The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

March 23, 2007 #2,841 Editor-Barry Block, DPM, JD

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Change in Heel Height Can Cause Foot Pain: NC Podiatrist

Foot and ankle problems are caused as much by the activity and environment of the individual as by the shoe, according to Dr. Rodney Fitzhugh. Fitzhugh, a podiatrist with the Foot and Ankle Associates of North Carolina, said that high-heeled shoes and flip-flops are the two main culprits of most foot injuries. High-heeled shoes lead to foot and ankle injuries because they exacerbate foot deformities, he said. If the shoes are too tight, they can cause bunions or microtrauma to the toenails.

Dr. Rodney Fitzhugh

Heel height is another factor in causing pain throughout an individual's legs. A heel above 3 inches puts seven times the amount of pressure on the ball of the foot, according to a study by the American Podiatric Medical Association. Drastic changes in heel height can cause pain because the body cannot adapt as quickly as the shoes can change, according to Fitzhugh.

"Young women should know that if they change their shoe to a flat that their heel, their leg, their foot is going to start hurting because the muscles and everything else now is stretched," Fitzhugh said. "You've now changed the position of the leg and the foot from being on a hill to now bringing the heel down to the ground."

Source: Harry Hoover, NC State College News [3/20/07]

New APMA President “Just Trying to Make My Profession Better”

Dr. Christian Robertozzi has been interested in medicine nearly all his life. At 14 he began working for a hospital and noticed, in the 1960s and early 1970s, there were not a lot of doctors of podiatry. At the same time, he began accompanying his parents to their podiatrist appointments. He became more interested in the field and began spending additional time with the foot doctors. "I fell in love with the profession," he said.

Dr. Christian Robertozzi

Sunday, March 25, Robertozzi, will be in Washington, D.C. to begin his year-long reign as the newly elected president of the American Podiatric Medical Association (APMA). Robertozzi ran for president of the organization because "I'm just trying to make my profession better," he said. Some of his responsibilities as president will include working with other APMA members to help resolve their issues and also to maintain relationships with the American Medical Association (AMA).

Robertozzi enjoys being a podiatrist and the satisfaction he gets when he helps his patients with their foot ailments. "People feel better when they leave," he said. Robertozzi received his undergraduate degree in biology from Seton Hall University, his Doctor of Podiatric Medicine from the California College of Podiatric Medicine and did his residency at Huntington General Hospital in Boston. He was also a clinical instructor of surgery at the University of Medicine and Dentistry of New Jersey.

Source: Roberta Fugate, New Jersey Herald [3/20/07]

Region B Offers New On-Line Error Prevention Tool

Suppliers in DMERC Region B may now sign up for a new on-line tool available from Administar. This feature will provide providers and suppliers with the ability to avoid claims processing errors in the first place. It will also provide you with a statistical analysis of errors both you and your peer groups have made for specific HCPCS codes.

Other features which previously were only available to the Provider Education Council will also soon be available. Sign up is free and a password will be issued. All this can be done in less than one minute by accessing the on line sign up browser at:
https://www.adminastar.com/Providers/ProviderReports/secure/enrollment.cfm

Source: Jurisdiction B DME MAC via Paul Kesselman, DPM

Massachusetts Establishes Minimum Coverage Requirements

The Massachusetts Commonwealth Health Insurance Connector Authority on Tuesday approved minimum coverage requirements for health insurance plans to comply with the state's universal coverage law, including requiring prescription drug coverage, the New York Times reports. The requirements, which are subject to final approval in June, would make Massachusetts the first state in the U.S. to establish standards for its residents and insurers.

Under the state's health insurance law, all residents must obtain health care coverage or face tax penalties. The board on Tuesday agreed to phase in some of its requirements to allow residents and employers an additional 18 months to buy health plans that meet the new criteria. Residents will need to have some level of coverage by July 1 but will not have to meet the required level of coverage until January 2009.

The board also agreed to place a maximum deductible of $2,000 on individual plans and a $5,000 annual limit on out-of-pocket spending if beneficiaries use health care providers within an insurer's network. The minimum standards would require all plans to include prescription drug coverage and allow plans to charge beneficiaries an additional deductible for drugs of up to $250 for individuals.

Source: Pam Belluck, The New York Times via American Health Line [3/21/07]

Query: Mitek Anchor Removal

Today, I tried to remove a Mitek anchor (G2) without success. Does anyone have any experience removing them? It would seem that Mitek should have an extractor for them. Please respond if you have any worthwhile information.

Joseph Borreggine, DPM, Charleston, IL

RE: ACFAS Meeting
From: Howard Zlotoff, DPM

I want to congratulate the ACFAS who have produced another remarkable quality program this year. Those of us that remember the early attempts to "raise the bar" with credible speakers and relevant topics can celebrate this year's success as proof that the ACFAS represents competent and well educated foot and ankle surgeons.

Evidence-based medical care is more than a buzz word now and the public will be well served as our members use their knowledge and skills to deliver quality care. So, congratulations to the College members and staff on a highly successful program that we can all hold out to the medical community reflecting our profession in such a positive light. I strongly encourage those who did not attend this year to make every effort to sign up for next year's meeting and take advantage of this educational experience and the opportunity to visit the exhibit hall and get exposed to the latest technology available to our profession.

Howard Zlotoff, DPM, Camp Hill, PA

RE: Woman Grows Nipple on Foot
From: Al Kline, DPM

I was amused to see your post of the pseudomamma of the foot. This case presentation was highlighted in “The Foot Blog” in December 2006.

http://thefootblog.wordpress.com/2006/12/17/this-week-5/

I believe this is the only reported case of this condition on the bottom of the foot. The article is worth a second read.

Al Kline, DPM, Corpus Christi, TX, al@kline.net

RE: Microvas (Palmer Branch, DPM)
From: Elliot Udell, DPM, Scott Knutson, DPM

Dr. Branch calls attention to a very important issue when he points out that the company in question cannot supply him with many, if any, solid research studies supporting the efficacy of their modality. In more than a quarter of century of practice I have been burnt and witnessed colleagues being financially harmed when companies sold us expensive physical medicine or diagnostic modalities with weak studies to support their efficacy. All of these modalities were heavily promoted at conventions, professional journal ads and office to office marketing.

I remember buying a small hand-held physical therapy modality when I first opened my practice. A year later, I received a letter from the FDA saying they reassessed it, found that it did not live up to its expectations and is now rendered illegal to use. I had to throw it out and the company went out of business. There have been diagnostic devices that many of us have invested lots of hard-earned money into buying only to find that after a year or two the company stopped supporting the device and no longer supplied essential day-to-day parts for it.

I personally have no experience with Microvas and I hope that this product does not follow any of the scenarios described above, but with any of these modalities, the level of research supporting them as well as wide scale usage by a cross-section of the entire medical profession may indicate how well and how long it will be received by both doctors as wells as the insurance industry. Being first online to invest in an expensive new modality can be helpful to our patients, but can also be a costly error.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

We had a bad experience with the company. They let us "try" the machine as we did not want to purchase it without proof of efficacy. We tried it on five patients with neuropathy and found no significant improvement. The $15,000 machine malfunctioned after about four weeks.

Sadly, when we told them to pick up the machine as we were not interested, they tried to say that we had purchased the machine and billed us for it. We found them very arrogant, hard to deal with and unprofessional considering the machine broke and didn't come close to the claims they made on neuropathy.

Scott Knutson, DPM, Albert Lea, MN, Drsknutson@aol.com

Editor’s Note: This topic is now closed

ASSOCIATE POSITION – CENTRAL NEW JERSEY

Associate Wanted....For well established Central Jersey practice, diversified in all aspects of podiatric medicine and surgery. I am looking for a highly motivated, conscientious, individual with strong work ethics. My practice may offer great potential for the right person. Minimum PSR 24. Please reply to Jerseypod@gmail.com

ASSOCIATE POSITION – HOUSTON, TEXAS

Lepow Podiatric Medical Associates looking for board certified podiatrist to join their six location group practice in Houston. Competitive salary and benefits. Email CV to lepowft@cs.com

SEEKING RESIDENT FOR PSR-24 POSITION: BALTIMORE, MD

Mercy Medical Center Position for a highly motivated individual with completed non-surgical residency or one desiring additional surgical training in well-established Podiatric Residency Program. Busy metropolitan hospital with high surgical numbers and inpatient care. Resident is integral member of multidisciplinary team. Begins mid June 2007. Includes competitive salary/benefits. Send inquiries to rsher18@yahoo.com

ASSOCIATE POSITION AVAILABLE - OCEAN COUNTY, NEW JERSEY

Immediate position available. 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

PRACTICE FOR SALE SAN 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 - SANTA FE, NM

Established, 30 year practice with multiple office locations looking for a PSR 24/36 trained, hardworking, personable, ethical, highly motivated individual for associate position with immediate partnership available. E-mail CV and reference letters to sfpodiatry@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

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

ASSOCIATE POSITION SE MICHIGAN DETROIT SUBURBAN PRACTICE

Busy podiatry group looking for associate interested in future partnership. We have a progressive team-orientated practice. Well-established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a surgical center. New third office being developed on hospital campus. Must be BQ/BC. Minimum PSR/24. Competitive salary and benefits. E-mail CV to jeffsz@msn.com

PODIATRY OFFICE FOR RENT – TUCSON, AZ

Shared space with podiatrist signage already in place for ten years. X-ray, processor, and all furnishings in place. Put your chair in and open for business. Contact Dr. Parks at 520-544-2445 or e-mail parksovc@aol.com

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 - 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 WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City. Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

PRACTICE FOR SALE - BUFFALO, NY

Part Time Practice with full growth potential. Mi of conservative, biomechanics and diabetic foot care. Great surgical potential. Gross 180K. Willing to stay through transition. Call 716-836-8123.

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