The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

May 08, 2007 #2,931 Editor-Barry Block, DPM, JD

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NY Podiatrist Sees Demand for Designer Feet

Podiatrist Oliver Zong says while some people still come in to have bunions or corns removed, most of his customers are now in for cosmetic foot surgery.

Dr. Oliver Zong

"What we do with that toe is we make it a little skinnier, a little thinner so that it doesn't bother them in a shoe and it also looks a little bit nicer," Zong said. Sometimes the patients bring in the shoes they want to wear to see how to change their foot for it.

Source: Jean Enersen, King 5 News [5/4/07]

PA Podiatrist to Write Book About Overcoming Challenges

"Cheer up," a therapist might tell a couple when things look bleak. But for some, cheerfulness and hope infuse everything they do. Such a man is Robby Wiemer of Havertown. Wiemer, 35, and his wife, Carrie, 32, have four daughters, three of whom are disabled and whose lives have hung in the balance more than once. "It takes faith in God and a positive attitude," Wiemer says. "When you see people in these life-altering situations, most people become depressed. We kept a positive attitude even in the worst of times."

Dr. Robby Wiemer

Wiemer, a busy Havertown podiatrist, tells anyone who will listen about his "unique family," how identical twins Callie and Cassie, now 10, were born with Down syndrome and developed leukemia at age 2, within days of each other. Then, daughter Kendyll, 7, was born with cerebral palsy. She uses a wheelchair, can't speak, and eats through a feeding tube. A fourth daughter, Ryleigh, 4, is the only one not disabled.

The chance that one family should be dealt such a daunting set of challenges is remote; that the same family should be happy despite the three girls' disabilities is even more remarkable, Wiemer believes. He has used that theme to craft the outline of a book called Breaking the Odds: The Wiemer Family Story. Shortly after he mailed off the proposal, two book publishers offered contracts, and several others were interested, Wiemer says. "We are happy with our lives," Robby Wiemer writes. "Many days are still challenging, but we try to expose our kids to almost everything. There are no limitations, and great expectations."

Source: Bonnie L. Cook. Philadelphia Inquirer [5/6/07]

Boomers Represent Potential For Practice Growth

No other generation has been studied, surveyed and monitored like the baby boomers when it comes to finding out where and on what they spend money. And research has found the health care industry has the largest potential for growth as baby boomers continually search for products and services that will make them look and feel young.

Knowing what defines each segment can help physicians better treat their patients, experts say. "While some are looking for a doctor to give them the quick fix, others want to find ways to reverse conditions by lifestyle changes or supplements, etc.," said Linda Fisher, PhD, research director for the National Member Research Knowledge Management division of the AARP.

The key to adapting to the boomer revolution, experts say, is to stay in tune to what they are seeking. "There seems to be a close relationship between a sense of control and their satisfaction," Fisher said.

Source: Pamela Lewis Dolan, AMNews [May 7, 2007]

Query: Ethics of Dealing With Impaired Partner

My partner is now in his 70’s and his vision and coordination are not longer what they once were. Several patients have reported to me or staff that he has cut patients while debriding skin or nails. I delicately broached the subject with him, but he came very defensive and claimed that there has been no deterioration in his skills. How do I proceed?

Name Withheld by Editor

Editor’s comment: PM News does not provide legal advice. This scenario presents an ethical dilemma. The overriding concern, however, should always be public safety. One option is to check your partnership agreement, which should contain a buy-out option.

If that is not a feasible option, the APMA Code of Ethics provides the following guidance.

ME6.11 The podiatrist who is physically, mentally, chemically, or emotionally impaired should withdraw from those aspects of practice that could be detrimentally affected by the impairment. If the podiatrist does not withdraw, other podiatrists who know of the impairment have the duty to take action to prevent the impaired podiatrist from harming him/herself or others.

Physical disability includes but is not limited to, deterioration through the aging process, or loss of motor skill that results in the inability to practice the profession with reasonable judgment, skill or safety.

RE: Bone Stimulators for Charcot ( James W. Clark, DPM)
From: Multiple Respondents

In my limited experience with bone stimulators for Charcot, I have used Exogen (Smith and Nephew) with excellent results. I have also have had excellent support from my S & N rep. as far as setting appointments, getting insurance coverage, paperwork completion (they do it all) and patient education and support. I would recommend Exogen without reservation. FYI, I have no financial relationship/sponsorship with Smith & Nephew.

Marc Greenberg, DPM, Dayton, OH, tripperdpm@yahoo.com

Although there have been some manuscripts written on the use of bone stimulation for acute Charcot foot, there is no high-quality evidence supporting their use, let alone supporting the use of one over another. The classes of external bone stimulators are pulsed electromagnetic field (PEMF), combined magnetic field (CMF), and ultrasonic (US).

There are "pros" and "cons" to each type. PEMF is used for at least 10 hours a day and can be used over a cast or an external fixator. CMF is used for 30 minutes a day and can be used over a cast or external fixator. US is used for 20 minutes daily, but must have a ultrasonic gel interface and have direct contact with the skin, thus a cast requires a window if you intend to use it with one. Even with the paucity of evidence, I routinely use bone stimulators for Charcot foot. You can also consider a total contact cast, intranasal calcitonin, and bisphosphonate therapy.

Lee C. Rogers, D.P.M., Chicago, IL, Lee.C.Rogers@gmail.com

RE: AAOS Provides Grants to Limit Podiatrists’ Scope of Practice (Robert Steinberg, DPM)
From: Multiple Respondents

Dr. Steinberg makes a very important point when he describes "hands-on participation" with legislators. I used to think that the only thing legislators cared about was money. While money is truly important, you cannot underestimate the importance of assisting them with their campaign.

Years ago, on election day, I stood out on a busy street carrying a sign for my local state legislator. His wife stopped by to thank me, and when she shook my hand she had tears in her eyes. Naturally I always contributed to his Seattle campaign.

Eventually, he ended up on a very important legislative committee on health-care. He would always take my calls no matter when I contacted him. There are reasons why my wallet card license says: "Podiatric Physician and Surgeon."

Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net,

We members of the CPMA worked long and hard here in California to achieve a political consensus with the California Medical Association in order to pass California Assembly Bill 932 that was signed into law by Governor Arnold Schwarzenegger January, 2006. The bill codifies our scope of practice and is fairly liberal. It took money, personal involvement in terms of time and travel, and strong support from a diverse community, including the MD’s. I read with dismay the efforts of the AAOS in regard to the practice of podiatric medicine in Florida and New York . I suggest a dialog among the various state associations with the CPMA in regard to the successful legislative efforts in passing AB 932.
Neil H Hecht, DPM, Sherman Oaks, CA, drhecht@sbcglobal.net

Every time I read something like this, I ask myself," Ok, so what are we going to do about it. I have personally attended Legislative Day every year since graduating from NYCPM 3 years ago. Additionally, I have donated to PPAC, write to my politicians and vigorously promote my profession to other medical professionals both actively and by example. Many times I feel like it is in vain. There must be more we can do?

Finally, maybe you can answer another question for me: Why do we let orthopedic surgeons advertise for foot and ankle specialists in our publications? I read the back of JFAS and there a dozen job offerings for orthopedic surgeons only. It doesn't seem fair.

Gerald Mauriello Jr., DPM, MA, New York, NY, gam47@columbia.edu

Editor’s note: Two wrongs do not equal a right. It is not fair to generalize and say that all orthopedists are our enemies. You are commended on your contribution to PPAC, which is one of the best ways to combat the efforts of those who would limit our ability to better serve the public.

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I was introduced to the ignorance and animosity that exists between the MD and DPM crowd in our area several months ago. I was invited by a friend in town who is a colorectal surgeon to attend a Nueces County Medical Society meeting to hear Dr. Lawrence R. Huntoon, PhD speak on the topic of ‘sham peer review.’

Before the speaker, there was ‘New Business’ and one item involved a vote to finance the efforts of the TOA (Texas Orthopaedic Association) and the TMA (Texas Medical Association) to fight the recent TSBPME (Texas State Board of Podiatric Medical Examiners) ruling that podiatrists have, as part of their scope of practice, the ankle. A gentleman sitting next to me during the meeting, who had been very warm and congenial up until that point turned to me and said “podiatrists are allowed to do ankle surgery? That’s shocking!” I answered him “yes, we do” and then explained that I was a podiatrist and do quite a bit of ankle work.

This gentleman stared at me incredulously for several seconds and then got up from his chair and moved to another table. There was shock at the news of podiatry ‘moving to the ankle’ throughout the room in general. I thought it was funny to be honest with you. I’m a swell guy until you find out I’m one of ‘THEM’ and then become ‘untouchable’, as though I were a leper. I would be rather surprised to find out that EVERY national, state and county medical and orthopaedic society wasn’t funding an effort to limit or contract the scope of practice for podiatry. Until we define ourselves and what we do with the public, the medical community and the legislature (or change our degree to M.D.) this will be de rigueur in our world for an unpredictable length of time.

David Secord, DPM, Corpus Christi, TX, David5603@pol.net

ASSOCIATE POSITION- KNOXVILLE, TN

PT/FT, multiple positions to fill, surgically and non-surgically trained, immediate and in near future. State-of-the-art facilities with in office surgical suites as well as full privileges at all area hospitals. Area nationally ranked as fifth best place to live and work. davidphawk@adelphia.net

ASSOCIATE POSITION – BOSTON, MA

20 year old, well established, modern practice with 2 locations just out of Boston, looking for associate, P/T or F/T, motivated 24/36 trained or ABPS-Certified or eligible to start immediately. Strong surgically-based practice. Looking for motivated individual, able to practice all facets of podiatry practiced. Electronic scanning for orthotics and voice activated EMR already in office. Fax CV to (617) 567-0822

ASSOCIATE POSITION WANTED -SOUTHEAST

Board Certified PSR/36 trained in FF/RF with clinical experience looking for a practice opportunity in the South East. Ethical, well trained with great bedside manners. Looking to join a large multispecialty group or a practice with a large referral base. Practice must be ethical and well respected in the community. Please contact flyfishingdoc@yahoo.com.

ASSOCIATE POSITION AZ - METRO PHOENIX

Busy expanding practice seeking surgical and/or non-surgical podiatrist. F/T or P/T. Motivated, personable, ethical. Send CV along with salary expectations to email dpmpcaz@yahoo.com

WELL ESTABLISHED PODIATRY PRACTICE IN MT. AIRY, NC

Dr. John H. Hodges had a well established practice in Mt. Airy, NC that is either for sale or in need of an associate/partner to take over patient care. Dr. Hodges unexpectedly passed away, leaving approximately 3,500 patients. This is a unique opportunity to be able to begin work in a busy podiatric practice. If interested, contact Carolyn McMackin at (336)577-2886 or cmcmackin@triad.rr.com

POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

OFFICE TO SHARE AND RENT - PLAINVIEW, LONG ISLAND (S. OYSTER BAY RD.)

3 treatment rooms, JACHO certified operating room, MRI extremity unit and x ray equipment on premises, turn-key operation -no investment- call 516- 4761815 or email podo2345@aol.com

ASSOCIATE POSITION – PHILADELPHIA AREA

Looking for licensed motivated medical or surgical podiatrist in Philadelphia or surrounding area to take over a clinic in west Philadelphia. Looking to develop a mutually rewarding relationship. call 215-665-9225 Dr. Smith

NORTHERN CALIFORNIA- PRACTICE FOR SALE

Great opportunity to own a well-established turn-key podiatry practice located in modern medical office building in East Bay; Electronic billing, good payor base, no HMO contracts; Biomechanics, general podiatry with great potential for surgery. Please send CV and letter of interest to: norcalpod@hotmail.com

ASSOCIATE POSITION NEW YORK CITY

Excellent opportunity for foot/ankle surgeon, Manhattan and Brooklyn Associate position leading to possible partnership. Requirements: Two years enrollment in a surgical residency program Qualities of self-motivation and impeccable skills in forefoot and rear-foot surgery. Package Includes: Malpractice insurance, Health Insurance plus salary, Incentives. Terms negotiable Email CV to Manfootcare@aol.com 212-349-7676

PRACTICE FOR SALE – OHIO – SOUTHEASTERN

Reputable, thriving, well-rounded practice available with EMR. Grossing over $320K over the last 3 years. Priced to sell. Owner relocating. Email inquiries and CV to podsx@yahoo.com

ASSOCIATE POSITION – SOUTHERN KENTUCKY

Southern Kentucky's largest and most respected foot and ankle group is looking for an associate to start in July 07. An amazing opportunity to grow with an established four provider practice on beautiful Lake Cumberland, Kentucky. Very competitive salary/bonus with a buy in opportunity will be offered. Established satellite offices will make for immediate patient base ready to be nourished and grown by a friendly, well-trained associate. Excellent benefit package. Lexington, KK is 1.5 hours North while Nashville, Tennessee is 2.5 hours South. Please fax CV to 606-679-4626.

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