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March 08, 2013 #4,710 Publisher-Barry Block, DPM, JD

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We’ve just posted the March 2013 CME titled

March 2013 CME

You can Earn 50 CPME-Approved CME Contact Hours Online

Stilletto Fitness Class Can Lead to Tendonitis: TX Podiatrist

The latest fitness craze has women leaving their sneakers at home and shaping up in high heels. The Stiletto Fit Class in Montrose is based on the premise that if Beyoncé and Lady Gaga can stay fit dancing in high heels, so can you.

Dr. David S. Wolf

Fun or not, Dr. David S. Wolf, a podiatrist, has a warning for women who want to try the class. "In any exercise, you need a stable base support, and if you're wearing a high heel shoe, you know the angle and the gravity is now pushed forward. So all the stress is on the forefoot as well as the front of the leg and that causes a lot of tendonitis problems," said Wolf.

Source: Lauren Freeman, click3houston.com [3/5/13]

Your Feet Can Get Larger as You Age: FL Podiatrist

After years of wear and tear, tendons and ligaments in your feet may weaken, according to Dr. Cary Zinkin, a Florida podiatrist. This can cause arches to flatten, which means feet get wider and longer.

Dr. Cary Zinkin

It won’t happen to everyone, says Zinkin, though—people who are overweight, who get swollen feet or ankles, or who have certain medical conditions, like diabetes, are more prone. If it does happen, the average gain is about one shoe size by age 70 or 80.

Source: Teresa Dumain, Reader's Digest (Canada)

APMWA Announces 27th Annual Student Writing Competition

The American Podiatric Medical Writers Association has announced its 27th Annual Student Writing Competition.

All papers MUST be non-technical in nature. Appropriate subjects include practice management, ethics, law, education, or any topic that would be suitable for a lay publication.

There is no word limitation. Papers will be graded for content, style, grammar, neatness, and overall impact.

First prize will be one thousand dollars ($1,000), sponsored by an APMA Educational Foundation endowment from Dr. and Mrs. Steven Berlin, and recognition in the APMA NEWS and the APMWA Newsletter. Honorable Mention Certificates may also be awarded.

This competition is open to ANY enrolled podiatric student.

Entries must be received by 4/15/13 via e-mail at bblock@podiatrym.com

Entries become the property of APMWA, which may arrange publication of the entry.

AL Podiatrist Loses $7K, But Honest Airport Employee Turns it in 

An Alabama foot doctor said he is grateful for the honesty of a part-time parking cashier at Atlanta’s airport who found $7,000 in cash on the curb outside the international terminal and promptly turned it in. Pamela North Holloway found the envelope on the curb where shuttles unload passengers at Hartsfield-Jackson Atlanta International Airport. She turned it in and watched her supervisor count the money and contact Atlanta police to pick it up.

Dr. Troy Zimbelman

Dr. Troy Zimbelman said he called the airport shuttle service he used and then police. He was eventually able to claim the 70 $100 bills since he knew specific writing on the envelope and how the money was wrapped. “I was very impressed and plan on sending her a little reward money, too. It was a nice thing,” Zimbelman said Wednesday.

Source: Associated Press [3/6/13]

New SNaP SecurRing Hydrocolloid Makes Dressings Easier: FL Podiatrist

Spiracur Inc., developer of the SNaP(R) Wound Care System, an advanced wound care dressing with the proven efficacy of negative pressure wound therapy (NPWT), announced today the introduction of its SNaP SecurRing(TM) Hydrocolloid. This new product, a hydrocolloid shaped into a ring, is designed to facilitate fast and easy applications of the SNaP Wound Care System on uneven skin surfaces or wounds in challenging locations. The new hydrocolloid is intended for patients suffering from chronic wounds such as diabetic foot ulcers (DFU) or wounds to the plantar surface of the foot, as well as acute wounds, such as ray or toe amputations.

Dr. Gary Rothenberg

"The SecurRing Hydrocolloid is an ideal solution for our clinic because it makes dressing applications faster and easier on a large number of our patients suffering from DFUs, ray amputations, and plantar wounds," said Gary Rothenberg, DPM, CDE, CWS, director of residency training and attending podiatrist at the Miami Veterans Affairs Healthcare System in Miami, FL. "When using the SecurRing Hydrocolloid, fewer accessories are required and less time is needed to get a seal. In addition, by using it with the SNaP dressing, we can now apply NPWT in challenging anatomic locations, which would not have been previously considered," said Dr. Rothenberg.

Source: Reuters.com [3/6/13]

No Delay in ICD-10 Implementation: CMS

The CMS and the Office of the National Coordinator for Health Information Technology are absolutely committed to using health information technology as a foundation for healthcare system payment and delivery reform. That was the message put forth Tuesday morning at the HIMSS annual conference and exhibition in New Orleans. “2013 is going to be a busy year,” said acting CMS Administrator Marilyn Tavenner. “I realize we're giving you a lot of work to do.” Included on the to-do list is preparation of the adoption of the ICD-10 set of diagnostic codes in October 2014.

“Are we going to delay ICD-10? The answer is no,” Tavenner said in an announcement that received audience applause. Tavenner said the CMS responded to the American Medical Association's concerns about ICD-10 by pushing back the adoption date by one year. She described that as a good compromise, “but it was a one-time visit to that compromise.”

Source: Andis Robeznieks, Modern Healthcare [3/6/13]

RE: Numbness in Foot When Driving (Olga Luepschen, DPM)
From: Art Hatfield, DPM, Peter Bregman, DPM

My first question would be: Does this happen while driving all vehicles or just a specific vehicle?

Art Hatfield, DPM, Huntington Beach, CA, afootjob@juno.com

This is likely a positional entrapment of one of the peripheral nerves in the distal leg or foot. You need to do a systematic evaluation of the peripheral nerves by percussion until you find the entrapment site. It should be noted that EMG/NCV studies are not reliable for picking up this type of entrapment, especially if the studies are done when the patient is not symptomatic. There also may be a subclinical radiculopathy that is not showing up on MRI that is creating a double crush syndrome when the patient is in a seated position. So, look for the Tinel's sign in the nerve(s) of the affected dermatome, and when you find it, decompress it. Normally, you could try more conservative options, but at this point, they are unlikely to work.

Peter Bregman, DPM, Las Vegas, NV, drbregman@gmail.com

RE: Numbness in Foot When Driving (Olga Luepschen, DPM)
From: Richard A. Simmons, DPM, Paul Busman, DPM, RN

Many men carry a wallet in one of their back pockets. If this is the case, have him remove the wallet when driving and/or sitting.

Richard A. Simmons, DPM, Rockledge, FL RASDPM3955@gmail.com

Is this on the side of the pocket where he carries his wallet?  We all have so many credit cards, etc. that a man's wallet can approach 2" in thickness, putting a lot of pressure on the sciatic nerve roots. I had a very similar problem myself, until my chiropractor suggested removing my wallet from my pocket when I drive. I'm not sure how taking his foot off the pedal and moving it helps, unless he's also unloading the wallet area. Now, I carry an innovative wallet called the All-ett (for which I have no financial interest). It redistributes credit cards, license, store premium cards, etc. into a much thinner profile. 

Paul Busman, DPM, RN, Clifton Park, NY, paul@busmanwhistles.com

RE: Efficacy of Lasers for Onychomycosis (Tip Sullivan, DPM)
From: Burton J. Katzen, DPM

Congratulations to Dr. Sullivan for being smarter than I am and not purchasing a laser. In all my research looking at numerous lasers and numerous pictures of “before and afters” from various companies,  no one ever showed me a completely thick nail getting thin and pink again after using a laser. Every nail I saw was pink and attached at least proximally, which meant to me that if the nail was cut down to the area attached or even removed and treated by other modalities, the desired results could be obtained. That being said, I made the plunge.

I obviously only performed lasers on positive cultures, but I now find myself many months later trying to explain to patients why they spent the money and still have "thick nails." I do follow up all laser treatments with local anti-fungals and periodic grinding down of the nails as they are growing. My weak explanation is that “at least we killed the fungus (the infection), but there was obvious chronic underlying root damage that caused the thickness.” 

I must say, however, that my laser website ($250/month) has bought in numerous patients, but I now find myself seeing new patients who are asking for laser treatment and recommending a different mode of therapy for 90% of them. I tell the ones who do opt for laser that we may kill the fungus, but I can't guarantee a pink nail. The good news - only 48 months left on my lease.

Burton J. Katzen, DPM, Temple Hills, MD, DrburtonK@aol.com

RE: Vacation Policy (John Scholl, DPM)
From: Joel Lang, DPM, Art Gudeon, DPM

After one full year of continuous employment, my employees got one week of paid vacation. Each year thereafter, they earned an additional week of paid vacation until they reached 4 weeks. That was maximum.

Joel Lang, DPM (retired), Cheverly, MD, langfinancial@verizon.net

My office manager of almost 34 years now (that's THIRTY-FOUR years!), takes her vacations any time she damn pleases...hey, we know who the real boss is in my office!

Art Gudeon, DPM, Rego Park, NY, afootdoc@hotmail.com

RE: Pre-Authorization for Imaging (Robert Steinberg, DPM)
From: Keith L. Gurnick, DPM

Rather than trying to "get even" with an insurance company, I am requesting that patients get  involved as an advocate in their own healthcare, as I too have often been asked to do. When I ask the patient to find out if a pre-certification or pre-authorization is required prior to obtaining an outside imaging study that I have requested,  the patient becomes a better patient and learns exactly how their health insurance works (or doesn't work).

Usually, the patient makes the call right away, sometimes on their cell phone while they are still in the office because they want to have the test done ASAP.  There is nothing wrong with having the patients do some of their own leg (foot) work. When authorizations are in fact required, my office also gets it done usually the same day, because I too want the test done ASAP so I can get the results and move forward with treatment plans for the patient.

Keith L. Gurnick, DPM, Los Angeles, CA, keithgrnk@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 - 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

ASSOCIATE POSITION - LEXINGTON, KY

Associate needed at fast growing, million dollar practice in beautiful Lexington, KY. All new office structure with gait analysis, med spa and heel pain center in prime location. Amazing benefits and chance to work alongside a forward-thinking podiatrist. Email emenold8@gmail.com with your resume.

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 - NORTHERN MICHIGAN

Tired of your current position? Looking to grow my practice in beautiful northern Michigan. Come and benefit from my years of hard work. Practice has just the right balance of hospital work, surgery and office. This is not a “gimmick” based practice, but a well integrated part of the medical community. Contact me if you are extremely interested in northern Michigan. Salary plus incentive based contract. Send CV/ letter- MichiganPod@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".

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 - 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

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

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 - 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.

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 to: sportsmed@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 - WEST PALM BEACH FLORIDA

Well established successful West Palm Beach practice grossing $475K with excellent reputation and good referral base. Consistent new patient growth, great opportunity with increased gross revenue and surgical growth potential. EHR implemented with meaningful use criteria met. Great area to live and work. Serious inquires E-mail wpbfootdrs@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

PRACTICE FOR SALE - LOS ANGELES, CA

Practice is in Boyle Heights area since 1998. 70%MM the rest consist of Cash/PPO/HMOs. Last 4 years grossed between 200-350k in a down economy. Constant referrals from PCPs in the area. Includes Padnet, and all podiatry equipments. Asking 130k. Please email me only footdoc525@yahoo.com

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

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

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