The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

February 09, 2009 #3, 465 Publisher-Barry Block, DPM, JD

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Education is Key to Preventing Amputations: PA Podiatrist

One of the most frightening risks those with diabetes must face is having a limb or appendage amputated. In fact, according to a recent study by the American Podiatric Medical Association, 25 percent of amputees with diabetes stated that they should have seen a specialist, such as a podiatrist, sooner than they had once their symptoms arose. "Today, diabetes is on the rise, and so having to endure these amputations is becoming all too common," says Ira Meyers, doctor of podiatric medicine, who, in practice with his wife, Theresa Tobin, is associated with several area hospitals.

Dr. Ira Meyers

Meyers agrees with advice from the APMA, which encourages those with diabetes or those at risk to have their feet examined by a podiatrist every year to avoid possible complications, such as amputation. 

"In the beginning, there often are no warning signs," explains Meyers, "which is why we recommend having at least a yearly visit with a podiatrist, especially for those over 40. When a new patient comes in to see us, we check the circulation for pulses in the foot, any skin changes, and poke around the foot to see if there is feeling. But most importantly, patients must learn to educate themselves."

Source: Rita Charleston, Jewish Exponent , [2/5/09]

NY Podiatrist Heading to Special Olympics Winter Games

When Robert Conenello graduated from the New York College of Podiatric Medicine in 1990, he never thought podiatry would take him around the globe. Yet Conenello has overseen athletes at the 2007 Special Olympics Summer Games in China and the 2005 Sahara Race in Egypt.  Today, he leaves for another weeklong trip. This time it's to Boise, ID, as a global clinical advisor for the Special Olympics World Winter Games.

Dr. Robert Conenello

Conenello, 44, a doctor at Orangetown Podiatry, is participating in the Healthy Athletes program, which provides health screenings free of charge to athletes at Special Olympics competitions. The screenings educate them on healthy lifestyle choices and identify problems that might need additional follow-up. "Some individuals have never seen a podiatrist," said Conenello, a 1982 Tappan Zee High School graduate, who is married with three kids. "They find out they might have serious infections, malformations. Sometimes they might just not have the proper footgear. We've seen people that are size 10 wearing a size 6 shoe."

Conenello works with senior global clinical advisor Dr. Patrick Nunan, an Ohio podiatrist. Besides the proactive care of screening athletes - the program is called Fit Feet - they also make referrals to local health practitioners; train health-care professionals and students about the needs and care of people with intellectual disabilities; collect, analyze and disseminate data on their health status and needs; and advocate for improved health policies and programs for them.

Source: Harold Gutmann, The Journal News [2/6/09]
 

Technology Costs May Be Tax-Deductible

You might have bought an iPhone or BlackBerry just to stay in touch with family and friends, but if it has become an integral part of your workday, you may be able to deduct its cost from your taxes as a business expense.

There are two types of expenses that come into play in this area. Basic business expenses, such as office supplies and phone service, can include cell-phone service or an Internet connection. There is no limit on the amount you can deduct.

Then there are expenses that fall under Section 179, the federal tax code that covers tangible property used for business, such as furniture and office equipment. These expenses, which are limited and are subject to depreciation, can include computers, cell phones, and PDAs. As a result of the economic stimulus package signed by President Bush on Feb. 13, 2008, changes to Section 179 allow practices to deduct purchases of up to $250,000 for 2008 if the taxable income of the practice is at least as much as the deduction.

Source: Pamela Lewis Dolan, AMNews [2/2/09]

Query: Erythromelalgia

I have a patient with erythromelalgia. What does the recent literature on it recommend as a treatment. Acetylsalicylic acid  (ASA) is a treatment, but what is the dosage?

Ken Jacoby DPM, Elgin, IL

Query: Healthcare Networks Of America, LLC   

Has anyone have any good or bad experience with Healthcare Networks Of America, LLC?  They are marketing to podiatry and trying to sign up doctors for a "new flow of patients to your office.”

David Zuckerman, DPM, Woodbury, NJ

RE: Ehlers Danlos Syndrome and Chronic Dislocating Ankles (Nicole Hancock, DPM)
From: Dennis Shavelson, DPM, Dan Haley, DPM

Consider a device which is a modified UCBL with  lateral and medial sides (28 mm. or more deep) that will stabilize her calcaneus (assuming and inversion-eversion dislocation) and/or one with high vaulting, foot type-specific that will greatly reduce unwanted motion.  In addition, I would add a leather gauntlet-type orthotic. I find that once you stabilize the foot and STJ, proximal flexibility decreases. If that is not enough, consider an arthroresis to reduce subtalar motion.
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Lower heeled shoes will also help absorb some ankle dorsi-flexion. Supplements of zinc, magnesium, and vitamin K, B12, and biotin are commonly needed in EDS. Blood tests could be considered to determine deficiencies. In addition, since yeast infections are more common in EDS, look for them as part of foot rashes, intertrigo, etc.

Dennis Shavelson, DPM, New York, NY, drsha@foothelpers.com

Editor’s Note: An extended-length note by Dr. Haley appears at: http://www.podiatrym.com/letters2.cfm?id=24446&start=1
 

RE: Amazing Charts (Michael Lawrence, DPM)
From: Jessica Lund, DPM,  Dean Clement, DPM

I have been using Amazing Charts for 3 months or so, and other than a few annoying things, it has been great! It has made our office much more efficient. I am now able to see more patients in less time and am able to complete notes before I leave the office.  After the initial set up of templates and scanning charts in, the program is fast to use. I don't use their billing service and am not using the e-scripts part yet.  
 
Jessica Lund, DPM, Port Townsend, WA, ptpod@yahoo.com

My multispecialty group practice (10 providers) has used it for three years. It's very user-friendly and simple, designed by physicians, a great piece of software for a small one or two physician office.  The larger the practice, however, the more data and users are trying to access it at once and it becomes prone to errors and other glitches, which is ultimately requiring our practice to look for a more robust system. 

The other downside is that you purchase the software and run it on your office server system, which if you don't utilize an office network already, will require additional investment, backups, etc.  But for small practices, it works very well. Data input is manual. You can type and carry old notes forward and edit the pertinent details at each visit, or you can dictate and have the transcriptionist load the notes directly into the software via remote access. Our practice utilizes an India-based transcription service that dictates and loads the notes into A/C overnight, so I get to the office the next morning and my notes are ready to sign. I love that feature.  

The messaging feature is simple and easy to use. It has the most recent ICD and CPT codes and is updated periodically. You can get a free, fully-functioning trial version to play around with for 90 days. Bottom line: If I were in solo or small group practice, I'd definitely keep it. 

Dean Clement, DPM, Chandler, AZ, dlmeb5@yahoo.com

RE: Carl Abramson, PhD
From: Harold B. Glickman, DPM, Allen Mark Jacobs, DPM

The podiatric profession has lost a great educator and friend. I had the pleasure, during my years in podiatric medical school, spending many hours doing research with Dr. Abramson and will never forget his commitment to the podiatric medical student. He was one of the first PhD's to teach at PCPM (now Temple) and had a wonderful enthusiasm for education. His early career was spent as a comedian in the Borscht Belt in New York State, where he spent many hours with entertainers such as Joey Bishop and Buddy Hackett. Dr. Abramson could spend hours talking about them and once work was done, he would even recreate his own comedy routine. He will be sorely missed.  

Harold B. Glickman, DPM, Past President, APMA

It was indeed disheartening to hear of the passing of my old microbiology professor, Carl Abramson. It the "early days" of our advancing profession, he demanded nothing less than the highest level of knowledge from his students, believing that the road to acceptance of our profession by the remainder of medicine was based upon knowledge and credibility. He was truly an inspiration, a great teacher, and an accomplished comedian.

Many of us dealing with bacteriology, virology, mycology, and parasitology issues owe our understanding of these subjects to Dr. Abramson. He instructed for many years at PCPM, local and national meetings. He was a great teacher and scientist who believed in our profession, brought credibility to our profession, and recruited others in academic medicine to build our profession. I recall him frequently, and fondly, and am sorry that he is no longer with us. 
 
Allen Mark Jacobs, DPM, St. Louis, MO

RE: EMRs and Privacy  (Lloyd S. Smith, DPM)
From: Elliot Udell, DPM
 
In reading Dr. Smith’s letter, can we infer that he has access to the medical data of two million people? Does this mean that a doctor can access the confidential medical records of any of those two million people without the expressed permission of any of those people? Can you access your next door neighbor’s private medical records even if the person is not your patient?  If so, this presents as a potentially dangerous invasion of privacy. Now, I am certain that Dr. Smith would never misuse another person’s private medical information but if you read the logs and newspaper articles about what some  physicians have been convicted of, you can see that there are many crazy people who happen to be doctors who could  misuse a person’s private medical data, especially if the nature of the condition was embarrassing. 

There are many embarrassing things in a person’s medical history that a patient seeing a podiatrist or dentist might not want known  and the data will have zero relevance to what they are presenting for.  For example, if a young patient of mine had undergone an abortion or gave birth to a child out-of-wedlock and wants to keep that aspect of her life behind her, what relevance would my knowing this data have on my treating her for a mycotic toe nail? She has the right to choose to make her sexual - medical history none of my business and my ability to access this data without her permission would be an invasion of her privacy. I am certain that the readers of PM News can think of many other similar examples. When considering the privacy of medical records, let us not forget that in addition to being doctors, we are also patients. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

OFFICE SPACE FOR RENT - SEATTLE, WA

Full-service, state-of-the-art podiatry office is offering office space for an independent podiatrist or podiatry group. We have digital X-ray, PADNET, physical therapy equipment, all podiatry equipment and staff to assist you to make the most out of your podiatry practice. Our office is conveniently located close to North West and Stevens Hospital right across from North Gate Mall. You can send your letter of interest to: seattlefootdoctor@yahoo.com or call 425-223-9588

ASSOCIATE POSITION-- METRO NEW YORK AREA

Part-time/Full time. Must be HIP Par Provider. Excellent opportunity for partnership. Must have surgical privileges at area hospitals. E-mail CV to rrranch7@yahoo.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. No seniority system. If you are motivated and have completed a PSR24-36 residency, your income is limited only by your enthusiasm and desire to achieve. Fax resume to: 513-577-7261 or E-mail resume to Kroesch4poh@aol.com

ASSOCIATE POSITION -SOUTHERN NEW JERSEY

I’m looking for podiatrist who wants additional practice hours. Perfect for combining your own practice with an additional income. Must be on Aetna Insurance, Horizon Blue Shield, Medicare, and most commercial carriers. I am looking for someone who has a desire to learn how a very successful practice is run, so that I will be able to have time away from my practice. Payscale to be discussed. Could lead to partnership or sale. E-mail contact information, CV, and why you would be perfect for this opportunity. Contact foot.care@verizon.net

PODIATRISTS NEEDED  CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC 
 
Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

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 - VIRGINIA IS FOR LOVERS

Immediate full-time amd part-time associate positions available. Unlimited income potential. Busy, diverse, 40+yr Hampton Roads practice. Must be compassionate; energetic; and motivated; PSR24/36. Looking for long-term arrangement. Please send letter and CV tofixafoot@cox.net or fax to 757-397-5889

ASSOCIATE POSITION – ST. LOUIS, MISSOURI

Excellent opportunity for PSR 24-36 foot and ankle surgically-trained physician. Looking for hard-working, personable, highly-motivated individuals to join our group and build their own practice. Position leading to partnership. Great opportunity with excellent salary and benefits. Please e-mail CV and references to cavallinig@foothealers.com

ASSOCIATE POSITION MONTANA

Great opportunity for a PSR-24 or 36 residency trained individual to join a dynamic two doctor group with physical therapy. Needs good FF surgical skills, RF a bonus. Beautiful office and great area of the country for outdoor recreation minded individuals. Opportunity for partnership after employment. Reply to: jclough@sofast.net

PODIATRY ASSOCIATE WANTED – NJ

Northern NJ. Bergen County Must be well-trained. No nursing homes or house calls. Modern well-equipped office. Digital x-ray and ultrasound. Excellent pay and opportunity. Must have NJ license. Call 973-472-4700.

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 - CENTRAL FLORIDA AREA

Exceptional opportunity for qualified candidates. Associate position available in a rapid growing, well-established multi-office practice. Well trained (PSR-24 or more). Compensation includes excellent salary plus incentives and benefits. Please e-Mail CV, letters of reference toCF_resume@hotmail.com

PRACTICE FOR SALE - CENTRAL FL

Practice sale at bargain, in beautiful growing area; 2000 sf building fully equipped/ designed for podiatry; excellent location, exposure; near hospital& wound center. Great opportunity for expansion; good insurance climate. 352-357-7499 / E-mail windnwave@earthlink.net

POSITION WANTED In NY or NJ AREA

Board certified podiatrist seeks part-time position in NY/NJ area. Experienced in all aspects of podiatry, including Diabetic Foot, Surgery and in patient care. I'm available Tuesdays and Thursdays. Please contact me at nyraider1@yahoo.com

ASSOCIATE POSITION NORTHERN CALIFORNIA

Need associate in busy office in two locations. Hospital privileges
available. Emphasis on wound care. All aspects of Podiatric Medicine and Surgery. Associate position to lead to partnership and buyout. Please contact jimf@humboldt1.com

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