The Voice of Podiatrists

Serving Over 10,800 Podiatrists Daily

April 22, 2008 #3,226 Editor-Barry Block, DPM, JD

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NV Podiatrist to Run for Mayor of Carson City

Sean Lehmann, 35, opened a campaign bank account, launched a Web site and has started spreading the word about his candidacy. "I hear almost every day from my patients that people are tired of having the 'good old boys' running this city," Lehmann said. "For the last 20 years, Carson City has been under the leadership of the same two men. It's time for a fresh face."

Dr. Sean Lehmann

The race for mayor will likely include some familiar names, but Lehmann said he is not afraid. "The vast majority of voters don't know the usual candidates anyway," he said. "You often hear them claiming that they are an outside voice. More often than not, they are more of the same. I am not a politician. I'm a doctor. I really am the outside voice that so many people want."

Lehmann said he believes that his lack of political history is actually a benefit. "I have run a successful medical practice for the last eight years. I have a Master's degree in administration. I know how to lead and administrate," he said. "I have dedicated my professional life so far to helping people. That's exactly what I'll do as mayor, help people and help Carson City."

Source: Reno Gazette-Journal (NV) [4/19/08]

NY Podiatrist Attends Papal Mass at Yankee Stadium

A crowd of more than 57,000 attended a papal Mass at Yankee Stadium Sunday led by Pope Benedict XVI, including a few Catholics from the Greater Little Falls area. Kathleen DeCarlo and her husband, Robert DeCarlo, a podiatrist with Slocum-Dickson, entered the lottery to attend the event and they were informed that they would be attending. “I’m very excited,” Kathleen, a freelance court reporter, said. “I think it’s going to be very spiritual.

Dr. Robert DeCarlo

We went to the Vatican about six years ago and the Pope wasn’t there.” Kathleen said she spoke to Father Mark Cunningham at her church, St. Francis de Sales in Herkimer. “He’s really excited for us,” she said. “We had quite the conversation. I got a lot of knowledge from him.” The DeCarlos are bringing several sacramental medals to be blessed for friends of theirs.

Source: Dana C. Silano, The Evening Times [4/18/08]

Query: Computerized Radiography vs. Digital Radiography

Could anyone make any recommendations concerning the pros and cons of computerized radiography (CR) vs. digital radiography (DR). From what I understand, CR is closer to the standard way we process in a sense that the film is shot on an x-ray plate (phosphor in this case). The film is removed from the cassette and place on a laser scanner where the image is transferred to a computer screen. The second, DR, I believe bypasses the unloading of the cassette as the image is transferred from the plate via a cable, directly to the monitor. I have seen this method used at dental offices but I am not sure if podiatrists are using DR.

Gary Gugliada, DPM, Staten Island, NY

Query: Treating a Patient with Severe Autism

I have a 16 Y/O male with severe autism. He has an infected ingrown nail but will not allow me to give an injection or even do a wedge resection. Since the patient has Medi-Cal, I submitted a Treatment Authorization Request twice in hopes of being able to do the procedure in the OR under sedation. However, Medi-Cal has refused stating that the procedure should be performed in the office setting. Now I have a patient who is in severe pain and a mother who is very upset with me and a pediatrician who calls me daily and wants to know why I have not treated her patient yet. Does anyone have any suggestions of how I should treat this patient? I even offered the pain management doctor next door (who is also an anesthesiologist) money to perform sedation for me in the office and he refused due to liability. I have everything documented and want to know how I can keep this from becoming a medical legal issue. But most of all, how can I help this patient?

Edwin Oghoorian, DPM, Glendora, CA

Editor's comment: PM News does not provide legal advice. The overriding principle should always be what is best for the patient. This means treating the patient first and worrying about reimbursement later. If you cannot treat this patient safely in your office, the patient should be referred to an emergency room at a local hospital. Proper documentation of your findings is the best defense for any potential legal problems that may arise.

RE: Recommended Work Boot (Frank DiPalma, DPM)
From: Robert M. Gaynor, DPM, Joe Boylan, DPM,

This is a Dunham 6" Black Ram Classic waterproof workboot featuring LUG TRU-TRAK® outsole design with ABZORB® cushioning and removable insert. Oil-resistant, non-marking rubber outsole. Fiberglass shank. Dunham is a New Balance brand.

Durham Boot

Robert M. Gaynor, DPM, Lake Worth, FL, nailcutter@aol.com

Redwing work boots seem to be top of the line. I have had many patients endorse them and they do have the construct and materials you are looking for. Google REDWING.

Joe Boylan, DPM, Ridgefield, NJ, Drb0327@aol.com

RE: Limb-Length Discrepancy in Biker (Steve Wolfington, DPM)
From: Amol Saxena, DPM, Stanley Beekman, DPM

I routinely see cyclists w this condition. I learned from Max Testa, MD a premier cycling doc that for a short femur, you should compensate by sliding the cleat forward, or on the opposite shoe (longer limb) the cleat back. For tibial shortening, as others have recommended, wedges between the shoe & cleat work well. I have used this method personally with great results.

Amol Saxena, DPM, Palo Alto, CA, Heysax@aol.com

I just wanted to expound on why the crank arm should be shortened on the short femur side. If we were to look at the power phase, For Illustration Click here ,we would find that most of the power is from 2:00 to 4:30. This means that this is the most critical time for the leg to be in the optimum position. If the femur is short, then the knee would have to be extended and not as perpendicular to the pedal.

At 6:00 both the material under the shoe, and the shortened crank would put the foot and leg in the same position.

At 9:00, the shortened femur would be in a better position with the shorter crank arm. The additional bending of the knee due to the pedal block and the longer crank arm would be disadvantageous at the second most important time in the pedal cycle.

At 12:00 the shorter femur would have a more extended knee. At this time the knee is extending, and there is less of a moment on an extended knee vs. a flexed knee.

Again, this is the way to treat a structural deformity of the femur. I agree with the additional material under the shoe for a short tibia. If the shortage is functional then different treatments are required. For instance, if the shortage is due to pronation, then orthoses are indicated.

Stanley Beekman, DPM, Cleveland, OH, sbkmn1@gmail.com

RE: Podiatrists Vs. Orthopods
From: Jerry Cosentino, DPM, Michael M. Rosenblatt, DPM

These letters can be read at: http://www.podiatrym.com/letters2.cfm?id=19102&start=1

PRACTICE FOR SALE - BUFFALO'S KENSINGTON SECTION

Established satellite practice. In urban metropolitan area on a busy commercial street corner - commercial building with an attached retail store that allows easy advertising of the podiatric medical practice. Gross $170K+ at 2 ½ day per week. Great potential for growth. 260 402-7490

ASSOCIATE POSITION – NW INDIANA (1 HR FROM CHICAGO)

Caring, hardworking podiatrist needed to join our busy practice. We offer great pay and benefits. Must be highly motivated, have a great bedside manner and superb surgical skills (forefoot and rearfoot surgical training a must). E-mail resume to friendlyfootcare@comcast.net or fax resume to (219)662-7290. Learn about here

PRACTICE FOR SALE - EASTERN WASHINGTON

Established practice located in the fastest-growing city in the state of Washington. Enjoy the lifestyle available in the area. Practice is directly across the street from the hospital - surgery center located within the hospital, and podiatric surgical privileges are not restricted. Gross $200K+ at 4 days per week. Can easily grow. 260 402-7490

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

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- CORAL GABLES, MIAMI AREA (FLORIDA)

Beautiful location in the heart of Miracle Mile. Excellent opportunity for a starting practitioner. Most insurances accepted. Good mixture of surgical and general podiatry. Fully equipped with low overhead. Located in a professional building, with referrals from other doctors in the same building. Contact zoesar@aol.com or call 786-877-5149.

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 – FLORIDA

Emerald Coast on the North Shore of the Gulf of Mexico, a well-established group practice with multi-offices, seeking an associate with opportunity for partnership for a PSR-24/36 Doctor well-trained in foot/ankle/diabetic problems/wound care/surgical and medical podiatric care, covering 3 area hospitals, NO nursing homes, Please fax a letter of interest, CV, and references to 850-862-5470, e-mail ecpodiatry@aol.com

ASSOCIATE POSITION – PART-TIME MARYLAND

Baltimore County, Maryland Practice seeking motivated and very personable individual with 2 years min. surgical training. Busy practice in great area with hospital grade ASC. Please fax your CV and contact information to: Dr. Maurice W. Aiken 410-602-9781.

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