The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

April 25, 2013 #4,751 Publisher-Barry Block, DPM, JD

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NY Podiatrist Discusses Cause of Blisters

Blisters are a common foot problem for runners. Caused by friction, heat, dirt, moisture and shoes that are too small, blisters are small bubbles of skin that are typically filled with clear fluid. Some blisters are painless; others are extremely painful, forcing you to discontinue your run.

Dr. Lori Weisenfeld

“Friction causes layers of skin to separate and foot blisters are the painful pockets of air or fluid that form between the layers,” says Lori Weisenfeld, DPM, a New York City sports podiatrist.

Source: Sherri Leimkuhle, The Advocate (MD) [4/23/13]

PM News has begun a new weekly feature called Quick Poll. Each week, we will post a new poll based on some of the controversial issues discussed in our Comments/Responses section. Straw polls are not scientific and do not represent standards of care.

Quick Poll
Is your office handicapped accessible?
Click HERE for Results

NC Male Podiatrist Walks in Heels for a Cause

Physician Tom Rehm is about to do something he spends his workdays urging others not to do, and he’s prepared to suffer the painful consequences of his radical act. Rehm, a podiatrist whose livelihood includes repairing the damage inflicted on women’s feet by modern fashion, will join dozens of other men Saturday as they stuff their manly toes into dainty high-heeled shoes and wobble through downtown Asheville for all the world to see.

Dr. Tom Rehm (2nd from right) with team from Appalachian Foot & Ankle Associates (Photo: Barbara Blake)

The blisters he’s happy to endure are for a good cause: the fourth annual Walk a Mile in Her Shoes event in conjunction with the International Men’s March Against Rape, Sexual Assault and Gender Violence. The walk is the largest fundraiser of the year for Our VOICE (Victims, Outreach, Intervention, Counseling, Education), Buncombe County’s rape crisis and prevention center.

Source: Barbara Blake, Citizen-Times [4/22/13]

CA DPM Voted "Best Podiatrist" by Local Newspaper

Dr. Steven Black says a good rapport with his patients is vital to the way he runs his practice. "I try to treat my patients as I would my family," said Black, who has been treating a variety of foot-related health issues in Valley residents, from infants to senior citizens, since 1988.

Dr. Steven Black

Black graduated from Dr. William M. Scholl College of Podiatric Medicine and is on the staff of Antelope Valley Hospital and Palmdale Regional Medical Center. He has been voted Antelope Valley's Best Podiatrist 2007, 2009, 2010, and 2011.

Source: Antelope Valley Press [ 4/20/13]

BioMedix Slashes Workforce, Enters Receivership

Med-tech firm BioMedix has cut its staff by 90 percent over the past year and sold off a software division in an effort to stay afloat. The Pioneer Press reports on the struggles of BioMedix, which also entered receivership to reorganize itself. The most recent cuts — which brought the company down to 19 people from more than 200 last year — came through the sale of a 50-person software business called TRAKnet to Nemo Capital Partners of New Jersey.

BioMedix, which makes diagnostic devices to detect vascular disease, said that 2012 sales were dampened by uncertainty in the healthcare market. The company had moved to St. Paul in 2010, when it posted revenue of more than $20 million.

Source: Mark Reilly, Minneapolis/St. Paul Business Journal [4/22/13]

Query: Non-Specific Bone Marrow Edema Syndrome?

A 13 y/o girl has chronic ankle/foot pain for one year, which has progressively worsened in the past few months. The patient's symptoms are aggravated by daily activities, running, and athletic activities. She denies any trauma, injuries. An exam showed mild lateral ankle instability and a negative anterior drawer sign. MRI report: "diffuse patchy bone marrow edema throughout the ankle. I suspect this represents non-specific bone marrow edema syndrome. Other more aggressive entities such as leukemia are not excluded though felt to be less likely. Consider follow-up MRI in three months." Labs: autoimmune panel tests and rheumatoid panel: all negative.

MRI

Treatments: RICE, immobilization with a CAM Walker, and crutches for two weeks helped a bit. Orthotics, ankle brace (AFO) helped minimally. The patient is able to walk and go to school in regular shoes with mild discomfort. She's unable to return to athletic activities. Has anyone seen this syndrome?  Any suggestion on the next step in treatment?

Query: Billing for Missed Appointments

I would like to know what other podiatry offices are doing regarding missed appointments/no shows (did not call to cancel). Do you charge the person for a missed appointment, and if so, how much? How do you bill them?

Olga Luepschen, DPM, Sebring, FL

Query: Replacement for Fabco?

I have been using Fabco wrap for years, but I understand it is no longer being manufactured. Can anyone suggests a replacement product?

Paul Taylor, DPM, Silver Spring, MD

RE: Post-Op Hallux Varus (Kel Sherkin, DPM)
From: Robert Chelin, DPM, Steven Silvers, DPM

Dr. Sherkin, perhaps you might consider a medial capsular tightening and a medial Akin osteotomy as the simplest correction to bring the toe into rectus and address your patient's cosmetic concerns. It seems that the attending surgeon may have been overly aggressive with the metatarsal head resection and, as a result, a hallux varus has resulted.

Robert Chelin, DPM, Toronto, CA, ft-biz@rogers.com

with all due respect, what does the fact that the initial procedure was performed by an orthopedic surgeon have to do with anything? I have been fortunate to have acted as a defense expert for many podiatrists in malpractice actions. Most cases involve complications which can and do occur and do not indicate that treatment rendered was below the standard of care. Foreseen complications of hallux valgus surgery include under-correction and over-correction of said deformity. 

Perform enough of these surgeries and all manner of complications of healing can arise. If they didn't, foot surgery conferences/seminars (be they podiatric or orthopedic) would not need to have lectures on correction of this complex deformity. Let's grow up folks, we're all foot surgeons, trying to do the best for our patients. Let's leave the petty professional jealousy and politics out of it. BTW, I'm guessing that the original procedure in this case was an opening base wedge.

Steven Silvers, DPM, Santa Monica, CA, drshs@yahoo.com

RE: Post-Op Hallux Varus (Kel Sherkin, DPM)
From: Robert Bijak, DPM, Jeffrey Kass, DPM

Simply correct the PASA with a Reverdin. 

Robert Bijak, DPM, Clarence Center, NY, rbijak@aol.com

If there is no pain, then of course one doesn't have to repair it. The patient does have a complaint and if you to chose to address it, you may want to consider the Arthrex mini tight rope. I would like to add, a podiatrist could have had the same outcome.
 
Jeffrey Kass, DPM, Forest Hills, NY jeffckass@aol.com

RE: Problem with Companies That Process Credit Card Payments
From: Elliot Udell, DPM
 
Two years ago, we signed up with a company that processes patient credit card payments. We are not totally happy with this company even though they market themselves as being "medical profession oriented." To our chagrin, the company informed us that there is a 700 dollar fee if we stop doing business with them. They showed me the contract I signed, and sure enough, in very small print in the 9th section of the contract, it says they can charge the client seven hundred dollars for leaving them. For those of you signing up with any of these companies, it behooves you to read the contract very carefully, especially the small print!
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Mobile Credit Card Processing (Philbert Kuo, DPM)
From: Jack Ressler, DPM, Michael J. Hodos, DPM

I have been using Square in a satellite office for almost two years and love it. The rates are very low, and you receive payment quickly. There are no monthly charges or minimums. I use it with my i-Phone and the patients seem to like how high-tech it is especially when they use their finger tip to sign their name on the screen of the phone. The option of sending them a receipt via email is also a plus. It allows your patients a fast option for payment instead of having to create a bill and the postage involved for both parties. Square allows for an easy transition to accepting credit cards. No downside! Just contact Square to sign up and order your free card reader.

Jack Ressler, DPM, Tamarac, FL, redwingcrzy@aol.com

My wife uses Square at her private counseling/therapy practice and loves it. We are considering using it in our office. I have no issues with the security of the system, and the cost seems extremely competitive.

Michael J. Hodos, DPM, Wake Forest, NC, mike@mikehodos.com

RE: Podiatry’s Secret Problem (Steven Moskowitz, DPM)
From: Michael J. Schneider, DPM

Dr. Moskowitz’s post was the second post in a few weeks by a member of our profession intimating that there are a significant number of our colleagues who are intentionally scamming/stealing from insurance companies by overbilling and billing for procedures or services not needed.

He based his statement on the fact that Medicare was billed $120 for his mother’s visit with a podiatrist at her assisted living residence and previous nail treatment by other podiatrists. My question would be...

Editor's note: Dr. Schneider's extended-length letter can be read here.

RE: AMA Initiative to Target Diabetes, Heart Disease
From: Robert Creighton, DPM

I was pleased to see the post today on the AMA’s effort to confront the various aspects of the pre-diabetes epidemic. This should be a multidisciplinary effort, and the APMA should be formally involved in this mission to stop pre-diabetes. As we know, the impact on metabolic health from the large muscle groups of the lower limbs is tremendous. We need to better academically and intellectually make the connection between lower extremity biomechanics (physics) and metabolism (physiology) so that we as a profession may practically impact the health of our country in this area. 
 
If we had more formal education on the role of movement, food, and lifestyle on health, we would be able to make a much more meaningful contribution - one beyond simply educating our patients on proper shoe fit and the hazards of hyperpronation. I was happy to see that there is an “Exercise is Medicine” lecture at my state’s upcoming podiatric medical association meeting. We need more of that.
 
Robert Creighton, DPM, St. Petersburg, FL, rcreightonjr@hotmail.com

RE: 104 Applicants Not Matched for Residency Positions (Jeffrey Kass, DPM)
From: Robert Scott Steinberg, DPM

Here's an idea. I suggest CPME start calling each residency director and ask what it would take for them to add another residency position. Prior to those discussions, CPME needs to make up their minds that they must find a way, before July 1, to solve this crisis. If the push back from residency directors is whether their existing resident might not make their CPME minimum case numbers, then CPME should be ready to reduce those numbers, at least in the short-term.

Getting a preceptorship is not a solution. It won't get them licenses, and it would just put them one year farther away from their goals. If CPME does not do something, this problem will just grow, with at least another 104 not being matched next year, and so on.

Robert Scott Steinberg, DPM, Schaumberg, IL, doc@FootSportsDoc.com

EQUIPMENT FOR SALE - FOX YAG LASER

Mint condition, still under warranty. Unit is portable & includes all the accessories. $14,500.00. Call 727 586-3668 or 727-321-310.

EQUIPMENT FOR SALE - BIOMEDIX PADNET SYSTEM
 
PADnet is clinically valuable, provides fair financial return with medically appropriate testing and seamlessly integrates with the complete suite of BioMedix® products and services. One year old. In Excellent condition. Buyer pays for shipping. Please contact Rhonda Daggs at info@footanklecenters.com

PRACTICE FOR SALE - VIRGINIA

62 years consecutive private podiatry practice, excellent referral base, busy, modern equipment; X-Cel Xray machine, digital Tigerview scanner, Traknet EMR, and 3 new Midmark chairs for the doctor and patient. Virginia license is required. Please contact Dr. Fine at drmichaelfine@aol.comor 703-582-5999.

PRACTICE FOR SALE - BROOKLYN, NY

28 year old practice in a desirable part of Brooklyn. EHR certified with stage 1 criteria successfully met. Practice has room to grow. Good mix of Medicare hazardous foot care; surgery and wounds. Low overhead. Priced to sell. Email Inquires to brooklynpracticeforsale@gmail.com.

PODIATRIC MERGERS - CHICAGO AREA

Weil Foot Ankle & Orthopedic Institute is expanding their presence in the Chicago metropolitan area. We are interested in discussing merger with current  podiatric practitioners in Chicago and surrounding area. Practices that have a minimum of 5 to 25 years of activity are welcome to meet with us and visit our rapidly expanding practice that currently numbers 18 DPMs, a neurologist, a rheumatologist, an orthopedic surgeon, and a primary care sports medicine physician. For more information contact: info@weil4feet.com  or call Stephanie Spiegel, COO at 847-390-7666.

ASSOCIATE POSITION - NORTH TEXAS

Associate position available. Located 50 miles from Dallas. All phases of podiatric care with no ER call. PSR 24 required. Hospital privileges & strong referral base. Practice has EMR, digital X-ray & on site vascular testing. Very competitive salary and benefits. Please send CV to Footdoc3143@gmail.com

ASSOCIATE POSITION – NORTHERN CALIFORNIA/SF BAY AREA
 
We’re expanding, seeking podiatrist to join multi-office practice. Must have great people skills, bedside manner, and positive demeanor. California license required. No nursing home visits. Prefer private practice experience. Send CV and cover letter to: ebpod2008@gmail.com

FT OR PT ASSOCIATE - SOUTH JERSEY

Great opportunity for FT or PT associate starting July 2013 in established practice in South Jersey. EMR, FDA-approved Lasers for fungus. Will work with Board Certified/Qualified podiatrist. Must have New Jersey License. Diverse practice in a nice area with a pleasant environment. e-mail CV at hhfootdoctor@gmail.com

ASSOCIATE POSITION - NEW JERSEY

Immediate opening for a full time podiatrist in a rapidly expanding multi-office practice in central New Jersey. Well established referral base with full admitting hospital privileges. Compensation is performance based with patients scheduled from day 1. Wonderful working conditions. Applicant must have at least PSR-24 surgical training. Valid NJ license and Medicare number is required. Applicant should also be familiar and competent in podiatric surgery, biomechanics, trauma, PRP, wound care, and ultrasound diagnostics. Participating insurance #'s a plus. Please fax resume to: (609) 259-6637

ASSOCIATE POSITION - SUBURBAN WASHINGTON

Busy 4 office practice in suburban Washington, DC seeing highly motivated individual for full time associate position leading to partnership. Minimum PSR 24. Competitive salary and benefits.  Respond to mlmltm@aol.com 

ASSOCIATE POSITION - SOUTH CAROLINA

South Carolina's largest provider of foot care is a multi-doctor, multi-location practice currently seeking a highly skilled, personable, and hardworking physician to join our TEAM. South Carolina License is necessary. Above average salary and benefits. Please send Letter of Interest and CV to scdpmjobs@gmail.com.

ASSOCIATE POSITION - NORTH CENTRAL, NJ

Well established busy solo physician seeking a well trained podiatrist (PMS 36) to join our growing practice. Bilingual English Spanish a big +. Competitive salary/benefits package. Send CV to email: njpod2013-1@yahoo.com

ASSOCIATE POSITION – MARIETTA, GA
 
An associate is needed for a dynamic practice located in Marietta, GA, a suburb of Atlanta. We are looking for a well trained, motivated and personable candidate. This is a great practice opportunity. 2 years or more of a surgical residency is required and practice experience is a bonus. Our office has a licensed and certified surgical center. This is a modern practice with ultrasound, digital x-ray and EMR. We offer a competitive salary and benefits along with potential for partnership. Please e-mail your cover letter, curriculum vitae, letter of references and picture to light@eastcobbfoot.com.

ASSOCIATE/PARTNERSHIP  MIAMI/KENDALL FLORIDA

Podiatrist with interest in foot and ankle surgery and comprehensive foot and ankle care. Pathway to partnership/ownership available. Send CV and information: ibaumdpm@bellsouth.net

ASSOCIATE POSITION - WASHINGTON, DC/ MD SUBURBS

Prominent, established two office practice seeking well rounded, personable, ethical individual with sharp medical and surgical skills. Must be 24/36 month trained, ABPS qualified or certified. Partnership opportunity with ownership potential. Competitive salary with benefits package. Please send CV to ponyrunner66@gmail.com

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, Midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 12/24 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977.

POSITION AVAILABLE - CENTRAL FLORIDA

Two doctor practice looking for an associate to take retiring doctor's position with partnership opportunity for the right person.  Competitive salary, health insurance and incentives. Two offices serving a diverse number of routine, surgical and wound care patients. Two years surgical residency training and FL license required. If interested in this great opportunity please e-mail CV, surgical log and references to toesrus7@yahoo.com.

ASSOCIATE POSITION DETROIT SUBURBS

Multi-location practice seeks individual with excellent surgical training.  Practice is well established for over 30 years.  EMR’s available, ultrasound, Doppler & circulation testing, digital x-ray.  Buy in opportunity as owner plans on retiring in 2016 or sooner.  Please send cover letter with CV to footlaw@hotmail.com

PODIATRIST NEEDED - VAN NUYS, CA
 
Looking for reliable, honest and motivated podiatrist to assist with house calls to patients home residence and various health facilities.  Candidate must be willing to drive throughout the San Fernando Valley and the greater Los Angeles areas. Flexible schedule. If interested, please email resume to homefootcare@hotmail.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Requiring full-time podiatrist (PSR-24 or greater) in established Practice situated in a foothill community of Southern California. There is an existing patient base and a strong support team. Compensation is performance based with practically an unlimited earning capability. A possible buy-in is negotiable. Send resume to office@uplandpodiatry.com, titled "podiatrist."

ASSOCIATE POSITION - UPSTATE NY

Busy multi-specialty practice of PCPs, general surgeons, OB-GYN, podiatric surgeons looking for a full-time podiatric associate in  Upstate NY, Binghamton, Finger Lake Region. Great Benefits, opportunity for partnership. Must be highly motivated, personable and be Board qualified/eligible. Our podiatrists have over 100 years combined experience. Please send CV to associateinfoot@yahoo.com or fax 607-723-1567.

ASSOCIATE POSITION – CENTRAL VIRGINIA

Two office practice, well established, modern offices. ED trauma call, good mix of medicine and surgery. Excellent compensation package. Please email letter of intent and CV to jdisabato@vfasa.com

TWO FOR TEXAS

Desiring to grow our group of successful medical and surgical professionals.  We are seeking an exceptional Podiatric Physician and Surgeon with great interest and talent to serve as 1) Our Diabetic Foot Care Team Leader or 2) Our Sports Medicine Team Leader.  Send CV, letter of interest, and current picture to:  greatdoctors1@gmail.com

ASSOCIATE POSITION - PUERTO RICO

Looking for a well motivated surgically trained podiatrist for a 20 years old hospital based multi office practice . Candidate must be personable, ambitious, and knowledge of SPANISH language a must. Hospital surgical privileges available with heavy load of High Risk Diabetic Foot patients. This position leads to PARTNERSHIP, and eventually ownership. Offices located near San Juan Metro area near Beaches, great schools, and major shopping malls. Please send CV to medicopodiatra@aol.com.

ASSOCIATE POSITION - MARYLAND, DC, PA

A podiatrist is needed for the Baltimore, Washington, Pennsylvania area. Partner for the corporation. Surgery center, emergency room call and a hospital location. All areas of podiatry. Established practice. Salary and commission. Fax resume 410-857-4227 or email at butler@qis.net

ASSOCIATE POSITION - SOUTHERN CALIFORNIA COAST

Wanting full-time podiatrist (PSR-24 or greater) in 30+ year established practice situated in coastal community just south of Los Angeles.  Building out a new office near hospital. Compensation is performance based with practically an unlimited earning capability. A possible buy-in is negotiable. Looking for someone to take over practice in the future.  Excellent opportunity for young ambitious doctor.  Send resume to asbf@pacbell.net, titled, "Podiatrist".

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 PODO2345@AOL.COM 516-476-1815.

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