The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

June 07, 2010 #3,877 Publisher-Barry Block, DPM, JD

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IA Podiatrist Discusses Shoe and Bunions

Des Moines podiatrist Dr. Colin Pehde wants you to work with your feet, not against them. Sorry ladies, he's mostly talking about bad (read: really cute and probably high-heeled) shoes. Sensible shoes will help you get more mileage from your feet. According to Pehde, the problems of aging feet are all manageable if you're paying attention.

Dr. Colin Pehde

Bunions and hammertoes mean it's time for different shoes. Both these foot deformities usually occur as we age and are often caused by shoes that are too short or too high, which puts excess pressure on the bones in your feet. Pehde says that not all cases require intervention. "You don't necessarily have to treat bunions or hammertoes if you can function normally. Just because you have them, doesn't mean you have to fix them."

Source: Jennifer Miller, Des Moines Register [6/4/10]

NYSPMA Elects New Officers and Trustees

The New York State Podiatric Medical Association has elected the following officers and trustees at its 114th Annual House of Delegates in Cooperstown.

Delegates at the NYSPMA House of Delegates

Elected were:

President: Robin Ross, DPM
President-Elect: Vito Rizzo, DPM
Vice President: Gary Stones, DPM
Treasurer: Robert Russo, DPM
Trustees: Andrew Shapiro, DPM (Re-elected) William Spielfogel, DPM (re-elected), Joseph Sciandra, DPM (returning member), and  Patricia Nicholas, DPM  (newly elected)

Dr. Patricia Nicholas

Mr. Leonard Thaler's contract as executive director was approved.

       NJ Podiatrist speaks at the International Symposium on Dupuytren's Disease
 
Terry L. Spilken, DPM, a podiatrist in Livingston, NJ,  addressed the International Symposium on Dupuytren's Disease on May 23 in Miami, Florida. The goal of the symposium was to spread knowledge of therapeutical options in treating Dupuytren's and Ledderhose diseases.  It was an opportunity to create an academic international task force to develop and carry out large scale collaborative multicenter research and clinical studies for these conditions.

Dr. Terry L. Spilken at the International Symposium on Dupuytren's Disease

Dr. Spilken spoke on the use of cryosurgery for plantar fibromatosis.  He was the first podiatrist to be invited and participate in this international event.

NY Podiatrist Inducted as Honorary Police Surgeon

On Tuesday, June 1, Dr. Rob Conenello, was formally inducted into the ranks of the Honorary Police Surgeon Corps with the New York City Police Department. The ceremony was held at Police Headquarters at One Police Plaza, where Conenello was sworn in by Police Commissioner Raymond W. Kelly.

(L-R) Raymond Kelly and Dr. Rob Conenello

Conenello is the Global Clinical Advisor of Special Olympics, International, and Board Member of the American Academy of Podiatric Sports Medicine.

Don't Mix Singular with Plural

Always match the appropriate pronoun with its noun. Keep in mind that a singular noun must be coupled with a singular pronoun, and a plural noun must be coupled with a plural pronoun. Examples:

Incorrect: When I asked the patient to pay for orthotics, they refused. 

Correct: When I asked the patient to pay for orthotics, he (she) refused.

Correct: When I asked my patients to pay for orthotics, they refused.

Those interested in finding out more about the American Podiatric Medical Writers Association can write to bblock@podiatrym.com

Query: Painful Dermatitis in 17-Year Old
 
A 17-year old male with no other health issues came to see me for skin breakdown on the plantar aspect of both feet and around the heels. He gets fissuring into the sulcus, but not actually between the toes. It is painful and intermittently pruritic. It has been going on for almost one year. No history of change in footgear, change in activity, change in health, hyperhydrosis, or medications. There are no other lesions elsewhere. Before seeing me he has been to his PCP, the emergency department, has been on oral antibiotics and antifungals, topical antibiotics , antifungals, and even Betadine soaks. The only thing that seems to help with the pain and itching is Neosporin. He has not been on topical steroids yet.
 

Painful Dermatitis

I took three 3 mm punch biopsies, and it came back as "Chronic perivascular dermatitis, with psoriasiform change, intra-epidermal bullae, and dense parakeratosis suggestive of viral effect." I asked the pathologist if he could give any additional direction and he added "possible impetigo vs. herpes-type dermatitis vs. drug effect vs. other." I am going to try a course of topical steroids. Any other treatment recommendations?
 
Jared Clifford, DPM, Prosser, WA

RE: Charcot STJ Complete Dislocation (Tip Sullivan, DPM)
From: Tim Vogler, DPM

First: CT scan to evaluate the actual position/fractures of the bones (3D reconstruction is helpful).

Second: Send the patient to an experienced Charcot reconstructive surgeon. Don't try to "get by" with a less than ideal procedure; it will fail every time. There are no short cuts to Charcot reconstructive surgery.

Tim Vogler, DPM, Advance, NC, tav@yadtel.net

If you can heal the wound, a tibiocalcaneal or tibiotalocalcaneal fusion could be accomplished with retrograde intramedullary nailing.  This is an excellent stable construct for such Charcot situations.

Daniel J. Tucker, DPM, Orange, CA, reekat@aol.com

RE: Maceration, Pitting Keratolysis, and Hyperkeratosis (Jacqueline Chen, DPM)
From: Multiple Respondents

I have a patient just like this. What finally gave us the upper hand was coating the bottom of the feet with Aquaphor, then applying Unna boots for a week. Debridement followed. This allowed us to finally gain the upper hand. We had used oral and topical erythromycin as well, but the hypertrophic skin prevented penetration. I would repeat the topical and oral after the debridement.

Juliet Burk, DPM, Stilwell, OK, juliet-burk@cherokee.org

If pitted keratolysis is the correct diagnosis, topical and/or oral erythromycin should work, and Dr. Chen indicates that it did, but returned. Although you certainly have to address the hyperhidrosis issue, I would also consider that the patient may have been colonized SYSTEMICALLY with yeast, and would refer to a primary care physician or gastroenterologist to try to find this out. Also, you should address alternating footwear daily, and the most severe cases may even require bed rest. Systemic anticholinergics prescribed by a neurologist may also be required.

As the diagnosis may not be correct, I would also consider a punch biopsy to make sure that you are not treating the superficial manifestations of a deep underlying dermatitis, perhaps a contact allergy. Lastly, shoe chemical patch testing may be revealing.

Bryan C. Markinson, DPM, NY, NY, bryan.markinson@mountsinai.org

The skin on the bottom of the foot is 10 times thicker than on the top, so it takes longer for the Lamisil to work. Also the skin in chronic cases is thickened. I order appropriate lab work at six weeks, and have rarely had to discontinue Lamisil.

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

RE: Standard of Care for Post-op Cast (Charles Lombardi, DPM)
From: Multiple Respondents

I believe it is very much within the standard of care to apply a full post-op cast following a planned surgery, as long as post-operative edema is planned for and considered, along with cast instructions to the patient. I believe the real issue with any cast application is keeping the cast below the head of the fibula for obvious reasons.  Otherwise, I believe it's surgeon's preference on casting or splinting.

Angelo Bigelli, DPM, North Providence, RI, toedocri@aol.com

When I attended NYCPM, our podiatric surgery "bible" if you will, was McGlamry's Comprehensive Textbook of Podiatric Surgery. If one opens the chapter on peroneal tendon surgery, it states, "after surgery, a below-knee cast is applied, and the patient abstains from weight-bearing for three weeks; weight-bearing is allowed for the next three weeks." While, this is specifically discussing subluxation/dislocations, I think the surgery that Dr. Lombardi performed is well within this category.
 
Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

I assume that Dr. Pressman's question is rhetorical, but let me answer anyway. For Money!  Did you read the whole transcript?  Look how much money this guy makes a year as an "expert."

When I was sued, the so-called expert made several statements that directly contradicted statements he had made in prior cases (in my opinion). My attorney pointed these statements out to him and the jury, and he just ignored them (in my opinion). Both were given under oath.

I contacted the district attorney about filing perjury charges after the case, and presented all the conflicting testimony. I was told that it would be impossible to make a charge like that stick because all the "expert" would need to say is that at the time of the testimony, that was his opinion, but that his opinion has changed since then. Go figure, the law protecting the law. PS, the jury found for me and awarded the plaintiff $0. I guess they saw the truth in the end.

Name Withheld

RE: Big Bother is Too Nosy (Teresa N Tobin, DPM)
From: David E. Gurvis, DPM

Several years ago, I cannot now recall the insurance company, but right under the question of "Have you been charged with any felony" was the following question; "Are you, or have you been, investigated or charged for child molestation?" DUH! comes to mind here. It makes you wonder about the intelligence of the people who come up with these questions, doesn't it. And for the record, although sorely tempted to do otherwise, I did answer "NO."

David E. Gurvis, DPM, Avon, IN deg1@comcast.net

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.

EQUIPMENT FOR SALE – CHAIRS, ETC.

Doctor retiring, office equipment for sale, including patient’s treatment chairs, one chair is one of the first podiatry chairs made ,can be used as a display in waiting room or use in treatment room, all in excellent condition, photos on request. E-mail Robin superrang@bellsouth.net

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

ASSOCIATE POSITIONS – MULTIPLE LOCATIONS

Looking for podiatrists to join group to work in nursing facilities in: Texas (Ft. Worth, Dallas, Houston) Washington, DC, Philadelphia, Northwest Pennsylvania, Delaware, Upstate New York, Massachusetts (Brockton). Please respond to: doconcall02@aol.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

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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