The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

May 14, 2012 #4,461 Publisher-Barry Block, DPM, JD

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TX Podiatrist Describes Exercises to Strengthen Foot Muscles

Trail running bolsters feet and ankles, which benefits hikers by preventing sprained or rolled ankles, plantar fasciitis, knee problems, and shin splints. Plus, running gets you in top hiking shape by working quads, hamstrings, calves, glutes, hips, shoulders, and abs. Here’s how to use running to get in prime trail condition this season. 1. ABCs - Use your big toe to air-write the alphabet, advises Dr. Marybeth Crane, podiatrist, foot and ankle surgeon, and life-long runner. The wide variety of movements improves flexibility and works foot and ankle muscles, both of which reduce your risk of sprains.

Dr. Marybeth Crane

2. Towel crunches - To strengthen the interossei and lumbricals, the tiny toe muscles that provide stability for navigating uneven terrain, Crane recommends this exercise: Put your foot on a towel and scrunch or grab the towel with your toes (either seated or standing). Do it 10 times, take a 30-second break, and repeat twice. If this gets easy, try grabbing a pen or marker with your toes instead.

Source: Allison Pattillo, Backpacker Magazine [May 2012]

NYCPM Students Receive Nearly $600K in Scholarship Awards

On Wednesday, May 9, members of the Classes of 2012 through 2015, along with faculty, administration, proud parents and other relatives, as well as several distinguished guests, gathered in one of the large lecture halls at the New York College of Podiatric Medicine (NYCPM) to honor more than fifty high-achieving members of the four classes with scholarship awards and certificates. 

Michael J. Trepal, DPM, Vice-President for Academic Affairs and Dean, introduces Susan Rice, DPM, Associate Professor of Surgical Sciences and Chair of the Scholarship Committee.

Laurence J. Lowy, DPM, Dean for Student Services introduced Louis L. Levine, President and CEO, and Michael J. Trepal, DPM, Vice President for Academic Affairs and Dean, both of whom offered brief remarks.  Distinguished guests included Vito J. Rizzo, DPM, President of  NYSPMA; Christian A. Robertozzi, DPM, Past President of APMA, who presented the Jonathan Robertozzi Foundation Memorial Scholarship; Israel Goldstein, DPM, Adjunct Associate Professor of Medical Sciences at NYCPM, who has endowed the Dr. Israel Goldstein Scholarship; and Gary Strauss, CEO of PEDiNOL® Pharmacal, who presented the PEDiNOL Award for Dermatology.

ADA Settlement After CA Podiatrist Refused to Perform Surgery on HIV Patient

The Justice Department announced that it has reached a settlement today resolving a claim that a healthcare provider refused to serve people with HIV in violation of the Americans with Disabilities Act (ADA). The complaint was filed by a man with HIV who went to the Mercy Medical Group Midtown Clinic in Sacramento, CA. After meeting with the patient and examining him, a podiatrist at the clinic informed the patient of his treatment options. Although surgery was one of the treatment options, the podiatrist incorrectly told the patient that he could not perform the surgery because of a risk that he would contract HIV from the patient during surgery.  

The United States determined that the podiatrist’s actions violated the ADA by denying the patient the full and equal enjoyment of the services offered at the clinic on the basis of his disability. The settlement agreement requires the entities to develop and implement a non-discrimination policy and to train staff on the requirements of the ADA. In addition, Mercy Medical Group and CHW Medical Foundation are required to pay $60,000 to the complainant and $25,000 as a civil penalty.

Source: 7thSpace Interactive [5/11/12]

RUC Physician Fee Lawsuit Dismissed

A U.S. district judge in Baltimore has dismissed a lawsuit filed by six primary-care doctors who were seeking to end the CMS' use of the American Medical Association Specialty Society Relative Value Scale Update Committee—commonly referred to as “the RUC”—to determine its annual Physician Fee Schedule.

Judge William Nickerson ruled May 9 to grant the government's motion to dismiss the lawsuit, which named former CMS Administrator Dr. Donald Berwick and HHS Secretary Kathleen Sebelius as defendants. He noted, in his opinion, that Congress has not only banned judicial review of the financial value and amounts that the CMS determines a physician's work is worth, “but also the method by which those values and units are generated.”

Source: Andis Robeznieks, Modern Physician [5/11/12]

Query: Stabilizing the Medial Column

My patient is a 30 y/o female (normal BMI) in need of a bunion surgery. She has a hypermobile medial column, and I have planned a Lapidus procedure. 

Pre-op X-ray

I have heard in a few lectures and seen cases where a midshaft or long-arm neck osteotomy is done along with a stabilization screw from the 1st metatarsal base (or medial cuneiform) to the middle cuneiform or 2nd metatarsal (without a MCJ arthrodesis). This would apparently stabilize the medial column instability. Comments?

David Weiss, DPM, Richmond, VA

Query: Support for Podiatrists Performing H&Ps

Our local hospital in Central Florida is requesting written information regarding podiatrists being allowed to perform H&Ps prior to hospital surgery. We were originally allowed to perform the H&Ps and the surgery Dept. is trying to take away this privilege. What information is available to support us?

Olga Luepschen, DPM, Sebring, FL

Query: Hand Instrument Repair

Does anyone have a source for broken springs on bone cutting forceps?

Michael DiGiacomo, DPM, Oakland, CA

RE: Soft Tissue Mass (Rob Lagman, DPM)
From: Bryan C. Markinson, DPM

An open incisional biopsy is the best choice for this case. The biopsy, if performed in a hospital setting, should be done by removing a small piece of the lesion and sending it for frozen section. If the frozen section diagnosis is benign, you can continue the surgery and remove the lesion. If the frozen comes back malignant, take another small piece for regular histology processing WHILE LEAVING THE REST OF THE TUMOR INTACT AND UNDISTURBED. Then close the incision and refer the patient to an orthopedic oncologist who will properly have the patient staged and plan for wide excision of the lesion.

A great office-based alternative would be a core needle biopsy of the lesion. If you elect to do this, make sure that your needle insertion is in what would be the planned bed of resection if the tumor turns out to be malignant. This is because if the needle is inserted outside of the planned bed of resection and it turns out to be malignant, the needle tract is considered contaminated and can greatly increase the amount of tissue that would have to be resected to handle the wide excision properly.

If any of the above two principles are unfamiliar to you, the patient may be better off being sent to an orthopedic oncologist for the work-up.

Bryan C. Markinson, DPM, NY, NY, Bryan.Markinson@mountsinai.org

RE: Non-Union and Malunion of Metatarsals (Bret Ribotsky, DPM)
From: David Secord, DPM

Maybe it's just me, but I'm confused by this post and the responses. With all due respect to Dr. Ribotsky and his comment “but that's why we love what we do, helping people with real problems,” isn’t the real problem here the patient and her malignant non-compliance issues? The prior procedure looked as though it was done competently with a pretty good hardware count and investment of time. If the patient had been compliant with post-operative orders, it would, most likely, have turned out fine.

I’m of the opinion that if you’re not willing to help yourself (i.e., be compliant with post-operative orders concerning weight-bearing status, nutrition, cessation of nicotine, and that sort of thing) and destroy a perfectly good surgery, why waste more time? This patient didn’t even seem to be ashamed of walking around in a regular shoe until it started hurting. I think that just reading a few of the posts in the Jury Verdict Reporter in PM News would make anyone walk away from this disaster.

David Secord, DPM, San Juan, TX, secord@medscape.com

RE: Marfan's Syndrome and Bunions (Tip Sullivan, DPM)
From: Carl Ganio, DPM
 
Just something of clinical interest to add. The only Marfan's syndrome patient I sugically treated was during my residency training. When we opened the 1st MPJ, the capsular tissue actually stretched like an Esmarch bandage. It was not the norm for us to follow the patients post-operatively at the attending's office, so I can provide no post-operative pearls on the head osteotomy we performed. It would seem that stabilizing the foot is improtant, because you will not be able to trust the soft tissues.
 
Carl Ganio, DPM, Vero Beach, FL, drcarlganio@veropodiatry.biz

RE: Is It Time to Bring Back Chiropody? (H. David Gottlieb, DPM)
From: Simon Young, DPM
 
This national discussion is preposterous and should never rear its ugly head. Chiropody, interventional podiatry - "a rose by any other name smells the same", and it wreaks. We are trying to integrate into medicine, and upgrade our profession, residency programs, and the laws, as well as improve our profession. We are dealing with local and national governmental agencies to improve our lot in life and this pops up.

We have practitioners who can't prescribe 10 OTC prescriptions in a 6-month period, which is embarrassing to hear on a national forum. There are free EHRs available. The foot and ankle surgeons are laughing at us. These proposterous posts will be used against us. I am sick and tired of hearing from the few aberrations in our profession and may the Lord help us if it's many, on this blog.

If you want to practice chiropody, interventional podiatry, have a cash practice and I wish you the best.

Simon Young, DPM  NY, NY, simonyoung@juno.com

RE: Humana Records Request (Pete Smith, DPM)
From: Philbert Kuo, DPM

The Humana reps bring their own scanner...no copying required. I pulled the requested charts and let them at it. They were in and out fairly quickly.

Philbert Kuo, DPM, Chesapeake, VA, philbear@pol.net

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.

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

PM News Classified Ads Reach over 13,500 DPM's and Students

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