The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

May 21, 2010 #3,863 Publisher-Barry Block, DPM, JD

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NY Podiatrist Sees Increase in Preventable Amputations in Diabetics

According to New York City podiatrist Dr. John Doolan, the severity of the diabetes crisis is illustrated by a trend he's seeing in his practice: more and more patients are undergoing highly preventable amputations due to complications from diabetes. Adding insult to injury, summer time - the season of family vacations and summer camp - is high season for the infections and injuries that often lead to amputations.

Dr. John Doolan

According to Dr. Doolan: "The statistics are staggering: more than 60 percent of all non-traumatic lower-limb amputations occur in diabetic patients" -- pointing out that foot problems are the leading cause of hospitalization among diabetics and adding that with proper treatment, many of those problems and most importantly, amputations, could have been avoided. Further, he adds, amputation rarely improves the patient's condition. In fact, 65 percent of those who undergo diabetic amputation die within five years.

Source: Gloria Gamut, Straight from the Doc [5/19/10]

OH Podiatrist Discusses the Demise of the Hightop Basketball Sneaker

While the NBA doesn't release any data on what its players wear on their feet from day to day, players, team officials, and shoe companies say hightops peaked about eight years ago and have been losing ground ever since. Podiatrist Richard Hofacker, who has worked with the Cleveland Cavaliers since the late 1980s, says that back then, 80% of players preferred the bulkier sneakers. Now, he says, the majority like to play "naked from the ankle down."

Dr. Richard Hofacker

In some ways, the shoe argument is irrelevant. Dr. Hofacker, the Cavaliers' podiatrist, says the use of special-made insoles that protect players' feet has spread among teams in the past several years. He supplies most of Cleveland's players with unique biofoam orthotics that cost as much as $600 apiece.

Source: David Biderman, The Wall Street Journal [5/19/10]

AMA Profits Up But Membership Down

Profits are up and membership is down at the American Medical Association, whose 2009 annual report listed an operating profit of $16.5 million—up 560% from $2.5 million in 2008—and a membership of 228,000, which is down almost 3.4% from the 236,000 reported the previous year.

Source: Andis Robeznieks, Modern Physician [3/19/10]

Query: Maggots, Post-op Neuroma Surgery

We had an unusual problem occur today. I did an Austin bunionectomy as well as an excision of a neuroma from the third interspace, bilaterally. The patient presented to the office today for dressing change and evaluation. She is 6 days post-op. She had no complaints and minimal pain. After removing the dressings, including an Unna boot, we found maggots at the site of the neuroma excision. We removed approximately 5-6 about 1-2 mm in size. I have never had anything like this occur. The patient is a healthy 44 year old white female. We are having her return daily for the rest of the week for evaluation. The surgery was done as an outpatient at one of our local hospitals. Any ideas or advice will be appreciated. 

Neil A Burrell, DPM, Beaumont, TX

Query: Disability Insurance

I will like to buy disability insurance and will like to know if there are any podiatry-friendly companies or any other helpful advice?

Yenisey Yanes, DPM, Frederick, MD

RE: Minimal Important Difference (MID) and  Outcome Measures (Michael Turlik, DPM)
From: Nicholas Sol, DPM
 
I have enjoyed the many comments from my colleagues regarding evidence-based medicine (EBM); especially those of Dr. Turlik who was an esteemed professor of radiology during my career at OCPM. While I agree that EBM has an important role to play in the evolution of healthcare, it should be remembered that NASA successfully flew five lunar orbital missions and seven lunar landing missions without the benefit of double-blinded placebo controlled studies. Each mission was based upon an achievable goal, strong hypothesis, lessons from previous missions, and the application of peer-reviewed/confirmed data. 

Medicine is, has been, and I hope will continue to be practiced one patient at a time. I hope that our pursuit of EBM doesn't eliminate the "art" of medicine from daily practice.

Nicholas Sol, DPM, Colorado Springs, CO, drsol@thewalkingclinic.com

RE: The Passing of Ryan Hess, DPM

I am sad to report the passing of Ryan Hess, DPM. He graduated from Scholl College just two years ago, and was in residency when he came down with cancer. Ryan was diagnosed in June of 09 with hepatoslpenic T-cell lymphoma (HSTCL). After three rounds of chemo and a bone marrow transplant, he went into a brief remission. He passed away peacefully at home with his family May 17, 2010, leaving behind his wife and two young daughters. He was a very inspirational physician and our profession has truly lost an important member. Please refer to his website  that his wife has set up throughout his entire fight. It would mean a lot to so many of us to recognize Ryan and his family in our community.

Timothy Mineo, DPM, Portland, OR, TMINEO@LHS.ORG

RE: Today's Podiatrist Campaign and Surgery
From: Larry Kosova, DPM

I have read with great interest that the APMA has not done enough to promote our profession in the light of surgery and advanced techniques. Recently, the office I share with my wife, Marlene Reid, DPM, was part of the Today's Podiatrist campaign. APMA members should have received (with the last APMA News) a Today’s Podiatrist CD. My impression was that a surgical campaign was in the works. Also, for the 8 hours the production team was in my office shooting videos of patients and ourselves, about half of that time was surgical related. We were also part of a group who gathered photos for a database of pictures. Our photos were surgery based.
 
I am also doing a small cable show interview tonight. The topic will be on tendon and ligament injuries and ankle sprains. This is what I practice and know. I think if we want to change perceptions, we need to start doing it ourselves and not wait for others to do it for us. 
 
Larry Kosova, DPM, Chicago, IL, lkosova@yahoo.com

RE: Kudos to Dr. Gurnick and PM News
From: Chuck Ross, DPM

I want to express my thanks for the superb service that PM News provides to allow colleagues to interact on a global basis. This was never more evident over the past two weeks. I had originally written for assistance regarding a "patient" with a drop foot and received many wonderful helpful replies. The most notable one was from a colleague, whom I have never met, and he forwarded a brace for my wife (the patient) to wear at no charge to me. He refused payment and was offering this device as a caring individual. We were both truly touched by his graciousness, concern, and generosity. Dr. Keith Gurnick's patients are lucky to have such a fine individual as their podiatrist. Thanks again, for making PM News a personal, meaningful means of sharing.

Chuck Ross, DPM, Pittsfield, MA, cross12@nycap.rr.com

Query: EMR and Stimulus Money (Elliot Udell, DPM)
From: Rob Katz, DPM

In reviewing Dr. Udell’s comments, I want to give additional information to try to help people sort through the “meaningful use” stimulus money topic. While he is correct that the final documentation is not complete on exactly what will be needed, the framework is in place to have a good understanding of what is needed for “meaningful use.” Rather than go out and purchase an inexpensive product, I suggest that you sit on the sidelines if your preference is to wait for this to be sorted out.  Another option is to do a little homework and...

Editor's Note: Dr. Katz's extended-length letter can be read here.

RE: Podiatrists and the Term “Physician” (Mario Dickens, DPM  Douglas Paccacio, DPM)
From: Multiple Respondents

Dr. Dickens and Dr. Paccacio miss the basic point. Dr. Paccacio says, "it’s your training, not your degree." Well, enjoy your 3-year residency and still not be able to treat a wart on the ankle in most states. It's your degree that determines your license, and that determines your limitations. How can you not see this? I'm sure it hurts after spending 3 years in residency. You have to rationalize - otherwise you'd realize you wasted your time. Who's living in a fantasyland? And to Dr. Dickens who says we should call ourselves physicians, may the state licensing board remind him, THEY tell you what you are. You are not what you think or hope you are. It's not that other podiatrists have a bad attitude and should retire as you suggest. They have a grasp on reality. Those who continue to deny podiatry’s limitations need psychological help for a delusional disorder.

Robet Bijak, DPM, Clarence Center, NY, rbijak@aol.com

Certainly, our DPM degree sets us apart. In many ways, we are discriminated against because of our degree. In some ways, it is a distinct advantage for those patients and referral sources who recognize that only a DPM can provide complete foot and ankle care. We have made so much progress in our training over the past 30 years that society does not fully recognize our skills and position in the medical community. Would it be easier if we had MD degrees and were educated in medical schools and academic health centers? Yes and, of course, some of that is already happening. Perhaps, attaining MD degrees will happen, but  I am not sure it is a realistic goal anytime soon.  In the meantime, the APMA Vision 2015 task force is our best opportunity for advancement.
 
Our PR efforts, individually and collectively, must keep the word "podiatry" in the public eye and have it equated with foot and ankle medicine and surgery.  That makes us unique, and separates us from others who claim to be foot and ankle specialists. My position on the AMA RUC panel demonstrates that if we demonstrate that we are, in fact, equal to our allopathic colleagues, we will be treated as such. In that capacity, I have an equal vote on the RUC panel that includes 28 other physicians, I have chaired committee meetings, and my advice and counsel is requested by specialties from family practice to psychiatry to general surgery.
 
It has taken our practice and the podiatric community many years to be part of the mainstream medical world, and collectively we must stay united and demonstrate our training, skills, and quality medical judgment on a daily basis for our profession to advance. Ultimately, it is what we do daily that will advance our profession. 

Lloyd S. Smith, DPM, Newton, MA, lloydpod@yahoo.com

I'm certain the dental profession is not "hung up" and wasting time and energy on an identity crisis like we are. Anyone out there ever heard of a dental physician? I'm reminded of the renowned forensic pathologist, Lester Adelson, MD, a professor at OCPM, who stated to our class in 1967, "You are doctors, so talk, act, and look like ones."

Stanton C. Southward, DPM, Colorado Springs, CO, sbsouthie@comcast.net

ASSOCIATE TO PARTNER POSITION - SOUTHERN MI (NOT DETROIT!)

Salary/Bonus/Benefits. Part of a 3 podiatrist group. All phases of surgery, forefoot/rear foot/ankle…whatever you want. Great chance of obtaining all cases needed for board certification in your first year! Area has lots of lakes, change of seasons, within a couple hours of Chicago. If interested email: paulapmac@gmail.com

PRACTICE FOR SALE – MAINE

25 year full scope in medical building, podiatrist friendly hospitals, appreciative and cooperative patients, excellent expansion potential, physician referrals. Wonderful place to raise a family. Retiring seller will stay for transition. mainefootdoc@yahoo.com

ASSOCIATE POSITION - SW FLORIDA, BEAUTIFUL GULF COAST AREA

Well-established podiatry practice with excellent mix office/surgery seeking full-time associate PSR 12-36. Excellent salary & benefits for the right hardworking, personable candidate. Email resume to pudos@aol.com or fax to 239-573-9201.

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 - 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

ASSOCIATE POSITION – TEXAS

Dynamic, growing practice in Dallas/Fort Worth area, seeking PSR 36 surgically trained, and/or Board Certified/Board Qualified Podiatrist. Excellent salary and benefits compensation package, for the right candidate, with partnership/buyout opportunity. Must have Texas license. Contact/Send resume to: jmh6122@yahoo.com

TN PRACTICE FOR SALE (SOUTH OF NASHVILLE)

Active, established practice with new equipment (digital x-ray, ultrasound, computer network, etc.). Great referral network with an excellent scope of practice. Turn-key operation with seamless transition. Grossed over $350K last year. Call 931-446-5724 or email mchad500@gmail.com for more information.

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

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

PRACTICE FOR SALE - MINNESOTA

Practice Grossing over $500K yearly. Good mix of surgery, orthotics, DME, diabetic care, general podiatry. Commute < 5 miles to work. Friendly Midwest lakes area with arts, good schools, affordable living, restaurants, shopping. Option to purchase building. Will consider associate to buy-in/ buy-out. Midwestpractice@gmail.com

EQUIPMENT FOR SALE -  PODIATRY CHAIR 

Midmark model 114 power podiatry chair, rose color, debris tray with matching stool. In perfect condition. Like new. Rarely used. $4000.00.  Contact: richard.dpm@sbcglobal.net

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

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 – 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 - 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 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

ASSOCIATE POSITION - SUBURBAN PHILADELPHIA

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

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.

ASSOCIATE POSITION - MARYLAND

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

PODIATRISTS WANTED BALTIMORE/CHICAGO/NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation, including malpractice. Contact Jake Shimansky, Director of Physician Recruitment. Phone 773-342-5221 FAX 773-486-3548 E-Mail jshimansky@homephysicians.com www.homephysicians.com

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

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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