The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

April 25, 2011 #4,143 Publisher-Barry Block, DPM, JD

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NY Podiatrist Discusses Prevention of Shin Splints

Noted Western New York podiatrist, Dr. James Hanna offered some seasonal advice on Channel 7's "Eyewitness News This Morning" with Patrick Taney and Ginger Geoffery. Shin splints can represent a variety of different conditions. Most commonly, it is an inflammation of the lining of the tibia, says Hanna. 

Dr. James Hanna

"It is caused by that constant pounding, where you have a pull on the tibia. Proper warm-up is essential. The importance of good footwear cannot be over-stated. Make sure that you have a good treadmill. Many treadmills have some 'give,' which acts as a shock absorber, says Hanna.

Source: Patrick Taney and Ginger Geoffery, WKBW-TV (Buffalo, NY) [4/21/11]

TN Podiatrist and Wife Active in Tour de Cure, Canine Rescue 

Tracy Toy of Murfreesboro is on the road again. Last year, her cycling team — Team AJ — for the American Diabetes Association's Tour de Cure raised the most funds in the Middle Tennessee area. Her husband, Dr. Martin Toy, a podiatrist in town, sees many patients who suffer greatly from foot issues caused by diabetes. Problems vary, from lack of nerve sensation in the foot to skin changes, foot deformity, poor circulation, and longer healing times for wounds. 

Dr. Martin Toy

Canine rescue is another passion. She and her husband have been involved with various dog rescue groups over the years, from being volunteers, to donating, fostering, and adopting dogs.
 
Source: Nancy De Gennaro, Murfreesboro Daily [04/23/11]

IL Podiatrist Inspired by Shen Yun Performing Arts

“It was a fantastic show,” said Dr. Stephanie Wu after catching Shen Yun Performing Arts, on April 20, at the Civic Opera House. Dr. Wu is Assistant Professor in the Department of Surgery at the Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, and Director of the Limb Preservation Center at Advocate Lutheran General Hospital.

Dr. Stephanie Wu with Robert Bacon (Photo: Kerry Huang)

Shen Yun Performing Arts New York company aims to revive the traditional Chinese culture through music, song, and more importantly, classical Chinese dance. Many Shen Yun dances tell legends from the 5,000 years of Chinese civilization. Dr. Wu said she particularly enjoyed the show because, although Asian, she grew up in the West. She said, “I thought it was very educational, so for someone who grew up here. … I'm not all that familiar with the culture, so it was very inspiring and educational.”

Source: Kerry Huang, Epoch Times [4/21/11]

Use of Conservative and Surgical Foot Care in an Inception Cohort of Patients with RA

Despite the known high prevalence of foot pathologies in rheumatoid arthritis (RA), only one-third of this cohort accessed podiatry. While older females were more likely to access podiatry care, and younger patients undergo surgery, the majority of the RA population did not access any foot care.  

Methods

• Use of podiatry and type of foot surgery were outcomes recorded in an inception cohort, involving 9 rheumatology centers that recruited patients with RA between 1986 and 1998 across England.
• Associations between patient-specific factors and service use were identified using univariate logistic regression analyses.
• Independence of associations were then verified through multiple binary logistic regression modelling.

Results

• Data were collected on 1237 patients with RA [66.9% females, mean (s.d.) age at disease onset=54.36 (14.18) years, median DAS=4.09 (1st quartile=3.04, 3rd quartile=5.26), median HAQ=1 (0.50,1.63)].
• Interventions involving the feet in the cohort were low with only 364 (30%) out of 1218 receiving podiatry, and 47 (4%) out of 1237 patients having surgery.
• At baseline, female gender, increasing age at onset, being RF positive and higher DAS scores were each independently associated with increased odds of seeing podiatrist.
• Gender, age of onset, and baseline DAS were independently associated with the odds of having foot surgery.

Source: Backhouse MR, et al. Rheumatology via MDLinx, [04/22/2011]

WSPM Meeting Features Practice Manangement and EHR Presentations

SOS Healthcare Management Solutions kicked off the Annual Washington State Podiatric Medical Association's Annual State Meeting in Bellevue on April 15 with a morning of practice management. Dr. Michael Brody and Lynn Homisak co-presented topics to a full house on EHR, meaningful use, and practice success strategies. 

Pictured by the Bako Labs booth are (L) Dr. Susan Scanlan, Executive Director of WSPMA and (R) Lynn Homisak of SOS. Bako Labs sponsored a well-attended biopsy workshop.

Query: Dexamethasone Substitute

Since Dexamethasone is on backorder with our medical supply companies due to a manufacturer's recall, I would like to know which corticosteroid other podiatrists are using for their injections, and in what combinations.

Olga Luepschen, DPM, Sebring, FL

RE: Post-op Nail Complication (Brent Rubin, DPM)
From: Carlos Montes, Jr., DPM

I recall several instances, such as Dr. Rubin describes, for post-op phenol nail procedures. There was serous weeping with local redness and some tenderness. It turned out to be an epidermal inclusion cyst, so you might want to explore this deep in the proximal nail fold. The cultures were negative, but the wound kept draining despite obvious measures as Dr. Rubin described. You need to use a tourniquet, of course, and look in there. I suspect that a small portion of the nail plate was the culprit and left in during the procedure.

Carlos Montes, Jr., DPM, MS, Melbourne, FL, Cimontesjr@aol.com

RE: Pecos Registration (Paul Kesselman, DPM)
From: Simon Young, DPM

I have used the representative endorsed by Dr. Kesselman - Kathy- cell # 615-563-2010. It cost approximately $850, with a $500 down payment. It took several months, but she was on top of everything and  responded  via e-mail promptly. I had an issue created by CMS which she ultimately resolved.

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

RE: Shoes and Pre-Fab Orthoses for Small, Narrow Feet (Charles F. Ross, DPM)
From: Roody Samimi, DPM

You may want to specifically contact one of these companies by phone/e-mail to find out if they can make/send their OTC product in your patient's size: superfeet.com, powerstep.com, or yoursole.com. Best bet is custom, though, even if you have to give it to them at a discount due to their financial situation. Just like for kids, we usually do use custom-made devices, so I don't see why you would treat her any differently.

Roody Samimi, DPM, Cincinnati, OH, roody.samimi@gmail.com

RE: CryoProbe (Mohammad Sharif, DPM)
From: Burton Katzen, DPM

I purchased the "upgraded" version of the Cryoprobe about 1 1/2 years ago and agree with Dr. Sharif's assessment - very expensive cost and very expensive cartridges for what it does.
1. It is good for raised dorsal lesions, but you will get inflammation, and it may take a few weeks to flake off.
2. It's not very good for plantar lesions.
3. Obviously, you are unable to send lesions to pathology.
4. I recently had lesions burned off by one of the top dermatologists in town who used a much cheaper "cryotherapy in a can" device which did the same thing.
5. Remember, you do not get paid for a surgical excision, only for 17110, so my advice for an immediate resolution is to get out the old trusty curette or punch biopsy, as I have done.

Also, I might add that one of my assistants tried contacting the company five or six times in the past week to ask a question, left a message, and never got a return call. Make sure they are still in business.

Burton Katzen, DPM, Temple Hills, MD, DrburtonK@aol.com

RE: Exogen Bone Healing System (Tip Sullivan, DPM)
From: Randolph C. Fish, DPM

I have used the Exogen 4000 by Smith and Nephew successfully for non-union fractures in diabetics and dysvascular patients. I believe it is the best bone stimulator on the market. I have had one complication, however. A young female with a delayed healing calcaneal fracture started using the device, then developed severe pain in the calcaneous.

After the first few uses, she always developed severe pain, slowly decreasing over several days. I have asked Smith & Nephew several times, even speaking to a scientist on one occasion, about the etiology of the pain, but no one has been able to provide an answer. I found four reports on the Internet about bone pain using the device, but no answers. Has anyone else seen this problem?

Randolph C. Fish, DPM, Tacoma, WA, rcfish1@juno.com

RE: Coming Down a Peg (Douglas Milch, DPM)

Dr. Milch reminds me of one day, long ago at the office. It was a particularly busy morning, and I saw quite a few patients. When, after about 3 1/2 hours of patient care, I had to run to the bathroom. I looked in the mirror and saw three pieces of toilet paper that I had affixed to shaving cuts that morning. Not one said a word to me (not even my staff). I laughed out loud in the bathroom. Now, I use styptocaine instead.

Robert Kornfeld, DPM, Manhasset, NY

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Great opportunity. 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

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. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

ASSOCIATE POSITION AVAILABLE - THE BRONX

Excellent hospital based opportunity. Inpatient & Outpatient Care. Busy clinics. Large diabetic population. Practice all aspects of Podiatric Medicine & Surgery. Requires Surgical Skills. CV to nealblitz@yahoo.com

ASSOCIATE POSITION – NEW JERSEY

Associate wanted full-time, for practice in East Orange NJ PSR 24-36 trained. Must be motivated to grow practice, especially build wound care and surgical services. Buy-in possible after the 1st year. send CV to Drfoot44@gmail.com

ASSOCIATE POSITIONS - NW INDIANA, CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

ASSOCIATE POSITION - CT - (FAIRFIELD AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to Dr.Kassaris@yahoo.com

ASSOCIATE POSITION - NEW YORK CITY & QUEENS

One of the fastest growing podiatry practices in New York City and Queens seeks a podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Preferably a Spanish speaking podiatrist. Contact me at Podocare@aol.com

PODIATRIST NEEDED - NY/QUEENS/LI

Must be min. PSR-3 with excellent training. Experienced in billing, selling non-covered services, products, Patient medical and surgical exp. with good rapport/comm. skills necessary. Unique position working in offices, clinics, hospital with orthopedist, podiatrist, P. therapists. P/T, F/T available. Growth, income potential and partnership opportunity excellent. A chance to use all your skills; foot, ankle and more. Please respond with cover letter and CV to hansfeet@aol.com

EQUIPMENT FOR SALE - COOL TOUCH LASER

Cool Breeze Cool Touch CT3 plus laser used for ugly, unsightly, toe nail infections. Less than six months old. Great price won't last long. Considering a laser? We also have the Q- Clear Q- switch laser too. This laser is perfect for you. Also a used Lumix 2 laser, best price today. Dr. Zuckerman is in the Fort Lauderdale area and will demo these lasers on your patients. E-mail footcare@comcast.net

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