The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

May 13, 2010 #3,856 Publisher-Barry Block, DPM, JD

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Feet Pay Price for Cheap Shoes: FL Podiatrist

"Like a cheap pair of shoes." It’s the most stinging insult you can hurl at footwear, whether you’re targeting appearance, fit or even odor. Adding injury to insult, feet pay the price when you skimp on shoes. "In large measure, you get what you pay for," says Dr. Dennis Frisch, a Boca Raton podiatrist who is a spokesman for the American Podiatric Medical Association.

Dr. Dennis Frisch

A shoe worth its salt offers support and protection, says Frisch, in the form of a firm, yet cushioned footbed, a heel cup that stabilizes the motion of the foot from side to side, arch support and mid-foot support. "We are seeing more people with heel pain and arch pain, even in teenagers, because they’re wearing flip-flops without support, and they’re wearing them for longer periods of time," he says.

Source: Staci Sturrock, Palm Beach Post, [5/10/10]

TX Podiatrist to Conduct Another Shoe Drive

A local podiatrist is doing his part to help elementary school children keep their feet healthy. Today, Dr. Daniel Bell kicked off his shoe drive benefiting L.I.S.D. students. Dr. Bell pledges to collect at least 100 pairs of shoes by the time the drive ends in August.

Dr. Daniel Bell

Bell says new shoes are important to avoid foot problems and infections. “If you use the same shoe every day, it's almost impossible to get rid of a fungal infection.”

Source: WKNS-TV [5/10/10]

Medicare Fraud Risk Created by Billing Loophole

Medicare paid a total of $87 million over 16 months for medical equipment and supply claims in which suppliers listed their own national provider identifiers in place of the NPIs of referring physicians, according to a report from the Dept. of Health and Human Services Office of Inspector General. Although these payments were allowed under a temporary provision, they represent a potential risk, because Medicare claims-processing systems did not verify if the equipment actually was ordered by eligible physicians, OIG reported. The oversight agency recommended that the Centers for Medicare & Medicaid Services end the practice "at the earliest date possible while maintaining beneficiary access to services."

In May 2008, CMS began requiring suppliers to include NPIs for both the supplier and the referring physician on every Medicare claim. But the agency has been allowing suppliers to use their own IDs in the claims field designated for the referring physician if the supplier is unable to obtain the information from the doctor. CMS plans to end the temporary provision on Jan. 3, 2011, when it will make several changes to its claims processing system. OIG noted, however, that this implementation date already has been postponed twice.

Source: Chris Silva, AMNews [5/10/10]

Feedback Guidelines

Remember these simple tips regarding timing when you deliver important feedback:

• Don’t approach someone who is just walking through the door in the morning. Doing so creates the impression that you have been waiting to “pounce” on the person. That triggers an instinctual defensive reaction that you will have to work to overcome.
•  Don’t attempt to discuss anything with someone who is halfway out the door, either. You will not be able to command that person’s full attention, because he or she has mentally left already.

Source: Adapted from The One-Hat Solution, Henry Rogers, St. Martin’s Press via Communication Briefings

Query: Podmed EMR

I am currently looking at Podmed EMR and it looks quite good – podiatry-specific, expandable (billing, scheduling), and not too expensive. I have been told that it meets the requirements for "meaningful use."  What are the pros and cons of this particular software?

R. Alex Dellinger, DPM, Little Rock, AR

RE: Post-Traumatic Pain in the Interspaces (Martin Pressman, DPM)
From: Peter Bregman, DPM

I respectfully disagree with Dr. Pressman that this is not a surgical case. While I think that a consult with a good pain specialist is warranted, it is likely that this will need surgical intervention to solve the problem, whether it is a decompression or a neurectomy, with or without replant. If the patient undergoes an epidural injection and has sustained relief, then this would contradict what I am saying, but if it does not provide sustained relief, then it is a more peripheral issue and not CRPS.

I think diagnostic blocks are in order, with lidocaine working distal to proximal. Careful mapping of this is important, as well as only blocking one nerve branch at a time. Even if it is CRPS, doing a decompression can be quite helpful, and this has been documented by Dellon. CRPS is not a contraindication to surgery, as it once was thought to be. I would start the patient on gabapentin 1,800-2,400mgs/day and or desipramine 100-150 mgs/day for pain relief.

Peter Bregman, DPM, footguru@comcast.net

RE: Bead vs. Autoclave Sterilization (Charles Morelli, DPM)
From: Avi Kornbluth

Years ago, when OSHA became a topic, Premier Dental (the mfg. of bead sterilizers) were not able to prove that their products actually were sterilizing the instruments and burrs (even though the thermometer read 425 degrees). They were not able to perform a spore (biological) test. OSHA does not recognize the "bead sterilizer," even as a disinfectant, such as any of the many low-level disinfectants, not to mention the glutaraldehyde solutions.
 
Premier lowered the temperature and renamed it a mirror warmer. If they were able to prove that it does sterilize, they would not have changed anything; in fact, they would have promoted it very strongly.
 
Avi Kornbluth, Stone Podiatry/HIS, getavi@aol.com

RE: Nurses to Take USMLE Exam in 2012 (Stephen Doms, DPM)
From: Multiple Respondents

Although many physicians will deny it, the fact that nurses will be allowed to take the USMLE Exam in 2012, along with their new doctoral degrees, will place them at a higher reimbursement rate than podiatry! Not only that, some day they may be substituting the general practitioners in the new healthcare reform model. If you have not realized it yet, in the state of Texas, CRNA's are commanding salaries close to $200K, and this is only after 6 years of total education from high school! In Florida, they are being paid over $120K.

I am not criticizing the nursing profession, I am commending them for their advances! We are the ones that will be left behind if we do not act NOW!

Narmo L. Ortiz, Jr., DPM, Cape Coral, FL, nlortizdpm@embarqmail.com

I think many PM News readers are naive to the fact that podiatry and medical education are not mirror images. It's not just a simple degree change. Currently, podiatric medical schools do not meet the criteria necessary for a DPM to MD degree change. This is not to say that the schools couldn't meet that criteria. While the first 2 years are fine and most students could take the USMLE 1, the curriculum would need a major overhaul in the 3rd and 4th years for students to be eligible to sit for USMLE 2. They would have to complete all the same clinical core rotations and electives as a medical student. It would be a difficult task mixed in with their podiatric rotations, but not insurmountable. A "degree change" has been talked about as far back as when I was a student 27 years ago, and like most soap operas, nothing much has changed. Maybe someone from one of the colleges can comment on how this could be accomplished.
 
Thomas Graziano, DPM, MD, Clifton, NJ, TGrazi6236@aol.com 
 

It is my understanding that nurses may be taking a portion of the USMLE, Part 3, comprised of retired questions, and are NOT taking the actual USMLE. The NBME currently gives the USMLE to MDs and DOs only, by contract.

The Vision 2015 Committee of APMA agrees with Dr. Doms when he states that, “it would benefit our profession to show competence in such an exam.”  Having our students be eligible to take the USMLE is one of the V 2015 objectives. In fact, discussions have been occurring among the Council of Deans (AACPM), the NBPME, and APMSA regarding this issue. There are many factors involved regarding this issue, including state laws which require the NBPME for licensure of DPMs.  We will keep the profession posted on this issue as it progresses.

Frank Spinosa, DPM, Chair, Vision 2015 Committee, Shelter Island, NY, FASpinosa@apma.org

RE: The Media Impression of Podiatry (Doug Richie, Jr., DPM)
From: Brandt R Gibson, DPM

I am surprised that as podiatrists or foot and ankle specialists, we are willing to let anyone, including the media, determine how we are perceived. In the era of RSS (Real Simple Syndication) and the internet, we have the ability and opportunity to become specialized in any aspect of the foot and ankle that we want to spend time with.  Although I also see great value in the research arm of specializing our profession, these research articles will often not enter the media. No longer do we need to wait for others to designate us as the specialist and come to us for information. Instead, we can produce articles over the internet, add content to blogs, publish videos on YouTube and other video sites, create podcasts, and have all of these feeds propagated over the Internet. When you add the power of social media, such as Twitter and Facebook, you can spread your content even quicker. 

How does this help? The media, like everyone else now, are searching for content over the internet. They will find your content and come to you, instead of you trying to go to them. If you are the specialist all over the internet (through RSS feeds), why would your local media or even the national media go to the local orthopedist or any other "less recognized" specialist. Gone are the days when others designate us as the specialists. Now is the time for us to become those specialists through the power of the Internet. What are we waiting for?

Brandt R Gibson, DPM, American Fork, UT, DrGibson@UtahFootDoc.com

1 YEAR PODIATRIC SPORTS MEDICINE FELLOWSHIP  - MONROVIA, CALIFORNIA

Applicants must have completed a podiatric residency program and must have or be eligible for a California license. Annual stipend: $48,000 and $60,000. If interested, please e-mail your resume with cover letter to the Program's management company at victoriamanagers@gmail.com

ASSOCIATE POSITION – MANHATTAN

Part-time, in-network Board Certified or Board Eligible Podiatrist wanted for busy Manhattan practice. Please email CV to parttimepodiatrist@gmail.com

ASSOCIATE POSITION - CONNECTICUT (FAIRFIELD AND NORTH HAVEN)

Great opportunity. Join one of the largest podiatric groups in Connecticut. Associate position leading to partnership. Well-established and progressive offices. Electronic medical records, digital x-ray, diagnostic ultrasound, Padnet vascular studies, nerve conduction studies, pinpoint and CO2 lasers, electrical stimulation and ultrasound therapies. Seeking a well-trained, personable, and highly motivated individual. Please send resume and current photo to dr.kassaris@yahoo.com 

PRACTICE FOR SALE - TENNESSEE

Established 30-year full-scope podiatry practice. Excellent hospital and surgery center privileges with investment opportunities. Fully equipped 2200 sq.ft. office across from hospital. High volume of new patients, DME, and local referral base. Great community for a family and the outdoorsman. Reply to tnfootdr@gmail.com

ASSOCIATE POSITION - PENNSYLVANIA

Western Philadelphia suburbs. 2-Office, Multi-Practitioner Practice ,has full-time position available. Must be ABPS Qualified or Certified. PSR-36 Preferred. Looking for hard-working, well-rounded, personable individual who is interested in all aspects of Podiatry including foot surgery and wound care. Please e-mail Resume to: pod1593@gmail.com

ASSOCIATE POSITION - TAMPA BAY, FL

Associate needed for a dynamic practice in the Tampa Bay area. Preference given to a PSR 24+ training and must have a Florida license. Well-established practice, high-tech with specialties in sports medicine, surgery and wound care. No nursing homes or HMOs. E-mail: drcosentino@tampabay.rr.com

ASSOCIATE POSITION - MARYLAND

IMMEDIATE Associate needed to join a multi-office podiatry practice in the Baltimore MD Region. Desired candidate should be surgically trained with Board Eligible/Certification. You must be hard-working, ethical, compassionate and confident in your abilities to deal with pathology, patients, staff and fellow physicians. Patient base is already established. Excellent income and growth potential for the right associate. Please forward a cover letter, resume, and surgical log (if a current resident) and availability to FootDocMaryland@Gmail.com

ASSOCIATE POSITION - PRINCETON, NJ

Looking for a full-time associate in a very high volume 2-office practice in the Princeton area in routine/sports/pediatric/surgical podiatric care. Excellent opportunity for a hard-working, ethical, individual with good personal and clinical skills. Candidate needs minimum PSR 24-36, board qualified/certified, and an active NJ state license. Send résumé’s – princetonpodiatry@yahoo.com

ASSOCIATE POSITION NORTH CAROLINA - ASHEVILLE/MOUNTAINS

Well established, multi-doctor, multi-office diverse practice has immediate need for associate doctor leading to partnership. Associate doctor will be very busy from day one. Attractive compensation and benefits. Buy-in potential after one year. Contact at smfc2@charterinternet.com or 828-734-1535

PRACTICE & BUILDING FOR SALE - MIDDLE TENNESSEE

Two locations each with 3 exam rooms, x-ray room, large waiting room, and ample parking. Excellent locations and growth potential. All equipment and furniture included. Website and marketing material included. Seller happy to assist with transition. Grossed 350K last year, priced to sell with financing available 200k. Call 931-446-5724.

SEEKING EMPLOYMENT - SOUTH FLORIDA

Board Certified Foot Surgeon. Had own practice in Texas for twenty years. E-mail:  ehe2852341@yahoo.com

ASSOCIATE POSITION - MINEOLA, NEW YORK 
 
Full-time or Part-time associate position with future partnership potential available with busy multi-office practices on Long Island. Must be proficient in all phases of podiatry with emphasis on surgery, biomechanics and RFC. Minimum standards include either a three-year PSR, or board qualified/certified status with ABPS. Existing hospital privileges with a NY-based facility helpful. Interested doctors are encouraged to e-mail their CV to mets724@gmail.com

ASSOCIATE POSITION - MARYLAND

Podiatrist needed for Maryland practice. Fax resume to 410-749-6807.

ASSOCIATE POSITION – GREATER MILWAUKEE, WI

Great opportunity: our busy multi-physician, podiatric group practice, with multiple locations, strong hospital based affiliations and clinical appointments, with teaching faculty positions at PM&S-36 residency programs, is seeking a full-time RRA BQ/BC, PM&S-36 surgically trained doctor. Position will be available for July/August, 2010. Applicant should be well trained in all aspects of conservative care and surgical forefoot, rearfoot, reconstructive surgery, trauma, wound care and limb salvage. Candidate should be ethical, hard working, outgoing and a self-starter. Commensurate pay, income guarantee, with incentives and full benefit package. Definitive plans will be discussed leading to partnership tract. Contact: Daniel Hellman, M.D. @ 414.831.0512 or by e.mail @ hellmandr@gmail.com

LOOKING TO PURCHASE PRACTICE IN FLORIDA

Experienced, surgically trained, very successful FL licensed podiatrist currently practicing out of state looking to purchase successful full time practice in Florida to relocate for family reasons. I have been in practice for over 10 years and am fluent in English/Spanish. Serious inquiries only. Please send email to faajobs@gmail.com.

ASSOCIATE POSITION -  NAPLES, FLORIDA  
Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office, multi-doctor practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. We rotate for ER call at all 4 hospitals. Candidate needs to be ethical and motivated. Established practitioner or new practitioner OK. Salary and percentage based on skills and experience, benefits including 401K. Current Florida license a plus. This a wonderful world class community. Fax CV to (239)566-8778 or Email CV to Drgordon@gulfcoastfootcare.com

CANADIAN PODIATRISTS COME BACK HOME!

An Edmonton, Alberta group of DPM’s requires an additional Podiatrist. Interest in biomechanics essential. Given Canadian visa restrictions, this position is open only to Canadian Citizens or permanent residents. Very attractive compensation package. Fax C.V. or letter of interest to: (780) 483-5796.

ASSOCIATE POSITION – NEW YORK 
 
Great Opportunity  NY podiatric practice – multiple locations – seeks well-trained, ethical DPM per diem and full-time positions available. Competitive salary. Send resume and CV to: info@advancedfootcare.org

ASSOCIATE POSITION - LAS VEGAS, DALLAS, HOUSTON, AND SAN ANTONIO AREAS

Seeking well trained ABPS board rearfoot/ankle certified/qualified foot surgeons for surgical practice with national foot/hand/orthopedic surgery group. Excellent salary/benefits. Email CV and cover letter to: slb99@pdq.net

TRAUMA FELLOWSHIP - FOOT & ANKLE

Broadlawns Medical Center in Des Moines, IA is currently accepting applications for its 12 month trauma surgery fellowship beginning August 1, 2010. Fellowship to include advanced techniques in all foot and ankle surgery with an emphasis on lower extremity trauma, reconstruction & total joint replacement. Residency training required. Competitive salary and benefits. Please submit a letter of interest, CV, and 3 letters of recommendation to: Ben Olsen, DPM, Director: Foot and Ankle Trauma Fellowship, Broadlawns Medical Center, 1801 Hickman Road Des Moines, IA 50314, 515-282-7927, bolsen@broadlawns.org

PM News Classified Ads Reach over 12,000 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 12,000 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

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