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The Voice of Podiatrists
Serving Over 9,000 Podiatrists Daily
January 22, 2007 #2, 789 Editor-Barry Block, DPM, JD
A service of Podiatry Management http://www.podiatrym.com E-mail us by hitting the reply key. COPYRIGHT 2007- No part of PM News can be reproduced without the express written permission of Kane Communications, Inc.
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Treatment of Diabetic Foot Infections in the Era of MRSA
An On-Demand Webcast
Available 24-7 for Your Convenience
Presented by:
Warren S. Joseph, DPM, FIDSA
and
David G. Armstrong, DPM, PhD
To participate visit www.virtualrounds.com
This promotional Webcast is sponsored by Pfizer Inc and will not provide continuing education credits.
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AT THE COLLEGES |
Barry Breaks Ground on Center for Community Health and Minority Medicine
Barry University broke ground Thursday, Jan. 18 on the long anticipated Center for Community Health and Minority Medicine. Many community officials and major donors were present, in addition to students, faculty and staff representing the Schools of Graduate Medical Sciences, Podiatric Medicine, Nursing and various other schools and divisions.
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Barry University officials break ground on the new Center. Pictured L-R: Bill Heffernan, Sister Jeanne O'Laughlin, OP, PhD, Pegge Bell, PhD, Dr. Chet Evans, Cyrus Jollivette and Sister Linda Bevilacqua, OP, PhD |
Barry’s School of Podiatric Medicine graduates more Hispanic podiatrists than any other school in the country. In the last 10 years, Barry’s doctors have treated and operated on nearly 50,000 crippled indigent children in the Yucatan Peninsula. Barry’s five Foot and Ankle Institutes are unique to the podiatric colleges and provide nearly $ 1-million a year in charitable care.”
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MEETING NEWS |
NY Clinical Conference Becomes Largest Podiatry Meeting Ever
This weekend's New York State Podiatric Medical Association (NYSPMA) Clinical Conference was attended by more than 1,500 DPMs and nearly 200 podiatric students, making it the largest podiatric meeting ever. "Records are made to be broken and we couldn't be more pleased," said Len Thaler, NYSPMA's Executive Director. Thaler humbly declined taking credit for this year's success, instead citing Foundation President Lawrence Santi, DPM and his Committee, NYSPMA President Scott Altman, DPM and his board, as well as Thaler's own devoted staff for this smoothly run meeting.
In addition to packed lecture hall and workshops, the exhibit hall, which this year rose to a record 252 exhibitors, also experienced high traffic.
Honored at NYPMSA's General Meeting were:
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Dr. David Schofield |
Lifetime Achievement Award--Dr. David Schofield, Current APMA President and former NYSPMSA president
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Dr. Joseph Cavuoto |
Meritorious Service Award--Dr. Joseph Cavuoto - Longtime advocate for PPAC (NYSPMA Led the nation in contributions in 2006)
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Dr. Benjamin Kauth |
Pioneer in Podiatry Award--Dr. Benjamin Kauth (First podiatrist to publish book in the lay press)
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HEALTHCARE NEWS |
Wyden Introduces Universal-Care Bill
All employers would contribute up to 25% of the average premium for essential care in their area. New state agencies would provide information about the private insurance plans available to residents and would connect individuals and families with sliding-scale premium reductions. According to the Lewin Group, the plan would cost the federal government $812.9 billion, but that would be offset by about $814 billion in premium revenue, savings to other programs and the elimination of certain business tax credits. Overall, the bill would save $1.48 trillion over 10 years, according to the consulting firm. A Wyden aide said the bill will be referred to the Finance Committee.
Sen. Ron Wyden (D-OR.), who sits on the influential Senate Budget and Finance committees, introduced a healthcare reform bill that he said would guarantee 99% of Americans healthcare coverage equivalent to that now offered to federal employees. Under Wyden’s Healthy Americans Act, all individuals would be required to buy insurance -- a mandate that over the course of two years would replace the current employer-based insurance system.
Source: Jennifer Lubell, Modern Healthcare [1/19/07]
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MEETINGS / COURSES
Bioterrorism/All-hazards Preparedness Available Free
Podiatric physicians are encouraged to take the first of a series of courses in bioterrorism/all-hazards preparedness included in a grant project funded to Nova Southeastern University College of Osteopathic Medicine by the U.S. Public Health Service, Health Resources and Services Administration as physicians. The first course is available without cost and is completely on-line. Registration is done on-line and a certificate of completion is granted upon completion. Access is obtained at www.nova.edu/allhazards
This initial course is designed to develop an awareness of the various acts of bioterrorism, weapons of mass destruction, man-made non-intentional disasters, and natural disasters ). For further information contact Leonard A. Levy, DPM, MPH, Associate Dean for Education, Planning and Research, Director, Center on Bioterrorism and All-hazards preparedness, Nova Southeastern University College of Osteopathic Medicine, levyleon@nsu.nova.edu or (954) 262-1469.
For a list of all meetings go to: www.podiatrym.com/meetings.pdf
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QUERIES |
Query: Plantar-flexion of Hallux S/P Fibromas Excision
Five to six weeks post excision of plantar fibromas, my patient has developed a plantar-flexion spasm of the hallux. After doing a posterior tibial nerve block along with a mayo-type block, the spasm relaxed a lot. I am assuming this is due to scaring around the flexor hallux brevis as the IPJ was not flexed. I injected some Kenalog 10 around a knot at the scar area and sent the patient to therapy for muscle stim. and deep massage, etc. Any other comments or recommendations?
Thomas R. Brant DPM, Columbia, MO
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CODINGLINE CORNER
CURRENT TOPICS BEING DISCUSSED ON CODINGLINE'S LISTSERV INCLUDE:
o Medicare as Second Payer o 2007 Destruction of Warts Coding o NY Blue Cross Sr Routine Footcare Guide o Metatarsal-Cuneiform Exostosis o E/M Auditing Question
Codingline subscription information can be found at http://www.codingline.com/subscribe.htm
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RESPONSES / COMMENTS |
RE: Peroneal Spasms (Mark Wolpa, DPM) From: Steve Gershman, Jeffrey A. Root
Dr. Wolpa inquired about surgical and conservative treatment options for a 52 y/o marathon runner who has developed a peroneal spasm associated with osteochondral defects in the sinus tarsi area. My father, Merton L. Root, DPM developed a highly successful, conservative method for treating peroneal spasm with functional orthoses that most podiatrists are unaware of.
First, evaluate the open chain range of motion (ROM) of the subtalar joint. You may find little to no STJ ROM on initial exam. If so, apply a continuous supination force to the subtalar joint for several minutes in order to stretch out the spasm. After stretching out the spasm, you should see an increased ROM at the subtalar joint. Again, move the STJ through its full open chain ROM. You will likely induce the peroneal spasm with non-weight-bearing supination of the STJ. If so, note the point in the range of motion that seems to trigger the spasm. Again stretch out the spasm and cast the foot with the STJ slightly pronated of the spasm trigger point.
The cast for this orthosis should be corrected to the same pronated position in which the foot was casted (i.e., heel everted to the floor by the same angle as it was casted). The orthosis should have a very deep heel cup (23 to 25 millimeters) and should have no motion in the rearfoot post with medial and lateral post flares. The goal is to prevent the pathological forces (motion) that induces a spastic response from the peroneals. This treatment may require a second, less pronated orthoses in order to get this foot to function closer the neutral position without spasm. In this case, I would recommend a temporary restriction on running so that the therapy has a greater opportunity to work.
Jeffrey A. Root, jroot@root-lab.com
My first comment is that Dr. Wolpa left out the most important clinical info especially in a runner. He failed to give any relevant biomechanical info. Most runners experience pain when long-term uncontrolled faulty biomechanics causes excess motion or motion in faulty dominant planes or unequal physical stresses to certain areas of the foot or ankle. You cant even begin to ask about surgery vs. conservative care or ANY treatment until you look for the underlying causes, especially in a runner.
Based on the info Dr. Wolpa did give, my guess is that his patient has either excess sub-talar motion, causing long-term irritation in the sinus tarsi (especially during the many miles of pounding needed to train for a marathon), or a planal dominance problem in the sub-talar joint with transverse motion or frontal plane dominance. Excess motion or dominant plane motion abnormalities can irritate the joint causing triggering of the protective splinting the peroneus brevis can cause when in spasm. You need to determine if this is occurring and if so, control the motion with orthotics appropriate to the cause. You can also calm it down initially by use of a CAM-walker to completely immobilize the ankle/foot for three weeks.
Steve Gershman, DPM, Obsidianom@aol.com
RE: Unethical Practices and a New Associate (Name Withheld) From: Shay Fish, DPM
When interviewing for employment, take advantage of the opportunity to inquire about the potential employer's policies. Are there written policies about the practice in general, OSHA, HIPAA, Medicare compliance, etc. Ask who the officers are for those various roles and try to talk with them. Consider talking with other podiatrists and hospitals in the community regarding the reputation of your potential employer. But remember that rumors may just be rumors. Some coding issues may not apply to your employer's situation, until there is a renovation. After employment you have two options: leave; or take the initiative to bring the practice "up to date," especially if it has potential. This demonstrates that you have a vested interest in the long term health of the practice. Everyone wins. Shay Fish, DPM, San Antonio, TX, fishdpm@aol.com
RE: State of Hospitals in the US From: Neil A Burrell, DPM, David Secord, DPM
One problem that we see is the increase of uninsured patients. Our hospital is a 500 bed facility with a trauma center. Only 33% of the ER patients have insurance. The avg ER wait is 8 hours. People do not go to the doctor until they are so sick they have to be hospitalized. One of our associates had to cancel two days in the office to operate on ER patients, which only 30 % had insurance. Hospitals are losing money but surgical centers should not be punished. Unfortunately I don't think there is an easy answer.
Neil A Burrell, DPM, nburrell@gt.rr.com
Hospital profitability is an odd issue at best. They have to provide uncompensated care and write off the loss, but pay outlandish salaries to people. An example of absurdity is a recent administrative decision at my local hospital. When I do an Evans or a TN fusion, I like to use a cannulated screw with a compressible staple. I just like doing it that way. My hospital recently decided to stop allowing the OSS staple in the O.R. to reduce vendors. They have no problem with me using the EBI VueLock plate for the same TN fusion, however. The OSS staple is a couple of hundred dollars to the best of my knowledge. The VueLock plate and screws runs several thousand (or so I'm told).
So.....to save money by reducing vendors, I can increase the cost of my procedure hardware usage 10X fold, without a problem? What possible sense does this make. I've appealed it directly to the suits in charge and they don't see the problem, as the VueLock is already used by the spinal surgeons and so it is an approved vendor. These guys must be working for the government.
David Secord, DPM, Corpus Christi, TX, David5603@pol.net
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PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
You can Earn 15 CPME-Approved CME credits Online for only $139(Less than $14 per credit) http://www.podiatrym.com/cme.cfm Choose any or all of over 20 CME articles posted You Can Now Take Tests and Print Your CME Certificates Online
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CLASSIFIED ADS |
OFFICE SPACE TO SHARE – MANHATTAN / PLAINVIEW, NY East 60th and or East 22nd in Manhattan and on South Oyster Bay Road Plainview. Turnkey operation, all equipment needed is available as well as an extremity MRI, fluoroscopy, x-ray and surgical equipment. Each office has an operating room with anesthesiologist available for iv sedation. Call 516 476-1815 or email to podo2345@aol.com include a phone #
ASSOCIATE POSITION—NORTH COASTAL CALIFORNIA
Two fully staffed rural offices with continually growing patient load. We take care of all aspects of podiatry: assisted-living centers, palliative care, wound care, biomechanics, surgery, diabetic care. Hospital privileges are available to those properly qualified. If you are interested in challenging and hard work leading to partnership, send your CV to jimf@humboldt1.com
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
WEEKLY SPECIAL - One week of ads (5x) for only $75
PM Classified Ads Reach over 9,000 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 9,000 DPM's. Write bblock@podiatrym.com or call (718) 897-9700 for details. Note: For commercial or display ads contact David Kagan at (800) 284-5451 dekagan@aol.com
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Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management Magazine and Podiatry Management Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.
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- Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.
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