The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

May 12, 2009 #3,543 Publisher-Barry Block, DPM, JD

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Smoldering Sand or Asphalt Can Injure a Child's Tender Soles: NY Podiatrist

Planning a backyard barbecue or a camping trip? Make sure your child's wearing the right shoes. A recent University of Florida study found that 69 percent of pediatric foot and ankle burns happened when kids stepped on hot coals, ashes, or embers. Most were wearing open shoes, like sandals, or no shoes at all.

Dr. Jacqueline Sutera

Even smoldering sand or asphalt can injure a child's tender soles, says Jacqueline Sutera, a podiatrist in New York City. If your child's feet get burned or blistered, first check them for pus, swelling, or bleeding. If you see any of these, a doctor should treat his feet.

If there are no signs of serious injury:
1. Wash your child's feet with gentle soap and water, or Epsom salts diluted in warm water.
2. If the blisters are closed, smooth on a thin layer of a burn cream like Silvadene twice daily, and bandage.
3. When the blisters open, put a triple-antibiotic cream and a Band-Aid on them twice daily for a few days.

Source: Laura Sullivan, Parenting [May 2009]

TX Podiatrist Elected Trustee to McAllen School Board

Javier Farias was elected to a third term on the McAllen school board Saturday, narrowly defeating retired educator James Torline by 82 votes. The board also has two new members: Sam Saldivar Jr. and Dr. Joseph Caporusso. Both men said they look forward to working with the board and the district's new superintendent, James Ponce, who started May 5.

Dr. Joseph Caporusso

For the board's Place 6 seat, Caporusso defeated former Parent-Teacher Association president Ralph Garcia by more than 600 votes. Caporusso, a podiatrist, said he was looking forward to working with fellow board members to assess which programs are working for the school district and which ones are not. "I hope to get a (public relations) program going that will tell the story of our school district and bring more students to our school district," he said.

Source: Jennifer L. Berghom, The Monitor [5/9/09]

Senate Panel Suggests Delay in Long-Term Reform of Medicare Pay

Senate Finance Committee leaders on April 28 offered a list of ideas for the first third of a national health reform bill, but a private discussion between senators and their staffs the next day did not produce significant agreements on the proposed solutions.

Nevertheless, the 48-page draft addressed improving patient care and reducing costs. It also provided more detail on the direction Senate Finance Committee Chair Max Baucus (D, MT) and highest-ranking Republican Charles Grassley (IA) would like to take for health system reform. The draft was released after the first of three Finance public roundtable discussions.
 
The initial draft suggests updating the Medicare physician fee schedule by 1% in both 2010 and 2011 and offering no update in 2012. The system then would revert to existing law but might have a new maximum percentage for cuts under the sustainable growth rate formula.

Source: Doug Trapp, AMNews [5/1109]

Connect With Potential Patients Online

Your website has elicted messages from potential patients. How do you respond? Use these strategies when sending e-mail to people who don’t know you well, if you want them to read your words and respond:

• Don’t attempt to overimpress. In an effort to impress, many people create long documents with sophisticated words and complicated sentences. However, those things leave busy professionals with a negative impression. Move to the point and be done.
•  Check your I/you ratio. Your message will be more appealing if you write more about “you,” meaning the patient, rather than about “I,” meaning you or your practice. Count your I/you usage, and remember the greater the “you” focus, the more likely you are to capture and keep the reader’s attention.
•  Restrain yourself. Strive to limit e-mail messages to one screen. Shorter messages deliver greater return. Recipients are able to attend to them now rather than setting them aside for later or hitting delete.

Source: Adapted from “Ten Tips to Get Busy People to Respond to Your Messages,” Bonnie Budzowski, InCredible Messages LP via Communication Briefings

Query: TOG Gait Scan

Does anyone have experience with the TOG Gait Scan?

TOG Gait Scan

Rich Resnick, DPM, Burke, VA
 

RE: DVT Risk in Podiatric Surgery?
From: Lee C. Rogers, DPM

A couple of weeks ago, PM News along with many other medical news outlets, reported on the article "Incidence and Risk Factors for Venous Thromboembolic Disease in Podiatric Surgery" by Felcher, et al. in Chest. The headlines from this article were that venous thromboembolism (VTE) risk was low and prophylaxis was not necessary. Certainly, a quick perusing of the abstract would support that headline, however, a deeper dissection of the article brings up some concerns. In the study of 7,264 patients undergoing podiatric procedures, nearly half (3,300) had only "injections of a joint/foot" or "drainage of a joint/bursa/cyst." 

No one would consider these procedures to have a risk of DVT, nor would we consider DVT prophylaxis after an injection. The bulk of the remaining procedures (~4100) were bunionectomies, hammertoe repairs, toe amputation, wound debridement, and foot exostectomy. These are also considered low risk by many practitioners. From what I can discern, there were no osseous rearfoot, ankle, or leg procedures. Also, possibly the largest risk factor for VTE, immobilization, was not recorded - nor would it have been necessary for many of the reported procedures.

Granted, the previous reports by Mizel, et al., Solis & Saxby, and Wukich & Waters have shown a relatively low risk of DVT after foot and ankle surgery. But the present study is biased toward foot procedures that likely have a low pre-test probability for DVT. Plus the use of the word "podiatric surgery" to describe injections or only minor forefoot surgery does not take into account the full breadth and depth of what surgeries podiatrists typically perform.  The results and recommendations of this article cannot be applied to rearfoot, ankle, or leg procedures.

Lee C. Rogers, DPM, Des Moines, IA, lee.c.rogers@gmail.com

RE: Intractable Arch and Heel Pain (Charles Gilarski, DPM)
From: Steven Melek, DPM, Peter Bregman, DPM

I also use ultrasound  to look at tears. Cryosurgery has worked well as long as we pinpoint the location.

Steven Melek, DPM, Charleston, WV, drstevenscott@yahoo.com

I think it would be wise to look for tarsal tunnel syndrome. Percuss the tunnel and look for a Tinel's sign and pain and deeply palpate the tunnel and medial calcaneal nerve and compare to the other side. If you have ultrasound, it  can rule out plantar fasciosis. Orthotics help in these cases less than 50% of the time in my experience. If it does not quack like plantar fasciosis and the ultrasound is normal, then it is most likely a nerve issue especially if present non-weight-bearing.  I had an OR tech who was 24. She underwent triple nerve decompression on both legs. After 3 months, she returned to work no problems.
 
 
Peter Bregman, DPM, Tewksbury, MA, www.painfreefeet.com

RE: Doctor of Plant Medicine (DPM)

My avocation is competitive gardening. Last Fall, I invested in a lot of prize-winning tulip bulbs. None sprouted and I couldn't figure out why until I saw a squirrel with one of the bulbs clenched between his two paws, eating it as if it were an ice cream cone. I called the nursery where I bought bulbs and spoke to their senior horticulturist. Her advice was that next Fall, I sprinkle foot powder on the bulbs before planting them. Any foot powder will do. Apparently there is some ingredient in it that wards off squirrels. The company has no idea that I am a podiatrist so they were in no way playing a joke. The advice was direct from the nursery in Holland where they grow the bulbs. 
 
Elliot Udell, DPM, Hicksville, NY
 

ASSOCIATE POSITION – TUCSON, ARIZONA

Full-time position which involves all phases of podiatry. Compensation based on training and experience. Must have current Arizona podiatry license. Send Resume to Transcription697@aol.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas

PODIATRISTS NEEDED – DALLAS/ FT WORTH – TEXAS AREA

Texas Home Footcare Associates, a podiatry exclusive company specializing in house calls and visits to facilities for the elderly, is looking to hire podiatrists. We are located in the Dallas area. Full and part-time positions are available. Immediate Openings Available. Must have a Current Texas license. Competitive Compensation Package. If interested fax curriculum vitae to 972 931-4819 or e-mail gjmdpm@tx.rr.com. For further information, call 972-380-8028.

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com                            

ASSOCIATE POSITION - HENDERSON, NEVADA

Associate wanted for thriving, well-mixed 3-doctor digital office, leading to partnership. Surgery, diabetic, pediatric, and general podiatry. Great office and location, fun area to live. Need 2+ years surgical residency. Must be energetic, self motivated, great patient skills. Salary plus bonuses. Email CV to gtorgesen@yahoo.com

ASSOCIATE WANTED - FLORIDA

Associate needed for a dynamic multi-doctor practice in the Tampa Bay area. Partnership opportunity for the right candidate. Preference given to a PSR 24+ resident completing their education this spring/summer, and must have a Florida license. Well-established practice, high tech with EMR and digital x-rays, with specialties in sports medicine, surgery and wound care. No nursing homes or HMO's. Excellent hospital privileges available. Choose an area of practice concentration that you are passionate about and enjoy a lifestyle for yourself and your family that is second to none. E-mail: kimvelez@tampabay.rr.com

OFFICE SPACE/ MRI RENTAL – NYC, LI   
 
Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, and Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITION – ILLINOIS 
 
Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings available. If interested, fax curriculum vitae to 312 225-9366 or e-mail feetwork@aol.com

ASSOCIATE POSITION - CONNECTICUT

Nice community outside of New Haven. Well-established, busy practice seeking part-time or full-time associate. Excellent opportunity for a highly motivated and ethical professional. Must have good patient skills. PSR-12 or higher with excellent skills required. Send resume and cover letter to fax # 203-439-7916.

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

PM News Classified Ads Reach over 11,500 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 11,500 DPM's. Write to  bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 Ext 110.

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