The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

March 15, 2007 #2,834 Editor-Barry Block, DPM, JD

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Children's Injured Feet Deserve Prompt Treatment, Full Rehab

Young athletes could see their sports dreams evaporate if they don’t seek prompt treatment and allow full rehabilitation of foot and ankle injuries. That warning comes today from sports medicine experts meeting in Orlando for the American College of Foot and Ankle Surgeons (ACFAS) Annual Scientific Conference. Surgeons say with more children playing high-level competitive sports such as gymnastics, tennis, soccer, volleyball, track and field, even golf, they're treating serious foot and ankle injuries in increasingly younger patients.

Dr. Robert J. Duggan

"I'm treating chronic heel injuries in pre-teen athletes, where a few years ago we saw these cases only among 16- and 17-year-olds," says Robert J. Duggan, DPM, FACFAS, a leading sports medicine expert with the ACFAS. "When the level of competition intensifies, so do the stresses on the feet and ankles and ultimately, injuries."

Duggan says the injuries he’s treated include high-level sprains, bruises to ankle bones responsible for transferring weight from the leg to the foot, sesamoid fractures, neuromas and heel injuries. Many injured children can avoid surgery. Instead, their foot and ankle surgeon will often immobilize the foot for a period of time followed with aggressive physical therapy. "With the diagnostic tools available to foot and ankle surgeons, and knowledge of the demands of the child's sport, we can make a decision on whether surgery’s necessary, and in many cases, avoid it altogether," Duggan says.

CA Podiatrist “Dr. Roadmap” Tackles Freeway Traffic

It's close to 5 o'clock on a weekday afternoon and traffic is so thick on northbound Interstate 5 in Del Mar that commuters creep along at a covered wagon clip. David Rizzo, in his black 1987 Mercedes-Benz, looks at the sorry scene and figures there must be a better – and faster – way north. “One nice thing about taking the road less traveled: You always get to see the cool stuff,” he said. Score another smooth move for the man who calls himself Dr. Roadmap.

Dr. David Rizzo

In the Los Angeles area, Rizzo is considered a go-to guy for tips on dealing with bad traffic. The native Southern Californian and part-time foot doctor has advised L.A. commuters for two decades – as a traffic reporter, newspaper columnist and in his 2006 book, “Survive the Drive!”

After completing medical school and becoming a podiatrist in 1976, he couldn't stand always working out of an office. He felt cheated. He wanted to be out, always moving, scouting the streets. So he built his medical practice around making house calls. Everyone else looks for ways to avoid L.A. freeways. Rizzo can't stay away from them.

Source: Steve Schmidt, Union-Tribune, [3/12/07]

Peeping Tom Australian Podiatrist Deregistered

A Brisbane podiatrist who secretly filmed female patients undressing in his clinic has been deregistered for two years. The Health Practitioner's Tribunal heard that on 67 occasions, 35-year-old podiatrist David Jude Fereiro secretly filmed female patients undressing before a massage therapy session at his southside Mt Gravatt clinic.

In 2005, he was sentenced to 18 months jail for three counts of indecent treatment of a child under the age of 16. The Podiatrists Board of Queensland today won a bid to have Fereiro deregistered from practicing for two years, saying his behavior constituted professional misconduct. The tribunal also ruled he be subject to strict conditions if he is re-registered after that time, including not consulting female patients or children under 16 without a chaperone.

Fereiro's actions spurred the introduction of new privacy legislation outlawing the use of film and video cameras to secretly record adults in private places in Queensland.

Source: Yahoo! Australia & New Zealand (Australia)[3/12/07]

Fewer Families Have Employer-Sponsored Health Coverage

About 47% of working parents in families with annual incomes of less than $40,000 are offered health insurance benefits through their employers -- a 9% decrease over the past decade, according to a report released Wednesday by the Robert Wood Johnson Foundation, the Detroit News reports (Kozlowski, Detroit News, 3/14).

For the report, analysts at the University of Minnesota's State Health Access Data Assistance Center examined data from the U.S. Census Bureau, CMS and CDC's National Health Interview Study. According to RWJF, the results "underscore that working parents who earn modest incomes are experiencing dramatic erosion in employee benefits" (RWJF release, 3/14). The report also found that about nine million children in the U.S. are uninsured, although two-thirds could qualify for government health insurance programs.

Source: Detroit News via American Health Line [3/14/07]

Query: Sedating Patients For Routine Care

I treat several patients from the local county home, all of whom are retarded with multiple behavioral problems. One currently refuses to come and have her nails trimmed apparently has some pretty alarmingly deformed and neglected toe nails. The home wants me to prescribe something to sedate the patient, and I am uncomfortable doing this in a patient who is already on multiple psychiatric medicines along with profound mental retardation. In my experience, an anxious combative patient often requires pretty heavy sedation to be calmed down. Has anyone ever had a similar situation wherein they have sedated a patient for routine care or had the family physician do this? Has anyone actually ever had to go to the OR for stronger sedation in a similar situation?

David E. Gurvis, DPM, Avon, IN

Query: Who Own Patients?

I have recently received a letter from a facility, stating that the facility would be changing podiatrists. I have seen patients there for many years. It is my understanding that the old podiatrist's patients cannot summarily be given to the new podiatrist. The old doctor's patients remain his, and the new podiatrist can be given new patients as they enter the facility. The doctor patient relationship cannot be broken, and all patients cannot legally be given to the new podiatrist.

Name Withheld by Request

Editor’s comments: PM News does not provide legal advice. The mere fact that you established a doctor/patient relationship in a facility does not give you any legal right to continue to see that patient in the facility. Similarly, just because an office patient is admitted to a hospital does not permit you to treat that patient in the hospital unless you are privileges at that hospital.

The real issue is whether you had a written agreement with the facility which would have prevented them from removing you without cause. If you do have such an agreement and you were summarily dismissed without due process, we suggest that you consult a healthcare attorney to pursue this matter.

RE: CMS’ New Policy Prohibits Payment For Foreign Outsourced Services
From: Sam Bell, DPM

I know that at least one of the two hospitals in my area have CT & MRI scans read by radiologists in Australia during certain night time hours. It will be interesting to see how this is handled now.

Sam Bell, DPM, Schenectady, NY, dpmbell@aol.com

ASSOCIATE POSITION- MINEOLA, NY

Excellent opportunity in fast-paced well-established podiatry practice for full time associate, all phases of podiatry including surgery, biomechanics, orthotics and routine foot care. Begins July 2007. Includes competitive salary and benefits. Please send CV and letter of interest to: cfcsteve@optonline.net

PRACTICE FOR SALE SAND DIEGO, CALIFORNIA

5 y/o LaJolla Ca (San Diego) office collecting $289.5K with mostly soft tissue office procedures, biomechanics, general care, and no HMOs. Affluent community with great schools. Major opportunity for growth. Selling due to age and health. Call 858-405-4780 before 8PM PDT. Serious only, please.

ASSOCIATE POSITION AVAILABLE - OCEAN COUNTY, NEW JERSEY

Immediate position avaliable. Desiring a hardworking, ethical, motivated and well trained individual. Minimum PSR 24. State of the art practice offering EMR, digital xrays, ultrasounds. Must be willing to do all aspects of podiatry. Competitive salary and benefits package. E-mail CV to NJFEET@aol.com

WELL ESTABLISHED PODIATRY PRACTICE IN MT. AIRY, NC

Dr. John H. Hodges had a well established practice in Mt. Airy, NC that is either for sale or in need of an associate/partner to take over patient care. Dr. Hodges unexpectedly passed away, leaving approximately 3,500 patients. This is a unique opportunity to be able to begin work in a busy podiatric practice. If interested, contact Carolyn McMackin at (336)577-2886 or cmcmackin@triad.rr.com

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

ASSOCIATE WANTED - BOCA RATON-DELRAY BEACH AREA

Full time for growing practice-surgical training a plus-hard working a real plus-opportunity of a lifetime-partnership after 1yr. Need Florida license. Fax resume to 561-865-2225

POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

ASSOCIATE POSITION – SOUTHERN CALIFORNIA

Seeking a position in a warm, friendly, and productive environment? Well, look no further! A well established podiatry facility in Burbank, California has an immediate position available for a podiatrist. He/She must be motivated, reliable, and dedicated. Depending on performance, partnership is possible. If interested, email your resume to drnickoghosyan@yahoo.com

ASSOCIATE POSITION SAN ANTONIO OR AUSTIN, TEXAS

Wonderful place to live. Great climate and much culture. Full or part-time podiatrist with current Texas license. Better pay. Unique mobile podiatry practice and mobile wound care clinics, in addition to office locations Check out our website at www.footmobile.com Fine working conditions with excellent support staff E-mail to footcenter1@sbcglobal.net or fax to 210-495-6484.

ASSOCIATE WANTED FOR SOUTH MIAMI AREA

Large group, busy, multi-office, partner potential. Motivated applicants only. Mail resumes and letters of intent to 999 N. Krome Avenue, Homestead , FL 33030. July start time OK, sooner preferable. E-mail lianadpm2@aol.com

ASSOCIATE POSITION - NORTHERN VIRGINIA

Well-established, busy, diversified, multioffice/multidoctor practice seeking associate with opportunity for partnership. Must be highly motivated and ethical with strong interpersonal and patient skills. Excellent opportunity for PSR 24 or higher trained DPM to complement a full-scope podiatric medical and surgical practice. Competitive salary and benefits package. Please send CV and references to saglag2@aol.com or fax to (703) 368-5103.

ASSOCIATE PODIATRIC SURGEON POSITION - TEXAS

We are looking for an exceptionally trained podiatric surgeon to work in the Houston, Texas area. Candidates seeking this opportunity need to be dynamic, people friendly, and have current licensure in Texas. Future licensure in Arizona will be required. Exceptional opportunity, with attractive benefits, and excellent starting salary. The successful candidate will find a rare opportunity to integrate into a specialized lower extremity practice with emphasis on peripheral nerve surgery, endoscopic and arthroscopic surgery, and other special surgery of the foot and ankle. Please submit a cover letter with current curriculum vitae via email to: Slb99@pdq.net Stephen L. Barrett, D.P.M., MBA

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