The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

June 10, 2010 #3,880 Publisher-Barry Block, DPM, JD

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                               Wear Flip-Flops Sparingly: CA Podiatrist                                           

The only way to get off on the right foot this summer is to wear flip-flops sparingly. According to Dr. Carolyn McAloon of the American Podiatric Medical Association, flip-flops should be worn “in moderation” in the summertime, not as everyday footwear. The foot doc says flimsy flip-flops don’t offer nearly enough arch support and can cause severe heel pain if overused.

Dr. Carolyn McAloon

Because the foot is entirely exposed, Dr. McAloon has also seen patients with major “foot trauma,” including a man who lost his big toe mowing the lawn in flip-flops. Ultimately, she believes it’s best to leave flip-flops for the beach or pool. The podiatrist also advises kicking the gladiator sandal trend since the popular styles boast very thin soles offering little support.

Source: Flashnews [6/8/10]

OCPM Provides Foot Aid Stations at 2010 Rite Aid Cleveland Marathon

Kathy J. Siesel, DPM, Chair of the Biomechanics Department coordinated a volunteer foot aid station for runners at the Rite Aid Cleveland Marathon, Half Marathon, and 10K. The event had an international field again this year with a record number of runners and walkers, totaling over 15,600. The OCPM Foot Aid Station was stationed on Mall C near the finish line. Dr. Siesel was joined by fellow faculty member Abe Osbourne, DPM of the OCPM Podiatric Medicine Department, and by 17 students currently enrolled at the Ohio College of Podiatric Medicine.

OCPM Faculty and Students at the 2010 Cleveland Marathon

The students participated in the evaluation, treatment, and basic charting for the runners who sought assistance. The station provided assistance to 87 participants. The conditions treated after the race included blisters, plantar fasciitis, peroneal tendinitis, extensor tendinitis, and generally sore feet. Numerous people were referred to the Cleveland Foot and Ankle Institute (OCPM’s clinical teaching facilities) for further treatment. Others were given referrals to podiatrists in their areas.

Fitness Shoes Require Flexibility or Stretching: TX Podiatrist

With the promise of quick results compounded by each step one takes, it's no surprise that toning shoes, or fitness footwear, have monopolized the retail market. But do they work?

Dr. Jeffrey Ross

“They work, but what you have to remember, because they have a rocker bottom and negative heal, if you have a tight heel cord or Achilles tendon, it can put tremendous strain on muscles,” says Texas podiatrist Dr. Jeffrey Ross in an article on MSNBC.com. “You have to be really flexible, or do stretching, when you wear these types of shoes.” 
 
Source: Sarah Carlson, Times Daily [6/8/10]

CMS Answers Questions About ICD-10

CMS has posted 11 new frequently asked questions about the implementation of ICD-10 diagnosis codes, which will revolutionize the reporting of diagnoses and procedures. “What should coders be doing now to prepare for implementation of ICD-10?” one FAQ asks. CMS says coders should learn about the structure, organization, and unique features of ICD-10-CM and ICD-10-PCS; plan to provide intensive coder training about six to nine months prior to implementation; do assessments to identify strengths and weaknesses in biomedical sciences; and refresh knowledge of biomedical concepts based on the assessment results.

To read more, visit www.cms.gov/ICD10/, click on “Medicare Fee-for-Service Provider Resources,” and click on “ICD-10-FAQs” under the “Related Links Inside CMS” section.

Source: Report On Medicare Compliance [6/7/10]

Diagnose and Fix Out-of-Control Goals

Setting employees’ goals may be your most important job, but getting goals just right is a tall order. If you make goals too challenging, employees will feel frustrated and may cut corners; make them too easy and employees’ productivity and motivation may plummet. Answer the following questions to perform a quick goals checkup:

• Are your goals too specific? Give your team as much latitude as you can. If you tell employees exactly what to do and how to do it, you hinder their creativity and engagement. Explain the components needed for success, including time lines, quantity and quality, and then turn them loose.
• Are they too challenging? Provide training to improve skills, suggest outside experts who can offer advice, and avoid harsh consequences for failing to hit targets.
• Is the time-line appropriate? Teams need a mix of long-term goals to promote forward thinking and short-term goals to provide a sense of progress and accomplishment that keeps morale high.

  Source: Adapted from “Manager’s Guide: 8 Tips for Setting Realistic Goals for Employees,” Business Management Daily via Communication Briefings

Query: Sleep Apnea, Restless Leg, and LE Pain

I have a patient whom I have been treating off and on for the better part of a year for generalized discomfort in both lower legs and feet (soreness in the anterior group, some heel and arch pain, etc.) Treatment consisted of inserts, NSAIDs, rest, change in footgear. He recently completed a sleep apnea study where the doctor in charge noticed that he had significant leg movement while trying to sleep. 

When the study was completed and my patient started on the C-Pap machine, his restless legs stopped and his daily leg pain diminished to the point that he has only mild discomfort at the end of the day. The doctor theorized that the leg movement was an attempt to get more oxygen to the legs, and when this was done, the increased oxygen via C-Pap allowed the legs to rest, and therefore ended the discomfort.  Has anyone else heard of this?
 
Pete Smith, DPM, Lancaster, PA

Query: Central Vacuum System

Is anyone using a central vacuum system for nail debridements? What are the pro's and con's of a central vacuum system, and where can I find information on the systems?
 
Bryan C. Satterwhite DPM, Southport, NC

RE: Golf Shoes for Hallux Limitius (Joe Boylan, DPM)
From: Multiple Respondents

For a right handed golfer, a right hallux limitus is much more difficult to deal with than one on the left foot. Proper weight shift requires the digits to dorsiflex during the golf swing. What is important here is the relationship of the proximal hallux phalanx to the first metatarsal. If the phalanges dorsiflex, then the first metatarsal in relation to the toe plantarflexes. 

I have never found a golf shoe that worked well for this condition. Rather, we use a thin graphite device with an extension under the first metatarsal-phalangeal joint. This causes the entire foot to plantarflex rather than just the first metatarsal. The left foot stays firmly on the ground. 

Michael Forman, DPM, Cleveland, OH, IM4MAN@aol.com

I suggest a classic/traditional leather sole golf shoe which offers a more rigid shank for the golfer with hallux limitus. Check out the Ecco Classic golf shoe. I suspect that Footjoy, Nike, Adidas, and others have an equivalent model. Patients should consult with their local pro or go to a specialty golf store.

Robert Chelin, DPM, Toronto, CA, ft-biz@rogers.com

Most golf shoes have a rigid shank. Advise your patient to look for a shoe with a nylon outsole and perform the torsion test by holding the shoe at the toe and heel in both hands and twisting in opposite directions. ECCO has a particularly thick removable footbed that, when removed, should accommodate most orthotics. Try the addition of a Cluffy Wedge to help hallux limitus.

Mel Cheskin, MBS, C.Ped, Boca Raton, FL, Melcheskin@aol.com

RE: Capturing Additional Income From Non-Covered Services (Bret Ribotsky, DPM)
From: Jeffrey Kass, DPM

Dr. Ribotsky remarks that "he feels the pain daily." I assume this to mean lowered fees, less covered, more bundled services. While, I applaud those who are keen and are able to expand their practices with means to increase their revenue, I encourage them not to allow themselves to be overcome by insurance companies.

How absurd is it that a strapping is bundled with an injection? That a podiatrist is only allowed a level 2 visit but a dermatologist can bill for level 3? These are just mere examples of the myriad of injustices carried out by "Big Insurance" - simply because they can.  I think they can because we let them. Dr. Ribotsky you are not the only one who feels the pain - but how much pain do we collectively want to take? This is a forum where we have an opportunity to discuss solving the pain Dr. Ribotsky speaks of. While he specifically requests "revenue increasing pearls", I request ways of practicing old school podiatry but getting reimbursed for what is done. We don't deserve to be shortchanged.
 
Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

RE: Scholl College Dean Receives Honorary Degree
From: David G. Armstrong, DPM, MD, PhD

I was so thrilled to see Dean Albright and Dean-elect Parsley up with President Welch and Nobel laureate Professor Prusiner. I thought it rather apt that Dr. Albright should be standing there because it is precisely because of him that someone in our profession is standing there. Dean Albright is our "Toebel" laureate.

David G. Armstrong, DPM, MD, PhD, Tucson, AZ, armstrong@usa.net

ASSOCIATE POSITION IN NORTH BROOKLYN, NY 
 
Well-established practice in a multispecialty medical center seeking a self-motivated individual with initiative and leadership skills for a full-time position. Spanish speaking ability a plus. Compensation possibly in six figures with partnership opportunity. Contact/Send resume to: bklypodiatry@aol.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

EQUIPMENT WANTED – CR SCANNER

Reina 812 Manual CR Scanner in good condition. Contact: pmh@wffeet.com

PODIATRISTS NEEDED NATIONWIDE

Seeking a part-time or full-time podiatrists to provide podiatry house call and diabetic shoe fitting services to patients nationwide. We are a podiatry management company and have contracts with clients that have 1,000’s of established patients and all we need are hard-working good doctors to service them. We offer an excellent compensation package with benefits and the opportunity to build a fairly large practice very quickly. coasttocoastpodiatry@yahoo.com

ASSOCIATE POSITION – HOUSTON, TEXAS

Full-time, surgically-trained podiatrist needed for multi-office practice in Houston, TX. Ideal candidate must be motivated, dedicated and personable. Practice is a good mix of general podiatry and surgery, no nursing facilities. Must also be willing to do significant networking and marketing to help build the practice. Please e-mail cover letter, and resume to faajobs@gmail.com

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

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 – 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

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.

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

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 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

PM News Classified Ads Reach over 12,000 DPM's and Students

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