The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

April 19, 2007 #2,915 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2007- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

MO Podiatrist Provides Tips for Flip-Flop Wearers

Flip-flops do not provide adequate protection for feet. To maintain your feet properly, Russell Dirksen, DPM (doctor of podiatric medicine) at The Foot Doctors, offers tips for flip-flop wearers.

Dr. Russell Dirksen

First, keep in mind that moderation is key. Because there is not adequate support for feet, flip-flops can cause damaged muscles in the feet and legs. Wearing flip-flops for short intervals is not so much of a problem. Particularly be cautious of wearing flip-flops during days that will require a great deal of walking or rocky terrain that can cause stress to the feet. Additionally, flip-flops should not be worn when participating in sports activities, due to the lack of structure to balance and support the feet.

Secondly, when shopping for shoes, look for flip-flops with a built-in arch support or flip-flops that stay on the foot (possibly with straps or Velcro) to avoid strenuous gripping by the toes. Finding flip-flops or sandals that are a bit pricier may be the best choice in the long run if they have the proper structure for support and protection.

Source: Amanda Foster, The Mirror [4/16/07]

MA Podiatrist is Boston Marathon Medical Volunteer For 22nd Time

Braintree's Dr. Paula Marella, 45, a podiatrist who owns Advanced Foot Care Inc. in Duxbury, has volunteered in the medical tent at the Boston Marathon for 22 consecutive years and said it wasn't as busy as in years when the marathon was run in higher-than-average temperatures, such as 2004.

Dr. Paula Marella

Marella thought there were two reasons: preparation thanks to all the media coverage of the storm, and the fact that inclement weather discouraged some lesser-prepared runners from competing.

“You don't see any college kids who decided to run the race last night out here,” Marella said. Had there have been, however, the medical tent would have been prepared.

Source: Nate Crossman, The Enterprise [4/17/07]

CA Podiatrist Jailed on Sexual Abuse Charges

A longtime Fresno doctor is in jail on Monday, after an investigation led to charges of sexual misconduct involving at least one patient. Matthew Sciaroni is a podiatrist in Fresno. According to court records, he's accused of fondling at least one teenage girl who visited him for an ingrown toenail.

Doctor Sciaroni was led away in handcuffs from his northeast Fresno office. A warrant for his arrest was issued after a criminal investigation revealed the doctor was inappropriately handling his patients. He's facing two felony counts of lew acts upon a child and one misdemeanor count of sexual battery.

According to court records, Sciaroni treated a teenage patient for an ingrown toenail, but told her the infection could spread. The patient was about 15 years old when she visited Sciaroni. The reports state "Sciaroni told her (patient) he needed to check her lymph nodes for infection. Sciaroni would check her front underwear line and just below." The patient also told investigators that Sciaroni told her the infection could move up to her breasts. The patient claims at that time the doctor again touched her inappropriately.

According to the California Medical Board this is the first time Sciaroni's been under investigation. He was put on probation for sexual misconduct in 2000 for an incident that happened at his Firebaugh office. That probation ended in 2005. Sciaroni could face punishment beyond jail time. He could lose his medical license for the latest incident if the board of podiatric medicine decides it's warranted. Sciaroni's office was closed early on Monday. He is in the Fresno County jail. His bail has been set at $101K.

Source: Sontaya Rose, KFSN-TV, [4/17/07]

Chondroitin Ineffective as Pain Treatment, Study Finds

The dietary supplement chondroitin, which typically is sold in the U.S. in combination with glucosamine as a treatment for osteoarthritis, is no more effective than a placebo for reducing pain, according to an analysis published in the Annals of Internal Medicine, the Los Angeles Times reports. For the study, researchers at the University of Bern in Switzerland looked at data from 20 clinical trials involving 3,846 patients (Chong, Los Angeles Times, 4/17).

The trials were conducted as early as 1970, and some of the earlier studies were not rigorously designed and involved few patients, according to study author Peter Juni. As a result, the researchers focused on three newer trials that together included about 40% of all patients in the 20 trials, Juni said. They concluded that chondroitin alone does not reduce joint pain, even though some patients believe that it is an effective pain treatment (Weise, USA Today, 4/17). The researchers also used x-rays to determine that chondroitin does not improve the health of joint cartilage.

Source: The Los Angeles Times, USA Today via American Health Line [4/17/07]

Query: Autism and Toe-Walking

I would like to hear of any current bracing and / or therapy that is effective in treating a two year old autistic patient that is a chronic toe-walker. He has moderate to severe autism and is reducible to zero (90 degrees), but fights it. Currently he has no sequella from a minor foot trauma, but is refusing to walk all together. His parents have noticed that when they attempt to reduce him, there is more resistance from apparent progressing contracture. He has fairly severe eczema, so I am hesitant to cast him. He usually removes any footgear they have tried to keep him in.

Jon Purdy, DPM, New Iberia, LA

RE: Bone Infarct in Sickle Cell Patient (Burton Katzen, DPM)
From: Lawrence Kollenberg R.Ph, DPM

Has this patient had a bought with food poisoning? Has the gall bladder been removed? Salmonella poisoning can accumulate in the gall bladder and also has been shown and is well-documented in the literature to cause septic joints and osteomyelitis in sickle cell anemia patients. What do the labs show? WBC changes in lymph or monocyte counts even if total wbc count is normal. What is ESR and C-Reactive Protein levels? Has patient been on deferoxamine?

One simple possible way to determine is to run a stool sample and see if chronic salmonella carrier. Diagnostically, a bone biopsy would be best to confirm if this is correct. If this is osteomyelitis, then you would have a difficult time achieving eradication without opening it up. The treatment of choice for salmonella is to use a flouroquinolone antibiotic at least six weeks in a healthy patient, even if you did open and drain. This achieves the highest bone and intracellular bactericidal levels of antibiotics to correct the problem. Again, you must debride the bone to achieve eradication of the organism.

Lawrence Kollenberg R.Ph, DPM, Jacksonville, FL, lkollenberg@hotmail.com

RE: Peppering the Plantar Fascia
From: Burton Katzen, DPM

Years ago, I believe in Switzerland back in the early 80's, they were doing experimentation with seven drill holes through the calcaneus, circumscribing the attachment of the plantar fascia, the theory being to redistribute the blood supply away from the inflamed portion, like a reverse irrigation system. I actually had very good results with about 15 to 20 cases that I did with almost no downtime to the patient. Since my long-term results have been less than optimal with ESWT over the past few years, I have actually been thinking of returning to that procedure as an alternative to open heel surgery. Be careful not to place the drill holes too close to the attachment to avoid an avulsion fracture.

Burton Katzen, DPM, Temple Hills, MD, DrburtonK@aol.com

RE: Lawrence Harkless, DPM Retires From UTHSCSA
From: Leonard Levy, DPM, MPH

While Lawrence C. Harkless, DPM, is leaving his post at the University of Texas Health Science Center at San Antonio after a stellar career heading its podiatric medical residency program, he will not be going off to sit in a rocking chair. Dr. Harkless. it has been announced, has accepted a position as the founding dean of a new podiatric medical school in a large and evolving osteopathic academic health center, Western University for the Health Sciences in Pomona, CA.

The experiences that he had at UTHSCSA over the past few decades make him uniquely qualified to meet this challenge. While there are those who claim there are too many podiatric medical schools, there is an outcry to train more physicians. In podiatric medicine in particular the growth of the aging population, the growing epidemic of diabetes, the rapidly increasing prevalence of chronic diseases including many with serious manifestations in the lower extremities, and of course, the increasing interest by Americans in physical fitness signals an era when podiatric physicians will be in much greater demand.

In addition, there is a continuing need to have podiatric medical schools become part of interdisciplinary academic health centers that include medical and/or osteopathic medical schools. This will improve the ability of our schools to produce highly qualified physicians by having a greater depth of medical and basic science faculty available, improve the profession’s research capability, enhance collaboration among many health disciplines, and increase the awareness of podiatric medicine among other disciplines as well as the public. This collectively will have a significant effect on increasing both the size and quality of our applicant pool, an outcome that too many in our profession have been unable to see.

Leonard A. Levy, DPM, MPH, Fort Lauderdale, FL, levyleon@hpd.nova.edu

Missing Person "Found" in MI Podiatrist’s Office

When Michael Blue, 48, of Detroit showed up at his foot doctor's office Monday, he got a big shock. His doctor pulled a newspaper article from Blue's medical file showing he had been reported missing in early December and was believed dead.

"I was shocked," Blue said Tuesday. "I wasn't missing. I went on vacation." His family had heard a story in his west side neighborhood that drug dealers in Blue's building had jumped him after he reported them to a drug hot line. Nothing could be further from the truth, Blue said. He was just out partying in Florida, Las Vegas and other cities with his girlfriend.

Source: Detroit Free Press [4/18/07]

ASSOCIATE POSITION - EASTERN NORTH CAROLINA

Multi-physician Podiatric practice looking for PSR-24/36 trained Podiatrist to join our progressive, diverse practice. High surgical volume with teaching opportunities. Competitive compensation package with definitive plan leading to partnership. Must have North Carolina license. Position available late 2007. E-mail CV and/or letter of interest to ncdpmsearch@earthlink.net

PRACTICE FOR SALE- FLORIDA

A 13 y.o. well established podiatry practice in Tavares, FL ( Lake County ) the 23rd fastest growing county in the nation. This is an opportunity not to be missed. All aspects of podiatry with hospital privileges available. PRICED TO SELL! If interested, contact Susan at (352) 406-2513 or at acrysue@gmail.com

PRACTICE FOR SALE: LA JOLLA CA (SAN DIEGO) Price reduced!

$287K '06. No HMOs, bone surgery, or insurance panels, so opportunity abounds! Affluent community. General practice, biomechanics, DME. Possible finance Serious/principals only. Cell:858-405-4780, 10-8 PDT. No Sunday calls, please. $129K Selling due to age, health problems. www.SDFootDoctor.com DrRDWorley@yahoo.com

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- 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

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 - MANHATTAN

Park Avenue and East 70’s. Excellent opportunity to work with renowned podiatrist/surgeon in beautiful, upscale practice. Seeking candidate with 2-3 year residency program, strong surgical skills. Assist with case documentation Opportunity to buy in. Please send CV and references to iblevinelautin@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

FELLOWSHIP IN PRACTICE MANAGEMENT, PODIATRIC MEDICINE & SURGERY. SOUTHERN CALIFORNIA

Must be board certified in a board approved by the Council of Podiatric Medical education Must be an APMA member. Salary 60K,to 75K with incentives. Fax resume to 562-997-9717

PRACTICE FOR SALE – CENTRAL FLORIDA

Well established surgical podiatry practice in Central Florida . Gross 2006 $744,136. Very attractive lease in an outpatient surgery center. Very low down payment. Contact Camille Todd/ Transworld Business 321 217 2625

PRACTICE FOR SALE: LA JOLLA CA (SAN DIEGO)

$287K '06. No HMOs, bone surgery, or insurance panels, so opportunity abounds! Affluent community. General practice, biomechanics, DME. Possible finance Serious/principals only. Cell:858-405-4780, 10-8 PDT. No Sunday calls, please. $149K Selling due to age, health problems. www.SDFootDoctor.com DrRDWorley@yahoo.com

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 1 yr. Need Florida license. Fax resume to 561-865-2225

PRACTICE FOR SALE - WASHINGTON, DC

Priced to sell, 100% financing available. Owner leaving area. Hospital based 27 yr old practice with large surgical and diabetic population. Four fully equipped rooms. x-ray, topical hyperbaic oxygen units. Hospital privileges - full scope. 600+ new/yr. Will lease to you until final sale. Contact Dr Benjamin at jhallux@yahoo.com or (202) 841-5545 (cell).

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

WEEKLY SPECIAL - One week of ads (5x) for only $85

PM Classified Ads Reach over 9,500 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 9,000 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 dekagan@aol.com

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.