The Voice of Podiatrists

Serving Over 10,900 Podiatrists Daily

May 22, 2008 #3,252 Editor-Barry Block, DPM, JD

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NY Podiatrist Perishes in WV Raft Accident

Vicki Jane Miller-Savard of Manchester, Ontario County, was known to go out of her way to help others. Over the weekend, she died doing just that, while doing something else she loved — spending time outdoors and with her husband Kerry Savard. Dr. Miller-Savard, 42, a podiatrist who had a private practice in Newark, Wayne County, died Saturday afternoon in a rafting accident on the Cheat River in Preston County, WV.

Dr. Vicki Jane Miller-Savard

Authorities reported yesterday that the raft Dr. Miller-Savard turned back to assist passengers on a second raft that had capsized. Dr. Miller-Savard’s raft then capsized as well, sending her into the deep, rushing water. Her body was recovered Sunday morning and was located about 100 yards from where she was last seen by the rest of the group. Authorities said they believed her foot was caught on a rock and the current prevented her from escaping from the rapids.

A longtime Bloomfield resident who recently moved to Manchester, Dr. Miller-Savard graduated from Bloomfield High School in 1983, Cornell University in 1987 and Dr. William M. Scholl College of Podiatric Medicine in Chicago in 1992.

Source: Victoria E. Freile, Rochester Democrat and Chronicle [5/20/08]

Charges Against NJ Podiatrist Falsely Accused of Selling Drugs Dismissed

The criminal case against a Randolph podiatrist/pharmacist and his wife, who were charged last year with illegally selling pain-killing drugs, has been dismissed, authorities said yesterday. All charges were dropped against Mark Spal, 54, who had been the podiatrist and pharmacist at Greystone Park Psychiatric Hospital, and his wife, Susan Spal, 55, according to a spokeswoman for the Morris County Prosecutor's Office. Police charged the doctor had issued 31 prescriptions for drugs, including Xanax and Oxycodone, in exchange for cash or services. Susan Spal, who does not work at Greystone, was charged with conspiracy to distribute drugs.

Dr. Mark Spal

The arrests capped an 11-month investigation, said police, who stressed the charges were not related to Spal's work at Greystone. "It was a living nightmare," Susan Spal said yesterday. "We didn't do what they said. But just being charged has really destroyed my husband's business and life."

Spal said the couple befriended a technician who came to their home a few times in 2006 to fix computers. The man, who later became Mark Spal's patient, stole blank prescriptions sheets from Spal's office, sometimes entering their Randolph house by using an electronic garage door code, she said. He then used the blanks to order prescriptions, she said. After the man was arrested on a drug charge last year, he gave police a phony story about getting prescription drugs in return for doing computer work for the Spals, said Susan Spal.

Source: Lawrence Ragonese, Newark Star-Ledger [5/20/08]

Armstrong Keynotes at Launch of UK World-Class Wound Healing Unit

On Monday, May 12 health care staff, patients and political officials gathered for the ribbon-cutting of a new integrated healthcare service center in Mayday University Hospital in London for people with diabetes, vascular conditions and those needing specialist wound care. The new center, based in the refurbished Fairfield wards, will provide a high standard of wound care for complex wounds and diabetic feet from a local specialist team. Several thousand patients each year are expected to be served by this new facility.

From left: Hellen Walley, CEO of Mayday NHS Trust, Stella Vig, Vascular Surgeon, Prof. David G. Armstrong and Richard Ottaway Conservative Member of British Parliament.

The official ceremony included keynote remarks by David Armstrong, DPM, PhD, Professor of Surgery at the William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science and International Wound Care Ambassador. Dr. Armstrong explained to the 100 guests how a multidisciplinary team working together can prevent an amputation. “It takes a team to prevent an amputation, and podiatrists, vascular surgeons, nurses, educators and diabetologists, among others, can work together to make a real difference,” said Dr. Armstrong.

Physicians’ Council Fights Medicare Payment Cut

The Practicing Physicians Advisory Council in various resolutions called on the CMS to help stop a 10% cut coming in July to Medicare payments to physicians, and allow for more physician input regarding the release of data from the Physician Quality Reporting Initiative. In one resolution, the council said that the CMS should support immediate congressional action to stop the impending cut. Medicare payments should be increased by 0.5% for the remainder of 2008, “followed by a 2009 update that reflects current medical practice costs,” recommended the council, which advises the HHS secretary and the administrator of the CMS on regulations that affect practicing physicians. A longer term fix to Medicare’s physician fee schedule should also be sought, the resolution stated.

On the PQRI, a voluntary reporting program where physicians collect a bonus for submitting quality data, a comment-and-appeals process should be made available to physicians prior to the release of any PQRI data, the council stated in another resolution.

The CMS last month announced new data-reporting options that will be available to physicians participating in the PQRI this year. As an alternative to submitting quality data as part of their Medicare claims, physicians may now be able to submit their data through a medical registry — a centralized data repository — that in turn will report the data to the CMS. The names of qualified registries will be announced on Aug. 31, CMS officials told the council.

Source: Jennifer Lubell, Modern Healthcare [5/20/08]

Getting Through on the Telephone

If you return someone’s call on the telephone and get a receptionist or secretary on the line, begin your call by saying that you are returning the call from their boss. If you take that approach instead of asking for the party, you’ll be connected more frequently.

Source: Inbound/Outbound

Query: Hookworm Infection

I have a 6 yr old girl who picked up hookworm infection a few wks ago while on vacation in Jamaica. I promptly placed her on mebendazole. The infection has continued to travel from the arch to the dorsum of the foot. The PDR states to treat again for another 3 days if it does not seem to be responding, so she is on her 2nd 3-day dose. I also have her on topical cortisone cream & oral Benadryl for the intense itching, which has helped. I should have stool culture results by tomorrow. The family is also manually checking their stools and I have counseled them on proper home hygiene. Any other suggestions?

Cynthia S. Ferrelli, DPM, Buffalo, NY

Query: Professional Services Plans "Podiatry Plus" Professional Liability Coverage

Does anyone have experience or knowledge of Professional Services Plans professional liability insurance company of Tampa, FL? If anyone has needed their services in a proceeding, please share your experience about this insurer.

Bruce M. Nigro DPM, Barefoot Bay, FL

RE: Dermatological Treatment (Robert M. Gaynor, DPM)
From: John F. Boyle, DPM

After a cursory glance of the clinical photo, one would surmise that this should be one of several genodermatoses, Unna-Thost, or keratosis palmaris y planus, etc. Does this also present on the contra-lateral foot or hands as well? A biopsy is always in order, but may be non-specific. A family history is pertinent and helpful as is a possible referral to a pediatric geneticist. As for immediate treatment, urea-based compounds and mild keratolytics, e.g., Whitfields ointment and debridement may be helpful.

John F. Boyle, DPM, Chillicothe, OH, jfboyle54@yahoo.com

RE: Pre-molded Orthotics (Dennis Shavelson, DPM)
From: Jeff Root

For clarification purposes, there is only one place that you can purchase a Root Orthotic and that is from Root Laboratory, Inc. Many orthotic laboratories manufacture so called “Root-type” functional orthoses. Some of these laboratories do a good job of producing a Root-type functional orthosis, while others do not. Unfortunately, I have seen far too many so-called “Root-type” functional orthoses that look nothing like the devices developed by Merton L. Root, DPM, nor like the devices produced by Root Laboratory, Inc. With so many generic looking “Root” orthoses on the market, it’s no wonder they are no better than pre-fabs.

Another factor influencing outcomes are the many different interpretations of Root theory. Practitioners, who possess the necessary theoretical knowledge and clinical skills, get excellent results with Root Theory. Unfortunately, Dr. Root never wrote a book on treatment or functional orthotic therapy, which is one reason why his treatment theories are not better understood. These skills were disseminated through his lectures and other methods of teaching. One has to admire the many practitioners who were dedicated enough to learn it on their own.

Poor outcomes can result from misdiagnosis, inadequate biomechanical examination, improper casting position, poor casting technique, improper or inadequate Rx, etc. We should not be quick to blame the theory nor the device until we know the cause of treatment failure. Unfortunately randomized, controlled studies don’t reflect the way real practitioners actually practice. Would you give every patient suffering from plantar fasciitis the exact same device regardless of foot type, medical history, occupation, biomechanical findings, etc? I hope not! It’s certainly not how Root biomechanists practice. I welcome the day when some of these alternative theories gain the status to be studied, so practitioners will have more than marketing claims to validate their use.

Jeff Root, President, Root Laboratory, Inc., jroot@root-lab.com

RE: Conflicts of Interest
From: Steven Goldstein, DPM, Paul Kesselman, DPM)

As Director of Medical Education for The Academy of Continuing Medical Education, one of my duties is to enlist potential speakers for our seminars. I can tell you firsthand, no one wants to speak without getting an honorarium. There are a few exceptions to this, but you can count them on one hand. Whether it is a drug company or medical product company, they almost always have to pay the physician an honorarium to speak. This is the way of doing business in today's marketplace.

The Academy's position is that as long as one discloses their relationship with the company as to whether they are stockholders, consultants, or paid speakers and give full disclosure, it meets with CPME guidelines. Before the speaker presents his or her lectures, we make a statement that the opinions or comments of the speaker are not endorsed by the Academy.

I would be hard-pressed to find enough speakers to fill up an entire day's worth of lectures without them receiving some form or remuneration by a manufacturer or drug company. This scenario is not just happening in our field, it happens in all the other specialties as well.

Steven H. Goldstein, DPM, Royal Palm Beach, FL,
stevefootdr1@cs.com

Editor’s Note: Dr. Kesselman’s extended-length letter appears at: http://www.podiatrym.com/letters2.cfm?id=19675&start=1

ASSOCIATE POSITION: BALTIMORE, MARYLAND

Seeking motivated and outgoing individual for part-time position in very comfortable office with a great working atmosphere. Office is turn-key with ASC in a fantastic location. Must be ABPS eligible. competitive salary + incentive and part-time benefits are available. CV to 410-602-9781.

ASSOCIATE POSITION – LEHIGH VALLEY, PA

Large medical/surgical practice centered in Lehigh Valley, PA looking for exceptionally trained podiatrist. Excellent opportunity for income as well as potential partnership. E-mail resume to jkaufman@lvfoot.com

INTERNET FOOT THEMED CANDY BUSINESS FOR SALE

Well-known foot-themed chocolate and candy company with over 6,000 customers. Unique products with trademarked names for seasonal (Mistle Toes, Valentoes, etc.) as well as everyday (A Foot of Feet, Twinkle Toes, etc.). Excellent opportunity to generate income from home with an established business. Serious inquiries to Mwolpa@ToeFood.com

ASSOCIATE WANTED - KNOXVILLE, TN AREA

Busy multi-doctor, multi office practice heavily weighted in surgery. PSR-24 + experience preferred. Part-time also available. Area consistently ranked in top five areas of country to live, work or retire. Ranked third in country 2008 Boaters magazine for boating destination. First year guarantee $150,000 plus bonuses and benefits. Send cover letter an c.v. to davidphawk@adelphia.net

ASSOCIATE POSITION – NW INDIANA (1 HR FROM CHICAGO)

Great opportunity for financial and personal success. Start at $150K plus incentive compensation, good benefits, and ownership potential. Must be highly motivated, have a great bedside manner and excellent surgical skills (forefoot and rearfoot). E-mail resume to friendlyfootcare@comcast.net or fax resume to (219)662-7290. Learn about us here

ASSOCIATE POSITION - ILLINOIS

Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings available. If interested fax curriculum vitae to 312 225-9366 or e-mail feetwork@aol.com

PRACTICE FOR SALE - FLORIDA

Well-known practice in Coral Gables,FL for over 20 years. Excellent location on Coral Way with heavy traffic, great visibility and plenty of parking. Busy, fully equipped, full-time office with established patients. Grossing over 300K with tremendous growth potential. Office is currently open and ready to take over immediately. For additional information contact QVAN@aol.com or 305-975-5516.

SEEKING RESIDENT FOR PSR-24 - BALTIMORE, MD (MERCY MC)

Position for a highly motivated individual with completed non-surgical residency or one desiring additional surgical training in well-established Podiatric Residency Program. Busy metropolitan hospital with high surgical numbers and inpatient care. Resident is integral member of multidisciplinary team. Begins mid June 2008. Includes competitive salary/benefits. Send inquiries to rsher18@yahoo.com

ASSOCIATE POSITIONS – MARYLAND

Are you motivated, personable and enjoy working with the elderly? We are offering full or part-time positions in Maryland. Our group provides care to the elderly in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your cv to drhprosen@comcast.net or fax to 410-486-2049 or call Dr. Herbert Rosen 410-580-0255

ASSOCIATE POSITION - SAN ANTONIO, TEXAS

Seeking three-year trained resident for associateship, hopefully leading to partnership. Competent in all phases of podiatry particularly reconstructive rearfoot surgery. Outstanding opportunity for the right individual. Reply to Richard Pollak at 210-692-0279, or fax resume to 210-692-0028 or e-mail drpllk@hotmail.com

ASSOCIATE POSITION - SOUTH JERSEY

Busy group practice. Digital x-ray, Diagnostic U/S, EMR. Located between Philadelphia and the Shore. Need ABPS Eligible/ Certified, PSR 2-3, hard-working, energetic, team player with good hands. Previous experience a plus. Must be willing and able to provide quality palliative care. Competitive financial package. Resume and references to dalilfeet@aol.com

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

SOUTH CENTRAL PENNSYLVANIA-PM&S 36 ASSOCIATE WANTED

Large, busy podiatry group looking for associate interested in future partnership. Practice facilities and technologies include: Surgical Center, Physical Therapy Department, 6 appointment locations, EMR, MRI, Clinical Trials and Digital X-ray. Full compensation and benefit package offered. Mail CV to Martin Foot and Ankle, 1203 S. Queen St. York, PA 17403 or email johnreitzelmfa@aol.com

Beautiful location in the heart of Miracle Mile. Excellent opportunity for a starting practitioner. Most insurances accepted. Good mixture of surgical and general podiatry. Fully equipped with low overhead. Located in a professional building, with referrals from other doctors in the same building. Contact zoesar@aol.com or call 786-877-5149.

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