The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

May 06, 2011 #4,153 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2011- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Wearing Flip-Flops is a Capitol Offense: DC Podiatrist

Now that the weather is warm, says Dr. Howard Osterman, a podiatrist who has practiced in Washington for 20 years, he will see at least one patient with a flip-flop injury every day through September. Osterman treats a lot of tourists whose flip-flops aren’t up to rigors of eight-hour days tromping across the Mall — “kids from Wisconsin who didn’t know they’d need a podiatrist when they went on vacation,” he said. 

Dr. Howard Osterman

The number one problem Osterman sees from the shoes are overuse injuries such as stress fractures of the metatarsals, the five long bones that reach out to the toes. A stress fracture happens after constant, repetitive stress to a bone and is generally treated with rest, more-supportive shoes, and perhaps a walking boot.

Source: Rachel Saslow, The Washington Post [5/2/11]

AZ Podiatrist Delivers Barry Commencement Address

Dr. David G. Armstrong, Professor of Surgery and Director of the University of Arizona's Southern Arizona Limb Salvage Alliance (SALSA), was the keynote speaker at this year's commencement for Barry University College of Podiatric Medicine in Miami. The speech capped off a busy weekend which also included the historic dedication of the Dr. Paul and Margaret Brand Center for Research at the institution. 

Dr. David G. Armstrong Delivering Commencement Keynote at Barry University

Armstong's speech, entitled "From Proto- to Pro-Fessional" focused on themes of service, humility and compassion. He said, "To know that these young doctors are going to go out into the rest of their careers with role models that they've collected here at Barry bodes well for the future of medicine in general and for podiatric medicine specifically."

AMA to Offer Payment Formula Proposal

The American Medical Association is expected to propose a three-part approach to changing the Medicare physician payment formula in a congressional hearing Thursday to examine the issue.

According to a copy of AMA President Dr. Cecil Wilson’s written testimony, the association representing 216,000 of the nation’s physicians suggests fixing the current payment system by repealing the sustainable growth-rate formula; implementing a five-year period of stable Medicare physician payments that keep pace with medical practice cost growth; and shifting to new payment models that enhance care coordination, quality, appropriateness and costs.

Source: Modern Physician [5/4/11]

Lasers a Hot Topic at Cherry Blossom Seminar, Lemont Honored

The annual Cherry Blossom Seminar, sponsored by the American Society of Podiatric Dermatology, was held this past weekend in Baltimore, MD. It was very well-received by the over 125 podiatrists, 12 prominent lecturers, and 22 exhibitors who participated. Among the exhibitors were five laser companies because of the increased interest in laser use for skin and nail disorders. 

Attendees at Cherry Blossom Dermatology Seminar

Dr. Harvey Lemont was presented the Mirror Award (“The skin mirrors the body”) in recognition of his many years of work in teaching, research, and leadership in the field of podiatric dermatology. In addition to clinical panels, a wet lab biopsy technique workshop was provided by Dr. Brad  Bakotic. Topics ranged from laser nail therapy to arthropod and plant dermitides.

Stop and Smell the Flowers

Spring is in the air, and with the sparkling sunshine, employees might have trouble concentrating on business. Draw on that springtime sense of renewal and energy. Follow this plan to make sure your team meets all goals and expectations—and still manages to squeeze in some fun:

•  Set short-term targets. Looking at your plans for the rest of the year, break large goals into weekly or bi-weekly targets. Those smaller goals will be more manageable, and meeting them will offer employees an immediate sense of accomplishment.
•  Reward effort. Keep staffers focused on work by celebrating or offering small rewards when your team hits a target. Examples: Allow people to leave early on a Friday. Devote an extended lunch to a potluck picnic outside. Schedule a Frisbee tournament at a nearby park.
•  Make long-range plans. Remind staffers that their efforts today bring results tomorrow. Don’t let them forget that they need to stay energized and ready to contribute. Before summer descends on your practice, invite all team members to submit dates for their vacations. Put them on a calendar now, so that you can begin to plan around them.

Source: Adapted from Communication Briefings [May 2011]

Query: Obligation to Report Proposed Insurance Fraud

Today, we had a patient state that he would be happy to come in for 'extra' visits so we can make extra money, so long as we don't charge him his co-pay. We most certainly do not participate in this or any sort of insurance fraud, but I want to know what my obligations are. I made a detailed (dated and time stamped) documentation about this conversation in the EMR about this, (separate from the chart note regarding the actual reason for today's visit).

My other concern is that in the short time he has been a patient of our office, he has consistently been difficult with the front office staff. I am strongly considering discharging him from the practice. Do I need to report this incident to anyone?

Name Withheld

Query: Is Marcaine Harmful to Bones?

As I was about to inject a patient who works as a nurse in a large group practice, she asked what anesthetic I used. When I told her that I use 0.5% Marcaine for injections with cortisone, she stated that she was concerned because all the radiologists and orthopedists in her group have stopped using Marcaine for any joint injection as they found it to be harmful to bone. Instead they use 2% Lidocaine. This is the first time I have ever heard about this. Has anyone else heard of this?

Tom Silver, DPM, Golden Valley, MN

RE: Recurrence of Club Foot (Sean S. Ravaei, DPM)
From: Dwight L. Bates, DPM

I would consider a neurological etiology for this mature looking patient in the picture. UMN, or maybe a LMN lesion, could cause this. Flexible deformities become rigid deformities. The photo appears to show a rigid foot, so bracing will not correct, but maybe it will arrest further deformity. If the deformity is progressive, the treatment may be different than if the pathology is static. X-rays would be interesting!

Dwight L. Bates, DPM, Athens, TX, dlbates04@yahoo.com

RE: Sgarlato Snap Fixation Pin Substitute (Mark H. Sugar, DPM)
From: Tip Sullivan, DPM

You can easily make your own. Back in 1985, when I did an externship at Atlanta hospital, Nate Schwartz had us students and residents filing K-wires about 1/2 way across with a sharp-edged file at 14, 16, 18, and 20mm. They snap right off as you bend them. One other thing you can do is mark the K-wire at 20 mm with a skin scribe, use that as your depth gauge, and get a good wire cutter that does not leave a prominent tip.

Tip Sullivan, DPM, Jackson, MS, tsdefeet@msfootcenter.net

RE: TrakNet EMR (Laura R Lefkowitz, DPM)
From: Jack Burgin

We made the switch to TRAKnet in February after being on a different EMR system for over eight years because of TRAKnet being podiatry-specific. Although the charting system is much better (especially for the doctors), the billing, scheduling, referral tracking, keyboard functions, employee security, and reports are worse.

We found the transition to be less than favorable with the majority of our staff and would not have made the change if I had known some of the limitations of this program. If you are a small practice with a few employees, this might be a good fit, but if you are a larger practice, I would think twice.

Jack Burgin, Ft. Collins, CO, jack@asafoot.com

Foot Sign Serves as Fortuneteller

F. Scott Fitzgerald's generation had its green light at the end of the dock in "The Great Gatsby," that symbol of unattainable dreams, and today's young literati have -- a podiatrist's sign? The sign for the Sunset Foot Clinic on West Sunset Boulevard in Los Angeles is known to some locals as a kind of fortuneteller. On one side is depicted a foot with a woeful face, a bandaged big toe and crutches, while the other side shows an ecstatic foot in gloves and sneakers giving the thumbs-up sign. (Yes, these feet have both arms and legs.) 

Sunset Foot Clinic Sign (Rachel Kramer Bussel)

When the sign is working, it rotates, and several residents of the nearby Silver Lake and Echo Park neighborhoods believe that whichever side they see first indicates what sort of day awaits them. Others use the sign as a guide: If they see the Happy Foot, they get to do something fun, while the Sad Foot condemns them to an afternoon of chores.

Source: Laura Miller, Salon [5/3/11]

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 – 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 - 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

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 - 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.

PRACTICE FOR SALE - MISSION VIEJO, CA

Relocating to Tulsa. Great opportunity to buy my office. Located on Mission Regional Hospital Campus. Gross income 2010 was $340,000. Approximately 1300 sq ft with 3 treatment rooms, digital x-ray and fully computerized. Only 3 years old. Will consider all offers. 949-702-1052. David Stoller, DPM (Family Footcare) david@missionviejofootcare.com

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.

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

PM News Classified Ads Reach over 12,500 DPM's and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 for a 50-word ad THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.