The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

January 21, 2011 #4,069 Publisher-Barry Block, DPM, JD

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APMWA Announces 25th Annual Student Writing Competition

The American Podiatric Medical Writers Association has announced its 25th Annual Student Writing Competition.

• All papers MUST be non-technical in nature. Appropriate subjects include practice management, ethics,or any topic that would be suitable for a lay publication.
• There is no word limitation. Papers will be graded for content, style, grammar, neatness, and overall impact.
• First prize will be one thousand dollars ($1,000.00), sponsored by an APMA Educational Foundation endowment from Dr. and Mrs. Steven Berlin, and recognition in the APMA NEWS and the APMWA Newsletter. Honorable Mention Certificates may also be awarded.
• This competition is open to ANY enrolled podiatric student.
• Entries must be received by 4/1/11 via e-mail at bblock@podiatrym.com
• Entries become the property of APMWA, which may arrange publication of the entry.

UK Podiatrist Lectures at Women's Health Institute

Four healthcare professionals in the Isle of Man have spoken to a local branch of the Women's Institute about the importance of looking after their ears, feet, and breasts. Audiologist Guy Wolstencroft, podiatrist Owen Thomas, and Sue Ardern and Hilary Miller from the Breast Care Team at Nobles Hospital spoke to the Spring Chicks Women's Institute last week.

(L to R) Dr. Owen Thomas, Spring Chicks Debbie Kenyon and Nicola Tooms, and Guy Wolstencroft.

Owen spoke about the importance of caring for feet from a young age and how relatively small muscles in the feet can have significant impact on the hips and knees if they are not used properly.

Source: Tessa Hawley, Iselofman.com [1/19/11]

House Votes to Repeal Healthcare Law

A majority of members in the Republican-led House of Representatives voted on Wednesday, mostly along party lines, to repeal President Barack Obama's landmark healthcare law.

The U.S. House of Representatives voted 245-189 to repeal the 2010 Patient Protection and Affordable Care Act, with three Democrats supporting the Bill. The measure is unlikely to go any further, as the Democratic-controlled Senate is expected to drop it.

Source: Donna Smith and Richard Cowan, Reuters [1/19/11]

Most Docs Fear Health Reform: Survey

Nearly two-thirds of U.S. doctors surveyed fear healthcare reform could worsen care for patients, by flooding their offices and hurting income, according to a Thomson Reuters survey released on Tuesday. The survey of more than 2,900 doctors found many predict the legislation will force them to work harder for less money.

"When asked about the quality of healthcare in the U.S. over the next five years, 65 percent of the doctors believed it would deteriorate with only 18 percent predicting it would improve," Thomson Reuters, parent company of Reuters, said in a statement.

Source: Reuters [1/19/11]

10 Reasons Why YOU Need a Practice Website - Part 1

1. To be discoverable - Done right, your search-engine optimized website will enable you to own the number one position in search engines for the search terms your prospective patients are using. These search terms aren’t necessarily the ones you are thinking of — you need to use the available tools to discover how your prospects are finding out about you on the Internet.

2. Broadcast your brand - Good design and well-written, thoughtful web copy will communicate the “promise” of your practice.

3. Build your reputation -You can use a blog and/or an article library on your site to share your expertise on the topics on which you are an authority. Remember – being an authority doesn’t mean you are a world-famous clinician or researcher. It simply means you know a whole lot more than your patients and are eager to share that knowledge!

4. Create trust - Your bio and credentials, your shared expertise, perhaps a homepage greeting video — all these elements, when crafted carefully, serve to enhance the perception that you can be trusted.

Source: Gary Ignotofsky

Query: Lobster Claw  Deformity

I want to share this interesting case. This 60 year old female complains of painful IPKs, plantar lateral B/L 5th & plantar medial B/L 1st metatarsals. The tylomas occur even with custom shoes.

Lobster Claw Deformity

What are the best non-surgical solutions?
 
Dale Shrum, DPM, La Quinta, CA

Query: Article in New York Times about Orthotics
 
I am sure by now most of us have read the article in the New York Times science section regarding orthotics. I am curious to hear what thoughts my colleagues have regarding this article.

Daniel Tellem, DPM, Rochester, NY

RE: Atypical Skin Lesions (Judd Davis, DPM)
From: Multiple Respondents

These lesions look verrucous. Do punch biopsy to exclude verrucous carcinoma.

Chris Orlando, DPM,  Hartsdale, NY, cao252@aol.com

I treated what appears to be a similar case. The margins were erythematous. A biopsy at the margins came back as psoriasis. I treated the lesion with prednisone (PO), keralytics, and urea cream (under occlusion). I suggest biopsying to confirm diagnosis.

Jay Hellman, DPM, Pearl River, NY, footdr80@hotmail.com

The patient appears to have a lymphatic obstruction of the distal aspect of the foot in conjunction with significant venous insufficiency history (with venous ulceration) of both lower extremities. The "green hue"  that appears with this patient's foot is most likely not a pseudomonal infection, but a secondary fungal or mold (Aspergillus sp.) colonization of the skin.
 
Treatments should consist of skin biopsy to rule out a verrucoid etiology; fungal and bacterial cultures to treat secondary infections; use as anti-fungal wash (Pedifix Fungasoap); placement of the patient on a urea-based moisturizer (ideally in 40% concentration) to aid in exfoliation, and use of venous compression stockings and/or pumps to treat the venous and lymphatic components of this disease manifestation. 
  
Gino Scartozzi, DPM, New Hyde Park, NY, Gsdpm@aol.com

RE: Homeopathic Injections?
From: Multiple Respondents

Do the same laws of nature apply to homeopathy as to modern Western Medicine? Someone write a commentary please!  

Dwight L. Bates, DPM, Athens, TX, dlbates04@yahoo.com  

When I read the response by Dr. Katz to my friend Dr. Bijak, I laughed long and loudly. His statements "Functional medicine is being embraced by major teaching institutions and is the future of medicine," and "I suggest that "we" crawl out of our holes and get up-to-speed with what is guaranteed to be the future of medicine" are classics. Self-delusional, absurd, and worthless, but classic.
 
The problem here is that it isn't medicine. It is a placebo with a very low dose of nostrum. As Dr. Udell pointed out, homeopathy is about nothing. You're injecting a parts per million or parts per billion  - it's NOTHING. No science. No method. If your people are getting better, I say "bully to you". More evidence of the placebo action in force.
 
I keep wondering when the aromatherapy and reflexology individuals will start weighing in on this, and we will attain the critical mass of absurdity.

David Secord, DPM, Corpus Christi, TX, secord@medscape.com

Dr. Bijak expresses his concern over my administering a homeopathic injection to my patient and asks if it's ethical, if it does justice to the patient, and if we should be paid for this. The problem I see here is that he is posing the question to the forum instead of directly to me. So, please let me answer your questions, Dr. Bijak, as I have been giving homeopathic injections for 25 years and have given well over 50,000 of them: A) Is it ethical? My answer to that is, of course, it is. After having given so many of them, I can tell you first-hand that I have never harmed a single patient with them.

The greater majority of patients do beautifully with them when they are appropriately used. They are NOT a substitute for cortisone. They are designed to...

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

RE: Scarf Complication (Name Withheld)
From: Roody Samimi, DPM

I recommend six weeks of IV Vancomycin; most osteomyelitis is Staph aureus without question. You will never know without a bone biopsy. If the wound is still open, the bone should be biopsied/removed in a staged fashion, so as to remove all infected bone. Don't forget to send the bone for culture. You can even consider bone graft after all infected bone has been removed, as a final step prior to closure. Removal of that second screw is preferred.

If the wound is closed and healed, proceed with IV antibiotics because it is best to assume that the wound is contaminated. Consult with an infectious disease specialist if you have any doubt. Developing a rapport with an ID specialist is always to your benefit. Take cultures ASAP, if you have not done so already. The Smart Toe looks pretty good, though.

Roody Samimi, DPM, Cincinnati, OH, roody.samimi@gmail.com

RE: Kudos on PM's January Issue
From: Phil Davidson, DPM

I can't let it go without extending orchids and bouquets for what I consider the best, or at least equal to that, of any previous publication by Podiatry Management.
 
Reading this issue cover-to-cover was absolutely a pleasure.
 
Phil Davidson, DPM, Youngstown, OH, Ohiofoot@aol.com

RE:  Credit Card on File (Joe Gonzalez, DPM)
From: Connie Lee Bills, DPM,

We take all co-pays and deductibles before the patient is seen. This amount is verified the previous day and the patient is advised at the time of the reminder call. If they don’t have the money, we will reschedule, but it will count as a “no show.” You may think this policy is blunt, but if you don’t get the money before the visit, sometimes you never will. This has eliminated the need for a collection agency.

Connie Lee Bills, DPM, Mt. Pleasant, MI, staff@familyfootcare.biz

Congratulations to Dr, Gonzales on having a 'written' financial policy for patients. I suspect you are in a minority. Based on past experience, you can 'estimate' the patient's liability for any given treatment. Tell them you are doing so, and ask for payment accordingly . . .  "cash or check."

Once the insurance carrier has processed the claim and the exact amount of the patient's responsibility is known, the account can be reconciled by asking for or billing for the shortfall. . . or promptly making a refund for any overage collected. Since refunds were my preference, I tended to err (reasonably) on the higher side.

Once the patient knows and understands the process (an explanation for which should be included in your financial statement), there is usually little resistance to payment - and they love getting refunds.

Joel Lang, DPM (retired), langfinancial@verizon.net

RE: The Passing of Donna Landi, DPM

We are all in a state of shock and very saddened by the sudden death of our wonderful friend and colleague, Dr. Donna Landi. We all give tribute to her selfless dedication in podiatry. She was always there for everybody. We lost a shining star in podiatry.

Pushpa Chauhan, DPM, Cindy Resnick, DPM, Jaleh Hoofar, DPM, Sapna Pandya, DPM

ASSOCIATE POSITION - CONNECTICUT 

Well-established, well-rounded, busy practice seeking part-time or full-time associate. Excellent opportunity for a highly motivated and ethical professional. Must have good patient skills. PSR-12 or higher with excellent skills required. Please fax resumes to 203-439-7916.

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 - 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!

Successful multi-office, multi-professional practice seeks well-trained new and established Podiatric Physicians with expertise in one of these areas: 1. Sports Medicine/Biomechanics/Gait Analysis, 2. Podopediatrics, 3. Diabetic Specialist, 4. Ankle & Rearfoot Surgery/Ankle Arthroscopy. A must to be really good in this niche, be outgoing, motivated, and personable with a dedicated hard working ethical desire to become successful. Send resume and letter of intent to sierrajip@gmail.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 - 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

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

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

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

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

SPACE AVAILABLE- NYC & LI

Office to sublet and share with DPM and chiropractor, East 60th Manhattan, and Plainview long island.  access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.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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