The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

March 09, 2012 #4,405 Publisher-Barry Block, DPM, JD

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MD Podiatrist Uses Compressed Air, Cold Water to Speed Healing

Mike Parker crushed his left ankle in a work-related accident in 2005 and has been in pain ever since. He has had six surgeries and has tried numerous treatments and pain medications. Nothing seemed to help. Then late last year, on the advice of his podiatrist, Dr. David A. Lieb of Frederick, he decided to try the vasopneumatic compression system, a machine that uses compressed air and cold water at the same time to treat injuries. 

Dr. David A. Lieb

Lieb learned of the treatment system last October. He was curious about it, got a test unit, and was so impressed that he bought one. "I've been very surprised by the results," he said. "The air causes compression and the cold water just circulates. They both work together. It's better than shots and medication." He said about 60 to 70 of his patients are using the device. "The patients love it," he said. Most patients will receive one or two treatments a week. The treatments can go as long as 30 minutes, but most are 15. The water temperature can be anywhere from 34 to 50 degrees. Lieb plans to begin using it post-operatively.

Source: Stan Goldberg, Frederick News Post [3/6/12]

OPMSA President Elected APMSA President of Presidents' Committee

Amy Miceli, OCPM Class of 2014

Amy Miceli, OCPM Class of 2014, has been elected APMSA (American Podiatric Medical Student Association) President of the Presidents' Committee. She currently serves as President of the Ohio Podiatric Medical Student Association (OPMSA). 

Source: Footsteps (OCPM) [February 2012] 

OH Podiatrist Glows in Aftermath of Primary Victory

On the first day after his upset win over Jean Schmidt in the 2nd Congressional GOP primary race, Brad Wenstrup spent more than two hours looking at people’s feet. Seeing his patients at Wellington’s Orthopaedic & Sports Medicine facility in Dent was the only semblance of normalcy for the politician/podiatrist on Wednesday.

Dr. Ben Wenstrup (Photo: Joseph Fuqua)

After defeating four-term Congresswoman Schmidt, Wenstrup is heavily favored to win the November general election against Democrat William R. Smith, a little-known candidate who squeezed past David Krikorian in Tuesday’s primary.

Source: Deirdre Shesgreen, Cincinnati Enquirer [3/7/12]

WI Podiatrist Elected as Surgery Department Chair

Beloit Health Systems in Beloit, Wisconsin has announced that Dr. Bob Sage has been elected for a 2-year term as Chair of the Surgery Department. Sage graduated from the Ohio College of Podiatric Medicine in 1998 and completed his residency at PHS Mt. Sinai East Hospital in Richmond Heights, OH.

Dr. Bob Sage

Sage is past president of the Wisconsin Society of Podiatric Medicine. He is board certified by the American Board of Podiatric Surgery.

Query: Atypical Forefoot Pain
 
I have a 50 year old white male patient with pain centered about his plantar R 1st-3rd MTP joints. Symptoms are pain, burning, and numbness, which only occur while he is driving his big rig. He is an avid mountain and road bicyclist, and this problem never bothers him cycling, walking, or driving a car. While he does have a positive Mulder’s Sign, and had temporary improvement after a trigger point steroid injection, this seems to be a most unusual presentation of Morton’s neuroma. He did not respond to low-Dye strappings, metatarsal pads, or oral prednisone. A chiropractor examined him and could find no spinal issues which might cause this. He has no medical problems and takes no medications. I am considering an MRI, but would appreciate any input before I proceed.
 
Gary Bjarnason, DPM, Roanoke Rapids, NC

Query: Depreciated Value of Equipment

I will be purchasing an older practice this year and am in negotiations with the owner. The patient load is great and the good will is also great. I have been working there a year and have noticed the equipment is older, but functional for now. We have started the talks for price, and the owner brings up the depreciation value of the equipment. I was wondering if anyone has insights about a depreciation schedule. We do not want to bring an outsider in to evaluate the practice. Any suggestions?

Name Withheld

RE: Re-excise Mass? (Joe Gonzalez, DPM)
From: Steven J. Kaniadakis, DPM

I excised a lesion almost exactly the way this looks and with Dr Gonzalez's description. After sending the neoplasm to National Health Labs, I was not convinced that they knew what it was. I sent the slides to one of our podiatry scientific labs and the report was an angiolipoma. This lesion was in the third inter-space (like a Morton's neuroma), however, there was clinical evidence of a slight bulge, atypical of my pre-op diagnosis. My intra-operative findings were an anterior and posterior cord-like structure. I ligated these cords before excising the mass. It was my intra-operative impression that the cords might be blood vessels suppling the mass. The mass was more superficial than a typical neuroma.

Steven J. Kaniadakis, DPM, St. Petersburg, FL stevenkdpm@yahoo.com

RE: Lapidus or Fusion (Philip Graham, DPM)
From: Thomas Graziano, DPM, MD

Before considering either of these two procedures first think about the functional demands of this patient. If the patient is rather sedentary, one might consider a 1st MPJ arthrodesis. This is a powerful procedure and most certainly will reduce an excessively high intermetatarsal angle. If the patient is very active and athletic, a Lapidus would serve him very well. Remember to treat the patient and not the x-rays.
 
Thomas Graziano, DPM, MD, Clifton, NJ, TGrazi6236@aol.com

RE: Painful, Discolored Toe (Chuck Ross, DPM)
From: V. Kathleen Satterfield, DPM

I was recently looking through Gary Dockery's excellent derm book (Cutaneous Disorders of the Lower Extremity), and I was immediately reminded of this continuing  inquiry on PM News when I read about blue toe syndrome. It sounded a great deal like this case.
 
Blue toe syndrome's etiology is from microemboli that lodge in the small digital vessels, producing ischemic pallor, erythema, or cyanosis which can go on to ulceration. The complete occlusion is called the blue toe syndrome.There are two major forms of atheromatous emboli - atheroembolism and cholesterol microembolism per Dockery.
 
V. Kathleen Satterfield, DPM, Pomona, CA, vksatterfielddpm@aol.com

RE: ICD-10 Preparation
From: Joseph S Borreggine, DPM

Anne Boynton, a 5010/ICD-10 director/specialist representative from United Healthcare, spoke on Tuesday March 7, 2012 in a webinar for the APMA. During the webinar, she stated that according to CMS, ICD-10 will cost a 1-3 physician practice $80,000 for an EHR-equipped practice and $250,000 for a non-EHR equipped practice. Ms. Boynton also explained that the healthcare industry will be greatly affected by the transition to ICD-10 which will most likely delay or slow provider payments 3-6 months, and possibly as long as 12-18 months. The transition for most carriers could take 5+ years before an error claims process occurs.

Ms. Boynton went on to say that a medical practice should have...

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

RE: ABPS Name Change (M. W. Aiken, DPM)
From: Craig Breslauer, DPM

I respectfully disagree with Dr. Aiken. The proposed ABPS name change is of paramount importance and is long overdue. It is not about where we have been or where we came from as a profession. It is not about you and me today as much as it is about our future practitioners and the challenges they will face.

We need much wider public awareness as to the skills and services modern podiatric surgeons offer. For example, I walked into a treatment recently to see an established patient of mine for an ingrown nail. I asked her about the Swedo brace on her ankle, only to learn that she recently suffered an inversion sprain. When I advised her that I would have been happy to help her with that problem as well, she stated, "Oh, I thought podiatrists only treated toenails." Then, after being thoroughly insulted, I learned that she saw one of my orthopaedic partners the day before for treatment of her ankle.

To the average person, ABPS might indicate that we are certified in toenail surgery. The American Board of Foot & Ankle Surgery leaves zero room for ambiguity. We do not need surgical board certification for the valuable services we provide day-to-day in our offices. However, we do need this certification to communicate to the public and insurance carriers that we are the most qualified physicians to address foot and ankle pathology in the OR as well as the hospital.

Craig Breslauer, DPM, Palm City, FL, cbreslauer@southflaortho.com

RE: ABPS Name Change (M. W. Aiken, DPM)
From: Gary R. Bauer, DPM

There is wisdom in support of changing the surgical certifying board of the podiatric medical profession to The American Board of Foot and Ankle Surgery. As a requisite to procuring surgical hospital privileges, board certification/qualification defines a level of minimal competence in the anatomic area of a recognized surgical specialty, that being foot and ankle surgery. This, coupled with our professional degree as Doctors of Podiatric Medicine, will clearly define our position in the mainstream medical community as the pre-eminent providers of healthcare for this anatomic realm.

We are not losing our identity, but reinforcing and clearly defining our scope of expertise. This will have positive repercussions not only in our hospital stature, but in validating our inclusion in legislative policies, healthcare reform, and our public image. I am confident that the Board will choose the correct course of action as we are at a crossroads, and this opportunity cannot be wasted.
 
Gary R. Bauer, DPM, Philadelphia, PA, garyrbauer@yahoo.com

ASSOCIATE POSITION – MIAMI, FLORIDA

Associate with potential for partnership. All phases of foot and ankle care. Bilingual in Spanish helpful. Send Resume and Letter of interest to miamifootandankle@gmail.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 - SEATTLE, WA AREA

Established podiatric clinic looking for an associate to join our team, 5 offices located around the greater Seattle, WA area. Great base salary, benefits and friendly work environment. Please send resume to:  seattlefootdoctor@yahoo.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 – 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 towww.YourFutureInPodiatry.com to find out about this opportunity.

ASSOCIATE POSITIONS - MULTIPLE STATES

Podiatrist Needed in Missouri, Nebraska, Iowa, Minnesota, North Dakota, South Dakota, Ohio, Texas, Colorado, Oregon, Washington, Arizona, Massachusetts, Rhode Island, Wisconsin, Indiana, Oklahoma, Connecticut and Vermont. Expanding multi-state medical practice seeking podiatrists to service long-term care community residing in nursing homes and assisted living facilities. We offer an established patient base, scheduling, equipment allowance and cover travel expenses. Provide generous compensation, bonus opportunities, disability, health insurance benefits, malpractice coverage and flexible scheduling. Looking for a Podiatrist with excellent skills, able to provide expert and compassionate care to patients. Email CV to: careers@aggeus.org or call 773-770-0140 x300/x305.www.aggeus.org

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

EQUIPMENT FOR SALE - SWISS DOLORCLAST ESWT

Swiss DolorClast ESWT. Complete with Cart. Extra hand pieces. Excellent condition. Low hours. Asking $12k. Pictures available upon request. Contact Carol at 708-596-3757 or carol.performance@sbcglobal.net 

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

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

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