The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

April 29, 2011 #4,147 Publisher-Barry Block, DPM, JD

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Early Intervention for Diabetics Saves Limbs: NY Podiatrist

The prevalence of diabetes among adults in Erie County (NY) is 10.5 percent of the population, compared with 8.3 percent in the United States, according to the state Health Department. "There has been an explosive growth in the number of high-risk people -- the elderly, diabetics and the obese," said Dr. David Davidson, a podiatrist involved in Save a Leg, Save a Life.    

Dr. David Davidson

About 15 percent of diabetics experience a sore on their foot and, like others who suffer from other conditions that interfere with blood supply, their sores can become infected, gangrenous and, ultimately, almost impossible to heal. The concept pushed by Davidson and others is to act quickly to deal with underlying medical issues, such as having a vascular surgeon open up narrowed arteries first to improve blood flow or having podiatrists attend to structural problems of the feet. A few weeks' delay can make the difference between losing or saving a limb.

Source: Henry L. Davis, Buffalo News [4/24/11]

NYSPMA Division Promotes Childrens' Foot Health 

The push for children to be more physically active and achieve a healthy weight is good, but first any problems such as foot pain need to be addressed, says Dr. Mark Durkin, a podiatrist in Lakeville, and president of the Monroe division of the New York State Podiatric Medical Association. The association is emphasizing the connection between pediatric foot health and childhood obesity. 

Dr. Mark Durkin

The group also recommends that parents take children to the doctor for problems such as athlete's foot, muscle cramps, and flat feet. When buying new shoes, have your child's feet measured since children can change sizes in just a few months. Have your child try on shoes with socks, tights,or whatever they normally wear, and choose shoes that are immediately comfortable, the group advises. Children shouldn't run around in flip-flops, but should wear shoes that match the activity, the association says.

Source: Chris Swingle, Democrat and Chronicle [4/27/11]

CA Podiatrist Receives Red Cross "Real Hero" Award

Dr. Holly Spohn-Gross is a podiatrist by profession, but these helping hands go far beyond the walls of the Sienna Wellness Institute in Mount Mesa. Several times a year, Spohn-Gross travels to other countries, like Mexico, to provide free medical care for children in need. "It's very rewarding. It's pretty humbling to have an experience where they're actually asking you to take a look at their child even though there's a language barrier," she explained.

Dr. Holly Spohn-Gross

She also traveled to India to help eradicate polio, and on those trips, she brings toys, clothing, and other gifts for the children. But, Spohn-Gross doesn't consider herself a hero. She's just glad she can help. "If you're in the position and you see someone that needs you, we're all human. And, I really feel that we all can make a difference," said Spohn-Gross.

Source: KGET-TV [4/25/11]

Don’t Get Mad or Get Even—Get Better

The most common reaction to being told you didn’t do well enough? Anger and resentment. The situation is so common that it inspired a well-known bit of advice: “Don’t get mad, get even.” If cutthroat vengeance just isn’t your style, take the sentiment in a more positive direction. Make this your motto: “Don’t get even—get better.”

Example: When Michael Jordan was a teenager, his school’s basketball coach cut him from the team. The future superstar was told that he just wasn’t good enough to play high school basketball. That was a crushing blow to a boy whose heart belonged on the court and on the team. However, Jordan used the incident to inspire him not to seek revenge but improvement.

Make “How can I use this?” your reaction to disappointment and criticism. That is the surest path to grow beyond others’ negative judgments.

Source: Adapted from 100 Ways to Motivate Yourself, Steve Chandler, Career Press via Communication Briefings

Query: Distal Hallux Nail Growing Into Distal Nail Edge

After one year of nail fungus treatment, my patient's great toe is finally looking healthy, except that the distal edge of the nail is growing down into the distal edge of the toe. If anyone has a possible solution to coaxing this nail to grow out normally, this patient would be quite appreciative. I currently have him keeping it covered in triple antibiotic and Band-aid to keep the area moist in the hope that the distal skin will soften enough, but it hasn't done so after 10 days.

David Kahan, DPM, Sacramento, CA

Query: Liquid Nitrogen for Warts

I would like to hear from those who have successfully used liquid nitrogen the old-fashioned way. What are the typical expenses and problems in using liquid NO_²? What has been your experience as to number of treatments necessary and effectiveness?

John Moglia, DPM, Berkeley Hts, NJ

RE: Post-op Nail Complication (Brent Rubin, DPM)
From: Charles F. Ross, DPM

On two occasions, I had the unfortunate experience of probing the post-op site, only to notice that there was a "second" nail spicule that had been left behind. It may have fragmented during the procedure, or after the procedure, or been around prior to the procedure due to previous trauma to the nail plate. 
 
I informed the patient of my discovery, removed the spicule, and re-applied phenol in an attempt to assure this would not recur. I did not charge the patient for a second procedure, nor did I admit to any wrongdoing. This was just an unfortunate unforeseen problem that I know others may have experienced at least once in their careers. I am happy to report that both patients were pleased, and the end result was a satisfactory procedure.
 
Charles F. Ross, DPM, Pittsfield, MA, cross12@nycap.rr.com

RE: E-mail Medicine (Will Parker, DPM)
From: Elliot Udell, DM
 
I get e-mail and even telephone queries from patients living all over the world. In some cases, the question is a general one such as, " how would you treat bunions?" In other cases, it is a complex podiatric medical issue that the patient is having, and I always tell the person that it is not possible to make a definitive diagnosis without examining them and that they should seek out a local podiatrist. If they do not know of a podiatrist in their area, I refer them to the APMA website where they have a window for locating a local podiatrist. If they are calling and do not have a computer, I might look up the information for them.
 
If an established  patients of mine contact me via e-mail, with a case similar to the ones described by Dr. Parker, I would tell them that they should come in to see me immediately because they may have a serious problem and it is not possible to make a proper medical diagnosis via e-mail. I would also call that patient on the phone just in case they do not read e-mail regularly. Since the person sending the e-mail is a patient, it is highly advisable to make a copy of the communication and enter it into the patient's chart just as you would enter a synopsis of a telephone conversation you had with a patient.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Amazing Charts (William H. FitzPatrick DPM, CPed)
From: Ronald W. Hines, DPM

I am a long-time Amazing Charts user and one of the first podiatrists to use this product. I have no business relationship to the company. It has evolved significantly since I first started using it over five years ago. I have chosen not to use the billing portion, since as pointed out by another poster, it is a weak point. It is owned and developed by a physician, John Bertman, MD, who is fully committed to the meaningful use requirements, user input, etc., and these are strong points for this product.

The price and support are also pluses, but its ease of use is its strongest point,...

Editor's Note: Dr. Hines' extended-length letter can be read here.

RE: Exogen Bone Healing System (Tip Sullivan, DPM)
From: Paul Resignato, DPM

I have had success with Tricare/Triwest paying for the use of the bone stimulator on osteotomies.

Paul Resignato, DPM,  El Paso, TX, pauleo@juno.com

RE: Reconstruction of Superior Peroneal Retinaculum (Cosimo A. Ricciardi, DPM)
From: From: Jeffrey Kass, DPM

Dr. Ricciardi makes a good point. I think all too often, in a service profession, one tends to devalue his/her own service. If you need a repair on your car, believe you me, you are paying for every component of the repair.

Obviously, the people who disagree with Dr. Ricciardi will take the stance, "it's incidental to the procedure." The reality is that if procedures were reimbursed at fair rates, this probably would not be an issue.
 
Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

RE: Sometimes Size Really Matters
From: Doug Milch, DPM

I recently saw a patient who happened to be a veterinarian. When I noticed his occupation on our intake form, I commented, "Oh I see you are a veterinarian." He replied, "Yes, I have a large animal practice on Sweeten Creek Road." I immediately thought to myself, "What a jerk, bragging about his practice." I almost replied, "Well, Buddy, I have a large podiatry practice, but I don't brag about it." I treated his heel pain and left the room. After he left, I realized that his "large animal practice" meant that he treated horses and cows, and not cats or dogs. Next visit, I told him how I had misinterpreted what he had said and we both had a good laugh.

Doug Milch, DPM, Asheville, NC

PRACTICE FOR SALE - NORTHWEST SUBURBS, CHICAGO, IL

Great Opportunity! Present owner to stay on for transition. Average 20% growth over 3 years while open only 4 half days a week. Excellent growth potential with increased hours. Perfect for a new practitioner or a 2nd location. contact podiatrynwsuburbs@gmail.com for information.

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 - TEXAS

Need a good paying job in San Antonio or Austin? Just ask the other podiatrists working with us. Good hours and great support staff. Consider us first! Check out www.footmobile.com and reply to footcenter1@sbcglobal.net

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 - SOUTH/CENTRAL PENNSYLVANIA

PSR-24/36 trained individual for busy practice in family-friendly college town. Seeking personable, ethical, motivated individual to join our well established practice providing all aspects of podiatric care. Competitive salary and benefits package. Reply with letter, CV and photo to Jagerone@aol.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 – 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 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

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