The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

June 04, 2010 #3,875 Publisher-Barry Block, DPM, JD

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CA Podiatrist Receives LA Proclamation for Amputation Prevention

Dr. Lee C. Rogers received a proclamation from the city of Los Angeles on behalf of the Amputation Prevention Center at Valley Presbyterian Hospital. Dr. Rogers is the co-founder of the center along with renowned vascular surgeon Dr. George Andros. The center aims to reduce the rate of amputations in those with diabetes and is the only one of its kind on the West Coast, and one of only a handful in the nation.

Dr. Lee C. Rogers with Los Angeles City Councilman Tony Cardenas.

"Every 30 seconds, somewhere in the world, a limb is lost as a consequence of diabetes," Rogers said. "This center has the right combination of talent, tools, and teamwork to combat what is mostly a preventable complication."  Rogers is the chair of the Foot Care Council for the American Diabetes Association and a course director of the Diabetic Foot Global Conference (DFCon) held annually in Hollywood, CA which attracts 1,000 doctors, scientists, and industry representatives from 40 different countries. 

Source: Gallatin North Missourian [6/2/10]

NYCPM and Mt. Sinai Sign Agreement to Offer DPM/MPH Degree Program

The New York College of Podiatric Medicine (NYCPM) and Mount Sinai School of Medicine have signed an agreement creating a dually-sponsored degree program that will enable NYCPM students to earn both the DPM and MPH degrees during the student’s four years at NYCPM.  The program will provide participating students with enhanced professional options, and will enable NYCPM to attract the highest caliber students, capable of navigating the demanding dual-degree program.

The New York College of Podiatric Medicine

The program will be available to NYCPM students beginning in September of this year. NYCPM will award the DPM degree, while Mount Sinai School of Medicine will award the MPH degree. Candidates for the dually-sponsored degree program must meet all eligibility requirements for both degree programs. Applicants to the program will not need to submit a separate application to the MPH program. Once granted admission to NYCPM, they will work with the NYCPM Admissions Office to apply for admission to the Mount Sinai School of Medicine MPH program.

OH Podiatrist Starts Junior High School Running Club

Local podiatrist Dr. Don Tupper is not a coach, but has some coaching experience helping out with the River View cross country team and coaching his own cross country team in high school when they were without a coach. He said one reason for his wanting to start the club was because of a lack of a program at Coshocton and getting students interested before high school.

Dr. Don Tupper

"After watching the varsity track team running and them having very few distance runners, I began to question why that was. They don't have a summer running program or a fall cross country program, and I felt that was a big factor in that situation," Tupper said. Tupper gave calendars to club members so they can mark how many days they run and how far. Tupper said his goal is to have the students rack up 100 miles over the summer, and he'll have an award for those who do so. Tupper himself said he runs about 30 miles a week.

Source: Leonard Hayhurst, Coshocton Tribune [6/2/10]

ACFAS Issues Position Statement on Total Ankle Replacement Surgery

Advances in surgical options for end-stage ankle arthritis have prompted the American College of Foot and Ankle Surgeons (ACFAS) to issue a position statement on the use of total ankle replacement surgery as an option for some patients with painful arthritis. According to ACFAS, total ankle replacement surgery is a safe and effective treatment option for select patients with end-stage ankle arthritis, a leading cause of chronic disability in North America. Studies have shown that total ankle replacement surgery in which the ankle joint is replaced with an artificial joint, can improve patient function, reduce pain and improve the quality of life for patients. 

Previously, the most often selected option for patients with end-stage ankle arthritis was ankle fusion, which involves surgically fusing bones together in order to eliminate painful motion. While ankle fusion is still a successful option for relieving the pain of the disease within the joint, a new generation of implant designs and surgical techniques have provided patients with an additional viable option for treatment. ACFAS surgeons note that not every patient with severe arthritic disease of the ankle is a candidate for total ankle replacement surgery.

Query: Charcot STJ Complete Dislocation

This obese, middle-aged female patient with IDDM and ESRD presented with a Charcot STJ complete dislocation (post 4 years) and a non-infected ulcer (Wagner 2, 8 months) at the plantar medial aspect of the talus. The talus is still in the ankle mortise. Osteomylitis has been ruled out. Her vascular evaluation indicated typical bounding pulses found in Charcot. I am sending this patient to a local wound care group. After the wound is resolved, I am considering reconstruction via a Wright ex-fix, using the talus for a stable proximal pin. The status of the talus in the mortice is unknown, but it looks fairly osteopenic, as does the rest of the foot.

(L) Photo (R) X-ray of Charcot Foot

Our state's practice act does not allow podiatrists to go above the ankle to place tibial pins for a cage. The patient will not consent to a BKA. I would appreciate some constructive suggestions as to the surgical options for foot salvage, and any pearls that anyone might have, given the constraints of my state law.
 
Tip Sullivan, DPM, Jackson, MS

Query: Standard of Care for Post-op Cast

In a recent malpractice case, Dr. Douglas Stabile testified that it is contrary to accepted podiatric standard of care to apply a cast following surgery for the repair of a chronic rupture of the peroneus longus tendon unless that cast has been bi-valved. A copy of his testimony with  highlighted text (starting on page 16) can be read here.

I do not believe that it is malpractice to apply a non-bi-valved cast following such surgery, and would appreciate commentary from the PM News readers on this matter.

Charles Lombardi, DPM, Bayside, NY

RE: Maceration, Pitting Keratolysis, and Hyperkeratosis (Jacqueline Chen, DPM)
From: Geoffrey Bricker, DPM

First, is it severely malodorous? I think you have a mixed bacterial and fungal infection. Culture the macerated interspaces; it is probably a Gram negative organism, so treat accordingly. I have had great success for the hyperhidrosis with Lazerformalyde from Pedinol, available by prescription in 3 oz. roll-on . Apply it to the entire foot daily for up to one week, then decrease to 3x per week for two weeks, then as needed 1-3x per week to control it. The hyperkeratosis is a papulosquamous tinea pedis. Treat it with oral Lamisil, 250 mg. QD for three months. This has never failed for my patients but the hyperhidrosis needs to be treated indefinitely, but lessens with age.

Geoffrey Bricker, DPM, Springfield, MO, geoffreybricker1@msn.com

RE: CRPS (Alan Mauser, DPM)
From: Elliot Udell, DPM
 
Regarding the suggestion that a patient even consider a regional sympathectomy for the treatment of CRPS, please read Dr. Hooshmand's text and writings on the matter. Dr. Hooshmand , a neurosurgeon, was one of the leading authorities on this condition, and he said that a doctor should only consider offering a CRPS patient a sympathectomy under one circumstance. The doctor doing the procedure must be certain that the patient's life expectancy will not be more than six months because the side-effects of the procedure will be so dire that the patient will not want to live more than a half a year. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Chaetomium Onychomycosis (Richard A. Simmons, DPM)
From: John Strisower

Efficacy for a specific organism can only be truly ascertained by adequate study. As there are numerous organisms involved in these multi-species infections, and because perhaps no one truly knows which are part of the disease process and which are not, there are no quick, simple and accurate answers to this type of question. Further, as individuals have greatly varied responses, even if the organism susceptibility is known, the patient outcome must also be studied in sufficient numbers to yield statistical significance.

In order for us to test an organism in-vitro as a first step, we must know what organism we are testing. KOH provides visible indication of fungal hyphae or not; it is binary and confirms presence or absence in a given sample, but not specific organism identification. Culture will provide the opportunity for traditional identification using microscopy by a trained mycologist and this will generally enable a specific identification of a species. Where the traditional microscopic identification is still ambiguous, DNA analysis can be performed, which will provide a species match in about 93% of cases (the other 7% may not be able to be identified due to un-cataloged specimens, redundancy, etc.).

Once we test in-vitro, we would have a good idea of likely outcome in-vivo and could then suggest methods for clinical studies in patients with the known organisms. If a sample of the chaetomium organism is still available from culture or nail sample, we would be willing to DNA analyze it, grow it, and test it.

John Strisower, CEO, Patholase, Inc., john@patholase.com

RE: Medical Marijuana and Liability Issues
From: Robert Wunderlich, DPM

The salient point to remember regarding "medical marijuana" is that it is NOT PRESCRIBED (per se) by any physician in California.  Medical marijuana can be RECOMMENDED by any physician in California without fear of repercussions by the Medical Board of CA, pursuant to the Compassionate Use Act of 1996. However, it is important to note that a recommendation for medical marijuana made by a physician IN WRITING "could trigger federal action." 
 
For more detailed information, please consider reviewing the following information at the CA Medical Board website:
 
Robert Wunderlich, DPM, San Antonio, TX, rwunder@gmail.com

ASSOCIATE POSITION – QUEENS & NYC

Part-time podiatrist needed for multi-office practice in Queens and NYC. PSR- 24+ a must. Experience preferred. Willing to train the right new graduate. Must be punctual, very personable, ambitious, and ethical. Job will involve usual podiatric medicine and surgery. Will also include significant networking and marketing to help build the practice. You must be well-trained and have people skills for this position. Possible full-time position leading to partnership for the right person. Please e-mail cover letter and resume to hansfeet@aol.com

PODIATRIC ASSOCIATE POSITION - CHICAGO, IL

Excellent Associate Opportunity for full or part-time position. Group practice with diversified mixture - Surgery Qualifications: 3 years Trained Resident Salary: Commensurate with training, benefits included Fax CV/Resume to 773-374-5860 J.B. Jenkins & Associates transcribe1706@aol.com

LOCUM TENENS WANTED - MANHATTAN

Due To Family Emergency looking for locum tenens for the month of July and August 1-2 days per week. Office located in Manhattan Upper West Side Fax CV to 212 362-9896. For more information you can call 212 724-4457. frottenberg@juno.com

ASSOCIATE POSITION – VICTORIA, BRITISH COLUMBIA

Beautiful Victoria, British Columbia, on the ocean, fast growing area. Associate for multi-office, full-scope practice. Reply to dr.cole@shaw.ca or phone 250-516-7440

LIMB PRESERVATION RESEARCH AND SURGICAL FELLOWSHIP

Boston University Medical Center offers a unique fellowship position
Be part of this unique opportunity at a major internationally-known teaching medical center. During this time, he/she will become a knowledge expert who will contribute significantly to research, surgical procedures, teaching, and innovations in limb preservation and tissue repair. Requirements: Completion of a two or three year surgical residency; Annual Salary: Year 1 $61,000, Year 2 $66,000 plus excellent benefits. Submit a CV and letter of interest to: Erin Springhetti @ erin.springhetti@bmc.org and Dr Vickie Driver @ vickie.driver@bmc.org

CANADIAN PODIATRISTS COME BACK HOME!

An Edmonton, Alberta group of DPM’s requires an additional Podiatrist. Interest in biomechanics essential. Given Canadian visa restrictions, this position is open only to Canadian Citizens or permanent residents. Very attractive compensation package. Fax C.V. or letter of interest to: (780) 483-5796.

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 WANTED DELRAY BEACH FLORIDA

Rapidly growing well established practice seeking part-time leading to full-time. PSR 12-36. Great opportunity for highly motivated, personable individual. Please reply by emailing a CV to nursebsf@aol or fax (561)498-9068.

ASSOCIATE POSITION IN NORTH BROOKLYN, NY 
 
Well-established practice in a multispecialty medical center seeking a full time associate. Spanish speaking ability a plus. Compensation possibly in six figures with buy-out opportunity. Contact/Send resume to: bklypodiatry@aol.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 – NEW YORK
Great Opportunity - NY podiatric practice – multiple locations –seeks well trained, ethical DPM Per Diem and full-time positions available. Competitive salary. Send resume and CV to: info@advancedfootcare.org

ASSOCIATE POSITIONS – TEXAS

Full-time podiatrist(s) needed in Austin or San Antonio. Current Texas license required. Unique mobile podiatry practice. Better pay, fine working conditions with excellent support staff. Check out our website www.footmobile.com. Reply to footcenter1@sbcglobal.net

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.

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

PART-TIME POSITION - NEW JERSEY

Available for a Board certified/qualified podiatrist. Located in Toms River and Manchester. We have a high-volume practice that treats routine care, trauma, sports-related injuries, hospital consults, and ER Consults. Possibly leading to full-time position for the right person. Please fax CV to (732) 349-0228 or email CV to njfeet@aol.com

ASSOCIATE POSITION- MONROE, MICHIGAN

Excellent opportunity to join a modern, growing 3 doctor/2 office practice located in SE Michigan between Detroit and Toledo. Responsibilities will include a mix of surgery, office, hospital and nursing home/housecalls. Salary, bonus and benefits. Learn more about us at monpod.com. If you are a personable, reliable team player with solid skills and a patient first attitude please contact dr.hughes@comcast.net for more information.

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 - WEST CENTRAL FLORIDA

General podiatry. High-level surgical skills are not required. Good diagnostician, compassionate and hard working individual is needed for busy high-tech practice. E-Mail: flpodiatrist@tampabay.rr.com

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 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

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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