May 23, 2006 #2587                                     Editor-Barry Block, DPM, JD

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3" Heels  Create 7X More Stress Than 2" Heels: MO DPM

Red flags continue to fly regarding damage to the feet. Speaking for the American Podiatric Medical Association, Dr. Holly Korges, a Kansas City podiatrist, advises women not to go over 2 inches, a far cry from current styles.

"A 3-inch heel puts seven times more stress on the ball of the foot than a 2-inch heel," she says. Consistent pressure can cause foot problems such as nerve damage.

For women intent on wearing heels, she recommends metatarsal pads found in drugstores. They cushion the foot and lessen the stress on the foot's forefront. Does the doctor wear high heels? "Once a year, maybe," she says. "When I go to an event."

Source: Kansas City Star

FPMA Defeats Proposed FL Scope of Practice Legislation

Thanks to the efforts of the Florida Podiatric Medical Association, two proposed bills, supported by the Florida Medical Association were defeated in committee.  House bill 575 would have changed the scope of practice of podiatric physicians by amending the definition of "practice of podiatric medicine" to limit the area that a podiatrist could diagnose or treat to the areas of the ankle and foot.

The bill also would have limited the optional podiatric Medicaid services for which podiatric physicians may be reimbursed. Under the provisions of the bill, a podiatric physician treating a Medicaid recipient for podiatric services could only receive payment for treatment and diagnosis of conditions of the human foot and ankle, not the leg.

House bill 575 died in the House Insurance Committee, and Senate bill 2624 died in the Senate Committee on Health Care.

Dr. Chet Evans testified before the House Health Care Committee and Dr. Stephen Meritt testified before the Senate Health Care Committee. Michael Schwartz, FPMA's Executive Director along with FPMA's lobbyist with the support of the Legislative Committee under Dr. Joe Strickland, did a masterful job and should be commended. Dr. Harold Vogler was also a great support to the Committee and should be recognized for his tireless efforts.

Query: Bariatric Surgery and Antibiotics

I have noticed a recent increase in the number of patients I am seeing who have undergone minimally invasive bariatric surgery. These patients have a port and an internal implantable clip. I have received a variety of opinions from a variety of surgeons on the necessity (or lack thereof) for antibiotic prophylaxis for minimally invasive clean podiatric procedures, i.e., injections, etc. Any thoughts, opinions would be appreciated.

Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net

RE: Medicare Part D (Stephen Bennett, DPM) From: Multiple Respondents

The information that Dr. Bennett received from the Part D prescription plan that obtaining the plan's formulary is "not their policy" is not only unfortunate, but it was inaccurate. In fact, every Part D provider must publish their formulary. CMS provides a Plan Formulary look-up tool to help Physicians obtain access to prescription drugs covered under each plan. The plan formulary information is contained within the Formulary Finder on www.medicare.gov.

Ross E. Taubman, DPM, APMA Vice President, retaubman@apma.org

I, too, have found that accessing information regarding various formularies such as Medicare Part D was cumbersome and time- consuming. Fortunately, there are now several very helpful tools available that save time and aggravation.  Epocrates has proven to be invaluable in my day to day practice.  They include formularies for a number of insurance products in their program, including Medicare D.  If you are currently using any Epocrates mobile drug reference, you can add the Medicare Part D formularies and many others for free.  Check it out at: http://www2.epocrates.com/resources/medicare-partd/   Personally, I could not practice without it.

Lorraine Loretz, DPM, NP, Shrewsbury, MA, lloretz@juno.com

RE: DMEPOS Competitive Acquisition Program From: William W. Godfrey DPM

This is a huge mistake. It's like telling everyone they have to get their widgets at WalMart or McDonalds. That's not right. This must on some level violate antitrust laws by proposing to give a single source a monopoly by region. The Army has gone to this type of logistical acquisition of DME for our base hospitals, and guess what? We're not saving money; in fact, we're paying more for the same exact stuff that we were getting from least cost sources. Thanks a lot; our budget has been continuously cut over the past five years but we're paying more for our supplies for our growing active duty/deploying/redeploying populations which we must support.

They're going to do the same thing to doctors/specialists who know better and local providers who can provide the best and most appropriate DME, the quickest, the easiest, the fastest, and the least expensive. What they're proposing is one more step towards socialism, lining the pockets of the rich, giving over more control to fewer who think they know better when in fact it will add bureaucracy, alienation, authoritarianism, decentralization, takes away empowerment to the local physician and provider, and will in fact cost more in terms of health, welfare, lost time/work/wages, and increased healthcare costs/headaches/marginalization to those of us who serve and are served by ingenious privatized healthcare. Forget the single supplier idea; they'll take over, then jack up the prices the same way foreign car companies, among other industries, have taken over in the USA.

Once again, it sounds good in theory, yeah sure to save money somehow for a hemorrhaging system, but it is in fact a disaster waiting to happen---certainly, there's gotta be a better way to run the store, but this cannot possibly be it.

William W. Godfrey DPM, Fort Polk,  LA, williamtrekkie@earthlink.net

I have used Transderma Verapamil as part of my treatment of plantar fibromatosis. The medication reduces the size of the lesions significantly, but in my experience, does not usually eliminate them. Treatment lasts 6 months to a year. I consider Verapimil an adjunct to other treatments which include perilesional steroid injections, orthotics with soft topcovers, and surgery.

Gary Friend, DPM, Glenview, IL, drfriend@nspodiatry.com

I have used it on two patients with symptomatic plantar fibromatosis. Both were no longer symptomatic after a couple weeks however the fibromas remained palpable.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

ESWT MACHINE FOR SALE

I have a DolorClast shockwave machine for sale 60% of cost, call 416-545-1166 or mailto:dracula65@hotmail.com   Thank you

PRACTICE FOR SALE - NEW YORK

FOR SALE - Rockland County. Well established, high-volume practice, general and surgical. Gross $500K, hospital privileges; excellent lease.  All interested parties reply to:
metroNYCpodiatry@aim.com

SURGICAL INSTRUMENTS FOR SALE

Complete Surgical Instruments, Hundreds;  Stryker Power  Set Electric motor; Reciprocating & Oscillating saw, Roto-osteotomes, also two major bone sets including DePuy osteotomes, several soft tissue sets, etc. Office instruments also. Call for exact items.
Art Korbel DPM, (MD)  954 753 7621

ASSOCIATE WANTED - NEW YORK

Associate Wanted - Rockland County, Rockland County. Associate with minimum 5 years experience, high volume established general practice.  Reply with CV to nypodiatry111@aim.com

BOOKS FOR SALE

22 books-Sold as Set- $ 500.00 Examples are; Foot Disorders – Giannestras, Surgery Foot & Ankle – Johnson, Foot & Ankle Trauma -Scurran Podiatric Office Management & Procedures - Kane, Schlefman & Vickers,  Minimum Incisional Surgery – Hymes, Foot Surgery  - McGlamry, Textbook of Bunion Surgery -  Gerbert & Sokoloff Disorders
of the Foot – Jahss. Call Art Korbel DPM, MD (954) 753 3146

ASSOCIATE POSITION RICHMOND, VIRGINIA AREA

Partnership possible after two years. Two office practice. Palliation; biomechanics/orthotics; woundcare; office/hospital surgery. Must have Virginia license. Associate will do most of the
practice's surgery.  PSR24/36/Board qualified/certified in surgery preferred. Available ASAP. Send CV to: Dr. Marc Jay Pinsky; 9550 Midlothian Turnpike; Suite 104; Richmond, VA 23235;
mjpinsky@juno.com .; FAX: 804-320-6627.

ASSOCIATE WANTED – HOUSTON, TX

Associate wanted for thriving Houston practice.  Forefoot and rearfoot surgery competency a must. Two locations, close to hospitals, ambulatory centers, etc.  Good salary with all kinds of benefit package and incentive bonus.  State-of-the-art equipment. Wonderful staff to work with. good person, with ethics a must. Please call 281-955-5500 or e-mail http://jrubinfoot@aol.com resume. Opportunity of a lifetime.

ASSOCIATE WANTED – MISSOURI

Well established 5 location podiatry group has position available for an associate leading to possible partnership after 3-4 years of demonstrated ethical service.  Our associates have acquired all of their cases for forefoot and rearfoot boards in less than 3 years. Full range of podiatric care.  We own our own surgical suite.  Low cost of living, nearly crime free area with excellent schools. Close to St. Louis and major state recreation areas.  PSR-12/24/36.   CV and letter of intent to:  sradpm1@fidnet.com or FAX 573-341-8174.

ASSOCIATE POSITON – TAMPA BAY, FL AREA

Two associate positions presently open with a large podiatry group in the Tampa Bay area. Salary and benefits are commensurate with applicant's qualifications. This is an excellent opportunity for a new practitioner to join a strong, existing group with extensive
hospital affiliations and referral patterns. Two-year residency and Fl license preferred.  zachander@aol.com   Fax 813-286-0200   Ph 813-334-2077

ASSOCIATE POSITION – TEXAS

Mature 3 DPM general podiatry and surgery practice in the Rio Grande Valley of Texas is seeking a DPM to fill an Associate position, partnership will be considered after a period of 2-3 years. Applicants should have at least 2 years of residency training and
enjoy diabetic foot and wound care. Diverse patient populations. (VA, Community Health Clinics, Hospitals and 3 offices)  Good practice environment in hospitals and community.  Salary, bonus and benefit package offered.  Interested DPMs should send a letter of intent along with a current C.V. to Complete Family Foot Care, 812 Lindberg Ave. McAllen, TX 78501.  Fax 956 971-9109

ASSOCIATE POSITION-  NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base.  Close proximity to hospitals with modern surgical suites.  Opportunity for shared ownership.  Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation.  E-mail CV and particulars to
NEAFC3@aol.com

EQUIPMENT FOR SALE - ESWT

If you are using or thinking of using ESWT, I have a new machine that has only been used twice. There is no Orbasone in the country priced like this one. Will provide training and installation. Take a look at http://www.orbasone.com   Call 1-856-229-2939.


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