query: Practice Fusion

I would like to hear some comments from anyone using Practice Fusion in their office? What have been your positive and negative experiences with this EHR program?

Steven Frydman DPM, Milwaukee, WI

RE: Macrodactyly in 16 Year Old
From: Tip Sullivan, DPM

This is a very interesting and rewarding case of a young man with macrodactyly, isolated to the second digit. Many physicians, like Chang in JBJS suggest ray resection for cases like this, but I believe that if one has the training and is willing to take the time and effort under loupe magnification and through staging, an acceptable result can be achieved. In this case, the patient was very pleased. I would not have attempted this if I had not had the opportunity to train as a fellow in plastics under Dr. Larry Oloff.

Clockwise: Pre-op, Operative, X-ray, Post-op

Macrodactyly in the foot is more rare than in the hand. There seem to be two types described in the hand: progressive and static. This is a case of progressive macrodactyly. There is a slight male predominance, but it is not a inheritable condition. There seems to be a debate in the literature as to the etiology/pathogenisis. This young man is now about a year out and there is no evidence of recurrence. 
 
Tip Sullivan, DPM, Jackson, MS, tsdefeet@msfootcenter.net

RE: Terbinafine and Tamoxifen Contraindicated

According to an article on Medscape ("Drugs to Avoid in Women Taking Tamoxifen" by Zosia Chustecka), physicians should avoid giving terbinafine (Lamisil) to people taking tamoxifen. Terbinafine is listed as as moderate to potent inhibitor of CYP2D6. Any interference with the metabolism of tamoxifen leads to lower blood levels and less protection against breast cancer.

Al Musella, DPM, Hewlett, NY, Musella@aol.com

RE: Undiagnosed Diffuse Skin Lesions (Robert Bijak, DPM)
From: Elliot Udell, DPM

I can understand where Dr. Bijak is coming from when he writes: "I cannot support that the profession accept his statements that biopsies and blood tests, in and of themselves, are rarely diagnoses makers..." Obviously if you take a blood test and the person has a serum glucose of 400, high sugars in the urine, high Hem A1C, you need not go further to make the diagnosis of diabetes. Another example, however, is a recent case in our office of a patient with a fast growing lesion. I took a punch biopsy and the initial report was benign. I called and spoke directly to the pathologist, and based on the clinical history that this pigmented lesion was not present  three months prior and was now invading both sides of the third interspace, along with dermatoscope findings which looked positive for a malignancy, the pathologist concurred that the entire lesion be excised in total immediately.

At our hospital orthopedic meetings, the issue of how MRI reports can often mislead a doctor into performing an unnecessary surgery has been brought up by the chairman of the department. We were admonished to use these imaging reports as a guide but not as an ultimate decision-maker. A patient of mine was diagnosed early this month with a cancerous bladder lesion. The surgeon removed it and the path report was negative. To the urologists trained eye, the lesion appeared malignant. Using the path report as a guide, but relying on his own clinical judgment, he is going to monitor this patient frequently rather than discharge him. There is not enough room to list all of the examples of this in 33+ years of practice. Perhaps others will fill in with more examples.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Phone System Recommendations (Jack Reingold, DPM)
From: Jason Gross, MHA

We just recently transitioned from the traditional land-line phone system to a VOIP system. We have 3 office locations that we were able to consolidate down into one system, ultimately saving us around $400 a month. It’s difficult to discuss all of the considerations, but here are a few things to consider. There are numerous VOIP suppliers out there that offer web-based or server-based systems, so you will want to look into those options.  Our DSL service has been very reliable over the years and we have a small number of phone lines we were dealing with.  

Before you seriously consider changing systems, you will want to make sure you can “port” or switch your current phone numbers to the VOIP supplier you choose. If you have been in practice for a number of years with an established patient base, you want to make sure your patients can still reach you. There are some up-front equipment costs but we were able to recoup that in one month. One final point: VOIP does not work like a regular land-line, but if you and your staff are willing to think “outside the box” a little, the VOIP system will give you capabilities far beyond your current system.

Jason Gross, MHA, Forest City, NC, jgross@footandanklenc.com

RE: X-Ray Comparison (Michael Forman, DPM)
From: Martin R. Taubman, DPM, MBA

Although I know I  risk the ire of those  who rationalize why they won’t spend the money for this diagnostic modality, I still believe it is necessary to separate the need for “profit-making” tools from those which improve one’s ability to provide excellence of care. I have found that when I treat my patients with better care garnered by the use of modern, main-stream technology (in this case digital x-rays) not only do my outcomes improve, but I also increase my income such that the device more than pays for itself.  It is a win-win for all concerned. Do I make as much profit as I could with wet developing?  Before I got the digital x-ray system, I doubted it, but now I see I am doing quite nicely.

Frankly, I get tired of hearing from  critics who, in actuality, are not really that familiar with the technologies they expound; who haven’t done the true math to determine profitability, or who misinterpret the information relayed to them and make unfounded  judgments. It seems to me that those who have the strongest emotional opinions about digital x-rays and EHRs are those who don’t use them. Those of us who have incorporated these technologies into our practices benefit from them every day as they allow more efficiency, increase our productivity, patient satisfaction, and bottom-line profit.

Martin R. Taubman, DPM, MBA, San Diego, CA, mtaubman@san.rr.com

RE: The Passing of John Carson
From: Gayle S. Johnson, Rodney Peele, Washington, DC

I read with sadness of the passing of John Carson.  Others have already written about his many accomplishments for the podiatric community, his great rapport with leaders in podiatry and politics.  I also remember that he had a quick wit, a ready smile, and seemed to meet everyone as a friend.  I'm so glad I had the opportunity to know him, and offer my condolences to his family.

Gayle S. Johnson, Edmonds, WA

PM News readers might like to know that John’s family and friends spoke vividly about his passion for podiatry, and his love of his work for APMA. What they did not know was how much podiatry loved John, so they were particularly appreciative of all the kind words that have been said on PM News and other forums this week.

The profession was well represented by some great, longtime APMA staff members at his funeral on Dec. 30, including: APMA Executive Director Glenn Gastwirth, DPM, and his wife Joy; APMA Deputy Executive Director Jay Levrio, PhD; Director of Legislative Advocacy Faye Frankfort, who worked for John many years before becoming APMA’s chief lobbyist; Alan Tinkleman, Director of the Council on Podiatric Medical Education; David Zych, the longtime APMA News editor who was at APMA when John was hired and when John retired; Senior Accountant Beth Ann Carr, who was introduced to her future husband by John many years ago; Junior Accountant Terry Edwards; Kathy Balderson, Associate Director, Scientific Affairs; and Joanne Gagnon, Assistant Director, Membership Services.

Rodney Peele, Washington, DC

ASSOCIATE POSITION - CHICAGO

Weil Foot & Ankle Institute, Des Plaines, IL (www.weil4feet.com) is seeking associate position in summer 2011. This 15 member podiatric medical and surgical group is internationally acclaimed. Twelve locations throughout Chicagoland, with a 3 operating room surgery center, MRI’s, computerized footprint analysis, orthotic and brace laboratory, radiofrequency coblation technology, extracorporeal shockwave devices, PRP and clinical research program. Successful candidate will have completed a 3-year residency, experience in wound care, trauma, and sports medicine. Competitive salary, bonuses commensurate with experience and training. E-mail letter of interest and CV to Harriet Kass, HR, hkass@weil4feet.com 847-390-7666

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Douglas Richie, DPM is seeking a well-trained, motivated podiatric physician to join his two office practice located in North Orange County, California. Applicants must have completed a 3-year residency program and must have exceptional skills in reconstructive foot and ankle surgery, sports medicine and podiatric biomechanics. This is a salaried position with a goal of long-term buy-in for equity ownership. Send letter of interest and CV to drichiejr@aol.com

PART-TIME/FULL-TIME PODIATRIST NEEDED - INDIANA

Part-time full-time Podiatrist needed for our Indiana offices. Must have Indiana license. Must have completed two years of surgical residency. If qualified email to f-massuda@footexperts.com

ASSOCIATE POSITION - KENTUCKY
 
Very well established Podiatry practice in Louisville, KY seeks a motivated, ethical practitioner trained in all phases of podiatry including routine care, surgery and wound care to join 2 other podiatrists. By joining our practice you will receive a competitive salary with a bonus structure and benefits. Our practice is equipped with DME, PadNet, Gait Scanner and on site retail store. There is a huge potential to grow your practice with our ideally located facility that has strong affiliation with leading area hospitals as well as 2 local residency programs. For immediate consideration, please forward CV to Samuel10530@yahoo.com

ASSOCIATE POSITION - BOSTON

CPME Board certified podiatrist wanted to join Orthopedic & Arthritis Center at Brigham & Women’s Hospital, Boston, MA. The position is per diem, 2 days/ week. Interested candidates should send their CV to: Brenda Surowiec, Orthopedic & Arthritis Center, 75 Francis Street, Boston, MA 02115. Or email to bsurowiec@partners.org

ASSOCIATE POSITION - CT (FAIRFIELD AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info, www.GreatFootCare.com. Send resume and current photo to Dr.Kassaris@yahoo.com. Applications due by Jan 31st.

PART-TIME / FULL-TIME PODIATRIST NEEDED ASAP - CHICAGO

Part-time podiatrist needed for 2 offices in Chicago with an average of 20 hours/week. Must have Illinois license. Must have completed 2 years of surgical residency. If qualified, email to: A-Storjohann@footexperts.com

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Immediate opening. Well-established multi-office practice with EMR, Digital x-ray, and more. Seeking full-time associate with PM and S-36 training. Independent and highly motivated. Must be BC/BS in rearfoot and ankle with confidence in complex reconstructive cases. Full benefits package, competitive salary. Email CV to: JLH459@aol.com

PRACTICE FOR SALE - BOSTON, MASSACHUSETTS

40 year old updated practice with outstanding potential. Within 5 miles of Boston hospitals and 5 blocks from train station. Buy the practice, equipment and goodwill for a reasonable price. Excellent opportunity for resident or second location for practicing podiatrist. Multiple referral sources. Email vshdeep@yahoo.com

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