The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

May 08, 2013 #4,764 Publisher-Barry Block, DPM, JD

A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2013- No part of PM News can be reproduced without the
written permission of Barry Block

Still Practicing at 80, Harry Truman’s Podiatrist has a Foothold on History

Dr. Robert Shemwell’s eyes light up when he tells the story. It was the late ’60s, and as a doctor he’d been called to an elderly patient’s home in Independence. He drove into an alley and parked between two garages. Medical bag in hand, he strolled down a walkway, then up wooden steps to the back porch where he reached for the door knob. Just then a powerful man grabbed him from behind and spun him like a top. “Dr. Shemwell!” the armed guard said, suddenly recognizing the good doctor. “I’m so sorry. I didn’t know you were coming!”

Dr. Robert Shemwell (Photo: Fred Blocher)

Don’t get Shemwell wrong. Harry and Bess Truman were wonderful people. But when they got up there in age, they did occasionally neglect to inform their Secret Service agents that their podiatrist was coming over to treat their feet. That’s just one of the memories Shemwell has of his famous former patients. Yes, 41 years after President Truman died in 1972, his podiatrist is still alive in Excelsior Springs and, at age 80, still performing surgery.

Source: James A. Fussell, Kansas City Star [5/6/13]

PM News has begun a new weekly feature called Quick Poll. Each week, we will post a new poll based on some of the controversial issues discussed in our Comments/Responses section. This question submitted by Dr. Michael Forman.

Quick Poll
What type of radiography system does your office use?
Click HERE for Results

PA Podiatrist Uses F-Scan Technology to Evaluate Tennis Shoes

Tennis Magazine consulted Dr. Allan Grossman, a podiatrist who directs the gait clinic at Harrisburg (PA) Foot and Ankle Center. Dr. Grossman's practice employs Tekscan F-Scan technology, which couples computer software with shoe inserts covered with more than 900 tiny pressure sensors. These sensors are able to objectively quantify how well a shoe absorbs shock. They can also show whether a particular shoe allows the foot to progress through the optimal gait cycle, which is key in preventing injury.

Dr. Allan Grossman

"There are distinct differences in function between sneakers, which can translate into either enhanced performance or an increased risk of injury," Dr. Grossman says.

Source: Justin DiFeliciantonio, Tennis [May/June 2013]

Region Three Meeting Matches Attendance and Exhibitor Records

The Region Three (PA, NJ, DE) Meeting was held at Trump Taj Mahal, Atlantic City, NJ, last week and matched the record doctor and exhibitor attendance that it evidenced last year. APMA President Matt Garoufalis, DPM, addressed the meeting on Saturday morning and detailed the efforts that APMA has been making since he took office at the House of Delegates in March.

(L-R) Drs. Leonard Portnoy and John Mattiacci

Leonard Portnoy, DPM, General Chairman of the Region Three Corporation, presented John Mattiacci, DPM, Dean of Temple University School of Podiatric Medicine, with a check for TUSPM’s James E. Bates, DPM Presidential Scholarship fund, adding to the amounts Region Three already has contributed.

IL Podiatrist Pleads Guilty to Shower Videotaping of College Wrestlers

Ninos Danny Jando, a Chicago-area podiatrist, has pleaded guilty as charged to secretly videotaping Muskegon Community College wrestlers while they showered at the college. Under a sentencing commitment by the judge made over the objection of the Muskegon County Prosecutor’s Office, Jando can expect to avoid a sentence to state prison.

Source: John Hausman, Muskegon Chronicle [5/6/13]

Query: Brachymetatarsia

I am curious as to the different opinions one would take to treat the brachymetatarsia for this patient.

Brachymetatarsia

Editor's note: In the spirit of HIPAA, we will not disclose the name or city/state of podiatrists submitting clinical cases.

Query: Joint Remodeling and Fusion

I have a patient who presented with severe 1st metatarsal-phalangeal joint degenerative arthritis with an abundance of hyperostosis to both the metatarsal and proximal phalanx. I took the patient to surgery when the joint - both metatarsal head and phalangeal base - was remodeled followed by an attempted permanent fusion via compression screw and then plate application.

CPT 28750 represents the fusion, but is there any allowance for the extra work regarding the extensive remodeling and the plate insertion?

Harry Cotler, DPM, Soldotna, AK 

Response: The procedure performed was a fusion of the 1st metatarsal-phalangeal joint. The procedure is performed because of degenerative changes to the joint. Degenerative changes include not only intra-joint destruction, but also the immediate adjacent bone - osteophytes, bossing, hyperostosis, etc.

To do the procedure, it would be expected that the joint would need to be remodeled...that is part of the procedure, just as use of fixation is part of the fusion procedure. The work - all the work - performed to fuse the joint is payable.

Tony Poggio, DPM, Alameda, CA

Codingline subscription information can be found here

APMA Members: Click here for your free Codingline Silver subscription

RE: Chronic First MPJ Pain (Don Peacock, DPM)
From: Charles Morelli, DPM

Not having seen this patient and basing these comment solely on the x-ray, I respectfully submit that this patient's condition was never addressed properly. Pre-op, there is an elevated first met and despite efforts to plantarflex the head, it is still dorsiflexed. Pre-op, there is a dorsal exostosis, and I would be surprised if there is any increase in hallux dorsiflexion. The dorsal bump was not removed aggressively enough and removing part of the dorsal aspect of the base of the proximal phalanx could have also been considered.

If you make a template and find the CORA, I believe you will see that this patient could have benefited from a Cotton procedure that would have required a graft and possible plate; depending on graft chosen.  I don't want to, nor will I, get into a debate about MIS vs. open, but this case required more that a 1.5 cm incision and needed to be treated much more aggressively.

Charles Morelli, DPM, Mamaroneck, NY, podiodoc@gmail.com

RE: Chronic First MPJ Pain (Don Peacock, DPM)
From: Sloan Gordon, DPM

Dr. Peacock, your x-rays are most impressive. You plantarflexed the first ray below the dorsal cortex, which will off-load the first ray, and you removed the 1st MTPJ exostosis just perfectly. I am not sure how you did this through a 1.5 cm incision, unless this was MIS. I guess we Texans like things big, including our incisions!
 
If this was MIS, I would be concerned about a non-fixated metatarsal osteotomy along with the gastoc lengthening. It seems like taking a risk for displacement of the osteotomy. But, the pre- and post-operative films are impressive. If this was MIS, why not drive a percutaneous 0.062" Kirschner wire through the osteotomy? I am certainly not faulting your technique!

Sloan Gordon, DPM, Houston, TX, sgordondoc@sbcglobal.net

RE: Dr. Lidtke's Remarks
From: George C. Trachtenberg, DPM

Roy Lidtke said, "What our research has shown is that a very flexible shoe will allow more motion to occur and thus decrease forces at the knee. Research that I have been involved with at Rush University has lead to the OA shoe. This specifically-designed flexible shoe has shown to decrease knee forces up to 20%."

Before we accept a statement as broad as this, let's see all of the research. Reducing force on the knee by using a specifically-designed shoe that creates "more motion" does not mean that the force reduced in the knee is not transferred to another area of the body, creating damaging repetitive motion injury in that new location. I do not think statements such as these should be made without seeing the supporting research and the consequences of the outcome, whether positive or negative that occur elsewhere in the closed kinetic chain as a result of its use.

We must remember that energy is neither created nor destroyed but only redistributed. If this force on the knee is not inappropriately transferred to another area, then bravo!  But if foot function is still not normal (in spite of the specifically-designed shoe), this force will stay in the body and move to a new location for the creation of future damage in that location. I fear this could be the case.

George C. Trachtenberg, DPM, Vestral, NY, doctor@georgetrachtenberg.com

RE: Dr. Lidtke's Remarks
From: Robert Scott Steinberg, DPM
 
I can understand how a soft shoe can attenuate GRF impacting the knee. I also understand that an overly soft shoe can exaggerate internal leg rotation at the knee in the presence of excessive subtalar pronation. I also understand that when you off-load one area of the knee, you do so by loading another. What I don't understand is what the OA Shoe does that others will not?

Robert Scott Steinberg, DPM, Schaumburg, IL, Doc@FootSportsDoc.com

RE: Bottoms Up

Drinking out of a shoe?

Source: Submitted by Dr. Joseph Borreggine

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 PODO2345@AOL.COM 516-476-1815.

PODIATRY PRACTICE LOCATION AVAILABLE - UPPER EAST SIDE NYC

Prime NYC Practice Location: 200 East 72nd Street. Street level with signage. My equipment or yours. Will stay on to introduce or leave.  E-mail Dr. Shavelson. drsha@lifestylepodiatry.com

EQUIPMENT FOR SALE - CUTTING EDGE MPL  THERAPEUTIC "COOL" LASER

Purchased 04/2010 Purchase price $27,000 Asking $13,000 (Image 1, Image 2, Image 3). Our doctors just haven't been using it enough. email mrobsondpm@aol.com

EQUIPMENT FOR SALE - BIOMEDIX PADNET SYSTEM
 
PADnet is clinically valuable, provides fair financial return with medically appropriate testing and seamlessly integrates with the complete suite of BioMedix® products and services. One year old. In Excellent condition. Buyer pays for shipping. Please contact Rhonda Daggs at info@footanklecenters.com

EQUIPMENT FOR SALE - NEW AEROLASE YAG LASER

Brand new Aerolase Yag Laser Bought Feb 2013- Never Used Paid $35,000. Will sell for $25,000. Contact Kathy (352) 867-1155 or Michael after 7pm (352) 816-1155.

EQUIPMENT FOR SALE - FOX YAG LASER

Mint condition, still under warranty. Unit is portable & includes all the accessories. $14,500.00. Call 727 586-3668 or 727-321-310.

PRACTICE FOR SALE - BROOKLYN, NY

28 year old practice in a desirable part of Brooklyn. EHR certified with stage 1 criteria successfully met. Practice has room to grow. Good mix of Medicare hazardous foot care; surgery and wounds. Low overhead. Priced to sell. Email Inquires to: brooklynpracticeforsale@gmail.com

PRACTICE FOR SALE - VIRGINIA

62 years consecutive private podiatry practice, excellent referral base, busy, modern equipment; X-Cel Xray machine, digital Tigerview scanner, Traknet EMR, and 3 new Midmark chairs for the doctor and patient. Virginia license is required. Please contact Dr. Fine at drmichaelfine@aol.comor 703-582-5999.

PODIATRIST SEEKING EMPLOYMENT - CHICAGOLAND AREA
 
Personable, well trained ABPS Board Certified podiatrist with 10 years experience seeking associate position or buy-in opportunity in the Chicagoland area. Please email inquires to ewcv5@hotmail.com.

ASSOCIATE POSITION - HAMPTON ROADS VIRGINIA

Needs to be highly motivated, INDEPENDENT and surgically-trained to join a successful 40+ year practice surrounded with water sports, beaches and hiking. PSR24/36; well versed in forefoot and rearfoot surgery, diabetic wound care, sports medicine and diagnostic ultrasound. Please email CV & cover letter to fixafoot@cox.net

ASSOCIATE POSITION - MASSACHUSSETS

Located near Boston. Busy multi-office podiatry practice looking to expand. Need extremely energetic dedicated individual. Must be PSR 12-24 trained, EMR, laser, vascular testing the works. Must have sense of humor. MA License, NH License A+! Surgery, sports medicine, pediatrics, shoe store. Please send resumes to resumesent11@comcast.net.

ASSOCIATE POSITION - MONTANA

Needed podiatric surgeon skilled in reconstructive procedures for complex deformities of the foot and ankle. All benefits are generous. Position provides an opportunity for immediate case load and professional fulfillment in a nationally profiled practice in Montana. 3 year PM&S or equivalent. Inquire at www.Selectapplications.com

ASSOCIATE POSITION - SOUTH CAROLINA

South Carolina's largest provider of foot care is a multi-doctor, multi-location practice currently seeking a highly skilled, personable, and hardworking physician to join our TEAM. South Carolina License is necessary. Above average salary and benefits. Please send Letter of Interest and CV to scdpmjobs@gmail.com.

ASSOCIATE POSITION - LAS VEGAS, NV

Need a Nevada licensed podiatrist to cover IN OFFICE for month of June 2013. Starting Date June 1, surgical experience not a requirement. Salary is negotiable. doctor@viawest.net

ASSOCIATE POSITION - SUBURBAN WASHINGTON

Busy 4 office practice in suburban Washington, DC seeing highly motivated individual for full time associate position leading to partnership. Minimum PSR 24. Competitive salary and benefits.  Respond to mlmltm@aol.com

FT OR PT ASSOCIATE - SOUTH JERSEY

Great opportunity for FT or PT associate starting July 2013 in established practice in South Jersey. EMR, FDA-approved Lasers for fungus. Will work with Board Certified/Qualified podiatrist. Must have New Jersey License. Diverse practice in a nice area with a pleasant environment. e-mail CV at hhfootdoctor@gmail.com

ASSOCIATE POSITION - NEW JERSEY

Immediate opening for a full time podiatrist in a rapidly expanding multi-office practice in central New Jersey. Well established referral base with full admitting hospital privileges. Compensation is performance based with patients scheduled from day 1. Wonderful working conditions. Applicant must have at least PSR-24 surgical training. Valid NJ license and Medicare number is required. Applicant should also be familiar and competent in podiatric surgery, biomechanics, trauma, PRP, wound care, and ultrasound diagnostics. Participating insurance #'s a plus. Please fax resume to: (609) 259-6637.

PODIATRIST WANTED - NEW YORK

Full-time podiatrist is needed in Brooklyn. Excellent salary and benefits for an excellent growing practice. Please send your resume to Metropolitanirene@gmail.com.

ASSOCIATE POSITION - NEW YORK

Large established podiatry practice 30+ years in New York Hudson Valley/Capital District area seeking associate/partner to eventually take over practice. Also would entertain reasonable offer to purchase one of the two offices. Serious Inquiries may contact: Podiatrygroupny@gmail.com

ASSOCIATE/PARTNERSHIP  MIAMI/KENDALL FLORIDA

Podiatrist with interest in foot and ankle surgery and comprehensive foot and ankle care. Pathway to partnership/ownership available. Send CV and information: ibaumdpm@bellsouth.net

ASSOCIATE POSITION - CALIFORNIA

Established foot and ankle specialty group looking for an experienced podiatrist. This position entails making rounds at local hospitals, skilled nursing facilities and having scheduled office appointments. Must be comfortable with all aspects of podiatric care and will be doing no less than the hiring partners. Full-time position with a competitive salary.  Looking for someone with a great bedside manner, energetic and will to go the extra mile to make a positive difference. Send CV to administrator@footnankledoc.com

PODIATRIST WANTED - PENNSYLVANIA

Multi-specialty physician group seeking part-time or full-time to join our Johnstown, PA facility offering on-site x-ray, vascular ultrasound and other services. Patient base already established. Experienced or recent graduates considered.  Applicants send resume to cfleegle@atlanticbbn.net or call 814-288-1418 ext. 7.

ASSOCIATE POSITION - UPSTATE NY

Busy multi-specialty practice of PCPs, general surgeons, OB-GYN, podiatric surgeons looking for a full-time podiatric associate in  Upstate NY, Binghamton, Finger Lake Region. Great Benefits, opportunity for partnership. Must be highly motivated, personable and be Board qualified/eligible. Our podiatrists have over 100 years combined experience. Please send CV to associateinfoot@yahoo.com or fax 607-723-1567.

ASSOCIATE POSITION DETROIT SUBURBS

Multi-location practice seeks individual with excellent surgical training.  Practice is well established for over 30 years.  EMR’s available, ultrasound, Doppler & circulation testing, digital x-ray.  Buy in opportunity as owner plans on retiring in 2016 or sooner.  Please send cover letter with CV to footlaw@hotmail.com

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, Midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 12/24 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977.

ASSOCIATE POSITION - SOUTH EAST FLORIDA

Large established podiatry practice looking for a part-time associate. Experienced or recent graduates considered. Serious inquiries may contact us at podiatryg@yahoo.com

ASSOCIATE POSITION - WASHINGTON, DC/ MD SUBURBS

Prominent, established two office practice seeking well rounded, personable, ethical individual with sharp medical and surgical skills. Must be 24/36 month trained, ABPS qualified or certified. Partnership opportunity with ownership potential. Competitive salary with benefits package. Please send CV to ponyrunner66@gmail.com

ASSOCIATE POSITION - MARYLAND, DC, PA

A podiatrist is needed for the Baltimore, Washington, Pennsylvania area. Partner for the corporation. Surgery center, emergency room call and a hospital location. All areas of podiatry. Established practice. Salary and commission. Fax resume 410-857-4227 or email at butler@qis.net

ASSOCIATE POSITION – MISSOURI

Podiatric medical group seeks PSR24-36 individual who is interested in working with former residency director who can enhance your already strong training. Full scope practice with the cases to fast track to board certification. Four hospital affiliations, certified surgical suite in office, ultrasound, EHR Certified Stage 2. We are located close to St. Louis for day use. Exceptional school system in a low crime, low cost of living area. E-mail resume to: drfootski@hotmail.com

PODIATRISTS NEEDED - LOS ANGELES, CA
 
Home Foot Care, Inc. Is looking for motivated podiatrists to provide quality mobile care to our home-bound patients. Flexible schedule, independence, great compensation. If interested, please email resume to homefootcare@hotmail.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Requiring full-time podiatrist (PSR-24 or greater) in established Practice situated in a foothill community of Southern California. There is an existing patient base and a strong support team. Compensation is performance based with practically an unlimited earning capability. A possible buy-in is negotiable. Send resume to office@uplandpodiatry.com, titled "podiatrist."

PM News Classified Ads Reach over 14,000 DPMs 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 14,000 DPMs. Write to:bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 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.