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February 05, 2007 #2,802 Editor-Barry Block, DPM, JD

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ESWT is Alternative to Heel Surgery: CA Podiatrist

Heel pain can be frustrating to treat. In the past, when ice packs and steroid injections failed to work, doctors often turned to surgery. Now a new, less-invasive treatment is using simple shockwaves. Novato physician Vincent Marino says part of the pain of plantar fasciitis is caused by scar tissue from the inflammation. He says the shockwaves break down the scar tissue.

Dr. Vincent Marino

Dr. Vincent Marino: "What this procedure does is by causing this new injury it's actually allowing the development of new blood vessels to go within the scar, help it reduce the scar, and the healing process then goes on its own in a normal physiologic way."

He cautions it doesn't work for everyone, but early results are promising. Dr. Marino: "We're seeing anywhere from 50 to 80 percent improvement and success rates with it."

Source: Dean Edell, ABC7/KGO-TV [2/2/07]

NY Singing Podiatrist Publishes Children’s CD/Book

If you're commuting to or from Manhattan and hear melodic sounds drifting from the car in the next lane, it may well be Armonk mom, Dr. Kathy Reilly Fallon — the singing podiatrist.

Dr. Kathy Reilly-Fallon

Dr. Fallon focuses on her surgical instruments once at work in her midtown podiatry practice. But driving to and from Westchester, she uses the downtime to practice the songs she performs in concerts at nursing homes and children’s health facilities. And on her brand-new CD, Heavenly Skies & Lullabies. The new album contains 11 beautiful lullabies, all soothing enough to calm a baby’s cries and a harried parent’s nerves, and comes packaged with a book.

Heavenly Skies & Lullabies

It is actually Dr. Fallon’s second venture into the world of music publishing. Her first CD, Heavenly Lullabies, was dedicated to the babies and orphans of 9/11. Dr. Fallon spent several weeks volunteering her medical expertise at Ground Zero. Based in the safe haven of the untouched St. Paul’s Chapel, she joined other volunteer health professionals to administer care to sore and injured rescue workers. The experience was a turning point. She saw the need to somehow help the children whose lives had been so altered as a result of that tragic day.

Source: NY Metro Parents Magazine

IA Podiatrist Wins Superbowl Lottery

A Bears fan is patient. Chuck Gilarski, a podiatrist in Ames, grew up in the southwest neighborhoods of Chicago. He applied for season tickets 25 years ago and got a postcard congratulating him for being 13,000th in line.

Some fans wait more than a generation to make the Bears' season-ticket list. It took Gilarski only a decade. A few weeks ago, Gilarski got another note from the Bears. He was one of the few season-ticket holders who had won the lottery for the right to purchase Super Bowl tickets, maximum two apiece, at face value: $600.

Chuck scrambled to get a travel plan together, but he pulled it off. He was slated to leave Friday on a $450 round-trip flight from Des Moines to Miami. He and his brother-in-law are splitting a $300 hotel room over three nights. "I definitely need to take a walk or a jog on the ocean," he says. "I feel like 'Pride of the Yankees.' I'm the luckiest guy."

Source: Sean Keller, Des Moines Register [2/3/07]

Stark to Seek to Revise Inflation Updates in Medicare Payments

House Ways and Means Health Subcommittee Chair Pete Stark (D-CA) on Wednesday said that he will seek to revise inflation updates in Medicare reimbursements for hospitals and other health providers to help cover the cost of other healthcare proposals, CongressDaily reports. The inflation updates affect Medicare reimbursements for hospitals, skilled nursing facilities, HMOs, nursing homes and home healthcare providers. Stark said he expects opposition to the proposal from some Democrats on the subcommittee, adding, "I'll need Republican support."

Source: American Health Line [2/2/07]

Query: Purple Toes on Dependency

I have a 16 year old patient with purple toes. There is no pain or swelling, and it goes away when she lies down. She is very embarrassed at gym class. Are there any medications or therapies that could help her out?

Michael Warheit, DPM, Buffalo Grove, IL

Query: Managing Surgical Logistics

I recently had a key back-office employee retire, and with her all the knowledge of managing all the aspects of my surgeries (consents, pre-op and post op appointments, pre-certs for sx and DME, boarding of the case, medical clearance, etc...)

Now as I try to train some new employees to do this work, we are finding this to be an area that is consuming a great amount of time as well as being done inaccurately and inefficiently. Have any of you found a smooth, efficient system for handling all of these peri-operative logistics? I was considering using some sort of "form" or "worksheet" to keep track of all this information. Perhaps some of you have already perfected such a form and wouldn't mind sharing it with us.

Dan Methuselah, DPM, Columbia, SC

Editor’s comment: This type of logistical task should be incorporated into your office manual. Unfortunately, many practices do not have office manuals, and as a result, run inefficiently. Policy and procedure manuals can be obtained from sources such as www.codingline.com or the American Academy of Podiatric Practice Management (www.AAPPM.org). These are wonderful benefits of being part of these organizations.

RE: Circulator Boots (Michael Rosenblatt, DPM)
From: Paul Kesselman, DPM, Simon Young, DPM

The intent of my posting was not for anyone to empathize with my opinion or posting, nor is it to defend anyone defrauding a governmental program. My intent was to simply state that the references to traditional and podiatric has nothing at all to do with this case.

If they did, every podiatrist would be "guilty" of something as we all provide unqualified routine foot care (non covered by Medicare), foot orthotics, latex shields etc. All are non-covered for the most part. No one however argues that these are non-traditional or non-podiatric.

I'll let the scientists and researches and those who use the circulator boot decide whether this treatment is worthwhile (whether covered or not).

Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net

I don't understand Dr. Rosenblatt’s point of view. True "the government" at times uses political means to exclude treatment regimens but it usually doesn’t do it wantonly. There is a protocol involving peer comments and CAC meetings. As far as the "circulator boot" and dealing with vascular issues. There are so many variables to be evaluated in PVD and to relegate all solutions to one modality is not reasonable or prudent. PMH, medications, location of vascular lesion ie: SFA, peroneal or tibial arteries, one or multiple areas of stenosis, how long is each stenosis? etc., did patient consult a general surgeon or someone with expertise in vascular and endovascular procedures?

I am no fan of government intervention - no doubt we all had enough. I do believe the CMS wants to benefit its members and get the most value for its money while reducing morbidity or mortality. Therefore, treatment protocols must be either proved in literature via strict research protocol and ultimately be evidence-based. If the "circulatory boot" is such a superior modality than let the manufacture provide peer reviewed literature for its efficacy and prove it will save money when compared to current treatment modalities.

Dr. Rosenblatt, I hope should join his local state society and deal with "political medicine" issue via political means.

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

RE: Integrative Medicine (Bob Kornfeld, DPM)
From: Multiple Responses

Editor's note: These notes appear at: http://www.podiatrym.com/letters2.cfm?id=12615&start=1

ASSOCIATE WANTED - NORTH CAROLINA , CHARLOTTE AREA

Incredible opportunity to join a busy, well-established group practice. Looking for a self-motivated, hard-working individual seeking to become a partner. Hospital and surgery center privileges. Salary plus percentage, 401k and real estate opportunities. Send CV to universityoffice@ bellsouth.net

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 POSITION LEADING TO PARTNERSHIP - TAMPA BAY AREA-FLORIDA

Immediate position available in growing multi-office/multi-physician practice. Looking for a highly motivated psr24/36 trained podiatrist. Must be board qualified/board certified ABPS physician and be highly enthusiastic, motivated, with excellent patient/ social skills. Excellent benefit package including salary/bonus, health ins, paid time off, paid CME, and much more. Please e-mail CV to drdad94@aol.com or contact (727) 944-2522 for more information.

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

ASSOCIATE POSITION -MINNESOTA – PRIME MINNEAPOLIS SUBURB

Busy, well-established, full-scope podiatry practice, seeking highly motivated podiatrist for a full-time position with potential partnership opportunity. Looking for PSR 24+ individual. Excellent opportunity for long-term growth with unlimited income potential. E-mail CV to employment@associatedpodiatrists.com or fax to (612) 866-5875 Attn. Jennifer.

PRACTICE FOR SALE -NORTHERN CALIFORNIA

Great opportunity to own a well-established turn-key podiatry practice located in modern medical office building in East Bay; Electronic billing, good payor base, no HMO contracts; biomechanics, general podiatry with great potential for surgery. Please send CV and letter of interest to: norcalpod@hotmail.com

PRACTICE FOR SALE -BOSTON SUBURBS

Established practice for sale. Practice averages 18 – 22 patients per day. Currently all surgery is referred out. Opportunity to transition patient base to full service. Priced for sale. Contact dpminboston@comcast.net

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

ASSOCIATE POSITION – CENTRAL NEW JERSEY

Associate Wanted....For well established Central Jersey practice, diversified in all aspects of podiatric medicine and surgery. I am looking for a highly motivated, conscientious, individual with strong work ethhics. My practice may offer great potential for the right person. Minimum PSR 24. Please reply to Jerseypod@gmail.com

ASSOCIATE POSITION - SOUTH CENTRAL PENNSYLVANIA-PM & S 36

Large, busy podiatry group looking for associate interested in future partnership. Practice facilities and technologies include: Surgical Center, Physical Therapy Department, six appointment locations, EMR, MRI and Digital X-ray. Full compensation and benefit package offered. Mail CV to Martin Foot and Ankle, 1203 S. Queen St. York, PA 17403 or email business administrator, johnreitzel@comcast.net

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

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