The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

April 20, 2012 #4,441 Publisher-Barry Block, DPM, JD

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Transition to Summer Shoes Can Cause Foot Problems: MA Podiatrist

According to Dr. Damien Lucius of Franklin Foot Care in Milford, the most common complaints in the spring and early summer are plantar fasciitis and Achilles pain caused from people going right from shoes with cushions and heels to flip flops and bare feet.

Dr. Damien Lucius

“Changing in to summer footwear should be a transition by wearing the flatter shoes for a couple of hours a day over a few weeks,” he said. If plantar fasciitis occurs, rolling the foot back and forth over a tennis ball can help resolve it.

Source: Lisa Vasile, Milford Patch [4/18/12]

"Minimalist Running is Good, but Minimalist Education is Bad": IN Podiatrist

Dr. Paul Sommer, a Valparaiso podiatrist and accomplished runner says, "Minimalist running is good, but minimalist education is bad." He recommends that runners do some homework before beginning a barefoot approach. "First, know your foot type. Go in once to a podiatrist and discuss any issues you've had before. Learn what you should watch for, based on your own foot type. You may save yourself time, money, and pain in the long run by preventing injury." 

Dr. Paul Sommer

Sommer cautions that all feet are not created the same and barefoot running is more doable for those with a normal to high arched foot. "Too often runners overdo it. They get these new shoes and they're all excited. They try too much too soon and get injured. When trying a minimalist shoe, start with small runs on a soft trail and increase very gradually," advises Sommer, who has been practicing podiatry for twenty-four years and has been running triathlons even longer.

Source: NWI Times [4/18/12]

TPMF Hosts Resident Case Competition

The Texas Podiatric Medical Foundation (TPMF) hosted the historical Bandera Ranch Meeting on April 13-15. Dr. Javier LaFontaine, VA Director- Temple, TX served as chairman. Guest speakers included Dr. Lawrence Harkless, Western University and Dr. Hisham Ashry, Private Practice, W. Palm Beach, FL. In addition to the open lecture format and sharing "pearls" at the cowboy bar, each Texas residency program competed for best overall case presentation judged by all attendees. 

(L-R) Drs. Kyle Haffner, Katy Walters, and Amy Reidel

The 2012 first place winner was: Dr. Kyle Haffner from West Houston PMSR-36 - Dr. Sam Mendicino, Director. The second place winners were a team: Dr. Amy Riedel and Dr. Katy Walters from Hunt Regional PMSR-36 - Dr. Steven Brancheau, Director.

TN Podiatrist to Release Neo-Soul Album 

Aside from practicing surgical podiatry in Memphis, TN, Dr. John E. Bell is also a recording artist poised to release his second Neo-Soul album entitled “Dating Again” in the Summer of 2012, following his first album “From Love to Love.”

Dr. John Bell

Bell is currently working on a movie with the Emmy award winning director Vincent Price. He has appeared in television and radio shows to talk about his work and books, which include The Blue Ball Syndrome, Invasion of the Baby Doctor, and Do I fit the Color of the Rainbow?

Performance Health Donates Biofreeze® Pain Reliever to U.S. Troops

Performance Health has made a donation of Biofreeze Pain Reliever, at a retail value of $212,000, to SupportOurTroops.Org. This donation, large enough to serve 25,000 troops, will be provided to U.S. service members in Afghanistan.

“This gift to the troops comes thanks to the patriotism and generosity of the great American company Performance Health in Akron, Ohio,” said Martin C. Boire, Chairman of SupportOurTroops.Org. “On behalf of the troops, we thank Performance Health for their voluntary contribution. It will do a great deal of good for the well-being of front line troops.”

Specialty Docs Protest CMS Overpayments Plan

A coalition of physician associations has joined hospital organizations in protesting a proposed rule from the CMS that calls for providers and suppliers to return excess payments within 60 days after the overpayments are identified. The proposed Medicare Reporting and Returning of Overpayments rule, called for in the Patient Protection and Affordable Care Act, was released by the CMS in February. It contains provisions that the Alliance of Specialty Medicine calls "onerous and unnecessary."

In a letter to CMS acting Administrator Marilyn Tavenner, the Alliance, which represents about 200,000 physicians, wrote that under the proposed 10-year "look-back period," fee-for-service providers would have to retain documents for four years longer than Medicare currently requires them to. The alliance proposed reducing the overpayment-liability period to three years.

Source: Andis Robeznieks, Modern Physician [4/18/12]

AZ Doc Practice to Pay $100,000 in HIPAA Settlement for Website Violations

Using a Web-based, electronic patient scheduling system without appropriate privacy protections has led to an Arizona medical practice reaching a $100,000 settlement with the federal government over potential privacy and security violations of the Health Insurance Portability and Accountability Act of 1996, HHS announced. Phoenix Cardiac Surgery has agreed to pay HHS and take corrective actions to protect patient information after an investigation by HHS' Office for Civil Rights, which has privacy and security rule enforcement duties under HIPAA.

The investigation was triggered by a complaint that the practice "was posting clinical and surgical appointments for its patients on an Internet-based calendar that was publicly accessible," according to an HHS news release. The civil rights office's investigation also found that the practice "had implemented few policies and procedures to comply with the HIPAA privacy and security rules and had limited safeguards in place to protect patients' electronic protected health information."

Source: Joseph Conn, Modern Physician [4/17/12]

RE: Charcot Foot
From: Tip Sullivan, DPM

I would like to get some comments on an interesting case from a practical and medical/legal standpoint. The main question that I think this case brings up is: when do we say “enough is enough” and avoid the major expense in our system that is incurred due to defensive medicine?

42 y/o male, married, employed as a machine shop foreman 

Suspected Charcot Foot

PMH: NIDDM x 15 years—well controlled (FBS 110, A1C 7.1), peripheral neuropathy not officially diagnosed, but...

Editor's Note: Dr. Sullivan's extended-length note can be read here.

Query: Sterilizing Bits Between Debridements

My board of registration has recently required me to undertake 30 hours of CME on "hygiene and sterility" because I do not sterilize the titanium bits I use in my Dremel debriding unit between patients. Are there evidence-based studies indicating that this is a significant problem in our profession? Are those of us who practice as I do really endangering the public health and spreading disease? Have any of you been rapped on the knuckles by your boards and threatened with license suspension/revocation for such an offense?
 
Jeff Kittay, DPM, Boston, MA

RE: Excisional Biospy (J P McAleer, DPM)
From: Bryan C. Markinson, DPM

The trouble with both the original post and responses is continued interchangeable use of the words excisional and incisional, in addition to not defining whether the lesions are skin lesions or soft tissue masses. Soft tissue mass refers to everything not bone and not skin. A wart is a skin lesion, not a soft tissue mass. Excision surgery and/or biopsy means the entire lesion is removed. Incisional surgery/biopsy means a piece of the lesion is removed.

In the original case presented by Dr. Borden, the large lesion described sounds like a skin lesion, and excision before determining whether the lesion is benign or not is not the best practice. Dr. McAleer's recommendation of normal skin in the biopsy is completely unnecessary, as stated by Dr. Shavelson. Furthermore, Dr. McAleer's recommendation for frozen section is considerably less than optimum for skin lesions, as this technique can obscure detail enough to make a determination impossible.

Lastly, the recommendation for use of cautery to "avoid seeding cancer cells into the general circulation" raises a concern that has been debunked for over 50 years. There is no evidence that biopsy of a lesion causes spread in any way, and cautery certainly would not prevent that if indeed it were true. But it is not true. It is true that these lesions need to be respected, not vigorously manipulated, and biopsied properly so as to ensure the best treatment options if indeed a malignancy is found to exist.

Bryan C. Markinson, DPM, NY, NY, Bryan.Markinson@mountsinai.org

RE: Urgent Care Clinics (Bret Ribotsky, DPM)
From: Larry Kansky, DPM, JD
 
I found it very interesting that Dr. Ribosky worries about the masses of patients who are getting treated in "doc in boxes" by a nurse  practitioner who has received a PhD, and is called DOCTOR.
 
Is this the same Dr. Bret Ribosky who gets upset when podiatrists (DPMs) receive the same or similar critical remarks from MDs? 
 
Larry Kansky, DPM, JD, Wilkes-Barre, PA, larry.kansky@gmail.com

RE: IN Podiatrist Invents Healthy Walking Technique
From: Kevin A. Kirby, DPM

Is it just me, or does it seem that every week, some health specialist claims to have "invented" a "new, natural way of" ________ing  (fill in the blank with any action) and then, of course, has given it some new name, and wants to profit off of their "invention".  Now, Dr. Niremberg has "invented" a "new, natural way of walking" that he calls FloWalking, has taken out a website devoted to FloWalking that claims "faster weight loss, greater energy, increased fitness, a taller, leaner look, less joint and muscle strain and pain, fewer walking-related injuries and benefits for young and old", along with a testimonial video (flowalking.com/).
 
Does anyone else think that this is somewhat odd that a physician claims he "invented" a new way to walk along with unproven health claims of his new "invention" on his webpage?  Or is this just a sign of the times that you can now claim anything you want to on the Internet, regardless of whether you have a shred of research evidence of the health benefit claims of this new "invention"?
 
Kevin A. Kirby, DPM, Sacramento, CA, kevinakirby@comcast.net

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PODIATRIC SPORTS MEDICINE FELLOWSHIP - ORANGE COUNTY CA

July 1, 2012 and ending July 31, 2013 (13 months). Responsibilities include assisting in all types of foot and ankle surgery, (approx. 500 cases), office and outside rotations including Sports Medicine Orthopedics Family Medicine, Biomechanics and Physical Therapy. Benefits include salary of $60,000/year, medical, dental, malpractice, and CME allowance. APPLICANTS MUST BE ABLE TO OBTAIN A CALIFORNIA LICENSE. Min. 24-month surgical residency training is a pre-requisite. Letter of interest, and CV to: Philip Radovic, DPM, Fellowship Director, 665 Camino de los Mares Suite 304, San Clemente, Ca. 92673. Ph: 949/493-8020 Fax: 949-488-0868. Email: Info@feetfixer.com.

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 to mybestnewjob@gmail.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.

PRACTICE FOR SALE - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact: podiatrypracticesale@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

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