The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

January 20, 2007 #2,794 Editor-Barry Block, DPM, JD

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Plantar Fasciitis Affects Women Twice as Often as Men: FL Podiatrist

According to podiatrist Jennifer Edwards Boeri with Holy Cross Hospital, plantar fasciitis is a disorder that affects women twice as much as men. It can be caused by overuse when starting a new exercise, by weight gain, that's why pregnant women often get this and also by simply standing on your feet for long periods of time.

Jennifer Edwards Boeri

"Plantar fasciitis is an inflammation of the plantar fascial ligament, which is a ligament that runs from your heel bone out to your forefoot. Plantar fasciitis is considered an overuse injury just like any type of tendonitis," said Boeri.

Source: Amber Statler, Local 10 TC [1/18/07]

Barry To Offer Disney-Style Board Review Course

Barry University School of Podiatric Medicine’s is offering a unique 2007 Comprehensive Board Review Course to be held, May 23-27, 2007. According to Dawn Lazar, director of continuing medical education (CME) for the Barry University Division of Medicine, “Barry’s board review offers podiatric physicians the opportunity to pursue an intense, high quality program, while leaving time with their families to enjoy the fun and pleasures of Disney and other nearby Orlando attractions.”

Dr. Albert W. Armstrong, assistant professor of radiology, will present welcome address and some courses

The goal of the comprehensive board review seminar is to educate and prepare podiatric physicians to take certification examinations in podiatric surgery, orthopedics, and primary podiatric medicine. Relevant materials will be presented in an abridged manner with notes supplied in respective areas and insight will be given on how to prepare for the oral examination. After completing the course, physicians should be able to identify disease processes, appreciate conservative treatment, surgical criteria, and appropriate therapeutic procedures.

Most traditional board reviews are geared toward full immersion in lectures, slide presentations, and panel discussions ten hours a day. What sets Barry’s review apart from the others is “that we plan the schedule to allow time with family members,” Lazar said. “And it seems to work – an overwhelming number of those attendees surveyed passed their surgical or medical board exam,” she added.

Groups Line Up Behind Universal Care

Prominent labor, business and consumer groups came out in favor of universal healthcare coverage and said they would work together to force political action in Washington and individual statehouses on a set of domestic issues. AARP, the Business Roundtable and the Service Employees International Union said their partnership, called Divided We Fail, would push a healthcare agenda that includes affordable care for all Americans and a focus on wellness and prevention. Other issues on its agenda include strengthening Social Security and establishing incentives to help workers save.

AARP Chief Executive Officer William Novelli said the group would press presidential candidates to discuss its agenda publicly. “We are here today to put political leaders on notice that Divided We Fail’s joint membership – representing over 50 million Americans – are demanding action on critical domestic issues,” he said in a news release.

Source: Matthew DoBias, Modern Healthcare [1/17/07]

Query: Peroneal Spasms

I have a 52 y/o marathoner who developed pain in his right lateral ankle region following his last marathon. There is no history of trauma. On exam he experienced peroneal spasm. X-rays were negative and trigger point lidocaine injections to the sub talar joint did relieve the peroneal spasms, however he continued to experience pain once he resumed running. A subsequent MRI revealed early osteochondral defects along the posterior anterior margin of the sinus tarsi. I am curious as to other's treatment, conservative vs. surgical, for this condition.

Mark Wolpa, DPM, Berkeley, CA

Query: Hammertoe + Skinplasty

If you perform CPT 28285 (correction, hammertoe [e.g., interphalangeal fusion, partial or total phalangectomy]) on the 2nd through 5th toes, and, additionally, needed to perform a "w-plasty," "z-plasty" or "v-y" skinplasty to lengthen the skin because of dorsal lesser metatarsal-phalangeal joint skin contractures, can you bill CPT 28285 + CPT 14040 (adjacent tissue transfer or rearrangement, feet; defect 10 sq cm or less), or is the plastic skin repair considered part of hammertoe correction?

Steven Berkey, DPM, Plano, TX

Response: I think it would be reasonable to bill for a tissue rearrangement, (CPT 14040), when performing a V-Y skin plasty in conjuction with a hammertoe correction presuming there is clear evidence (documentation) of significant skin contracture requiring significant tissue rearrangement to reduce the deformity.

Howard Zlotoff, DPM ,Camp Hill, PA

Codingline subscription information can be found at
http://www.codingline.com/subscribe.htm

RE: Codingline New York Seminar
From: Daniel Chaskin, DPM

Bravo is all I have to say to Barry Block, Harry Goldsmith and all the folks at Codingline for having one of the most informative seminars that I have ever attended. I remain hopeful that there will be more seminars to come.

Daniel Chaskin, DPM, Ridgewood, NY,podiatrist1@optonline.net

Editor’s note: Much of this excellent program will be repeated in Oakland, CA on Saturday, January 20, 2007. See www.codingline.com/events-ca.htm The New York Meeting was a sellout, limited on-site registration will be available in Oakland.

RE: State of Hospitals in US (Eugene A. Batelli, DPM)
From: James J DiResta, DPM, MPH, Allen Jacobs, DPM

Dr. Batelli asked "Is there a balance to allow hospitals to be profitable and thrive as well as allow these surgical centers to stay open?"

The public health concern with this issue is an ethical one of causing an increased disparity in healthcare services. It is inevitable that free standing surgicenters with physician financial interest will place increased burden of indigent care upon the community "not for profit" hospital and thus increase the disparity in health care that has become one of the major present public health initiatives. This problem is driving legislation that will hurt the future of surgicenters and attempt to help hospitals survive.

The flip side is the same old question as to why hospitals cannot provide cost effective and efficient quality of care in comparison to that provided by the surgicenter. The answer is complex but ultimately lies in the burden that is placed upon the hospital to follow its mission to serve "all" the members of its community as well as the reality of economies of scale.

James J DiResta, DPM, MPH, James.J.DiResta.DMS04@Alum.Dartmouth.ORG

Ambulatory surgical centers provide benefits to patient and podiatric physician not available at hospitals. When the administrators of the hospitals you are concerned about are salaried in excess of $200,000-1,000,0000/yr, you need not worry about the profitability of those institutions. Here in St. Louis, hospital administrators bemoan the effects of ASI's on their bottom line. Meanwhile, they pay the salaries of PA's for orthopedic surgeons, provide them with cars, offer them priority operating room and admission privledges,advertise and generate patient referrals for them,refer all foot and ankle cases to them, and on and on and on. Podiatrists get NOTHING.

My opinion? Hospitals have, in general gotten what they deserve.

Allen Jacobs, DPM, St. Louis, MO, allenthe pod@sbcglobal.net

POSITION AVAILABLE – SOUTHERN CALIFORNIA

Los Angeles and/or San Fernando Valley. House Call Practice, Doctor on maternity leave needs Podiatrist to assist with housecalls in San Fernando Valley and Los Angeles (310, 323 and 818 area codes). Must have own car and malpractice insurance. E-mail responses to Docrandi@sbcglobal.net

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

ASSOCIATE POSITION – ST. LOUIS, MISSOURI

Immediate Opening. Busy practice in prime suburban St. Louis location looking for a surgically trained associate, possible partner. Must be honest, ethical and hardworking. ABPS preferred, but not required. Please reply with CV and requirements to mdwrtw@aol.com

EQUIPMENT FOR SALE

1 Whitehall whirlpool JO 140, 1 Whitehall whirlpool P 15 M, 3 Bailey physiotherapy stools. Would prefer to sell as package, but will sell separately. Please respond to Bob Kornfeld, DPM at Holfoot153@aol.com or call 516-869-3338.

ASSOCIATE POSITION - MID-EASTERN, NORTH CAROLINA

Potential partnership - Well-established and extremely respected single location practice. Small city east of Raleigh near coast with excellent fishing, hunting, and outdoor activities. Must be personable & motivated with strong surgical and medical skills. Prefer PSR-24/36 training with active (or in process of obtaining NC license). Send CV to ncfootankle@aol.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-SOUTH FLORIDA/BROWARD COUNTY

Needs 2 or 3-year post surgical training in forefoot and rearfoot
Salary plus incentives Email responses to office email: advfoot@bellsouth.net

EQUIPMENT FOR SALE - METTLER SONICATOR 715 ULTRASOUND

Mettler Sonicator 715 Ultrasound with 5cm2 with delivery head, great in any podiatry office for multiple uses. The cheapest I am able to price this machine new, is on Esurg at $1396.77. My unit was used about 20 times, and is about 2 years old. I will let it go for $650.00 plus shipping. Like new condition. If interested, write deg1@comcast.net

EXCELLENT ASSOCIATE OPPORTUNITY – SOUTHERN CALIFORNIA

Established 25 year well-rounded biomechanical and surgical practice seeking energetic, enthusiastic, personable and proficiently-trained PSR-24 or PSR-36 foot and ankle surgeon for associate with ultimate partnership opportunity in LA area. Excellent position for an individual interested in all aspects of podiatric medicine with emphasis on reconstructive foot and ankle surgery. Only 8% Medicare with No HMO. Email CV to dr4feet@sbcglobal.net

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

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- 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

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