The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

May 12, 2012 #4,460 Publisher-Barry Block, DPM, JD

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Scholl Student Wins APMWA Student Writing Competition

Benjamin Saviet, a second-year student at  the Scholl College of Podiatric Medicine has been named the winner of the 26th Annual American Podiatric Medical Writers Association Student Writing Competition. His paper was entitled, "Where is My Life-Work Balance?”

Benjamin Saviet

Saviet will receive a one thousand dollar honorarium from a special endowment by Dr. and Mrs. Steven Berlin to the APMA Educational Foundation.

The award for Honorable Mention went to Eric Beights, a third-year student at the  Temple University School of Podiatric Medicine for his paper, "The Evolving Transformation of Podiatric Medical Education."

Canadian Podiatrists May Soon Have the Authority to Prescribe Narcotics

More healthcare providers may soon have the authority to prescribe narcotics, a move one nurse practitioner says could help piece together fragmented healthcare for Canadians. Proposed changes to the Controlled Substances Act and its associated regulations would allow midwives, nurse practitioners, and foot specialists to prescribe medications classified as controlled substances as soon as this fall. They would be allowed to prescribe in those provinces and territories that have laws that allow such groups to write prescriptions. 

Dr. Richard Bochinski

Dr. Richard Bochinski of the Canadian Podiatric Medical Association said the changes are a "huge step" and will have great benefits, especially for podiatric surgery patients. "They don't have to run around looking for some-one who's going to give them pain medication," Bochinski said. "They can get it from the source, the actual surgeon who's doing the procedures." Another benefit, Bochinski said, will be cost savings; fewer visits to doctors will save money not only for patients, but for the healthcare system as well.

Source: Gemma Karstens-Smith, vancouversun.com [5/10/12]

NYSPMA Members Storm Albany on Legislative Lobby Day

70 member podiatrists of the New York State Podiatric Medical Association, along with residents and students from across the state, descended on Albany. 

Members of NYSPMA in Albany for Legislative Lobby Day

Altogether, they held close to 100 individual meetings with legislators and their staff, explaining our scope of practice bill and answering questions. Our leadership assessment is that real progress was made in moving the legislative process forward.

NJ Podiatrist Coordinates "De-Feet Childhood Hunger" Food Drive

For many years, Dr. Hal Ornstein, a podiatrist here in Howell and his wife Anna have been involved in helping the community in many ways. Recently, Ornstein found a way to use his passion for photography to provide a much appreciated service for a local lacrosse league while also benefitting the local food bank. 

Dr. Hal Ornstein with Food Drive Volunteers

The doctor said his wife is a volunteer at the food bank and recently told him that their supplies were at "an all time low." He said this inspired him to find ways to not only help the pantry but also take on another personal challenge. He said he calls this initiative an effort to "de-feet childhood hunger." In the past, Ornstein said he had taken pictures of the Howell Pride Lacrosse team and given the pictures to the teams and parents. This year, that amounted to 180 players. "I said why don't we ask each parent to give a couple of cans of food," he said.

Source: Adam Hochron, Patch.com [5/10/12]

OR Podiatrist, a Triathlete, Follows a Strict Regimen

Dr. John Mozena, 56, is a podiatrist in private practice and a published writer. An Oregon native, he graduated from Central Catholic High School and the University of Oregon. A triathlete, Mozena has six Ironman competitions under his belt as well as 13 half-Ironmans and more than 20 marathons. He competes all over the country and is trying to get to the world championships. 

Dr. John Mozena

Mozena exercises at least 15 hours a week and at least 20 hours a week before a competition. He keeps a log of all workouts. He swims for an hour three times a week. He bikes three times during the week for one to two hours; his weekend ride is three to six hours. He runs three times during the week for an hour, and his weekend run is two and a half to three hours.

Source: Nancy Dow, The Oregonian [5/9/12]

Bipartisan House Bill Would Repeal SGR

Two House members—including one physician—have introduced bipartisan legislation that would repeal the Medicare sustainable growth-rate formula used to pay physicians and avert a more than 30% payment cut to doctors next January. The Medicare Physician Payment Innovation Act  from Reps. Allyson Schwartz (D-PA) and Joe Heck (R-NV), a physician trained in emergency medicine, would freeze payments to physicians at 2012 levels through Dec. 31, 2013.

It would then provide positive annual increases of 0.5% for all physician services each year for four years. Between the years 2014 to 2017, the bill would provide an annual increase of 2.5% for primary care, preventive and care coordination services that are offered by clinicians for whom 60% of their Medicare charges are for those services.

Source: Jessica Zigmond, Modern Healthcare [5/9/12]

HHS Moves to Streamline Reporting, Update e-prescribing Requirements

HHS issued final rules Thursday to streamline reporting requirements for hospitals and update technical requirements for electronic prescribing that the Obama administration says could save more than $5 billion in federal funding over five years.

One regulation eliminates outdated hospital management requirements and some reporting rules—in the Medicare Conditions of Participation for those hospitals that treat Medicare and Medicaid patients, which is expected to save more than $900 million annually. The other rule applies to providers other than hospitals and includes changes such as updating e-prescribing technical requirements to meet today's standards. That regulation is expected to yield more than $200 million in the first year.

Source: Jessica Zigmond, Modern Healthcare [5/10/12]

Query: Soft Tissue Mass

I have a patient with a mass under the 2nd MPJ of his right foot. He has history of plantar fibromas which have been present for years, but this mass developed 8 months ago and has gotten bigger. It isn’t painful to him and feels spongy. It seems to be almost directly under the 2nd metatarsal head and extends distally to the plantar base of the proximal phalanx of the 2nd toe.  

X-rays revealed nothing remarkable, and an MRI done without contrast was unable to see the lesion due to poor positioning and images only obtained to the MPJ. Clinically, it measures about 3.6 x 2.8cm. I am sending him for a new MRI with and without contrast, limited to just the forefoot for this lesion. The radiologist did see a part of this mass and gave 2 differentials: giant cell tumor of tendon sheath and synovial sarcoma. Based on this information, would you recommend a biopsy, and if so, what type?

Rob Lagman, DPM, Covington, LA

Query:  Humana Records Request

I just received a call from Humana (I am contracted with them) for a medical records audit of 16 charts. The person from Humana wants to come to my office and review the records.

1. Can I refuse the on-site review and send records instead?
2. Can I charge for a records' copy fee and if so how much?
3. Can I charge them for the use of my office space?

Pete Smith, DPM, Lancaster, PA

Response: Generally, providers agree to cooperate with audits as a condition of the contract. However, there may be some state laws that co-govern whether the provider can charge for copying, and if so, how much. It may be possible to offer to send copies of the records, but Humana likely can reject the offer. Whether records are sent or made available on site, copies should be made of everything the auditor looks at or has a copy of.

Lisa Doup Stevenson, DPM, JD, Baltimore, MD

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RE: Non-Union and Malunion of Metatarsals (Bret Ribotsky, DPM)
From: Elliot Udell, DPM
 
While ordering a vitamin D 25 OH on such a patient is a no-brainer before ordering a parathyroid test, one might consider serum calcium levels first. Most labs will this include as part of a "SMAC". The parathyroid test is expensive and might need to be justified by being able to show elevated serum calcium levels first.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Marfan's Syndrome and Bunions (Tip Sullivan, DPM)
From: Jerry Peterson, DPM

I learned different numbers than Dr. Sullivan did. 0-8 degrees of IM angle was considered normal. Neck osteotomy was performed from 8-14 degrees, and 15 and up was base wedges and Lapidus territory. So, I agree with Dr. Mullens on this one. However, this is NEVER a hard and fast rule as I do a lot of base wedges and even Lapidus procedures on patients with lower angles, and neck osteotomies on higher angles, depending on age, bone quality, foot function, and desired outcomes. Anyone who states that a certain angle of measurement entirely determines the procedure we do needs to wake up from dreamland. These are too broad statements, and I believe were not intended to be dispositive.
 
Jerry Peterson, DPM, West Linn, OR, DRP@ifixft.com

RE: Is it Time to Bring Back Chiropody? (H. David Gottlieb, DPM)
From: Jeff Mennuti, DPM

I really don't agree that biomechanics is given secondary emphasis in the current model of foot and ankle [podiatric] residency. As a matter of fact, I remember that prior to any bunion case, my attending always put up the x-rays and we discussed biomechanics at length. My opinion was that clipping toenails as a resident was an obligation in return for the training. What I disagree with most is that we shouldn't force residencies to demand x, y, and z. During my residency, I learned more from general surgery, plastic surgery, and sports medicine than I did in podiatry. The podiatry rotations kind of taught me "in the box" skills and mindsets, but the other rotations taught me "out of the box" methodology. I currently practice using a combination of all the above.

I believe each individual needs to have more elective time in order to obtain competencies. If all the residencies make a stringent track for each individual, then we would have a fleet of drones with exactly the same skill sets, mindsets, and routines. Wouldn't it be great to refer to your colleague for wound care, and that person referred back for reconstruction, for example.

Jeff Mennuti, DPM, Orange City, FL, dr.mennuti@gmail.com

RE: Sterilizing Bits Between Debridements (Jeff Kittay, DPM)
From: David E. Gurvis, DPM

If you are going to grind nails, I feel your burrs need to be as sterile as any other instrument. Mine are wire brush-scrubbed, ultrasounded, individually wrapped in a self-sealing autoclave bag, and autoclaved. It's a simple routine, and actually requires minimal time of my assistant. This prevents the spread of contaminants. Further, if one nail is mycotic and the others are not, grind or smooth the non-infected nails first, then the infected nail last, or change burrs in between infected and non-infected nails.
 
If you are going to grind nails (again, to do so or not is not the argument here), you need better than a Dremel, so changing burrs is a simple snap.  All the above ignores the other concern about lungs, eyes, etc. for both you and patients. For that, you truly do need an efficient evacuation system.
 
David E. Gurvis, DPM,  Avon, IN deg1@comcast.net

RE: Podiatrists Portrayed on TV (Chuck Ross, DPM)
From: Russell L. McKinley, DPM

The same forensic podiatrist character was featured in an episode last season. In that episode, his input helped solve the case.  This had a favorable impact for forensic podiatry. This week's episode did not show forensic podiatry, or podiatry as a whole, very favorably.

Russell L. McKinley, DPM, Elizabethtown, KYrussell@russellmckinley.com

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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 516 476-1815 PODO2345@AOL.COM

PRACTICE FOR SALE - AUSTIN TEXAS

Great opportunity. 18 year practice with large patient base. Current physician is retiring. Start turn-key. Will owner finance with a down payment. Will stay to help transition. EMR based office. Great place to live, work and raise a family. E- mail susieintx@aol.com or call to schedule a look at the office 512-719-4545.

PRACTICE FOR SALE - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact:podiatrypracticesale@gmail.com

PRACTICE FOR SALE — BROOKLYN, NY

This practice has been in the same location for 31 years, seeing 80-100 pts/week, working 4.5 days/week. Grossing $350K and netting close to 70%. All surgery referred out. Low rent, option to buy the building in future. Asking $225K, doctor willing to finance. Call 800-983-4194, or email:contactus@podiatrypracticeconsultants.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Very busy, two location group practice seeking a full-time, self motivated and hard working podiatry associate. Competitive salary and benefits are offered. Please email CV to: footcare4all@aol.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 24-36 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 - OH 

Join a well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and to Ohiodoctors@aol.com

ASSOCIATE POSITION - CALIFORNIA

Office and hospital-based podiatry group in Bakersfield, CA seeks highly-trained surgical associate to join us. Prefer surgeon with trauma and Charcot reconstructive experience. Staff privileges with 5 local hospitals. Offering health insurance, CME allowance and competitive salary. Must be PSR 24/36 trained, ethical and thoughtful when treating patients. Please forward CV to: aghams2@aol.com

ASSOCIATE POSITIONS - MULTIPLE STATES

Podiatrist Needed in Arkansas, Kansas, Missouri, Nebraska, Iowa, Minnesota, North Dakota, South Dakota, Texas, Colorado, Wisconsin, and Oklahoma. Expanding multi-state medical practice seeking podiatrists to service long-term care community residing in nursing homes and assisted living facilities. We offer an established patient base, scheduling, equipment allowance and cover travel expenses. Provide generous compensation, bonus opportunities, disability, health insurance benefits, malpractice coverage and flexible scheduling. Looking for a Podiatrist with excellent skills, able to provide expert and compassionate care to patients. Email CV to: careers@aggeus.org or call 773-770-0140 x300/x305.www.aggeus.org

ASSOCIATE POSITION - ST. LOUIS

Multi-location group practice seeks motivated DPM with initiative and leadership skills to contribute to our growing group practice. Foot Healers Podiatry Group enjoys a strong reputation within St. Louis and looking for the right individual to complement our team. Must have the confidence to lead you own clinic and the willingness to draw on the expertise that exists within our group. Starting salary ($100k), plus incentive comp plan, malpractice coverage, health insurance, 401k, group bonus/profit sharing. Please send CV to: jmurray@foothealers.com and visit our website www.foothealers.com

ASSOCIATE POSITION - FLORIDA

Great opportunity for new practitioner or experienced physician looking to relocate to Florida. Practice currently owned by physicians with a solid patient base after over 12 yrs of practice in this area. Current physicians transitioning to part-time (and eventual retirement from the practice) in order to pursue other business opportunities. Seeking a friendly, dependable, independent ‘go-getter’ who can transition in as seamlessly as possible with staff and patients while maintaining the high-quality foot/ankle care on which our reputation was founded.  Start turn-key without need of a bank loan. For more information or to express your interest, please forward your CV to: podiatristsearch@gmail.com

ASSOCIATE POSITION - MIAMI AREA, FLORIDA

Multi-office podiatry group looking for a dynamic and motivated associate to join our practice. Immediate schedule available. Filling in to cover busy schedule and need an energetic associate to expand to your own new office. Competitive salary with bonus incentives.  Two or three year surgical residency preferable. Any candidate that applies should be ABPS qualified or certified. Located close to Miami, FL. Send CV to QVAN@aol.com.

ASSOCIATE POSITION - NEW YORK

Full-time position available immediately in Capital District multiple doctor practice. Good salary with percentage. All phases of podiatry. NYS license required. Email resume to: Lchittenden68@gmail.com or call Lori at 518-577-6171

ASSOCIATE POSITION - KANSAS CITY, MISSOURI

Kansas City may be the perfect move for you and your family. I am looking for an entrepreneurial minded associate who wants to grow and then own part of an already successful practice. If you are the right candidate for this associate position, you will enjoy a competitive compensation package and you will be working with a doctor who is as committed to your success as he is to his own. Go to:www.YourFutureInPodiatry.com for full details.

ASSOCIATE POSITION- PALM BEACH CO, FL

Young, enthusiastic three location dynamic practice seeks motivated, personable associate for full or part time position. Competitive salary, benefits and incentive structure. Please send CV tosflfootandankle@yahoo.com

ASSOCIATE POSITION - TENNESSEE/NORTH GEORGIA

Multi-physician, Multi-office practice looking for motivated new associate leading to partnership. We are a busy practice with state of the art technology: EHR, Digital X-ray, Diagnostic Ultrasound, PADnet, EPAT machine. Applicant should be PMS 36/Board Qualified/Certified. Applicant should be ethical, personable, hard working and interested in providing all aspects of podiatric care to our patients. Competitive Salary and benefits. All interested candidates please send a CV with two letters of reference to:mybestnewjob@gmail.com

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