The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

January 28, 2010 #3,765 Publisher-Barry Block, DPM, JD

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Marco A. Rubio-Ardila, DPM, 58

Dr. Marco A. Rubio-Ardila passed away on January 24, 2010, at Valley Baptist Medical Center Brownsville, with his loving wife and close friends at his side. Marco was raised and lived in Hawaii. He was a veteran of the U. S. Army, proudly serving his country during the Vietnam conflict as a medic. Upon completing his service, he returned to Honolulu and studied at the University of Hawaii at Manoa. He received his Bachelor of Nutrition Science in 1975 and his Master of Public Health there in 1977. He received his Doctor of Podiatric Medicine in 1982 from the Ohio College of Podiatric Medicine.

Dr. Marco A. Rubio-Ardila

As a captain in the U.S. Public Health Service Commission Corps, he joined the Brownsville (TX) Community Health Clinic to initiate the Podiatric Service in July of 1982. He then opened the Podiatric Service at Su Clinica Familiar in 1983, serving in Harlingen and Raymondville. He was the first podiatrist to have surgical privileges at Brownsville Medical Center (now Valley Baptist Medical Center).  He was an active member of the American Public Health Association since 1975, and received national recognition through his receipt of the Dr. Stephen Toth Memorial Award in both 1981 and 1997.

Source: Valley Morming Star [1/27/10]

High Heels Create Health Risk for Tots: NY Podiatrist

Heeled shoes are showing up on T.V., but also in preschool and kindergarten social circles. "With very few exceptions, every little girl has walked through this door in some kind of high heels. We had a little girl here the other day in a diaper and flip-flop high heel shoes," said Samantha Fein, a parent.

Dr. Rock Positano

But doctors say there are health risks for making dress-up a daily routine. "We're dealing with a foot that's in development, which means the muscles, the tendons, and the ligaments are certainly not as strong at that age as they are at age 18," said Dr. Rock Positano, a podiatrist.

Source: Erin Gibson, News Channel 8 (Arlington, VA) [1/27/10]

Help Still Needed in Haiti: MI Podiatrist 

Marie Soledad Nelson, a podiatrist originally from Haiti, hopes to prevent the escalating amputations faced by those caught in the rubble. "It is my country, and I have to contribute whatever I can to this tragedy," she said. "All these people are getting their legs amputated, but I feel if they have the right equipment and proper supplies, many could be avoided."

Dr. Marie Soledad Nelson

Nelson said doctors in Haiti are badly in need of anesthetics. "It drives me nuts to imagine all the surgeries being done without anesthetics," she said. "And they need sterile dressings, cleansers needed to scrub down before surgery, sutures, laceration kits -- so many supplies."

Source: Shawn D. Lewis, The Detroit News

Judge Warns MI Podiatrist in Polygamy Case

An angry judge warned a metro Detroit podiatrist this morning that she would throw him in jail if he again skipped a hearing on a pending polygamy case against him. Dr. Kenneth Mitchell was to be in Oakland County Circuit Court this morning to explain why he is months behind on mortgage payments on a Rochester Hills home he once shared with Faye Miller, a woman he married in 1999, even though he still had a wife in California. He also married a Canadian woman in 2003.

His attorney, Stephen Barker, told Judge Cheryl Matthews that his client, who has several podiatry clinics in metro Detroit, was in surgery this morning and could not attend the hearing. Judge Matthews, noting that Mitchell also was failing to follow other court orders, including providing necessary financial information to the court, appeared to be considering throwing him in jail this morning. “Well, he can’t operate in jail, now can he,” the judge said.

Source: L.L. Brasier, Detroit Free Press [1/27/10]

Query: Dox and EMR

What experiences have PM News readers had with Dox Podiatry as far as implementation of EMR and/or assimilation with billing software? Any responses would be appreciated.

Stephen Kinard, DPM, Rocky Mount, NC

RE: Palpable Mass in Dancer (Barrett E Sachs, DPM)
From: Multiple Respondents

In treating the soft tissue mass on the 15 year old dancer, I would first find out through aspiration if it is a fluid-filled mass, or take a puncture biopsy to find exactly what the mass may be. I have utilized cryoablasion of the soft tissue masses like these, utilizing cryosurgery to lyse or destroy the tissue to reduce the size of the mass(also have cryoabladed on plantar fibromas). Often times, if done properly, the mass will decrease in size with one or two cryo-treatments.
 
Steven S Melek, DPM, Logan, WV, drstevenscott@yahoo.com

Take a punch biopsy so that you know exactly what you are dealing with. I think that would be a prudent place to start. Use a 2mm punch, which should not prevent any loss of activity until you get the report back. 
 
Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

Dr. Sachs presents a case and photo of what he calls a "palpable mass” and goes on to say that it does not “exhibit any of the typical characteristics of verrucae." It is important not to use the word “mass” or “soft tissue mass” when describing a skin lesion. Because of this, we do not know if Dr. Sachs’ patient has a skin lesion or a soft tissue mass. In general, the discussion of “masses” EXCLUDES skin lesions. We also cannot know by the description if the lesion is possibly simply nothing more than chronic skin irritation from the underlying superior aspect of the calcaneus.

These distinctions are important before ordering imaging studies as it is also necessary to alert the radiologist whether or not you are suspecting a skin lesion or soft tissue mass, as some soft tissue masses lie in very close proximity to the skin and indeed cause effacement of the skin overlying the lesion which could get confusing without clear description as to whether or not the lesion is moveable in the subcutaneous tissue or is derived in the skin itself. 

Bryan C. Markinson, DPM, NY, NY, Bryan.Markinson@mountsinai.org

RE: On the Passing of  Benjamin Kauth, DPM

It was with great sadness that I learned of the recent passing of Dr. Benjamin (“Benny”) Kauth. My relationship with Dr. Kauth began several decades ago, and he was a guiding force for me both personally and professionally. He was one of the leaders in the profession of podiatry for as long as I can remember, and for many years he was a larger-than-life presence at both the New York College of Podiatric Medicine and the Foot Clinics of New York.

Dr. Kauth served for many years on the Board of Trustees of our institution, sitting on or chairing several sub-committees, and he also demonstrated a remarkable ability to raise much-needed funds for the education of podiatric medical students. He also helped in the development of the Foot Clinics of New York, and his contribution to the community of East Harlem is felt every year, even now, by tens of thousands of New York’s indigent and working people when they receive medical care at FCNY.

Dr. Kauth’s experience and passion for the profession were a source of advice and guidance for many younger podiatrists, as well as for his fellow Trustees, and even for a number of faculty members. His leadership, mentoring, and accomplishments in the field of podiatry, combined with his kindness and his philanthropy, made Dr. Kauth a one-of-a-kind member of the NYCPM community and the entire community of podiatric medicine. He will be very much missed.

Louis L. Levine, President & CEO, New York College of Podiatric Medicine 

RE: Physician Executive MBA Programs (Sloan Gordon, DPM)
From: David Helfman, DPM

As CEO of Village Podiatry Centers, PC in Atlanta, I was enrolled in Emory University's EMBA program many years ago. This was at a time when getting an MBA was in vogue. In month six of the program, I found that the material I was learning was not relevant or had any direct correlation to running a successful practice. Many of the classes were theoretically based, and I couldn't seem to apply the material to building a successful and thriving podiatry practice. I decided to drop out of the program and invest my time elsewhere, and ended up focusing on my business and hiring MBA's within the company.

I think that an MBA degree is great if you have time, but can also be a big distraction if you are trying to build a successful practice. MBA programs require an immense amount of time and commitment, and if you think that having an MBA will give you a competitive advantage in the marketplace, as is marketed by many programs, I would urge you to do your homework and reconsider. Okay, some would say, “well, now they have MBA programs designed for physicians which will be more focused and applicable.” I think MBA programs are a big business and physicians are a great target since they are looking for answers.

My experience tells me that most successful entrepreneurs DO NOT have MBA degrees; however, they have many MBA staff members on their team. My focus has always been on developing unique abilities and delegating everything else. Podiatry is a great profession, and you would be better off perfecting your skills, leveraging your podiatric education, and recruiting the appropriate talent to manage your practice.
 
David Helfman, DPM, Atlanta, GA, dhelf18809@aol.com

RE: Dropping out of HMO's, PPO's and Medicare (Steve Goldstein, DPM)
From: Bryan C. Markinson, DPM, Bob Kornfeld, DPM

The discussion on whether or not we get hurt by dropping out of poor paying plans gets busier as the onslaught of poor payment continues. Until very recently, at least in NY, the success of being out-of-network depended on forgiving co-payments and deductibles. Some might argue that in view of how we have been treated, it is justifiable. Not so, says the attorney general (AG). All specialties in medicine are involved, as well as surgi-centers. An orthopedic surgeon will easily forgive his typical $350 consult fee if eaten up by the deductible, to get at an out-of-network arthroscopic shoulder repair, or total joint replacement case.

A group of surgi-centers on Long Island got banged for 8 million dollars by the attorney general for forgiving out-of-network deductibles/co-pays on operating room fees. Therefore, any advice printed that states, “How you handle the deductible issues are up to you,” should be taken not only with a grain of salt, but ignored.  This is beyond a fraud and abuse matter, but under the heading of “unfair business practices,” which the AG loves. In the surgi-center cases, patients were actually called to determine why they would choose an out-of-network facility, and they were very explicit in stating that they were told that they will not have to pay. 

In any case, it soon will not matter. The insurance industry has caught on, and they are about to implement changes in the reimbursement scheme that will severely blur any distinction between in and out-of-network fees.

Bryan C. Markinson, DPM, NY, NY, Bryan.Markinson@mountsinai.org

Editor’s Note: Dr. Kornfeld’s extended-length letter appears here.

RE: Res Ipsa Loquitur (The thing speaks for itself)

Check out these Medicaid and Medicare checks for podiatric services.

Actual Checks from Medicare and Medicaid

Submitted by Tip Sullivan, DPM, Jackson, MS

EQUIPMENT FOR SALE – DIAGNOSTIC ULTRASOUND

Diagnostic Ultrasound Siui CTS-7700, 5-10MHz Linear array probe for podiatry. Digital. Portable. Purchased in 2008. $4,500. Please Call Jan Kapenga at 616 392-7472

ASSOCIATE POSITION – TEXAS

Dynamic, growing practice in Dallas/Fort Worth area, seeking surgically trained, Board Certified/Board Qualified Podiatrist. Excellent salary and benefits compensation package, for the right candidate, with partnership/buyout opportunity. Contact/Send resume to: jmh6122@yahoo.com

ASSOCIATE POSITION IN WESTERN NORTH CAROLINA

Well diversified growing podiatry practice with good mix of office, surgery center and hospital procedures seeking a full-time associate. Must have NC license or taking state exam this year. Candidates should have excellent bedside manner equal to their medical skills. E-mail a cover letter and CV to DPMCAREER@AOL.COM

ASSOCIATE POSITION - TEXAS

Wonderful opportunity! Successful multi-office, multi-professional practice seeks well-trained new and established podiatric physicians with expertise in sports medicine, podopediatrics, rearfoot/ankle surgery, or hospital podiatry. A must to be outgoing, motivated, and personable with a dedicated hard-working ethical desire to become a winner. Send resume, current photo and letter of interest to sierrajip@gmail.com

PRACTICE FOR SALE - TENNESSEE

Well established practice for sale. Full scope medical and surgical practice including DME. Exceptional practice with a high volume of new patients. Excellent hospital and surgical center privileges with investment opportunity. Great area for a family and the outdoorsman. 731-446-7285/E-mail nraines@charter.net

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

ASSOCIATE POSITION - MARYLAND

Associate needed to join a multi-office podiatry practice in the Baltimore MD Region. Desired candidate should be surgically trained with Board Eligible / Certification. You must be hard-working, ethical, compassionate and confident in your abilities to deal with pathology, patients, staff and fellow physicians. Patient base is already established. Excellent income and growth potential for the right associate. Please forward a cover letter and resume and availability to FootDocMaryland@Gmail.com

SPORTS MEDICINE FELLOWSHIP

The Palo Alto Medical Foundation Surgical/Sports Fellowship Aug 1, 2010 -  July 31, 2011. Applicants must be able to obtain a California license. Responsibilities include assisting in all types of foot and ankle surgery, (approximately 500 cases), seeing patients in the sports clinic and must complete 2 papers/research projects. Benefits include salary of $56K/yr, medical, dental, malpractice, and CME allowance. Interviews will be at the Midwest Podiatry Conference March 11-13, 2010, but on-site visit is preferred. Minimum 24-month surgical residency training pre-requisite. Applicants should send a letter of interest, CV and three letters of recommendation to: Amol Saxena, DPM,  650/853-2927 HeySax@AOL.com

ASSOCIATE POSITION – CINCINNATI, OHIO

This is your once in a lifetime opportunity to join one of the most successful practices in the United States. We do not have a seniority system. If you are motivated and have completed a PSR 24-36 residency, your income is limited only by your enthusiasm and desire to achieve. Email resume to khart@cincinnatifootcare.com

PRACTICE FOR SALE - CENTRAL FL 

Practice and medical building for sale, in beautiful, high quality of life, growing area, Central Fl.; 2000 sf bldg. fully equipped/ designed for podiatry; excellent location, features & exposure; near hospital, wound and HBO center. Great opportunity for expansion & investment; good insurance climate. 352-223-2713 / E-mail: windnwave@earthlink.net

ASSOCIATE POSITION FULL-TIME - SUBURBS OF CHICAGO

PSR 36 - month-trained podiatrist needed for busy suburban Chicago practice. Full benefit package included. If interested, please email your curriculum vitae to foot1st@yahoo.com

ASSOCIATE POSITION - MASSACHUSSETTS

Full-time/Part-time podiatrist needed for a busy nursing home practice. Please send inquiries to debbierobertsm4@hotmail.com

ASSOCIATE POSITION – MISSOURI

Expanding multi-location practice seeks motivated individual to contribute to growth. Practice enjoys strong reputation and name recognition. Prefer candidates with interest in partnership opportunity. Established locations available for PSR 24+ and includes incentive comp with benefits/coverage. Please send CV to jmurray@foothealers.com or call John Murray at 314.842.3875

ASSOCIATE POSITION - MARYLAND (Kensington/Rockville/Silver Spring)

If you are a graduating resident in July, or an esablished practitioner, and you are enthusiastic, personable, motivated and well-trained, we would be delighted to discuss an associate position, in our group, with you. Established practitioner relocating. 5-doctor, 3-office practice with significant patient flow already in place to keep you busy from the start! All the bells and whistles-EMR, digital x-rays, ultrasound, computerized scheduling, certified ambulatory surgical centers, hospital and physician referral base. Please send cover letter and resume to mddpmassociate@comcast.net We look forward to hearing from you.

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

ASSOCIATE POSITION - NORTHERN VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes. Top hospitals. Fax CV with references to 703-491-9994

ASSOCIATE POSITION – ILLINOIS

Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings are available. If interested, fax curriculum vitae to 847-674-2113 or e-mail to feetwork@aol.com

ASSOCIATE POSITION - MASSACHUSETTS

PSR-24 trained podiatrist for busy multi location practice, high volume and high-tech. Seeking energetic individual for high volume of patients with multiple needs. Orthopedic, sports medicine, wound care, pediatric orthopedics and surgery skills required. Looking for immediate hire for the right candidate with possibilities for partnership. Contact Debbie Roberts debbierobertsm4@hotmail.com

ASSOCIATE POSITION – NORTH AND CENTRAL FLORIDA

Quality Podiatry Group of Florida provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings are available. If interested, fax curriculum vitae to 847-674-2113 or e-mail to feetwork@aol.com

PM News Classified Ads Reach over 12,000 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 12,000 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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