The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

March 11, 2011 #4,005 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2011- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

PRP Not Just For Professional Athletes: IL Podiatrist

You don't have to be a professional athlete to benefit from a new procedure called platelet-rich plasma (PRP) therapy. Used in Pittsburgh Steelers wide receiver Hines Ward and Major League pitcher Takashi Saito, the technique also is being used to treat foot and ankle conditions in "weekend warriors" and to heal wounds in diabetics. It can even help those suffering from arthritis, according to Sean T. Grambart, DPM, FACFAS, an Illinois foot and ankle surgeon presenting on PRP at the American College of Foot and Ankle Surgeons' (ACFAS) Annual Scientific Conference in Fort Lauderdale.

Dr. Sean T. Grambart

 

According to Grambart, he has used PRP for almost three years now and has experienced successful responses with it in his patients. "I have seen positive outcomes with chronic Achilles tendon pain, bone healing for non-unions and acute ligament injuries in athletes. I also have seen it work well in patients with chronic pain syndromes."

Source: Fox19.com [3/9/11]

Over 1,000 Podiatrists Attend ACFAS Scientific Meeting

Balmy breezes greeted over 1,000 ACFAS members as they convened in Fort Lauderdale, FL for the 2011 ACFAS Scientific Meeting. Lecture halls were packed solid as a world-class faculty presented the lastest advances in foot and ankle surgery.

Dr. John Etcheverry lectures before a standing room only audience at the 2011 ACFAS Scientific Conference.

During scheduled breaks, attendees visited the 140 exhibitors that filled the massive Broward County Convention Center floor. The day concluded with a festive beachside opening reception.
 

SD Senator Introduces Medicare Telemedicine Bill

Sen. John Thune has introduced a bill aimed at promoting long-distance telemedicine for Medicare recipients. The Fostering Independence Through Technology Act would provide incentives for home health agencies, particularly in rural areas, to use home monitoring and communications technologies.

"Access to high-quality healthcare in rural areas can be costly and limited," Thune, R-SD, said in a statement. "Telehealth technology stands to bridge the distance gap between patients and specialized healthcare providers through new and innovative measures and can bring down the cost of healthcare in rural communities." Under the bill, agencies that participated in the telemedicine pilot program would receive annual payments based on Medicare savings through telemedicine technology. Thune said the bill does not increase the federal deficit.

Source: Rapid City Journal [3/8/11]  

Feds Seek Quick Review of FL Judge's Ruling

The U.S. Justice Department has asked for expedited review of a judge's decision that the entire Patient Protection and Affordable Care Act is void because the provision requiring individuals to buy health insurance is unconstitutional. U.S. District Judge Roger Vinson in Pensacola, FL. responded last week to a request for clarification of his sweeping Jan. 31 opinion with a combative order reiterating that it should be taken as the “functional equivalent of an injunction,” blocking further implementation of the law.

Vinson added, however, that he would stay the ruling pending the outcome of the appeals process as long as the Obama administration pursued expedited review from the U.S. Supreme Court or the circuit court, which the Justice Department's latest filing aims to satisfy.

Source: Gregg Blesch, Modern Healthcare [3/9/11] 

IL Podiatrist Still On Death Row Despite State Law Repeal

Gov. Quinn’s landmark decisions to repeal the death penalty and commute death sentences to life in prison may have cleared out Illinois’ Death Row — but they did little to help a one-time Chicago doctor who remains condemned to death. Ronald Mikos, 62, still awaits execution after a 2005 conviction.

That’s because the death penalty is still legal in the federal court system where he was tried. Mikos, a former podiatrist, was sentenced to death after he killed a disabled patient of his who was about to testify against him in a Medicare-fraud investigation in 2002.

Source: Natasha Korecki, Chicago Sun-Times [3/9/11]

RE: Painful 1st Metatarsal-Cuneiform Joint in Runner (Harry Cotler, DPM)
From: Tip Sullivan, DPM

Does the pain change with hills? In flats? Look for an anterior tibial enthesiopathy. Does the pain correlate with any particular nerve distribution? or dermatome? I have found that diagnostic blocks with straight Marcaine (not cortizone) is helpful in delineation of the source of pain, intra-articular vs. extra-articular. Have the patient come into your office ready to run and keep blocking areas, having him run until you can identify the origin--process of elimination.
 
If you have an ultrasound, you might avoid an MRI--If you are not experienced in ultrasound, send the patient to a colleague who is.
 
Tip Sullivan, DPM, Jackson, MS, tsdefeet@msfootcenter.net

RE: Subtalar Joint Fusion Revision (Frank Cobarrubia, DPM)
From: Gino Scartozzi, DPM
 
The question that "nags" me with this surgical failure is "why?" So why did the foot heal in varus? Was it patient non-compliance with pre-mature weight-bearing, improper surgical technique (it is more probable for a valgus deformity to develop with a subtalar joint arthrodesis than a varus one) or underlying orthopedic situations not fully evaluated in the pre-surgical planning that may have led to this failure?

With reference to the x-rays that have been presented by this case, there is a metatarsus adductus deformity (pre-existing to the surgery) of the foot along with a global cavus deformity (again pre-existing to the surgery) of the foot. The absence of hardware leads one to believe that external wire/pin fixation (which subsequent removal) or grafting with above-knee or below-knee casting was the initial surgical procedure utilized.

Is there a limb-length discrepancy? Is the surgical lower extremity shorter than the non-surgical side? Is so, post-operative considerations for orthoses posting or heel lift may need to be considered. Orientation of the Dwyer osteotomy cut fashioned (if selected as your procedure) can further contribute to a pre-existing shortening. Is there a contracture of the Achilles tendon (probable with pre-existing global cavus foot deformity with metatarsus adductus) or a "medialization" influence of the Achilles tendon course (as seen with a genu varus)? If so, a lateral transposition of the posterior calcaneal osteotomy and/or Achilles tendon lengthening may need to be considered with this revision.
 
Gino Scartozzi, DPM, New Hyde Park, NY, Gsdpm@aol.com

RE: Hyperkeratosis in an 87 year old (Elliot Udell DPM)
From: Matthew Roberts, DPM

Obviously, this patient has severe calcaneal valgus deformity with midfoot collapse. If she is not a candidate for invasive surgery, you may consider a planing osteotomy of the midfoot with fractional lengthening of the Achillies tendon. I have had good results with this approach  in the elderly population.

Matthew Roberts, DPM, Miami, OK, matrob@pol.net
 

RE: Midmark, MTI Podiatry Chairs (David Gurvis, DPM)
From: Gayle S. Johnson, PMA

Our office has both Midmark 117 and Midmark 417 treatment chairs. When we expanded three years ago, we looked at several options, even though we expected to stay with Midmark. We compared costs, but also researched customer satisfaction feedback. Our final choice was MTI. MTI's product was less expensive, but we were also impressed by the higher weight capacity and lower seat. Repair resources told us that MTI had the better track record. 

Patients like the MTI chairs, and some who find themselves in a Midmark chair ask if they can have "the comfortable chair" next time. We have been very pleased with our MTI chairs.

Gayle S. Johnson, PMA, Edmonds, WA, Gayle Johnson, PMA

RE: Fraud and Abuse (Philip Larkins, DPM)
From: Richard A. Simmons, DPM

If there is to be a revolution of physicians, it will have to start with the young physicians. Unfortunately, most of the older physicians are deeply entrenched in the current healthcare situation and all of the establishments thereto appertaining. I foresee younger practitioners gaining momentum through social media. No one should expect any reasonable change from any of the established organizations. To be succinct:: stop supporting that which contributes to your demise.

Richard A. Simmons, DPM, Rockledge, FL RASDPM32955@gmail.com
 

RE: OR Podiatrist Embraces Zero-Drop Shoes (Ray McClanahan, DPM)
From: Robert Scott Steinberg, DPM
 
I said nothing about shoe design that accommodates Achilles tendonitis. And I am sure we are all aware of the shortening and tightening of the calf muscle in women who wear high heels.
 
Theory and "researchers'" opinions are a dime a dozen. There are far too many non-peer reviewed "opinions" being published. There is no conspiracy among high quality, well designed, non-gimmick athletic shoe manufacturers. And, while you may think we are all clueless, most of us are not. I bet if you surveyed your colleagues who are seriously into sports medicine, you will find they also instruct their patients on an active stretching program.
 
I may be guessing here, but I have a feeling that Dr. McClanahan is nothing like the overweight, tight, abducted, externally rotated, excessively pronated patients we all see with Achilles tendonitis that has nothing to do with the heel height of their running shoes.
 
Robert Scott Steinberg, DPM, Schaumburg, IL, Doc@FootSportsDoc.com

ASSOCIATE POSITIONS - NW INDIANA, CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

ASSOCIATE POSITION - MARYLAND

IMMEDIATE Associate needed to join a multi-office podiatry practice in the Baltimore MD Region. Desired candidate should be surgically trained with Board Eligible/Certification. You must be hard-working, ethical, compassionate and confident in your abilities to deal with pathology, patients, staff and fellow physicians. Patient base is already established. Excellent income and growth potential for the right associate. Please forward a cover letter, resume, and surgical log (if a current resident) and availability to FootDocMaryland@Gmail.com

ASSOCIATE OPPORTUNITY - FREDERICKSBURG, VA

Progressive, busy practice seeks personable, ethical, confident associate interested in future partnership. Lucrative opportunity for self-starter with strong work ethic. State-of-the-art office in rapidly growing community with two new hospitals and new surgery center. Practice has excellent reputation with well established referral base. Cover letter/CV to: fredfeet@verizon.net

ASSOCIATE POSITION - SOUTH/CENTRAL PENNSYLVANIA

PSR-24/36 trained individual for busy practice in family-friendly college town. Seeking personable, ethical, motivated individual to join our well established practice providing all aspects of podiatric care. Competitive salary and benefits package. Reply with letter and CV to Jagerone@aol.com

 ASSOCIATE POSITION AVAILABLE - NY

Busy Midtown Manhattan state-of-the-art practice with 2 locations seeking part time/full time associate. Must be in-network Empire BC/BS. Looking for a personable doctor with immediate availability. Residents Need not apply. DrB@myfcny.com

ASSOCIATE POSITION - WEST CENTRAL FLORIDA

A great opportunity to join a very busy, well-established, diversified practice in Clearwater, FL. Seeking an associate who has the drive and desire to work hard, has strong work ethics, and is very personable. BC/BE and minimum PSR24 +. We offer competitive salary and benefits. Send resume to Jaye@fdn.com

TWO ASSOCIATE POSITIONS - WEST CENTRAL FLORIDA

One in general podiatry, second with surgical residency. Good diagnostician, compassionate, hard-working individuals needed for high-tech group practice. flpodiatrist@tampabay.rr.com

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION - DAYTON, OHIO

Join a well-established modern practice with an excellent reputation and referral base. Base salary $100,000 and benefits with a bonus structure. EMR, diagnostic ultrasound, all aspects of DME, Padnet vascular studies, and CO2 lasers. We seek a surgeon that is well trained, personable and motivated to join our group of 3 Podiatric Surgeons. Would like this individual to buy in the practice eventually. Please send resume to ohiodoctors@aol.com

ASSOCIATE POSITION/PARTNERSHIP - CHICAGO

Chicago Podiatric Surgeons, one of Chicago’s leading podiatric practices, is searching for a FT podiatric surgeon. Applicant must be a personable and confident surgeon with ability to manage surgical patients independently and be at least board qualified. High compensation. Will be working in new 7000 sf state of the art office in AN upscale Chicago neighborhood. Ownership/partnership opportunities. Send letter of intent and CV to drcarr@chicagopodiaty.com

EQUIPMENT FOR SALE - COOL TOUCH LASER
 
Cool Breeze Cool Touch CT3 plus laser used for ugly, unsightly, toe nail infections. Less than six months old. Great price won't last long. Considering a laser? We also have the Q- Clear Q- switch laser too. This laser is perfect for you. Dr. Zuckerman is in the Fort Lauderdale area and will demo this lasers on your patients. E-mail footcare@comcast.net
 

EQUIPMENT FOR SALE

Hausted 825 GMCOO Unicare III stretcher. Approximately 7 yrs old, but rarely used. Great condition. Excellent condition, no rips or tears. $250 PDM J120B Podiatry chair-Used. Navy blue upholstery with some wear. Has Lift, Tilt and Back functions. Foot pedal. Screen and doctor’s stool included. $1,750. Photos on request. 410-768-5800 jferris@chesapeakefootandankle.com

Hand and power pieces available. Sagittal saw, wire driver- fits Ergo electric systems Complete Synthes internal screw fixation sets 2-0,2.7 and larger with screws self-drilling/tapping Complete packs of stats, retractors, rasps, rongeurs, etc. Email questions and requests to Podassociate@aol.com

FELLOWSHIP OPPORTUNITY
 
Applications are being accepted for the Central Kentucky Diabetes Management Fellowship. Dr. Jonathan Moore, former UTHSC Diabetes Fellow, OCPM adjunct faculty, AAPPM board member and national lecturer and author on diabetes and practice management related topics is director and founder. Don't miss out on the most unique, dynamic fellowship in Podiatric medicine. Learn latest advances in Diabetes management/surgery along with knowledge to run and grow a successful practice. Generous stipend, full benefits and free housing in resort setting. Email CV and letter of interest to: jmoore@aappm.org  Visit our website

PRACTICE FOR SALE - WASHINGTON STATE - SUBURBAN SEATTLE

6 year established part time practice. Includes Midmark 417 (4 position keypad), Excel X-ray, processor, Ritter M9, instruments, bandaids, etc. 1 Day/week $50K gross. Asking $35K. Shared office with 2 FP's. Easily expandable. Reply: practiceforsale18@yahoo.com

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Great opportunity. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K. dpmpracticeforsale@yahoo.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. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

PM News Classified Ads Reach over 12,500 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 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 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.