The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

March 29, 2011 #4,120 Publisher-Barry Block, DPM, JD

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Stretching Calf and Achilles Tendon Can Prevent Heel Spurs: NY Podiatrist

Stretching your calf and Achilles tendon can prevent heel spurs, said Dr. Jean Archer of Eden Spa Foot Care in New York. “It helps to stretch the ligaments and the muscles in the bottom of the foot, and by [the calf and Achilles tendon] being more flexible, they’re less likely to be strained or cause strain to surrounding structures in that area,” she said.

Dr. Jean Archer

First, sit on the floor with your legs straight out in front of you. Loop a towel around your feet so that when you pull the towel toward your body, you feel the stretch in your calf muscles. Hold for 30-second intervals and then rest. Repeat until you feel nice and flexible.

Source: Jan F. Lee, S2SMagazine, [3/25/11]

OR Podiatrist Favors "Less is More" Approach to Running Shoes

Dr. Ray McLanahan of the Northwest Foot and Ankle Clinic suggests setting aside the thickly cushioned, anti-roll shoes and trying something lighter. The less-is-more approach has yet to enter the podiatric mainstream, he said. "It's mostly patients coming in and asking for it," especially after reading Christopher McDougall's Born to Run. The recent best-seller describes "ultrarunners" like Mexico's Tarahumara Indians, who jog hundreds of miles in sandals made from old car tires. 

Dr. Ray McLanahan

Still, the professional podiatric community clings to the idea of arch support, even though a lifetime of it may actually weaken the arches, like a cast worn too long. "It doesn't really make much sense, when you think about it," McLanahan said.

Source: Julian Smith, The Oregonian [3/27/11]

Meaningful-use Attestation Starts April 18

The window opens April 18 for eligible professionals, hospitals and critical-access facilities to line up and attest that they've met their respective meaningful-use criteria and are eligible to receive Medicare incentive payments for the installation and use of electronic health-record systems under the American Recovery and Reinvestment Act of 2009.

During this first year of the Medicare program, both eligible professionals and hospitals must attest that they've met the criteria for 90 consecutive days. Registration opened in January for both eligible professionals and hospitals for the Medicare EHR incentive program.

Source: Joseph Conn, IT Strategist [3/28/11]

DFCon 2011 Marks Record Attendance

The Diabetic Foot Global Conference (DFCon) in California concluded on Saturday, March 26, 2011 as nearly 1,000 attendees from all 50 states and 50 countries travel back to their clinics to implement new strategies to prevent diabetes-related amputations. The faculty was as diverse as the audience presenting new information on topics like vascular disease, foot infections, reconstruction, and chronic wounds. Workshops gave participants hands-on experience with all sorts of new tools that can be used to treat wounds and vascular disease. 

(L-R) Dr. Joseph L. Mills receives Award from Edward James Olmos.

The conference is the setting for the annual Edward James Olmos Award for Advocacy in Preventing Amputations in Diabetes.  The 2011 award recipient was Joseph L.R. Mills, Sr., MD, a vascular surgeon from the University of Arizona in Tucson, Arizona. Preparations are underway for DFCon 2012, which will mark the 10th anniversary of the premier meeting.

Editor's Note:  PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: What have you noticed about different casting techniques when you teach students? 

Dr. Beth Jarrett

Beth Jarrett: Teaching the neutral position of weight-bearing is not an easy thing to do. I think that in terms of getting students to understand foot position, when they actually can hold the plaster cast in their hands and see what the foot looks like, it works much better. In terms of casting and comfort and reduction in symptoms, there was actually a study done probably 15 years ago or so. They compared an orthosis made with the pressure weight-bearing cast to an orthosis made with a neutral position off-weightbearing cast orthotic. Initially, the partial weight-bearing cast orthosis was more comfortable, but down the road, the off-weight-bearing neutral position cast orthosis turned out to be more comfortable and provided better relief of the symptoms. 

Dr. Alan Catanzariti

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). The next segment  will feature Dr. Alan Catanzariti, Director of Podiatric Residency Training at The Western Pennsylvania Hospital. You can register for this event by clicking here

Two Kinds of Feedback Keep Staff on Track

Giving feedback is important. Giving the right kind of feedback is even more important. Make sure that you tell employees when they:

• Meet or exceed expectations. Tell them that they are on course. Let them know what they did right and encourage them to do it again.
• Fail to meet expectations. Let them know that they are off course. Lead them to decide what they need to do to restore positive progress.

Bottom line: Employees want and need direction. Like flying a plane or driving a car, maintaining course requires constant small adjustments.

Source:  Adapted from “Real-Time Performance Reviews,” Jim Whitt, Purpose Unlimited via Communication Briefings

Query: Basic Website Cost

I am embarrassed to say that I do not have a website yet for my office. I finally got on the stick and started contacting various companies who do medical and podiatry websites. What should I reasonably expect to pay for a good, clean basic website for my office?

Thomas E. Silver, DPM, Golden Valley, MN

RE: Obesity and Foot Pain (Juliet Burk, DPM)
From: Jon Purdy, DPM

I must take exception with Dr. Burk claiming Oklahoma as the state with the highest rate of heart disease. Here in Louisiana, we claim that distinction and seem to take pride in it. I believe we will hold our title again this year.

In residency, I had a 300 pound plus patient with Achilles tendonitis.  After all conservative means were exhausted without resolution, I explained that surgery was the only other option. She was more than ready for the knife but I informed her that the failure rate was increased significantly with her weight. I suggested that she try to lose some of it prior to serious surgery consideration. I could see her bowing up as I explained the problem. With every sentence, she increased her volume. “I tried them light meals. I can’t eat no light meals! I need HEAVY meals!.”  And, now in my face and angry, screamed, “I’M HUNGRY NOW!” I wonder what happened to that sweet thing.

Jon Purdy, DPM, New Iberia, LA, Podiatrist@mindspring.com

RE: Obesity and Foot Pain (Evan Meltzer, DPM)
From: Michael M. Rosenblatt, DPM

Dr. Evan Meltzer states that he practices in the "most obese State in the Country"...(city, Jackson, MS). I have never been in Jackson, MS, but I have been to Tillamook, OR, where I was shocked by the morbid obesity of almost everyone I saw there.
 
We went out for dinner to a Chinese restaurant and I turned around to see not ONE person, man, woman or child under 300 lbs. The order I got was enough for 3 people. I cleared all the artificial gravy off it and ate a corner of it. I don't consider myself a "light" person, but I was a rail compared to that population. This is a catastrophe waiting to happen. The costs of treating those people for the degenerative diseases they have will suck Medicare dry, even if they "die young." Their podiatric prognosis is incredibly bad. My heart goes out to them. 

Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

RE: Obesity and Foot Pain (Scott Shields, DPM)
From: Jerry Katz, DPM

If we do not counsel our patients on body weight, not only on their pedal well-being, but on their overall health, we are doing a disservice to both our patients and ourselves. We, as physicians, should be familiar with terms such as body mass index, waist circumference, waist to height ratio, and ideal body weight (the latter not being used any more in preference to healthy body weight).

You can further expound on the discussion to include...

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

RE: Idea for Interactive Foot Museum
From: Jack Buchan, DPM

There is an exciting opportunity to develop an exhibit for a local center of science and industry complex in Columbus, OH regarding feet in a large comprehensive health exhibit seen by over a million people per year. This must be an exciting, interactive exhibit that would educate adults and children about the complexities of the foot, its evolution, and importance in our ambulation from youth to adult and also promote foot health ideas, and certainly include podiatry.

We are looking for ideas from current exhibits around the country or thoughts that could help promote lower extremity awareness to the thousands of visitors that will visit every year. Please send ideas, or if you have already “invented the wheel”, I would love to talk with you so we can spread the word! Our hope is that this is something that could be shared and actively promoted among the many science museums of the country. All ideas and contacts are welcome.

Jack Buchan, DPM, Columbus, OH, Jbuchan3@gmail.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  www.greatfootcare.com. 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

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

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

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

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