The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

April 23, 2007 #2,918 Editor-Barry Block, DPM, JD

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MPMA Sued By Two Former Executives

A suit has been filed on behalf of two former top officials of the Michigan Podiatric Medical Association (MPMA), alleging that the association and seven of its 12 board members conspired to violate the Michigan Public Health Code and Whistleblowers’ Protection Act. The suit charges that the MPMA has been helping podiatrists to renew medical licenses by fraudulent or deceitful means—specifically through a “sign and dash” policy sanctioned by the MPMA. Under that policy, according to the lawsuit, the MPMA intentionally awarded continuing medical education (CME) credits to podiatrists for merely signing in at educational conferences, but not actually attending them.

State law requires podiatrists to obtain 150 CME credits every three years in order to renew their licenses to practice medicine. The MPMA, under the auspices of the American Podiatric Medical Association Council on Podiatric Medical Education, acts as an official sponsor of CME courses for podiatrists seeking relicensure in Michigan. The "sign and dash" CME policy “endangers the public health and safety by allowing podiatrists to continue to practice medicine without having participated in mandatory continuing medical education,” the lawsuit asserts. In addition, it is a violation of the Michigan Public Health Code for any licensee, including MPMA board members, to engage in "fraud or deceit in obtaining or renewing a license or registration."

The suit was filed by former MPMA Executive Director Mark A. Dickens and former Director of Membership Services Meghan Webber. Both were terminated on March 5, 2007—after two years of attempting to reform the “sign and dash” policy from within the association. Dickens and Webber are asking the court for compensatory damages including lost salary and benefits, and emotional distress, as well as punitive damages and an injunction barring the MPMA from further retaliation.

Read the complete story from the Detroit Business News at:
http://detroit.dbusinessnews.com/shownews.php?newsid=115845&type_news=latest

CSPM to Hold 1st Annual Robert L. Rutherford Memorial Golf Tournament

The California School of Podiatric Medicine’s (CSPM) Student Body Association is hosting its first annual Robert L. Rutherford, DPM Memorial Golf Tournament on Thursday, May 17th at Monarch Bay Golf Club in San Leandro, CA. This fundraising event is held in honor of Dr. Rutherford to benefit the CSPM Student Association. Proceeds will be used to fund educational speakers, ceremonial gatherings and developmental workshops.

Dr. Rutherford, an avid golfer, graduated from the CCPM 1940. When he started medical school, Dr. Rutherford only had a linen suit, straw hat and a set of golf clubs. He began his teaching career at CCPM in the Department of Surgery in 1943. For the next 27 years Dr. Rutherford served as chairman of the surgery department and chief of surgery of the Podiatry Hospital from 1960 until his retirement in 1970.

Dr. Rutherford was instrumental in developing plans for a teaching hospital which opened in San Francisco in April 1960 and became an outstanding program for learning foot and ankle surgery.

Health IT Bill Introduced in Congress

Rep. Charles Gonzalez (D-TX), chairman of the House Small Business Committee's Regulations, Healthcare and Trade subcommittee, and Rep. Phil Gingrey (R-GA), one of a handful of medical doctors serving in Congress, have introduced legislation that would dole out grants, loans and tax incentives to small physician practices to help offset the high costs of health information technology.

The bill would allow Medicare to give qualified physicians payment incentives that would be used toward the purchase of a health IT infrastructure, such as an electronic health-records system, evidence-based clinical decision-support tools and secure e-mail. HHS could include additional payments for evaluation and care-management services, payments for structured e-mail consults plus any other method the department deems necessary.

Additionally, the bill would amend the tax code to increase the amount that can be deducted for purchasing qualified health IT products for physician practices that fall under the IRS’ broad definition of a small business. Doctors could use the higher deduction for equipment that was put into service at the beginning of the year.

Source: Matthew DoBias, Modern Healthcare [4/20/07]

Query: Enchondroma in an 11 Year Old

I have an 11 y/o female whom I removed an enchondroma from the distal phalanx of her hallux four years ago (the enchondroma was causing nail dystrophy and paronychia). Although I was aggressive and removed about 1/3 of the distal phalanx along the medial aspect, follow-up x-rays taken last week revealed reoccurrence of the bone tumor. I explained to her mother that if the growth causes symptoms, I would have to perform a distal Symes-type procedure. The mother is concerned about the cosmetic appearance and inquired about an implant for the distal phalanx. I'm not familiar with any material or implant, but it seems like this could be done. Any suggestions?

Michael Ryan, DPM, Charlotte, NC

RE: 6E Rubber-Soled Baseball Shoes (Charles F. Ross, DPM)
From: Gary Bjarnason, DPM

Try Eastbay. If they don't have it, it isn't made. Reach them at:
http://www.eastbay.com/

Gary Bjarnason, DPM, Roanoke Rapids, NC, pedalpod@charter.net

RE: Videotaping Runners (James M. Petko, DPM)
From: Michael B. DeBrule, DPM

I recently researched video analysis and motion captures systems. Consider a Zflo motion system with 3 or 4 cameras. The salesperson will work with you for training and great results. Make sure you have enough room in your office for the cameras. There are other systems available: Contemplas, Dartfish, etc., but most don’t really allow for the more than two cameras if you want more than two views. There is a report page that you can customize as needed with your logo. Alex will basically send you a system you can take out of the box ready to use for a very reasonable price. The system will pay for itself in less than half a year.

Here is the contact info: Alex Czarowicz, zFlo Motion, Motion Capture and Analysis, 67 Federal Avenue, Quincy, MA 02169, phone (617) 890-1042, www.zflomotion.com

Michael B. DeBrule, DPM, Marshall, MN, drdebrule@starpoint.net

RE: Psoriasiform Dermatitis? (Tip Sullivan, DPM)
From: Bryan Markinson, DPM

Conditions like this are managed, rarely cured. Clinically, this needs more than a Dosepak to really quell the inflammation. I would put the patient on a sliding dose of prednisone as follows: 60 mgs. per day for three days, 40 mgs. per day for three days, 20 mgs. for three days, 10 mgs. for three days, and then 5 mgs. per day for three days. If the condition abates, and it should, I would continue the 5 mg. daily dose for another week. This would total 22 days of therapy. You can even go to 2.5 mgs. per day for the last week.

Topically, we need an ultra-high potency steroid in an ointment vehicle. I prefer Clobetasol 0.05 %. If you want to enhance the local effect of the steroid, occlusion is good...urea is better. Applying the steroid over skin that has been treated with urea will result in greater effect, as you enhance the penetration of the steroid and remove scale. The trick is to occlude the urea therapy, not the steroid.

This is done as follows: Apply Keralac Ointment (50% urea to the area at night after a shower, and occlude with cellophane. The new Kerol 42% Redi-Cloths (Doak Dermatologics) seems ideal for this case, as you can have the patient apply the entire pad over the area and occlude it. In the morning, the patient showers again (or thoroughly washes the foot) and then applies the clobetasol ointment into the area. In this manner you apply big guns, but cumulatively you are actually giving a lesser dose of steroids.

You should seek out the possible reasons for the dermatitis, such as searching for an irritant which may be an occupational exposure, or an allergen which is something eaten or inhaled. I send these patients for patch testing for this purpose. Most allergists do this and I would request that they test for shoe chemicals as well.

Please note that I am an active consultant and speaker for Doak
Dermatologics.

Bryan C. Markinson, DPM, New York, NY, bryan.markinson@mountsinai.org

Editor’s Note: The full version of this note can be read at:
http://www.podiatrym.com/letters2.cfm?id=13746&start=1

RE: Peppering the Plantar Fascia (Stanton Cohen, DPM )
From: Barry Mullen, DPM, Stanley Beekman, DPM

I believe Dr. Cohen is referring to the article written by Hassab and El-Sharif entitled Drilling of the os calcis for painful heel with calcaneus- Acta Orthop Scand 45: 152, 1974. Dr. Richard Jay, et. al., wrote a short article documenting his experience w/ the same technique entitled “Calcaneal Decompression for Chronic Heel Pain” (JAPMA Vol 75, No 10, Oct 1985). I also recall reading an article where a few clinicians tried treating "calcaneodynia" secondary to renal osteodystrophy utilizing the same technique, but cannot recall the specific reference.

Barry Mullen, DPM, Hackettstown, NJ, YAZY630@aol.com

The procedure was lectured on by Guido LaPorta, DPM. The rationale was that the pain of plantar fasciitis was caused by stasis. The procedure was supposed to cause a revascularization of the calcaneus. The reason this procedure fell into disuse was due to the calcaneal fractures that resulted from it.

Stanley Beekman, DPM, Cleveland, OH, sbeekman@internationalbandage.com

Editor’s note: This topic is now closed.

ARIZONA- OFFICE SPACE TO SHARE- TUCSON, AZ

Office was previously occupied by a podiatrist for ten years. Shared space in a modern, well designed, chiropractic and podiatry office. X-ray and processor provided. High growth area in Northwest Tucson. Potential patients walking in asking when a podiatrist will open for business. Respond: parksovc@aol.com, 520-544-2445.

ASSOCIATE POSITION - SANTA FE, NM

Established, 30 year practice with multiple office locations looking for a PSR 24/36 trained, hardworking, personable, ethical, highly motivated individual for associate position with immediate partnership available. E-mail CV and reference letters to sfpodiatry@aol.com

ASSOCIATE POSITION – SOUTHERN KENTUCKY

Southern Kentucky's largest and most respected foot and ankle group is looking for an associate to start in July 07. An amazing opportunity to grow with an established four provider practice on beautiful Lake Cumberland, Kentucky. Very competitive salary/bonus with a buy in opportunity will be offered. Established satellite offices will make for immediate patient base ready to be nourished and grown by a friendly, well-trained associate. Excellent benefit package. Lexington, KK is 1.5 hours North while Nashville, Tennessee is 2.5 hours South. Please fax CV to 606-679-4626.

Seeking Resident who wishes additional training: Baltimore, MD Mercy Medical Center

Resident position CPME accredited either 12 or 24 month commitment for a highly motivated individual 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 2007. Includes competitive salary/benefits. Send inquiries to rsher18@yahoo.com

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 – BRONX, NEW YORK

Seeking an ethical and personable Board Certified/Eligible residency trained individual (PM&S 24/36). Position available June 1, 2007 to become part of this prestigious and established NYC podiatric practice operating for 25+ years. All aspects of podiatry - Excellent opportunity leading to partnership with unlimited income potential and more. Fax CV to (718) 931-9324. WWW.BRONXFOOTCARE.COM

ASSOCIATE WANTED - MICHIGAN-DETROIT AREA

Great opportunity-must be hard-working, reliable, responsible and good with patients & staff-surgical training a plus-partnership after 1 yr. Michigan license required fax resume to 248-478-1370

ASSOCIATE POSITION-YORK, PA

Excellent opportunity for PSR/24-/36 residency trained podiatrist to join 32 year established podiatric practice. Partnership opportunity. All aspects of podiatry, surgical, biomechanical and general podiatry. State of the art practice with up-to-date facility. Call and speak to Troy Wentling office manager or fax CV to 717-854-6519 or e-mail to beechtreepod@aol.com

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

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

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 3625

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

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