The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

June 05, 2009 #3,563 Publisher-Barry Block, DPM, JD

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MA Podiatrist Discusses Ingrown Nails

The risk of ingrown toenails is raised by wearing shoes that are too tight, too narrow, or too short. According to Dr. James Ioli, Chief of Podiatry at Boston's Brigham and Women's Hospital, women's high heels are a common source of trouble.

Dr. James Ioli

One approach is to relieve pressure by lifting the ingrown nail edge and placing a small piece of cotton or dental floss or a splint underneath it. According to Dr. Ioli, this is more likely to harm than help; for example, cotton under the nail could trap bacteria and other infectious organisms. Another risky practice strongly opposed by experts is "bathroom surgery" -- trying to dig out and trim the corner of the ingrown toenail yourself.

Source: Premium Health News Service [6/3/09]

MI Practitioner Named Podiatrist of the Year

Dr. Ali Safiedine recently was named podiatrist of the year by the Southeast Division of the Michigan Podiatric Medical Association.

Dr. Ali Safiedine

Safiedine is on staff at Oakwood Southshore Medical Center in Trenton and Oakwood Hospital & Medical Center in Dearborn. He owns Michigan Foot and Ankle Specialists in Dearborn.

Source: The News Herald [6/2/09]

VT Bans Industry Gifts, Tightens Reporting Rules

Starting July 1, Vermont physicians will get no more free lunches from the pharmaceutical industry. That is one of many changes doctors in the state can expect thanks to a new state law that may be the most sweeping attempt yet to target the influence of industry marketing on physicians' medical decisions.

The law, passed by wide margins in the Democratic-led Vermont House and Senate and signed into law in May by Republican Gov. Jim Douglas, covers gifts and payments from drugmakers, device makers and biotech firms.

In addition to the ban of most gifts, the law requires that industry publicly disclose payments to physicians, with reporting required for amounts starting at one cent. Reports are to be included on a website searchable by doctor name. Failure to disclose could cost companies $10,000 per violation.

Source:  Kevin B. O'Reilly, AMNews [6/1/09]

If You're Going to Sell Spinach, Sell it to Spinach Eaters

Most marketing doesn't work because we are sending out the wrong message. People don’t care about us, they care about them. They are too busy to focus on anything except what's important to them. So, if you want to attract heel pain patients, focus your marketing message on the problems and concerns that heel pain patients have. Good marketing always "enters the conversation that is already going on in the mind of the person you want to attract."

Source: Rem Jackson, CEO of Top Practices. For infomation on The American Academy of Podiatric Practice visit www.aappm.org
 

Query: Spontaneous Blisters

I have a 65 year old female who presented with spontaneous blisters.  She relates mild pain from these areas. They presented on the left hallux and right 2nd and 4th toes, however, have shown up on other toes in the past. They resolve after a while, but the patient is concerned as to why they continue to arise.

Spontaneous Blisters

She relates no past medical history but some sensitivity to cosmetics.  No allergies otherwise and no significant medical history. Any suggestions or thoughts? 

Jeffrey E. Kleiman, DPM, Fort Myers, FL

Query: Medicaid Exclusion
 
With the elimination of many healthcare services, including optional providers, what has been the experience of podiatrists in other states that have been excluded from the Medicaid or equivalent welfare programs? Was it a blessing in disguise? Do you find some Medicaid patients still wish to be seen, and will pay out-of-pocket for treatment?  
 
Joe Borden, DPM, Reseda, CA

RE: Calcific Mass of The Plantar Heel (James Anderson, DPM)
From: Barry A. Wertheimer, DPM

I have seen this type of mass appear after a patient has had a previous series of cortisone injections by orthopedists and FP's that love to put large amounts into the area. The residual residue stays for years when the vehicle is other than a phosphate base. If this is in the patient's history, your problem might be solved.
 
Barry A. Wertheimer, DPM, Redondo Beach, CA, bwertheimer@cox.net

RE: Orthotics and Evidence-Based Medicine
From: Elliot Udell,DPM
 
Today, when I go to podiatry conferences, I often hear lectures by  lab directors or academicians on how to make an orthotics, and the theories behind them differ totally from what I learned in the past. What I find most disturbing is that many of these contemporary pedal biomechanics experts differ from each other like night and day, and leave many attendees confused as to what is right and wrong. 
 
Perhaps the problem is that the biomechanical gurus of the past did not do the kind of research and produce the kind of evidence that we now call EBM. It would behoove the labs and colleges to invest in more research so that we can justify the work we do - to our patients, insurance companies, newspapers, and even more importantly, to ourselves. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com
 

RE: PADnet Vascular System (Chris Seuferling, DPM)
From: Multiple Respondents

I think it’s a great system. The examination takes about 20-25 minutes to perform. It doesn't interrupt my patient flow because I actually set aside a separate day to do the exam. One could allow other office personnel to perform it to free you up if so desired. It’s very easy to learn, with almost no curve. Reimbursements overall are there, though you will get some "this type of service is not allowed by this type of provider."
 
Disclaimer: I have no financial affiliation with the company.
 
Jeffrey Kass, DPM, Forest Hills, NY, Jeffckass@aol.com

I have used this testing system in my office for over a year and couldn't be happier with it. Ease of use, training and tech support have been wonderful. The reports are better than some I've seen from vascular surgeons' offices. The reports give wave forms, ABI's and digital toe pressures. The company will set your office up over a secure connection to have the reports forwarded to a vascular surgeon to be interpreted and then sent back over the same secure connection. The tech support will train and certify your staff. The best part is that this can generate income (NY Medicare reimburses well) when I am not even in the office. Why refer to a hospital vascular lab? I simply have my trained staff administer the test (30 minutes) when I am out of the office either on a day off, or when I am at the hospital.
 
Disclaimer:I am not a paid spokesperson for Biomedix.
 
Frank Lattarulo, DPM, New York, NY,

I have had the BioMedix Padnet system for close to two years now. I have nothing but positive things to say. The testing is quick (about 15 minutes), and all of the office staff were easily trained to perform the examination. The reimbursement varies widely by insurance panel, but I can safely say the norm is between $150 and $200 per examination. I only have the basic arterial setup, but you can add the venous and post- exercise studies for higher reimbursement if desired.  I usually schedule the testing to be performed when I am out of the office, but I often have it done right then and there if it is indicated. In fact, I added an extra employee pretty much for this purpose only.  Four tests per month and you break even, I average about 12 a month.

More important than reimbursement is the good you do for your patients by performing this examination when indicated. I have had several patients who underwent revascularization procedures for pathologies first identified by the test. I routinely perform the exam pre-operatively when any question of vascular compromise is evident. This goes for anything from nail avulsions to bunionectomies. Medically / legally, it is an asset to have in your chart.

The patients like the test; the referring PMD's like the test; along with the detailed printouts. I even now have some referring MD's send patients with a request for the examination written on the consult sheet. In my mind, it is a no-brainer.

Jason Cohen, DPM, Bronx, NY, phootdr@optonline.net

RE: Post-Op Care for Alzheimer's Disease Patient (Daniel Cohen, DPM)
From: Wm. Barry Turner, RN, DPM

I am unsure if this has been recommended, but mittens are frequently used to protect patients from self-mutilation. The mittens are typically made from canvas or leather. Patients will try to pull the mittens off with their teeth, so the mittens must have a very bad taste. Some mittens have attachments that can be used to reduce the range of motion or reach of the limb. I have even seen boxing gloves used. Every couple of hours, the patient will work them off and they will have to be put back on, but it does reduce the self-mutilation. 
 
Wm. Barry Turner, RN, DPM, Royston, GA, claret32853@gmail.com
 

Editor's note: This topic is now closed.

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

EQUIPMENT FOR SALE - NEW X-RAY MACHINE
 
MIN-x-ray Mobile system Model PM200R40. Brand new. Less than 1 year old. Never used at all. I was opening a new location that fell through. Completely brand new. Paid $11,000. Will sell for $6,500. Located in the Bronx, NY- call 914-714-0667

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 

EQUIPMENT FOR SALE

Amfit Orthotic Making System. Includes new computer, recently updated digitizer, and orthotic mill, and $2,500.00 in supplies (which would generate about $20,000.00 in orthotics). skip the middleman. Cost $35,000.00. Asking $23,000.00 OBO AMERICAN FOOT CLINIC 405-733-2783 OR 405-820-6887 americanfoot@email.com

PRACTICE OPPORTUNITY - DALLAS TEXAS AREA

New practice started in Irving Texas by two 15 year established podiatrists from Austin. We've decided to stay in Austin and travel only for research. Opportunity for new practitioner podiatrist to start practice immediately with no money out-of-pocket. Write to MRobsonDPM@aol.com

PRACTICE FOR SALE -BRIGHTON, MICHIGAN

Outstanding opportunity to purchase 12 year established general podiatry practice. Now working one day per week seeing approx. 20 patients. with 3-4 new patients per week. Steady flow of returning patients. Selling because of disability. Turn-key.  First quality equipment, furniture, and build-out. Priced to sell for the value of the equipment.  Call (248) 538-5958. e-mail: DocPod@aol.com

PRACTICE FOR SALE - FLORIDA

Part-time non-surgical practice for sale Palm Beach County Florida. Established practice (32 years) for sale. Fully-equipped office in area heavily populated with seniors. Storefront location with excellent exposure. Practice includes one nursing home. Great opportunity for expansion. To inquire, please call  561 965-3300

ASSOCIATE POSITION - SOUTH JERSEY

Ethical, highly-motivated, personable, PSR-24/36 trained  ABPS-certified/eligible individual proficient in surgery, biomechanics, palliative care, wound care. Hospital privileges available. EMR , Diag U/S, digital radiology, etc. Benefits include competitive salary, health and malpractice insurance, and seminar allowance. Email CV and three references. Toetrukr@aol.com

OFFICE SPACE/ MRI RENTAL – NYC, LI   
 
Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, Hicksville and/or Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITION/WASHINGTON, DC/SILVER SPRING, MD

Excellent opportunity to join a multi-doctor practice with its own Certified Surgical Center. Practice is full-scope with an emphasis on sports medicine. Competitive salary plus bonus structure. PSR 24+ only. Send CV to hgodpm@verizon.net

PRACTICE FOR SALE - FLORIDA

Who wants to continue making good money in a down economy, and who would like to live in Florida on the coast? I have been working for over 45 years and have had enough. My business grosses over $940,000 dollars a year and my net is over $250,000. I see approximately 40 patients a day in a coastal Florida town and am sitting on a little gem. Office is 2000 sq. ft. Hospital very close with surgical center. Large scope of practice in Florida. Contact me if you are ready to step up. $585,000 dollars. Contact me at: hagen5644@yahoo.com

ASSOCIATE POSITION - NORTHWEST IOWA

Great opportunity for hard-working, ethical podiatrist to join Midwest multi-physician, podiatric group with multiple locations. A well-established, successful, growing practice with strong hospital affiliations seeking FT and PT surgically trained physician. Applicant should be well-trained in all aspects of surgical care, completed a 24-36 month residency, & at least board eligible. Diverse practice offering high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume to: 712-258-9977 

LOCUM TENENS POSITION - FLORIDA

Florida licensed podiatrist needed for an on-going locum tenens position for a large group practice in Central Florida. Payment is $400 per day plus a travel if coming from out of the area. Please email response and resume to gregr@orlandofootandankle.com

SALES REPRESENTATIVES WANTED

SureFit has immediate openings for three sales representatives – one for Midwest, Mid-Atlantic and Southeast territories. Responsibilities include but are not limited to obtaining new business, executing sales strategy, initiating contact with customers, identifying their needs and selling appropriate products to meet those needs. Ideal candidate will be enthusiastic, highly motivated individual with a positive attitude who prefers a team environment. Minimum requirements include Bachelor’s degree, 3+ yrs sales experience, preferably in Podiatry and/or O&P Industries. Position requires up to 70% travel with residency in each territory. Please e-mail resume and references to: James R. Grady, Director of Sales SureFit jgrady@surefitlab.com

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

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 Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

CASE CONSULTING

Dennis Shavelson, DPM is accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds, pigmented & derm lesions, PRP and diagnostic dilemma’s from DPM’S. Full reporting with second opinion only and rapid return after care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

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