The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

June 06, 2011 #4, 179 Publisher-Barry Block, DPM, JD

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Lawn Mover Accidents to Children's Feet are Preventable: IL Podiatrist

According to the U.S. Consumer Product Safety Commission, in 2007 nearly 210,000 people, including 16,200 children, were injured in lawn mower accidents. Time and again, Dr. Edwin Harris, a Loyola University Health System pediatric podiatrist, has treated children who have lost toes or the front parts of their feet in lawn mower accidents.

Dr. Ed Harris

Cases he has seen include a boy, riding on an adult's lap, who fell off a riding mower and got his foot caught in the blade, and a young boy who jumped off a swing into the path of a lawn mower. “These accidents are devastating but totally preventable,” said Harris. “Kids should never be around a running lawn mower. And children under the age of 16 should not be allowed to operate either a riding lawn mower or walk-behind mower.”

Source: Sandy Smith, EHS Today [6/3/11]

AZ Podiatrist Appointed FIP Diabetic Foot Commission Chair

Dr. David G. Armstrong, Professor of Surgery and Director of the University of Arizona's Southern Arizona Limb Salvage Alliance (SALSA) has been appointed Chairman of the Diabetic Foot Commission of the International Podiatry Federation (FIP). The Federation was founded in 1947 and now includes 31 organizations representing 30 countries spread over six continents, representing tens of thousands of clinicians.

(L-R) Drs. David Armstrong and Joseph Caporusso

FIP Vice President Dr.  Joseph Caporusso of the United States noted, "The formation of our DM Foot Commission provides an outlet for our members and our patients to learn more about this horrific disease and its effects on the feet. Every 20 seconds, someone loses a leg due to diabetes. That figure alone is enough to get us all out of bed every morning to try to do our part to make a positive difference."

Rule Would Allow Access to Medicare Data for Reports on Providers

The CMS has proposed a new rule (PDF) that would allow organizations that meet certain qualifications access to patient-protected Medicare data to produce public reports on physicians, hospitals and other healthcare providers. According to the agency, these reports would combine Medicare claims data with private-sector claims data to identify which physicians and hospitals provide the highest quality, most cost-effective care to patients.

In this initiative, the CMS would provide standardized extracts of Medicare claims data from Parts A, B and D for a fee to qualified entities that have the capacity to process the data accurately and safely. The data could then be used only to evaluate provider and supplier performance and generate public reports detailing those results.

Source: Jessica Zigmond, Modern Healthcare [6/3/11]

Take Advantage of Your Mistakes

Never say “Wow, I really blew that one.” Instead, say “I just learned one way not to …”

Source: Adapted from Close the Deal: Smart Moves for Selling, Sam Deep and Lyle Sussman, Perseus Books via Communication Briefings

Query: MRI Evaluation of Recurrent Soft Tissue Mass

My patient is a 46 yo DM man who has a recurrent soft tissue mass size .8 cm in diameter, medial 1st MTH. The initial mass (3.5 x 2 x .8 cm) was removed one year ago and diagnosed as a ganglion cyst. The wound was completely healed in about one month. The recurrent mass is much firmer upon palpation than a cyst, and appears to be well encapsulated. PMH is significant for HTN, hyperlipdidemia, and multiple back surgeries, including laminectomy, diskectomy, and spinal cord stimulator implantation. The patient states that he could not have MRI because of the spinal cord stimulator implant.  

Is the implant an absolute contraindication for MRI? I don't think there is anything in the firm mass to aspirate. Any suggestions would be appreciated.

Catherine Wu, DPM, Revere, MA

RE: New CMS Ruling Opens Door for Podiatry in Medicaid Battle
From: Lee C. Rogers, DPM

“Medicaid programs may not exclude qualified health care providers from providing services that are funded under the program because of a provider’s scope of practice.” These were the words of CMS Administrator Dr. Donald Berwick in a recent letter to the State of Indiana addressing the state’s law to eliminate funding for Planned Parenthood. This ruling may have opened a door for podiatry associations fighting to keep states from eliminating services rendered by a doctor of podiatric medicine.

Foot-related services such as foot or ankle surgery, trauma care, and diabetic foot care are covered services under Medicaid, but 10 states do not reimburse podiatrists for providing these services. Directly applied, the Berwick letter would not allow states to discriminate against podiatrists providing services that would otherwise be covered by another physician based on the scope of practice of the provider.

In reality, these discriminatory policies do not...

Editor's Note: Dr. Rogers' extended-length letter can be read here.

RE: Touch Screen Notebook (Laura R Lefkowitz, DPM)
From: Marv Boren, DPM
 
I have been using tablets (Acer and Lenovo) for 6 years and feel that one of their best features is  handwriting recognition. This feature allows you to scribble an entry with a stylus and then convert your entry to typewritten form. Having trained many podiatrists in EMR using a tablet, I have found that the handwriting recognition accuracy varies among the different tablet models. The less accurate your tablet's handwriting recognition, the more the editing required. Of course with the right EMR, you should have very little typing. Nonetheless, on a typical note, I might add a few words in the subjective findings. Writing it in rather than typing it is much faster for me. Of all the tablets that I have tried, Motion Computing by far has the best handwriting recognition.

Additionally,  I would recommend a 12" screen. It's easier on your eyes and you'll have less scrolling. If you are going to carry the tablet from room to room,  most people find anything under 4lbs is manageable.
 
Marv Boren, DPM, Canton, OH drboren@smartdrs.com

RE: Surviving a Malpractice Lawsuit (Name Withheld)
From: Elliot Udell, DPM

Being sued is a painful situation irrespective of whether the merits of the case are on your side or not. It's a lengthy process with many unknowns all along the way. I don't know anyone who would feel otherwise unless that person either has many lawsuits against him or lacks the ability to experience emotions. One thing that can really help is talking to friends and colleagues about it who are not involved in the case and who you can trust to keep whatever you say in complete confidence. To this end, I am volunteering to help.

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

RE: LA Podiatrist Testifies Before Congressional Committee on Health IT
From: Michael L. Brody, DPM

Dr. Elliott emphasized that “... requiring eligible providers to implement electronic health records for Medicare in a meaningful way over the next five years places an undue financial burden on the majority of podiatrists who are small business owners..."

It is good to see that the APMA is representing its members and testifying before Congress on important matters such as Health Information Technology. Kudos to Dr. Elliott, Dr. Christina, and other members of the APMA staff for seizing on this opportunity to have our voice heard.

Unfortunately, I must strongly disagree with...

Editor's note; Dr. Brody's extended-length letter can be read here.

RE: Reflexology Massage Can be a Good Thing: FL Podiatrist (Michael Lawrence, DPM)
From: Charles Morelli DPM
 
Dr. Lawrence actually spent a "good deal of energy" over 30 years trying to debunk reflexology. He has far too much free time. For the past 15 years, I have been sending patients to my local reflexologist whenever I have a patient who has a condition where deep massage may help (heel pain, fasciitis, tendonitis, etc.), and s/he has not responded to traditional modalities. This is nothing more that a form of physical therapy. Has Dr. Lawrence spent 30 years trying to debunk that too?   

Do I believe that if a foot is rubbed in just the right spot, that a patent's liver will start to function better, or their pancreas will be able to secret more insulin, or you will cure their allergies?  Frankly, no. But do people feel better after having their feet rubbed for 90 minutes with warm oils? Almost every time.
 
Charles Morelli DPM, Mamaroneck, NY, podiodoc@gmail.com

RE: Heimlich Maneuver Complication

A 78 year old female presented to my office last week with a chief complaint of right 5th toe pain. She stated that she had trouble in shoes and pain when walking. When I asked if she hit or injured the toe, she replied that three weeks ago she was at a dinner with her family and began to choke. Her son-in-law, a medical doctor, performed the Heimlich maneuver on her, saving her life  In the process, he broke a few of her ribs, and apparently broke her 5th toe. She states that she must have hit her toe against the table or chair while her son-in-law was saving her life.

John Brummer, DPM, NY, NY

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 - NORTH DALLAS, TX

PRACTICE FOR SALE - HOUSTON, TEXAS

28 year old busy, progressive practice for sale with an excellent reputation and well established referral base. Well trained, dedicated, supportive staff. Excellent cash flow $475K income after overhead. EMR, digital x-ray, diagnostic ultrasound. Free standing building also available with large outdoor sign. Owner retiring and willing to stay part time during transition. softechpodiatrist@gmail.com

PRACTICE FOR SALE - NORTHERN NJ

Well established, part-time practice is for sale in Northern NJ. Digital X-rays, EMR, located in a medical condo building. Surgery 35%, Routine 30%, Average Gross is 130K on 2 half days per week. Practice is expandable to full time with increasing hours and marketing. Real estate available for purchase. Financing available. Please call 800-983-4194, or email contactus@podiatrypracticeconsultants.com

PRACTICE FOR SALE - BROOKLYN, NY

A large, busy practice is for sale in Brooklyn, NY. This practice has been in the same location for over 50 years. Average 150 pts/week, average gross 730K, most surgery is currently being referred out. Financing available. Please call 800-983-4194, or email contactus@podiatrypracticeconsultants.com

ASSOCIATE POSITION - ILLINOIS PERMANENT P/T

Podiatrist needed for Medinah Spine/Rehab/Podiatry. Upper middle class suburb multi-disciplinary established office seeks perm P/T podiatrist to service established podiatry practice. Please call SueL 630-529-0077 or fax resume to: 630-529-0087.

ASSOCIATE POSITION - SOUTHERN NEW JERSEY

Seeking personable, ethical, motivated individual for a growing, well-rounded practice with potential for partnership. Must be PSR 24-36 trained. Competitive salary, incentive and benefits. Email CV to orin915@comcast.net

ASSOCIATE POSITIONS - NEW JERSEY

Podiatrists wanted to work multiple nursing homes in New Jersey. Must have a N.J. license. Please contact 44footcare@gmail.com

ASSOCIATE - POSITION - SOUTHEAST GEORGIA & SOUTH CAROLINA

Seeking recent residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facility. E-mail to melissafoot@pol.net

ASSOCIATE POSITION - WA (KIRKLAND, SEATTLE, EVERETT, AND REDMOND)

Join one of the fastest growing podiatry practices in Washington state. Must be motivated to grow practice. Competitive salary and benefits. For more information go to seattlefootdoctor.com. Send resume to seattlefootdoctor@yahoo.com

ASSOCIATE POSITION - CANADA

Beautiful Victoria, B.C. Canada on the ocean, fast growing area. Associate for multi-office full scope practice. Reply to dr.cole@shaw.ca

ASSOCIATE POSITION - SOUTHERN MI (NOT DETROIT AREA)

Leading to partnership for rapidly growing 3-physician group practice. Must be residency trained and willing to learn and follow our very successful business model. Salary plus incentive. If you're unhappy with where you're at now this may be the answer! If, interested send CV to: paulapmac@me.com

ASSOCIATE POSITION - NEW YORK CITY & QUEENS

One of the fastest growing podiatry practices in New York City and Queens seeks a podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Preferably a Spanish speaking podiatrist. Contact me at Podocare@aol.com

ASSOCIATE POSITION - NORTHWEST FLORIDA BEACHES

Excellent opportunity for an energetic, compassionate, hardworking individual with superior surgical and medical proficiency. Recent graduate or experienced practitioner. Excellent salary, benefits and partner-buy in offered, full admit privileges and surgical scope. Fax CV to Ecpodiatry@aol.com

ASSOCIATE POSITION - NY

Opportunity of a Lifetime. Are you the one-in-a-million podiatrist I’m searching for? Do you aspire to greatness? If you have a great smile, great attitude, take initiative, then you should consider this exceptional opportunity. I am seeking a smart, residency-trained podiatrist with great surgical skills to become an associate in one of the top practices in the country. Don’t miss out on this outstanding opportunity! Please email your CV to institutebeaute@aol.com with “Attn: Sophia Johnson” in the subject line.

ASSOCIATE POSITION- NEVADA

Well established 22-year practice in Las Vegas/Henderson, Nevada seeking full-time associate. General podiatric care with moderate amount of surgery to be done in local hospital or surgery center. Competitive salary and benefits. Modern office in new area. Please respond by email to lvfootandankle@gmail.com

ASSOCIATE POSITION – NEW YORK

Great opportunity to share “state-of-the-art” offices and equipment in mid-town Manhattan and White Plains with Board Certified podiatrist. Out-of-network or participating providers welcome. Please call 212-704-4310 for additional information and fax your CV to 212-704-4311

ASSOCIATE POSITION - CENTRAL NORTH CAROLINA

Well-established, busy podiatric practice is seeking highly motivated, well-trained and personable associate for full-time position. Competitive Salary and Benefits, Buy-in Opportunity. Interested persons must be actively pursuing or have NC license. Send resume and letter of intent to gpagpa530@yahoo.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Southern California practice looking for highly motivated podiatrist for very busy, two location practice. Excellent salary and benefits offered. Please email resume to mrsmcmackin@aol.com

ASSOCIATE POSITIONS - NW INDIANA, CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.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. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

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