The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

March 18, 2013 #4,718 Publisher-Barry Block, DPM, JD

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IL Podiatrist Works to Help Prevent and Treat Injuries in Ballet Dancers

A study published in the February 2013 issue of the Journal of Physical Activity and Health revealed the climbing rates at which children are injured in all types of dance, including ballet, jazz, tap, modern, break dance, and ballroom dance. The study found that from 1991 to 2007, an estimated 113,000 youth, ages 3-19, were treated for dance-related injuries in the emergency room. Furthermore, the annual number of injuries jumped 37 percent from 6,175 ER visits in 1991 to 8,477 injuries in 2007.

Dr. Lisa Schoene

Dr. Lisa Schoene, a podiatrist, and Dr. Brian Marion, a chiropractor, work with Ballet Chicago to help dancers recover from injuries as well as prevent them. Depending on the severity of the injury, which can typically includes sprains, contusions, and fractures, the doctors must determine the length of rest away from ballet.

Source: Jason Peterson, Mary Posani, and Sandy McAfee, NWI Times [3/15/13]

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
Are you in favor of the training of podiatric assistants to do routine foot care?

Results of last week's poll

NJ Podiatrist Takes Icy Plunge to Raise Funds for ALS Research

Lou Gehrig once stood in front of a sold-out Yankee Stadium, dying from ALS, and said, “I consider myself the luckiest man on the face of the earth. I might have had a tough break, but I have an awful lot to live for.”

Dr. Patrick Caputo

“I find Lou Gehrig truly inspiring, for myself and for my community”,  said Dr. Patrick Caputo, shortly before he plunged into the cold and rip current waters of Manasquan Beach. He and one of his medical assistants, Lindsey Tanner, were 2 of the 500 participants who helped raise nearly $250,000 in the Valentine Plunge for ALS.

MN Podiatrist Loses License After Mis-codings and Improper Billing

A podiatrist who has a history of professional disciplinary action and has been sued seven times for malpractice since 1997 had his license revoked recently, according to an order made public by the Minnesota Board of Podiatric Medicine Thursday. Starting in 2006, Dr. Robert S. Mullin, of Minnetonka, used incorrect coding to bill Medica and Healthpartners for more than two hundred procedures not normally covered by the providers. When confronted, Mullin failed to repay more than $93,000 he had wrongly collected from the providers.

Source: Jane Friedmann, Minneapolis Star Tribune [3/14/13]

Providers Struggle With New HIPAA Security Rules

Smaller healthcare providers, as well as many of the firms that work with all healthcare providers, are struggling to comply with federal data security rules that take effect soon. But even larger healthcare providers would do well to examine their contracts with the firms with which they deal, to be sure their contracts include proper indemnification and other safeguards, experts say.

In January, HHS' Office of Civil Rights issued its final rule modifying the Health Insurance Portability and Accountability Act's privacy, security, enforcement, and breach notification rules under the Health Information Technology for Economic and Clinical Health Act, which is often referred to as the HIPAA omnibus final rule.  The final rule becomes effective March 26, and final compliance is required by Sept. 23. The new rule significantly broadens the definition of healthcare providers' business associates, bringing many more downstream subcontractors and others under HIPAA's authority.  It also changes the criteria to be used in deciding whether a breach requires notification, placing a greater onus on the healthcare provider to establish why notification should not be made./>  

Judy Greenwald, Modern Healthcare.com [3/15/13]

Query: Forefoot Surgery on an 84 Year Old

This 84 y/o male has a chief complaint of a second hammertoe, bilaterally. The radiographic findings reveal a bilateral hallux varus L>R with adducto varus deformities of 2-5 digits with the deformities lessening going from digits 2-5. There is no actual met adductus. I plan to correct the right foot first by releasing the abductor hallucis tendon and doing a reverse Akin, if needed. The R 2nd and 3rd toes will be repaired with a Weil osteotomy, and moving the metatarsal head laterally, then fixating, and performing a plantar plate repair of the MPJ, and a PIPJ arthrodesis of each toe with a headless screw (Osteomed Extemifix screw).

Hallux Varus and Painful Hammertoes in an 84 Year-Old

The right 4th toe will have just an arthrodesis of the PIPJ like the 2nd and 3rd toes, and the R 5th toe will just have an arthroplasty. The L foot will have the same procedures in the future, but 1st MPJ fusion is more likely because of the severe varus deformity and 1st MPJ DJD. Any other thoughts would be appreciated, along with any expected problems during the proposed/planned correction.

RE: Mycotic Nails in a 5 Year-Old (Billie Bondar, DPM)
From: Michael B. DeBrule, DPM, Robert Bijak, DPM

Studies have described use of topical Penlac, oral weekly fluconazole, or oral-pulsed itraconazole. My gut feeling is that kids are more likely to respond to topical therapy than adults. Also, why not use laser therapy? I have a five year old who I am treating with laser now. Kids like wearing sunglasses, but under the age of five, laser might be tricky.

Michael B DeBrule, DPM, Richfield, MN, innovativefootcare@gmail.com

I think you could do more of a service to this 5 year old by realizing a systemic work-up is necessary. I think onychomycois in this age group is a little suspicious. Not that there isn't a fungal infection, but more importantly, why at this young age? An immuno electrophoresis, hematology assessment, and at least a blood glucose, along with a good family history of diseases are imperative. Perhaps, if the pathophysiology is better understood, a more reasoned treatment plan can be made.

Robert Bijak, DPM, Clarence Center, NY rbijak@aol.com

RE: Refusing Routine Care to a Compromised Diabetic Patient (Michael Schneider, DPM)
From: Brian Kiel, DPM, Charles Morelli, DPM

I respectfully disagree with Dr. Schneider regarding the compromised diabetic patient who was requesting nail debridement. I perform nail debridements on diabetic and non-diabetic patients in my office as well as perform surgery, both on a daily basis. However, I have yet to see an emergency need for nail debridement, and if someone needs that sort of treatment, my office is available for appointments. I doubt that a dentist would clean teeth in a hospital. If you have the proper instrumentation for performing that sort of treatment in that setting, then do it, but in my opinion, it is only done as a convenience, not as a necessity.

Brian Kiel, DPM, Memphis, TN, footdok4@gmail.com

Dr. Schneider states, "We podiatrists should be doing everything in our power to project that we care about all of our patients' needs, not just the lucrative ones." I agree. And unless someone has a different fee schedule than I do, you will make more money in the long run doing RFC and "basic podiatry" than you do performing surgery. I perform as much surgery as I can because I simply love to do it. I love teaching residents and performing challenging cases as it makes me better at what I do. The reality is  that I have family, employees, and the same bills as everyone else does, including college for 3 daughters. Basic podiatry pays for all of that. Surgery is just icing on the cake -- for me. 

For the podiatrist (sorry, I meant to say "foot surgeon") who is too important to help an elderly patient in need of care, remember that you will be old one day, and that day will be here before you know it. I hope when you are lying in a hospital or nursing home that you don't have the same experience. Matthew 25:40 "whatever you did for one of the least of these brothers and sisters of mine, you did for me."

Charles Morelli, DPM, Mamaroneck, NY, podiodoc@gmail.com

RE: The Passing of Charles Bradley, DPM, MA

Many people do not remember that Charles Bradley was a very active member of the Board of Trustees of the then California College of Podiatric Medicine. I do. He was one of those who interviewed me when I was a 31 years old candidate for the position of dean of the college. He was one of those responsible for and bold enough to select someone so young for the position, as well as literally changing the path my life would take. Even then, I knew him as a true gentleman. I was indeed fortunate to know him and to try to meet the expectations that he had for the college during the late 1960s and 1970s. He will be missed.

Leonard A. Levy, DPM, MPH

RE: The Passing of Charles Bradley, DPM, MA

I was deeply saddened to learn of the passing of Dr. Charles Bradley or “Brad” as those who knew him called him. He was truly a wonderful, honest, warm human being who always maintained his humility as well as his passion for the profession. Upon relocating to California in 1988, I had the good fortune to become an associate in practice with Brad, and he became my mentor. Coming fresh out of residency on the East Coast, I knew absolutely nothing about the business side of podiatry. Brad and his office manager took the time to teach me business ins and outs of practice, which, back in those days, were much simpler than they are today.

He never became outwardly angry and was always laughing. He loved his patients and they loved him. I found him to be a fantastic sounding board and full of objective, well thought out ideas and opinions, especially when it came to the political side of podiatry. He will be forever missed. 

 
Vince Marino, DPM, San Francisco, CA

While a student national leader in the late 80's, I and many other student leaders had a handful of podiatric icons whom we adored, and who always treated us with great respect at national meetings. On the top of the list was Dr. Bradley.  Most memorable was his constant smile and offer to provide advice for students. He always reminded us that we picked the greatest profession and that will all be very successful. Dr. Bradley along with others like Drs. Harvey Lederman, Eric Hubbard, and Jon Hultman were the driving forces for me and many others to support in any way possible students, residents, and new practitioners. Love you Dr. Bradley!

Hal Ornstein, DPM, Howell, NJ, halo@footdoctorsnj.com

RE: MA Podiatrist Discusses Plantar Fasciitis
From: Robert Laroche, DPM

Come on. Let's get real. 18-20 patients per day with plantar fasciitis. I practiced in the Air Force for twenty years - my last 5 years at Lackland AFB, TX where basic training is held. I saw patients of all ages. I cannot remember ever seeing more than 5-6 patients with this condition on any given day. In addition, I spent the first 21 years of my life living in Fall River, MA. I know people there have increased in weight, but I cannot believe this might have contributed to this epidemic of heel pain.

Robert Laroche, DPM, San Antonio, TX, larochebob@sbcglobal.net

RE: PA Podiatrist Among Highest Paid by Big Pharma
From: Paul J Maglione, DPM, Vinny Giacalone, DPM

We all respect Dr. Joseph as an educator and a fellow podiatrist. However, it is indeed a slippery slope when you deal with Pharma sponsors and the number he has dealt with in past years.
 
Paul J Maglione, DPM, Ossining, NY, drmaglione@aol.com

If you have ever attended a Dr. Warren Joseph lecture, then you understand that he is a consummate professional who is objective, truthful, and not influenced by the name on his honorarium check.  We as a profession should not be ashamed of the fact that one of our own has risen to such a prestigious level. A simple Internet search will astound you with the amount of money that is given to politicians through their PACs, from the pharmaceutical and healthcare industry. This list not only includes large corporations such as Blue Cross Blue Shield, Aetna, Pfizer, Merck, and Johnson and Johnson, but small start-ups, generic manufacturers, and Biotech companies that also donate millions to our nation’s leaders. The tens of millions of dollars donated to our politicians, on both sides of the aisle, is staggering.  So, I ask these rhetorical questions: why is this money donated in the first place and what are the politicians doing to earn their money?

Dr. Joseph is reading, working, researching, developing lectures, traveling, spending time away from his family and patients in order to provide the medical community with useful and clinically appropriate knowledge.
 
Vinny Giacalone, DPM, Emerson, NJ, VinnGiacalo@aol.com

RE: PA Podiatrist Among Highest Paid by Big Pharma
From: Hartley Miltchin, DPM, Robert E. Kuvent, RPh, DPM

Dr. Joseph is an asset to our profession as he presents information via his presentations in a concise, factual, and easy-to-understand manner.  I have listened to Dr. Joseph lecture numerous times, and his passion about the information and his ability to deliver it is quite evident in his presentations. Who and how Dr. Joseph gets paid is really irrelevan., He is entitled to receive payment for time out of his office, expenses, as well as a loss of valuable family time. I would commend Dr. Joseph for teaching his colleagues on relevant topics that apply to all of our practices. I would prefer to see podiatrists paid for presentations rather than being paid for being malpractice expert witnesses for plaintiffs.
 
Hartley Miltchin, DPM, Toronto, Canada, doctortoe@aol.com

I don't know why Dr. Joseph should have to defend himself, or in any way be vilified for making an honest buck. I say more power to him, and I hope he earns twice that much this year. He has taught us all a lot and saved many lives and limbs. Think of the relative value to society of Dr. Joseph vs. some supermodel or star athlete who nobody questions.

Robert E. Kuvent, RPh, DPM, Chandler, AZ, ftfixr@gmail.com

Editor's note: This topic is now closed.

SPACE AVAILABLE - NYC & LI

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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 footcare@comcast.net

ACADEMIC POSITIONS - SCHOLL COLLEGE

The Dr. William M. Scholl College Podiatric Medicine is seeking up to three full-time academic podiatrists to train and lead the next generation of podiatrists in an interprofessional, multicultural learning environment. Applicants must be board qualified with preference for board certification in foot surgery and reconstructive rearfoot/ankle surgery. Salary and academic rank will be commensurate with scholarly credentials. Contact Robert Joseph DPM, PhD at Robert.joseph@rosalindfranklin.edu or (937) 479-1793. Rosalind Franklin University of Medicine and Health Science is an Equal Opportunity/Affirmative Action Employer. The administration, faculty and staff embrace diversity and are committed to attracting qualified candidates from historically underrepresented groups.

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

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

ASSOCIATE POSITION - N.E. INDIANAPOLIS (FISHERS/ANDERSON)

Full or Part-time associates to join board-certified podiatrist in diverse, modern podiatry practice in hospital and office settings.  EHR, digital x-rays, PADnet, Cutera Genesis Plus laser, Pinpointe Laser, ESWT, mini-C-arm, all aspects of DME, and hospital affiliations with three networks. Limited wound care. No nursing homes. Current Indiana podiatrists welcome. Tremendous potential for individual(s). Send C.V. with salary and benefit expectations: john.lloyd@lloydpodiatry.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".

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 - CENTRAL FLORIDA

Associate position for busy practice in Central Florida. Competitive salary with complete benefit package available. Please send resume to cmedders@atlanticpodiatry.com

ASSOCIATE POSITION – PHILADELPHIA SUBURBS

Seeking an outstanding, highly motivated candidate with top-notch personal, clinical and surgical skills and training to joint established & highly esteemed diverse practice. Full privileges available for entire podiatric spectrum of practice. Great opportunity with long term career potential. Respond with Resume, Photo, C.V. and references to footandankle22@aol.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

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- SUBURBAN PHILADELPHIA

Full time, PSR 24-36 month trained podiatrist needed for busy suburban Philadelphia group practice. Multidimensional, multi-office group treating a wide range of patients including forefoot, rearfoot & ankle surgery, diabetic wound care, sports medicine, and workrelated injuries. Office & diagnostic equipment state-of-the-art. Full benefit package included with bonus incentive. Position available starting July, 2013 excellent opportunity leading to partnership. Please email to: bailliemw@gmail

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.

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 - 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/PARTNERSHIP MIAMI/KENDALL FLORIDA

Podiatrist with interest in foot and ankle surgery and comprehensive foot and ankle care. Pathway to partnership/ownership available. Send CV and information: ibaumdpm@bellsouth.net

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.

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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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