The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

March 01, 2013 #4,704 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2013- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

PM Practice Management Survey Posted

We've just posted Podiatry Management's 30th Annual Practice Management Survey results.

Podiatry Management's 30th Annual Practice Management Survey

This comprehensive survey compiled and written by Stephanie Kloos Donahue can be read by clicking here.

NYCPM Faculty Member is Reviewer for Study Section at the NIH

New York College of Podiatric Medicine (NYCPM)  Faculty Member Khurram H. Khan, PhD, Associate Professor of Medical Sciences in the College’s Division of Pre-Clinical Sciences, recently served as a reviewer for a study section at the National Institutes of Health (NIH). His section was on “Musculoskeletal Rehabilitation Sciences.”

Dr. Khurram Khan

Dr. Khan is the second NYCPM Faculty Member to serve as a reviewer for the National Institutes of Health. Early last year, NYCPM Faculty Member Peter Barbosa, PhD, a Professor in the College’s Division of Pre-Clinical Sciences, served as a grant reviewer for the NIH.

IL Podiatrist and Son Climb Skyscaper for Charity

Kenneth E. Jacoby, DPM recently participated in the Hustle Up the Hancock, a 95-story climb on 2/24/13 to raise funds and awareness of The Respiratory Health Association of Metropolitan Chicago. Jacoby was very excited to participate in both the climb and working the medical crew with his son, Cory Jacoby, a fourth year podiatric medical student. 

Dr. Kenneth Jacoby (R) with son Cory

Dr. Jacoby is proud to have completed the 95-story climb in 17 minutes and 41 seconds, a personal best and even prouder to be outdone by his son, who completed the climb in 16 minutes and 25 seconds. Working the Medical crew involved climbing down 95-stories twice to help climbers in distress.

Podiatrists Finding New Demand for Their Specialized Care

As a waitress, Lauren Affatatti spends more than 10 hours a day on her feet. "I come home and my feet are pounding," says the 27-year-old Chicagoan. "I soak them in ice and get ready for the next day." But last year, Affatatti felt a new pain just below her ankle, a pain that didn't go away with her customary ice treatments.

"I went to my regular doctor, who referred me to a podiatrist, which seemed kind of funny to me," says Affatatti. "I always thought of podiatrists as doctors for older people, not someone relatively young like me." But on Affatatti's first trip to the podiatrist, she was surprised at the diversity of the patients in the waiting room. "There were kids and moms and teen-agers," says Affatatti.

Source: Chicago Tribune [2/26/13]

Medicare Pay to Shrink 2% as Sequester Looms on Friday

Unless a Congressional miracle occurs, Medicare reimbursement for physicians will decrease by 2% as $85 billion worth of automatic, across-the-board budget cuts called sequestration take effect on March 1 for the current fiscal year.

Organized medicine is complaining not only about reduced pay, which could push struggling medical practices further into a hole, but also about the deleterious effect of even larger budget cuts in store for federal agencies such as the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, and the National Institutes of Health.

Source: Robert Lowes, Medscape News [2/27/13]

Query: Relinquishing Hospital Privileges

I have been on leave of absence from one of three hospitals I am on staff at. I am too busy with the other two hospitals, I am willing to relinquish my privileges at that facility. Does it look bad on future endeavors by making this move? Obviously, I would have to list this on applications to other hospitals or surgical centers, but is it a negative mark?
 
Name Withheld, FL

RE: Replacing Implant (Daniel Tucker, DPM)
From: Ben Wehrli, DPM

First, there is an obvious non-union of the syndesmosis. It surprises me that this hasn't failed sooner. Osteolysis is usually a sign of soft tissue reaction to pieces of the polyethylene spacer, metal fragments, or mechanical forces. With the syndesmosis not fused and widened, mechanical shear forces make sense. I agree with Dr. Tucker that there is definitely subsidence of the talar component, as you can see the medial malleoli has dropped and the lateral malleoli is lower than the lateral process of the talus. 

I agree that a CT scan would be very useful to determine the next procedure. If there is a lot of soft cystic bone, a fusion would be better, and I would fuse the femoral head with a nail of your choice. If the bone is decent, I would revise with the inbone. I use the STAR for primary TAR, but revise with inbone. I don't believe bracing would serve this patient well.

Ben Wehrli, DPM, La Quinta, CA, ben.s.wehrli.cvfa@gmail.com

RE: Fixation vs. Non-Fixation of Metatarsal Osteotomies (Gino Scartozzi, DPM)
From: Elliot Udell, DPM
 
Arguing the pluses and minuses of minimal incision surgery in this day and age is akin to rehashing the merits of the Civil War in 2013. Both are old news. When it comes to the concept of minimal incision surgery, we are no longer talking about an exclusive podiatry topic. Today, the rest of the medical surgical world is performing surgeries with minimal incisions and promoting it in their advertisements.

There are minimal incisional spinal procedures, herniorrophies, gall bladder removals, and knee procedures. I even heard an advertisement on the radio today of a hospital doing cardiac bypass procedures utilizing minimal incisions. The days when patients would leave a hospital with "train track incisions from "head to toe' are long gone. My only question is whether podiatry had any significant impact on the minimal incisions surgeries done by the rest of the medical profession. 

Elliot Udell, DPM, HIcksville, NY, Elliotu@aol.com

RE: Fixation vs. Non-Fixation of Metatarsal Osteotomies (Gino Scartozzi, DPM)
From: Don Peacock, DPM

I respectfully disagree with Gino Scartozzi, DPM on many of his  points regarding the obligation to fixate lesser metatarsals. I do respect his experience and do not disregard all of what he says.  However, what does the literature say?

Let’s take a look at recent literature. Thomas Bauer, MD (West Paris University) performed a recent study on distal metatarsal mini-invasive osteotomies (DMMO). He performed 118 non-fixated DMMO cases of metatarsalgia with a mean follow-up of 26 months. IPKs and metatarsalgia disappeared on average in 2.5 months in all cases. AOFAS forefoot score significantly improved from a mean of 60/100 pre-operatively to 94/100 post-operatively. Only 2 patients had...

Editor's note: Dr. Peacock's extended-length note can be read here.

RE: Fixation Vs. Non-Fixation of Osteotomies (Randall Brower, DPM)
From: Sheldon Nadal, DPM

What Dr. Brower is missing is that a minimally invasive surgical first metatarsal osteotomy differs from a post-traumatic fracture in that it is a planned osteotomy, not an accident.

Minimally invasive sagittal plane V-osteotomies such as that used in a modified Wilson or Austin bunionectomy, or a first metatarsal head osteotomy such as the Reverdin-Isham bunionectomy, when performed properly, are designed to be much more stable than a post-traumatic first metatarsal fracture. In most cases, these bunion surgeries can be fixated adequately by impacting the capital portion of the osteotomy onto the first metatarsal shaft, followed by appropriate post-operative bandaging and footwear. If the situation calls for it, osteotomies can even be fixated percutaneously.
 
If Dr. Brower is really interested, I invite him to attend the next conference of the Academy of Foot and Ankle Surgery at the Louisiana State University in New Orleans June 20-22, 2013. We will be happy to teach him the procedures in the cadaver lab.

Sheldon Nadal, DPM, Toronto, Ontario, Canada, shel14@rogers.com

RE: Pre-Authorization for Imaging (Bill Weis, DPM)
From: Gary J. Fischman, DPM, PhD

Pre-authorization is used by insurance companies to ensure medical necessity for the procedure. Since the referring physician knows the patient's condition, he/she should know the medical necessity for the test that is being ordered. That is why the referring physician has the obligation to apply for the pre-authorization.

Dealing with insurance companies and/or their agents is somewhat time-consuming. However, if you have all the information in front of you, it will go much easier.

Gary J. Fischman, DPM, PhD, Idant Laboratories, gfischman@idant.com

RE: Pre-Authorization for Imaging (Bill Weis, DPM)
From: Cynthia Ferrelli, DPM

Yes, I agree that pre-authorization for imaging can sometimes be tedious. I actually make the call myself because I don't feel that my staff understands the patient's case enough to answer all of the detailed questions that are asked. It only takes me about 10 to 12 minutes to do this, so it does not bother me that much. I am not sure how the imaging facility could answer questions about the patient's case since it is not their patient. 

With the authorization companies that I deal with, they are asking questions like: Has the patient used a cane or crutches? Has the patient failed a course of physical therapy? Has the patient taken NSAIDs? Does the patient have a documented range of motion? If I really want the patient to have the imaging study performed, I feel I need to make sure all of the answers are accurate so that I am able to obtain authorization and help the patient's case.

Cynthia Ferrelli, DPM, Buffalo, NY, drfoot1@roadrunner.com

PODIATRIC SPORTS MEDICINE FELLOWSHIP - ORANGE COUNTY CA

July 1, 2013 and ending July 31, 2014. $60,000/year, medical, dental, malpractice, and CME allowance. APPLICANTS MUST BE ABLE TO OBTAIN A CALIFORNIA LICENSE. Letter of interest, and CV to: Philip Radovic, DPM, Fellowship Director, Email: Info@feetfixer.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 PODO2345@AOL.COM 516-476-1815

EQUIPMENT FOR SALE - COMPLETE AMFIT ORTHOTIC FABRICATION SYSTEM

Complete Amfit Orthotic Fabrication System with Footfax SL Contact digitizer-3 years old. System includes milling machine, 2 PCs, all cords, parts, hardware and assorted insole blanks. $45K New, Asking $10K. E-mail inquiries tosportsmed@fdfac.com.

EQUIPMENT FOR SALE - USED Q-CLEAR LASER

Still under warranty. New laser head just added. First Best Offer. Marketing and training included. Dr. Zuckerman will train you. e-mail with questions to mook863@comcast.net

PRACTICE FOR SALE - SOUTHWEST FL

Multilocation multidoctor practice in beautiful Southwest Florida . Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to: practiceforsaleswfla@gmail.com

PRACTICE FOR SALE - MISSION VIEJO, CA

Relocating to Tulsa. Great opportunity to buy my office. Located at Mission Hospital. Gross income 2012 was $560,000. Approximately 1300sqft with 3 treatment rooms, digital x-ray and fully computerized. Will consider all offers. Call David at 949-702-1052 or david@missionviejofootcare.com

PRACTICE FOR SALE - CORONADO, CA

Unique opportunity to purchase a very well established practice in beautiful San Diego. Hospital privileges available. Large and stable patient and referral base with consistent new patient growth. Why not practice where people vacation and retire? Willing to stay for transition. Inquires please email pestibear@gmail.com

ASSOCIATE POSITION - ST. LOUIS

Multi-location group practice seeks motivated DPM with initiative and leadership skills to contribute to our growing group practice. Foot Healers Podiatry Group enjoys a strong reputation within St. Louis and looking for the right individual to complement our team. Must have the confidence to lead you own clinic and the willingness to draw on the expertise that exists within our group. Base salary starts at $100k and no limit to your earnings as you grow YOUR practice. We also offer malpractice coverage, health insurance, 401k, group bonus/profit sharing. Please send CV to jmurray@foothealers.com and visit our website www.foothealers.com. 

ASSOCIATE POSITION NEEDED FOR CENTRAL FLORIDA

FT/PT associate needed for nursing home work. Great compensation and a great way to supplement your income. Must be willing to travel.  Contact us at (786) 975-2090 or fax to (847) 674-2113 you may also email to feetwork@aol.com.

ASSOCIATE POSITION - WASHINGTON, DC/ MD SUBURBS

Prominent, established two office practice seeking well rounded, personable, ethical individual with sharp medical and surgical skills. Must be 24/36 month trained, ABPS qualified or certified. Partnership opportunity with ownership potential. Competitive salary with benefits package. Please send CV to ponyrunner66@gmail.com

ASSOCIATE POSITION - CENTRAL FLORIDA

Associate position for busy practice in Central Florida. Competitive salary with complete benefit package available. Please send resume to cmedders@atlanticpodiatry.com

P/T ASSOCIATE NEEDED QUEENS & NYC

PSR-36+ board qual/Cert. Highly motivated, Confident, Ambitious podiatrist with Excellent patient communication skills required! F/T possibilities in future. Base Sal. With Incentives. Spanish and Greek speaking a plus. Please respond with cover letter and resume to: hansfeet@aol.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Requiring full-time podiatrist (PSR-24 or greater) in established Practice situated in a foothill community of Southern California. There is an existing patient base and a strong support team. Compensation is performance based with practically an unlimited earning capability. A possible buy-in is negotiable. Send resume to office@uplandpodiatry.com , titled, "Podiatrist".

ASSOCIATE POSITION - VA (SOUTH CENTRAL)

Thirty year established practice seeking associate. PSR 24/36 training, must be highly motivated, personable, ethical and willing to provide all aspects of podiatric care. Early partnership opportunity with potential ownership. Competitive salary and benefits. Excellent opportunity for a successful career. Please send CV to footcare2020@aol.com or fax to 804 733-5946.

ASSOCIATE POSITION - CENTRAL VALLEY/SOUTHERN CA

Seeking associate with partnership availability. Must be highly motivated and have good patient skills and personality. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Compassionate and well-trained for immediate position. Surgery Center and hospital-based with no HMOs/no rest homes. Bilingual in English and Spanish preferred. Offering a permanent position/partnership in a multi-million dollar hi-tech practice with Partnership also in Surgery center. Please e-mail CV and short bio to: Tonya@wetreatyourfeet.com

ASSOCIATE POSITION – MARIETTA, GA

An associate is needed for a dynamic practice located in Marietta, GA, a suburb of Atlanta. We are looking for a well trained, motivated and personable candidate. This is a great practice opportunity. 2 years or more of a surgical residency is required and practice experience is a bonus. Our office has a licensed and certified surgical center. This is a modern practice with ultrasound, digital x-ray and EMR. We offer a competitive salary and benefits along with potential for partnership. Please e-mail your cover letter, curriculum vitae, letter of references and picture to light@eastcobbfoot.com.

ASSOCIATE POSITION - HOUSTON, TEXAS

PSR 24+/ Equiv. DPM, Texas license, Busy diverse practice. Greater Houston Area, Guaranteed Salary and benefits All Aspects of Podiatric Medicine and Surgery. Board eligibilty, Bilingual A Plus. Send CV to Randal Lepow at rmldpm1@att.net

POSITION AVAILABLE - WEIL FOOT ANKLE & ORTHOPEDIC INSTITUTE-CHICAGO

Weil Foot Ankle & Orthopedic Institute is expanding their presence in the Chicago metropolitan area and suburbs and is recruiting qualified podiatric surgeons. A three-year residency is required and a podiatric fellowship is preferable. Current practicing podiatric practitioners in Chicago and surrounding area are also welcome to join our rapidly expanding practice that currently numbers 16 DPMs, a neurologist, an orthopedic surgeon, and a primary care sports medicine physician. For more information contact: info@weil4feet.com or call Stephanie Spiegel, COO at 847-390-7666.

ASSOCIATE POSITION - SOUTH CAROLINA

South Carolina's largest provider of foot care is a multi-doctor, multi-location practice currently seeking a highly skilled, personable, and hardworking physician to join our TEAM. South Carolina License is necessary. Above average salary and benefits. Please send Letter of Interest and CV to scdpmjobs@gmail.com.

ASSOCIATE POSITION - DAYTON, OH

Join a well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and to Ohiodoctors@aol.com

ASSOCIATE POSITION – NORTH CAROLINA

New associate position available that may lead to partnership. We are a very busy practice providing care in both office and hospital settings. EHR, arterial vascular testing, and ESWT in the office. We are fully integrated in a large tertiary teaching hospital. We are located in the beautiful mountains of western North Carolina. Research opportunities are available. Applicant should be ethical, personable, hard-working, and committed to quality in patient care. We are offering a competitive compensation package and a wide range of benefits. All interested candidates should send a CV to MFAS828@aol.com

ASSOCIATE POSITION - NEW YORK

Looking for a once in a lifetime opportunity to join a state-of-the-art well rounded Long Island practice with hospital privileges? Then our office is what you're looking for. Located 20 miles from NYC, LI offers great schools and lifestyle. Perfect for an experienced practitioner or 2013 residency graduate who is ethical, productive, and board certified/qualified looking to be part of a winning team now and in the future. Want to be a partner in a successful practice or own your own office? Serious motivated practitioners only invited to send their CV and personalized cover letter to: mets724@gmail.com.

PODIATRIC PHYSICIAN/SURGEON - CHICAGO AND SUBURBS

Chicago Podiatric Surgeons is searching for a full-time podiatric physician/surgeon. Prefer ABPS qualified/certified with experience in private practice. Great benefit package and partnership opportunities. Please send letter of interest, CV to dr.tcarr@gmail.com

ASSOCIATE POSITION - ORANGE COUNTY, NY

Looking for a highly motivated surgical trained podiatrist in the Orange County, NY (West Point area). Hospital, wound center and surgical center affiliated. It is a busy practice that covers hospital inpatients, Wound Center, and takes ER call. The applicant has to be trained in all foot surgery and be able to handle advanced diabetic wound care. The practice is a 1 hour car ride from NYC and is close to hiking, fishing ,skiing and state parks. Please Email a CV and contact info to clsp4@yahoo.com

POSITION AVAILABLE - BALTIMORE MARYLAND

Confident, surgically trained associate position available to join well-established practice locations. Leading to ownership within 3 years! Great salary and benefits. Will train on practice management, business management, and billing. Call 301-514-9781

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 12/24 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977.

PM News Classified Ads Reach over 14,000 DPMs 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 14,000 DPMs. Write to:bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 for a 50-word ad. 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.