The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

April 19, 2012 #4,440 Publisher-Barry Block, DPM, JD

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New Tattoo Being Developed Will Monitor Blood Glucose: MI Podiatrist

Diabetics may soon be lining up for a special new tattoo that does “tricks.” Scientists at Massachusetts Institute of Technology, and at the Texas Diabetes Institute are working on a new tattoo that is designed to change color when a person’s blood sugar drops, or when it spikes. Oakwood Hospital podiatrist, Dr. Debbie Woody told WWJ she thinks it’s a fantastic idea. “It’s very fascinating and amazing,” Woody says. “It’s really still a few years away. It can actually monitor a patient’s blood sugar."

Dr. Debbie Woody

Dr. Woody said it’s not going to be a tattoo that is readily visible to the naked eye. A patient would use a “monitoring device” such as a black light to see the color changes. The tattoo is designed to go from yellow to orange to pink depending on whether a patient’s blood sugar is high or low. Woody doesn’t think it will ever entirely replace a glucose meter, but it will give constant monitoring which can’t be done now.

Source: Roberta Jasina, WWJ 4/17/12]

Podiatrists Man Medical Tent at Boston Marathon

The 116th running of the Boston Marathon took place yesterday in record temperatures. Over 2,100 runners were treated in the medical tent for dehydration, heat exhaustion, and other ailments including foot-related injuries.

Podiatric Volunteers at Boston Marathon

The medical team included 34 podiatrists and podiatry students, led by Dr. Jonathan Kaplan. Other podiatrists who volunteered at the medical tent included Drs. Howard Palamarchuk, Paul Heffernan, Paula Marella, Richard Baker, Neal Zomback, Kirk Neustrom, Lori Lundberg, Richard Cullen, and Scott Aronson. Also, students from both NYCPM and TUSPM traveled to Boston to help treat the runners.

Barefoot Running Just a Craze: IA Podiatrist

“Barefoot running is hard to justify because there is a lot of room for error,” said West Des Moines podiatrist Dr. Kirk Neustrom. “I have seen many stress fractures and puncture injuries from people who try barefoot running.” Neustrom said that he would never suggest barefoot running to his patients, unless they were experienced runners who had been injured from heel-first running styles. 

Dr. Kirk Neustrom

Because barefoot running is a forefoot running style, smaller and more fragile bones in the ball of the foot receive the most impact. Typical heel-first running puts the pressure on the calcaneus, a larger bone, which can better absorb the impact. “I would definitely be wary to jump on the bandwagon,” Neustrom said. “I think barefoot running will end up like bell bottoms ... just a craze.”

Source:  Kelly Madsen, Iowa State Daily [4/16/12]

Tight Shoes Can Trigger Many Foot Ailments: UK Podiatrist

Bunions run in families, but they are often triggered by "years of squashing feet into tight shoes and can be excruciatingly painful if left untreated," says podiatrist Simon Costain, of the Centre for Gait and Posture in London. "Any tight shoes can lead to blisters, corns and calluses, ingrown toenails and swollen ankles, forcing fluid out of the feet into the ankles where it pools," adds Costain.

Simon Costain

Meanwhile, cramping your toes in shoes that are too small is the main cause of hammertoes, a deformity caused by bending the toe joints out of shape so they curl up instead of lying flat. And athlete’s foot, a fungal infection, can affect anyone who wears tight shoes for long periods due to insufficient airflow around the feet. The retained heat and moisture provide the perfect conditions for the fungi to thrive in.

Source: Matthew Barbour, England Daily Mail [4/16/12]

IL Podiatrist Volunteers at Diabetes Meeting

Des Plaines podiatrist Dr. Zacharia Facaros from the Weil Foot and Ankle Clinic in Des Plaines, volunteered at the American Diabetes Association Expo on Saturday April 14th at McCormick Place. Facaros answered questions people with diabetes had about how their disease affects foot care. 

Dr. Zacharia Facaros

Diabetes, if left untreated, can lead to foot ulcers and amputations. But research shows that patients with diabetes who seek podiatric care significantly reduce their risk of these serious medical conditions.

Source: Chris Martin, Trib-local Des Plaines [4/16/12]

IN Podiatrist Invents Healthy Walking Technique

According to Dr. Michael S. Nirenberg, from Friendly Foot Care in Crown Point, bad habits of walking with poor posture and with the wrong muscles are a common problem. These habits get repeated step after step, so Dr. Nirenberg invented FloWalking, a low-impact, natural technique that reprograms your body's motions to enable you to walk as correctly as possible. Not only will this help increase the benefits of exercise, but it will also help you as you move through your day. 

Dr. Michael Nirenberg

Not everyone walks poorly, but most people have bad habits, Dr. Nirenberg adds. Some will let their head hang in front of them when they walk; others won't use their mid-section to wind back and forth as they step. Some might not use the muscles in legs and feet to walk. "To get from Point A to Point B we use the minimal effort we need," Dr. Nirenberg says. "And when you walk with incorrect posture, you're not burning all the calories you could be burning or helping your muscles."

Source: NWI Times [4/7/12}

Inproved Reimbursement for Apligraf®

Organogenesis, Inc. has announced that Apligraf® has established improved coverage from multiple payors, improving access to care for millions of patients suffering from chronic, non-healing wounds.  Apligraf is the only cell-based product with FDA approval for the treatment of both diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs). The changes will also enable physicians to treat patients with Apligraf in accordance with its FDA labeling criteria of weekly assessment and up to five applications, as needed.

National Government Services, one of the country’s largest federal healthcare contractors, is changing its coverage policy for Apligraf to five applications, with weekly assessments for re-applications for both DFU and VLU patients. Noridian Administrative Services, LLC, a contractor for the Medicare program, is updating the VLU coverage policy for Apligraf to treatment for patients with the presence of VLU of greater than two months duration, including one month of documented failed conservative treatment. The company expects all of these changes to become effective this month.

Search is on to Cure EHR Alert Fatigue

Almost every physician who has typed orders into an electronic health record or e-prescribing system probably has experienced so-called alert fatigue — the frustration of warning after warning popping up before that order is accepted. The alerts are designed to inform physicians of possible patient safety issues, but their frequency and often lack of necessity make them the electronic equivalent of the boy who cried wolf.
 
As researchers and healthcare organizations work to alleviate alert fatigue, it’s clear that the answer is to create systems that take human behavior and supplemental patient data into account when writing rules that decide when and why an alert is fired off. That way, the alerts could have more success in their purpose: protecting patient safety.

Source: Pamela Lewis Dolan, AMNews [4/16/12]

RE: Excisional Biospy (J P McAleer, DPM)
From: Dennis Shavelson, DPM

My understanding is that the “standard” that Dr. McAleer mentions which is to take “a punch biopsy containing both healthy and pathologic tissues” actually is not the preferred method among the derm/path community. There is no real need for “normal tissue”, as those looking under the microscope would rather visualize as much tumor from various locations as possible.

Two 2mm punches from two different areas of the tumor containing all tumor is what I believe is their current accepted standard.

Dennis Shavelson, DPM, NY, NY, DrSha@foothelpers.com

RE: Urgent Care Clinics (From: Bret Ribotsky, DPM)
From: Elliot Udell, DPM
 
My perceptions of the urgent care facilities that I personally took advantage of in Lancaster, PA, require some clarification. I liked it because I did not have to wait all night in the local hospital in order to be seen by a physician. Secondly, the urgent care centers were all owned by the local hospital and were staffed with board certified internists, not nurses. Lastly, each center stated both over the phone and on the entrance what conditions they were there for.

The center we went to was for colds, flu and non-life-threatening emergencies. By having these centers available, the hospital ER is better able to serve the needs of people with serious illnesses such as myocardial infarctions, peumonias, etc. It also allowed people such as my family to have been evaluated and treated by internists without having to wait more than ten minutes, and without taking away precious time from people with very serious medical conditions. Many insurance companies charge a large co-payment if you use an ER, whereas urgent care is the same as visiting a doctor.
 
In my geographical area, where corporations and hospitals are buying up and consolidating primary care medical practices, getting an appointment for an emergency is rarely possible. The attitude from the front desk of most busy internal medicine practices is that if you need to be seen before two weeks from now, go to the emergency room. Urgent care facilities are filling an important public health niche.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: OH Podiatrist Discusses Celebrity's Neuroma
From: Simon Young, DPM

I've seen this foot type as a result of neuroma surgery.

Simon Young, DPM, NY, NY, simonyoung@juno.com

RE: Removal of Screw (Kathy Jagger, Office of Mark Goldberg, DPM)
From: Charles Morelli, DPM
 
I have certainly asked my share of coding questions of this forum, and have been helped each time. I want to suggest to Ms. Jagger and all others in need of this type of service that they utilize AMPA's coding resource center (apmacodingrc.org/index1.asp). It's inexpensive and your answers are realized immediately. This is the wave of the future, and in a short period of time, I can assure you that there will no longer be ICD-9 (soon to be ICD-10) and CPT books anymore. I have no vested interest in this site.
 
Charles Morelli, DPM, Mamaroneck, NY, podiodoc@gmail.com

PRACTICE FOR SALE - AUSTIN TEXAS

Great opportunity for new practitioner or an additional office. 18 year practice with large patient base. Current physician transitioning to part time then retiring to pursue another business opportunity. Start turn-key without need for a bank loan. Great area to live and work. Susieintx@aol.com (512) 565-6634

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Be an owner not a worker. 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

PRACTICE FOR SALE - SOUTH NEW JERSEY

Great practice for sale, lease it, work in practice, rent-free first year, associateship possible. Must have NJ licensure have own TIN participation for Horizon, Cigna, Aetna, etc. Retiring. Anyone is welcome to make offer or come up with other ideas. Contact footcare@comcast.net

MIDTOWN MANHATTAN OFFICE SPACE AVAILABLE

Office space available Wednesdays & Fridays (possibly Saturdays) on 46th & Madison. 2 Exam Rooms + Reception Space. Share with General MDs, Chiropractor & PT's. Potential for cross referrals. Downtown space at Fulton & Nassau also available on Thursdays. Call Kathy @ 646-483-1337 for more details.

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. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

ASSOCIATE POSITION – VIRGINIA

Two office practice, hospital and surgery center privileges, trauma call, modern offices, EHR, digital x-rays. Excellent compensation package. Position may lead to partnership. Candidate needs to be experienced in foot and ankle reconstruction and trauma. Email letter of interest and CV to Dr. Joe Disabato at jdisabato@vfasa.com

ASSOCIATE POSITION - PART TIME - OCEAN COUNTY, NEW JERSEY

Looking for PSR 24/36, board eligible preferred. Busy podiatric practice with up to date EMR & practice management program. Practice currently offers digital x-rays, ultrasounds, vascular studies and laser treatment. Good mix of general podiatry, wound care and surgery. Must be ethical, hardworking and committed to quality patient care. NJ license needed. Competitive salary and benefits. Send cover letter and resume to: AOKNDPM@gmail.com

ASSOCIATE POSITION - MARYLAND

Looking for 3rd associate. Must be personable, well trained and highly motivated. Great locations in Southern Maryland, including an Ambulatory Surgical Center. We currently have EHR, digital radiography, dispensing center and PADNet. Looking for immediate hire! Please send CV to: myfeetfeet@aol.com

ASSOCIATE POSITIONS - MULTIPLE STATES

Podiatrist Needed in Missouri, Nebraska, Iowa, Minnesota, North Dakota, South Dakota, Texas, Colorado, Wisconsin, Indiana, and Oklahoma. Expanding multi-state medical practice seeking podiatrists to service long-term care community residing in nursing homes and assisted living facilities. We offer an established patient base, scheduling, equipment allowance and cover travel expenses. Provide generous compensation, bonus opportunities, disability, health insurance benefits, malpractice coverage and flexible scheduling. Looking for a Podiatrist with excellent skills, able to provide expert and compassionate care to patients. Email CV to: careers@aggeus.org or call 773-770-0140 x300/x305.www.aggeus.org

ASSOCIATE POSITION - MANHATTAN

Podiatrist needed for busy state-of-the-art offices in Manhattan. Offices are located near Penn and Grand Central Station. 10+ years experience only and an out-of-network doctor for most insurances.  Please forward your information and CV to: roni@myfcny.com

ASSOCIATE POSITION - SENIOR CARE DIVISION - ATLANTA, GEORGIA

Village Podiatry Centers, LLC: Immediate openings for physicians who are interested in caring for the elderly in nursing homes throughout Georgia. Full time position. Excellent salary, benefits, and opportunity for growth. Must understand the coding/billing process and have excellent documentation skills. You don't have to be board certified in foot or ankle surgery for this position. If interested, please contact Dr. Helfman at dhelfman@vpcenters.com

ASSOCIATE POSITION - ATLANTA, GEORGIA AND SURROUNDING COUNTIES

Village Podiatry Centers, LLC: Immediate openings for board eligible or certified, 3-4 year trained surgical physicians. Equity based model, Excellent salary and benefits to start depending on qualifications. (Average physician salary is 2-3 times industry median salary).Full benefits included. Access to practice owned surgery centers, pathology lab, imaging center(s), and other in house ancillaries. Very selective process: must be flexible, well trained, and must participate in our "Physician Training Program." You live off income and retire off wealth! Serious inquiries only! E-mail: David N. Helfman, DPM, FACFAS at dhelfman@vpcenters.com

PHYSICIAN FOR CLINICAL RESEARCH DIVISION - ATLANTA, GEORGIA

Village Podiatry Centers, LLC: If you have experience in running clinical research trials and would like a full time position in managing and overseeing multiple clinical research trials for our growing group, please contact Dr. Helfman @ dhelfman@vpcenters.com. Excellent salary, benefits and equity opportunity for the right individual. 

ASSOCIATE POSITION - TENNESSEE/NORTH GEORGIA

Multi-physician, Multi-office practice looking for motivated new associate leading to partnership. We are a busy practice with state of the art technology: EHR, Digital X-ray, Diagnostic Ultrasound, PADnet, EPAT machine. Applicant should be PMS 36/Board Qualified/Certified. Applicant should be ethical, personable, hard working and interested in providing all aspects of podiatric care to our patients. Competitive Salary and benefits. All interested candidates please send a CV with two letters of reference tomybestnewjob@gmail.com

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