The Voice of Podiatrists

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January 21, 2008 #3,146 Editor-Barry Block, DPM, JD

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SC Podiatrist Will Run for U.S. Senate

Howard A. Staley, 52, announced yesterday that he would enter the Democratic primary against state Sen. Kay Hagan and Chapel Hill investment banker Jim Neal.

Dr. Howard Staley

He said that he wants to add his experiences as a doctor, patient and employer to the upcoming debate over health care in Congress. In particular, he argued that insurance companies are charging excessive fees at unsustainable levels.

A native of Philadelphia, he moved to Chatham County 26 years ago to work as a podiatrist. Having never run for public office before, he said he knows he faces an uphill battle. Cary, SC graphic artist John Ross Hendrix and Lexington trucker Duskin Lassiter are also running as longshot candidates. "I know that it's a longshot," he told Dome, "but I wanted to offer myself up as a candidate."

Source: Raleigh News & Observer (NC) [1/19/08]

Superbones ’08 Biggest and Best Ever

Dr. Stanley Kalish and his Superbones conference committee (Drs. Karen LeMorge, Richard Reuter, John Steinberg, and Charles Zelen) did it again. A capacity crowd of over 260 DPM's were treated to world-class lectures in a weather-perfect tropical paradise.

Dr. Kalish presents Superbones Lifetime Achievement Award to Dr. Allie

One of the highlights of this year's meeting was the presentation of the Superbone Lifetime Achievement Award to David Allie, MD. Dr. Allie, an endovascular surgeon has been a stauch supporter of podiatry and has been instrumental in convincing both hospitals and allopathic seminars of the importance of having podiatrists on staff and included in educational presentations. Also honoring Dr. Allie, a Louisiana native, was a rescued sea lion from Hurricane Katrina.

Dr. Allie surpised by Sea Lion

Among the engaging activies were performances by hypnotist Kevin Lepine and a gala Bahamian Reception.

Next year's Superbones conference will be held January 15-18, 2009 at Atlantis Resort on Paradise Island, The Bahamas. Special Kudos to Drs. Alan Sherman and Michael Shore for their role in taking this meeting to the next level.

WSPM Elects New Officers, Presents Awards

The annual meeting of the Wisconsin Society of Podiatric Medicine was held January 19, 2008 in Milwaukee, WI. Distinguished service awards were given to Louis Lapow, DPM for years of work in residency education, to Lisa Reinicki, DPM for her chairmanship of the State Podiatrists Affiliated Credentialing Board, and to Michael Thompson, DPM for his service as President of WSPM 2006-2007.

Dr. Robert Sage

The new officers elected for two-year terms were:
President: Robert Sage, DPM
President Elect: Todd Connell, DPM
1st Vice President: Steve Merckx, DPM
2nd Vice President: Michael DeGere, DPM
Secretary: Mark Smith, DPM,
Treasurer: Giuseppe Miceli, DPM
Board of Directors: Michael Nute, DPM, William Weis, DPM, Rene Settle-Robinson, DPM and Alyssa Stevenson, DPM

Query: Hibbs Tenosuspension

I am looking for feedback from some readers in regards to the Hibbs tenosuspension. What has worked better, tenodesis to the metatarsal heads or more proximal into the lateral cuneiform? And what type of fixation has worked best?

Brandon M. Zuklie, DPM, Piscataway, NJ

Query: Employee Sick Time and Vacation Time

Does anyone know what the industry standard is in regard to staff sick time and vacation time? I have an employee who has been with me for two years now. She functions as my office manager, receptionist, and biller.

Chris Seuferling, DPM, Portland, OR

RE: Resistant Verruca (Richard Burnell, DPM)
From: Multiple Respondents

If warts appear to be resistant to treatments they should be biopsied for confirmation that they are really warts. Once that has been established, then I will continue to treat warts with a variety of methods. One technique that appears to be very effective in children is to use the handheld nitrous oxide CryoProbe for cyotherapy. I sometimes recommend combining several types of treatments if one doesn't appear to be working well for me.

G. Dock Dockery, DPM, Seattle, WA, gdockdockery@aol.com

I think the first appropriate thing to do in this situation is a simple punch biopsy. I always biopsy warty lesions that have been resistant to numerous treatment modalities (regardless of whether I have treated them or other physicians have treated them). The literature is pretty supportive that a high percentage of warty looking lesions in children are verruca, but in adults, maybe only 50% of warty looking lesions are verruca. Even in kids, I have found a few warty looking lesions not to be verruca.

With resistant lesions, I have had tremendous success with intralesional injections of bleomycin. Your local compounding pharmacy should be able to make the medication for you. I perform a proximal "V" block with 2% lidocaine with epi and then inject the lesion directly until it blanches. Most lesions require about 0.1-0.2cc of bleomycin. The lesion will be painful for 3-4 days and should turn black. I debride them in 3 weeks and find pink healthy skin underneath.

Patrick Campbell, DPM, Wadsworth, OH, drcampbell@wadsworthfootandankle.com

If your patient's feet are hyperhidrotic, your ability to eradicate the warts are diminished. The feet have to be dried out with formaldehyde solution or aluminum chlorhydrate for several weeks before attempting re-excision. When you excise warts, it's helpful to electrodesiccate the lesions and scoop out the skin in layers until you can see skin lines. I also use CO2 laser for smaller lesions - but for large and multiple lesions, CO2 laser treatment lends itself to concern about a zone of expanding thermal necrosis which can cause scarring. Check out the JAPA 1982 article by Grayson, Ratner, and Shaps on treating resistant verruca plantaris with DNCB. DNCB in the right medium can covalently bind with wart cells and the warts can be eliminated via T-cell immunity quite effectively. The key is to keep the response under control. Hyperhidrosis must be under complete control.

Rich Grayson, DPM, Avon, CT, rjg2002@hotmail.com

RE: Overpayment Demands
From: David Mullens, DPM, Esq.

In response to several emails from podiatrists asking what is needed to prove damages in a lawsuit against an insurance company regarding repayment of overpayment demands, here is what you should put together for each claim:

1. A copy of the progress note or procedure report for the date of service at issue,
2. A copy of the HCFA 1500 claim form submitted for that date of service,
3. A copy of the EOB showing payment for that date of service,
4. A copy of the demand for repayment of overpayment from the insurance company,
5. A copy of your protest letter regarding the overpayment,
6. A copy of the notice from the insurance company stating the overpayment would be taken out of your future earnings, and
7. A copy of the subsequent EOB demonstrating the overpayment amount was deducted from payment of another claim.

If you can’t find some of the above insurance company-generated documents, send the ‘provider relations’ department a registered letter requesting those documents. If they stonewall you, and you want help, you may contact my office (by email, please). I will help you draft the appropriate letter to the insurance company to get these documents and you will not be charged a fee for this service.

David Mullens, DPM, Esq., Palo Alto, CA, dmullens@mullenslawoffice.com

ASSOCIATE POSITION - NEW YORK CITY

Excellent opportunity for foot/ankle surgeon, Manhattan and Brooklyn Associate position leading to possible partnership. Requirements: Two years enrollment in a surgical residency program Qualities of self-motivation and impeccable skills in forefoot and rear-foot surgery. Package Includes: Malpractice insurance, Health Insurance plus salary, Incentives. Terms negotiable Email CV to Manfootcare@aol.com 212-349-7676

SEEKING ASSOCIATE WITH POTENTIAL TO FULL PARTNER

Busy multi-physician podiatric group with 2 locations seeking BQ/BC surgically trained doctor. Applicant should be well-trained in all aspects of surgical and conservative care. Seeking ethical, hard working and outgoing physician to join our 4-hysician group. Excellent quality of life in suburban Houston, near NASA and the Gulf of Mexico. Email CV and cover letter to Dr. M. Rockett at Mrockettman@comcast.net.

INTERVIEWING AT NEW YORK CONFERENCE: JAN 25-26TH

Looking for well-trained (PSR- 24/36) personable, energetic practitioner to join multi-office practice in the beautiful Hudson Valley. Well-rounded practice including general podiatry, high volume orthotics, and reconstructive surgery. Outstanding opportunity to work into partnership. Competitive starting salary, bonus incentives, benefits, and pension. Submit: CV, letter of intent and references to: footassociate@yahoo.com

Unique & rare opportunity for a Japanese-bilingual podiatrist. Seeking motivated, conscientious, and ethical individual with excellent people skills for associate leading to ownership or a buyer for immediate purchase. No nursing homes & well-established referral base. Serious inquiries only. E-mail letter of introduction, photo and CV to: socaldpm@gmail.com

ASSOCIATE POSITION- CONNECTICUT

Established Practice looking for PSR 24/36 trained surgeon. Must have experience and be responsible for all surgical cases for the
practice. EMR and digital x-ray in new 6-treatment room office.
Hospital privileges available. Connecticut has a new ankle law for the
Properly-trained DPM. Competitive salary, benefits, and bonus. Great area to raise a family. Fax resume to 860 243-5790

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com -- www.homephysicians.com

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City . Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

PRACTICE FOR SALE - SOUTH CAROLINA

Upstate SC practice of 25 years. Retiring. High volume, high grossing. 60% routine foot care, 40% surgery. Several nursing homes. Plenty of opportunity for growth. Hospital and Surgery Center privileges. Financials available upon request. Serious inquiries only! Beautiful area. Contact: Carolinafootdoctor@yahoo.com

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 – VIRGINIA

Must have Virginia license. Requires 24 to 36 month Residency. Permanent position with potential buy in. Includes all phases of Practice excluding nursing homes. Competitive Salary and Benefit package. Please send Resume including salary requirements and availability date to needpodjob@yahoo.com

PART-TIME PRACTICE FOR SALE - FLUSHING, NY

40 year old part time practice for sale. Priced for quick sale. Please contact me at footdoc60@gmail.com. Serious inquires only, please

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