The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

May 28, 2013 #4,781 Publisher-Barry Block, DPM, JD

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Barry University Yucatán Crippled Children Project Renews its Mission

Recently, the Barry University's Yucatán Crippled Children Project was once again held in Progreso and Merida, Yucatán, Mexico. This project was started in 1996 by Dr. Charles Southerland of Barry University. Medical teams go to the Yucatán four times a year to treat impoverished children and adults with post-traumatic, disease-related, and congenital deformities of the lower extremities. Twice a year, the Seattle Team, led by Dr. Dock Dockery, Dr. Byron Hutchinson, the senior surgeon, and two residents from the Seattle area participate. The Seattle Team is sponsored by the International Foot & Ankle Foundation for Education and Research (IFAF).

Front Row L-R: Drs. Mario Cala, Deandrea Duffus, Kenneth Hegewald. Back Row L-R: Drs. Mikkel Jarman, Charles Hastings, Daniel Hall, Juan Sanchez - YCCP Coordinator, Dock Dockery, Byron Hutchinson, David Wood, and Albert DaCosta, CEO, Paragon 28, Inc.

During these trips, the Seattle Team joins a Miami Team and performs surgical corrections for two full days at the Red Cross Orthopedic Hospital (Cruz Roja Mexicana Hospital de Ortopedia), Merida. The Chief of Staff, Dr. Adolfo Rocha Geded, pediatric orthopedist, coordinates the surgeries, assists, and does all of the follow-up care for the post-operative patients.

IA is First Podiatrist Named Chief of Staff at Methodist Medical Center

Eric Barp, DPM of Des Moines, Iowa, has been chosen to become the new chief of staff for Iowa Methodist Medical Center. He is the first podiatrist to ever serve as chief of staff at Methodist Medical Center.

Dr. Eric Barb

Dr. Barp is Board Certified in Reconstructive Foot and Ankle Surgery by the American Board of Podiatric Surgery and is also on staff at Iowa Lutheran Hospital, Mercy Medical Center, Broadlawns Hospital, Lakeview Surgery Center, and Madison County Hospital.

Source: Star Herald [5/25/13]

Podiatrist Joins Medical Staff at FL Hospital

Podiatrist Matthew J. Hentzel, DPM, has joined the medical staff at Florida Hospital DeLand and opened the Foot and Ankle of Volusia practice. Dr. Hentzel is board certified in Foot Surgery by the American Board of Podiatric Surgery.

Dr. Matthew Hentzel

He earned a doctorate in Podiatric Medicine from Barry University School of Graduate Medical Sciences in Miami Shores, FL. He completed a podiatric surgical residency at Palmetto General Hospital in Miami. Additionally, Dr. Hentzel has traveled to Mexico to volunteer with Barry University’s Yucatan Crippled Children’s Project (YCCP).

Source: Beacononlinenews.com

NJ Podiatrist Named President of The Allendale Community for Mature Living

Dr. Timothy Giancarlo has been named president of The Allendale Community for Mature Living. Tim Giancarlo will replace his father, Dr. Hector R. Giancarlo, who is stepping down as president after nearly 50 years at Allendale’s helm.

Dr. Timothy Giancarlo

Dr. Tim Giancarlo, a 48-year-old Bergen County native, is a graduate of the New York College of Podiatric Medicine where he received his DPM degree. He is a licensed nursing home administrator and licensed podiatrist. He lives in Ridgewood with his wife, Sandra, and two children.

Source: Mel Fabrikant, The Paramus Post [5/25/13]

Query: Dislocation of the Second Metatarsal Phalangeal Joint

A 48-year-old female patient presented to the office with extreme pain in her right forefoot. Her pain was located in the 2nd and 3rd MPJs. She was previously treated by other providers and her treatments consisted of multiple cortisone injections and orthotics. These treatments were initially successful, but left her with a plantar plate tear and dislocation of the 2nd MPJ. She began to have extreme pain after starting an exercise program which entailed walking on a treadmill approximately 30 minutes per day. On examination, she had capsulitis in the second and third MPJs. 

Dislocation of the Second Metatarsal Phalangeal Joint

She has lots of deformity in her toes and has obvious dislocation of the second metatarsal phalangeal joint. The deformity was reducible with clinical manipulation. Her AP x-ray confirmed that her second toe was dislocated. How would you address this type of deformity?What is the average post-operative course with respect to post-operative pain for your patients? 

Don Peacock, DPM, Whiteville, NC

RE: Status Post Motorcycle Accident
From: Gregory B. Nellis, DPM

Cast it, non-weight bearing. Tell the patient all the potential sequelae you can think of, and how they might need to be addressed later. I can't see anything coming out of invasive intervention except your work potentially taking the blame for the same problems that are going to be there anyway. Get another opinion.

Gregory B. Nellis, DPM, Gloversville, NY, gbndpm@yahoo.com

RE: Documenting Radiological Findings
From: Michael G. Warshaw, DPM

When you utilize the CPT Manual, and turn to the RADIOLOGY section, preceding the codes and their descriptions are the RADIOLOGICAL GUIDELINES. It clearly states under Written Report(s): "A written report signed by the interpreting individual should be considered an integral part of a radiological procedure or interpretation." It states "written report." It doesn't state "summary of findings." It doesn't state "template of findings." It doesn't state "diagnosis." This is not open to interpretation. It isn't subject to someone's opinion. It clearly states "written report."

The issue here is, what should be present in an x-ray report? There are three "key components" that make up an x-ray report:
1. The views that were taken
2. A general overview of the x-ray findings
3. "Target the Diagnosis" - When x-rays are taken, they are billed for. When the claim is submitted for payment, a diagnosis code is utilized. Isn't it prudent to make mention of that diagnosis in the x-ray report; otherwise, how can you justify through your documentation that the professional component of the x-ray service was actually performed? Remember, when x-rays are billed for by a podiatrist in the office setting, the only modifier that is applied to the CPT code is either RT or LT. This leads to the assumption that both the technical and the professional components of the x-ray service were performed.

Michael G. Warsxhaw, DPM, Ravenna OH, mgwarshaw@aol.com

RE: Staff Makes it Difficult to Get Appointments (Name Withheld)
From: Bryan Markinson, DPM

I feel compelled to add another point of view to this discussion. First of all, any staff member purposely refusing urgent appointments to decrease their workload speaks to volumes of office procedural flaws and should never be tolerated. On this, everyone agrees. However, think of how many times patients call on an "urgent" basis for things that turn out to be minor but embellished by the patient into an emergency because they are going on vacation the next day? This is disruptive to your schedule as well as selfish to legitimate emergencies.

In addition, many physician offices are...

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

RE: New Study Confirms Hereditary Link for Bunions (Elliot Udell, DPM)
From: Leonard A. Levy, DPM, MPH

Elliot Udell, DPM is right that there are more than hereditary factors that lead to bunions and many other pedal deformities. However, these factors are products of the human genome. Genomics unlike genetics which refers to diseases that are due to a single gene (e.g., sickle cell anemia, hemophilia, etc.), is the study of all genes in the human genome interacting with each other as well as the environment.

If they have not done so already, podiatric medical schools, residencies, and continuing education programs need to include genomics as a core part of the continuum of podiatric medical education. The current director of NIH who previously directed the National Human Genome Research Institute referred to genomics as “one of the major landmarks that rank up there with going to the moon.”
 
Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL, levyleon@nova.edu

RE: We Walk in a Tripod Fashion: CA Podiatrist (Robert Phillips, DPM)
From: Kevin A. Kirby, DPM

To further add to the excellent points made by Dr. Phillips about the importance of weight- bearing function of the metatarsal rays, I believe that the biggest misconception most podiatrists have about the metatarsals is that they somehow have a “locking position”, where they will not dorsiflex further under increasing dorsiflexion loading forces. This is certainly not the case, and, unfortunately, seems to be a myth that is perpetuated from one generation of podiatrists to the next.

The metatarsal rays do not “lock”, like the ratcheting wrench, in a “fully dorsiflexed position” where they remain in...

Editor's note: Dr. Kirby's extended-length letter appears here.

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.

PODIATRIST SEEKING EMPLOYMENT - PORTLAND, OR AREA

Motivated, highly surgical trained podiatrist seeking employment opportunity in the Portland, OR or Vancouver, WA area. Both hospital and office-based training. Please email inquiries to poddoc3890@gmail.com.

PRACTICE FOR SALE - BROOKLYN, NY

28 year old practice in a desirable part of Brooklyn. EHR certified with stage 1 criteria successfully met. Practice has room to grow. Good mix of Medicare hazardous foot care; surgery and wounds. Low overhead. Priced to sell. Email Inquires to: brooklynpracticeforsale@gmail.com

PRACTICE FOR SALE - CALIFORNIA

Unique opportunity to purchase a very busy 50 year old practice in Coronado Ca. Large and stable patient and referral base with consistent new patient growth. Low overhead. Priced to sell. Great staff. Hospital privileges available. Willing to stay on for transition. Inquiries please email foothold@msn.com

IMMEDIATE OPENING OR PURCHASE IN DALLAS TX  

Turnkey in Dallas’ beautiful and prestigious Uptown neighborhood:   modern, fully furnished office in 24/7 security high rise and large patient base. There is tremendous growth potential in this affluent and diverse area. Perfect for new practitioner, to share, or second office.  afc1dfw@gmail.com

PRACTICE FOR SALE - SOUTHWEST FL

Multilocation multidoctor practice in beautiful Southwest Florida . Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to: practiceforsaleswfla@gmail.com

PRACTICE FOR SALE - WEST PALM BEACH FLORIDA
 
Well established successful West Palm Beach practice grossing $475K with excellent reputation and good referral base. Consistent new patient growth, great opportunity with increased gross revenue and surgical growth potential. EHR implemented with meaningful use criteria met. Great area to live and work. Serious inquires E- mail wpbfootdrs@gmail.com

PRACTICE FOR SALE IN CENTRAL FLORIDA 

33 year old practice grossing $550k seeing an average of 40 patients per day. Possible owner financing for both practice and large office building. Five year average profit margin of 35%. New Listing. For more information call Chas Smith at 863-688-1725 or email Chas@cpalliance.com

PODIATRIST FOR NURSING HOME CARE - MASSACHUSETTS

Excellent Opportunity. Seeking independent physician for growing nursing home podiatry care Work independently, make your own hours. Must do own billing. YOU KEEP 100% OF PROFITS. Must be personable and have good patient skills. Acquisition fee based position. Please e-mail CV and short bio to: americanmobile@verizon.net

ASSOCIATE POSITION - CENTRAL FLORIDA

Associate wanted for well-established practice in central Florida. Experienced support staff, malpractice coverage and health insurance provided. Excellent opportunity for a promising future, this position will provide for the possibility of partnership in the future. To apply please go to www.yourcareerinpodiatry.com

POSITIONS AVAILABLE - UPSTATE NY, DOWNSTATE NY, AND BUFFALO AREA

Looking for podiatrists to see residents in Nursing Homes. Great opportunity for supplemental or full time income. Email inquiries to phasetwopodiatry@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 - 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 - 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

ASSOCIATE WANTED - CENTRAL/SHORE AREA - TOMS RIVER, NJ

FT/PT Looking for a HIGHLY motivated, organized, ethical associate. EMR/digital 20/20 x-ray/NCV/vascular testing all on premises. Trauma, DM, wound care & large routine & children mix. Must have NJ license. Should be Board Qualified/Certified Potential for future BUY-IN Send CV to toesec@aol.com

ASSOCIATE POSITION - NAPLES, FLORIDA

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. Candidate should have the skills and desire to perform rearfoot/ankle surgery. Florida has a great scope of practice law and we rotate for ER call. Candidate needs to be ethical and motivated. Established practitioner or new practitioner. In a cover letter tell me why you should be selected for the team. Email cover letter and CV with subject line "I am your new team member." to: Drgordon@gulfcoastfootcare.com

ASSOCIATE POSITION- DAYTON, OHIO

Join an established group practice in Dayton, Ohio excellent reputation, large referral base. Base Salary$120,000, benefits and bonus structure. EMR; diagnostic ultrasound; Padnet; CO2 and Cutera Laser for nails, all aspects of DME. We need well trained personable PSR24/36 surgeon. Future Buy-in available. Please send CV to Ohiomedical@aol.com

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 - BEVERLY HILLS 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

FT OR PT ASSOCIATE - SOUTH JERSEY

Great opportunity for FT or PT associate starting July 2013 in established practice in South Jersey. EMR, FDA-approved Lasers for fungus. Will work with Board Certified/Qualified podiatrist. Must have New Jersey License. Diverse practice in a nice area with a pleasant environment. e-mail CV at hhfootdoctor@gmail.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.

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