The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

May 03, 2012 #4,452 Publisher-Barry Block, DPM, JD

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Thorough Foot Scrubbing Means Healthier Feet: IL Podiatrist

When's the last time you really scrubbed your feet? "Most people are so rushed in the shower that they ignore their feet altogether," says Chicago-based podiatrist Dr. Debra Young. But skipping the loofah "allows dead skin cells to build up, producing the ideal breeding ground for icky nail-fungus infections and warts," says Young.

Dr. Debra Young

Young recommends swiping a nailbrush across a bar of soap and running it back and forth along your toenails as part of your daily shower routine.

Source: Jessica Girdwain, MSN Health & Fitness [5/1/12]

CA Podiatrist Receives the Kenison Award

College of Podiatric Medicine Dean Lawrence Harkless, DPM, was honored by the American Podiatric Medical Students Association for his outstanding efforts and contributions to podiatric medical students and the profession. “There’s probably no better honor than to be recognized by the individuals you had the opportunity to inform and inspire through your teaching efforts,” Harkless said. “It’s a testament to how we are rewarded for our effort.”

Dr. Lawrence Harkless

Harkless received the Kenison Award which is named for Nehemiah Kenison, a visionary and leader in the profession of chiropody in the mid-1800s. Harkless was nominated for the award by his podiatric medicine students at Western University of Health Sciences.

A Novel Change for UK Podiatrist's Career

A podiatric practitioner has seen his career take a different direction; from medicine to writing. Kevin Catterall is the recently published author of The Appian Way, a spy novel for which he is already planning a sequel. 

Kevin Catterall

Kevin, 66, who lives in Morecambe, is celebrating after his first attempt at writing a spy novel was published by Yellow Bay Books. The Appian Way follows the story of four undergraduates at Cambridge University, spanning from 1939 to 1982 during the Marxist alternative to communism. Kevin is already at work on a sequel, and hopes to produce a collection of 10 books.

Source: Lancaster Guardian [5/1/12]

Reduction in Amputations From Toe and Flow Collaboration: AZ Podiatrist 

The "Team approach to diabetic wound healing and amputation prevention," is a UA study that Dr. David Armstrong and Dr. Joseph Mills worked on, which has shown that collaboration between vascular and podiatry is making a major difference in wound healing and amputation prevention for patients with diabetes.

Dr. David Armstrong

The study shows for the first time in the literature that an integrated surgical team can have a dramatic impact on the surgery type (many more proactive procedures rather than reactive emergency amputations) and on amputation reduction (46% reduction in high-level amputation in the first two years). This collaboration, pioneered at the University of Arizona, is called a "Toe and Flow" program; the toe being the podiatrists and the flow being the vascular surgeons.

Source: KVOA, [4/30/12]

Mobile Health Apps Prompt Questions About Privacy

As smartphone users have grown more comfortable forking over information about their bank accounts and physical whereabouts to mobile applications, a growing group of app developers are betting health-related data will be next.

The Food and Drug Administration will likely finalize its first-ever guidance on mobile health applications later this year, giving the agency at least some oversight of mobile products that replace or complement other medical devices, such as a stethoscope or EKG machine.

Source: Steven Overly, The Washington Post [4/29/12]

Query: Numbness and Blue Discoloration of Hallux

A 25 year old well-developed, well nourished male presented with a complaint of "numbness" in the right hallux and "blue discoloration" when wearing shoes regardless of type for one week's duration. He wakes up every 5 hours and places the toe in warm water until normal color returns. He teaches barefoot during the day. There is no pertinent medical history. He has been an active runner and hiker, running 100 miles per week but has ceased any physical activity.
 
PE reveals absence to pinpoint pain sensation at the distal tuft of the hallux and decreased temperature. All other sensations are intact. The entire hallux is NOT involved. There appears to be a positive Mulder's sign in the 2nd interspace and pain on palpation plantar to the 2nd met head. I ordered radiographs today. Any thoughts on a diagnosis and treatment?

Chuck Ross, DPM, Pittsfield, MA

RE: Nerve Compression Vs. Fictitious Injury (Barry Mullen, DPM)
From: Jeffrey Smith, DPM

CRPS was never ruled out. The patient was referred to an inteventional pain management specialist, as well as PT from me. When I got the consult, it had already been about a month from the injury. The patient never got improvement from PT. The interventional pain management physician never scheduled the patient for follow-up. Also, many distraction techniques were attempted during my physical exam. This did not help with making a conclusion, as the patient was very conscious of not extending the toes. I contacted PT to administer TENS therapy while trying to elicit an extensor firing. No conclusions could be made on any account.

Usually, one will see color changes, as well as temperature changes in the extremity. The patient never expressed these symptoms. No atrophy was identified as well. After about a month, an MRI will demonstrate fatty tissue around the muscle belly where there is atrophy. Due to lack of physical findings, lack of improvement from PT modalities and continued pressure from the WC, I sent the patient for a functional capacity evaluation. Results showed inconsistencies with findings, per their note. The only significance in the evaluation showed little to no muscle strength with toe extension.

Shouldn't one find other related symptoms with this sort of injury? Spasms, color changes, atrophy, loss of tone are related symptoms that gain a level of confidence in an organic diagnosis.

Jeffrey Smith, DPM, Miami, FL

RE: Recent Research Confirms Therapeutic Effect of Foot Orthoses for Anterior Knee Pain) Kevin Kirby, DPM)
From: Jeff Root

Kevin Kirby, DPM is one of the most knowledgeable people in the world when it comes to research related to foot orthotic therapy. It comes as no surprise to me that he was kind enough to take the time to post a letter in the 4-30-12 issue of PM News in order to highlight a study examining the efficacy of foot orthoses in the treatment of patellofemoral pain syndrome in an effort to help educate his colleagues. The objective of this study outlined by Dr. Kirby was simply to investigate the short-term clinical efficacy of three pre-fabricated orthoses as compared to a “wait-and-see” approach to treatment.

In the very next issue of PM News, there were two letters questioning the methodology of the study. Obviously the study was not designed to compare...

Editor's Note: Mr. Root's extended-length letter can be read here.

RE: Transmitting Schedule II-V Controlled Substances Electronically
From: Edmond F. Mertzenich, DPM

While the DEA rules allow for e-prescribing of controlled substances, schedule II – V, state laws must also allow to do this. Check this reference from the AMA September 14, 2011. This document gives some good information on the subject.

Edmond F. Mertzenich, DPM, MBA, Rockford, IL, doctoreddpm@frontier.com

RE: Don Joy Velocity Brace (Howard J. Bonenberger, DPM)
From: Robert M. Gaynor, DPM, Rob Bowan

Go to www.dmepdac.com to view Medicare allowables for your state for DME products and to see if a manufacturer and/or a distributor has a product they sell which is PDAC coded. I think the bigger question to ask is: Should podiatrists dispense ankle braces, CAM walkers, pre-fab AFO's and custom AFO's that are not PDAC-approved?

Robert M. Gaynor, DPM, Wellington, FL, NAILCUTTER@aol.com

To find out if your product has been certified by PDAC for a specific code, simply go to  www.dmepdac.com/dmecsapp/do/search. There you can perform a search for any code, generate a list of the products that have been verified for that code, and see the Medicare fee schedule for each state. You can also search by manufacturer, or product name to find which code (if any) it has been certified for. Many products out there have suggested codes which have not been certified by PDAC, so caution should be used by any supplier dispensing DME without verifying that the products are covered under a particular code, as the liability ultimately lies with the supplier.

Rob Bowan, Rob@HamesOrthoTech.com

RE: The Passing of Virginia "Ginny" Jewell
From: Susan Scanlan, DPM

On behalf of ASPE (American Society of Podiatry Executives), I would like to express our condolences to both the personal and professional families of Ginny Jewell. Ginny was one of the longest (if not THE longest) serving executive directors in our organization from the state of Indiana. She was a "can do" type of gal and a pleasure to be around. We will all miss her very much.
 
Susan Scanlan, DPM, Immediate Past President, ASPE

RE: The Passing of John Pagliano, DPM
From: Robert Weiss, DPM
 
Dr. John Pagliano was a legend in his own time and came from a family of podiatrists. We first met in the mid-70’s when running with Dr. George Sheehan, who asked if I knew a podiatrist named John Pagliano in California. Dr. Sheehan said you should meet him, and so I did. We went running. He talked and I listened. His pace was so fast that I had a hard time keeping up with him and breathing. Pag ran 86 marathons which was double what I had accomplished at the time. We had many adventures while attending AAPSM meetings and, at times, got into mischief. I always enjoyed visiting Pag in his Long Beach, CA office, and meeting with his lovely wife Ellen at their ranch in Rolling Hills, CA. My running friend and fellow will be greatly missed.

Robert Weiss, DPM, Darien, CT

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F/T CERTIFIED MEDICAL ASSISTANT - NEW YORK

**Must have NYS certification for podiatric x-rays. Primary responsibility is to provide full clinical support to the podiatrist. THIS INCLUDES THE FOLLOWING: Maintenance logs, inventory, preparing patients for visits, x-rays, assisting with patient registration, appointment scheduling, calling in prescriptions to pharmacies, chart retrieval, providing lab result with charts to physicians, etc. Salary commensurate with experience; benefits/ after probationary period. Fax resume to 212-713-1631 or e-mail to ttolliver@wpmg.org

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

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 POSITIONS – MARYLAND
 
Are you motivated, personable and enjoy working with the elderly? We are offering part-time positions in Maryland. Our group, Podiatry Management Services, provides care in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your c.v. todrhprosen@verizon.net or fax to 410-486-2049 or call Dr. Herbert Rosen at 410-580-0255.

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 - 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 - 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 - 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 at dhelfman@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.

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

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