The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

April 26, 2012 #4,446 Publisher-Barry Block, DPM, JD

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Fungal Infections are Widespread: NY Podiatrist

"Nail fungus may affect anyone at any time. It makes no difference how impeccable your hygiene is." This is the claim of a 25-year veteran podiatrist, Dr. Alexander Fish. "The results of our clinic's intensive two-year study reveal a startling truth: Every person is susceptible to acquiring skin and nail fungus. The presence of fungus throughout our daily environment is more prevalent than we once thought."

Dr. Alexander Fish

According to the study, there are various comfortable homes for fungus spores. Inside of the shoes is the most obvious one. Spores thrive and may attach themselves as parasites to a human host at any given time. Public areas that are damp, dark, and warm such as saunas, gyms, and nail salons are common breeding grounds for a wide array of fungus infections.

Source: Sacramento Bee [4/20/12]

NYCPM Sports Medicine Club Takes the Polar Plunge

On March 3, 2012, over 300 people attended the Polar Plunge held at North Hempstead beach in Port Washington, Long Island. This event is hosted by the Special Olympics of New York. All teams that enter set a goal of the amount of money they would like to raise. Once the set goal has been reached, each team member is allowed to jump on plunge day.

(L-R) Rob Nwosu, Paul Carroll, and Brandon Ewald

The Sports Medicine Club at New York College of Podiatric Medicine has participated in this event for the past 3 years. This year, Paul Carroll (2014), Rob Nwosu (2015) and Brandon Ewald (2015) represented NYCPM.

Source: Prema Hampapur, NYCPM Alumni Report [Spring 2012]

Runners Should be Examined Before Going Barefoot: NZ Podiatrist

Bruce Baxter, president of Podiatry New Zealand, agrees people need to be careful about barefoot running. "It's not just a question of taking your shoes off, but whether your running is actually any better without shoes," says Baxter.

Bruce Baxter

In many cases, it is possible to improve posture and technique without removing your shoes entirely. And people with foot problems should be wary of ditching all support. "The most sensible thing to do is to be examined first," says Baxter.

Source: Susan Edmunds, New Zealand Herald [4/25/12]

IL Podiatrists Lecture to the Illinois Osteopathic Society

Drs. Ada Paolucci and Marlene Reid lectured last week to the Illinois Osteopathic Medical Society at their "City Conference" that was hosted jointly with the Midwestern University Chicago College of Osteopathic Medicine. This resulted from efforts to work together on educational and community services.

(L-R) Drs. Marlene Reid, Richard Feeley (President of the IL Osteopathic Medical Society), Ada Paolucci, and David Yeager.

Dr. Paolucci spoke on diabetes, the Thomson-Reuters and Duke studies, podiatry's role in the care of diabetics, ulcer care, and advances in wound healing. Dr. Reid spoke on musculoskeletal pathology from the podiatric perspective - tendonitis vs. tendonosis, podiatric orthopedic deformities, and how biomechanics plays a role in treatment approaches.

More Physicians Calling the Shots in Latest Round of ACOs

Thousands of physicians will be among those coordinating patient care in the 27 accountable care organizations that were chosen in April to participate in the new Medicare shared savings payment model. The Centers for Medicare & Medicaid Services selected physician groups, hospitals, and health system organizations to be among the first networks that will share the potential rewards — and in some cases the risks — associated with coordinating quality and costs of care for beneficiaries, including at-risk populations.

The newest organizations to be chosen, which involve more than 10,000 physicians, have agreed to coordinate care for nearly 375,000 Medicare beneficiaries, the agency said during an April 10 briefing with reporters. In December 2011, 32 pioneer ACOs were selected for a similar shared savings initiative separate from the system-wide program.

Source: Charles Fiegl, AM News [4/23/12]

Clarify Patients' Questions

Clarify questions before you answer them. Restate a patient's question in your own words. Doing so ensures that you answer the correct point and grants you a few more moments to consider your reply.

Source: Adapted from “Morgan’s 10 Holiday-inspired Rules for Public Speaking—Especially When Things Go Wrong,” Nick Morgan, Public Words via Communication Briefings

Query: Toe Hyperpigmentation

A 40 year old African-American lady applied corn remover pads over the fourth toes and developed hyperpigmentation. She is going to a wedding and does not want her toes to look dark. I recommended avoiding shoe irritation and possibly using a concealer until the color normalizes. She wants to try a skin lightener. I would appreciate hearing from those with experience with skin lighteners on feet.

Philbert Kuo, DPM, Chesapeake, VA

Query: Satellite Office Build-Out

I am looking to build-out a satellite office. Are there any good books, websites, etc. that show floor plans for medical office configurations?

Jack Ressler, DPM, Lauderhill, Delray Beach, FL

RE: Healthcare Alliance Fax (Richard Simmons, DPM)
From: Jon Strickler, DPM

I also received this fax. I filed it with the other unsolicited faxes I receive right in the recycle bin. Unless I am wrong, companies sending unsolicited faxes are breaking the law, and it rubs me the wrong way that they are marketing their business using my paper and ink/toner. A company that can't be bothered with complying with the law isn't likely to be of much benefit to our patients.

Jon Strickler, DPM, Chattanooga, TN, jlspod@gmail.com

RE: Sterilizing Bits Between Debridements (Jeff Kittay, DPM)
From: Alan Meyerberg, DPM

I am not agreeing or disagreeing with Dr. Kittay's office procedures. I would like to point out his willingness to describe a possible deficiency and his request for validation from colleagues. Is it really necessary to post Dr. Albright's demeaning criticism? Dr. Michaels, Medical Director of the Reconstructive Foot & Ankle Institute Surgery Center, uses a laser to treat mycotic nails. He warns about numerous OSHA regulations against grinding. I checked as best I could, and could only find one reference (04/30/1993) - that toenail particles do not qualify as regulated (OSHA online).
 
Dr. Elliot Udell proclaims, "I have not burred any nails in my practice." I went on to Pub Med and typed in "nail dust" as he suggested and could not find NUMEROUS articles on infectious aerosol. Is anyone aware of a statistically significant number of our colleagues who are suffering from pulmonary disease related to grinding nails?

Why the hysteria? More importantly, why not stand by another podiatrist? There are companies that sell devices to reduce nail dust. There are disposable sanding discs that can be used only once for each patient. It sounds to me that Dr. Kittay may have been criticized excessively, and the very people who should close ranks gleefully join in condemnation. It's amusing how we are still our own worst enemies.
 
Alan Meyerberg, DPM, Staten Island, NY, footquest@aol.com

RE: OH Podiatrist Discusses Celebrity's Neuroma (Anthony Luzzi)
From: Michael M. Rosenblatt, DPM
 
Like other readers, I have become curious about Steven Tyler's diagnosis and treatment. He apparently had a neuroma excision by an orthopedic surgeon. He now has a cross-over 2nd toe, probably the result of disconnecting intrinsic musculature from their respective insertions (FDB). This may also be the result of excision of the base of the proximal phalanx of the 2nd toe. Without seeing x-rays or getting more information, these are just guesses. Podiatric anatomists reading this should chime in with their own explanations.
 
The over-riding question is: "Did he have any conservative care prior to the surgery, and what was it? Naturally, I am thinking about absolute alcohol injections and orthotics. That would be my choice.
 
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

RE: A Shoe is More Than Just a Place for Your Foot

This patient was determined not to forget where she placed her list of foot complaints.

Footnotes?

Can you think of a better place to put it?

Submitted by: Dr. Paul Kesselman

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 516 476-1815 PODO2345@AOL.COM

ASSOCIATE POSITION - TENNESSEE/NORTH GEORGIA

Multi-physician, Multi-office practice looking for motivated new associate leading to partnership. We are a busy practice with state of the art technology: EHR, Digital X-ray, Diagnostic Ultrasound, PADnet, EPAT machine. Applicant should be PMS 36/Board Qualified/Certified. Applicant should be ethical, personable, hard working and interested in providing all aspects of podiatric care to our patients. Competitive Salary and benefits. All interested candidates please send a CV with two letters of reference to mybestnewjob@gmail.com

ASSOCIATE POSITION - SE FLORIDA

Growing practice in SE Florida (Palm Beach Co.) seeks personable, hard working 3-year trained Podiatric surgeon for associate position. Rearfoot/Ankle trauma & reconstruction experience preferable. Competitive salary and benefits. Reply to: sflfootandankle@yahoo.com 

ASSOCIATE POSITIONS - MULTIPLE STATES

Podiatrist Needed in Arkansas, Kansas, Missouri, Nebraska, Iowa, Minnesota, North Dakota, South Dakota, Texas, Colorado, Wisconsin,  and Oklahoma. Expanding multi-state medical practice seeking podiatrists to service long-term care community residing in nursing homes and assisted living facilities. We offer an established patient base, scheduling, equipment allowance and cover travel expenses. Provide generous compensation, bonus opportunities, disability, health insurance benefits, malpractice coverage and flexible scheduling. Looking for a Podiatrist with excellent skills, able to provide expert and compassionate care to patients. Email CV to: careers@aggeus.org or call 773-770-0140 x300/x305.www.aggeus.org

ASSOCIATE POSITION - NEW YORK

Full-time position available immediately in Capital District multiple doctor practice. Good salary with percentage. All phases of podiatry. NYS license required. Email resume to Lchittenden68@gmail.com or call Lori at 518-577-6171

ASSOCIATE POSITION - KANSAS CITY, MISSOURI

Kansas City may be the perfect move for you and your family. I am looking for an entrepreneurial minded associate who wants to grow and then own part of an already successful practice. If you are the right candidate for this associate position, you will enjoy a competitive compensation package and you will be working with a doctor who is as committed to your success as he is to his own. Go to:www.YourFutureInPodiatry.com for full details.

ASSOCIATE POSITION - MANHATTAN

Podiatrist needed for busy state-of-the-art offices in Manhattan. Offices are located near Penn and Grand Central Station. 10+ years experience only and an out-of-network doctor for most insurances. Please forward your information and CV to: roni@myfcny.com

ASSOCIATE POSITION - SENIOR CARE DIVISION - ATLANTA, GEORGIA

Village Podiatry Centers, LLC: Immediate openings for physicians who are interested in caring for the elderly in nursing homes throughout Georgia. Full time position. Excellent salary, benefits, and opportunity for growth. Must understand the coding/billing process and have excellent documentation skills. You don't have to be board certified in foot or ankle surgery for this position. If interested, please contact Dr. Helfman at dhelfman@vpcenters.com

ASSOCIATE POSITION - ATLANTA, GEORGIA AND SURROUNDING COUNTIES

Village Podiatry Centers, LLC: Immediate openings for board eligible or certified, 3-4 year trained surgical physicians. Equity based model, Excellent salary and benefits to start depending on qualifications. (Average physician salary is 2-3 times industry median salary).Full benefits included. Access to practice owned surgery centers, pathology lab, imaging center(s), and other in house ancillaries. Very selective process: must be flexible, well trained, and must participate in our "Physician Training Program." You live off income and retire off wealth! Serious inquiries only! E-mail: David N. Helfman, DPM, FACFAS atdhelfman@vpcenters.com

PHYSICIAN FOR CLINICAL RESEARCH DIVISION - ATLANTA, GEORGIA

Village Podiatry Centers, LLC: If you have experience in running clinical research trials and would like a full time position in managing and overseeing multiple clinical research trials for our growing group, please contact Dr. Helfman @ dhelfman@vpcenters.com. Excellent salary, benefits and equity opportunity for the right individual.

PRACTICE FOR SALE - AUSTIN TEXAS

Great opportunity for new practitioner or an additional office. 18 year practice with large patient base. Current physician transitioning to part time then retiring to pursue another business opportunity. Start turn-key without need for a bank loan. Great area to live and work. Susieintx@aol.com (512) 565-6634

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