The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

April 25, 2007 #2,920 Editor-Barry Block, DPM, JD

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MA Podiatrist Sees More Overweight Children With Foot Problems

Podiatrists said they are starting to see more overweight children who are damaging their feet. "We're seeing a lot of strains and inflammation," said Dr. Thanh Dinh at Boston Children's Hospital. "More severe deformities, more severe injuries because of the obesity increase."

Dr. Thanh Dinh

New research found obese children have wider and longer feet. Dinh said the extra weight changes the structure of the feet. The pressure can exacerbate existing foot conditions. It can make it more difficult for a heavy child to balance, even walk.

"You want to keep them active to lose the weight, but at the same time when they're active, it's painful for them to be on their feet so they don't want to do it," Dinh said. But there is treatment. Custom orthotic devices and physical therapy can help alleviate some of the pain, Dinh said.

Source: Liz Brunner, WCVB-5 TV (Boston, MA) [4/19/07]

Three Prominent Alumni to be Inducted into OCPM Inaugural Hall of Fame Society

On Saturday, May 26, 2007, the Ohio College of Podiatric Medicine will induct three prominent alumni into their Inaugural OCPM Hall of Fame Society. Richard J. Berkowitz, DPM, Henry B. Green, DPM, and Raymond J. Suppan, DPM will all have the honor of being the first class inducted into the Hall of Fame.

Dr. Richard J. Berkowitz

The OCPM Hall of Fame Society was created to honor and recognize alumni for their outstanding contributions to the Podiatric Community, the OCPM Community, and their Living Community. The induction ceremony will take place at the OCPM Glass Slipper Fete, which is a black tie gala event that raises money for the OCPM Scholarship Fund for deserving students.

Dr. Henry B. Green

The Hall of Fame Members will have their pictures and bio copy displayed inside the college building for all OCPM students, alumni, faculty, staff and visitors to see.

Dr. Raymond J. Suppan

MA Considers Requiring All Surgeries to be Videotaped

Massachusetts physicians are not smiling about the possibility of being on camera in the operating room. Legislation introduced there in January would require licensed hospitals to make video and audio recordings of all surgeries. Failure to do so would result in a yet-to-be-determined fine.

Physicians and plaintiff lawyers alike say the idea might seem like a useful tool for providing hard evidence in medical liability cases as to what happened in the operating room. But in reality, they say, it will do more harm than good. "It becomes an imposition on the physician-patient relationship and starts out by saying, 'I don't trust you to do my surgery,' " said Kenneth R. Peelle, MD, president of the Massachusetts Medical Society, which opposes the bill.

The measure also comes at a time when, anecdotally, doctors and legal experts say many hospitals over the past several years began prohibiting patients from taping births because of liability concerns.

Source: Amy Lynn Sorrel, AMNews [4/23/07]

Query: Serum Homocysteine Levels

I have been reading and studying about serum homocysteine, and what problems elevated levels may cause. The lab I use puts the normal range at 5.0-15.0 umol/L, but I have read where levels above 12 umol/L are considered elevated, and can cause problems. I have also read that levels below 24 are considered normal. What is the normal serum level of homocysteine?

Gary Adsit, DPM, Marion, IN

Query: Recommendations for the Strongest Marketing Tools

What are the best tools for marketing a practice and building the best awareness in both the medical and surrounding communities? By "tools," I mean things like practice folders, pens, pads, coffee mugs, Post-it pads, Rolodex cards, etc.

Chad Schwarz, Howell, NJ

Query: Coding the Fusion of a Tarsal Joint

We have a patient who has osteomyelitis of the calcaneal-cuboid joint. We are going to debride the bone, replace the dead space with bone substitute impregnated with vancomycin, and stabilize the site with an external rail in hopes to fuse the joint. What would be the most appropriate code/codes for such a procedure?

David Sands, DPM, Great Neck, NY

Response: The issue would be whether your intention is to debride infected bone, or perform a primary fusion of the calcaneal-cuboid joint.

Consider: CPT 11044 (debridement of skin, sbcutaneous tissue, muscle and bone) or
CPT 28740 (arthrodesis of midtarsal joint, single).

If you intend to create a fusion, it would be reasonable to use the fusion code. Realize that a "fusion" procedure has a 90-day Medicare post-operative follow-up whereas the debridement code has a "10" day Medicare post-operative care assigned to it. This may impact your decision.

Howard Zlotoff, DPM, Camp Hill, PA

Codingline subscription information can be found at
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RE: Cosmetic Foot Surgery
From: Ivar E. Roth, DPM,MPH

I keep reading about practitioners opinions of cosmetic surgery of the foot. Some say it is fine; others bad mouth the thought. Why not think of it this way. Not all physicians are plastic or cosmetic surgeons. The few that have been trained to hang out their shingle advocating their abilities take the challenge and provide the services. Not all podiatrists are created equally, let’s face it, some are better trained than others. Why not embrace the idea that cosmetic surgery of the feet is a specialty area and let those who have the talent and skill provide the service. The bottom line is if a podiatrist provides the service and takes the risk .i.e., his reputation, then he or she should be able to provide the service.

Ivar E. Roth, DPM, MPH, Newport Beach, CA, ifabs@earthlink.net

RE: CME Challenges (Lloyd Smith, DPM)
From: Bret M. Ribotsky, DPM

For nine years I served on the Board of directors of ACFAOM, leading to my being president. I have also attended seminars throughout the country where I spend the full day in meetings, missing all the education offered, but in no way can I say this helped my clinical knowledge. I agree with Dr. Smith that in these meetings you learned much about organizational management, but that is NOT what the system had in mind when CME credits were started.

Almost all professionals need to stay abreast with the newest trends, CPA's, attorneys, and even fitness professionals require continuing education. We are all patients at sometime in life, and I want to be sure that my physician is up-to-date.

I feel the issue is that podiatric meetings need to have great speakers and stopping having speakers that are selected by only the "Industry." We have all (painfully) listened to a speaker read pre-done company slides. Our profession has some outstanding communicators, who at each seminar pack the meeting hall. If the presentations are outstanding, no one will be "walking the halls." AAPPM meetings offer zero credits and sell out each year.

Bret M. Ribotsky, DPM, Boca Raton, FL, Ribotsky@doctorbret.com

PRACTICE FOR SALE – DETROIT MICHIGAN

General practice for sale. This well established muiltple location practice is grossing over $1M. Potential, potential, potential! Professional sports, acedemia, dining, and entertainment galore. Nice mix of commercial insurance, cash, Medicare. Staff willing to stay making this a true "TURN-KEY" opportunity. Contact AMERICAN DOCTOR SALES at 614-918-3000 or email sell_my_practice@yahoo.com www.americandoctorsales.com

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- 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

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

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 - BOCA RATON-DELRAY BEACH AREA

Full time for growing practice-surgical training a plus-hard working a real plus-opportunity of a lifetime-partnership after 1 yr. Need Florida license. Fax resume to 561-865-2225

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

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

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