The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

February 11, 2010 #3,777 Publisher-Barry Block, DPM, JD

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We've just mailed the February 2010 issue of Podiatry Management. This is our annual survey issue which includes over 30 pages of demographic and statistical data. This is the most comprehensive analysis of America's podiatrists available. This month's edition  is also filled with interesting, informative, and useful articles.  In addition, you'll  find our usual assortment of features, including our columns, and a CPME-approved CME.

February 2010 Podiatry Management

MI Podiatrist Uses Titanium Implants to Correct Flatfeet

Caroline Baar had her bunions removed and had special shoe inserts made. Afterward, she could wear only certain shoes, and they didn’t include heels. That’s when Baar’s podiatrist suggested a titanium-made implant the Food and Drug Administration approved in 2004 to correct the aptly named “miserable malalignment syndrome.”

Dr. Jim Bender (Photo: Octavian Cantilli)

An incision less than an inch long is made to place a stent just above the heel bone to restore normal motion. The outpatient procedure can be performed on patients age 3 and older, and the stent does not have to be replaced as a person grows older, said Dr. Jim Bender, Spectrum Health’s podiatry chief.

Supportive shoes and arch supports still are viable options, said Bender, but they’re not a cure-all. There are some limitations, however. The implants treat only mobile flat foot, a condition in which the foot becomes flattened when standing. It cannot help those with rigid flat foot, which is caused by degenerative joint disease, trauma or genetics.

Source: Paul R. Kopenkoskey, The Grand Rapids Press [2/9/10]

PM Appoints 3 New Consulting Editors

Podiatry Management Magazine has announced the appoint of three new Consulting Editors:

(L-R) Dr. Nicholas Bevilacqua and Lee Rogers

Lee Rogers, DPM and Nicolas Bevilacqua, DPM are two of the fasterst rising stars in podiatric medicine and surgery. They are diabetic wound care specialists who have written extensively in Podiatry Management.   

Lynn Homisak

Lynn Homisak is an institution in podiatry. She is a noted author and lecturer, and has elevated the status of podiatric staff members. 

APMWA Announces 24th Annual Student Writing Competition

The American Podiatric Medical Writers Association has announced its 23rd Annual Student Writing Competition.

• All papers MUST be non-technical in nature. Appropriate subjects include practice management, ethics,or any topic that would be suitable for a lay publication.
• There is no word limitation. Papers will be graded for content, style, grammar, neatness, and overall impact.
• First prize will be one thousand dollars ($1,000.00) and recognition in the APMA NEWS and the APMWA Newsletter. Honorable Mention Certificates may also be awarded.
• This competition is open to ANY enrolled podiatric student.
• Entries must be received by 4/1/10 via e-mail at bblock@podiatrym.com
• Entries become the property of APMWA, which may arrange publication of the entry.

Obama Budget Freezes Physicians' Medicare Pay for 10 Years

President Obama promised spending freezes during his first State of the Union address, but his $3.8 trillion fiscal 2011 budget request still would protect physicians from Medicare pay cuts and extend enhanced federal support for state Medicaid programs.

Obama's proposal, unveiled Feb. 1, sets aside $371 billion over a decade to pay for the cost of preventing Medicare pay cuts under the sustainable growth rate formula. But the funding would only be enough to turn annual reductions into rate freezes, not to fund pay raises. Also, the president left the specifics of how to prevent the cuts up to Congress, said Jonathan Blum, director of the Centers for Medicare & Medicaid Services Center for Medicare Management.

Source: Doug Trapp, AMNews [2/8/10]

Query: PRP

I would like to know if any of my colleagues have been using PRP for connective tissue pathology. What has your experience been? Are you impressed with the outcome of the treatment? Where did you train in the technique?
 
Bob Kornfeld, DPM, Manhasset, NY

RE: Allergy to Concrete? (Chuck Ross, DPM)
From: Bryan C. Markinson, DPM, Robert Scott Steinberg, DPM

Cement dermatitis is a well-known entity, but occurs almost exclusively in cement workers as a result of exposure to WET cement. The dermatitis can range from simple irritation to blistering and even burns. It takes handling of the wet cement to cause cracking in the skin and then a compound called hexavalent chromium penetrates and causes the inflammation.

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

If the patient is working with concrete and is wearing cheap boots, he could suffer from alkali burns.
 
Robert Scott Steinberg, DPM, Schaumburg, IL, doc@footsportsdoc.com

RE: Billing/Scheduling (Margaret Portela, DPM)
From: Marc Bendeth, DPM,  David Helfman, DPM

I have been using Sammy 2000 and Sammy EMR for more than 12 years. It's support is exceptional, as is the program overall. I have no interest in this company other than being a very satisfied client.

Marc Bendeth, DPM, mbendeth@optonline.net

There are many excellent practice management and scheduling systems on the market. Our practice is utilizing Vision Enterprise System, a product of Allscripts. They were formerly Misys and before then, had a product called Basemed. Our practice has been with this company for 15 years and have grown along with them. They are one of the largest practice management systems in the country. Now with that being said, this system is geared toward a larger practice with many doctors and many locations. They also have a very robust and dynamic EHR system.

This Allscripts system is quite expensive and is not very practical unless you are a part of a large practice. However, with the new stimulus money "allocated" to purchase and upgrade your systems, it's not as big of a financial hit to your practice. If you are a smaller practice, there are many systems out there, many of which advertise in PM Magazine and at most of the podiatry shows. Here’s a list of 18 different vendors that have podiatry applications: 

In the past, I have gone to medical technology shows and it took us three years to choose Allscripts. My only recommendation is to check references after you pick a PM system and make sure they really cater to the podiatry world. I have found many companies will show beautiful demos that are flawless, and then at the end of the presentation, they have no podiatry clients.
 
David Helfman, DPM, Atlanta, GA, dhelf18809@aol.com

RE: ABPS Examination Statistics (Robert Bijak, DPM)
From: Multiple Respondents

Test-taking is a learned skill. It is not possible to pass the exam without knowing the material, but it is very possible to fail despite knowing the material well.   

Dwight L. Bates, DPM, Dallas, TX, dlbates04@yahoo.com

If so many do fail exams, is their education to blame (the schools), or are the exams unfairly written? It has to be one or the other. There is no getting around this. I have always felt that some tests are purposely written to fail at least 50%. Why? Is this to elevate the status of those who are good at taking exams? Why do some boards want to be more about exclusion than inclusion? Why aren't the big shots at ABPS screaming bloody murder at the level of students they are graduating, if the education process is to blame? Could it be that ABPS knows it's the design of the exam and not the educational process?
 
This issue has haunted us for all the years that I have been in practice, and is the single reason for the divisions in our profession. And it is these divisions that have kept us totally distracted from the real issues that are important for our survival as professionals and practitioners.

Robert Steinberg, DPM, Schaumburg, IL, doc@FootSportsDoc.com

The recent comment that orthopedic surgeons are "board certified" in specialty areas (e.g.-hip, knee, foot and ankle) is not correct. The AAOS is working on CAQ's (certificates of added qualifications) with which an individual can declare subspecialty expertise.
 
Drawing any specific conclusions from the high failure rate of the ABPS examination is, at best, difficult. Perhaps what may be helpful is a listing of the percentage of pass/fail from each school and residency, thereby assisting future students and residents in their selection process if interested in surgical board status.
 
In a recent malpractice case, I refuted the plaintiff's expert's (a foot and ankle orthopod) assertion that the orthopedic boards were "more rigorous" than that of podiatry by pointing out that the first attempt passage rate of the orthopedic boards in greater than 90%, compared to our boards.
 
Is our board examination too difficult? It depends on what you want the board to represent to the general public and medical profession. We have leaders in our profession in, for example, diabetes, whom I suspect could never pass a rigorous testing on clubfoot correction or trauma. We have trauma leaders in our profession who probably couldn't tell athlete’s foot from cutaneous lymphoma. We have excellent forefoot surgeons who never do external fixation.
 
I'm not sure how you package all this in one examination. Perhaps, we should look into certificates of added qualification which are standardized by the ABPS and accepted by the APMA. After years of diabetes-related work, let such individuals sit for a diabetic foot CAQ, etc. 
 
Allen Mark Jacobs DPM, St. Louis, MO, allenthepod@sbcglobal.net

RE: EMR Change-Over (Michael Brody, DPM)
From: Jim DiResta, DPM

While I respect Dr. Brody’s opinion in his "100% disagreement" of my assessment and recommendations, I stand strongly by my experience and the present timetable of "meaningful use" when purchasing an EMR. I feel it is reckless in promising that everything needed will be present in about another five years.

I serve on my local IPA board and have been a member of our HIT steering committee of Wellport, a health information exchange network. In addition, I have had the privilege of being on the receiving end of the Massachusetts eHealth Collaborative Initiative in securing an EMR back in 2006. At that time, I/we were promised the interconnectivity that Dr. Brody states will be present for everyone in about five years. Even if it is present, don't bet on it being easily and inexpensively available, particularly if you are with a stand-alone system. Second, even if (and that's a big if) the platform for exchange is available in five years, you will be two to three years behind the present government timetable for "meaningful use."

The problem I have with your statement is the "matter of factness" in it. Meaningful use will require the "capability" of the EMR in 2011, but your EMR will be required to be a part of a functional HIE in use in 2013. There is likely to be more fall-out in the next couple of years, BUT I stand strongly by my own experience in stating that an EMR that is functionally compatible with systems in your local community should be your first priority, and I would look at systems with the highest penetration in your community first. Whether the EMR system is more podiatry-friendly should be a distant second if you want to hedge your bets in making your best investment.

Jim DiResta, DPM, Newburyport, MA, James.J.DiResta.DMS04@Alum.Dartmouth.org

PRACTICE FOR SALE - NEW YORK

Dr. Mark Levine's Office in Middle Village, Queens, NY. Dr. Levine passed on several weeks ago BUT practice has been covered and is being actively manned. Call cousin Art Korbel, DPM, MD who is handling the sale, for details. 954 753 7621 or classicboats4425@aol.com

ASSOCIATE POSITION - HUDSON VALLEY, NY

Do you enjoy teaching residents and being in the O.R.? We are seeking a well-trained foot surgeon. Experienced foot surgeons or new graduates with excellent training considered. We are an expanding multi-office group practice with a great group of doctors, located in the scenic Hudson Valley. We also have a Wound Center and Residency Program affiliated with this special opportunity. Please forward CV to: healthyfeet4ever@yahoo.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. Please reply to: jclough@bridgemail.com

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 - 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 - INDIANAPOLIS, INDIANA 
 
Hospital clinic practice with a large volume of all patient types. In need of 1-2 podiatrists, willing to work as a team and make a career in Indianapolis. One - two year residency training can be medical or surgical. Excellent income and ownership possible. Curriculum vitae to  twz1001@sbcglobal.net

ASSOCIATE POSITION - MARYLAND/D.C AREA

We are looking for an energetic and well-trained podiatrist to join our rapidly growing group; we have offices in Maryland and D.C and are in need of someone who is hard-working and growth-oriented. This candidate must be a graduate of a PM&S 36 residency program or have the equivalent in practice experience. We are looking for the person that wants to make this area their home and become an integral part of our group. If interested, e-mail your CV and cover letter to washingtonpod@aol.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

SPACE AVAILABLE  With MRI– NYC/LI

Turn-key office space, East 60th and 22nd St. Manhattan and Plainview, Long Island. Available extremity M.R.I and dynamic ultrasound (East 60th St Manhattan and Plainview, LI). Tests are run by DPM and read by board-certified radiologist. Call for rental agreement. Satisfies Stark laws (516) 476-1815.

ASSOCIATE POSITION - W FLORIDA, BEACHES

Well established podiatry practice with excellent mix office/surgery seeking full time associate PSR 12-36. Excellent salary & benefits for the right hardworking, personable candidate. Email resume to capecoralpodiatry@live.com or fax to 239-573-9201

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 - NORTHWEST CHICAGO SUBURBS

17 year-old surgical practice for sale. Practice sees a wide variety of foot and ankle pathology and is largely referral especially regarding surgical patients. Two offices fully equipped. Lease or purchase of office condo also possible. Doctor willing to stay Please email inquiries to crystallakefootandankle@live.com

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 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-INLAND EMPIRE, SOUTHERN CALIFORNIA

Associate needed full or part-time for multi office practice. Must be ABPS BC/BQ. Hard working, ethical individual who is looking to a possible partnership opportunity. Looking for current licensed or resident completing program this spring. Email CV to bkatzman2@earthlink.net

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

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

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

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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