The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

February 02, 2011 #4,079 Publisher-Barry Block, DPM, JD

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1. Advance Notice - PM News will be taking a mid-winter break and will not be publishing from February 10 - 17.  

2. Attention New York Subscribers - We have just learned that NY podiatrists can take up to 25 credits of home study CME via PM's CPME-Approved program

NYCPM Alumni Association Prepares for Centennial Celebration

On Sunday, during the NY Clinical Conference, the New York College of Podiatric Medicine's Alumni Association held its annual meeting. Dean Michael Trepal addressed the Association and reported both a rise in applications, and acceptances for the coming school year.

(L-R) Drs. Michael Trepal and Arthur Gudeon (Alumni Association president)

NYCPM Alumni Relations Director Howard Rusk, Jr. informed alumni that there is growing enthusiasm for the college's centennial celebration, which will be held at the Grand Hyatt Hotel in Manhattan on May 18th. 

Four U.S. podiatrists Speak at International Foot and Ankle Seminar in Spain

A total of 23 speakers recently presented lectures at the Seminario Internacional de Patolgia del Pie in Zaragoza, Spain. Drs. Kevin Kirby, Steven Spinner, Madeline Ramil, and Yanira Salas all represented the U.S. podiatric profession as speakers. 19 other podologists and orthopedic surgeons from Spain, Portugal, and France also presented lectures for the three-day foot and ankle seminar. 

Seminar organizer Dr. Moises Pardos Barrado (left), and lecturers Drs. Kevin Kirby and Javier Pascual Huerta (right)  at the  international foot and ankle seminar in Zaragoza, Spain.

More than 300 registrants attended the daily lectures at the seminar, which was one of the largest international foot and ankle seminars ever held in Spain. The seminar included 37 lectures on foot and lower extremity biomechanics, sports medicine, and foot and ankle surgery, and was enjoyed by all the podiatrists that attended this historic scientific meeting for the Spanish podiatric profession.

APMA Continues Its Response to Remove Defamatory Video

APMA’s Center for Professional Advocacy (CPA) has been working on a daily basis with legal counsel and the South Carolina Podiatric Medical Association (SCPMA) on a coordinated response to an inaccurate and defamatory video comparing orthopedic surgeons to podiatrists. APMA’s counsel sent a cease-and-desist letter last week.    

The orthopedist's attorneys have assured APMA that he is not actively distributing the video. APMA also has been in direct contact with the websites hosting the video. The video has been removed from one site, and APMA will use the response from the surgeon’s attorneys to reinforce our demands that the second site remove the video. The CPA will explore further legal options if the website does not comply.

Source: APMA News Brief [1/31/11]

FL Judge Declares Reform Law Void

U.S. District Court Judge Roger Vinson in Pensacola, FL on Monday declared the entire Patient Protection and Affordable Care Act void because its key provision—the individual mandate to buy health insurance—is unconstitutional. In a 78-page ruling, Vinson ruled that Congress, which aimed to give 32 million more Americans healthcare insurance by 2019 through the reform law, exceeded its constitutional authority by threatening Americans with fines if they don't buy health insurance.

Vinson declined the argument by states objecting to the law that Congress exceeded its authority by forcing states to expand their Medicaid programs. Vinson concluded, however, that the individual mandate is inextricable from the rest of the law and thus the entire law is void.

Source: Joe Carlson and Gregg Blesch, modernhealthcare.com [1/31/11]

Query: CRTECH Digital X-Ray Systems

Does anybody have any experience with CRTECH Digital x-ray systems?

Richard Jaffe, DPM, Jerusalem, Israel

Query: Billing Double Calcaneal Osteotomies

We are trying to bill for a medial displacement osteotomy at the anterior portion of the calcaneus and an Evans-type osteotomy with GraftJacket at the proximal aspect of the calcaneus.

We are billing CPT 28300 (osteotomy; calcaneus, with or without internal fixation) for the first procedure. How are we to code and bill for the second osteotomy (Evans) procedure?

Anna Marie, Office of Vito Rizzo, DPM, Bay Shore, NY  

Response: If done at separate sites, the coding would be CPT 28300, CPT 28300-59.

There is no code for the application of the allograft, GraftJacket.

Walter Pedowitz, MD, Linden, NJ

Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

RE: Xiaflex (Kory Williams, DPM)
From: Les Niehaus, DPM

Why not try transdermal Verapamil? It works well on my patients, and no injections are involved.

Dave Williams, DPM, Alamogordo, NM, bdavolley@hotmail.com

RE: Radiographs and Plantar Fasciitis (Michael Forman, DPM)
From: Brian Kashan, DPM, Arnold B. Wolf, DPM

Arguably, most cases of plantar fasciitis can be diagnosed correctly without radiography, but, I think we have to appreciate the (sad) fact that, all too often, the "community standard" for diagnosis and management is not established by the medical community. Significant influence on our respective practice "algorithms" are established by the legal community. Does anyone believe that if you went to the ER, Urgent Care, PCP, etc., for heel pain, they wound not take an x-ray? X-rays are an inexpensive test (check your reimbursement) as long as you're not taking bilateral complete sets to evaluate this type of problem. Take the picture...and avoid that "sinking feeling" when you find out you missed something that should have been identified at the outset by performing a simple, inexpensive diagnostic test.
 
Arnold B. Wolf, DPM, Sterling Heights, MI, omnifootcare@prodigy.net

In reading the postings regarding the need, or lack thereof, in taking x-rays for plantar fasciitis, I believe some of the comparisons and rationale are lacking. An x-ray is an inexpensive and very informational diagnostic tool. It takes less than 5 minutes to do, costs about $25 or $30, and provides us with a great deal of information. It probably tells us more about what isn’t than what is, but excluding a white elephant can be useful.

Besides the medical-legal aspects of missing something, patients seem to be comforted by having an x-ray. That is a component of their care. If I can utilize an efficient, low-cost, and highly informational modality to diagnose and rule out pathology, why not do it? I do not feel this is comparable to sending a patient for an MRI or CAT scan for any complaint, as an MRI is very costly and isn’t usually a first line diagnostic tool.

We treat the entire patient, not just the foot. Alleviating concerns of the patient, while providing  diagnostic information, is a win-win. While I am not a “standard of care”  kind of person, (I hate standard of anything!), I think that taking an x-ray for heel pain is a valuable, although not necessarily required, tool.

Brian Kashan, DPM, Baltimore, MD, drbkas@att.net

RE: Help Sought for Indian Pastor with Clubfoot
From: Joseph Borreggine, DPM

I am in search of any podiatrist interested in traveling to India to help this pastor and maybe a few others at the mission with clubfoot  deformities. I understand the logistics involved may be a tremendous undertaking and involve funding to make this happen. If someone has contacts with a medical mission that could possibly raise funding to fly him and his family to the U.S. so that surgery could be performed, it would be a blessing to this man. Or, if there is a medical mission that goes regularly to India, then please let me know.

Indian Pastor with Clubfeet

By his permission, I have attached a photo of the pastor's feet.

Joseph Borreggine, DPM, Charleston, IL, footfixr@consolidated.net

RE: Universal Training of Podiatrists and Parity (Geoffrey Bricker, DPM)
From: Narmo L. Ortiz, Jr., DPM

Dr. Bricker stated that he has no answer and just deals with the situation of many young people being disrespectful and not hard-working. So, who are we to blame? The government, the schools, or ourselves? Education, morality, and respect start in the home. Those attendings who keep criticizing their residents, shame on you for not educating, guiding, or disciplining them; and the same goes to the parents who have failed to do so as well. Pay attention everyone, or soon you will have no answers as to why you lost the beloved United States you once knew.

Narmo L. Ortiz, Jr., DPM, Cape Coral, FL, nlortizdpm@embarqmail.com

RE: Providing Post-op Care (Robert Boudreau, DPM)
From: Richard A. Simmons, DPM, Simon Young, DPM

Considering that the patient's family does not respect your surgical skills, please be prepared that any post-op disappointment will immediately be your fault in their eyes. From reading your question, I think you have already decided that providing post-op care is not worth the trouble, and that you would be opening yourself up for aggravation that you do not need. 

Richard A. Simmons, DPM, Rockledge, FL  RASDPM32955@gmail.com

Dr. Boudreux makes a profound statement of which I am in full agreement. Many years ago, a colleague referred a complication from a verrucae hyfercation to me for follow-up. The patient was hospitalized, with all necessary follow-up done, and many consultants called. Her problem ultimately resolved. Still, she sued and since the surgeon had no malpractice insurance, I was on the hook. The patient died several years later, prior to trial.

I disagree with Dr. Bourdreux's decision to discharge the patient. In essence, you are coercing the patient to do surgery with you. I feel if a patient wants a second opinion or even seeks surgery anywhere else, I support the decision and will assist in any manner. If your surgery failed, litigation would certainly follow, and that incident certainly wouldn't help your case.

Simon Young, DPM, NY, NY, simonyoung@juno.com

RE: APMA Takes Swift Action on Defamatory Video
From: Keith Gurnick, DPM, Stanley R Kalish, DPM

Although APMA has taken action against the orthopedist who made outrageous claims on a website video by sending a cease and desist notification, I hope other APMA members and non-members agree with me that this is a weak response at best. The APMA should also file a class action lawsuit against this orthopedist and seek monetary damages. A cease and desist, and retraction is not enough. This weak "swift action" sets a precedent that those who make slanderous, libelous, and defamatory claims against our profession and its members can get away with it.

This orthopedist needs a punishment for his actions, not merely a retraction of his words. He can retract his words, but he cannot erase the video. His video may be available on the Internet forever. By suing this doctor for monetary damages and publicizing such an action, the entire "foot orthopedic" community will be placed on notice that we, as a strong association, will no longer sit idly back and allow individuals such as orthopedists to bash  podiatry, either face-to-face with a patient, or surgeon-to-surgeon at the scrub sink, or to a scrub nurse in the O.R., or in the doctor's hospital lounge,  or even on the Internet for anyone, including the lay public, anywhere in the world to see. What is he going to say, "I'm sorry I said that, boo hoo?

Keith Gurnick, DPM, Los Angeles, CA, keithgrnk@aol.com

It's Interesting tht the Dekalb Medical Center in Decatur Georgia, where we have 13 podiatric surgical residents, recently performed 21 open ankle fractures on ice storm victims. I remember when a podiatrist was considered incompetent by orthopedists in Georgia to handle open ankle fractures. We've come a long way in training our residents in fracture management since I took the AO courses in Davos with John Ruch, Harold Vogler, et al. in the late 70's. I'm very proud of my podiatric staff at the Dekalb Hospital as I spent many a day and night trying to get ER physicians to send us lower extremity trauma cases.

Stanley R Kalish, DPM, Atlanta, GA, srkalish@bellsouth.net

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 - 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.

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 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

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 - 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? We also have the Q- Clear Q- switch laser too. This laser is perfect for you. E-mail footcare@comcast.net

EQUIPMENT FOR SALE - MICROVAS UNITS

Two lightly-used microvas units, 16-lead machines (included) , $7,000 each or best offer for both. Great therapy modality: edema, neuropathy pain, increases peripheral flow, increase soft tissue healing. Great practice from vascular surgeons sending patients for treatment, pays for itself. Unit will come with the charger. jhalvorsen@familyfootandlegcenter.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

SPACE AVAILABLE - BRANSON, MO

Great opportunity to develop a podiatry practice in a four condominium Branson office building with a growing ophthalmology practice along with a well established optometry practice and a multi-disciplinary ambulatory surgery center in Branson, a top ten retirement destination.The available condominium is a grey box so it can be build out to specifications. Rental and/or ownership options are available for this condominium. Practice development financing and ASC ownership available for the right doctor. Great schools and affordable lakeside or golf course living available. Contact Dr. James Bureman @ jbureman@missourieye.com or 417-861-5839

PM News Classified Ads Reach over 12,500 DPM's and Students

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