The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

May 14, 2013 #4,769 Publisher-Barry Block, DPM, JD

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SC Podiatrist Demonstrates Destructive Forces From Wearing High Heels

For many women, it's a love-hate relationship between them and their heels. At the end of the day, they aren't willing to sacrifice style for comfort. In a recent survey of women, 42 percent say they wear shoes that hurt. A startling 73 percent admitted to already having a shoe-related foot issue like bunions, corns, calluses, or hammertoes. "You know when they become a condition that affects you on a daily basis, it's time to talk about some surgery," says Dr. Jordanna Baker of Coastal Podiatry Associates.

Dr. Jordanna Baker, X-rays With and Without High Heels

In a rare look of what's inside those heels, Dr. Baker took an x-ray of the foot with and without heels, remarking that when a foot is inside a heel, "that's almost a 90 degree angle right there, so there's an excessive amount of pressure right here, and directly under the heel, and the Achilles tendon is contracted," Dr. Baker says. "Over time, those become major deforming forces on the foot." What many may not realize is that as we get older, the fat pad in the bottom of our foot actually diminishes. With less cushion between bone and shoe, it makes wearing high-heels  very difficult to bear.

Source: Heather Biance, WMBF [5/9/13]

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.

Quick Poll
Do you charge a penalty fee for missed appointments?
Click HERE for Results

Wireless Monitoring Tech Will Transform Healthcare

It's not hard to imagine that a sensor as small as the size of a Band-Aid could collect information about your heart rate or temperature and then transmit that data using a wireless signal to a smartphone or another device. What might be hard to grasp is how large and transformative the market for so-called medical body area networks could be in the years ahead.

Philips Healthcare recently received federal clearance for a cableless respiration sensor. Devices using MBAN spectrum will offer a wide variety of monitoring capabilities.

Some technologies tap into allocated spectrum bands set aside by the Federal Communications Commission for medical use, or use device-specific networks built by hospitals. Those technologies usually require oversight from the Food and Drug Administration. Other devices, some of which are regulated by the FDA, rely on unlicensed Wi-Fi to aid consumers as they track anything from physical activity and blood glucose levels to when they take their medications.

Source: Jaimy Lee, Modern Healthcare [5/10/13]

Patient Claimed Failure to Monitor Wound - California

Case Summary: On Jan. 7, 2009, the plaintiff, 54, an operations manager and Type II diabetic, presented to a physician's office with pain in his left foot, due to a misstep from a day or so prior. The plaintiff previously treated since July 2007 with the physician for diabetic care for his right foot.

The physician diagnosed the plaintiff with a Lisfranc's fracture with possible Charcot's foot. The physician placed him in a walking boot and sent him home, telling him...

Editor's note: This extended-length jury verdict report can be read here.

Award Details: The parties agreed to settle for $350,000 five days prior to trial.

Plaintiff's podiatric expert: Nancy Kaplan, DPM, Napa, CA

Defendant's podiatric expert: Bruce M. Dobbs, DPM, Daly City, CA 

Bret Ribotsky: (Talking about coding patients with multiple problems) We could all find 4-5 things wrong with a patient such as: HAV, HTs, onychomycosis, xerosis, and PVD. How can you maximize your bullet points to increase your coding?

Dr. Gabriel Halperin

Gabriel Halperin: While the auditors will look at your bullet points, it really comes down to your complexity of care. When you're not using IV ABX, the complexity is difficult to arrive at. For example, you have a patient with an ingrown nail, tinea, and a few other minor conditions. You have a few minor complexities, but together you do not get a major complexity. However, if this patient had leukemia and a bleeding discrepancy and required advanced consideration prior to the nail procedure, then the complexity goes up, as does the coding.

Dr. Matthew Garoufalis

Meet the Masters is broadcast each Tuesday night at 9 PM (EST). This week's guest is APMA President Dr. Matthew Garoufalis. You can register for future events by clicking here

RE: Overlapping 2nd Digit Status Post Bunionectomy (Don Peacock, DPM)
From: Ed Cohen, DPM

If you have a 77 year old patient with painful corns between the big toe and the second toe along with a bunion (assuming the patient had sufficient circulation), a great procedure would be an MIS resection of bone from the medial PIPJ of the second toe and an MIS resection of bone from the lateral hallux distal hallux joint.

These procedures are very atraumatic and can dramatically improve the quality of life in this type of patient. My assumption is that...

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

RE: Dragon Problem (Craig Breslauer, DPM)
From: John M. Wray, DPM

If Dragon is used over a server, it may drop text. An easy solution is to use a Dragon feature called "Dictation Box". The dictation box is opened and your dictation is done within the Dragon program, and then transferred to your EHR or other document. I use the Medical version of Dragon with a Power Mic which allows me to control these function from the microphone.

John M. Wray, DPM, Chicago, IL, jmwraydpm@gmail.com

RE: Dragon Problem (Craig Breslauer, DPM)
From: Mark K. Johnson, DPM

It sounds like your files may still be corrupted OR your microphone has a defect which is introducing problems into the speech recognition. Try installing your Dragon Medical 9.5 disc in REPAIR mode. Check your microphone. Create a new user file with Best Match III as a choice if
you can. Retrain your common custom words or phrases by selecting "custom" in vocabulary editor. Form another USER with a different microphone. Any viruses or spyware on your computer? 

Consider upgrading to Dragon Medical 10 if all else fails --  we currently use 11 (Dragon Medical Practice Edition) and are pleased.  Other resources for your problem would be Lunis at Knowbrainer.com or Dr. Larry Kosova in Chicago.  

Mark K. Johnson, DPM, West Plains, MO, DDR004@centurytel.net

RE: Flex OA Shoe (Roy H. Lidtke, DPM)
From: Robert Scott Steinberg, DPM

I want to thank Dr. Lidtke for engaging in this discussion. I have read his extended-length letter. Since it was not mentioned in Dr. Lidtke's letter, I am left to assume that the OA shoe does what it does without the aid of any sort of foot orthotic. Am I correct? And, that the correction/posting is internal to the shoe?

Robert Scott Steinberg, DPM, Schaumburg, IL, Doc@FootSportsDoc.com

RE: Army Podiatrist is Protagonist in New Novel
From: Warren S. Joseph, DPM

I have not yet read Lisa Scottoline’s newest thriller Don’t Go and I cannot speak to how the protagonist, Dr. Scanlon, is portrayed throughout the novel. I can say that Ms. Scottoline appears to be very “pro” podiatry and has written many times in her weekly Sunday column in the Philadelphia Inquirer about her recent bunion surgery.  Making the assumption that Dr. Scanlon is the hero of this book and turns out to be the “good guy”, I don’t think we can overvalue the importance of this to our profession. For those unfamiliar with her work, Ms. Scottoline is one of the most read authors in the country having appeared many times on both the NY Times and USA Today’s best sellers list.

In fact, Don’t Go reached as high as #5 on the NY Times list the week it was released. That equates to hundreds of thousands, if not millions, of readers learning about podiatric physicians in a positive light. Kudos not only to fellow Philadelphian Lisa Scottoline but, more importantly, to that unsung hero - the DPM who performed her bunion surgery and so impressed her that she decided to write a book featuring a podiatrist!
 
Warren S. Joseph, DPM, Huntingdon Valley, PA, wsjoseph@comcast.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 - 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

TWO FOR TEXAS

Desiring to grow our group of successful medical and surgical professionals. We are seeking an exceptional Podiatric Physician and Surgeon with great interest and talent to serve as 1) Our Diabetic Foot Care Team Leader or 2)Our Sports Medicine Team Leader. Send CV and letter of interest to: greatdoctors1@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 - 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

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 - 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

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

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.

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.

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.

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