The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

February 23, 2010 #3,787 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2010- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

April 10 Editorial - An Open Letter to CPME RE: Document 320  

We are reposting this notice because some readers were unable to access our site due to a temporary server problem.

We've just posted our April editorial regarding the proposed new residency standards. You can read our letter by clicking here.

We recommend that you read these proposed changes by clicking here.

We urge you to send your own comments to CPME Director Alan Tinkleman artinkleman@apma.org 

NY Podiatrist Offers Advice on Caring for Achy Feet

You danced all night and pulled out your best moves, but now your feet are achy. That happens because high heels strain the balls of your feet and the metatarsals, the long bones in the forefoot, explains Marc A. Brenner, DPM, a podiatrist based in Glendale, New York.

Dr. Marc A. Brenner

“Depending on how pointy the shoe, you may also have pain in your toes,” he says. When you get home, soak your feet in cool water for 10 minutes. Then dry off and massage them with a foot balm containing menthol, which offers short-term pain relief. 

Source: Tiffany Sun, Health.com [2/19/10]

AAPSM Seeks Nominations For Excellence in Athletic Training Award

The American Academy of Podiatric Sports Medicine, the largest sports medicine affiliate of the American Podiatric Medical Association, is now accepting nominations for an Award to be presented to an athletic trainer who displays commitment and excellence in the field of sports medicine.  This award will be presented at the National Athletic Trainers’ Association annual meeting June 22-25, 2010 in Philadelphia, Pennsylvania. All nominees must be members in good standing of the NATA.

All nominations should be accompanied by a brief description of qualification(s), not to exceed 200 words. Please contact Rita Yates if you submitted a nomination last year and would like to re-nominate. Deadline for submission is March 15, 2010. Please submit nominees to: Ms. Rita Yates, Executive Director ritayates2@aol.com

As Obama Readies Reform Proposal, Reid Backs Use of Reconciliation

The Senate's top Democrat said he would use a legislative process known as reconciliation to unstick the now-stalled effort to reshape the $2.5 trillion per year U.S. healthcare sector. Senate Majority Leader Harry Reid (D-NV), appearing on the Nevada news show Face to Face with Jon Ralston late Friday, said he would likely use the legislative maneuver to pass a smaller-scale bill that harbors a number of provisions already negotiated by House and Senate leaders.

Reid said the reconciliation bill could be passed within the next 60 days. Presumably, the move would have to hold until the House passes the Senate's version of the bill first—something it has previously been reluctant to do.

Though complicated, the reconciliation process effectively allows legislation to pass the Senate on a simple majority vote rather than the typical 60 votes needed to overcome a filibuster. But it's the lack of a clear understanding on what the White House wants, coupled with the fact that many lawmakers have been away from Washington for more than a week and have had little contact with the key framers of such a proposal, that has the healthcare industry puzzled over what to expect next.

Source: Matthew DoBias, Modern Healthcare [2/21/10]

Query: Ask the Specialist Website

I received an unsolicited fax (this usually sets my antennae on alert) regarding my participation to be on the Advisory Review Board for a proposed syndicated TV medical information program called, "Ask The Specialist." Has anyone else been approached and does anyone have any feedback as to their legitimacy?

Chuck Ross, DPM, Pittsfield, MA

RE: Smart Toe Implant Complications
From: Multiple Respondents

I have had similar issues with the Smart Toe implant, but only with the fourth toe. I believe that the implant is too wide for the size of the phalanges in the average fourth toe. I plan on suggesting to MMI that they consider the development of a narrower device that reduces the implant width from 2 mm to approximately 1.5 mm. I have successfully used the implant in the second and third toes. I am cautious about using the Smart Toe in patients over the age of sixty five due to bone density issues.

Howard A. Stone, DPM, Glenview, IL, justus313@comcast.net

Hopefully, my comment will serve as a caution to others. I have recently seen a patient with a fractured Smart Toe implant in a mal-union IPJ fusion. His implant was implanted by another surgeon post-crush injury. The implant is now palpable plantarly. Years ago, I attempted six digital fusions for a bilateral hammertoe case. I used the then new product, Stayfuse. One of the implants also fractured and the toe became symptomatic. I took the patient back to surgery. It took more than an hour to attempt to remove the implant. The manufacturer offered little help with to ideas or instrumentation. It was a challenge, to say the least. A bone graft was needed to maintain a reasonable length. My take: "beware of new and smart," Are K-wires so bad?

Michael J Marcus, DPM, Montebello/Irvine, CA, ftmed@aol.com

I have put in approximately 10 of these implants over the past eight months. While I have not had one break yet, I have been less than thrilled with the use of these devices. They are not as simple to place as one is led to believe. I do not think that the instrumentation is appropriate.  The rep from the company has told me of similar complaints from others. For now, I will put my use of them on hold. Currently, they are not worth the time and effort. 

Larry Cohen, DPM, Clinton, NJ, larrydpm2002@yahoo.com

RE: Osteochondral Defect (Marc S. Greenberg, DPM)
From: Gary M. Lepow, DPM, MS

I have a robust experience utilizing Tornier's Osteocure for OCDs of the 1st metatarsal head. My follow-up of a cohort of patients for three years has demonstrated excellent results based on clinical exams, x-rays, and MRIs. This is a readily available synthetic allograft made up of calcium sulfate and a co-polymer. I perform a micro-fracture  (marrow stimulating technique) just prior to inserting the Osteocure plug.

Gary M. Lepow, DPM, MS, Houston, TX, docgml@aol.com

RE: Dependence on Medicare Ruined Me
From: Name Withheld (GA) by Editor

I am in the process of closing my office. I had one car repossessed last week and they are picking up my other car Monday. I am making arrangements for my wife and I to move in with my Mother. The bank will be foreclosing on my home next Wednesday.
 
I am not a “bad” business person. I average a thousand office visits per month in a pretty busy practice. Two years ago, I had almost $ 200,000 in savings and a hundred acre farm almost paid off.  What happened? Drugs? Alcohol? Partying too much? Alas, I wish that had been the case.
 
My mistake, too much of my income was dependent on Medicare. Two years ago, Medicare...

Name Withheld (GA) by Editor

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

RE: Health Insurance Options for Early Retiring DPMs 
From: Michael M. Rosenblatt, DPM

Based upon demographics of the baby-boomer generation, a large number of podiatrists will be looking to retire. Some will stop working as podiatrists, even though they don’t yet qualify for Medicare, and they may (or their spouses) have “pre-existing” conditions. This may delay retirements. The individual insurance market is highly limited and picky.

A retired podiatrist might think of changing a hobby into a “family business.” There are infinite examples: From real estate ownership to re-finishing furniture, writing, multi-level marketing, etc. Ideas for family business are as varied as your imagination and interests. It’s difficult to work part-time as a podiatrist due to malpractice exposure. And it’s still important to keep your brain occupied. 

Family business will allow you to obtain major medical (no questions about pre-existing conditions.) You need a local business license, and work at it about 20 hours/week, on average. Small business insurance for you and your spouse is expensive, but of excellent quality. You can reduce costs by selecting an HSA plan, and only purchase catastrophic coverage. Whether you choose HSA requires analysis of each separate situation. 

Some insurers require you to send in a copy of your last tax return, but most do not. In almost all states (to my knowledge), it is possible to operate a family business and get health insurance, even with pre-existing conditions.

Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

RE: CA Podiatrist Sees 35% Rise in Insurance Premium
From: Elliot Udell, DPM

There has been a great deal of national news about the sudden increases in health insurance premiums. Insurance premiums are going up as much as 20%, and they are too high already. I received a letter from my carrier saying that my insurance co-pays will go up from ten dollars to fifty dollars, and they refuse to tell me what the premium will be when I renew my policy. Congress is set to do investigations into what is happening, especially since there are reports that certain healthcare insurance companies made over 250% additional profits last year on the backs of consumers who are already suffering from the severe recession.
 
It all boils down to healthcare reform. Whether you like the plan advocated by Democrats or the ones being suggested by Republicans, our way of life will not continue to exist unless insurance premiums are brought under control, and I have a gut feeling that some compromise between both parties will come out of Congress. They say all politics is local politics, and if John Q Public has to pay double for his family's health insurance by this November, his representative in Congress will get walking papers, irrespective of what political philosophy that congressperson espouses. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

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 VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes. Top hospitals. Fax CV with references to 703-491-9994

ASSOCIATE POSITION - MICHIGAN - (OAKLAND COUNTY)

outstanding opportunity for associate in well established practice, general & surgical podiatry forefoot, rearfoot & ankle (full or part-time). Well-trained, responsible, motivated with good communication skills, ABPS qualified or better. Send CV & letter of interest to: PodiatristWanted@AOL.COM

ASSOCIATE POSITION - INDIANAPOLIS, INDIANA

Hospital clinic practice with a large volume of all patient types. In need of 1-2 podiatrists, willing to work as a team and make a career in Indianapolis. One - two year residency training can be medical or surgical. Excellent income and ownership possible. Curriculum vitae to twz1001@sbcglobal.net

ASSOCIATE POSITION - MARYLAND/D.C AREA

We are looking for an energetic and well-trained podiatrist to join our rapidly growing group; we have offices in Maryland and D.C and are in need of someone who is hard-working and growth-oriented. This candidate must be a graduate of a PM&S 36 residency program or have the equivalent in practice experience. We are looking for the person that wants to make this area their home and become an integral part of our group. If interested, e-mail your CV and cover letter to washingtonpod@aol.com

ASSOCIATE POSITION - W FLORIDA, BEACHES

Well established podiatry practice with excellent mix office/surgery seeking full time associate PSR 12-36. Excellent salary & benefits for the right hardworking, personable candidate. Email resume to capecoralpodiatry@live.com or fax to 239-573-9201

SPACE AVAILABLE With MRI– NYC/LI

Turn-key office space, East 60th and 22nd St. Manhattan and Plainview, Long Island. Available extremity M.R.I and dynamic ultrasound (East 60th St Manhattan and Plainview, LI). Tests are run by DPM and read by board-certified radiologist. Call for rental agreement. Satisfies Stark laws (516) 476-1815.

PRACTICE FOR SALE - NORTHWEST CHICAGO SUBURBS

17 year-old surgical practice for sale. Practice sees a wide variety of foot and ankle pathology and is largely referral especially regarding surgical patients. Two offices fully equipped. Lease or purchase of office condo also possible. Doctor willing to stay Please email inquiries to crystallakefootandankle@live.com

ASSOCIATE POSITION - TEXAS

Wonderful opportunity! Successful multi-office, multi-professional practice seeks well-trained new and established podiatric physicians with expertise in sports medicine, podopediatrics, rearfoot/ankle surgery, or hospital podiatry. A must to be outgoing, motivated, and personable with a dedicated hard-working ethical desire to become a winner. Send resume, current photo and letter of interest to sierrajip@gmail.com

PRACTICE 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.

ASSOCIATE POSITION - TEXAS

Dynamic, growing practice in Dallas/Fort Worth area, seeking surgically trained, Board Certified/Board Qualified Podiatrist. Excellent salary and benefits compensation package, for the right candidate, with partnership/buyout opportunity. Contact/Send resume to: jmh6122@yahoo.com

PRACTICE FOR SALE: TENNESSEE 

Established 30-year full-scope podiatry practice. Excellent hospital and surgery center privileges with investment opportunities. Fully equipped 2200 sq.ft. office across from hospital. High volume of new patients, DME, and local referral base. Great community for a family and the outdoorsman. Reply to tnfootdr@gmail.com

ASSOCIATE POSITION - MONTANA

Great opportunity for a PSR 24 or 36 residency trained individual to join a dynamic two doctor group with physical therapy. Needs good FF surgical skills, RF a bonus. Beautiful office and great area of the country for outdoor recreation-minded individuals. Opportunity for partnership after employment. Please reply to: jclough@bridgemail.com

ASSOCIATE POSITION FULL-TIME - SUBURBS OF CHICAGO

PSR 36 - month-trained podiatrist needed for busy suburban Chicago practice. Full benefit package included. If interested, please email your curriculum vitae to foot1st@yahoo.com

ASSOCIATE POSITION-INLAND EMPIRE, SOUTHERN CALIFORNIA

Associate needed full or part-time for multi office practice. Must be ABPS BC/BQ. Hard working, ethical individual who is looking to a possible partnership opportunity. Looking for current licensed or resident completing program this spring. Email CV to bkatzman2@earthlink.net

PM News Classified Ads Reach over 12,000 DPM's and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 12,000 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.