The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

February 23, 2007 #2,817 Editor-Barry Block, DPM, JD

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NY Podiatrist Elected Rochester Democratic Committee Co-Chair

The new co-chairs of the Rochester Democratic Committee said their main goal this year is to get more registered city Democrats involved with their group. Walter Hoerman, pediatrician and former Rochester mayor, and John DiNella, podiatrist, were unanimously elected Monday evening to finish Carol Shea-Porter's term in that office.

Walter Hoerman, left, and John DiNella (Monika O'Clair/Democrat photo).

"Our highest priority is to make the Democratic Committee grow," DiNella added. "We want to get members to be much more active." All of the committee members who gathered for their monthly meeting Monday night, held at DiNella's practice on Columbus Avenue, agreed to recruit more heavily in the coming weeks to get more registered Democrats involved.

Source: Amanda Dumond, Foster's Daily Democrat (NH), 2/21/07

Armstrong Delivers Keynote Address at Spanish Symposium

The Spanish National Symposium on the Diabetic Foot last week was the scene for a keynote address that delivered a strong message proposing “a marriage of technology with common sense for the next decade.” The address was delivered by David G. Armstrong, DPM, PhD, Professor of Surgery and Associate Dean at Scholl College at Rosalind Franklin University. More than 500 specialist physicians, surgeons, and healthcare providers packed a standing-room-only lecture hall in historic Toledo, Spain. “I believe that the outpouring of interest in this area is emblematic of the importance of the problem,” noted Dr. Armstrong.

Drs. Rogers (L) and Bevilacqua address Spanish Symposium via Video Conference. Dr. David Armstrong (Insert)

In the lecture, Dr. Armstrong editorialized about the scope of the problem: “...my friend and colleague, Dr. Jeff Robbins, often equates a diabetes-related amputation with a high-grade cancer, like breast or colon or lung. But 5-year survival is generally worse with amputation. We would never withhold high-quality therapy from a cancer patient but we do so all the time with people at high risk for amputation or re-amputation. This must stop.”

Workshops with Armstrong also included other members of Scholl’s Center for Lower Extremity Ambulatory Research (CLEAR), including Dr. Lee C. Rogers and Dr. Nicholas Bevilacqua, who joined via video conference to help highlight many technologies being used at Scholl’s North Chicago-based foot and ankle center.

CIGNA to be the DME MAC for Region C

Protests filed by Palmetto GBA regarding the award of a contract to CIGNA Government Services to serve as the DME MAC for Region C were recently denied by the Government Accountability Office (GAO). Palmetto GBA previously served as the Region C DMERC. The denial of the protest clears the way for CIGNA to serve as the Jurisdiction C DME MAC. Until the transition is complete, Palmetto GBA continues to process claims and serve as the Region C DMERC. Once CIGNA takes over, providers in Virginia and West Virginia will move permanently to Jurisdiction C.

CIGNA will function as the DMAC for region C out of their Nashville, TN headquarters. Further details regarding the transition will be available on CIGNA’s website on or about Mar. 15, 2007.

CMS will announce that it intends to solicit bids from any of the four DME MACs interested in performing the duties of the National Supplier Clearinghouse (NSC) and Data Analysis and Coding (DAC, formerly SADMERC). This role is currently filled by Palmetto GBA, which will no longer be eligible to continue performing these duties after the transition because the contractor selected for these projects must be one of the four DME MACs.

Source: AOPA News Briefs via Paul Kesselman, DPM

Query: Other H & P Courses?

Are there any courses for H & P Exam other than the one offered in Chicago at the Scholl College? I need to take the course, but will be unable to make it to Chicago in early March when the course is offered.

Gerald N Zeringue, DPM, Austin, TX

RE: Perioperative Anlagesia (Tip Sullivan, DPM)
From: Scott Hughes, DPM, Mitchell R. Mosher, DPM

The reality is that post-op pain is one of the main criteria patients use for grading their surgeons. My pain protocol is: Lyrica 75 mg., 2 hs pre-op then 1 bid x 2 days. Toradol 60 mg IV intra-op then 10 mg. tid x 5 days and Vicodin or Percocet PRN. For anything but minor procedures I also use the ON-Q pain pump which delivers 2 cc per hour of local anesthetic for 50 hours. I used to get fancy trying to place the catheter but now I’ve found it works best for me to just lay it in the incision. With the pump there is usually more swelling at the first post op visit, but this resolves within a week and patients are very happy to be pain free for the first 2 days. I have had several people who were too active those first two days post-op because their foot didn’t hurt so I’m very clear about the need for elevation and limited activity to limit complications.

Scott Hughes, DPM, Monroe, MI, dr.hughes@comcast.net

Circa 1980, podiatry pioneered the outpatient surgery pathway. We were encouraged to perform local and steroid injections proximal to the operative site prior to applying the dressings in order to reduce postoperative pain, since the patient was going home, and did not have IM or IV pain meds available.. Sure enough, these outpatients suffered far less pain than those inpatients who went to recovery room, and then to their rooms for post-op care.[these did not usually receive the injections]. Shortly after, two of my colleagues encouraged me to use T.E.N.S. units post-op. These patients did even better. They required very few, if any post op narcotics. I used this combination until I retired last year.

The best post op injection turned out to be a mixture of 9cc of 0.5% Marcaine with epi. plus 1 cc. of Celestone, or Depo Medrol 40 mg/cc proximal to the operative site.

Mitchell R. Mosher, DPM, Belmont, NC, bowenfootdoc@yahoo.com

RE: Podiatrists of Yesteryear: Dr. Samuel Hoffman
From: Mark Schilansky, DPM

You can see a video of Dr. Hoffman playing his Theramin on "You Asked for It" at
http://www.youtube.com/watch?v=d5EzKtn2ARE

Pretty cool that he's on YouTube! It's a fun video to watch.

Mark Schilansky, DPM, Catskill, NY, schilansky@mhcable.com

RE: Dox Podiatry EMR (Lori Weisenfeld, DPM)
From: Bruce Werber DPM

DOX Podiatry has only a Monthly Service charge for each Physician on the system. There are no other charges, this monthly fee includes all office staff, all updates, customer support, data storage and data backup. As far as other costs:

* You can purchase a scanner to scan all documents and attach them to the patient chart notes (about $200-$300)

* Wireless Card from Sprint for remote access whenever I am not in the office (surgery center, hospital, etc) ($59/month for unlimited access) or have other high speed internet access.

* Depending on your state, you may need to purchase special paper for printing your prescriptions

* Another option is to purchase an inexpensive PC from Dell to put in the waiting room for patients who did not complete their medical history online prior to coming to the office ($500)

* Training costs are modest, and there is a small decrease in production during the few days of training, this is very small and worth the gains once you are up and going.

There is substantial dollar savings by eliminating dictation costs and by eliminating all supplies associated with charting (folders, copies, paper, staff time to pull/replace charts). The program works very well and is the best solution for Podiatry available today since it is written specifically for podiatry, you don’t have to build any templates, macro, it is already done for you.

Bruce Werber DPM, Warwick, RI, dr.werber@gmail.com

RE: APMA State Leader as an Expert Witness (Name Withheld)
From: Bryan Markinson, DPM, Barry Block, DPM, JD

Editor's note: This discussion concludes at: http://www.podiatrym.com/letters2.cfm?id=12866&start=1

ASSOCIATE POSITION - EAST/CENTRAL TEXAS

Practice in East Central Texas has an opportunity for an associate to join as an associate leading to partnership. Hospital supported practice which has two doctors seeking a third for new office. Practice is leading provider in market and offers an outstanding compensation and benefit package. This position is targeted to be an equity partner within two to three years. easttxdpm@comcast.net

ASSOCIATE POSITION - SANTA FE, NM

Established, 30 year practice with multiple office locations looking for a PSR 24/36 trained, hardworking, personable, ethical, highly motivated individual for associate position with immediate partnership available. E-mail CV and reference letters to sfpodiatry@aol.com

ASSOCIATE WANTED FOR SOUTH MIAMI AREA

Large group, busy, multi-office, partner potential. Motivated applicants only. Mail resumes and letters of intent to 999 N. Krome Avenue, Homestead , FL 33030. July start time OK, sooner preferable. E-mail lianadpm2@aol.com

ASSOCIATE WANTED - NORTH CAROLINA , CHARLOTTE AREA

Incredible opportunity to join a busy, well-established group practice. Looking for a self-motivated, hard-working individual seeking to become a partner. Hospital and surgery center privileges. Salary plus percentage, 401k and real estate opportunities. Send CV to universityoffice@ bellsouth.net

ASSOCIATE WANTED - MICHIGAN-DETROIT AREA

Great opportunity-must be hard-working, reliable, responsible and good with patients & staff-surgical training a plus-partnership after 1 yr. Michigan license required fax resume to 248-478-1370

SOUTH CENTRAL PENNSYLVANIA-PM&S 36 ASSOCIATE WANTED

Large, busy podiatry group looking for associate interested in future partnership. Practice facilities and technologies include: Surgical Center, Physical Therapy Department, six appointment locations, EMR, MRI and Digital X-ray. Full compensation and benefit package offered. Mail CV to Martin Foot and Ankle, 1203 S. Queen St. York, PA 17403 or email business administrator, johnreitzel@comcast.net.

POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

ASSOCIATE POSITION -MINNESOTA – PRIME MINNEAPOLIS SUBURB

Busy, well-established, full-scope podiatry practice, seeking highly motivated podiatrist for a full-time position with potential partnership opportunity. Looking for PSR 24+ individual. Excellent opportunity for long-term growth with unlimited income potential. E-mail CV to employment@associatedpodiatrists.com or fax to (612) 866-5875 Attn. Jennifer.

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

ASSOCIATE POSITION – WASHINGTON, DC

Associateship leading to full purchase or immediate sale. 25 Year old practice located in a hosp. w/ full surg privileges. Large number of diabetic patients and referrals. Fully equipped with x-ray, topical hyperbaric oxy units, 4 tx rooms and more. $400K on only 3 days a week. Will finance with generous terms and stay to introduce. Owner leaving area. Contact R. Benjamin, DPM jhallux@yahoo.com or 202-841-5545

SEEKING RESIDENT FOR PSR-24 POSITION: BALTIMORE, MD

Mercy Medical Center -Position for a highly motivated individual with completed non-surgical residency or one desiring additional surgical training in well-established Podiatric Residency Program. Busy metropolitan hospital with high surgical numbers and inpatient care. Resident is integral member of multidisciplinary team. Begins mid June 2007. Includes competitive salary/benefits. Send inquiries to rsher18@yahoo.com

ASSOCIATE POSITION – NY & CONNECTICUT

Opportunity to be a part of a prestigious and well-established large Orthopaedic and Rehabilitation practice, with locations in Stamford, CT and West Harrison, NY. Looking for a Podiatrist to join an already busy practice with opportunity to build. We have state-of-the-art offices with MRI, digital x-ray, paperless charts, physical and occupational therapy. Applicants should be Board Certified or Board Eligible. Competitive salary and benefits. For further information on the practice, log onto WWW.NYCONNORTHO.COM Interested candidates should forward their C.V. to: Cliff Katz, Executive Director ckatz@nyconnortho.com

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