The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

February 20, 2009 #3,474 Publisher-Barry Block, DPM, JD

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Dan Glassman, MBA

Daniel Glassman, MBA chairman of Medimetriks Pharmaceuticals passed away on Tuesday after bravely fighting an aggressive illness for the last several months. Glassman is better known to the podiatric community as founder and CEO of Bradley Pharmaceutical, Inc. Bradley’s Doak Dermatologics division had been a prominent supporter of podiatric education.

Daniel Glassman

Glassman received an Honorary Doctorate of Humane Letters by the New York College of Podiatric Medicine in 2005 and a Superbones Achievement Award in 2007. He is survived by his wife Iris, three children (Bradley, Heath, and Stacy), and six grandchildren. Dan was a man with great vision and passion. He will be sorely missed by the podiatric community.

TX Podiatrists Participate in ADA-APMA Fellowship

Diabetes complications are one of the many research areas funded by the American Diabetes Association. In a joint effort, the ADA and the American Podiatric Medical Association (APMA) are sponsoring a fellowship to focus attention on lower extremity complications due to diabetes. According to the ADA, about 60% to 70% of people with diabetes have mild to severe forms of nervous system damage.

Dr. Lawrence Lavery

Lawrence Lavery, DPM, MPH of the Scott and White Hospital in Temple, Texas is the recipient of the ADA-APMA Fellowship which began in July 2007. The main goal of this award is to pair an experienced clinical research mentor with a postdoctoral fellow in the field of podiatry. Nathan Hunt, DPM, the postdoctoral fellow training with Dr. Lavery, will learn to conduct clinical research and enhance the understanding of diabetic foot research and complications. To engage in his training, Dr. Hunt’s first task is to work on Dr. Lavery’s ADA Clinical Research Award entitled, “Epidemiology of Lower Extremity Complications in Dialysis Patients with Diabetes.” 

Dr. Nathan Hunt

The future of diabetes research will be enriched with the ADA-APMA fellowship and the outcome of the ADA study. With Dr. Hunt’s mentored training, the diabetes complications research field will benefit from a specialized investigator. Trained investigators increase research, discoveries and prevention of diabetes complications. Analysis and data reporting performed by Dr. Hunt will provide new information about foot complications in end-stage renal disease. Identifying the occurrence, frequency, risk factors and causal pathways of lower extremity complications could lead to improved strategies in prevention and intervention.

Source: American Diabetes Association

FL Podiatry Residents Invited to Join Surgery Mission to Haiti 

Podiatry residents from the University of Florida & Shands Jacksonville Medical Center have been invited to join with their orthopaedic colleagues in their mercy mission to Haiti. Haiti is now the poorest country in the Western Hemisphere, and one of the poorest nations in the world. Per-capita annual income is $330.00. Life expectancy for women is 54, for men 51. Fourteen of every 100 children die before the age of two.  In 1986, the CRUDEM foundation built the Hopital Sacre’ Coeur. It is the largest private hospital (64 beds) and only reliable medical provider in the Milot region of Northern Haiti, serving a population of 225,000.

Top (L-R) Drs. Stephen Meritt, Joseph Sindone, and John Harris. Bottom: Drs. Hilaree Milliron, Sadia Mahmood, Carrie Gosselink, Bernard Meadows, Sachin Brahmbhatt, and Lanie Huffman.

Each year, hundreds of doctors pay their own way to donate time and their expertise to the people of Haiti. Their goal is not only to provide quality healthcare to the sick and poor, but to educate the Haitian people so that one day they might be able to sustain the hospital on their own. The Jacksonville group of orthopaedic doctors, joined by an orthopaedic resident and podiatry resident will travel to Haiti three times per year. They will perform as many operations as possible during their stay. The Shands Jacksonville Medical Center Podiatry Residency Program is a fully approved CPME PMS-36 program.
 

LA Podiatrist Arrested on Drug Charges

A Shreveport podiatrist and his office manager turned themselves in to the Caddo Correctional Center Wednesday. 60-year-old Dr. Dale Fazio is being charged with unlawfully distributing a controlled substance and 49-year-old Leighton Fazio is being charged with obtaining a controlled substance by fraud. The arrests stem from an extensive investigation spear-headed by the New Orleans DEA.

Dr. Dale Fazio (photo: Caddo Sheriff's Office)

KSLA News 12 has learned that diversion agents checking orders of controlled substances noted Dale Fazio's DEA number was used to obtain six orders of hydrocodone pills and one order of codine pills back in January. Fazio is not licensed to dispense controlled substances, he can only write prescriptions for them and can give them by injection, but cannot give out pills.

Through investigation, it was learned that approximately 1,500 hydrocodone tablets and 100 codine tablets were ordered using Fazio's DEA number. On Wednesday, Fazio surrendered his DEA license to Diversion agents. He can still practice medicine.

Source: KSLA-TV - Shreveport, LA [2/19/09]

Query: Instrument for Incurvated Toenails

Does anyone remember a device utilized in pushing the sides of skin away from an incurvated toenail?  It looks like a spring arch placed over the nail, pushing the skin margins away. If so, who is the manufacturer?

Vincent L. Travisano, DPM, St. Louis, MO
 

Query: Extracting Names/Addresses from Medisoft

Can anyone tell me how to get 500 specific names and addresses from patient files in Medisoft (I do not want the entire patient data base, just 500 specific people) to a .csv or Excel file? I want to send a patient newsletter and the newsletter mailing service is requesting names and addresses to be sent in .csv or Excel format.

Jaryl G. Korpinen, DPM, Plano, TX

RE: RSD Post-Neuroma Surgery (Tip Sullivan, DPM)
From: Multiple Respondents

Dr. Sullivan’s dilemma is not that uncommon. I have treated a number of CRPS (RSD) patients who have been referred from other practitioners. I have a good relationship with a few of the pain management docs specializing in CRPS. After much discussion, we have concluded that if one is able to identify the source of the pain, hence, the triggering mechanism for the pain cycle, then it should be addressed. I would recommend having the pain docs place an in-dwelling catheter for constant sympathetic block for the first 2 weeks after surgery (place it pre-op or at the time of surgery) or more depending on how your patient does.

Without addressing the trigger, the pain cycle will just continue and never abate and may even worsen and spread to the other extremity. Of course, if the CRPS is not sympathetically mediated, then this won’t work but it sounds like it is Type-I based on your description of symptoms.

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

This condition can be especially difficult to treat when the RSD is active. Surgery may exacerbate the symptoms and therefore make the RSD worse. Even injections or cryotherapy can present a problem. Should you decide to operate, make sure it is perfectly clear to the patient that surgery could make the RSD worse and have the patient sign a consent form in your office prior to any surgery. If the patient signs the consent on the day of surgery, the patient can say that she signed it under duress. Tread carefully here!

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

I would make sure that you look proximal to the tarsal tunnel as a possible source of the pain. If it is painful to palpation and shows a Tinel’s sign to those toes then do a diagnostic injection of Marcaine. If it gets better, then consider a decompression of the Tarsal tunnel. I know that Dr. Dellon has done some work on decompression for CRPS or RSD. 

Peter J. Bregman, DPM, Tewksbury, MA, footguru@comcast.net 

RE: Mucoid Cyst (Bonnie Tatar, DPM)
From: Multiple Respondents

I have found that the only way to eliminate the cyst permanently is to do an arthroplasty of the joint. Generally, these cysts tend to present over the DIPJ of toes 2,3, or 4. Excising them is a waste of time. It appears to have some continuum to the underlying joint. The arthroplasty will do the trick.
 
Brian Kashan, DPM, Baltimore, MD, drbkas@worldnet.att.net

These cysts are curious and they have a high recurrence rate unless you treat them aggressively. The treatment is surgical and involves a few steps. One is excise the skin border and cyst together. The second step involves remodeling of the underlying bone, usually through arthroplasty. The third is to perform a small rotational skin flap. Do not leave the bony work out since this is more than likely the irritant cause of the cyst.  
 
Thomas A. Graziano, DPM, MD, Clifton, NJ, TGrazi6236@aol.com

Since drainage of the cyst and corticosteroids have not worked, I would consider surgical excision. Your photo looks like the lesion is over the right 5th PIPJ. Make two semi-elliptical incisions to excise skin and sub-Q and do PIPJ arthroplasty. Orient the incisions on the long axis of the toe as there does not appear to be a rotation problem with digit. Make ellipses 3 times the length of lesion and take enough bone at the proximal phalangeal head and you should have enough soft tissue laxity to close without flaps. Send excised tissue for pathology work up if you still have doubts about diagnosis.

Dan Haley, DPM, Reynoldsburg, OH, Dhaleyman@aol.com

RE: Dan Glassman
From: Bryan C. Markinson, DPM

It is with a personal deep sense of loss that accompanies the passing of Daniel Glassman, a great supporter of the podiatric profession. As CEO of Bradley Pharmaceuticals, Dan dedicated the company to the service of the podiatric profession and its patients. I was privileged to be the speaker at the first ever Bradley-sponsored podiatric lecture in July 2001. Shortly after that, Dan asked me to begin to formulate a podiatric advisory board and the rest is history.

Dan pledged the full breadth and power of his company behind podiatric medicine, with support at major meetings, in the podiatric colleges, and in radio and print education programs for the public. He held podiatric focus groups many times which were influential in the company’s product development and planning. The podiatric community responded in kind, resulting in stellar company growth.

Throughout the years since 2001, I became good friends with Dan and his children. I also got to know his wife, Iris, who was a major force in his business success. Dan’s friendship was truly meaningful, always with a special concern for others. Although he has passed, he leaves us having realized most of his dreams for himself and his family, and positively touching the lives of many. May he rest in peace.

Bryan C. Markinson, DPM, New York, NY

RE: Computerized Gait Analysis (Bruce Pinker, DPM)
From: Paul Kesselman, DPM

There are a myriad of computerized programs offered to podiatrists which provide some level of computerized gait analysis while other programs are scanners which are used as a substitute for plaster or fiberglass slipper casts.

Those programs which provide computerized gait analysis in your office, while somewhat sophisticated, are no match for those provided in research facilities which are dedicated gait analysis laboratories. Programs sold to podiatrists range from matt scanners to others which provide sensors that are placed on the feet. You may also wish to incorporate digital video technology.

I’m no expert at which program is the best (several advertise in podiatric journals), however, none of these are generally reimbursable, yet will provide significant data about your patient. Medicare and many other third-party payers will not reimburse for computerized gait analysis unless it is performed in a qualified gait analysis laboratory. These laboratories have very sophisticated computer technology, are located in tertiary research facilities and their set-up-costs are generally in the millions of dollars. Medicare (and others) also restricts coverage for computerized gait analysis to patients not typically seen in most podiatrists’ offices, including patients with cerebral palsy, CMT, etc.

Paul Kesselman DPM, Woodside, NY,  pkesselman@pol.net

RE: Reference Checking Plus (Practice Management Tip of the Day)
From: Jon Purdy, DPM
 
I completely disagree with the statement that checking references on  a potential employee is not worth the time. We have found on many occasions that a reference will reveal a red flag or give negative statements concerning the candidate.
 
We seldom have companies call us regarding a reference check on a former employee. We have found that candidates give references out of obligation and erroneously assume they will not be checked. Although most may not check them, they are mistaken to assume we will not.  There are cases where a person has assumed a positive relationship with a reference, or the relationship has fallen apart between the time they put them down and the time we call.
 
Valuable information is often learned listening to another person's point of view regarding a candidate. It costs on average $4,000 to turn over an employee and much more in the case of a management position. Turnover is often an emotionally draining experience, and training a new hire takes significant office resources and time. One can never get enough information prior to hiring an employee.
 
Jonathan B. Purdy, DPM, New Iberia, LA, podiatrist@mindspring.com

RE: Heel Spurs Don’t Cause Pain: IL Podiatrist
From: Robert Scott Steinberg, DPM

It is called heel spur syndrome for a reason! It is generally accepted by the public, and by a lot of physicians, that plantar heel pain means heel spur. Okay, we know different, but no matter who, many of us get ourselves quoted in the media that the problem is not the spur. We cannot stop the inaccurate description. What we will do is confuse people and physicians. Instead of trying to sound smarter than everyone else, the only important thing is to let people know the pain can be treated. If there is a spur on x-ray, you can turn to your patient, and say, "Guess what? You are right. You have a spur!"
 
Robert Scott Steinberg, DPM, Schaumburg, IL, doc@FootSportsDoc.com

GREAT OPPORTUNITY- ATLANTA, GEORGIA

Forget getting paid by percentage or a salary, be your own boss. Great opportunity to have your own office with patients without major financial burden. Well-established practice/ office, fully equipped, five treatment rooms, x-ray room, lab, kitchen, doctor’s office, large street sign on a main road, office location and doctor's name is well-known in the community, lease or lease to buy. The doctor is cutting back on this location to become semi-retired. E-mail superrang@bellsouth.net

PRACTICE FOR SALE – ANDERSON, INDIANA

Well established office in Anderson Indiana for sale. Seller currently works 3 half-days per week and gross over $200K. Excellent locations and growth potential. Very podiatry-friendly community. All equipment and furniture included. Seller is willing to help with transition. Contact seller at mddpm@sbcglobal.net for more information.

PODIATRY ASSOCIATE WANTED – NJ

Northern NJ. Bergen County Must be well-trained. No nursing homes or house calls. Modern well-equipped office. Digital x-ray and ultrasound. Excellent pay and opportunity. Must have NJ license. Call 973-472-4700.

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 NORTHERN CALIFORNIA

Need associate in busy office in two locations. Hospital privileges
available. Emphasis on wound care. All aspects of Podiatric Medicine and Surgery. Associate position to lead to partnership and buyout. Please contact jimf@humboldt1.com

ASSOCIATE POSITION – BRONX, NY

NYNJ Foot & Ankle Associates www.nynjfootandankle.com is a rapidly growing practice that was started 12 years ago. All aspects of foot and ankle services are provided including large surgical volume, diabetic wound care, trauma and general podiatry. We are now hiring part-time for our Bronx, NY location. Excellent salary opportunity for the proper candidate.  A partnership track is available for the proper candidate. Fax CV to 718-547-9232

ASSOCIATE POSITIONS - CALIFORNIA

Three podiatrists needed for busy North Hollywood office.  Full-time Monday-Friday 8am-2:30pm.  No weekends and no call. Pay negotiable. New podiatrists are encouraged to apply. Please email resume and salary request to Coasttocoastpodiatry@yahoo.com

OFFICE SPACE FOR RENT - SEATTLE, WA

Full-service, state-of-the-art podiatry office is offering office space for an independent podiatrist or podiatry group. We have digital X-ray, PADNET, physical therapy equipment, all podiatry equipment and staff to assist you to make the most out of your podiatry practice. Our office is conveniently located close to North West and Stevens Hospital right across from North Gate Mall. You can send your letter of interest to: seattlefootdoctor@yahoo.com or call 425-223-9588

ASSOCIATE POSITION – CINCINNATI, OHIO

This is your once-in-a-lifetime opportunity to join one of the most successful practices in the United States. No seniority system. If you are motivated and have completed a PSR24-36 residency, your income is limited only by your enthusiasm and desire to achieve. Fax resume to: 513-577-7261 or E-mail resume to Kroesch4poh@aol.com

ASSOCIATE POSITION -SOUTHERN NEW JERSEY

I’m looking for podiatrist who wants additional practice hours. Perfect for combining your own practice with an additional income. Must be on Aetna Insurance, Horizon Blue Shield, Medicare, and most commercial carriers. I am looking for someone who has a desire to learn how a very successful practice is run, so that I will be able to have time away from my practice. Payscale to be discussed. Could lead to partnership or sale. E-mail contact information, CV, and why you would be perfect for this opportunity. Contact foot.care@verizon.net

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

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.

NEEDED  CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. 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 Visit our website

  
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