The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

February 18, 2012 #4,388 Publisher-Barry Block, DPM, JD

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VA Podiatrist Serves as Chairman of PACT Oversight Committee

Healthcare leaders from across the nation met in Potomac, Maryland, February 9–11, 2012, at the Amputee Coalition Limb Loss Summit to review the U.S. Department of Veterans Affairs’ (VA) Preservation Amputation Care and Treatment program (PACT), which has shown compelling outcomes in limb loss prevention. This group examined elements of the VA program to develop a plan for limb loss prevention for the private sector healthcare system.

Dr. Jeffrey Robbins

“We are pleased to share our experiences from the VA system with healthcare leaders, and we are eager to do what we can to assist the civilian healthcare system to learn from our success,” said Jeffrey Robbins, DPM, director of podiatry services, Veterans Administration, and chairman of the PACT program oversight committee.

Source: Orthopedic & Prosthetic Edge [02/16/2012]

NYCPM Residents’ Poster Wins Commendation at Hospital's Resident Research Day

NYCPM residents Drs. Jamie Chaffo and Magdalena DeLaCruz, working under the direction of NYCPM faculty members Drs. Khurram Khan and Anthony D’Antoni, have been awarded a commendation for their podiatry poster at the first Resident Research Day sponsored by New York Medical College/Metropolitan Hospital. 

Drs. Jamie Chaffo and Magdalena DeLaCruz

The poster is entitled "Pedal Complications of Diabetic Subjects in a Cohort of Patients in an East Harlem Population." 

APMA President to Address National Labor and Management Conference

Podiatrists are vital to maintaining a healthy workforce, and saving billions in healthcare expenditures. That’s the message APMA President Michael J. King, DPM, will share with hundreds of labor and management industry leaders this Saturday as he speaks at the 35th Annual National Labor & Management Conference (NLMC) in Hollywood, FL. Dr. King will join an elite panel of healthcare leaders to discuss “The Current State and Future of American Health Care.”

Dr. Michael King

“Untreated ailments, especially those related to the feet, are leading to chronic problems in America’s workforce. We must come together to find real solutions for these problems,” said King. “Including podiatrists in all healthcare plans can help to cut healthcare costs while increasing value. By investing a small amount in prevention, we can provide quality care and proper footwear, maintain a healthy workforce, and save billions in healthcare expenditures.”

Source: Yahoo News [2/16/12]

MI Podiatrist Gives Back to The Profession Via His Work With Diabetes Groups

Dr. Guy Pupp, 64, is a Pennsylvania native who traveled through the halls of Penn State and Temple and has worked his way to becoming one of the top foot and ankle specialists (podiatrists) in the country. After attending medical school at Temple, Pupp moved to Oakland County in 1973, set down roots and hasn’t looked back. Pupp lectures future physicians in residencies across the country and serves on the boards of organizations such as the Michigan Chapter of the American Diabetes Association and the national foundation “Save a Leg, Save a Life,” to educate about the dangers of diabetes.   

Dr. Guy Pupp

"Essentially, it’s giving back to the profession. These are my passions. I’m not a golfer, so I do this eight days a week. And with diabetes comes problems with circulation, numbness in the lower extremities, and ulcerations and sores and things that are difficult to heal. We have screenings, fund-raising events, educational events, materials that we use for education pamphlets, etc. It’s a pretty involved thing, but it feels good to do it," says Pupp

Source: Michael Shelton, Spinal Column [2/16/12]

TX Podiatrist Awarded a Patent for Flatfoot Implant

Dr. Gary M. Lepow, a highly respected foot and ankle surgeon in Houston, TX was recently awarded a patent by the United States Patent Office for a medical device to treat children and adults with painful flatfoot deformities.  

Dr. Gary Lepow and the Conical Subtalar Implant (CSI)

Dr. Lepow’s patented device called the Conical Subtalar Implant (CSI) was developed to minimize the complications of other devices, as well as improve the overall success of flatfoot surgery. The device, distributed by Tornier Orthopedics is now being utilized throughout the world and has become a standard for other developers considering devices for correction of flexible flatfoot deformity.

Details of SGR Deal Released

Federal lawmakers on Thursday agreed on a payroll tax holiday bill that would prevent a 27.4% cut in Medicare physician payment rates scheduled for March 1 and would freeze current payment rates through Dec. 31, 2012. The provision also requires that the Government Accountability Office and HHS submit reports to help Congress develop a long-term replacement of the existing Medicare physician payment system.

As expected, lawmakers had to agree on ways to pay for the Medicare spending in the bill, which amounts to about $21 billion over 10 years. One so-called “offset” in the agreement would lower the reimbursement level that Medicare pays hospitals for bad debt payments. Currently, Medicare reimburses hospitals and skilled nursing facilities for 70% of the beneficiary cost-sharing they are unable to collect, while community health centers and dialysis centers are reimbursed at 100%. The bill agreed in conference would decrease the reimbursement level to 65% starting in fiscal 2013 for those providers currently reimbursed at 70% and phase in the 65% level over three years for those other providers who now receive 100% reimbursement. These changes are expected to reduce spending by about $6.9 billion over 10 years.

Source: Jessica Zigmund, Modern Healthcare [2/16/12]

Query: Calcaneal Pain

I have a 51 y/o healthy female patient with a history of polio as a child who presents with increasing right heel pain. There is no post-static dyskinesia. She cannot ambulate for any length of time without a shoe on her right foot. In 2007, I dispensed a custom orthotic with a horseshoe pad, and she states this provides the most relief. Injection of the heel in 2007 provided no sustained relief.

Calcaneal Pain

PE reveals a very fleshy plantar right heel with no pain on palpation plantarly or along the TA. Dorsiflexion of the right ankle is approx. 18 degrees. X-ray exam reveals a severely increased calcaneal inclination angle on lateral view. Her pain seems to be mainly due to the severe angle of the calcaneus, causing excessive pressure while ambulatory and weight-bearing. Any suggestions on braces, padding, shoe modifications, or orthotic modifications? Are there any surgical alternatives?

Michael Ryan, DPM, Charlotte, NC

Query: Podiatry Plus Malpractice Insurance
 
Would anyone please comment on their experience with Podiatry Plus malpractice insurance?
 
Brett Roeder, DPM, Gilbert, AZ

RE: Complete Tear of Peroneus Longus (David Taylor, DPM)
From: Michael B. DeBrule, DPM, Mike Piccarelli, DPM

If the PL tendon cannot be repaired or restored to its original function, one should consider the effects on the first ray. Attaching the PL to the PB will not help restore first ray function. Will this patient suffer from metatarsus primus elevatus or functional hallux limitus? I think a Lapidus procedure that plantarflexes the first metatarsal should be given strong consideration.

Michael B. DeBrule, DPM, Marshall, MN, Dr.DeBrule@InnovativeFootCare.com

Yes, tenodesis to the peroneus brevis will do well with a Lapidus to neutralize the loss of the longus effects.

Mike Piccarelli, DPM, Staten Island, NY, mcpdpm@verizon.net

RE: Gouty Tophi, 3rd Digit (Charles Baik, DPM)
From: Stephen Musser, DPM, Chris Browning, DPM

As long as the patient is a good surgical risk (diabetes control, pedal pulses intact, compliance, etc.), amputation of the digit is a practical solution to this problem. Be sure to have the patient follow up with the primary physician for control of the gout. Make the patient aware of the surgical cons and that the possibility for further surgical intervention in the future may be necessary.

Stephen Musser, DPM, North Olmsted OH, ly2drmusser@gmail.com

Amputation is a very excellent option for a patient with tophaceous gout, especially when the case is as far advanced as your patient's case appears in the photo. I have seen these same patients have a chronic draining wound from which one can constantly express tophaceous material. Often times, on x-ray, the bones are dissolved, leaving just a bag of tophus. This chronic wound, often coupled with microvascular disease, can also be seen with cellulitis of the toe and even osteomyelitis. You are right on track with your choice to amputate!

Chris Browning, DPM, Temple TX, chrisbrowning@att.net

RE: Podiatry and FQHC Health Centers
From: Paul Kruper, DPM
 
The article in Podiatry Management Nov/Dec 2011 regarding this topic effectively outlined the advantages of working in a FQHC clinic; specifically with respect to being part of a primary care team.

Last year, in California, this employment opportunity was eviscerated when podiatry coverage was scratched from the Medicaid/Medi-cal program. Since most patients who use the FQHC clinics have Medicaid, the staff podiatrists could no longer treat those patients unless they paid cash. The PA, FNP, and other allopathic docs took over care of most foot problems previously seen by podiatrists. The physician assistants are now performing Medicaid nail surgery at these clinics.

This is just another example of how quickly and easily podiatry is excluded from mainstream medicine because we do not have a primary care license. The fact that the state will not save any money because the foot problems are still treated, just by different providers, does not prevent myopic public officials from viewing podiatry as an easy target for elimination. An allopathic license would remove the bullseye from our backs.
 
Paul Kruper, Kingsburg, CA, prkruper@yahoo.com

RE: New MD Shoe Company Tells People to “Ditch Your Orthotic” (Kevin Kirby, DPM)
From: Juliet Burk, DPM

I read the comments in PM News with interest about OESH Shoes. All the fuss was enough to drive me to the OESH shoe site. I was interested enough by the concept to order a pair, and have been wearing them almost two weeks. I have also been in contact with the folks at OESH via email.

They have recently changed their marketing stance on orthotics as listed on their website. Although they still preface their page with the slogan “Ditch your orthotics,” they no longer attempt to wholeheartedly condemn orthotic therapy. But I wouldn’t care if they didn’t. Here’s why. First, the shoes are great. I have already...

Editor's Note: Dr. Burk's extended-length letter can be read here.

ASSOCIATE POSITION - CENTRAL NJ

Looking for a three-year surgically-trained associate who has entrepreneurial spirit. Partnership guaranteed within three years for the right person. Must be very outgoing and personable. Great opportunity for a person who is confident and a go getter. drwfoot@verizon.net

ASSOCIATE POSITION - NORTHEAST GA

Well-established 18 year practice in Northeast Georgia seeking full-time associate leading to partnership. General podiatric care with moderate amount of surgery to be done in local hospital or surgery center. Competitive salary and benefits.  Please respond by email to: Fivetoes1946@aol.com

ASSOCIATE POSITIONS - MULTIPLE STATES

Podiatrist Needed in Missouri, Nebraska, Iowa, Minnesota, North Dakota, South Dakota, Ohio, Texas, Colorado, Oregon, Washington, Arizona, Massachusetts, Rhode Island, Wisconsin, Indiana, Oklahoma, Connecticut and Vermont. Expanding multi-state medical practice seeking podiatrists to service long-term care community residing in nursing homes and assisted living facilities. We offer an established patient base, scheduling, equipment allowance and cover travel expenses. Provide generous compensation, bonus opportunities, disability, health insurance benefits, malpractice coverage and flexible scheduling. Looking for a Podiatrist with excellent skills, able to provide expert and compassionate care to patients. Email CV to: careers@aggeus.org or call 773-770-0140 x300/x305. www.aggeus.org

ASSOCIATE POSITION - MARYLAND

Looking for 3rd associate. Must be personable, well trained and highly motivated. Great locations in Southern Maryland, including an Ambulatory Surgical Center. We currently have EHR, digital radiography, dispensing center and PADNet. Looking for immediate hire! Please send CV to:myfeetfeet@aol.com

PART-TIME PODIATRIST NEEDED - LOS ANGELES, CALIFORNIA

Busy podiatrist looking for assistance with patients located in facilities, homes, office, etc. Flexible hours, independence, and great compensation. If interested email CV to or call Terri at 323-353-8103.homefootcare@hotmail.com

ASSOCIATE POSITION – FLORIDA

Emerald Coast on the North Shore of the Gulf of Mexico, a well-established group practice with multi-offices, seeking an associate with opportunity for partnership for a PSR-24/36 Doctor well-trained in foot/ankle/diabetic problems/wound care/surgical and medical podiatric care, covering 3 area hospitals, NO nursing homes. e-mail letter of interest, CV, and references to basewedge@yahoo.com

ASSOCIATE POSITION – F/T MARYLAND

Looking for a bright, hard-working, personality plus, extremely well trained podiatrist with both top notch surgical and non-surgical skills. Remarkable opportunity with our busy practice. Excellent salary and benefits. Email CV and salary requirements to Marylandpodiatrist@live.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Full-Time Associate needed for busy multi-office locations in LA, Orange, San Bernardino and Riverside counties. SIX FIGURE SALARY PLUS BENEFITS!! Knowledge of Spanish is helpful. Good mix of office patients, house calls, some surgery, etc. NO NURSING HOMES!! Needed in July, 2012 or sooner. If interested, please send contact information and CV to scpodgroup@yahoo.com

ASSOCIATE POSITION - MIAMI, FLORIDA

well established modern practice all phases of podiatric medicine/surgery needs associate. Respond with CV and cover letter. podiatristinsouthflorida@aol.com

ASSOCIATE WANTED - MANHATTAN

Park Avenue office seeks personable, capable and experienced podiatrist, part-time. Office needs coverage March 21 until May 2, possibly longer, with one day a week position available after May 2 .Growth potential. Please fax CV to 212-889-6150 or email info@healthyfeetny.net

ASSOCIATE POSITION - UPSTATE NEW YORK

Outstanding Opportunity. Our medical surgical group is recruiting a well-trained licensed podiatric physician. Located in Beautiful upstate NY. Full hospital privileges, as well as working with two residency programs. Must be highly motivated and great with patients. Opportunity for growth. Competitive salary and benefit package. Please send CV to associateinfoot@yahoo.com

SOUTHEAST GEORGIA- SAVANNAH & SURROUNDING AREAS

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking podiatrist looking to build a career & long-term relationship. Either established practicing physician or new residency graduate. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

ASSOCIATE POSITION - SOUTHERN KENTUCKY

Available in beautiful southern Kentucky in progressive, multi-office practice with 6 providers. Excellent base salary, malpractice, full benefit package with 2-year track to partnership. Looking for someone that wants to grow with our practice, work hard and develop relationships with local hospitals and surrounding communities. Strong communication skills, bedside manner and willingness to learn a must. Narrow window for interviews: email CV and letter of interest before March 1: footdocky@gmail.com

ASSOCIATE POSITION - KANSAS CITY, MISSOURI

I'm not just looking for an associate. I am looking for a doctor who wants to build a highly successful career with a doctor who is as committed to their success as he is to his own. Go towww.YourFutureInPodiatry.com to find out about this opportunity.

EQUIPMENT FOR SALE

Ultrasound w/printer, Cryo-Pac w/ two probes, Flouroscan/w/printer. There may be other surgical equipment as well. Please contact Jolene at young_jolene@yahoo.com

EQUIPMENT FOR SALE - COOL BREEZE COOT TOUCH VARIA

Cool Breeze Coot Touch Varia. Very low use. You won't find a laser at this price. $39,500. Has about 19 hours of use of it. E-mail for photos, and ask any questions. Will go fast. David Zuckerman DPM 856-229-2939 footcare@comcast.net

EQUIPMENT FOR SALE - ARE YOU CONSIDERING A PADNET UNIT?

If so, save thousands of dollars on a lightly used unit with venous option and laptop. Why pay full price for our unit which is in perfect working order. We also have a SIUI CTS 200 ultrasound with 7 mHz probe and SONY printer. Let's Make a Deal!! Call 516-220-8258 today. 

EQUIPMENT FOR SALE

Koven Doppler, Synthes Titanium Mini Frag screw set, Zimmer & Hall Micro 100 set (all 5 heads including wire driver), Two full major surgical instrument sets, miscellaneous surgical tools including osteotome set (curved & straight). All German stainless steel. Best offer. Retired due to illness. Call 586-675-4311 or 440-285-2827. Dr. Gary Docks.

EQUIPMENT FOR SALE

Cosman Radiofrequency Generator for Sale! Model RFG-1B Like New Condition. Comes with Manual, 17 Dispersive Electrodes, 2 CSK-R 10 Kits, 2 CSK-R 5 Kits, 11 CC RF Cannula 10cm/10mm/22G, 4 CC RF Cannula 10cm/5mm/22G, 1 - 5cm RF Cannula/22G (4mm Sharp Curved Tip), & 2 Replacement Fuses. Asking $10,500 OBO Please Contact: nffpbosk@gmail.com

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

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