The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

March 28, 2011 #4,119 Publisher-Barry Block, DPM, JD

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Correction

The correct photo of Dr. Billie Bondar from the story that appeared in the March 25th issue of PM News can be found below. 

Dr. Billie Bondar

We apologize for this error.

Exercises Can Strengthen Feet and Toes: TN Podiatrist

Narrow shoes have your toes in a bunch? “You can do exercises to help strengthen the toes,” said Dr. Nathan Lucas, Memphis-based podiatrist who created Pretty Toes Fade-n-Cover along with his wife, a licensed aesthetician. Dr. Lucas advised trying to pick up marbles or grasping towels with your toes to strengthen your toe muscles.

Dr. Nathan Lucas

We often see women who wear high heels who have what we call tight heel cords,” said Dr. Lucas. “The higher the heel, the shorter the heel cord [Achilles tendon], so you want to do heel exercises to help stretch out the heel cord.” To do so, lean forward against a wall while putting one leg behind you, then pushing your heel down toward the ground.

Source: Jan F. Lee, S2S Magazine [3/27/11]

GA Podiatrist Appointed Medical Director for Physical Therapy Group

Pro Therapy recently appointed podiatrist, Dr. Mark Snyder, to serve in the position of medical director for 2011. The physical therapy group based in Cumming has multiple locations in northeast Georgia. Dr. Snyder's responsibilities will include monthly chart reviews and providing medical advice regardiing foot and ankle treatment plans as needed. 

Dr. Mark Snyder

Dr. Snyder is a podiatrist with Village Podiatry Centers. He is a graduate of Georgia Southern University with a BS in Biology. He obtained his doctorate in podiatric medicine from Temple University in Philadelphia. Dr. Snyder's three-year surgical residency was completed at The Crozer Keystone Health System in Philadelphia. He furthered his training as a foot and ankle surgeon at the Rubin Institute for Advanced Orthopedics at Sinai Hospital in Baltimore, where he was trained in techniques of external fixation for complex foot deformities along with Ponseti casting technique for clubfoot correction.

OK Podiatrist to be Honored as Panhellenic Woman of the Year

Dr. Maureen Lee Crotty is among eighteen area women who will be honored as Women of the Year when the Tulsa Area Alumnae Panhellenic holds its "Greek Women: A Sisterhood of Life Loyal Friends", held at the Tulsa Country Club. The women, most of whom have been active in their sorority alumnae chapter, will be recognized for their leadership and contributions to the community. Honorees include career professionals, philanthropists and long-time volunteers. 

Dr. Maureen Lee Crotty

Dr. Crotty has been owner of Green Country Podiatry for 28 years. Dr. Crotty received her DPM degree at the Illinois College of Podiatric Medicine in Chicago, IL. She completed her residency training in podiatric medicine at Podiatric Medical and Surgical in Pittsburg, Pennsylvania. She is board certified in podiatry and podiatric surgery. 
 
Source: Danna Sue Walker. Tulsa Word [3/26/11]

Medicare Panel Recommends 1% Physician Pay Boost in 2012

Lawmakers should increase Medicare payment rates to physicians and prevent a massive across-the-board cut set for 2012, the Medicare Payment Advisory Commission recommended in its annual March report to Congress. The commission suggested a 1% increase in doctor pay in place of the scheduled reduction. The report was released March 15, days after the Centers for Medicare & Medicaid Services projected that doctor pay faces a 29.5% cut next year under the sustainable growth rate formula.

The MedPAC recommendation is not binding on Congress, although lawmakers sometimes use the advice as a starting point for congressional negotiations on preventing upcoming pay cuts. The 2012 reduction is the largest that physicians have faced to date.

Source: Charles Fiegl, AM News [3/21/11]

Plan Now for a Relaxing Getaway

Now that spring has arrived, look ahead and start planning to take some time off before summer’s end. Thinking about a vacation is a practical tactic to relieve stress, and putting dates on your calendar now ensures that you will be able to take the time you need. Use these guidelines to plan your vacation:

• Plan for at least seven days. You need that much time to travel, unplug, and relax.
• List what you will leave behind. Most people list the things they want to bring with them: passports, swimsuits, currency. Form a new habit, and list the things you definitely do not want to take, including certain electronic devices and work-related materials.
• Consider leaving your cell phone. If you cannot bear to be out of contact, make clear that you do not want others to contact you except in cases of true emergency. Provide the names of people whom co-workers can turn to in your absence.
• Pack plenty of books and magazines — just make sure that you are reading for pleasure and not for work. Accept the vacation for what it is, a chance to recharge, and give yourself permission to do just that.

Source: Adapted from Tips for Handling Everyday Stress, Michael Carney and Heather Hutchins, Global Professional Publishing via Communication Briefings

RE: Enrollment Fees for DME Suppliers
From: Paul Kesselman, DPM

CMS, in its infinite wisdom, is now charging an enrollment fee of $505 for ALL DME suppliers, including physicians. An excerpt from the announcment reads: ”Note that a physician, non- physician practitioner, physician group, or non- physician practitioner group that is enrolling as a DMEPOS supplier via the CMS-855S application must pay the required application fee."

This fee does not differentiate between physicians who only dispense to their own patients and those who own DME companies which are open to the public. The National Supplier Clearinghouse has said that all suppliers must pay this amount.

Does CMS really believe that a DME supplier (who is not exempt from paying thousands of dollars per year for accreditation)  is going to sneeze at paying $505 for enrollment? Will the extra $505 over three years really keep nefarious elements from enrolling as suppliers? I urge every podiatrist to speak with professional colleagues in other professions (e.g., MD/DO, optometry, PT) who dispense DME to their own patients to discuss this matter. Ask them to report this to their professional associations.

I’m a bit leery now of: As goes Medicare so goes the other carriers.

Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net

RE: Obesity and Foot Pain (Scott Shields, DPM)
From: Evan F. Meltzer, DPM, Jeffrey Kass, DPM

I practice in the most obese state in the U.S. Many of your patients are mirror images of mine. In my opinion, we have a responsibility to explain the causes of foot pathology to our patients when we know them. Educating your patients about the adverse effects of excess gravity on the foot structures is the same as teaching them about any other podiatric pathology.

I do not recall ever offending anyone by respectfully explaining the effects of obesity on the foot. If you document this discussion, I believe you have performed your due diligence in this matter.  You can certainly offer to refer the interested patient for nutritional counseling or to a weight loss center. What patients choose to do with this information is their choice. As my wise wife once said, “You can’t save people from themselves.”

Evan F. Meltzer, DPM, Jackson, MS, Evan.Meltzer@va.gov

Dr. Shields, of course obesity should be addressed. Whether or not patients follow your advice or recommendations is another story. I find a number of my diabetic patients exhibit passive-aggressive behavior. They come in for treatment only when their foot is about to fall off...and the behavior gets repeated after one amputation. As a doctor, you can inform your patients of their conditions, possible etiologies, and associated co-morbid factors. You can make recommendations, give referrals, etc.; that is your job.

Obviously you don't want to offend your patient - so find a way to be tactful about it. Obesity is definitely a problem that causes many foot-associated ailments and hence should be documented.
 
Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com  

RE: Podiatrists And All Health Care Professionals are Advised to have a TDAP Vaccination (Elliot Udell, DPM)
From: Joe Agostinelli, DPM
 
I just had my yearly physical examination at Eglin AFB,FL and was due for the "ten year" tetanus-booster immunization. Now, that booster is the TDAP vaccine. In the past, for my age group of age 56, we have had "DPT" vaccines that included the pertussis protection. The resurgence of pertussis, according to our infectious disease specialists, is that over the past several decades, there had been a lack of public health awareness that the diseases that we have vaccinations for are not de-activated; they are still prevalent. The military does a really good job of ensuring that we have had the required vaccinations. They also vaccinate our military members when they deploy to other parts of the world where many of the diseases we do not worry about in the U.S. are still present and deadly. However, do not panic, check with your healthcare providers as to what vaccination you need/should receive/and really do not need.

In the 1950's, with the polio vaccinations of Salk and Sabin, and the small pox vaccinations, we all received when our generation started grammar school, there was better public awareness than with our younger parents concerning vaccinations due to political correctness, religious beliefs, economic disparity, vaccination "scares" from a small breakout of a disease, etc. The public health system in this country needs to ensure that our kids and we adults also receive the proper information and receive the vaccines we still need to protect our population.
 
Joe Agostinelli, DPM, Niceville, FL, jmpa21@cox.net

RE: Dizziness from Urea Cream? (David Weiss, DPM)
From: Albert Nejat, DPM

I believe the package insert warning on dizziness and urea pertains more to blood levels of urea, such as cases of renal failure and elevated BUN. As the kidneys fail and urea levels increase, dizziness and feelings of euphoria are common (the pre-dialysis euphoria). But when dialysis has been done, you can note that some of your patients will complain of feeling like "s**t".

So, if you are concerned that topical urea will affect blood urea level, by all means discontinue the use of urea cream. Better yet, refer them to have a renal work-up.
 
Albert Nejat, DPM, Los Angeles, CA, TheDoctor@AlbertNejat.com

RE: 1947 Flatfoot Surgery
From: Tip Sullivan, DPM

I do quite a number of flat foot repairs and have been doing them for 21 years. I have a few that I have seen for >10 years, but most get lost to follow-up. I had a patient yesterday, mid 80s, still active who came in for nail problems. As I did my exam, I noticed surgical incisions and inquired as to their origin.  HIs answer was, "Oh yea, I forgot about that. When I was a kid, I had flat feet and the doctors said I needed surgery. My parents took me to New York and the doctors said that there was an orthopedist in Jackson (where I practice) who could fix me" So, in 1947, this guy had a flat foot procedure done (on both feet) by a local general orthopedist (now deceased) who started one of the big ortho groups here that is still here. This old man's foot looked great! (with the only structural problem a callus under his right 1st MTPJ).

I did a complimentary "C" arm evaluation for the sake of curiosity. Both sides look like...

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

RE: IPad and MDLogic
From: Michael Chin, DPM

I  made the leap to converting my EMR to MDLogic almost three years ago in hopes of reducing the paper load, charting time, and billing inefficiencies in my office. It worked. Now, with the iPad 2, the interface is fast and accurate. Patients and staff love the tech advances in my office. I'm not usually one to spout praises, but I really can say that this was an worthwhile investment.

Michael Chin, DPM

Disclaimer: I have no conflicts or financial gain in discussing this product.

Michael J. Chin, DPM, Chicago, IL, mchin88@mac.com

ASSOCIATE POSITION - CT - (FAIRFIELD AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info, http://podiatrym.com/go.cfm?n=655. Send resume to Dr.Kassaris@yahoo.com

POSITION AVAILABLE – PHOENIX, ARIZONA

Full-time or part-time position available for an associate to join a modern, well established practice. Needed is a motivated, hard-working, well-rounded, surgically-trained podiatrist to complement our office. Excellent income potential with possible partnership opportunity available. Arizona license required. Email CV to Foot.doctor@hushmail.com

ASSOCIATE POSITIONS - NW INDIANA, CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

ASSOCIATE POSITION - MARYLAND

Associate position for  podiatry office on Maryland’s Eastern Shore. Certified ambulatory surgery center on-site. Please fax letter and CV to 410-749-6807.

ASSOCIATE POSITION - EAST TEXAS, DELAWARE

Looking for podiatrist to see patients in Nursing Home Facilities in East Texas and Delaware. AVAILABLE IMMEDIATELY.  Please contact me at doconcall@aol.com.

POSITION AVAILABLE – NEW YORK
 
Well-established, multi-doctor podiatry practice with offices in Putnam and Westchester counties. Compensation based on productivity. Excellent opportunity for recent residency graduate to build skills and learn practice management. Full-time preferred but right part-time candidate will be considered. Email cover letter and CV to: Podiatry2011@gmail.com

ASSOCIATE POSITION - TEXAS

Are you looking for a busy, well-rounded practice experience?" Group practice in DFW area looking for a 3-year surgically-trained associate with a sports medicine background. Needs to be as comfortable making orthotics as fixing a complex flat foot. Email CV to crane@faant.com

ASSOCIATE POSITION - NYC, NY

ASSOCIATE POSITIONS – MARYLAND

Are you motivated, personable and enjoy working with the elderly? We are offering full or part-time positions in Maryland. Our group, Podiatry Management Services, provides care to the elderly in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your c.v. to drhprosen@verizon.net or fax to 410-486-2049 or call Dr. Herbert Rosen at 410-580-0255.

EQUIPMENT FOR SALE - DOPPLER, SURGICAL INSTRUMENTS

Koven Technology Smartdop 45 hand-held bi-directional vascular ultrasound Doppler with real-time waveform LCD - like new in carry case. all attachments for ABI and Digital PPG & PVR. AC charger and computer cords included. Also available are surgical hand instruments, rasps, Weitlanders, stats, needle holders, retractors, and more. Email. Podassociate@aol.com

EQUIPMENT FOR SALE -  SONOACE ULTRASOUND

2007 Sonoace, Pico color ultrasound image, Medison, MY202C MAI, 7.5 mhz small head, hl59edn, 40 mm, 4 modes - 2d, Doppler, 3-D, and multi-image. $9,800 or best offer. Just finished servicing by Universal, includes Sony black and white printer. Charles W. Kelley III, DPM cwkell@aol.com

EQUIPMENT FOR SALE - COOL TOUCH LASER
 
Cool Breeze Cool Touch CT3 plus laser used for ugly, unsightly, toe nail infections. Less than six months old. Great price won't last long. Considering a laser? We also have the Q- Clear Q- switch laser too. This laser is perfect for you. Also a used Lumix 2 laser, best price today   Dr. Zuckerman is in the Fort Lauderdale area and will demo this lasers on your patients. E-mail footcare@comcast.net

PRACTICE FOR SALE - WASHINGTON STATE - SUBURBAN SEATTLE

16 year established part time practice. Includes Midmark 417 (4 position keypad), Excel X-ray, processor, Ritter M9, instruments, bandaids, etc. 1 Day/week $50K gross. Professional Business appraisal at $48K. Asking $35K. Shared office with 2 FP's. Easily expandable. Reply: practiceforsale18@yahoo.com

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Great opportunity. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K. dpmpracticeforsale@yahoo.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. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

PM News Classified Ads Reach over 12,500 DPM's 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 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 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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