The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

January 04, 2007 #2,781 Editor-Barry Block, DPM, JD

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Re-Heeling Shoes Helps Walking: AZ Podiatrist

Your worn-out shoes can affect your health from the soles of your feet up, says Phoenix podiatrist Arlene Polakof, medical director of specialty care for CIGNA Medical Group. "If the heels or soles are worn out, there's a shift in how you walk," she says. "You get a sore back or sore knees, and it affects your posture."

With new heels, new soles or a whole new pair of shoes, "you'll walk better, your back will feel better, and you'll look better," Polakof says.

Source: Connie Midey, Tucson Citizen [1/1/07}

Wiggin New President of OPMA

Peter A. Wiggin, DPM from Mansfield, Ohio was elected as 2007 President of the Ohio Podiatric Medical Association (OPMA) at the OPMA House of Delegates.

Dr. Peter Wiggin

Dr. Wiggin graduated from OCPM in 1985 and completed his residency training at Oxford Hospital in Philadelphia, PA in 1986. He is a Diplomate of the American Board of Podiatric Surgery and a member of the North Central Academy of Podiatric Medicine in OH. Dr. Wiggin practices in his hometown of Mansfield, OH and is on staff with the MedCentral Heath Systems. Dr. Wiggin previously served as a trustee of the North Central Academy of Podiatric Medicine and as an APMA HOD delegate.

MS Podiatrist Loves Small Town Lifestyle

Mike Lyons met Sarah Murray in 2003 while attending Temple University School of Podiatric Medicine in Philadelphia. She was working in the alumni department, and when he saw her in the cafeteria he had to meet her. A residency and a marriage later, Lyons found himself with a wife, a son and a new practice in Hernando, MS.

Dr. & Mrs Mike Lyons & Ethan Photo by Justin Shaw

Lyons had planned on completing his residency in his hometown of Rochester, N.Y., but he decided to stick around Philadelphia to finish so he could spend time with Sarah. He trained with a Memphis podiatrist, who convinced the couple to look for a practice in his part of the country.

"We fell in love with Hernando," Mike said. "It was a small town, and we knew there wasn't going to be any crime, and everybody knew each other." They like it so much, they're trying to keep it a secret. "We tell all our friends back home, 'Don't come here.' We don't want it to get too big," Mike said.

Source: Lesley Young, Memphis Commercial Appeal [12/31/06]

Query: Patient Education Software

Any recommendations for what products, such as "Primal Pictures" 3-D which have been the most helpful?

James M. Petko, DPM, Falls Church, VA

Query: Equal Pay For Equal Work

I participate in the same plans as another podiatrist in my area. He is employed by a large medical group, and his fees/reimbursement, through this medical group, are substantially higher.

I don't think that's fair. How can I or any other podiatrist in the area have any bargaining power when we do not belong to a similar group that can negotiate fees? Are there any doable suggestions?

Michael Giannone, DPM, Mt Kisco, NY

Response: It isn't fair playing ground because the larger group invests in help that can protect them from low payments. That is either by hiring a skilled manager, a savvy consultant, a healthcare accountant (is there such a thing?), healthcare attorney, or healthcare consulting firm. And most likely, all of the above.

I personally believe one of the most economically devasting business arrangements is the solo practice who negotiates on their own. Quite honestly, it's this kind of practice that keeps me in business.......undoing the (unfair) contract arrangements, working around the low payments by designing better practice efficiency, dropping plans that poorly pay, etc. My clients are amazed at what they have agreed to do and what they are actually paid for.........

Look at all of your health plan arrangements. Contact all of them for the renewal date. When it's time to renegotiate, get professional help to ensure you are treated fairly. Ideally, select someone who is very familiar with the plans in your area. If there is no renewal date, contacting the representative to start the renegotiation process is in order, if you have a history of 3 or more years with the plan.

Practicing medicine is one profession, doing the business of medicine is most certainly another.

Karen Hurley, CMM, CPC, Waldorf, MD

Codingline subscription information can be found at
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RE: Golfer with Hallux Limitus (Ido Friedman, DPM)
From: Multiple Respondents

The stiffest golf shoe I have found is the one that New Balance came out with last Spring.
I remember reading an article in Golf Digest last spring about weight shift during the swing. Nowhere did the author mention how excessive pronation would affect weight transfer and follow-through.

Golfers will do whatever it takes to lower their handicap. Feet and legs supported by orthotics will provide better balance and lessen fatigue, keeping them stronger toward the end of the game. This will lower a golfer's handicap!

Robert Scott Steinberg, DPM, Schaumburg, IL, doc@footsportsdoc.com

Since Dr. Friedman notes a first metatarsus elevatus which will limit hallux DF, perhaps a devise such as the "Kinetic Wedge" (Langer Biomechanics) which uses the dancer's pad theory to allow some PF of the first met & thus increase available DF motion of the hallux may help somewhat at "toe-off." If there is very LITTLE motion (i.e., Rigidus) to be had and it's painful, another device may be of benefit- a thin rigid carbon graphite foot plate, called "Dynaflex," manufactured by Wrymark (800) 969-3668. This will block motion.

I have used both with pretty good results, depending on the
circumstances. These may obviate or postpone the need for surgery.

Robert K. Hall, DPM, C.Ped., Ft Lauderdale, FL, robertkhalldpm@bellsouth.net

I have found that patients with a hallux limitus will have increasing symptom which appears to go along with any activity that is the cause of pain and the desire not to eliminate the activity.

I have found that steroid/local anesthetic injections are a definite help, but not a cure. I also put my patients in both shoes and orthotics that are as stiff as possible to limit the action of dorsi-plantar flexion of the 1st MPJ. Once these no longer hold the pain/swelling then it is time to consider surgery.

Barry A. Wertheimer, DPM, Torrance, CA, feetfixer@cox.net

RE: Alternative to Isopropyl Alcohol (Will Godfrey, DPM)
From: Richard A. Simmons, DPM

A simple alternative that I have found to be cost-effective and equally effective is to remove the cap of the alcohol bottle and insert a spray top. Set it for a drenching mist level and a few sprays will accomplish what you are attempting. If you need to scrub the feet to remove dirt or debris, this is not effective; but for what you describe this can be ideal. You can also add a few drops of Oil of Wintergreen, Oil of Camphor, etc. to 'deodorize.'

Richard A. Simmons, DPM, Viera, FL, RASDPM32822@aol.com

ASSOCIATE POSITIONS - VIRGINIA

Immediate/July full time associate positions available. Unlimited income potential. Busy, diverse, 40+yr Hampton Roads practice. Must be compassionate; energetic; and motivated; PSR24/36. Looking for long term arrangement. Please send letter and CV to fixafoot@cox.net or fax to 757-397-5889; www.podiatryltd.com

ASSOCIATE POSITION - MISSISSIPPI

Well established, busy, 3-doctor practice seeks PSR 12 or 24 trained podiatrist for associate position to fill vacancy of retiring member. East central location is a great area to raise a family and is a prime location for accessibility to several major cities. Competitive salary, benefits, and incentives. Partnership possible in 2 years to right individual. June - July start date. Applicant must be ethical, personable, and motivated. Please E-mail CV and letter of intent to shanegan@bellsouth.net

ASSOCIATE POSITION - LOS ANGELES/SOUTH BAY AREA

Multi-office, multi-doctor, well-established practice near the beach cities. Seeking a board eligible/certified PSR-24 or PSR-36 trained foot and ankle surgeon. Well-rounded practice requiring knowledge in biomechanics, pediatrics, sports medicine, diabetic wound care, trauma, and reconstructive foot and ankle surgery. Full-time position available immediately with generous compensation and benefits, including malpractice, and health insurance. Two-year commitment required with partnership opportunity. Send CV to akemfoot@sbcglobal.net or fax to (310) 838-0227.

POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

ASSOCIATE POSITION - CENTRAL CALIFORNIA

Central California multi-location practice looking for PSR-36 associate leading to partnership. PSR-36 trained podiatrist with great opportunity for reconstructive surgical practice. Practice has Medicare-approved surgery center. Must have excellent interpersonal skills. Excellent salary and incentive. Respond to: westsidefoot@yahoo.com

ASSOCIATE WANTED FOR SOUTH MIAMI AREA

Large group, busy, multi-office, partner potential. Motivated applicants only. Mail resumes and letters of intent to 999 N. Krome Avenue, Homestead, FL 33030. July start time OK, sooner preferable. E-mail lianadpm2@aol.com. I can also be reached at 305-331-4501.

ASSOCIATE POSITION - CINCINNATI, OHIO

One of the largest podiatry practices in the United States is again in need of a PSR 24-36 Associate. All present doctors are in their thirties with similar training. Everyone is treated equally and there is definitely no limit to your success. Please submit resume or contact Karen Roesch via email or phone. Kroesch4poh@aol.com (513) 729-4455

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

ASSOCIATE POSITION--PHOENIX SUBURB

Attractive opportunity for enthusiastic, proficient, and personable associate. Well-established modern practice with multiple newer spacious offices, technology and equipment. Solid referral base, close to hospitals, knowledgeable certified staff. 22% MCR. Practice and surgical center partnership potential opportunity. Prefer 24-36+ PSR. Send CV: AZpodassociate@aol.com

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