The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

January 24, 2011 #4,071 Publisher-Barry Block, DPM, JD

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Vibram Five Fingers Shoes Are No Problem if Used Correctly: IN Podiatrist

Long-time runner Frank Cobarrubia, 46, a podiatrist and an owner of Northwest Footcare in Bend, said he sees no problems with Vibram Five Fingers shoes as long as they’re used for reasonable distances (not marathons) or for running on dirt trails (not pavement).

Dr. Frank Cobarrubia

He doesn’t wear FiveFingers, but he certainly knows about them. He said they are “the rage” right now. “As many things, through our history, things come and go,” said Cobarrubia. “I’m not saying these won’t be used in 10 years, but sales will be less than what they are now or were last summer.”

Source: Anne Aurand, The Bulletin [1/20/11]

FPMA Installs New Officers

The Florida Podiatric Medical Association has installed its new officers at the 71th Annual Meeting, held at the Scientific and Management Meeting (SAM) in Orlando, FL. Elected were:

(Top Row) Drs. John Baker, Samir Vaklil, Maria Noll, and Stephen Levin. (Bottom) Drs. Terence McDonald and Robert Iannacone.

President: Robert A. Iannacone, DPM
1st Vice President: Samir S. Vakil, DPM
2nd Vice President: John Baker, DPM
Treasurer: Maria Noll, DPM
Secretary: Stephen Levin, DPM
Past President: Terence McDonald, DPM  

AZ Podiatrist Returns To Lecturing After Trauma of Tucson

Nearly two weeks to the hour after the Tucson tragedy, David G. Armstrong, Professor of Surgery at the University of Arizona, completed a keynote lecture to the Connecticut Podiatric Medical Association via video link from Tucson's University Medical Center (UMC). Armstrong noted, "After what our community and our country have been through this past fortnight, it is a pleasure to get back to some degree of normality.

Dr. David G. Armstrong in the UMC studios in Tucson

To use the same facilities to talk about healing wounds today that our center was using over the past two weeks to share stories of healing with the world is both profoundly heartwarming and simply an honor." The lecture, which discussed the latest in team building and technological innovations, was delivered to a symposium chaired by Dr. Marc Lederman and hosted by St. Francis Medical Center in Hartford, Connecticut.

NY Podiatrist Disciplined for Inaccurate EHR Records

The state Education Department has taken disciplinary action against a Liverpool foot doctor charged with professional misconduct. Dr. Bryan Gregory Popovici, a podiatrist, was fined $2,500 and placed on probation for two years by the state Education Department. Popovici admitted in a signed consent agreement that he failed to keep accurate patient records.

The state said Popovici failed to document diagnostics performed, whether treatment options were discussed with a patient, and his rationale for placing a patient in a hard cast rather than a soft cast. Meghann N. Roehl, Popovici's attorney, said the problems stemmed from Popovici's new electronic medical record system. "Dr. Popovici was an early adopter of electronic medical records," Roehl said. "The earlier versions had software glitches which he is working hard to correct."

Source: James T. Mulder, The Post-Standard [1/21/11]

FPMA Honors Podiatrists at Annual Banquet

One of the highlights of the Florida Podiatric Medical Association's Scientific and Management Meeting is the presentation of special awards at its annual banquet.

Dr. Nicholas Kayal

This year's honorees were:

Podiatric Physician of the Year - Barney Greenberg, DPM

President's Award - Nicholas Kayal, DPM

Young Practitionner of the Year - Joseph Conti, DPM

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: What are students learning about tinea pedis?

Dr. Tracey Vlahovic

Tracey Vlahovic: They are learning that tinea pedis should be managed with topical antifungals, especially the newer ones that are more anti-inflammatory in nature. I am strict about their not using steroids on tinea pedis, especially Lotrisone, and that they can also concurrently use urea or lactic acid or salicylic acid in combination to desquamate. I have been involved with tinea pedis trials. Those trials only run for six weeks, so patients are never really getting a cure even in those trials. They are just getting a reduction in symptoms.

Dr. Michael Brody

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). The next segment  will feature electronic medical records expert Dr.  Michael Brody. You can register for this event by clicking here

Query: Servicing for X-Cel X-Ray Machine

I recently had a state inspection and was advised that I needed to have my X-Cel x-ray machine serviced. I need a recommendation for servicing in the Philadelphia area. 
 
Greg Caringi, DPM, Lansdale, PA, DrGregC@msn.com

RE: Article in New York Times about Orthotics (Kevin Kirby, DPM)
From: Michael Turlik, DPM, Eric Fuller, DPM

As a clinician, I am interested if an intervention works (1,2) rather than how it works. Much of this article deals with surrogate outcomes which are difficult to generalize to patients since there is not always a correlation between surrogate outcomes and patient-focused outcomes (3) (pointed out in the article). The majority of this article discusses surrogate outcomes and how foot orthotics work rather than if they work. Good for researchers but not helpful to clinicians.

The other important issue is the variability of custom foot orthotics. Different impression methods and fabrication techniques produce different outcomes, some of which are better than others. Research reports regarding custom foot orthotics may be valid but the results may not be relevant. If your technique significantly differs from the reported intervention, the results are not relevant to you. Lack of standardization in the custom foot orthotic prescription process implies that comparisons are difficult to generalize (4). Variability in process is not the hallmark of quality healthcare.

1. Baldassin V, Gomes CR, Beraldo PS. Effectiveness of prefabricated and customized foot orthoses made from low-cost foam for noncomplicated plantar fasciitis: a randomized controlled trial. Arch Phys Med Rehabil. 2009 Apr;90(4):701-6.
2. Landorf KB, Keenan AM, Herbert RD: Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial. Arch Intern Med 2006, 166:1305-1310.
3. Bucher H., Kunz R., Cook D., et al. Users’ Guides to the Medical Literature 317-341.
4. Hylton B Menz. Foot orthoses: how much customization is necessary? JFAR , 2009.

Michael Turlik, DPM, Cleveland, OH, mmturlik@aol.com

There are several points in the article. 1."His overall conclusion: Shoe inserts or orthotics may be helpful as a short-term solution, preventing injuries in some athletes. But it is not clear how to make inserts that work. The idea that they are supposed to correct mechanical-alignment problems does not hold up." This statement is accurate and fair.

2. “That’s the first problem we have,” Dr. Nigg said. “If you do something to a shoe, different people will react differently.” Mert Root created his foot types based on neutral position because...

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

RE: Homeopathic Injections? (Dwight Bates, DPM, DPM)
From: Jengyu Lai, DPM, Elliot Udell, DPM

We have seen the same debate several time in this forum. I believe at issues are scientific methods and evidence-based medicine. I'd encourage everyone to read two articles in the December issue of The Scientist. Evidence: a Seductive but Slippery Concept (the-scientist.com/2010/12/1/32/1/). Evolving the Scientific Method (the-scientist.com/2010/12/1/30/1/).

Jengyu Lai, DPM, Rochester, MN, jylai99@yahoo.com

Dr. Bates asks: "Do the same laws of nature apply to homeopathy as to modern Western Medicine?" The answer is that homeopathy is not scientifically based. It was developed in the 1800's by a Dr. Hanneman at a time when classical medicine was also backward. In the next century, with advancement of modern medicine in the treatment of so many conditions, medicine advanced and most if not all homeopathic hospitals closed.

To fully understand the history of homeopathy and why it is something that licensed physicians should stay clear of, visit these two websites: Homeowatch.org or quackwatch.com. Because homeopathic preparations are so dilute as to be nothing more than a vial of water, they cannot harm a patient. The problem is that some  homeopathic practitioners will give a patient homeopathic "water" in lieu of chemotherapy, radiation, and surgery for cancer or in lieu of antibiotics when an infection is present. In England, homeopaths were prescribing homeopathic preparations in lieu of malarial medications and this posed a serious health risk.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: PM's January Editorial
From:Robert Bijak, DPM

In the January 2011 issue of Podiatry Management, Dr. Block editorializes a case for podiatrists taking the USMLE'S OR COMLEX exam to show parity. He is absolutely correct, and this should be instituted ASAP. As long as podiatry continues on a solo path with its own exams and boards, it will be questioned by the "gold standard", the MD degree.

As for the APMA and the podiatry college administration elite, cue the crickets.

Robert Bijak, DPM, Clarence Center, NY rbijak@aol.com

RE: Expensive Office Modalities and Reimbursement (Michael Schneider, DPM)
From: Ken Meisler, DPM, James J DiResta, DPM,MPH

I did not say that every patient with classic plantar fasciitis should NOT get an x- ray. I said that the doctor who did NOT take an x- ray should not be criticized for it, in fact "applauded" in my opinion, for not taking x-rays on everyone with heel pain. I also almost always take an x-ray when a patient has what I think is plantar fasciitis. However, there are cases where I feel comfortable treating the patient with stretching, strappings, ice, and I have the patient return in 1-2 weeks.  If totally asymptomatic at the follow-up visit, I will not get an x-ray, however, I will tell the patient that if the pain recurs, that they will need an x-ray.

I recently saw an orthopedist who is a shoulder specialist. He did a thorough exam and history. He diagnosed bursitis of my shoulder, which he said should resolve with the Naprosyn I had already started; if not he would give me a steroid injection. He did not order an x-ray, ultrasound, or MRI. I was a little surprised. The pain has resolved. Could I have a bone tumor of my shoulder? Possibly, but I am not getting an x-ray of my shoulder.

I think that we should be comfortable enough with our diagnostic abilities that we do not have to "always" do anything. We have to treat each patient somewhat differently based on the presentation.

Ken Meisler, DPM, NY, NY, kenmeisler@aol.com

In this world of risk-sharing and management, "more care is often not better" and can even prove harmful and, of course, expensive. Should we x-ray every patient who presents with heel pain? I think not. Could the medical profession justify getting a chest x-ray on everyone who presents with a cough or other respiratory symptoms? Is that best practice? Unnecessary tests are a big part of healthcare reform.

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

GREAT OPPORTUNITY AVAILABLE- PHOENIX, AZ
 
A great opportunity to join and gain ownership interest in a well-established, diversified practice in Phoenix. Seeking motivated, ethical, well trained, personable AZ licensed DPM with excellent office management and clinical skills in all phases of podiatry. Practice is state-of-the-art and encompasses all phases of podiatric care. New and established practitioners are welcome, or someone open to merging a smaller practice with ours. Board Qualified/Certified required. Please send CV  phxpod@gmail.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

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 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

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

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 - 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 - SOUTHERN CALIFORNIA

Strong & diverse local economy, in a beautiful beach community. Well-rounded, established since 1983, fully equipped. Grossing over $600K, with continued yearly growth. Many types of insurance, reimbursement, and revenue sources. Local hospitals allow full scope of podiatric care. Terms available.  mcrosby@providerresources.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

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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