The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

January 20, 2011 #4,068 Publisher-Barry Block, DPM, JD

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Correction

Dr. Frank Spinosa was elected President Emeritus of the New York Foundation for Podiatric Medicine, not of the NY Clinical Conference, as previously reported.

Soccer Playing Kids Should Not "Play Through the Pain": TX Podiatrist  

Soccer season is in full swing, and a local foot and ankle surgeon strongly urges parents and coaches to think twice before coaxing young, injury-prone soccer players to "play through" foot and ankle pain. "Skeletally immature kids, starting and stopping and moving side-to-side on cleats that are little more than moccasins with spikes - that's a recipe for foot and ankle sprains and worse," cautions Dr. Ed Davis, a member of the American College of Foot and Ankle Surgeons.

Dr. Ed Davis

"Kids will play with lingering, nagging heel pain that, upon testing, turns out to be a stress fracture that neither they, their parents, nor their coaches were aware of," he said. "By playing with pain, they can't give their team 100 percent, and they make their injuries worse, which prolongs their time out of soccer." Davis said he has actually had to show parents x-rays of fractures before they'll take their kids out of the game. "And stress fractures can be subtle - they don't always show up on initial x-rays."

IA Podiatrist Elected President of Broadlawns Medical Staff

Denise M. Mandi, DPM has been elected President of the Medical Staff at Broadlawns Medical Center in Des Moines, Iowa and will begin her term on Feb. 1, 2011. Dr. Mandi currently serves as Section Chief of Foot and Ankle Surgery at Broadlawns. She was recently named Vice-Chair of the Iowa Board of Podiatry and is a guest editor of the total ankle joint replacement issue of Foot and Ankle Quarterly. 

Dr. Denise Mandi

Dr. Mandi is the first podiatrist in the State of Iowa to be certified in all total ankle joint replacement procedures and was a pioneer in the use of DeNovo cartilage graft replacement in the great toe joint.

Retired OH Podiatrist is Partner Racetrack/Resort Plan 

Two Ohio developers announced this morning that they have an option on land to build a multi-million dollar racetrack and resort in the Mahoning Valley. They did not reveal the exact location of the complex, only saying that it would be announced in the coming weeks. Speaking at Mr. Anthony's, Rick Lertzman and Dr. Bradford Pressman - partners in the Mahoning Valley Development Group - also said the $300 million complex, dubbed Mahoning Valley Downs, would employee about 2,000 people permanently, have a mile-long horse track, as well as an 18-hole golf course, among other amenities.

Lertzman, a former business consultant, and Pressman, a retired podiatrist announced last week that they plan to build an entertainment complex that will include Ohio's eighth horse racing track, a five-star hotel and spa, a championship golf course, live entertainment, theaters, restaurants, and possibly a casino.

Source: Tribune Chronicle [1/18/11]

House Takes up Reform Repeal Debate

The U.S. House of Representatives has begun its ambitious legislative agenda with healthcare, as House members started consideration of repealing the Job-Killing Health Care Law Act. The House re-convened at 2 p.m. ET, and a schedule released last week called for seven hours of debate on the measure.

House members are expected to conclude consideration of the repeal bill with a vote on Wednesday before they consider a resolution on Thursday to replace the Affordable Care Act. 

Source: Jessica Zigmond, Modern Healthcare [1/18/11]

OH Joins Growing List of States Challenging New Healthcare Law

Ohio Attorney General, Mike DeWine (R), took actions Jan. 10 to join the increasing number of states challenging the constitutionality of the health reform law. “Our Constitution provides for a federal government of significant, but defined and limited powers,” DeWine said in a prepared statement. “By ignoring the constitutional limits on federal power, the healthcare law tramples on the rights of Ohio’s citizens.”

More than 20 states have asked the court to declare the healthcare law unconstitutional in a lawsuit pending before the U.S. District Court for the Northern District of Florida.

Source: AIS's Health Reform Week [1/17/11]

Query: Atypical Skin Lesions

This 66 y/o male presented with thick keratotic plaques on the dorsum of his R 1st-4th toes of four years duration. Patient denies any pain or itching associated with them, but would like to consider treatment because of the unsightly appearance. Exam reveals keratotic build-ups up to 1 cm. thick with small villous-like projections and deep fissures at the natural skin fold areas. There is a greenish hue and mild malodor suggestive of pseudomonas colonization.

Atypical Skin Lesions

The patient has similar plaques without the villi on the medial/lateral aspect of his contralateral ankle. PMH - venous insufficiency b/l ankles with chronic R ankle stasis ulcer, meds - none, SH - smokes 1 ppd  x 40 yrs. His overall foot hygiene is very poor. I suspect he does not wash his feet or change socks on a regular basis. I would appreciate any thoughts on diagnosis/treatment options for this condition.
 
Judd Davis, DPM, Colorado Springs, CO
 

RE: The Passing of Donna Landi, DPM
From: Simon Young, DPM, A. Olvera, DPM

I was saddened to learn about the tragic death of my classmate, friend, and colleague. She died in the same type of motor vehicle accident which killed her beloved parents. She was a nice, down-to-earth, and humble person.

Simon Young, DPM, NYC, NY

I am saddened to hear of Dr. Landi's passing. I got to know Donna quite well during our time at St. Vincent's Midtown in New York City, a few years back. She exemplified the true epitome of what and how a podiatrist should be. If only, we had more podiatrists like her. She will be greatly missed. Rest in peace, Dr. Landi.

A. Olvera, DPM, San Antonio, TX

RE: Homeopathic Injections? (Robert Bijak, DPM)
From: Marc Katz, DPM, Elliot Udell, DPM

Dr. Bijak is "on the money" when he questions whether it is ethical for a licensed physician to administer a homeopathic injection or preparation. Such concoctions are along the lines of witchcraft. The website, Homeowatch.com gives the entire history of homeopathy and explains how unscientific it is.  Whatever is in the vial  is so diluted that what you are injecting is in essence plain water. On the other hand, there are many people who believe in these so-called remedies and will gravitate to healthcare professionals who will give these injections in lieu of legitimate medical therapies. They are willing to pay large sums of money to these practitioners.

The way to give a homeopathic injection and still be ethical is to be honest with the patient. Let them know that homeopathy lacks scientific credibility. Let them visit the website and see why astute physicians react in the way Dr. Bijak does toward the concept of a licensed doctor giving these injections. Then, and only then, if the patient wants such an injection, can the doctor administer it and still have a clear conscience. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

Great question Dr. Bijak. First, everything cannot be looked at as "we." As licensed physicians, each individual can provide various effective treatments to patients. Poll each physician, and most will provide differing treatments. Podiatrists have a choice; they can practice in the past or they can get up-to-speed with the new medical paradigm. That includes integrative and functional medicine. Homeopathy is part of that paradigm. 

Do you suggest that a physician not take money for providing medical care?  I would assume most podiatrists take money for giving someone an NSAID and never really find out the cause of the patient's inflammatory process. The patient just keeps getting drugs to treat symptoms. Should we be taking money for this medical care without addressing the source of the problem? Now, that's an even better question! If podiatry stays asleep, it will once again be left behind while all other medical specialties are recognizing and implementing the new paradigm. Functional medicine is being embraced by major teaching institutions and is the future of medicine. 

I suggest that "we" crawl out of our holes and get up-to-speed with what is guaranteed to be the future of medicine. It is already here and only going to become larger. I suggest that people keep an open mind. This is the excellent level of care that patients deserve, and it can be life-changing.

Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

RE: Scarf Complication (Name Witheld)
From: Tip Sullivan, DPM

Treat this like you would an open fracture (>6-8 hours old). Here are some other points (assuming that you have a good consent): Did you culture the screw that you took out? Was there contracture at the IPJ hallux pre-op? Is the fancy clip in the 5th digit in the 5th MTPJ? Why would you fuse the PIPJ of the 5th digit? Were the 2nd and 3rd MTPJs subluxed before surgery? There appears to be some radiolucency at the proximal screw that was left in the site. Did you get an ID consult?
 
If you do not feel comfortable handling this type of complication, I suggest that you ask a colleague to help you locally. Document, document, document, and take photos at each visit.
 
Tip Sullivan, DPM, Jackson, MS, tsdefeet@msfootcenter.net

RE: Overlapping 2nd Toe (Sean Ravaei, DPM)
From: Jeffrey Kass, DPM, Jon Purdy, DPM

In dealing with a case like this, I think it is important to know more about the patient, i.e., the patient's age. The simplest procedure would be a second digit amputation. The toe itself is serving no mechanical function, and that is the only location where there is pain. There would be little worry with regard to post-op healing.

From a cosmetic standpoint - I think the foot would look more "normal" as well. If the patient, for whatever reason, is against an amputation, the apex of the deformities looks to be at the MPJ, and so I think you would have to perform transverse osteotomies of 2-5, moving the heads medially, and then fixing the hammertoe via plasty or desis, depending on your preference. 
 
Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

It appears from the one x-ray shown that the lesser metatarsals are long enough, compared to the first, to undergo decompressive Weil osteotomies in conjunction with capsular work for this wind-swept deformity. I believe you would find this long-term contracture a problem post-operatively without some type of decompression proximal to the MPJ level.

Jon Purdy, DPM, New Iberia, LA, Podiatrist@mindspring.com

RE: Credit Cards on File (Joel Lang, DPM)
From: Joe Gonzalez, DPM

Thank you, Dr. Lang. While we do have a concise well-written financial policy for patients, I am just wondering if there is a second choice for having a credit card on file. For patients who do not have a credit card or do not want to leave one on file, are offices requiring them to pay in full for the visit up-front, then reimbursing them once insurance pays? Or can you just take the patient's money in full up-front and have the patient submit a bill to the insurance company?

Joe Gonzalez, DPM, East Lansing, MI, gonzalez.joe@gmail.com

RE: Contact Management Software (Ken Meisler, DPM)
From: Paul Hilbert, DPM

I bought Cardscan about 15 years ago for less than $100. I don't know how much it is now, but you might want to check it out.

Paul Hilbert, DPM, Navarre, FL, coastalp@bellsouth.net

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.

TEXAS- WONDERFUL OPPORTUNITY! 

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 - 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

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 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 - NASSAU COUNTY, NY

Experienced board certified podiatrist wanted for busy diversified practice located in Nassau County, New York. Energetic DPM, please send CV to JELLA810@GMAIL.COM

ASSOCIATE POSITION - TEXAS

Associate position leading to partnership available for motivated, surgically skilled, personable podiatric physician. Good compensation and benefits. Respond to footcenter1@sbcglobal.net with a cc: to lisa.schulze@yahoo.com

POSITION AVAILABLE - NEW YORK

Well-established, multi-doctor podiatry practice with offices in Putnam and Westchester counties.Compensation based on productivity. Excellent opportunity for recent or June 2011 residency graduate to build skills and learn practice management. Full-time preferred but right part-time candidate will be considered. Email cover letter and CV to: podiatry2011@gmail.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

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

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.

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 

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 - 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

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

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451. 

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