The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

March 21, 2013 #4,721 Publisher-Barry Block, DPM, JD

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LA Podiatrist Discusses Bunions

Every day, our feet take a pounding. Podiatrist, Dr. Vernon Garber with Garber Foot and Ankle Center, says your whole foot is susceptible to conditions such as bunions that can stop you in your tracks. "A bunion is an enlargement of both the soft tissue and bone near the big toe joint," said Dr. Garber, "it can cause pain when the shoe rubs up against the area."

Dr. Vernon Garber

Bunions go hand-in-hand with high heels and heredity. Severe cases need surgery, but oftentimes the right shoe can fix it. Dr. Garber said, "{it's important} that you don't have a lot of impingement, because that can cause a lot of problems."

Source: Britney Glaser, KPLC-TV [3/14/13]

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. Straw polls are not scientific and do not represent standards of care.

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

Global Podiatry Leaders Meet in DC for APMA HOD

Global podiatry leaders gathered in Washington, DC to celebrate the installation of APMA President Dr. Matthew Garoufalis at the American Podiatric Medical Association's House of Delegates. FIP President Dr. Joseph Caporusso and FIP Chief Executive Officer, Dr. Robert Chelin attended the meeting.

(L-R) Neil Simonette, Drs. Robert Chelin and Matt Garoufalis, Alison Wishart, Drs. Joseph Stern and Joseph Caporusso.

Dr. Joseph Stern, President of the Canadian Podiatric Medical Association, and Alison Wishart, Chairman of the Society of Chiropodists and Podiatrists of the United Kingdom, addressed the APMA HOD, wishing Dr. Garoufalis much success in his presidency, and offering any support and consultation that they could provide. Also in attendance was Neil Simonette from the United Kingdom, Chair of the FIP European Council of Podiatrists (ECP).

Aussie Podiatrist Educates the Public About Foot Health

Good foot healthcare has been a lifetime career for Jan Johnston, who has always believed there was a great need to look after the health of people's feet by diagnosing, treating, and preventing foot abnormalities, and by educating the public about good foot health.

Jan Johnston

Jan began her training straight after school, studying for a diploma through the London College of Chiropody. When qualified in 1976, she began practicing part-time and continued during her marriage while raising three children. Like all podiatrists, Jan specializes in providing comfort and pain-free feet.

Tanya Easterby, Gympie Times [3/19/13]

Smart Sox Can Prevent Ulcers in Diabetics: AZ Podiatrist

It might seem hard to believe, but a sock could change the lives of people with diabetes. Some of those experts at the University of Arizona are in the process of helping to produce and test the Smart Sox. It's made with what's called intelligent textiles. It's not thread, but fiber optics. There are sensors inside the sock too. Dr. David Armstrong says UA researchers are interested in measuring how people move through the world, while working to heal them and keep them healed. It's expected that Smart Sox will give doctors the information they need to do both. This is a collaboration involving doctors, researchers, engineers, and patients.

Dr. David Armstrong

Armstrong says the Smart Sox and other similar technology will help doctors decide which treatment is best, and even help them dose physical activity like they dose medicine. "Too high, that's bad. Maybe you'll get a wound. Too low and you don't get all the benefits, the anti-diabetes benefits of being active. So there's that sweet spot," Armstrong says.
 
Source: Barbara Grijalva, Tucson News Now [3/19/13]

New OR Law Offers Med-Mal Alternative

In another display of bipartisan healthcare reform, Oregon Gov. John Kitzhaber signed a bill Monday that creates a process in which adverse healthcare incidents can be resolved without patients and providers going to court. The bill was approved by a 26-3 vote in the state Senate on March 5, and was then passed 55-1 by the state House of Representatives on March 12.

A summary on the Oregon Legislature website notes that prison inmates are exempt from the new law and, even if patients participate in the disclose-and-offer process, it “does not preclude a negligence claim in court.”

Source: Andis Robeznieks, Modern Healthcare [3/19/13]

Query: Drug-Seeking Patients

A patient presents with a complaint of a painful (foot/bunion/heel, etc.). After a history and physical, a diagnosis and treatment plan is presented. Then the question!, "Doctor, what can I do for this pain? I took some Percocets my wife had from a dental procedure which helped a lot. Could I get some of those to tide me over?"

I refuse to do pain management. I refer them back to primary care if I think they are drug-seeking.  Post-op patients may be an even larger challenge if they are looking for meds months after a procedure has healed. What do others do in this uncomfortable situation?

Bruce Lebowitz, DPM, Baltimore, MD

RE: 104 Applicants Not Matched for Residency Positions
From: (Kyle Duncan, David Applegate, Byron Peck-Collier), Richard Simmons, DPM

With the announcement yesterday that this year’s match will leave 104 qualified applicants without a residency position, it may be time for the field of podiatry to take a look at its collective self in the mirror. In times like this, it’s easy to quickly point fingers in an attempt to blame. This letter, unlike the many that will undoubtedly be received in response to this crisis by the editor of PM News, will point no fingers.

Yes, a large number of qualified students will not be receiving a residency program this year. Yes, there are things that we could have all done differently; but...

Editor's note: The complete text of this letter can be read by clicking here.

This is a very sad commentary for our entire profession.

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

RE: 104 Applicants Not Matched for Residency Positions
From: Brian Kashan, DPM, Robert Scott Steinberg, DPM

I awoke this morning and read my daily PM News, only to see that 104 of our students will not be getting residencies. My blood pressure immediately rose, and I started my day off badly. How can this happen? The excuses that more people passed the Boards, and the first graduating class of a new school added to the numbers are ridiculous! When we open a school, it should be based on need. I have seen many postings debating whether another podiatry school was even needed. I guess we now know the answer to that.

Blaming more students passing the boards is equally ridiculous. Aren’t they supposed to pass the boards? Isn’t that the goal? If anyone fails...

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

If this isn't a time for "finger pointing", then maybe it's time for toe pointing. This problem lies at the feet of the AACPM and CPME. They were supposed to be the profession's forward thinkers. Both knew there is a residency slot ceiling, yet they continue to push for larger class sizes. This is dishonest to the students who are graduating with huge school debt. Now there are 104 of them in a sheer state of panic. Preceptorships are NOT the answer.

Robert Scott Steinberg, DPM, Schaumburg, IL, Doc@FootSportsDoc.com

RE: Long-Term Pain, Right Foot (Edmond F. Mertzenich, DPM, MBA)
From: Gary W. Docks, DPM

The main question is: where did the dislocated talo-navicular joint come from? The history of second degree burns does not seem germane at all, only misleading. Is there any history of antecedent trauma? Does he have any neurologic symptoms such as a steppage gait? My gut tells me that this might be the beginning of CMT (Charcot Marie Tooth). I do feel, however, that his current symptoms are a direct result of the dislocation at the T-N Joint.

A CT Scan or MRI might be helpful to ascertain the true extent of the dislocation and any other damage to the subtalar joint. Assuming the talo-calcaneal joint is intact, I would quit looking for zebras at a cattle ranch and perform an isolated talo-navicular fusion. Nothing short of a fusion will reduce his symptoms. If, however, CMT becomes the diagnosis, then don't pass go and go directly to a triple arthrodesis.

Gary W. Docks, DPM, Beverly Hills MI, gwdocks@aol.com

RE: Suggestions for Painful Bunion (Tip Sullivan, DPM)
From: Richard Gosnay, DPM

This patient has hypermobility of the first metatarsal-cuneiform joint. That fact, alone, makes the Lapidus procedure most appropriate for her. Failure to address the hypermobile joint will make the correction likely to fail over the next several years.

I do not think that we are best served by being fixated on inter-metatarsal angles. In this particular case, placement of the first metatarsal head over the sesamoids, along with resection of the hypertrophic medial eminence, will restore first ray function and drastically eliminate the deformity.

I am concerned with the track-bound first MTPJ with mild crepitus, which suggests that some adaptive changes have occurred. It may be necessary to carefully free the sesamoids with a McGlamry elevator and perform a distal osteotomy to keep the hallux from undermining the second toe once the first metatarsal has been aligned with the Lapidus procedure.

Richard Gosnay, DPM, Danbury, CT, glabroushead@gmail.com

RE: The Passing of Jack Morris, DPM

It is so sad to hear of the passing of Jack Morris. He was my professor and friend. He taught me much about biomechanics, and was very kind to me while I was a student and resident. The world has lost a kind person and brilliant mind. My condolences to his wife Joni and his colleagues, friends, and family who will surely miss him.

Estelle Albright, DPM, Indianapolis, IN

I first met Jack in 1968, and we became close classmate friends at CCPM. Seeing the news of his passing is indeed heartbreaking. He had a beautiful practical medical mind, and was often consulted on difficult cases including interpretation of lab results by both podiatrists and medical doctors. He was gifted, and upon graduation went confidently directly into practice  in Yakima, Washington. My wife Bea and I visited there in 1970 and were impressed with his status in the medical community. I know Jack is now a podiatric medical consultant in heaven. And, of course, I will always remember his colorful language.(bleeps) We will miss you Jack.

Stanton C. Southward, DPM, Colorado Springs, CO

RE: Strangest Orthotics Ever

Just when I thought I had seen most orthotic designs, a patient came in with these. The patient is to turn the screw 1 complete turn per year, which will "increase her arch height." This metal lever bends the forefoot and rear foot.

Screwed Up Orthotics

These are paper thin, and the patient weighs 280 pounds. She states the metal screw assembly hurts her arch. She has a rigid pes planus foot, and has been using this design for 10 years. She claims they are not working!
 
Hartley Miltchin, DPM, Toronto, Canada

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 - 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 - 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

ASSOCIATE POSITION - VICTORIA, B.C. CANADA

Beautiful Victoria, B.C. Canada on the ocean, fast growing area. Associate for multi-office full scope practice. Reply to dr.cole@shaw.ca

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 - 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 join 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

PODIATRY OFFICE FOR LEASE (PART-TIME) - MANHASSET, NY

Podiatry office available for part-time sub-lease in Manhasset, Long Island. Available Tues, Thurs, Sat. Adjacent to L.I.E. and North Shore Hospital. Contact Holfoot153@aol.com for appointment.

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

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

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

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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