The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

May 18, 2012 #4,465 Publisher-Barry Block, DPM, JD

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“Bunions are Misunderstood" - CA Podiatrist

“Bunions are misunderstood. They are genetic, and they’re not from wearing high heels or improperly fitting shoes,” said Dr. Jay Berenter, a podiatrist at Scripps Memorial Hospital in La Jolla. “A bunion isn’t new bone, it’s a change in the angulation, just a shift in the position of your metatarsal bone.” 

Dr. Jay Berenter

A bunion won’t disappear on its own, so go see a podiatrist when there’s persistent pain. Ultrasound and massage can help calm the inflammation. Orthotics, special corrective insoles, can be prescribed to help support the foot. Surgery should be a last resort.

Source: R.J. Ignelzi, U-T San Diego [5/15/12]

WesternU Podiatrist Appointed to Special Medical Advisory Group

The College of Podiatric Medicine at Western University of Health Sciences has announced the appointment of Lester J. Jones, DPM, MS Ed, to the Special Medical Advisory Group (SMAG) that advises the U.S. secretary and undersecretary for health. Jones, Executive Associate Dean for Academic Affairs at CPM, was appointed to a two-year term by Undersecretary for Health Robert A. Petzel, MD, who reports to Secretary for Veterans Affairs Eric K. Shinseki, who is a member of President Obama’s Cabinet. 

Dr. Lester Jones

Jones will represent the podiatric medical profession and will serve as one of several members of the health professions providing advice and counsel on healthcare delivery for U.S. veterans. Jones said homelessness, and access and timeliness of care are major concerns for veterans, as are the challenges associated with traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD).

5K Run/Walk to Benefit Yucatan Crippled Children’s Project at Barry

Barry University’s School of Podiatric Medicine will host the second annual “Heal the Stride 5K Run/Walk” benefiting the Yucatan Crippled Children’s Project, which provides indigent crippled children from the Yucatan Peninsula with surgical care of deformed limbs. The fundraiser will take place on Barry’s Miami Shores campus on Saturday, May 19, beginning at 8 a.m. A variety show featuring music, food, and entertainment will begin at 10 a.m. 

(L-R) Alexis Kreplick and Elizabeth Sanders

More than $4,000 has been raised for the Yucatan Crippled Children’s Project, and about 100 runners are expected to make the stride around Barry’s campus and Miami Shores, where village police officers will help escort the runners on their route. Alexis Kreplick and Elizabeth Sanders, both podiatry students, with the help of their peers in the class of 2014 and 2015, have organized the event.

TX Podiatrist Tops Readers' Poll for Best Podiatrist

Mesquite News readers have spoken. In the newspaper’s just-released 2012 Readers’ Choice poll, 70-bed TRMC-Sunnyvale drew the most votes against other area medical centers. Many of TRMC-Sunnyvale’s physicians and their practices also received readers’ nods. They include: Best for Podiatry - Dr. William Arrington, II of Beltline Foot & Ankle Specialists in Mesquite. 

Dr. William Arrington

Dr. Arrington graduated from the Ohio College of Podiatric Medicine and completed his residency at Presbyterian Greenville. He is Board certified in Foot Surgery and Rearfoot Reconstructive Surgery by the American Board of Podiatric Surgery.

Source: Dallas Morning News [5/16/12]

Malpractice Trends: Good News and Bad News

Results of a new study of medical malpractice claims offer a mix of reassurance and sobering reality. According to the results, 55.2% of medical malpractice claims that required some defense cost led to litigation. However, of the claims that do go to court, most are ultimately decided in the physician's favor. For physicians, that is the good news.

The sobering news is that litigated claims often take months or years to be resolved, according to the study, which was published online May 14 in the Archives of Internal Medicine. Dealing with malpractice claims is often a lengthy process, according to the study results. The mean time required to resolve claims was 19.0 months, which included 11.6 months for nonlitigated claims and 25.1 months for claims that were litigated.

Source:  Steven Fox, Medscape News via Arch Intern Med. [5/14/12]

Medicare, Medicaid Overhaul Deal Unlikely, Lawmakers Say

Congress is unlikely to reach a “grand bargain” to overhaul Medicare and Medicaid during the post-election lame duck session, according to two congressional budget leaders. In successive appearances Tuesday at a deficit-reduction summit sponsored by the Peter G. Peterson Foundation, Reps. Paul Ryan (R-WI), chairman of the Budget Committee, and Chris Van Hollen (D-MD), the panel's ranking member, agreed that any deal to enact long-term changes to the federal healthcare programs is more likely in 2013.

“In the lame duck, you'll see something to make sure we don't have a train wreck,” Ryan said when asked about entitlement overhaul in the post-election legislative session. “Does that mean we'll have permanent entitlement reform, a grand bargain that will fix every fiscal problem once and for all? I don't see that happening.”

Source:  Rich Daly, Modern Healthcare [5/15/12]

Query: ZocDoc

Is ZocDoc worth $3000 per year? I'm wondering if those who have tried ZocDoc, the online appointment booking website add-on, feel it is worth the upfront, $3000 per year fee.

Gary Hoberman DPM, Chicago, IL

RE: Hyperpigmentation of African-American Women After Using Corn Remover Pads
From: Shelley Gath, DPM

Removing friction from shoes will not help alone with hyperpigmentation. Scarring with hyperpigmentation may take several months to years to lighten, especially with women who have olive or darker complexions. I have experience with lighteners in parts of the body other than the feet. Obagi has an extended line with the key ingredient hydroquinone 4%. This percentage can be higher by prescription only. You need to test in the intended area and only apply with a Q Tip to the hyperpigmentation. This process may still take several months, so in the meantime, patients would need to use concealer. Older women will take longer to heal.

Shelley Gath, DPM, Arcadia, CA, footdoc.gath5@gmail.com

RE: Soft Tissue Mass (Bryan Markinson, DPM)
From:  Robert Lagman, DPM

I do appreciate the answers to my original post on this soft tissue mass. The patient is extremely hard to deal with and has yet to follow up on the repeat MRI with contrast as recommended. At his last visit, he said he feels that the tumor is a result of trauma from kicking against the side of the pool when making turns.

I have tried to express the importance of identifying and treating this soft tissue mass and hope he will follow up with the MRI. I am a little disturbed though when advice is given stating that if you have to ask the question on PM News, then you probably aren’t the best person to handle the patient and refer him to someone else. I feel that this is a terrible answer. Should this be our standard answer now when a clinical question is asked on this forum?

I pride myself on always putting the patient first and never getting in over my head. I feel that I am exceeding the standard of care with this patient and trying to get all opinions prior to moving forward. I will absolutely refer this patient if...

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

RE: Sterilizing Bits Between Debridements (Warren Joseph, DPM)
From: Gary S Smith, DPM
 
I agree with everything Dr. Joseph has said about what is cultured from un-sterilized bits. I did, however, attend a lecture by Dr. Joseph about 20 years ago where he told us that research had been done where people had been purposely exposed to fungus spores and there was no increase incidence in onychomycosis. In other words, it was like with warts. Many people are exposed to the pathogen, but only those already pre-disposed become infected. The likelihood of giving somebody onychomycosis by using a bit that has been wiped or soaked as opposed to autoclaved is pretty much nil.
 
Gary S Smith, DPM, Bradford, PA, penndoc@verizon.net

RE: Sterilizing Bits Between Debridements
From: Jeff Kittay, DPM

I would like to thank all the respondents to my original post, even the unpleasant ones. Those of you who so loftily ridiculed my inquiry may some day be defending the practices you now call state-of-the-art. It was never my intention to claim that my method of practice was superior to anyone else's, only that it is common and not dangerous. 

I now stand corrected and have no problem altering my practice methods, though I still know of no published study confirming actual disease spread from a doctor's office to the patient from the use of unsterilized nail burrs. Growing fungal cultures from burrs does not equate with transmission of disease. Our hands, with which most of us touch patients everyday and which we wash scrupulously, are teeming with bacteria and fungi; yet patients escape our offices unharmed.

It was, however, my intention to ask if you feel that my board's requirement that I undergo 30 hours of CME on "hygiene and sterility" was overreaching and excessive. I remain convinced that this is so.
 
Jeff Kittay, DPM, Boston, MA, twindragons2@verizon.net

RE: Shorting a Hunt Brother (Carl Solomon, DPM)
From: Paul Busman DPM, RN

Yeah, oil people are a different breed. When I started in practice back in '77, I "inherited" a patient who was the head of a large local oil distributor. Dan was a nice guy, but he made sure people knew who he was and that he was very wealthy.  Back then, my office visit fee was something like twenty bucks and Dan always offered a hundred dollar bill to pay for his visit.  We didn't often have change for that, and he'd harrumph a bit but always found the right cash to pay. One day, I noticed that he was due in that afternoon, so I made a point of going to the bank across the street and getting a LOT of extra cash in all denominations. When Dan proffered his C-note to pay for his office visit later that day, my receptionist didn't blink an eye when she asked, "How would you like your change? Tens? Twenties? Fives?" He never tried that again.

Paul Busman, DPM, RN  Clifton Park, NY, paul@busmanwhistles.com

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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 - HOUSTON, TEXAS

30 year old busy, progressive practice for sale with an excellent reputation and well established, diverse referral base. Well trained, dedicated, supportive staff. Excellent cash flow ($400K net income after overhead). EMR, digital x-ray, diagnostic ultrasound. Free standing building also available with large outdoor sign. Owner retiring and willing to stay part time during transition. Contact: mcrosby@picagroup.com or call (888) 776 2430.

PRACTICE FOR SALE - BROOKLYN, NY

A large, busy practice is for sale in Brooklyn, NY. This practice has been in the same location for over 50 years. Average 150 pts/week, average gross 730K, most surgery is referred out. Financing available. 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 - MANHATTAN

Podiatrist needed for busy state-of-the-art offices in Manhattan. Offices are located near Penn and Grand Central Station. 10+ years experience only and an out-of-network doctor for most insurances. Please forward your information and CV to: roni@myfcny.com

ASSOCIATE POSITION - BEAUTIFUL LONG ISLAND

Business-oriented, mature Board eligible/certified podiatrist who is not just looking for a job, but a secure future. Buy-out of practice will be available. Practice does in excess of $500K. 2 hospitals available. No nursing homes, no Medicaid. Competitive package. Please fax CV to 631-581-0857.

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 – ANCHORAGE, ALASKA

Associate wanted for hospital-based podiatry group practice. Full scope of practice. Surgical residency 24month+. Outstanding opportunity, work environment, and recreational pursuits. Fax CV to 907-562-5195, please call 907-562-4958, e-mail us at contactus@alaskapodiatry.com

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 POSITION - NEW JERSEY

Immediate opening for a full-time podiatrist in a rapidly expanding multi-office practice in central New Jersey. Well established referral base with full admitting hospital privileges. Availability to become part owner of a multi-room, multi-specialty ASC. Excellent opportunity for the right doctor with potential to achieve $200K in the first year. Wonderful working conditions. Applicant must have at least PSR-24 surgical training. Valid NJ license and Medicare number is required. Applicant should also be familiar and competent in biomechanics, trauma, ESWT, PRP, wound care, and ultrasound diagnostics. Participating insurance #'s a plus. Please fax resume to:(609) 259-6637.

ASSOCIATE POSITION - ILLINOIS

Full and Part-time opportunity to provide conservative, ethical podiatric care to residents in long-term care throughout Illinois . Full time position includes health, disability, 401, auto/travel expenses. Ideal Full-time candidate would be willing to travel 2-3 days per month, or be located in central or downstate IL. We have a 30 year history of providing exceptional care and service, with appropriate reimbursement. Please email queries or resumes to gh@podiatryplus.net.

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 - WORCESTER MASSACHUSETTS

Podiatry practice in Worcester Massachusetts is looking for an associate podiatrist. Busy 2-person practice. High surgical numbers. No nursing homes. Call to hear free recorded message for more information. Call 641.715.3800 Access Code 32299 and message 4 to learn about the practice. Visit our website www.centralmasspodiatry.com

ASSOCIATE POSITION - VICTORIA, BC

Beautiful Victoria, B.C. Canada on the ocean, fast growing area. Associate for multi-office full scope practice. Reply to dr.cole@shaw.ca

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

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