The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

May 09, 2013 #4,765 Publisher-Barry Block, DPM, JD

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Toenails Can Provide a Health History: IN Podiatrist

There are certain parts of the body, like skin, hair and teeth, that can reveal a lot about your health, but have you ever given much thought to your toes? A local podiatrist says your toes can reveal much more. In the town of Garfield, NJ, thousands of residents were exposed to a toxic chemical from a factory leak. Now scientists fear residents could have cancer, and the only way to know for sure—examine toenail clippings.

Dr. Lynn Stafford

Fort Wayne podiatrist Dr. Lynn H. Stafford of Aboite Podiatry says toenails can hold up to months, or even years worth of information. "The average person, it's approximately 12 months. Obviously there's some variation on how much blood flow there is getting to the extremity; age is a factor. So those of us who have good blood flow, maybe closer to the 10-month mark. Those who have slow blood flow may be closer to the 18-month mark,” said Dr. Stafford.

Source: Rachel Martin, indianasnewscenter.com [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

WSPMA Elects New Officers

At its annual conference May 4th, the Washington State Podiatric Medical Association elected Joanne Gormley, DPM, president of their association. 

Dr. Joanne Gormley

Other officers elected were:

Vice President - Eric Leonheart, DPM
Secretary-Tony Kim, DPM  
Treasurer - Ron Douglas, DPM

Skin Cancers of the Feet are Often Painless: NY Podiatrist

The Centers for Disease Control have declared May as “Skin Cancer Awareness Month” and the New York State Podiatric Medical Association (NYSPMA), which represents more than 1,200 foot specialists across the Empire State, is urging New Yorkers to pay special attention to the skin on both the top and bottom of their feet.  While harmful sunrays may be the primary cause of skin cancers on parts of the body that receive sun exposure, skin cancers of the feet are more often related to viruses.  Doctors of Podiatric Medicine (DPMs) are foot specialists, trained to recognize and treat conditions that present on the skin of the foot.  

Dr. Gary Stones

Skin on the feet, especially on the bottom, is often overlooked during routine medical exams. According to Dr. Gary Stones, NYSPMA’s President and a practicing podiatrist, skin cancers of the feet have several features in common. “Most are painless, but often there’s a history of recurrent cracking, itching, bleeding or ulceration,” he cautions. “These cancers often go undiagnosed until another issue presents itself near the affected site,” added Stones.

EHR Implementation Rising, But Hurdles for Healthcare Providers Remain

Recent data from the Centers for Medicare and Medicaid Services point to progress in Electronic Health Record (EHR) implementation. Under the meaningful use program established by the 2009 stimulus bill, 75 percent of eligible hospitals and 73 percent of healthcare providers have received incentive payments for attesting to EHR use, CMS says.

However, the picture is far from rosy. Separate studies suggest that 23 percent of providers want to switch EHR systems and that, given the choice, 40 percent of providers wouldn't buy the same EHR system again.

Source: Brian Eastwood, CIO.com [5/6/13]

RE: Brachymetatarsia
From: Thomas Graziano, DPM, MD, Sam Bell, DPM

This is an interesting case. You would use external fixators on the 3rd and 4th metatarsals. You also have local access to and can harvest an autogenous bone graft from the osseous bridge between the 1st and 2nd metatarsals. In an attempt to better balance the length pattern, you might consider shortening the 2nd metatarsal and performing an IPJ arthrodesis on the 2nd toe. Stage the procedure and make sure the patient is well aware of the rather cumbersome post-operative course involved.
 
Thomas Graziano, DPM, MD, Clifton, NJ, TGrazi6236@aol.com

Wouldn't the problem the patient is having determine how you would treat the short metatarsals? We need more information.

Sam Bell, DPM, Schenectady, NY, dpmbell@aol.com

RE: Chronic 1st MPJ Pain (Don Peacock, DPM)
From; Scott Hughes, DPM

I assume Dr. Peacock shared his pre- and post-op x-rays to show the success of his MIS technique.  I think most of us would agree that decompressing the 1st MPJ by shortening and plantarflexing the 1st met head is desirable for hallux limitus. However, the osteotomy, besides being inherently unstable and an elevatus waiting to happen, is oriented to create lengthening. Also, the osteotomy creates a plantar shelf directly above the sesamoids.

I am happy to hear the patient is pain-free, but when I look at this case, my thought is 'better lucky than good' rather than MIS is a viable alternative.

Scott Hughes, DPM, Monroe, MI, dr.hughes@comcast.net

RE: Chronic 1st MPJ Pain (Charles Morelli, DPM)
From: Don Peacock, DPM

I have to respectfully disagree with Dr. Morelli regarding this particular case. I too am a fan of the  Cotton procedure. It is a great way to stabilize the medial column and achieve plantarflexion of the first ray.

Addressing of the gastrocnemius equinus will give you plantar flexion of the first ray as well. When I first heard of this, I was very skeptical myself. The reason plantarflexion of the first ray occurs after a gastrocnemius recession is because...

Editor's note: Dr. Peacock's extended-length letter can be read here.

RE: Outside Magazine’s Article by Andrew Tilin on Barefoot Running
From: Amol Saxena, DPM

I am sure the article was designed to fuel the debate between minimalist/barefoot running and traditional shoes. Unfortunately, it isn’t that clear-cut. By printing McDougall’s inflammatory comments towards podiatrists, specifically saying they aren’t research scientists (neither is he the last I checked), actually weakened his argument. He should also note that Dr. Kevin Kirby has published extensively in many high-level biomechanics journals before he (McDougall) casts stones. In general, podiatrists see only people with injuries, so they will be biased in that regard.
 
Back in the 1970s, runners wore minimalist shoes and got injured. Shoes got more supportive and...

Editor's note: This letter was originally send to the editor of Outside Magazine. Dr. Saxena's extended-length letter can be read here.

RE: Source for X-Cell X-Ray Tube (Bruce Krell, DPM)
From: Henry Slomowitz, DPM

If you're looking  to replace an x-ray head, make sure that you need one. My supplier, Avi Kornbluth, who works for Schein, once told me of a doctor who made the same request of him. He asked him why do you think you need a head. The doctor's answer was that the old one does not work, and it had a smell of smoke in it. To this, Avi replied that all he might need is a capacitor in the head, not a new tube. It sounds like the capacitor burned out. Avi was right and the repair was much less expensive than buying a new head. Hats off to Avi; he is the most honest sales person I have ever met.

Henry Slomowitz, DPM, Paramus, NJ, minggao@optonline.net

RE: Purchasing a Digital X-Ray System (Jon Purdy, DPM) 
From: Larry Kosova, DPM

Why would anyone choose a more cumbersome CR system to “process” films, which takes more time and effort than a DR system? There are about $10-15,000 reasons why. There is a large difference of cost between the CR and DR. That is just the basic podiatry versions. Most really good DR systems are about $60,000-$150,000.

The reason you don't just buy the cheapest product is not the technology; it is the software and customer service and reliability of the product. Some software can do different things. Mine can capture photos from my...

Editor's note: Dr. Kosova's extended-length letter can be read here.

RE: Dr. Lidtke's Remarks
From: Bret Ribotsky, DPM

I love to read the comments each day on PM News, and I would also like to be fair to the guest masters and to Dr. Block. The Q&As that are published each week are taken out of a conversation that is fluid.  For this, I would request that anyone wishing to make a comment at least listen to the show to see if my follow-up questions answer your concerns.

Each Tuesday night, the microphones are open to anyone listening live on a topic that should be of interest to you. I believe that we collectively can move our knowledge forward. Roy's comments were taken out of a long discussion about how research has demonstrated how podiatric biomechanics was taught and is evolving, and that there is so much we all need to learn. Last Tuesday, we were exposed to a theory that stability can be bad (sorry, Dr. Root) to forces and to orthotic therapy when dealing with arthritis and joint wear. What I learned is that each patient needs to be individualized, and even then, sometimes it's a flip of a coin as to which way to go. Listen to Roy's talk. He is very knowledgeable and makes his points very well.

Bret Ribotsky, DPM, Boca Raton, FL, ribotsky@gmail.com

ASSOCIATE POSITION - NEW JERSEY

Looking for full time/part time associate in busy 3 office practice.  Offices are located in Union, Hudson, and Bergen counties. Competitive salary with benefits. Excellent growth opportunity. Please send C.V. to njpodiatry33@gmail.com.

ASSOCIATE POSITION - VIRGINIA

Well-established practice in Arlington Virginia looking for first year associate DPM perhaps leading to purchase of office. Office is one block from metro and has onsite private parking for patients. Present owner is retiring but will aid with smooth transition. This practice has been in the same location for the 40 years and has an excellent referral base. Must be licensed to practice in the state of Virginia. Please contact drmichaelfine@aol.com. Cell Phone 703-582-5999.

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- HUDSON VALLEY REGION, NY

Hudson Valley Foot Associates has a great opportunity available! We’re a high-volume, diversified, multi-office group practice utilizing state-of-the-art modalities. Great growth for a personable and motivated DPM. Please visit www.hvfa.com and forward cover letter with CV to info@hvfa.com.

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

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

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.

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.

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.

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