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February 06, 2007 #2,803 Editor-Barry Block, DPM, JD

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TN Podiatrist Has Automated Reception Room

In one Signal Mountain doctor’s waiting room, clipboards and tedious paperwork are becoming a thing of the past. Podiatrist Robert Spalding of Area Podiatry Center recently installed a kiosk that allows customers to check in by themselves. The diminutive machine sitting on a table in the reception room automatically verifies patients’ insurance, determines co-pay and can even be used to upload medical records. "This is going to be the wave of the future," Dr. Spalding said.

Dr. Robert Spalding

The kiosk is the first of its kind in Tennessee, Dr. Spalding said. The service saves patients from having to fill out tedious forms and allows receptionists to bypass transcribing all that information into computers and placing daily calls to insurance companies. With just three other employees in his office and 25 to 30 patients a day, Dr. Spalding said the time saved with the kiosk is a huge benefit.

"If you don’t become more efficient, smaller (doctor’s) offices have the possibility of being overburdened by paperwork," he said. "This just gives you a better tool to work with." When patients enter the waiting room, instead of heading to the receptionist, they enter their name and insurance ID number into the kiosk. Within seconds, the kiosk pulls up all pertinent patient information, including the Health Insurance Portability and Accountability Act privacy form for e-signing. Everything is automatically uploaded into the local office’s system.

Source: Emily Bregel, Chattanooga Times Free Press [2/3/07]

CA Podiatrist Discusses Etiology of Tendinitis

Two major factors can lead to tendinitis, says Dr. Bob Baravarian, chief of podiatric surgery at the Santa Monica-UCLA Medical Center and director of the Foot and Ankle Institute of Santa Monica. One is abnormal motion of the foot, either rolling too far inward or outward. "This causes spasming of the Achilles as it tries it stabilize the foot," he says, "and that results in the tendon getting irritated from overuse."

Dr. Bob Baravarian

The other is changing something about your routine or shoes that would cause the Achilles to overstretch: upping your mileage too quickly, running hills instead of flat ground, running on sand instead of hard surfaces or going from a highly cushioned shoe to one with far less stability. "Those," he says, "can cause the tendon to become inflamed because it's overworked."

Baravarian says your first line of defense should be to see if any of these factors apply to you. If you're running a lot of hills, go back to flat ground and add inclines gradually. Try different shoes, especially if yours are old and worn.

Source: Jeannine Stein, Los Angeles Times [2/4/07]

7 Podiatrists Attend Largest-Ever Nail Disorders Conference

The Council for Nail Disorders held its annual scientific meeting on February 1, 2007, in association with the American Academy of Dermatology meeting in Washington, DC. This year's attendance was the highest ever, including seven podiatrists, which also is a record. Dr. Joel Morse, the current president of the American Society of Podiatric Dermatology attended as well. This organization is international in its reach and includes experts in nail diseases and nail surgery who share interesting cases. This year's subject matter was critical for podiatrists and offered concentrated expertise not available in any other venue. All DPMs with interest in nail pathology can visit the Council's website www.nailcouncil.org

Source: Bryan Markinson, DPM

Query: Achilles Rupture and Posterior Spur

I have a patient 65 y.o. active, healthy female with a non-painful non-debilitating complete rupture of the Achilles about 4 cm. prox. to insertion w/1.5 cm. retraction. She was injected by another doctor for a very painful posterior spur, which remains very painful to all closed shoe pressure. She does fine in a clog-style shoe. She wants surgery (primarily for the post-calcified Achilles insertion). The more prox. Achilles rupture is now a month old. Is there any problem repairing both at the same time, and which procedure should be done first. Does anyone advocate waiting for the rupture to heal at this point with casting and then delay just repairing the calcific tendon?

Loren Miller, DPM, Saint Petersburg, FL

Query: PowerPoint Presentations

Is anyone aware of a resource for purchasing pre-made Powerpoint presentations. I am looking for one to include biomechanics and sports medicine for an annual meeting for athletic trainers.

Nicholas Varveris, DPM, Hilliard, OH

RE: Purple Toes on Dependency (Michael Warheit, DPM)
From: Mike Boxer, DPM, Roody Samimi, TUSPM ‘07

Purple toes in a 16 year old are most likely due to acrocyanosis. In a 16 year old it is unlikely that she has cardiac disease (such as Eisenmenger's reaction) or pulmonary disease, but they should be ruled out. If there is no history of cardiac or pulmonary disease the best treatment is posterior tibial (sympathetic) nerve blocks and keeping the extremities warm. It is due to a functional vasomotor disturbance. You can also try topical applications of nitroglycerine paste (if it's still available) to the involved parts, but PT blocks work best together with keeping the feet warm. The problem will improve as the weather warms up.

Mike Boxer, DPM, Woodmere, NY, MCBDPM@aol.com

She could have a vascular malformation and maybe should have an MRI or ultrasound/Doppler, and follow up with interventional radiology for sclerotherapy or depending on what it is, another type of therapy.

Roody Samimi, TUSPM ‘07, roody.samimi@gmail.com

RE: Integrative Medicine (Bob Kornfeld, DPM)
From: Eric D. Widen, DPM, DC

I am a podiatrist and also a chiropractor. I have been performing various alternative approaches to healthcare since 1987. In my studies and experiences, I have found some alternative therapies work great and others I would consider quackery. For example, I perform applied kinesiology (muscle testing and strengthening) combined with manipulation of the foot and spine and other articulations of the body. I have found this is incredibly effective, however without proper biomechanical foot function (sound podiatric principles), I do not think my treatments would be stable.

Dr. Widen muscle testing a patient for low back pain.

It is difficult to think out of the box. In school, we learn traditional approaches to treat patients. When something new comes along, which is against one’s reality, one can become defensive and closed-minded. I consider myself very open-minded, however I must admit I often become closed-minded when something (out of my box) comes along.

Eric D. Widen, DPM, DC, Marietta, GA chiropod@aol.com

Editor’s note: This topic is now closed.

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

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

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