The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

January 14, 2011 #4,063 Publisher-Barry Block, DPM, JD

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UGG Boots Create Fungus Risk: NY Podiatrist

For the past few years, UGG Boots and copy-cat designs like them have been found on the feet of women – and men – all over the world. Known for being as ugly as they are comfortable, the boots are a staple in the closets of those who can afford them. Aside from being rather unattractive, there is a new reason you might want to refrain from purchasing the boots other than simply not wanting to look like everyone else: they may increase your chance of contracting foot fungus. 

Dr. Oliver Zong

According to Olivier Zong, DPM, the director of surgery at NYC Footcare, “fungus breeds in dark, wet environments. These are conditions that are usually seen inside trendy sheepskin boots.” Such fungi, according to Dr. Zong, can be very difficult to get rid of once the fungus gets into your toe nails.

Source: Danielle Odiamar, Long Island Press via Fashionista.com [1/11/11]

VA Podiatrist Organizes 20th Shoe Drive for the Needy

Charlottesville's "Shoes For The Homeless" drive is in full swing, but more donations are needed to make sure no one's feet get cold this winter. Over the past 20 years, the shoe drive has given away more than 80,000 pairs of shoes to people who need them. Organizers say shoe donations are pouring in, but there's a special need for shoes in children's sizes.

Dr. Samuel Schustek

Dr. Samuel Schustek, an area podiatrist and organizer said, "Bring me your shoes. We take shoes in almost any condition. The shoes are distributed in early February to the local community. The shoes that are not distributed sometimes will go overseas to the needy, and we also distribute them in other areas in our community."

Source: Kasey Holt, WVIR-TV (NBC) [1/11/11]

NY Podiatrist, Now Realtor, on Hit Cable Show

Richard Steinberg has gone from charging by the foot to, well, charging by the foot. The newest broker on the second season of HGTV's hit show Selling New York has a past in podiatry. The Warburg Realty broker, who was on the series' season premiere Thursday, tells us he got his start in podiatry in the '80s with practices in Staten Island, Riverdale, and Brooklyn.

Dr. Richard Steinberg

Steinberg says he switched to real estate in the early '90s, but continued to be a podiatrist for three years.

Source: New York Daily News [1/11/11]

MGMA Finds Traits of Top Practices

Better-performing medical practices outshine other groups in four categories—accounts receivable and collections; patient satisfaction; productivity, capacity and staffing; and profitability and cost management—according to a new Medical Group Management Association (MGMA) report, Performance and Practices of Successful Medical Groups: 2010 Report Based on 2009 Data.

The top-performing practices in the survey kept their accounts receivable much lower than other practices did and for the most part spent more on information technology, according to the report. Among multispecialty practices, accounts receivable 120 days or older were reported to be 10.2% of the total, while for the rest of the multispecialty practices in the survey, they were 21.3%. In addition, the highlighted practices performed more procedures per full-time-equivalent physician than the others in the survey.

Source: Paul Barr, Modern Physician [1/12/11]

Query: Blue Goo Orthotic

Ruch's orthotic lab used to make an insole for rheumatoid patients that was soft and cushiony. It was called a Blue Goo orthotic. Does anyone know of a company that makes these inserts now?

Francois Harton, DPM, South Haven, MI

RE: Recurrent Neuroma Pain (Randy Lisch, DPM)
From: Doug Smith, DPM, Tip Sullivan, DPM

Just a reminder to check adjacent interspaces for neuromas. I had a similar case referred to me for persistent pain after another surgeon removed a 3rd interspace neuroma. After failed ETOH injections, I re-examined her and, sure enough, there was an obvious Mulder's sign in the 4th interspace. Treatment of this resolved her symptoms. Diagnostic injections of anesthetic into the 4th or 2nd interspace may help pinpoint the problem.

Doug Smith, DPM, Raleigh, NC, footfixer@nc.rr.com

After you are sure this is the problem using appropriate nerve blocks, I would schedule about one hour or more to do a very careful dissection under loupe magnification to find the common digital nerve stump (Plantar incision following the relaxed skin tension line as much as possible), then resect it more proximally, and bury the end into the closest muscle belly. Some people try to close the perineureum with 9.0 nylon; others believe in burning the end of the nerve. I am a proponent of simply carefully spreading the muscle fibers, tucking the nerve gently into the muscle and placing a 5.0 or 6.0 suture in the muscle (not the nerve) to purse-string  the nerve in place. 
 
Tip Sullivan, DPM, Jackson, MS, tsdefeet@msfootcenter.net

RE: Verruca Needling Technique (Laurence Rogers, DPM)
From: Bryan C. Markinson, DPM

We often see what I call “innocent exaggerations” in these forums and others. Examples are statements like “I have excised hundreds of plantar fibromas,” or “I have excised several thousand neuromas.”  Dr. Laurence Rogers reports that his needling technique for verrucae has a 95% success rate. This is an impossible number to calculate unless he tells us how he does it. If the warts come back, which he implies is only five percent of the time, how does he calculate that? What of the recurrences that do not return to his office? And how long after the procedure does a re-growth qualify as a failure? And lastly, why doesn’t he report these extremely fantastic results in...

Editor's Note: Dr. Markinson's extended-length letter can be read here.

RE: Recalcitrant Verraca (Simon Young, DPM)
From: Multiple Respondents

In dealing with a lesion of this size, it would be prudent to make multiple biopsy sites at the periphery and central portions of the lesion. This ensures an accurate determination of the pathology and formulation of the patient's treatment.
 
Gino Scartozzi, DPM, New Hyde Park, NY, Gsdpm@aol.com

A laser that I have used with great success is the Q-Clear Quick Switch laser. This portable 35 lb laser has both a 1064 and 532 wavelength. It is FDA-approved for the treatment of warts. 
 
David Zuckerman, DPM, Cherry Hill, NJ, footcare@comcast.net

I am concerned about some of Dr. Young's comments that may be misleading to the profession and should be addressed. First, he says, "your body doesn't recognize their existence." This is not correct. Viral antibodies can be found in the serum through appropriate lab testing. He seems to forget that verrucae are supplied by blood vessels from the dermis and there is an intimate interaction. Where does the blood come from and the "black dots"? A verruca isn't just a callus sitting dead on the skin.

Multiple respondents have addressed using the immune system via immune stimulating treatments (needling, candida injections, and...

Editor's Note: Dr. Bijak's extended-length letter can be read here.

RE: Comprehensive Diabetic Foot Examination: E/M, LOPS, or $$$
From: Paul Kesselman, DPM

Over the last two years, I have published several articles and have been an advocate of performing the comprehensive diabetic foot examination (CDFE). Apparently, many of the readers of these forums have misinterpreted my strategy, and I would like to set the record straight.

Some physicians are advocating billing carriers for a CDFE irrespective of the patient’s eligibility under either medical necessity for E/M coding or loss of protective sensation (LOPS). The following should serve as a wake-up call for...

Editor's Note: Dr. Kesselman's extended-length letter can be read here.

RE: Phreesia Joe Gonzalez, DPM
From: Mathew M. John, DPM

We used a similar company here in Georgia that was set up to verify insurance and swipe credit cards. We tried it for a year and were very disappointed. The verification was not available for all insurance plans and it did not provide specific info on coverage for certain items such as orthotics. The credit card fees were not a savings compared to other companies. We ended up canceling our contract and went back to the only thing that seems to work every time: calling the insurance company to verify benefits. I switched my merchant account to a major credit card processor and got great rates. The concept sounds great but they are far from making it what we really need.

Mathew M. John, DPM, Marietta, GA, footdoc@afcenters.com

RE: Practice Fusion
From: Thomas Clark, DPM

There has been a lot of discussion on Practice Fusion. If you have had the opportunity to view the program, you will have to agree to their legal terms. Although this is a general synopsis and not legal opinion, I thought it may be helpful for some to consider with respect to the use of Practice Fusion.

BOTTOM LINE: Security of the system relies heavily upon doctors following the rules. Back your own data up. If you decide not to use the program anymore, they'll give you your data back for free in a form that can be accessed by "commercially available" software.

1) Practice Fusion promises to... 

Editor's Note: Dr. Clark's extended-length letter can be read here.

RE: Vibram Five Fingers Should Not be Marketed to Runners: CA Podiatrist
From: Dennis Shavelson, DPM

I have a much more moderate position than Dr. Kirby’s call to ban advertising of Vibram shoes to runners. Barefoot running is a lifestyle that has its success stories. Many of its followers have successfully chosen barefoot running after failures with modern running shoes and orthotics. The extremists in their ranks are calling for the ban of modern running shoes, orthotics, and podiatry.

I believe that some of us can or would effortlessly barefoot run, and some should never think of joining that lifestyle. Others can become barefoot runners safely with the mentoring and care of a biomechanically-oriented podiatrist who is capable of delivering a custom training regimen, temporary training orthotics, muscle engine exercises, and rehabilitation.

Podiatry’s place on the barefoot running issue and others (rocker bottom shoes, for example) is not political (call for banning); it is to educate the public on the medical and biomechanical pros and cons of these issues and to provide safe avenues for those who wish to assume the lifestyle.

Dennis Shavelson, DPM, NY, NY, drsha@lifestylepodiatry.com

ASSOCIATE POSITION - OHIO/INDIANA

PrimeSource Healthcare, a leading provider of mobile, on-site healthcare services at long-term and skilled nursing facilities. Our exceptional growth has created a need for traveling, independent contractors of podiatry services in Ohio/Indiana. Earn between $175k and $225k per year. E-mail CV to Kris Wright, kwright@pshcs.com. 847-580-5960. Visit us at pshcs.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

ASSOCIATE WANTED - CENTRAL FLORIDA

Well-established Multi-practice Central Florida Office is seeking an associate. Look for a personable, energetic individual who is self-motivated and conscientious. We offer a Competitive salary with full complement of benefits. Excellent opportunity for a promising future. Please submit CV to cmedders@atlanticpodiatry.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

Board certified podiatrist (ABPS, ABPOPPM) 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

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

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 - 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

ASSOCIATE POSITION - SOUTH CENTRAL PENNSYLVANIA

Eight-physician podiatry group with six locations in South Central Pennsylvania looking for a ninth full-time associate with a minimum of a three-year surgical residency and interest in future partnership. We offer a very busy, fast paced environment with an excellent support team. State-of-the-art practice with our own physical therapy department and surgical center. We offer a six figure salary with competitive bonus incentives, CME allowance, 401K, paid malpractice insurance, as well as established patient base. Persons interested in pursuing this opportunity, email CV to: MFATRANS@AOL.COM

ASSOCIATE POSITION – CENTRAL VIRGINIA

Immediate opening. Multi-office practice, completely automated, hospital and surgery center privileges available, ED call, full service foot and ankle practice. Competitive salary/incentive structure and full benefits. Investment opportunities include practice partnership and two surgery centers. Submit letter of interest and CV to Rex Wilson, Practice Administrator at www.silverjet21@hotmail.com

ASSOCIATE POSITION - WISCONSIN

Seeking a surgical podiatrist in Central Wisconsin. Great salary and benefits. Potential for partnership. Busy, well-balanced practice in a rapidly growing area. Email interest to ftsurg@yahoo.com or fax resume and cover letter to 715-241-8102.

ASSOCIATE POSITION - PHILADELPHIA, SOUTHERN NEW JERSEY 

  Seeking motivated, independent foot & ankle surgeon to join large practice. Our multi-office practice covers all aspects of foot and ankle pathology, including heavy hospital volume. Offering competitive salary and benefit package. Send CV and two references to bleich5252@yahoo.com

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

SHOCKWAVE MACHINE FOR SALE

D-Actor 200 by Storz Medical. High Frequency Extracorporeal Pulse Activation Treatment (EPAT) System. A little over a year old, excellent results for plantar fasciitis and Achilles tendonitis. Must sell;  practice merger. Selling for $18,000 (new machine >30K) Will include onsite training if necessary. Email footdoc21@gmail.com

EQUIPMENT FOR SALE - MICROVAS UNITS

Two lightly-used microvas units , 16-lead machines (included) , $7,000 each or best offer for both. Great therapy modality: edema, neuropathy pain, increases peripheral flow, increase soft tissue healing. Great practice from vascular surgeons sending patients for treatment, pays for itself. Unit comes with the charger and 16 leads. jhalvorsen@familyfootandlegcenter.com 

EQUIPMENT FOR SALE - COOL TOUCH LASER 

Cool Breeze Cool Touch CT3 plus laser used for fungus toe nail infections Less than six months old. Great price won't last  long. Considering a laser? This laser is perfect for you. E-mail footcare@comcast.net

BOSTON UNIVERSITY LIMB PRESERVATION FELLOWSHIP PROGRAM

Boston University Medical Center has a accredited fellowship position. Become an expert in Limb Preservation, Tissue Repair and Regeneration. Be part of this unique Fellowship at a major teaching facility. During this time, you would be expected to become a knowledgeable expert who will contribute significantly to research, surgical procedures, teaching, and innovation. Requirements: Completion of a two or three year surgical residency; Candidate must possess a commitment to an academic career in Podiatric Medicine and Surgery. Submit a CV and letter of interest to: Erin Springhetti erin.springhetti@bmc.org and Dr. Vickie Driver Vickie.driver@bmc.org or if questions call 617-414 6821.

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

PM News Classified Ads Reach over 12,500 DPM's and Students

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