The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

January 07, 2011 #4,057 Publisher-Barry Block, DPM, JD

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Wound Care is a Team Effort: FL Podiatrist

Poor circulation, complications from diabetes and infection are among the reasons wounds don't heal well. PAD occurs when narrowed blood vessels prevent enough blood from flowing to the legs. "To prevent amputations, the standard of care is a team approach," Dr. Jeffrey Karr, a Lakeland podiatrist and a founder of Lakeland Vascular Institute said. Patients need to be assessed carefully for circulation problems, bone infections, nutritional deficiencies, diabetic control and compliance, and such overall health concerns as smoking, obesity, and infection.

Dr. Jeffrey Karr

Once patients do that, Karr said, he can make appropriate referrals to other doctors for treatments as needed. "Recognition and prompt treatment of arterial vascular disease is one of the most important factors in preventing amputation," Karr said, adding that wound-specific treatment alteratives are available in offices and at wound-care centers.

Source: Robin Williams Adams, The Ledger [1/4/11]

OCPM Mourns the Death of Chairman of the Board

James E.A. John, PhD, OCPM Chairman of the Board, recently passed away at his home in Medina, OH. Dr. John served on the OCPM Board of Trustees for over 15 years as a board member and vice chairman. In October of 2008, he was elected as Chairman of the Board. Dr. John provided valuable insight and leadership during the college's last accreditation, especially regarding enhancements to the College's Mission and Vision Statements and overall institutional goals. He was a strong advocate for students and education. 

Dr. James E. A. John

Dr. John was the former President of Kettering University in Flint, MI from 1991-2005 where he presided over many transformation projects at the university. "Dr. John has served in educational roles for over 50 years", stated Thomas V. Melillo, DPM, President of OCPM. "The OCPM community will miss his leadership and contributions he made to the college."

LA Podiatrist Participates in Health Fair

Jefferson Community Health Center in Avondale recently put on a health fair at the Avondale Community Center. People from Avondale, Bridge City, Nine Mile Point, Waggaman and Westwego were all welcomed to come and get free health screenings.

Dr. Elaine Fulmer

Dr. Elaine Fulmer is a podiatrist for the Jefferson Community Health Centers. Fulmer was at the health fair to inform people about diabetic foot and skin care. 

Source: Jeanie Sorbet-Rentz, The Times-Picayune [12/30/10]

Podiatrist Admits False Medicare Claim

A Buffalo, NY podiatrist admitted submitting a false claim to Medicare for a procedure he did not perform. 47-year-old William Holley pleaded guilty to U.S. District Judge Richard Arcara to theft in connection with healthcare. In April 2005, Holley submitted a false claim to Medicare claiming he performed a nail wedge excision on a patient, when he hadn't.

The charge carries a maximum penalty of one year in prison, a fine of $100,000 or both. Sentencing is scheduled for April 13.

Source: Eli George, WIVB.com [1/5/11]

RE: Zumba and Heel Pain

Yesterday, I saw two new patients with acute, unilateral heel pain. Symptoms were of classic plantar fasciitis. Both patients were 40ish females who had been in different Zumba classes (Latin dance/fitness class). Is anyone else seeing this?
 
Neil Levin, DPM, Sycamore, IL

Query: In-office Fluoroscopy

I'm curious to hear from other DPM's using in-office fluoroscopy. I've considered going digital but cannot see an adequate ROI. Fluoroscopy provides many benefits: low radiation dose, digital integration with my EMR, no films, ease of use, and provides real time/motion imaging. Why is the focus on digital X-rays and not on fluro?
 
Dan Waldman, DPM, Asheville, NC

RE: Recalcitrant Heel Pain (Tip Sullivan, DPM)
From: Gino Scartozzi, DPM

This is a case that makes one highly suspicious of a stress fracture, despite a report that the radiologist concludes a "calcaneal bruise." One's treatment of any patient should be based on all clinical data obtained. MRIs, CAT Scans, ultrasonography and nuclear imaging studies are important, but the practitioner's exam, patient history, radiographs and clinical symptomatic progression are indicators of diagnoses and treatments to be rendered.
 
From the clinical history presented, the patient reveals onset of athletic activities recently with symptomatology developing shortly afterward. The history suggests a possibility of a stress fracture diagnosis. In addition, the patient has pain of the calcaneal segment with collateral pressure applied. This clinical examination sign definitely should make one highly suspect of a stress fracture. Cases of stress fractures may reveal normal T1 images with low signal intensities with failure to detect definitive stress fractures. It appears to me that there are regions in the calcaneal segment on the T2 images to suggest intra-medullary pathology of the calcaneal segment.

I would consult with the radiologist, however, my advice is to place the patient in a cast and keep her non-weight-bearing for a period of 4-6 weeks. 
 
Gino Scartozzi, DPM, New Hyde Park, NY, Gsdpm@aol.com

RE: Achilles Procedure With Distal Incision (Daniel Chaskin, DPM)
From: Peter Bregman, DPM

I read with some dismay regarding the query about a talus level Achilles lengthening. First of all, unless this is a pediatric equinus, I don't think this type of procedure would provide enough lengthening to achieve a quality result. Second, if this is a scope issue, then trying to get around it by making the skin incision lower but going above with a blade above the talus is unwise. A lawyer would have a nice lunch with this one should there be problems. In this case, I would call a colleague who has the privilege to do leg procedures and have him/her help you, or refer it to them.

Peter Bregman, DPM, Las Vegas, NV, footguru@comcast.net

RE: Undiagnosed Diffuse Skin Lesions (Robert Bijak, DPM)
From: Simon Young, DPM

Dr. Bijak's comments often tend to be radical. Before he comes to outrageous conclusions, he should contact the source. Unfortunately, I have to clarify a moot point. The premise for a biopsy is obvious suspicion of pathology, but fortunately most biopsies reveal benign lesions.

Simon Young, DPM, NY, NY, simonyoung@juno.com

RE: Ultrasound Courses (Brian Kiel, DPM)
From: Donna Ferri

Biosound Esaote offers podiatry-specific training courses 6-7 times per year at their US operations in Indianapolis. The training is one full day (Saturday) and is taught by Nathan Schwartz, DPM. You receive 6 CME credits and a certificate through the Scholl College. You can view the course schedule at mskultrasound.com or call Donna Ferri at 732-245-0091. It is well worth your travels, and the course is FREE for their customers.

Donna Ferri, Biosound Esaote, dferri@biosound.com

RE: Practice Fusion
From: Roger L. Friedman, DPM, Richard A. Simmons, DPM

I have found there is almost always a work-around for whatever obstacle you might encounter in the computing world. While it may not be the most elegant solution, and it does require an extra step, I can copy my finished note in Practice Fusion using the capture program Snag-it, and then save it on my computer, thus providing me with a local back-up.

Roger L. Friedman, DPM, Elyria, OH, Roger@RogerFriedman.com

After reading Dr. Morelli's post, I once again contacted Practice Fusion about their EHR. I think it prudent for all of us to know that no system is going to guarantee you that you will get money from the government; however, qualified EHR systems can guide practitioners to accomplish those tasks necessary to receive the rebate. I also believe that ICS software has a phenomenal system, however, the original question asked about Practice Fusion.

Personally, I am pursuing Practice Fusion because I was recently financially burnt during the Medinotes debacle and am shy about obligating myself for tens of thousands of dollars more. Today, a new U.S. Congress was sworn in and ...

Editor's note: Dr. Simmons' extended-length note can be read here

RE: Digital X-Rays (Philip E. Larkins, DPM)
From: Pete Harvey, DPM

Dr. Larkins has a valid point. However, after Guttenberg published the first books, they could only be afforded by the wealthiest people. Digital advantages outweigh non-digital. Within the next  decade finding anything in a print form will be almost impossible. There will be no chemical x-ray systems. It will all be in the Smithsonian. There will be no hardcopy newspapers, magazines, books, etc. I already prefer to read books on Kindle or iPad because I can store thousands of books in one tiny device to carry on an airplane. Sadly, you can’t fight city hall. Faults or no-faults, digital is here to stay. People may still be able to buy books, which will revert to leather bound, gold leaf editions at very high prices.

Pete Harvey, DPM, Wichita Falls,TX , pmh@wffeet.com

ASSOCIATE POSITION - FLORIDA

Three physicians providing comprehensive podiatry services to Jacksonville, FL. Senior partner retiring after 37 years is seeking associate with 3-year residency trained in reconstructive foot and ankle surgery. Salaried position leading to buy-in. Send letter of interest and CV to padler@adlerpodiaty.com

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

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION - DAYTON, OHIO

Join a well-established modern practice with an excellent reputation and referral base. Base salary $100,000 and benefits with a bonus structure. EMR, diagnostic ultrasound, all aspects of DME, Padnet vascular studies, and CO2 lasers. We seek a surgeon that is well trained, personable and motivated to join our group of 3 Podiatric Surgeons. Would like this individual to buy in the practice eventually. Please send resume to ohiodoctors@aol.com
 
ASSOCIATE POSITION - SOUTHWEST FLORIDA

Immediate opening. Well-established podiatric group in Southwest Florida. Multi-office practice with EMR, Digital x-ray, Ultrasound and more. Seeking full-time associate that is PM and S-36 trained, personable, independent and highly motivated. Must be BC/BS in rearfoot and ankle with confidence in complex reconstructive cases. Full benefits package, competitive salary, excellent lifestyle. Email CV to: JLH459@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 - SOUTHEAST FLORIDA

Southeast Florida practice seeks PMS-36 graduate for associate position. Candidate should posses strong work ethic, motivation and excellent interpersonal skills. He/She should be comfortable in multiple clinical settings and all aspects of foot and ankle surgery. Competitive salary, benefits, incentive structure. Reply to petaldaisy@gmail.com

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 to Dr.Kassaris@yahoo.com. Applications due by Jan 31st.

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 - NEW YORK CITY
 
One of the fastest growing podiatry practices in New York City and Queens seeks a podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Preferably a Spanish speaking podiatrist. Contact me at Podocare@aol.com

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

PODIATRY PRACTICE FOR SALE - DENVER, COLORADO 

Turn-key operation with very low overhead in a multi-disciplinary office. Young patient population. Physician’s office building affiliated with a prestigious hospital. Very low buy-in/buyout. Expected transition of about two years. Perfect for family. Contact podpracsale@hotmail.com

PRACTICE FOR SALE- SOUTHERN CALIFORNIA

An extremely well-run, paperless  office on sale.  Owner moving out of state due to family reasons. State-of-art EMR system, trained staff. Office across from main hospital. From 2005-2009, average gross was ~500 K with potential of grossing a lot higher. For more details contact: podiatry-practice4sale@hotmail.com

PRACTICE FOR SALE- MARYLAND, DC SUBURBS 

Be an owner not a worker. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K. dpmpracticeforsale@yahoo.com

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