The Voice of Podiatrists

Serving Over 10,800 Podiatrists Daily

April 05, 2008 #3,212 Editor-Barry Block, DPM, JD

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UT Podiatrist Provides Tips to Minimize Damage From High Heels

Women love their high heels, saying they make them feel sexy and make their legs look nicer. But doctors say they're cruel shoes leading to ankle sprains, stress fractures, bunions and hammer toes. “High heel shoes are not made to fit a normal human foot, they are usually very tapered in the front of the shoe and there is not much room up there,” said Dr. Anna Marie Edwards, podiatrist at Innermount Hospital.

Doctors say avoiding heels is the best bet. But for those women who refuse to give up their stilettos, there are some things that might help. Alternate between your heels and sneakers during the day especially when walking long distances. “You just have to be careful when you wear them, careful when you walk because you are walking on your tip toes all day long,” said Dr. Edwards.

Source: KUTV - Salt Lake City,UT,USA [4/4/08]

2008 House of Delegates Underway

The eighty-eighth APMA House of Delegates has the potential to be one of the most exciting in years. Despite the record low number of resolutions to be considered, delegates will be dealing with larger issues, including the ACFAS membership vote, which was e-mailed to ACFAS members yesterday, and APMA’s reaction to the AMA Scope of Practice Report, which was released in late December.

Drs. David Schofield and Christian Robertozzi

Last Night’s Presidential Dinner was a memorable one. Outgoing APMA Christian Robertozzi, DPM chronicled his tenure with APMA, and graciously acknowledged a long list of podiatrists and APMA staff members who have assisted him over the years.

PM News will be continuing our long history of “on the floor” coverage of the HOD proceedings, including election results, award presentations, and other significant highlights.

RE: Repair of Kidde Pneumatic Tourniquets

Does anyone have a name and phone number of an individual or entity that repairs and/or inspects Kidde pneumatic tourniquets?

Scot Zindel, DPM, Lynchburg, VA

Query: Excision of Sesamoid Coding

I have a patient that I'm excising a hypertrophic sesamoid bone on. What is the most appropriate diagnosis and CPT code for the procedure?

David Sands, DPM, Great Neck, NY

Response: The proper coding for the surgical procedure you have described is CPT 28315 (excision of sesamoid, first toe).

As far as the diagnosis code, there would need to be more clinical findings other than hypertrophic bone (ICD-9 733.99) - e.g., arthritis, keratoma, fracture, osteochondritis, pain, etc.

Howard Zlotoff DPM, Camp Hill, PA

Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm

RE: Symptomatic Treatment of Peripheral Neuropathy (Tip Sullivan, DPM)
From: Elliot Udell, DPM

I would hope that podiatrists considering the use of Sinemet for peripheral neuropathy review the list of potential common side-effects before considering this off-label usage. Sinemet (carbidopa and levodopa) is a powerful drug that is used to treat parkinson's disease. It has many neurological and other side-efects. Oddly, peripheral neuropathy is one of them. Dykenesias and other neurologic-emotional problems are part of the long list of potential side affects associated with this pharmaceutical.

The Hippocratic oath says, "help but do no harm." A drug like Sinemet, when administered by a trained neurologist for the treatment of Parkinsonism, is a therapeutic option with a decent benefit to risk ratio because of two reasons. One is that untreated Parkinsonism is a devastating life-altering disease and powerful drugs are needed to give any measure of control. The other is that a neurologist is trained to quickly recognize and treat the common side-effects associated with the drug.

Podiatric physicians do not see the neurologic- psychiatric side-effects that Sinemet can cause and we might not be able to handle them before it is too late. Hence, this drug really should remain in the domain of neurology. In my geographic area, I rarely if ever see this drug being prescribed by non-neurologists. In terms of potential neurological side affects, it really is in a different class than gabapentin and the common drugs that we use to treat peripheral neuropathy.

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

RE: Unilateral Foot Drop and ProActive?

Recently had a patient experience I thought I'd pass along. I'm not sure if this is common knowledge, but I was not aware of the connection. I had a healthy 17yo female develop unilateral foot drop after taking oral OTC acne medication "ProActive" for 2 weeks. This is advertised frequently on TV and sold at some kiosks in malls. Apparently ProActive has a fair concentration of Vit B6. She developed B6 toxicity within 2 weeks of starting medication.

Steven Block, DPM, Owensboro, KY, sblock@excite.com

Custom Shoes and Soccer Cleats for 5 Y.O. (Pat Evoy, DPM)
From: Paul Kesselman, DPM

I would contact Hersco at 1 800 301 8275 and ask for one of the Kennedy brothers. If you provide them with a shoe or photo to replicate, they should be able to match it.

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

RE: Testimony of Ivar Roth, DPM
From: Robert Wunderlich, DPM, Bryan Markinson, DPM

I agree with Dr. Kesselman's statement that "the actual performance of any examination and/or treatment must be medically justified." My impression has been that even our MD colleagues (except for OB/GYN, urologists, and proctologists) rarely do pelvic/rectal exams unless there is a specific complain that warrants such an exam. To confirm this notion, I pulled the admitting H&P for my last 5 inpatient hospital consults (all diabetic foot infections)....not one of these patients had a pelvic or rectal exam by the admitting MD.

So, while it may be within our scope of practice to do these examinations, that doesn't mean it's appropriate or necessary.

Robert Wunderlich, DPM, San Antonio, TX, rwunder@gmail.com

Editor’s Note: Dr. Markinson’s extended-length note appears at: http://www.podiatrym.com/letters2.cfm?id=18818&start=1

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

ASSOCIATE POSITION - FLORIDA PANHANDLE

We are looking for a hardworking, ethical physician to join our busy practice. We are well-established and looking to expand. Must be a PS24+ with interest in all aspects of podiatric medicine and surgery. Partnership available. Fax resume to (850) 478-5227, call (850) 477-9015 or email PenFootAnk@aol.com

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

PRACTICE FOR SALE - AUSTIN TEXAS

Live and work in the best place in Texas. 14-year established practice which includes beautifully finished office condo. Own a practice AND real estate. Nicest office in town. Located between 2 major hospitals and in the most heavily populated part of town. Major employers including Dell and IBM. Office can support 2 podiatrists easily. Serious inquiries only. mrobsondpm@aol.com 512 585 0242

ASSOCIATE POSITION – CONNECTICUT

Connecticut Surgical Group, one of the largest multi-specialty surgical group practices in New England, is seeking a Podiatrist to add to our three-physician Podiatry division based in Hartford. Provide all aspects of Podiatric care with a focus on wound and surgical care to a well-established patient base. PSR-36 training and board certification or eligibility and excellent surgical and wound care skills required. We offer competitive salary and productivity bonus, partnership opportunities, excellent benefits, and reasonable overhead. Apply online at https://home.eease.com/recruit/?id=21426 or via our website or fax your CV to 860-524-2653. No phone calls. EOE.

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com -- www.homephysicians.com

ASSOCIATE POSITION - FT. MYERS/CAPE CORAL FL

Great opportunity for BE/BC established DPM or podiatric surgical resident with strong surgical skills. Well-established podiatric practice offering high surgical volume, advanced wound care, PT, vascular diagnostics and large diabetic population. Exceptional pay with incentives for high performers. Generous benefit package. Relaxed lifestyle, golfing, boating, fishing, close to beautiful SW FL beaches. Please send CV with references to janekelly331@msn.com

Great opportunity: our busy multi-physician, podiatric group practice, with multiple locations, strong hospital affiliations and faculty positions with PM&S-36 residency program, is seeking a full-time RRA BQ/BC, PM&S-36 surgically trained doctor. Applicant should be well trained in all aspects of surgical and conservative care. Candidate should be ethical, hard working and outgoing physician to join our practice. Commensurate pay with incentives and benefit package. Definitive plan leading to partnership tract. Contact: Daniel Hellman, M.D. @ 414.831.0512 or by e.mail @ hellmandr@gmail.com

EQUIPMENT FOR SALE- OSTEOPOWER2 SAW, ETC.

I have a Osteomed saw with many accessories! This is in Immaculate condition asking $15,000 or best offer. Medical office notepads x2 with docking station and keyboard. 3 docking stations and keyboards for other rooms, $1500.00 each. $75.00 each for the the docking stations. OBO email Harbor_Foot_and_Ankle_clinic@msn.com Call 360-533-7388

ASSOCIATE POSITION - NORTHWEST INDIANA

Full-time podiatrist wanted for Northwest Indiana (4 offices) 30-40 minutes away from downtown Chicago. Busy hospital and office based practice. Must have 3 year surgical residency. For more information please email footdocml@gmail.com

PRACTICE FOR SALE - LAWRENCE, KANSAS

Great place to live and raise a family (college town). 250+ K yearly gross with good potential for growth. Good mix of general podiatry, sports medicine, and surgery. Hospital privileges available. 4 treatment/procedure rooms and well-equipped. Fully computerized. Partnership in a 4-office medical building. Partnership is for sale. Inquires to foothlr@sunflower.com 785-841-4225.

ASSOCIATE POSITION – CENTRAL NEW JERSEY

Multi-office practice located in Ocean and Monmouth counties. Lokking for a well-trained PSR 24-36 individual. Must be personable and ethical. Excellent opportunity to join a well-established diverse practice. Please fax resume to (732) 255-9364.

ASSOCIATE POSITION - CHANDLER/GILBERT/PHOENIX, AZ

Multi-location office and soon to start a wound care office in a local hospital. Seeking a well-trained graduate of a PSR 24+/36 Residency. This is a practice with a nice mix of 35% surgery/trauma, 20% diabetic/wounds, 25% biomechanics, 20% pediatric. ER Call for 2 hospitals. Opportunity for partnership at 2 surgery centers. Very modern office with EMR, U/S, Digital X-Ray, Vascular Testing /Nerve Testing Machines and our own ESWT. Excellent referral base, and a well-trained certified staff. Board eligible/certified a plus. Competitive salary, bonus structure, benefits. Please e-mail CV and references to main@footanklespecialtycenters.com

SEEKING RESIDENT FOR PSR-24 - BALTIMORE, MD (MERCY MC)

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 2008. Includes competitive salary/benefits. Send inquiries to rsher18@yahoo.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.

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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 10,800 DPM's. Write bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 Ext 110.

Busy multi-dimensional practice; 70 miles north of New York City . Currently four (4)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

PRACTICE FOR SALE - MINNESOTA: PRIME LAKES AREA

Great place to live and raise a family. $400+K yearly gross with continued growth and potential. Good mix of general podiatry & surgery. Hospital privileges available. Fully computerized, electronic notes, with capability to go completely paperless. Recently remodeled office, 5 tx/procedure rooms, well-equipped in owner-occupied building (for sale or lease). 260 402-7490

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