The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

April 19, 2011 #4,138 Publisher-Barry Block, DPM, JD

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Gait Mis-alignment Can Cause Knee, Hip, or Back Pain: FL Podiatrist

"When you think about how there are 26 bones in the foot, with 33 joints and a network of 100 tendons, muscles and ligaments, it makes sense that foot pain can be caused by many different conditions," says Scott R. Jason, DPM, a board certified podiatrist and foot surgeon with Jacksonville Foot Clinic and Foot Clinic of Palatka. "Often we accept pain in our feet as something we have to live with or work through. However, you could be doing more damage by ignoring it." 

Dr. Scott R. Jason

"It's not unusual to see a patient experiencing knee, hip, or back pain, and upon further questioning, discover that one or both of their feet had been hurting for some time, says Dr. Jason. "Knee pain in particular, can develop from misalignment in a person's gait as a result of foot pain. In fact, all muscles in the lower leg are affected by your feet."

Source:  Florida Times-Union (Jacksonville, FL)  [4/6/11]

Newly Approved Anti-Cancer Device has no Side-Effects: NY Podiatrist

Device maker Novocure said Friday that the Food and Drug Administration approved its first-of-a-kind treatment that fights cancerous brain tumors using electrical energy fields. The FDA approved the device for patients with aggressive brain tumors that have returned after treatment with chemotherapy and other interventions. Patients with recurring brain cancer usually live only a few months. Studies showed that people using the device lived about as long as those taking chemotherapy, roughly six months. However, patients using the device had significantly fewer side-effects.

Dr. Albert Musella

"This is as effective, or better, than anything that's ever been tried after standard treatment has failed. And while you're on it, you don't have any side-effects from the treatment." said Dr. Al Musella, founder of the Musella Foundation for Brain Tumor Research and Information in Hewlett, NY. Musella's father and sister-in-law died of brain cancer.

Source: Associated Press [4/15/11]

Negotiation Tactic

One of the most valuable negotiation tactics you can master is also a surprising one: silence. You cannot give away anything—concessions or information—if you do not talk. Plus, because silence tends to make people feel uncomfortable, your negotiating opposite is likely to start talking to fill the void, and you could gain valuable information.

Source: Adapted from Mastering Business Negotiation: A Working Guide to Making Deals and Resolving Conflict, Roy Lewicki and Alexander Hiam, Jossey-Bass via Communication Briefings

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

Bret Ribotsky: Do you think that there are too many or too few podiatrists?

Dr. John Grady

John Grady: I think we definitely have a lot of shortage areas in podiatry. I am in favor of having more podiatrists in general.  I think podiatry is a great profession. This is a complicated issue because we currenty do not have the resources to give residencies to all graduating students.  

Dr. Earl Horowitz

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). The next segment will feature practice management expert Dr. Earl Horowitz. You can register for this event by clicking here

Query: Exogen Bone Healing System

Does anyone have any experience with Smith & Nephew's Exogen Bone Healing System? I have recently been detailed and am thinking about using it with all osteotomies, even routine low-risk ones. They claim to decrease healing time by up to 40%. Does this mean that I can ambulate patients up to 40% sooner on osteotomies that I would usually keep non-weight-bearing for 4-6 weeks?

Tip Sullivan, DPM, Jackson, MS

RE: Uric Acid Crystals, Post-op
From: Michael DeBrule, DPM

About five years ago, I performed a bunion surgery with extensive adjacent tophi. I was unable to remove all the tophi from the tissue, and the post-op wound drained for almost three months. Multiple cultures were negative, and there was no vascular compromise. I flushed the wound from the inside out with local anesthetic several times, but healing was still slow. The patient was treated with local wound care and made a full recovery.  

Michael DeBrule, DPM, Marshall, MN, Dr.DeBrule@InnovativeFootCare.com

RE: Uric Acid Crystals, Post-op
From: Randall Brower, DPM

I'm in an unusual and pretty unique situation as the only podiatrist in a large ortho/pain group. I hope to give you insight from their perspective. My trauma sports med ortho colleagues have no desire to write for gouty arthritis of the knee, etc. They refer back to the PCP without a thought. They have no desire to do a pre-op H&P. They defer to the PCP for every surgery medical clearance and/or pre-op H&P.

There is no desire from their specialty service to go it alone. My colleagues and I write for an NSAID and send patients back to their PCPs to coordinate lab work with gout med dosing and other meds. Their comments to me are, "why potentially create hypertension because I gave them gout meds?" First of all, I'm too busy to run labs, check other drug interactions, etc. But second, I'm alienating a potential referral source, my local PCP. Ask them. They hate when specialists add meds and treat without their input. That's what they do. It takes away what shrinking revenue they get. And you lose a referral. For what?

We need, like my ortho colleagues, to be happy being a specialist, and be part of a team. You do no one, including the patient, any favors going it alone.

Randall Brower, DPM, Peoria, AZ, footdoctor33@yahoo.com

RE: Mosaic Wart Treatment (Stephen Merena, DPM)
From: James Ricketti, DPM

I would pre-treat the lesion with Lazerformalyde Solution [Pedinol] daily for two weeks; then have the patient return in two weeks for debridement and application of Monocyte [Pedinol] with a dispersion pad. The next day, apply Lazerformaldye solution and Salactic Film [Pedinol] to the lesion daily. The patient returns every two weeks for the Monocyte application. It usually takes 2-4 treatments for full resolution.

Disclosure: I am the Inventor of the Monocyte Swab

James Ricketti, DPM, Hamilton Sq, NJ, drj4foot2002@netscape.net

RE: HIPAA and Doctor Reviews on Websites (Richard Boone, Esq)
From: Marv Boren, DPM

The real issue is preventing criticism in the first place, whether it comes via the Internet or otherwise. Of course, there will always be those patients who are very critical and are never satisfied. Nonetheless, patient satisfaction is critical to the success of our practice and shouldn’t be taken for granted. How can we truly know what patients think of us, our office, our staff, etc? The only way to know is to do a patient satisfaction survey. You may be surprised with the findings.

You could create and conduct a survey yourself, use templates from practice management resources, or hire a professional. I strongly suggest using a professional custom survey. A professional survey will be more thorough, less biased, and have greater credibility. You can have one created for as little as a few hundred dollars. How many dissatisfied patients would you need to save from leaving your practice to cover the cost of the survey?

I used Decision Point Marketing & Research Inc. (decisionpointconsulting.com) to create and conduct a survey that was well worth the cost. I highly recommend them. Not only did the survey help me identify areas that needed improvement, it gave me ideas for new services. They also do market research that can help you make other decisions such opening an additional office, practice location, and so on.

Marv Boren, DPM, Canton, OH drboren@smartdrs.com

RE: Routinely Taking Patients' Blood Pressures in a Podiatric Setting (John Scheland, DPM)
From: David E. Gurvis, DPM

Although I wish I could take finger stick routine glucose readings in the office, I was under the impression that CLIA forbade that without signing up and following all their guidelines. I admit I haven't kept up with this area of oversight, but am I wrong?

David E. Gurvis, DPM Avon, IN, deg1@comcast.net

Evaluating All-Purpose Lasers (John Moglia, DPM)
From: Elliot Udell, DPM
 
Calling out for suggestions on PM News  is a good start. Another good way to find out about lasers is to attend a large podiatry convention where there will be many vendors displaying lasers. I would assume that the 2011 APMA convention in Boston would be an ideal place to see many lasers displayed. This way, you can physically feel what it's like to hold and use a particular product, as well as get references from the reps on other doctors using their devices.
 
Prior to buying an expensive laser, it is important to evaluate the company itself by finding out how long they have been in business and how many units they have sold. One would not want to have the experience of spending 35 thousand dollars for a laser only to find out a month later that the company went under, leaving customers with no support for their unit.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Mrs. Malaprop Visits My Office
From: Michael Forman, DPM, Richard A. Simmons, DPM

I loved Joan Shiller's malapropisms. How many of us have NOT had a patient who came to us with "athletic feet." I had one little old lady tell me her previous doctor said her toenail was "all infucted with fengus." My son, the doctor, had a patient tell him that she had "the smile of mighty Jesus." (He finally figured out she had spinal meningitis.

These make me feel a little better after all of the malapropisms that have come out of my mouth over the years.

Michael Forman, DPM, Cleveland, OH

Like Dr. Schiller, I used to hear my patients saying these funny sayings. Last year, I was fitted with hearing aids, and Mrs. Malaprop has gone away!

Richard A. Simmons, DPM, Rockledge, FL

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

ASSOCIATE POSITION - NEW YORK CITY & QUEENS

One of the fastest growing podiatry practices in New York City and Queens seeks a podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Preferably a Spanish speaking podiatrist. Contact me at Podocare@aol.com

PODIATRIST NEEDED - NY/QUEENS/LI

Must be min. PSR-3 with excellent training. Experienced in billing, selling non-covered services, products, Patient medical and surgical exp. with good rapport/comm. skills necessary. Unique position working in offices, clinics, hospital with orthopedist, podiatrist, P. therapists. P/T, F/T available. Growth, income potential and partnership opportunity excellent. A chance to use all your skills; foot, ankle and more. Please respond with cover letter and CV to hansfeet@aol.com

ASSOCIATE POSITION - SOUTH CAROLINA

Upstate, two-office practice seeking PSR-24/36 trained associate. Full-time position with partnership opportunity. Must be ethical, highly-motivated with strong surgical and medical skills. Please send CV to palpodiatry@att.net

PART TIME PODIATRIST NEEDED- LOS ANGELES, CALIFORNIA

Busy podiatrist looking for assistance with treating home-bound patients. Flexible hours, independence, and great compensation. If interested, email CV to homefootcare@hotmail.com

ASSOCIATE POSITION – NEW JERSEY

Associate wanted full-time, for practice in East Orange NJ PSR 24-36 trained. Must be motivated to grow practice, especially build wound care and surgical services. Buy-in possible after the 1st year. send CV to Drfoot44@gmail.com

ASSOCIATE POSITION - NORTH CAROLINA

Cornerstone Health Care, one of the largest physician owned and managed multispecialty groups in the Southeast, seeks podiatric physician for office located in the Piedmont Triad of North Carolina. The physician must be licensed in NC, have three years of training, and board qualification in forefoot and rearfoot surgery. Cornerstone has over 290 providers in 75 locations. Physicians benefit from centralized billing, purchasing, and human resources, while maintaining autonomy over office practices. A state-of-the-art EMR system provides instant access to all Cornerstone patient records. Send CV to page.redpath@cornerstonehealthcare.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 - 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

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 these lasers on your patients. E-mail footcare@comcast.net

PRACTICE FOR SALE - HOUSTON, TEXAS

28 year old busy, progressive practice for sale with an excellent reputation and well established referral base. Well-trained, dedicated, supportive staff. Excellent cash flow $475K income after overhead. EMR, digital x-ray, diagnostic ultrasound. Free standing building also available with large outdoor sign. Also available are two transferable surgical center partnerships(with distributions). Owner retiring and willing to stay part time during transition. Cover letter/CV to softechpodiatrist@gmail.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

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