The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

June 09, 2011 #4,182 Publisher-Barry Block, DPM, JD

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Final Reminder - PM News will be taking an early-summer break and will not be publishing from June 8 - 16.

Minimalist Shoes Change Gait: CA Podiatrist

Dr. John Pagliano, a runner, podiatrist, and clinical professor at the Long Beach Memorial Medical Center Podiatric Surgery program in California, says the design of the minimalist shoes changes a runner's gait. "The idea is that you run more forward on your foot, rather than back on your heel," he says. This prompts you to take shorter, more frequent strides and to land more softly than with conventional running shoes. 

Dr. John Pagliano

Whether that prevents injury or makes you faster is debatable. "There is no specific evidence that runners [using minimalist shoes] have fewer foot injuries or ankle sprains," he says. However, "there are some studies that show that barefoot conditions increased muscle strength," Dr. Pagliano adds.

Source: Jen Murphy, Wall Street Journal [6/6/11]

State Health Commissioner and APMA Exec Director Receive Honors at NYCPM Commencement 

Nirav R. Shah, MD, MPH, the New York State Commissioner of Health, delivered the keynote address to the Centennial graduating class of the New York College of Podiatric Medicine (NYCPM) and received the honorary degree of Doctor of Humane Letters-Honoris Causa, during the College’s Centennial Commencement Ceremony at Lincoln Center’s Alice Tully Hall in New York City on Thursday, May 26th. Dr. Shah addressed the 75 graduating seniors—who received their Doctor of Podiatric Medicine degrees—and an audience of nearly 1,000 faculty members, parents, family, and friends.  

(L-R) Drs. Nirav Shah and Glenn Gastwirth

In addition, Glenn B. Gastwirth, DPM, Executive Director & CEO of the American Podiatric Medical Association (APMA), and a magna cum laude graduate and valedictorian of the NYCPM Class of 1974, was awarded the College’s honorary doctorate. Michael J. King, DPM, President of the APMA, also delivered brief remarks.

OCPM Graduates 104 DPMs and Honors State Treasurer

On May 20, 2011 at the Palace Theatre in downtown Cleveland, Ohio, the Ohio College of Podiatric Medicine (OCPM) graduated 104 students and welcomed them into the podiatric profession. The Commencement ceremony featured the presentation of the Honorary Doctor of Humane Letters degree, which was awarded to State Treasurer Josh Mandel. 

OH Treasurer Josh Mandel

OCPM also honored the reunion alumni classes of 1961 (50 years), 1971 (40 years), 1986 (25 years), and 1995 (15 years) as part of the commencement program.

Source: OCPM Footsteps (May 2011]

“The Price Is Right” for WesternU Student

College of Podiatric Medicine student Pamela Hong, 24, won more than $50,000 in prizes on “The Price is Right” episode that aired on Thursday, June 2, 2011. Hong appeared in the audience along with several yellow-T-shirt-clad members of the College of Podiatric Medicine’s Class of 2014, who are almost finished with their first year of school. She was told to “Come on down!” and successfully bid on an iPhone 4, sending her onstage with host Drew Carey. 

(L-R) Patricia Hong with Drew Carey on "The Price is Right"

Hong went on to successfully play the “One Away” game, winning a 2012 Honda Accord, then won her round of the “big wheel” spin, and was one of two contestants in the concluding showcase. Her winning showcase bid of $27,000 --- just $565 lower than “the actual retail price” of her showcase – earned her Swiss Army watches, a trip to New York City, and a 2012 Ford Mustang.

MO Podiatrist Wins Amateur Golf Tournament

The ninth annual Mesquite Amateur had everything from non-stop activities to an increased field and a glorious day for the championship round played June 3 at the CasaBlanca Golf Club. Jeff Miller, a 56-year old podiatrist from St. Louis, MO, recorded a gross 79 net 59 score to win the overall Mesquite Amateur Championship. 

St. Louis podiatrist Jeff Miller, left, is congratulated by Black Gaming Sporting Events Manager Christian Adderson

"This is the first time that I have been to Mesquite, and never in 1,000 years would I have guessed that I would win this," he said. "The courses I played (Falcon Ridge, Coyote Springs and CasaBlanca) were fantastic, and we could not have asked for better weather. This is a very humbling experience."

Source: San Francisco Chronicle [6/7/11]

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Renee Hamel: I am a second year student at OCPM. How do you get patients to really embrace the severity of their critical limb ischemia? 

Dr. Craig Walker

Craig Walker, MD: The statistics on this are very interesting. If one has an ankle brachial index of 0.8 or less, which is not such a low ankle brachial index, this is just simply a claudication and not critical ischemic. That person has a worse five-year prognosis than a patient with a new diagnosis of Hodgkin’s disease or a new diagnosis of breast cancer. If your ankle brachial index is 0.4 or less, your prognosis over five years is as bad as lung cancer. So these are messages that we have not gotten out. I think it is very important to understand that we are talking about life expectancy and not limb expectancy. 

Dr. Richard Bouche`

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). The next segment will feature sports medicine expert Dr. Richard Bouche . You can register for this event by clicking here

RE: Botox for Dorsal Contracture of the MPJ (Brian Kiel, DPM)
From: Bret Ribotsky, DPM

I learned this technique from Allen Jacobs. Use 50-100 units of Botox on the motor point of the muscle that you are attempting to paralyze. If it is a large muscle (such as the hamstrings in patients who are contracted), 200-300 units are needed. It can take up to five days for the results to take effect. I find it lasts about four months. I use it often in the gastroc for patients who are toe-walkers (kids) and for those who need a TAL who have a forefoot ulcer.

Bret Ribotsky, DPM, Boca Raton, FL, ribotsky@yahoo.com

RE: MRI Evaluation of Recurrent Soft Tissue Mass (Peter Bregman, DPM)
From: Multiple Respondents

I suggest aspirating with an 18 gauge needle. If no exudate is retrieved, then at least you might recover some cells. The retrieving of the cells in the needle is accomplished by flushing the needle into a formalin biopsy jar; then sending it to pathology. You might not be able to see any cells but pathology can. 

Jay Helman, DPM, Footdr80@hotmail.com

I would  go directly to needle aspiration. If you succeed in removing fluid fine, if not, send the needle that punctured the mass directly to your podiatric dermatopathology lab. Call the lab first to get instructions on how to ship the specimen and what fluids to use. A good lab can identify the existence of cancer cells even from tissue at the end of the needle.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

Instead of aspiration of the soft tissue mass, I recommend a punch biopsy of the lesion. I would take two 2mm punches spaced out on different parts of the lesion.

Jeffrey Kass, DPM, Forest Hills, NY, Jeff Kass@aol.com

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

I would like to compliment Dr. Rogers on bringing up this ruling by Donald Berwick from CMS. Although related to a dispute for Planned Parenthood in Indiana, Mr. Berwick made a very significant statement: “Medicaid programs may not exclude qualified healthcare providers from delivering services that are funded under the program because of a provider’s scope of practice.” Classically, it had been my understanding that many of the "Title XIX" battles were based on having podiatrists defined as a physician (vs. allied health practitioner, etc.) in each state.

After some searching, I found the full Title XIX of the Social Security Act on a website (ssa.gov) and have provided some info. from it below. Of note is the LACK of wording specifying "physician."

Although I do consider myself a physician, and...

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

RE: Helping Colleagues When Diaster Strikes
From: Michael Lawrence, DPM

Last month, our area incurred a great deal of destruction, death, and injuries due to multiple tornadoes, including an F5. As far as I know, none of our colleagues were affected. There was a chiropractor whose office was totally destroyed. He stated in the media how grateful he is for all the help that has come from his colleagues, local and throughout the country, who have sent donations of equipment and supplies to get him back up and running.

Though our experience in the Chattanooga area was tragic, it was nothing compared to others, especially in Tuscaloosa, AL and Joplin, MO. It would be nothing short of a miracle if DPMs in those cities came out unscathed. I have heard nothing about how our colleagues fared and would be interested to know. I also hope that we, as a profession, would respond as well or better than the chiropractors in such events.

Michael Lawrence, DPM, Chattanooga, TN, ftdoc@joimail.com

RE: Vito Rizzo, DPM Elected President of NYSPMA
From: Sloan Gordon, DPM

I wish to offer a heartfelt congratulations to Dr. Rizzo, whom I am proud to call my classmate (Class of '82 NYCPM). Vito was always a staunch supporter of our class and a superstar, even when we were 'kids'. I'm so pleased to see him achieve this important position. I wish him only the best, and I am certain he will do an amazing job, as he has done for almost 30 years! Congratulations Vito.

Sloan Gordon, DPM, Houston, TX,  sgordondoc@sbcglobal.net

RE: LA Podiatrist Testifies Before Congressional Committee on Health IT (David Gurvis, DPM)                                                          
From: Marc Mauss

I am not a podiatrist, but I often read my wife's copy of PM News.  I am a physicist and a computer scientist, and over the years, I've been cited as, among other things, an expert in office automation. Although I no longer am involved in that particular aspect of office automation, I was, at one time, the regional distributor for medical records software.

I must point out that Dr. Gurvis ignores certain obvious facts in his letter. He talks about "a decrease in care while the physician spends more time looking at his computer than the patient."  While it is true that a practitioner can spend more time with his computer than he currently does on hard-copy records, there is no need for him to do so. After a brief learning period, entering data into the computer takes less time than manually writing the same records. Retrieval of information is far quicker on-screen than manually searching a file cabinet for the chart (which, of course, could never be mis-filed).

He talks about having to print records when referring a patient. That is certainly quicker and easier than photocopying records to be sent. He is right about one thing, though: EHR are no more accurate than the data input, just like with paper records. The use of EHR, if properly implemented in an office, should allow the practitioner more time to spend with patients.

I must agree with Dr. Gurvis's dislike of bureaucracy, and having a government bureaucrat second-guessing one's decisions is to be abhorred.  But mandating electronic records is a far cry from controlling your practice.

Marc Mauss, Coram, NY, marc@shadowriders.org

PRACTICE FOR SALE - WASHINGTON STATE - SUBURBAN SEATTLE

16 year established part time practice. Includes Midmark 417 (4 position keypad), Excel X-ray, processor, Ritter M9, instruments, bandaids, etc. 1 Day/week $50K gross. Professional Business appraisal at $48K. Asking $35K. Shared office with 2 FP's. Easily expandable. Reply: practiceforsale18@yahoo.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 - SOUTHEAST GEORGIA

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 - 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 - NYC

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 - 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 - 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 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

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
 

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 

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