The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

February 12, 2010 #3,778 Publisher-Barry Block, DPM, JD

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OR Podiatrist Questions Marketing Claims of Fitness Shoes

They burn calories, give you good posture and tone your calves – at least, so they claim. Skechers recently came out with a new kind of shoe that promises to make you fit simply by wearing them. Some doctors and fitness experts are skeptical.

Dr. Justin Tidwell

Legacy podiatrist, Justin Tidwell, said there may be a lot of hype, but he’s waiting for the other shoe to drop, so to speak.“My first thought was people are going to be tripping, and hurting ankles while they use them,” said Tidwell. He said, without any sort of ankle support, these Shape-ups shoes could damage a person’s Achilles tendon, among other things, because the sole is not a level surface. He questions the marketing claims that they can get you fit.

Source: Jenny Hansson KOIN-TV CBS 6 (OR) [2/10/10]

TX Podiatrist Lectures at ADA Post-Graduate Course

Dr. Lawrence Lavery lectured at the ADA's 57th Annual Advanced Post-Graduate Course in San Francisco, February 6th in the "Meet the Expert" sessions. The "Meet the Expert" section of the meeting involves four concurrent 90-minute sessions on diabetes-related complications. Dr. Lavery lectured on "the diabetic foot and neuropathy." 
 

Dr. Lawrence Lavery

"The American Diabetes Association provides excellent education programs. I would recommend this meeting to podiatrists who treat patients with diabetes. All of the topics were well thought out and expertly presented," said Lavery.

Docs Wrestle With Cultures, Languages: Survey

Physicians are struggling to overcome language and cultural barriers in communicating with patients, according to a new national survey released by the Center for Studying Health System Change. The survey, Modest and Uneven: Physician Efforts to Reduce Racial and Ethnic Disparities, funded by the Robert Wood Johnson Foundation, found that nearly half (48.6%) of all physicians in 2008 had reported minor communications problems associated with language or cultural barriers, affecting their ability to provide high-quality care.

While less than 5% viewed it as a major problem, physicians’ efforts to overcome communication barriers “are modest and uneven,” the survey stated. Only about 7% reported they routinely used information technology to keep track of patients’ preferred languages, while 40% said they had received training in minority health issues. Slightly more than half said their practices provided some interpreter services, according to the HSC survey.

Source: Jennifer Lubell, Modern Healthcare [2/10/10]

Examine Staff Complaints

Before dismissing employee complaints, consider their roots. Authentic resistance has merit that you can—and should—explore.

Example: “I did not have the resources required to complete that project.” That differs from pseudo complaints that mask another motive or a hidden agenda: “The project isn’t worth doing” or “That is a waste of time.”

Source: Adapted from Mastering Office Politics: How to Finesse Your Way to Success, Berkeley Books via Communication Briefings

Query: Plantar/Palmar Keratosis

I have a patient with severe plantar keratosis on both feet. She is also afflicted with these lesions on her hands. Manual debridement only provides minimal relief. Any suggestions? Any new treatments out there?

Misty McNeill, DPM, Elmhurst, IL

Query: AthenaHealth Software

I am thinking about using AthenaHealth as my billing company/practice management software. Has anyone had any experience with it that they can share with me?

Jordana Szpiro, DPM, Boston, MA

RE: PRP (Bob Kornfeld, DPM)
From: Vince Marino, DPM, Jeffrey Kass, DPM

I have utilized autologous PRP injections in approximately a dozen patients thus far. Half have been for chronic Achilles tendinosis and the other half for chronic plantar fasciitis. They are easy to do and no special training is necessary. In fact, some of your orthopedic colleagues are already probably utilizing PRP to augment their ACL and rotator cuff repairs, and they can give you some help. I do recommend doing it under some form of MAC anesthesia or even general.

I have seen the best effect on tendinosis and have had approximately 80% improvement at about 4 months out. My treatment of a patient with plantar fasciitis is still less than 4 months duration, so it is premature to give any report.

The question that no one can answer is this: Is it the PRP or the multiple injections which, in and of themselves, cause a “new injury”, and thus re-stimulate the body’s own healing response? Also, the reimbursement of the kits in the office setting (and even in some outpatient settings) is NOT enough to cover the costs, so beware. I think you can only bill for an injection procedure but some may argue that you are performing, on the Achilles, some form of delayed repair or even partial tenotomy, but I am not sure.

Vince Marino, DPM, San Francisco, CA, drmarino@marinofootandankle.com

I tried PRP a few years ago. I did not have a large patient sample. I was told it was a covered service, and that the company I used was to do all my pre-authorizations. I tried it on five people for various pathology, hence my results are really meaningless. To comment on the question though: I don't think there is much "training" involved.  Blood is drawn and is then spun down. Various companies have various contraptions, most with a centrifuge, some gravity-dependent. Most of the reps are well versed with their equipment and can easily demo it for you.

What I find interesting is that when I review articles, there does not seem to be any specific protocols. i.e., for plantar fasciitis - can the person walk immediately or should he be with crutches? Is a CAM walker okay?  Where do you exactly inject? The spot of maximum tenderness? Ultrasound-guided? Around the fascia? Needling the fascia?

The same holds true for the Achilles tendon: inject around the deformity? into the sheath? Without protocols, these studies don't tell me much. By the way - even though the company got me pre-authorizations, I did not receive payment for my "experimental procedure." I’m not sure what the purpose of the pre-auth was. A recent published article compared PRP to placebo. The conclusion was that the placebo was just as effective. In its defense, there are "white papers" showing its effectiveness (none that I have seen related to feet.).
 
Jeffrey Kass, DPM,  Forest Hills, NY, jeffckass@aol.com

RE: Collagenase Clostridium Histolyticum For Plantar Fibromas
From: Bret Ribotsky, DPM

The FDA has granted approval for the marketing of collagenase clostridium histolyticum (Xiaflex), a biologic product indicated for the treatment of Dupuytren’s contracture in adult patients with a palpable cord. (Source: Ortho Supersite)

I wonder if this will work in the foot for plantar fibromas.

Bret Ribotsky, DPM, Boca Raton, FL, ribotsky@yahoo.com

RE: Airport Screening Foot Safety
From: Stanton C. Southward, DPM

In the interest of public health, why not have foot sanitizer/wipes at airport screening areas? These could be provided free to the public, sponsored by podiatry as a public service. I'm certain the media would find this all very newsworthy.

Stanton C. Southward, DPM, Colorado Springs, CO, sbsouthie@comcast.net

RE: ABPS Examination Statistics (Robert Bijak, DPM)
From: H. David Gottlieb, DPM

In regard to the recent responses to Dr. Bijak's comments, as director of a podiatric residency program, I would like to say the following:

1. ALL current podiatric residency programs are surgical and are expected to be even more so in the future.
 
2. Pretty much all orthopedic surgeons become Board Certified at the completion of their programs, not 5-7 years later. Board Certification to most MD's signifies a common level of competence and not an elite status. "Certification by the American Board of Orthopaedic Surgery means that the orthopaedic surgeon has met the specified educational, evaluation, and examination requirements of the Board."  Elite status is indicated by completion of approved fellowships and attainment of sub-specialty status. A non-Board Certified orthopedic surgeon has serious issues with competence.

3. Residents currently take the practice ABPS and/or ABPOPPM board certification exam; yearly in my program. The 'practice' exam is identical in scope and format to the real one. This gives the residents invaluable feedback as to their academic progress and identifies areas of weakness to guide future study. It does not, of course, say anything about their manual dexterity. There is no real excuse for not passing.

I understand that podiatry has chosen board certification to signify an elite status. I'm not here to argue that. I just wanted to point out that both the osteopathic and the other allopathic profession do not share that same outlook. 
 
H. David Gottlieb, DPM, Baltimore, MD, hdavidgottliebdpm@gmail.com

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

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 – 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

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