The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

March 11, 2013 #4,712 Publisher-Barry Block, DPM, JD

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OH Podiatrist Discusses Plantar Fasciitis

Plantar Fasciitis is an  Inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of your foot from the heel to the toes. People with all arch types - high, medium, or low - can be prone to this type of irritation, says Dr. Carly Robbins, a podiatric surgeon in Columbus, Ohio.

Dr. Carly Robbins

Wearing shoes with very flat or very high heels can worsen the problem. “If a shoe doesn’t support the arch, the fascia will be stretched, and that can cause inflammation,” says Robbins. And if your Achilles tendon often feels tight, it can exacerbate the issue.

Source: Sally Wadyka, Real Simple [3/8/13]

PM News has begun a new weekly feature called Quick Poll. Each week, we will post a new poll based on some of the controversial issues discussed in our Comments/Responses section. 

Quick Poll
If you use a laser to treat fungus nails, compared to oral terbinafine, do you think the laser is:

Results of last week's poll

Regular Exercise Can Prevent Ankle Sprains: MI Podiatrist

Spring is right around the corner, which means robins, daffodils, and switching over to lighter weight clothes. The warmer weather of spring is a signal to begin sports season for many, from amateur athletes to weekend warriors. Because of this, it's also ankle sprain season for foot and ankle doctors. Anthony Weinert, DPM, a board certified foot and ankle surgeon with offices in Warren and Troy, says that ankle sprains are one of the most common sports injuries he treats this time of year.

Dr. Anthony Weinert

"As people emerge from their winter hibernation and start to get active again, they can injure their ankles playing sports such as basketball, baseball, tennis, and soccer, says Weinert. "People should take care when they begin playing sports after a period of inactivity, and seek to strengthen their ankles through regular exercise to prevent injury."

Source: Laura Mikulski, Troy Patch [3/7/13]

TX Podiatrist Re-Appointed to State Health Services Council

Gov. Rick Perry has appointed Dr. Jeffrey Ross to the State Health Services Council for a term to expire Feb. 1, 2019. The council makes recommendations regarding the management, operation, policies, rules for public health, mental health, and substance abuse.

Dr. Jeffrey Ross

Ross is an associate clinical professor at the Baylor College of Medicine in Houston and chief of the Quentin Meese County Hospital Diabetic Foot Clinic. He is a fellow of the American Academy of Podiatric Sports Medicine, American College of Sports Medicine, American Professional Wound Care Association, and American College of Foot and Ankle Surgeons, a diplomate of the American Board of Podiatric Surgery, and co-chair of the Governor's Advisory Council on Physical Fitness. He is being re-appointed to the council.

TX Podiatrist Tries to Regain School Board Seat

Dr. Camille Rodriguez

Podiatrist Dr. Camille Rodriguez, who was defeated in 2008 in her bid for a second term on the Fort Worth school board by educator Carlos Vasquez, is challenging him to win the seat back. Rodriguez, 44, has filed paperwork to run for District 1, on the north side. Vasquez, 45, a political newcomer in 2008, won with 64 percent of the vote; Rodriguez took 36 percent.
 
Source: Jessamy Brown, Star-Telegram

 Gravesite of Lincoln's Foot Doctor Now a Tourist Attraction

He may just be a footnote to history, but Dr. Isachar Zacharie is having a posthumous mini-moment, thanks to the Hollywood-sparked surge of interest in the presidency of Abraham Lincoln. Zacharie was buried in London's famed Highgate Cemetery in 1900, but he is only being added to the cemetery guide Friday, joining such notables as communist philosopher Karl Marx, and novelist George Eliot.

Grave of Dr. Isachar Zacharie (Photo: Alastair Grant)

Zacharie's claim to fame? He was Lincoln's foot doctor. And a good one at that, if the president's signed endorsement can be taken at face value. "Dr. Zacharie has operated on my feet with great success, and considerable addition to my comfort," the 16th president of the United States wrote in 1862, when the United States was gripped by civil war.

Source: Gregory Katz, Associated Press [3/7/13]

RE: Efficacy of Lasers for Onychomycosis
From: Scott Day, CEO

Managing patient expectations is paramount to any successful medical practice. All legitimate laser companies that have gained FDA clearance to market their laser in podiatry can officially state "temporary increase in clear nail." Nowhere in that statement do we claim "new pink nail" or "thinner nail." Although these two claims would be nice, they are not necessary to maintain satisfied laser patients. It is enough to offer your patients hope to improve the appearance of their nails.

Most established and successful laser practices have effectively managed their patients' expectations. Those expectations are based on "improvement in the appearance." The key is improvement from the baseline, which is recommended to be documented with photographs. Surprisingly, often these patients see positive change before the podiatrists do, but photographs serve as a helpful reminder.

Patients, who are willing to pay cash, often are embarrassed about how their nails look. Most of your current patients are resigned to live with a  personally disgusting condition for which their foot specialist has no viable solution. The laser gives your patients new hope to look and feel better. The fact that you have invested in a technology that gives your patients an alternative treatment option speaks volumes about you as a medical practitioner. How effective you manage your patients' expectations will determine your patients' satisfaction with your laser service. As a medical practitioner, the laser you purchase (or not) is only one variable in your ultimate success.

Scott Day, CEO, Hyperion Medical, sday@hyperionmed.com

RE: Efficacy of Lasers for Onychomycosis (Adam Landsman, DPM)
From: Paul J. Maglione, DPM, David Zuckerman, DPM

Having had a laser for a year and a half, I have kept my own statistics: 1) For long-standing mycotic toenails (onychauxic type), the nails will thin out. However, they will not become the "thin, pink type." The result will please patients. 2) For recent infections, the results are gratifying to both the patient and myself. 3) Nails must have a positive fungus culture; the laser will do nothing for psoriatic nails. 4) Technique is very important. Any missed portions of nail will affect the result. 5) I do not use a topical concurrently. Based on laser physics, this may or may not affect the action of the laser. Dr. Zuckerman can weigh in on this.
 
Paul J. Maglione, DPM, Ossining, NY, drmaglione@aol.com

It’s important to first acknowledge that any type of laser treatment for fungus toenails is not a miracle cure. We need to continue to develop the research investigating laser treatments in order to determine the exact mechanisms of action, how we can improve outcomes, what the biomechanical and structural role of the foot is, and how it affects outcomes, as well as to examine the systemic implications of laser treatments, i.e., auto-immune disease, diabetes, etc.

I was surprised that Dr. Landsman believes that heat plays the primary role in destroying fungus, especially given his research with the laser company Normir in photo-inactivation along with...

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

RE: Efficacy of Lasers for Onychomycosis
From Michael Turlik, DPM

Therapeutic efficacy is best determined from level-1 evidence to include: randomized, controlled trials and a systematic review of pooled trials. Laser therapy for onychomycosis is promoted as an alternative to oral therapy. I am unaware of any valid level-1 evidence which demonstrates laser to be equivalent or superior to oral therapy.

Landsman and associates published a placebo-controlled trial in JAPMA evaluating the efficacy of laser in the treatment of nail fungus. I am unaware of any other comparative trials of laser for nail fungus. The Landsman study is an industry-sponsored study. The reader should carefully read the article to assess the validity and relevance before accepting the conclusions.

With the paucity of valid published trials, I am amazed anyone would be confident enough to use laser in the treatment of nail fungus. It may be an effective treatment, but in my opinion, there is no level-1 evidence to support the use of this expensive therapeutic option. This is what healthcare critics would suggest as costs which do not show an improvement in patient-centered outcomes.

Michael Turlik, DPM, Cleveland, OH, mmturlik@aol.com

RE: Numbness in Foot When Driving (Olga Luepschen, DPM)
From: Joel Lang, DPM, Al Musella, DPM

I suggest you investigate his driving seating position for possible pressure on the sciatic nerve or venous return. In addition, I would look at possible venous incompetency, causing swelling and pressure in his shoe when his foot is dependent and not moving much. Finally, check the shoe fit to see if it is too small and may not be able to accommodate the possible expansion of the dependent and relatively inactive foot. Sometimes, when we hear hoofbeats, we need to think "horses", not "zebras."

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

He probably has lost his fat and muscle padding over the sciatic nerve and the car seat is compressing it. Examine the position he is in when driving. Try adjusting the angle and height. Try this gel cushion: amazon.com/Wondergel-Original-Gel-Seat-Cushion/dp/B004EMXZKW/
Make sure he doesn't have his wallet in his back right pocket.
 
Al Musella, DPM, Hewlett, NY, Musella@aol.com

RE: Numbness in Foot When Driving (Olga Luepschen, DPM)
From: Kim Carroll, DPM

I had a patient with a similar complaint of numbness in only the right foot when driving. I also assumed nerve problems but studies came back normal. I ordered vascular studies and it turned out to be claudication. It was treated, and the problem went away. 

Kim Carroll, DPM, Fargo, ND, kcarrolldpm@icloud.com

RE: Your Feet Can Get Larger as You Age: FL Podiatrist (Robert S. Schwartz, CPed)
From: Dennis Shavelson, DPM

Mr. Schwartz has a “pedorthic” take on feet getting larger. I would like to offer a “podiatric” take in response. Growth is a good thing; pathological spread of the closed-chain architecture of the foot is not. This can happen before epiphyses close (juvenile bunions) or after (not at 30, as suggested).

In foot centering theory, we call these events “juvenile tie beam expansion” and “adult tie beam expansion,” respectively. Tie beam expansion is pathologic and is a precursor of...

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

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

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.

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

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 - NY AND NJ

Highly ethical, motivated self starter wanted. Must be willing to work hard. Must have excellent people skills. There is partnership opportunity if you are willing to work for it. This is not for everyone. No whiners, and no slackers. Send C.V. to ddfcfootdoc@gmail.com

ASSOCIATE POSITION - EASTERN SHORE OF MARYLAND

Seeking highly motivated, ethical, enthusiastic associate to join successful, well-established practice located in close proximity to Maryland and Delaware beaches. Certified/qualified by ABPS with rearfoot experience preferred. The practice incorporates surgery, wound care, sports medicine and general podiatry. Fully equipped office with diagnostic ultrasound, fluoroscopy, vascular testing, radio frequency ablation, six treatment rooms and three satellite offices. Main office has accredited ambulatory surgery center. This opportunity has excellent salary potential with benefits for the right individual. Send CV to dpmkthomas@gmail.com.

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.

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 - 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 - 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 - 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".

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

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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