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| PM News | |
The Voice of Podiatrists
Serving Over 20,000 Subscribers Daily
February 19, 2021 #6,890  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management https://podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2021- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL | |
Last Chance to Vote
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Are you in favor of podiatrists getting a plenary license?
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| PODIATRISTS IN THE NEWS | |
Stress Fractures Often Difficult to Confirm on X-Ray: IL Podiatrist
Foot doctors do a few things to diagnose the source of top of foot pain. First, they'll ask you some questions about your medical history and do a physical exam, Brian Burgess, DPM, board-certified podiatric surgeon at Illinois Bone & Joint Institute says. Knowing the nature of the pain (Is it sharp or dull? What activities make it worse?) and the location will help your doctor narrow down the potential causes. Then, they'll probably do an x-ray.
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Dr. Brian Burgess |
Stress fractures can sometimes be the hardest cause to accurately diagnose, Dr. Burgess says. "A lot of times, x-rays are negative initially—it's not until the body starts to heal and lay down bone callus that you start to see radiographic changes," he explains. If your symptoms sound like a stress fracture but an x-ray comes back negative, your doctor may send you for an MRI, which could pick it up. Or, they may just treat it as a suspected stress fracture, Dr. Burgess says.
Source: Amy Marturana Winderl, MSN [2/17/21]
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| PODIATRISTS AND FOOTWEAR | |
NY Podiatrist Discusses How to Buy Running Shoes
Casey Ann Pidich, DPM, an NYC-based podiatrist, says that most people think their big toe is their longest toe, but it might actually be the second toe that’s your longest.” So, whichever the longest toe, first or second, that’s where you should measure from. “You should have a bit of wiggle room from your longest toe—and actually all your toes—when fitting a sneaker,” says Dr. Pidich.
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Dr. Casey Pidich |
Whether you’re running a marathon or trying to get in 10,000 walking steps, Dr. Pidich says that as you run or walk, sneakers eventually mold to specific pressure points on your feet, but this takes some wears. So don’t opt for the pair just out of the box for a big race or long hike.
Source: Dara Katz, Pure Wow [2/16/21]
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| MEETING NEWS | |
OR and IN Podiatrists Present at Annual Forensic Conference
John DiMaggio, DPM and Michael Nirenberg, DPM lectured this week at the 73rd Annual Meeting of the American Academy of Forensic Sciences (AFS). Dr. Nirenberg presented "Forensic Podiatry—An Overlooked Science in the Analysis of Feet, Footprints, Gait, and Tracks" and "Forensic Gait Analysis—Scientific Foundations, Applications, and a Case Study". Dr. DiMaggio and Dr. Nirenberg also presented a lecture "Footprint Analysis: Data From North India Study Suggests New Features for Individualization and Biologic Profiling.”
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Drs. Michael Nirenberg and John DiMaggio |
Nearly 4,000 forensic experts attended the meeting. Dr. DiMaggio is past-president of the American Society of Forensic Podiatry and Dr. Nirenberg is the current president. Their analysis of foot-related evidence has helped solve crimes.
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| PRACTICE MANAGEMENT TIP OF THE DAY | |
Nine Ways to Improve Your Patient Communications - Part 2
Research has demonstrated the connection between better communication scores and improved patient adherence, lower re-admission rates, improved mortality rates, lower malpractice risk, and reduced cost per case. No other area of medical knowledge or technical skill has a greater impact on our patients. Try some of these suggestions.
2. Be Present - In our hectic environment, we are very task oriented. We walk around with our to-do lists flooding our brains. It’s no wonder that patients sometimes perceive us as talking at them instead of with them. When we practice being present, we encourage our patients to really engage with us in that moment. Consequently, the overall quality of the interaction is better, and we often hear things in a different way than when we are multi-tasking.
To practice being present, take a deep breath, quiet your racing mind and bring your attention to the moment. Turn your body so you are fully facing the patient, open your palms and lean forward, smile and maintain eye contact. Make the human being in front of you the only priority in that moment. Do not think about what you are going to do the rest of the day.
Source: Rohit Uppal Logan Lutton, Physicians Practice [2/9/21]
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| RELEVANT RESEARCH | |
Intralesional Antigen Immunotherapy for Treatment of Periungual Warts
In this blinded prospective study, 150 patients (aged 6–22 years) with periungual warts were randomized to receive intralesional measles, mumps, rubella (MMR) vaccine; Candida antigen; or purified protein derivative (PPD). Patients were treated at 2-week intervals for a maximum of 5 treatment sessions or until complete resolution. Complete clearance of warts was achieved in 80% of the Candida antigen group, 74% of the MMR group, and 70% of the PPD group. The mean number of sessions needed to treat ranged from 1.88 (Candida) to 4.22 (MMR). Erythema, edema, and flu-like symptoms were experienced by a minority of patients in all three treatment groups. No recurrence was noted following 6 months of follow-up in all treatment groups.
These data suggest that intralesional antigen immunotherapy with MMR, Candida antigen, or PPD may be efficacious in the treatment of periungual warts with low recurrence potential. Intralesional immunotherapy was well tolerated and did not cause cosmetic disfigurement of the nail.
Source: Kelly B. Scarberry, MD, Practice Update [2/16/21] via Dr. Allen Jacobs
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| CODINGLINE CORNER |
Query: Everyone Gets Bilateral X-Rays
We have a doctor that takes bilateral x-rays on all their new patients. The justification is “thorough exam.” I know how I feel about this, but I would like to hear what this forum has to say on this subject regarding medical justification, patient safety, billing, etc. for said x-rays. Does CMS or the APMA have any documentation on this topic?
Name Withheld by the Moderator
Response: The taking of bilateral x-rays on “every” new patient is excessive and unnecessary. If the x-rays are done as a standard order on “all” new patients as part of a “thorough exam”, it is still excessive and unnecessary, and unjustified even though the ordering physician would disagree. Doctors should have sound reasoning, justification, and indications when ordering any tests, whether it be x-rays, blood labs, advanced imaging, non-invasive vascular or neurologic testing. Sure, the more information we have on our patients the better we are able to diagnose and treat. However, there is a time and place for diagnostic tests and they should only be ordered when they are medically necessary.
Keith Gurnick, DPM, Los Angeles, CA
For information on Codingline subscriptions, click here
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| RESPONSES/COMMENTS (CLINICAL) - PART 1A | |
From: Daniel Waldman, DPM, Mark S Ross, DPM
I have had very good results for my patients affected by Raynauds by prescribing compounded 4% nifedipine in PLO ointment. Apply BID-QID prn.
Daniel Waldman, DPM, Asheville, NC
Adding nitroglycerin in the treatment of Raynaud’s disease has been around for quite a while. I would caution to ask the male patient if he is also taking Viagra or Cialis as the addition of this medication will cause severe hypotension. It is not unusual to see males not list Viagra when they present their medication list. They probably figure "why does a podiatrist have to know my business?”
Mark S Ross, DPM, Morristown, PA
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| RESPONSES/COMMENTS (CLINICAL) - PART 1B | |
From: Charles Morelli, DPM
Dr. Komp states that topical nitro paste 2% is no longer available, but that is not true as it can be made by most compounding pharmacies and mailed to the patient. I use this frequently and have the patient apply it to their calf or posterior medial malleolus or plantar aspect of their foot. The perfusion increases dramatically and patients have responded positively to this. I have not had a problem with their blood pressures but recommend it be checked periodically. I start with BID and increase to TID if needed.
Oral meds: One with low risk of side-effects is Minipress at 1mg daily and it can be titrated up to 4x/day. Others are terazosin, nifedipine, and doxazosin; but I have their PCP or cardiologist get involved with these two and monitor their BP. I don’t bother with pentoxifylline as I have not found it helpful
Adjunctive: I also recommend the purchase of battery-operated socks for increased warmth as well as foot warmer pads; the type used in ski boots and by hunters. These are easily found online and in very serious cases, I suggest they start to consider moving to a warmer climate as this can lead to frostbite and gangrene. I warn against activities like shoveling snow and participating in winter sports as well as visually inspecting their feet daily. Treatment is supportive as there is no cure for Raynaud’s and you always want to rule out conditions associated with CREST syndrome.
Charles Morelli, DPM. Mamaroneck, NY
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 1 | |
From: Chris Seuferling, DPM
I'm not sure what your definition of "reasonable" is, but we just purchased a flat of 10 bottles (5ml each) for $2,500 ($250 per bottle) from FFF Enterprises, Inc.
That is the cheapest and apparently only company I could find still selling this product. FYI, I did go in with another practice to purchase the bottles.
Chris Seuferling, DPM, Portland, OR
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 2 | |
From: Richard M. Maleski DPM, RPh
Thanks to Dr. Jacobs for including this paper on the value of primary foot care services. It does point out that other medical practitioners also recognize the importance of such services. However, to my mind, it points out an even more poignant observation; that is that podiatrists are only considered for primary services, such as nail care and ulcer care. The authors specifically point out that other services, such as rehab and orthotics should be referred to physiatrists; and bone and joint problems, including surgery, should be referred to orthopedists. Granted, this article was written in Great Britain, but published in the U.S.
This is just another example that our profession needs to pursue true equivalence with our MD and DO colleagues. Otherwise, we will continually be responding to such biases on a case by case basis.
Richard M. Maleski DPM, RPh, Pittsburgh, PA
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 3 | |
From: Glen N. Robison, DPM
Dr. Levy, you ended your post by saying the time is NOW. My question to you is HOW? How do we become equals in the medical field with our colleagues that we work with each and every day from both the allopathic and the osteopathic fields? Ever since you signed my podiatric medical degree certificate back in 1997, we have had these ongoing debates on small platforms. The question I will end with is if now is the time, then how? I would love to hear a real debate from the top 5 podiatrists in the country who oppose this change to the 5 podiatrists who are in favor of such a change. List the pro’s and con’s and then have the debate on a Zoom conference for everyone who has a DPM degree to listen in.
Glen N. Robison, DPM, Globe, AZ
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoes of the Day
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You stepped in what? |
Source: pinterest.com
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MEETING NOTICES AND WEBINARS
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| CLASSIFIED ADS - ASSOCIATE POSITIONS AND FELLOWSHIPS |
ASSOCIATE POSITION – NORTH CAROLINA
Immediate Full-time or Part-time. General podiatry. Offices in Durham and Oxford. Diabetic foot care, diabetic shoes, custom orthotics/AFO, reconstructive surgery, wound care, shockwave therapy, laser nail, hospital/surgery center. Ideal for experienced podiatrist or recent graduate. Salary plus bonus and benefits. Must have NC podiatry license and BC/BQ. oxfordjob123@gmail.com
FULL TIME PODIATRIST - NEW JERSEY
We are a fast-growing podiatry practice in New Jersey with multiple locations and Doctors. We are currently looking for a full-time motivated and caring Doctor to join our busy practice. Some benefits include: competitive six-figure salary, generous, guaranteed bonus structure, health insurance (including vision & dental), paid vacation time off, paid malpractice insurance and CME time off. Great prospects for experienced Doctors as well as new Associates. This is an excellent opportunity to expand your Podiatric medical and surgical experience in an office-based practice! If interested, please submit your CV to DrSamofal@PodiatryCenterNJ.com
ASSOCIATE POSITION – NEW YORK
Seeking a highly motivated individual interested in evolving in private practice to a wealthy and knowledgeable affiliate entity with a large surgical based podiatry group. Surgeons with a two or three year residency preferred. Come join and Let’s keep New Yorkers on their feet! Please email your CV at podiatrynewyork@gmail.com
ASSOCIATE POSITION – NORTH NEW JERSEY
Seeking bilingual, highly surgical trained associate to join a fast-growing multi locations, North Jersey podiatry group practice. Motivated, entrepreneurial, individual who desires to join a private independent practice. Partnership opportunity, with full practice medical management services in house. Send your CV kmercado@footandankleps.com
MOTIVATED PODIATRIST WANTED - CENTRAL TEXAS
Seeking full-time motivated podiatrist to join our busy practice in Waco, Texas. Candidates should be proficient in diagnosing/treating all foot and ankle related pathology including trauma, rear foot and ankle reconstruction, forefoot procedures, wound care, and diabetic foot related conditions. We are offering a competitive compensation package. Specific details of the compensation package will be discussed with interested qualified candidates. Please email your CV to aszanto@wacofootcare.com www.wacopodiatry.com
ASSOCIATE POSITION - ABINGDON, MARYLAND
Immediate associate position for a well-trained, highly motivated and compassionate individual. Rapidly growing, well established practice with a loyal patient following and strong physician referral base. Offering competitive salary with bonus structure, 401K, PTO, CME allowance, health (including vision and dental) and malpractice insurance. All aspects of podiatry with emphasis on wound care/diabetic surgery/limb salvage. Please email cover letter and CV to michael@mkblockdpm.com
ASSOCIATE POSITION - CENTRAL PA
Once in a lifetime opportunity for a highly motivated physician. We are located in the fastest growing county with a top-rated school district. Our newly expanded office features digital x-ray, MLS Laser, EPAT, DME, 4-D Orthotics, ABI, extensive OTC products including orthotics and footwear. We service a large hospital system and train residents in a 3-yr PMSR. Must be BQ /BC FF/ RRA and interested in Limb Preservation. Offering six figure salary with sign on bonus, PTO, full medical/dental, STD/LTD, 401K, malpractice insurance, all dues and CME paid, partner opportunity. Send CV to footpainpros@gmail.com.
GREAT OPPORTUNITY IN RURAL NORTH CAROLINA
20+ year old practice in North Carolina, all aspects of podiatry. Loyal patient following, physician referral base. EHR, staff in place. Low overhead. Great potential for any type of podiatrist. Will stay for transition if desired. 252-813-3136.
ASSOCIATE POSITION - NW FLORIDA/COASTAL ALABAMA
Busy, well-established practice, EHR, digital x-ray, diagnostic ultrasound. Offering competitive six-figure salary w/bonus structure, health/malpractice insurance, and PTO. PSR-36 required. Partnership path to motivated and compassionate associate. Must obtain Florida and Alabama licenses. Send CV: Brentmharwood@gmail.com
ASSOCIATE POSITION - SOUTHWEST, FL
Immediate position for busy practice in Sunny Southwest, FL. ABFAS RRA BC/BQ. EMR, E x-rays, US, DME. Base salary + bonus w, PTO, 401K, fees, health benefits. Also 1 ACFAS fellowship avail, must be BQ ABFAS by start of program 8/2021: DrLam@NaplesPodiatrist.com
ASSOCIATE POSITION WITH OPTION TO BUY – BRONX, NY
Full time or part time with option to purchase. Co-Op City, Bronx New York. Established in 1969. Full scope of podiatry. MUST PARTICIPATE IN INSURANCE PLANS. Pleasant office; great patients; Great opportunity. Call or text 914-772-3842 or email: Lwolstein@aol.com
ASSOCIATE POSITION - FLEETWOOD, PENNSYLVANIA- SOUTHEASTERN PA
Suburban 3 office practice looking for a full-time, motivated, outgoing associate for immediate opening leading to possible partnership. Well trained surgically & board qualified/certified. Competitive salary, bonus, health insurance, and malpractice insurance. Email CV to Kathy.Geist@FleetwoodFootcare.com
ASSOCIATE POSITION - HUDSON VALLEY, NEW YORK
We are a high-volume, diversified, multi-office podiatry practice utilizing state-of-the-art modalities. Ample growth opportunity for a personable and highly-motivated DPM. Please forward CV to: jobs@hvfa.com
WOUND CARE FELLOWSHIP - NEW YORK
CPME APPROVED 12 month fellowship beginning July 1st, 2021. Hospital and clinic environment, with onsite hyperbaric medicine. Working with infectious disease, dermatology, as well as, general, vascular, and podiatric surgeons. Must have completed a PMSR residency. Please contact drarnoldhertz@aol.com or jtfootcare@gmail.com. EOE employer.
PM NEWS CLASSIFIED ADS REACH OVER 20,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 20,000 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com or call (215) 808-0770
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| CLASSIFIED ADS - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICE FOR SALE - WEST COAST/TAMPA FLORIDA SUBURB
World class beaches, top rated communities, water sports, golf, reasonably priced real estate, active lifestyle and “Champa Bay” pro sports await you. Unique opportunity to own a reputable, profitable practice. Control rental overhead as this medical condo is also available for purchase. Practice in a well-integrated foot & ankle environment, including hospital privileges. Serious inquiries only please email Sunpodiatry5@gmail.com.
PRACTICE FOR SALE - TEXAS
COVID Proof practice grossing 500K in 2020 - 2 ½ days weekly. Primarily biomechanics - orthopedics. Easily double gross by retaining surgery & wound care. Freestanding office included with 4+ TX rooms. No money down owner financing available. Can stay for transition. Contact fjhenry2111@yahoo.com
PRACTICE FOR SALE - SOUTHEASTERN VIRGINIA
Well established practice with sustained high income, great location. Diverse surgical and general practice with full hospital privileges available, Digital x-ray, ultrasound, DME program, EMR linked to National billing company. Willing to stay for transition. Email: officemail1@cox.net
PRACTICE FOR SALE - MANHATTAN EAST SIDE
Part-time practice opportunity on Manhattan's upper east side. Hospital and public transportation one block away. Ground floor. Fully furnished. Expansion of hours possible. Contact 917-841-6805.
PM NEWS CLASSIFIED ADS REACH OVER 20,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 20,000 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details.
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| Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management® Magazine and Podiatry Management® Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
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PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.
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