The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

March 06, 2012 #4,402 Publisher-Barry Block, DPM, JD

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“High Heels Keep Us in Business”: FL Podiatrist

“High heels keep us in business,” says Dr. Paul Durney of the Orlando Foot & Ankle Clinic’s offices in Melbourne and Merritt Island. And as if to prove the point, a large photo on the home page of the practice’s website (orlandofoot.com) is of a pair of feet in pointy, spiked heels.

Dr. Paul Durney

Durney and his colleagues say wearing high-heeled shoes results in a long list of conditions from the merely annoying to the serious: from bunions and neuromas to sprained ankles and Achilles tendinitis.

Source: Lyn Dowling, Florida Today [2/22/12]

UK Podiatrist's Service Named Best in Southwest

Debbie Sharman is Consultant Podiatrist for Diabetes working with the Diabetic Foot Service, a partnership between Dorset HealthCare University NHS Foundation Trust and Royal Bournemouth and Poole Hospital Foundation Trusts. 

Debbie Sharman

Following a significant expansion, the service was recognized as having the lowest amputation rates in the region at 1.8 per 1,000 patients – which is also below the national average.

Source: Karen Middleton, Allied Health Professions Bulletin [2/27/12]

NY Podiatrist Prepares for 2013 Winter Games

Robert Conenello, DPM, President-Elect of the American Academy of Podiatric Sports Medicine (AAPSM) and Global Clinical Advisor, Special Olympics International recently spent time in Korea preparing and troubleshooting with the local Korean Clinical Directors for the upcoming 2013 Winter Games. 

Dr. Rob Conenello (R) recently spent time in Korea preparing for the 2013 Winter Games with Korean Clinical Directors.

The 2013 Games will be the 10th Special Olympics World Winter Games. The Games are scheduled to be held from January 26-February 6, 2013 in Pyeony Chang, South Korea. The Event will be one of the largest winter multi-sport events ever held in South Korea.

IA Podiatrist Appointed to State Podiatry Board

Gov. Terry Branstad last week announced that Dr. Mindi Feilmeier has been appointed to the Iowa Board of Podiatry. Feilmeier graduated from Des Moines University College of Podiatric Medicine and Surgery in 2005 and completed her residency at the Trinity Regional Medical Center.

Dr. Mindi Feilmeier

Dr. Feilmeier serves as an attending physician for the Trinity Regional Medical Center residency program. She also serves on the Marketing Committee for Trimark Physicians group, and on the Infection Control Committee at Lakes Regional Hospital in Spirit Lake.

Source: Des Moines Register [3/3/12]

UT Podiatrist Named to Head Mission in Brazil

Dr. Keith R. Reber of St. George, Utah has been called by The Church of Jesus Christ of Latter-day Saints to serve as president of the Brazil Cuiaba Mission, beginning July 1, 2012 replacing Cleto Oliveira. Dr. Reber, 58 completed his residency training in Albuquerque, New Mexico after his medical schooling at the California College of Podiatric Medicine in San Francisco, CA.

Dr. Keith Reber (FAI photo)

Dr. Reber organized the Foot and Ankle Institute in 1981. Over the last 28-years, the practice has become the largest and most comprehensive podiatry practice in the State of Utah, with four offices and seven doctors. He has volunteered his time, resources and skills for medical missions to Bangladesh, Brazil, and Mexico, helping to assist under-privileged communities with common foot problems and care.

Source: Morgan Skinner, KCSG News [3/4/12]

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: Are we graduating the right number of podiatrists to meet market needs? 

Dr. Gregg Young

Gregg Young: The basic answer to that is we’re not turning out enough. My graduating class in ’84 had 620 people. Right now, we’re talking about graduating classes that are right around 500. What that means is that we’re not replacing our own graduating classes. So, what happens is that we are shrinking as a profession. Are we getting better trained overall as a profession? Probably, but we’re still shrinking as a profession. At some point, that is going to be fatal to the profession. We really should be graduating somewhere in the 700 range right now, with adequate residency training for all of them; and there are actually studies that show that that’s even too low.

Dr. Keith Kashuk

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's guest is residency director Dr. Keith Kashuk. You can register for future events by clicking here

Query: Discharging a Non-Compliant Patient

In regard to sending letters for patient termination, what are the legal ramifications? Does this exonerate the physician from downstream liability? I have been told to write discharge letters to many non-compliant patients, but I am not 100% sure this would relieve any form of liability. For example, you send the letter to a patient with a foot ulcer who does not comply with complete NWB, neglects getting the proper studies done, etc. If that patient eventually gets a BKA, would that letter of termination shield the physician from liability?

Jeff Mennuti, DPM, Orange City, FL

Editor's note: PM News does not provide legal advice. The key in sending a discharge letter is to be sure that it is actually received by the patient. This is accomplished by sending it U.S. Certified Mail, Return Receipt requested. In today's litigious society, there is no guaranteed method to shield yourself from liability, but proper documentation at least gives you a fighting chance.

Query: Medisoft Clinical EMR with Medisoft Billing Software

What has been the the experience of those who are using Medisoft Clinical EMR with Medisoft Billing software?
 
Joel Morse, DPM, Washington, DC

RE: Lapidus or Fusion (Philip Graham, DPM)
From: Ken Jacoby, DPM, Randall Brower, DPM

I recommend a Keller bunionectomy with a fibular sesamoidectomy and digital arthroplasty. 

Ken Jacoby, DPM, Elgin, IL, kenjacoby18@gmail.com

I'm confused by Dr. Graham's question. A first MTPJ fusion alone won't correct the IM. A Lapidus alone would fix the IM, but not address the 1st MTPJ. The best surgeon knows his/her limits. The worst surgeon is one who doesn't know that he doesn't know his limits!

Randall Brower, DPM, Avondale, AZ, footdoctor33@yahoo.com

RE: Painful, Discolored Toe (Chuck Ross, DPM)
From: Gino Scartozzi, DPM,Stephen Musser, DPM

I always have a saying in medicine, "when in the forest, you are more likely to see a deer than a zebra." However, the occasional "zebra" will present itself rarely with the patient seeking care. In this case, did the patient have a cardiac or other vascular thrombolic event that dislodged and now manifests itself into the toe? Probably not, since the patient is described as "healthy."
 
In regard to the second toe of the right foot being in a significantly more elongated state, repetitive micro-trauma, either due to the patient's activity level and/or shoe wear, is probably the culprit. The atypical presentation of a unilateral involvement of Raynaud's syndrome or disease I cannot ever recall seeing in my practice. However, micro-vascular injury from such trauma with its associated symptoms should be addressed. Suggestions of shoe/activity modification, oral non-steroidal anti-inflammatory medications, and vascular assessment may be indicated if the provider feels that such arterial supply has been significantly compromised.
 
Gino Scartozzi, DPM, New Hyde Park, NY, Gsdpm@aol.com

Raynaud's phenomena would be lower on my differential diagnosis list (is there any involvement with the fingers?). With the information  provided, I would include the following in my differential: 1) 'sausage digit' (treat appropriately). (2) did the patient have a recent medical test/procedure where she may have thrown a clot that lodged in her toe? 3) an atypical presentation of gout (is she taking a diuretic, low dose ASA?). Any labs ordered?

Did you measure her feet to determine if her footgear is appropriate? This would help rule out the Morton's foot type being a contributing factor. This is an interesting case. Write back and let us know how it worked out.

Stephen Musser, DPM, Cleveland, OH, ly2drmusser@gmail.com

RE: Podiatry Chairs (Robert Lagman, DPM)
From: Nat Chotechuang, DPM

Hill chair pros: Reliable; Light enough weight that one person can move it around the room fairly easily; price is right

Hill chair cons: The seat portion of the Hill chair when in a flat or "fully-down" position is pitched forward ever so slightly. When one sits in this position, one wants to slide forward. One has to tilt the seat up a few degrees to achieve a comfortable position. Unfortunately, there is no pre-set or memory for the "right" position.

I was told by the sales representative that the foot rest might not be strong enough to support a very heavy person who sits on it, and for whatever reason, if I leave the foot rest extended, half of my patients want to sit on it instead of sitting on the seat portion of the chair. I must therefore lower the foot rest after seeing each patient, and then raise it again for the next patient to prevent them from sitting on the foot rest and possibly breaking it or falling onto the floor in a big crash. 

The foot extension is manually adjusted rather than motor-driven.  All of these nuances cost extra time and energy. Having to do it a few times per day is not a big deal. Having to do it dozens of times a day would get annoying.

Nat Chotechuang, DPM, Bend, OR, natchot@hotmail.com

RE: DR X-Ray Equipment (Neil H Hecht, DPM)
From: Andrew Shapiro, DPM
 
We have been using the A2D2 DR digital x-ray system for 8 months. The quality of images, ease of use, and support (with no extra fees!) have been superior.
 
Andrew Shapiro, DPM, Valley Stream, NY, drshapbark@aol.com

Codingline & PM News
In conjunction with AAPPM Present
The Greenbrier Coding & Practice Management Workshop - August 20-22
(Following the 2012 APMA Annual Scientific Meeting in Washington, DC)  

The Greenbrier, White Sulphur Springs, WV

Speakers: Harry Goldsmith, John Guiliana, Barry Block, Michael Brody, Paul Kesselman, Jonathan Moore, Rem Jackson, Chad Schwarz, Josh White, and other nationally-known authorities. 

Earlybird Bonus Until April 1 - Save $50 

Click Here for information or to Register

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 516 476-1815 PODO2345@AOL.COM

PRACTICE FOR SALE - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact: podiatrypracticesale@gmail.com

ASSOCIATE POSITION - NORTHEAST GA

Well-established 18 year practice in Northeast Georgia seeking full-time associate leading to partnership. General podiatric care with moderate amount of surgery to be done in local hospital or surgery center. Competitive salary and benefits. Please respond by email to: Fivetoes1946@aol.com 

ASSOCIATE POSITION - CENTRAL NEW JERSEY

Associate Wanted for Central NJ offices. Looking for highly motivated self starter to build/expand practice locations. Great part-time opportunity for the right candidate. Email your CV with references to: ejema@aol.com

SOUTHEAST GEORGIA- SAVANNAH & SURROUNDING AREAS

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking podiatrist looking to build a career & long-term relationship. Either established practicing physician or new residency graduate. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

ASSOCIATE POSITION - MANHATTAN

Podiatrist needed for busy state-of-the-art offices in Manhattan. Offices are located near Penn and Grand Central Station. Along with CV, please provide medical plans that you are currently participating in. Please forward your information to roni@myfcny.com

ASSOCIATE POSITION - LOS ANGELES
   
Multi-specialty group seeking part time podiatrist. Opportunity to transition into full time position. Required:  3 years or surgical residency, including Charcot reconstruction, fellowship or interest in biomechanics, and ability to train surgical residents. Send CV to podiatricri@yahoo.com 

ASSOCIATE POSITION – PORTLAND, OREGON  

$120K approx. starting salary plus malpractice and benefits! Long-term possibility with a unique buy-in plan. Busy, well-established private practice has an immediate opening with an established patient base for a dynamic, motivated, surgically-trained podiatrist. Practice is mainly general podiatric medicine and forefoot surgery with very little nail care. Some rearfoot and very occasional ankle and trauma. Prefer PSR 24-36. Call (503) 652-1121 and ask for Dr. John Mozena or email jlmozena@aol.com.

FULL-TIME  PODIATRIST NEEDED - 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 calls. 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

ASSOCIATE POSITION – SUBURB OF DALLAS, TEXAS

Available in suburb of Dallas 2-office practice. Excellent base salary/ bonus structure, malpractice, full benefit package with 4-5-year track to partnership. Looking for someone that wants to grow with our practice. Must have strong communication skills, excellent bedside manner and be PSR 24-36 trained. Email CV and letter of interest to myfeethurt2@yahoo.com

ASSOCIATE POSITION – ALBANY, NEW YORK

Solo practitioner looking to wind down after 29 years. Immediate position available in a well- established diversified practice. Must be ethical, hardworking and committed to quality patient care. Must have good communication and surgical skills. Patient base established with additional growth present. Excellent salary & benefits. Please send cover letter and resume to McBride719@aol.com

ASSOCIATE POSITION - KANSAS CITY, MISSOURI

I'm not just looking for an associate. I am looking for a doctor who wants to build a highly successful career with a doctor who is as committed to their success as he is to his own. Go to  www.YourFutureInPodiatry.com to find out about this opportunity.

ASSOCIATE POSITION – BROOKLYN NY

Busy multi-specialty Medical office in Brooklyn, NY is seeking an experienced podiatrist. We are offering great compensation, flexible schedule and great office environment. Our Requirements: Must have Experience Must have Medicaid & Medicare provider. Please respond by email to:  ddpropertymgmt@gmail.com

EQUIPMENT FOR SALE

Summit Doppler, Hall Micro 100 set with 5 heads including burrs, drills, and rasps (pristine condition). Original Hall/Zimmer set (still works), two major podiatry surgical packs; will sell them complete or piecemeal. Titanium Synthes Mini frag set; Osteotome sets, etc. Inventory of all equipment for sale available on request. Best offer. Call 586-675-4311 or 440-285-2827 or email me at gwdocks@aol.com

EQUIPMENT FOR SALE - COOL BREEZE COOT TOUCH VARIA

Cool Breeze Coot Touch Varia. Very low use. You won't find a laser at this price. $39,500. Has about 19 hours of use of it. E-mail for photos, and ask any questions. Will go fast. David Zuckerman DPM 856-229-2939 footcare@comcast.net

PM News Classified Ads Reach over 13,500 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 13,500 DPM's. 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.

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