The Voice of Podiatrists

Serving Over 10,700 Podiatrists Daily

February 18, 2008 #3,170 Editor-Barry Block, DPM, JD

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Livio Spaccapaniccia, DPM

Dr. Spaccapaniccia was a World War II veteran. In 1949, he graduated from The Chicago College of Chiropody (later Illinois College of Podiatric Medicine). Dr. Spaccapaniccia worked as a podiatrist serving Chicago's west side and Oak Brook for 51 years. He was on the medical staff of Northlake Community Hospital, St. Ann's Hospital and Gottlieb Memorial Hospital.

Dr. Spaccapaniccia served as chairman of the podiatry department and was involved with training podiatric residents for 25 years at Northlake Community Hospital. He was a 50-year member of the American Podiatric Medical Association and the Illinois Podiatric Medical Association, and was appointed by Gov. Jim Edgar to the Illinois Department of Professional Regulation Podiatric Medicine Licensing Board in 1992.

Dr. Spaccapaniccia received the Lifetime Achievement Award from the Illinois Podiatric Medical Association in 1994 and donated podiatry services to Villa Scalabrini Retirement and Nursing home in Northlake for more than 30 years.

PM News policy is to request that memorial donations be made to the APMA Education Foundation Student Scholarship Program, 9312 Old Georgetown Rd. Bethesda, MD 20814.

Source: The Doings Clarendon Hills (IL) [2/16/08]

PA Podiatrist Provides Advice on Treating Dry Skin In Winter

If this cold winter weather is causing your skin to get dry, flaky or cracked, you are not alone. Dry skin is a particular problem every winter, said Chambersburg podiatrist Dr. Kirk Davis, adding that the colder the weather, the drier the skin.

Dry skin can be sore, itchy, red, rough and appear scaly; and serious cases can result in cracks and fissures that can become infected. In those who inherit the condition, it is called ichthyosis and the dry skin presents itself earlier in life and is much more severe," Davis said. "It often requires medical attention."

For those with dry skin or heel fissures where heel skin cracks, Davis recommends applying a softening agent to the affected skin and wrapping it in plastic wrap. Do it three times a week before bedtime, then wash or wipe off the affected area in the morning. When the area is under control, repeat as needed. For the softening agent, the podiatrist advises mineral oil, petroleum jelly, bag balm or other inexpensive moisturizers. Typically, this procedure is only needed during the winter.

Source: Iris Hersh, Chambersburg Public Opinion (PA) [2/15/08]

NY Podiatrist to Appear on Today as “Big Loser”

Dr. Howard Dinowitz (2006)

He’s now less than half the man he used to be! Dr. Howard Dinowitz of Brooklyn, NY, loser of 218 lbs. will be featured on the NBC’s Today On Monday, February 18, 2008 at 10 AM.

Dr. & Mrs. Howard Dinowitz (2007)

Dinowitz’s starting weight in November '06 was 388 lbs but by January '08 he weighed in at 170 lbs. His amazing transformation was not the result of surgery or pills. “Just good old fashioned counting calories, low fat, high fiber type of diet, which I will be happy to share with anyone who wants to know exactly what I did. And of course an amazing wife who never gave up on my weight and was my source of inspiration.”

Query: Lateral Cuboid Syndrome S/P EPF

Does anyone have any pearls for treatment of a patient S/P endoscopic plantar fasciotomy (EPF) with lateral cuboid syndrome? This has not resolved with immobilization, Medrol-dose-paks, and NSAIDs

John Levin, DPM, Atlantis FL

RE: Degloving Toe (Juliet Burk, DPM)
From: Multiple Respondents

When something looks suspicious and is not healing, a biopsy is called for a punch biopsy would be a good way of having the pathologic tissue analyzed to find out what is going on to make a proper diagnosis. If the outer surface keeps drying up and scabbing, you may want to consider applying a hydrogel dressing to keep it moist.

Steven H. Goldstein, DPM, Royal Palm Beach, FL, stevefootdr1@cs.com

I find this happens often if the patient has a functional hallux limitus or a hallus rigidus. If the patient uses her feet to help move the wheelchair along it or even walks short distances, the excessive pressure on the tip of the toe could be the cause of the problem. If this is the case, a rigid bottom flat surgical shoe on that foot may solve the problem.

Kent Biehler, DPM, Adel, GA, kbiehler@pol.net

Sometimes there is still a pressure and shear force even to a well-padded prominence. This is often caused by the prominence resting on a hard surface. Investigate the position and involuntary movement of your patient in relation to her wheel chair when in motion, or doing a particular activity like eating, resting, etc.

Robert S. Schwartz, C. Ped., New York, N. Y., rss@eneslow.com

RE: Non-Paying Cash Patient (Michael J. Schneider, DPM)
From: Robert Wunderlich, DPM, Jeffrey Kass, DPM

Dr. Schneider brings up a great point. His patient came in, saw him, was treated and left without paying. Although, maybe not from a legal sense. I do feel 100% unequivocally this was a theft of service. This is always a problem in our "service" industry. If you walk into any store, do you get to take a product, walk over to the counter and tell the cashier you'll pay them later? If someone does steal an item the store gets to prosecute the individual and if the item is not returned the store can write it off come tax time. A physician gets screwed.

Dr. Schneider if you do have the patient's real information - take him to small claims court. I was recently informed by a colleague he has started doing this. He informs me in NY at least it costs 10 bucks to file a claim. As a P.C. he himself doesn't have to show up, so a member of his office shows up.

He has been very happy with doing this. He feels the money is lost anyway, so he will either collect, or possibly make it difficult for the person later on in life. Case in point he had a patient who stiffed him and then four years later wanted to get a mortgage for a house. The guy had a judgment against him and had to pay the doctor what he owed plus interest. Apparently the court sets the interest rate which in this case I believe was around 11%.

Another classmate of mine collects all monies for cash paying patients prior to performing the service. While I personally think this is a little tacky - she has never gotten stiffed once.

Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

My policy in this situation is to require the patient to pay for an initial office visit up front (i.e. before they are taken back to the exam room) with the explicit understanding that any additional diagnostic testing or minor procedures done on the same day would necessitate an additional charge. Similarly, payment for these additional charges is expected at the time of service. And yes, in my office that means the staff asks them for cash, check, or credit card while they're sitting in the exam chair.

Another piece of advice I would give you is to invest in a check scanner with POS (point of sale) capability. This allows your staff to scan personal checks, instantly verify available funds, and instantly transfer those funds to your account. You can then simply stamp the check as electronically deposited, and give it back to the patient. This system eliminates any possibility of accepting a check with insufficient funds. An extra bonus is that you can use the scanner to instantly deposit insurance checks too!

Robert Wunderlich, DPM, San Antonio, TX, rwunder@gmail.com

RE: Number of Podiatrists Needs to Triple by 2014 (SUNY Report)
From: Bryan Markinson, DPM

Approximately two years ago, while in attendance at a New York State divisional meeting, two officers from the NYSPMA were present and were discussing a critical legislative agenda that required PAC money. They effectively, in my opinion, articulated the importance of PAC donations as the only way to get heard, like it or not. At about this time, independent of the issues they spoke of, I was becoming increasingly concerned about class size in podiatry schools, evidenced by low numbers of residency applicants at the organized interview weekends throughout the country. I theorized out loud to them that I didn't think there were 1,000 applicants to podiatry school nationwide. "No way" they said. Impossible!" One actually said that his son was entering podiatry school, and he knew "four or five of his son's college classmates" were applying to podiatry school. I responded that all that may indicate is that his son was an effective spokesperson for his chosen profession. My concerns were dismissed.

Now, a study completed at the SUNY at Albany states that we face a manpower shortage in a climate of increasing demand for podiatrists. The report goes on to say that there are approximately 500-700 applicants, and that 85% of them get accepted! AACPM on their website reports 779 applicants in 2006.

Is it just me, or are we playing ostrich here? Spinning this news in the positive by stating that due to the shortage, podiatrists' median income is at an all time high is very anemic at best. This data should be used to get funds for scholarships and grants or incentives to the best and brightest in our undergraduate colleges to consider podiatry as a career. This effort should be prioritized over Project 2015. Maybe we should bring back the Podiatry Opportunities Program of the early 80's?

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

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. 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 -- www.homephysicians.com

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City . Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

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

PRACTICE FOR SALE -AUSTIN, TEXAS

15 year established practice with good mix of surgery and clinical patients. Nice office condo for sale with practice or lease. Current female Podiatrist will transition the practice. 300-400K yearly gross. Flexible payment options

ASSOCIATE POSITION – RICHMOND VIRGINIA

Hospital-Based Practice with Tremendous Growth Potential and a Fantastic Opportunity for the Right Doctor. I am looking for someone who will be an associate for a couple of years, then discuss Partnership Buy-In. ABPS Certified/Qualified candidate DOES NOT need significant rearfoot experience, but arthroscopy skills appreciated. Need strong surgery and people skills, with emphasis on wound care, forefoot surgery, diabetic problems, etc. No nursing homes. My office is an extremely busy brand new state-of the-art facility with digital x-rays, computerized EMR, etc. Immediate start available, SALARY commensurate with experience. Please send resume to: podmed@mac.com

MEDICAL SPACE FOR RENT OR SALE - NEW YORK CITY

305 Second Avenue (17-18th Sts), 3 Treatment rooms, Private office, Lab, Separate Receptionist/Business area, waiting room, bathroom w/ stall shower Deluxe/Landmark/Prime Building and Location, 24/7 security. Multi-specialty condominiums originally designed specifically for podiatry has also been upgraded for dentistry. For further details contact Laura Dobrusin, Ny2azld@aol.com or jdobr@arizonamed.com 480-951-2480 602-980-8457.

PODIATRIST WANTED – MICHIGAN

Busy 2-Office practice looking for the right podiatrist to take the practice to the next surgical level. Fast track to partnership. PSR 24/36 ABPS qualified/certified. Email resume to drflatfoot@yahoo.com

EQUIPMENT FOR SALE - AUTOMATIC PROCESSOR

AFP Mini-Medical/90 automatic X-ray processor. Excellent condition. Purchased in 2003. Have monthly maintenance records. Location: Pasadena, MD. $1000. View at http://www.afpimaging.com/medmini Contact Jayne at jferris@chesapeakefac.com for details.

PRACTICE FOR SALE - PORT ST LUCIE, FLORIDA

The office is 0.2 miles away from the hospital. Good mix of Medicine, Surgery, Wound care, and general podiatric care. Wound care center privileges available. No HMO's. Please call 1-772-475-7920 or derrico@pol.net for details

ASSOCIATE WANTED -BOCA RATON-DELRAY BEACH AREA

Great opportunity-must be hard-working, reliable, Responsible and good with patients & staff-surgical Training a plus-partnership after 1yr. Florida License required fax resume to 561-865-2225.

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