The Voice of Podiatrists

Serving Over 10,900 Podiatrists Daily

June 12, 2008 #3,270 Editor-Barry Block, DPM, JD

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Summer Foot Care Means Treating Feet Like Hands: NH Podiatrist

Podiatrist Ilana Itenberg wishes everyone would dry between their toes. Wear sunscreen on the bottoms of their feet. And bring their own instruments to every pedicure. "People need to treat their feet as well as they do their face or their hands," said Itenberg, with Foundation Foot & Ankle Medicine and Surgery.

Dr. Ilana Itenberg

Thing is, we don't. And woe to the beleaguered foot, which bears the brunt of our summertime shenanigans. By far the most common malady, said Itenberg, is heel pain ignited by the transition from high heels to flip-flops, strappy sandals or ballet flats, a change that can spur inflammation in the Achilles tendon.

And sunscreen is an absolute must, on the tops and bottoms of feet, as well as between the toes and on any surgical scars to protect delicate, immature skin. "There are rare and quite aggressive melanomas on the feet, as well as between the toes," said Itenberg, noting that the dark-skinned suffer disproportionately from skin cancers on the foot. "You can have it on the tips of the toes, in between the toes. And even if you're walking from the parking lot to your office in sandals, you could develop a problem. You're still exposed."

Source: Christine Phelan, Sentinel and Enterprise [6/9/08]

Armstrong is First Podiatrist to Receive RFU's Top Research Award

David G. Armstrong, DPM, PhD, Professor of Surgery and Director of the Dr. William M. Scholl's Center for Lower Extremity Ambulatory Research at Rosalind Franklin University of Medicine and Science and the North Chicago VA Medical Center, was honored last week with the Morris L. Parker, MD, Research Award. The award, Rosalind Franklin University's top research honor, is a long-term achievement award given to the faculty member who has demonstrated national and international leadership in his or her chosen field through advances in science.

Dr. David G. Armstrong

"This award is a testament to both this University in general, and to podiatry specifically," said Dr. Armstrong, "While it is awarded to a single clinician-scientist, I believe it should be shared across the Scholl College, particularly to Dean Terence Albright, DPM, and to Rosalind Franklin University President and CEO K. Michael Welch, MB, ChB, FRCP, as well as Chief of Podiatry at the North Chicago VA Medical Center, William Chagares, DPM.”

Armstrong has published more than 240 manuscripts and more than two dozen book chapters or books. In 2005, he became the first podiatrist at Rosalind Franklin University to be awarded another top honor, the Lawrence Medoff Award for Teaching and Research.

Ranks of Underinsured on the Increase, Study Finds

The number of underinsured adults nationwide rose by 60% over the past four years, to 25.2 million people from 16 million, a trend that healthcare researchers called “startling.” Middle-income families were hit especially hard, according to the study by the Commonwealth Fund and published online by Health Affairs. From 2003 to 2007, underinsured rates tripled among families with annual incomes of $40,000 or higher. The underinsured were defined as those who were insured all year but spent 10% or more of income on medical expenses, or 5% of total income for those with incomes under 200% of the federal poverty level. Adults with deductibles equal to 5% or more of household annual income were also included.

With premiums, copayments and other out-of-pocket healthcare costs rising, the underinsured were more likely to go without needed care, even if they had a chronic condition, the telephone survey of 3,501 adults found. “The underinsured look a lot like the uninsured,” said Cathy Schoen, senior vice president of the Commonwealth Fund and lead author of the study.

The rise in the number of underinsured is largely because of employers—especially smaller businesses—shifting more healthcare costs to workers, and because of eroding coverage on the individual market, the authors said.

Source: Rebecca Vesely, Modern Healthcare [6/10/08]

Let Employees Evaluate Themselves

Before conducting your next employee performance reviews, ask your employees to fill out self-appraisal forms. Putting their strengths and weaknesses, successes and failures in writing will give them a more realistic view of their performance.

Bonus: This will give you a better insight into the employees' perspective.

Source: Lisa A. Beach via Communications Briefings

Query: MTBC Billing

I am wondering if anyone on this list has experience with MTBC billing. If so, what can you tell me are its strengths and weaknesses.

Juliet Burk, DPM, Tahlequah, OK

RE: Dry Socket (Melinda Hefti, DPM)
From: Robert Fridman, DPM, Simon Young, DPM

I have not had any cases of "dry socket", but you may be able to extrapolate a treatment option from early hallux rigidus. I have had success, as have others, in treating 1st MTPJ arthrosis with off-label hyalouronic acid injections, such as Supartz. I suggest doing a local field block prior to injecting the Supartz because you want to really distract the joint and make sure that you are injecting intra-articularly. I use 1.25 to 1.5cc of Supartz, which can help alleviate pain for 7-9 weeks. Additionally, I have found that after 4-5 injections, the period between injections may be lengthened to 10-12 weeks.

Robert Fridman, DPM, New York, NY, RFridmanDPM@aol.com

Before Dr. Hefti proceeds any further, she should get bloods, i.e., RA and an MRI. What about the sesamoids? Tailor your treatment based on these outcomes and report back.

Simon Young, DPM, NYC, NY, simonyoung@juno.com

RE: Surgical Excision of Lipomas
From: Allen Mark Jacobs, DPM, Ivar E. Roth DPM, MPH

Although uncommonly painful, juxtamalleolar lipomas are of cosmetic concern to some. Liposuction techniques or the injection of fat dissoluting agents may be utilized with success.

Allen Mark Jacobs, DPM, St. Louis, MO, Allenthepod@sbcglobal.net

I have been removing these ugly bags in the front and rear of the ankle for years. I have never once had any problems with this procedure, just happy patients who got rid of their unsightly Cankels. It looks to me that those weighing in on the subject do not have any actual experience in doing this procedure. This is another example of a Dr's tale that can be put to rest.

Ivar E. Roth DPM, MPH, Newport Beach, CA, ifabs@earthlink.net

RE: Synthes Electric Pen Drive System (Greg Caringi, DPM)
From: Ira Weiner, DPM

Last year, our hospital needed to purchase a new system as well. I tried several systems and it the general opinion of both the podiatrists and orthopedists that there were two standouts: The Stryker Core, and the Osteomed Osteopower.

Ultimately, we went with the Stryker Core system since Stryker is on contract with the hospital and they were able to get a better price on the unit(s). Stryker does have an interesting new saw called the Sabo, which is smaller and lighter than the older 4100 and 4102 for bigger osteotomies. We have not purchased one of those yet as we have no need to replace our others.

Ira Weiner, DPM, Las Vegas, NV, vegasfootdoc2005@yahoo.com

RE: Ethics Courses in Podiatry Schools (Richard Boone, Sr, Esq.
From: Edward R. Nieuwenhuis Sr., DPM, Chet Evans, DPM

When we paint with a wide brush, we cover large areas, but usually not very evenly. The comment that most podiatrists no longer hold to the ethics which were taught in school is a slight and tarnish on all those who conduct themselves ethically in life and practice.

Having been a member of ethics committees during my 44 years of practice, I am not naive to the fact that there are those who violate ethical principles in our profession. They should be admonished and punished if it is deemed appropriate. I hardly believe, which is confirmed by reading my local newspaper, that podiatry has the local market to itself when unethical practices are exposed.

I enjoy and appreciate Mr. Boone's comments, and feel they are a valuable tool in evaluating ourselves. I hope that he is always factual in what he brings to the foreground.

Edward R. Nieuwenhuis Sr., DPM, Wycoff, NJ, EDFEET@AOL.COM

Barry University was founded as a Catholic independent college, now a Catholic comprehensive university, with a strong mission focused vision and orientation. Ethics, whether from the theological focus or philosophical focus, is the foundation of the educational endeavor here at Barry. Every course MUST have an identified ethics component, whether in the School of Podiatric Medicine or yes, even in our School of Law.

In addition, the podiatric medical students receive a specific course in biomedical ethics, and a significant portion of their courses in the Intro/art of doctoring, medical psychiatry, practice management, community and minority medicine, and risk management are devoted to the comprehensive ethical aspects of those content areas.

I hope this information has helped to "reduce" the deafening silence Mr. Boone was referring to.

Chet Evans, MS, DPM, Dean, Barry University School of Podiatric Medicine, RWBoone@aol.com

ASSOCIATE POSITION – LONG ISLAND

Busy Wantagh, NY office. Motivated, preferably board certified, hard working, experienced in all phases of Podiatry. F/T, P/T hours available. excellent salary, call 516 242 7540 or Fax Resume 516 826 9036 or email jobke@aol.com

ASSOCIATE POSITION WITH OPPORTUNITY FOR PARTNERSHIP NY/PA

Group practice located on NY-PA border with excellent growth in the area’s industrial, retail, and college campuses. Surgical privileges in medical centers in NY and PA. This position will involve rotating through multiple office locations, and wound care centers. Local insurance reimbursement involves mostly private pay PPO models. We are looking for an ABPS Board Qualified podiatrist to join our team. Candidates would need to obtain licenses in NY and PA, and become ABPS certified to maintain hospital privileges. Base salary starting at 85,000.00 with bonus plan incentive, vacation, and health/mp insurances. Forward CV to prefprovider@hotmail.com

PRACTICE FOR SALE – NEW JERSEY

Well-established practice in Teaneck, NJ (10 minutes from GW Bridge). Excellent location (in Medical building) heavy traffic, great visibility and large parking lot. Fully equipped, full-time office with established patients. Grossing over 220K with tremendous growth potential. Office is currently open and busy ready to takeover with seamless transition. For additional information please e-mail doctors@gramercyparkpodiatry.com

ASSOCIATE POSITION – CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for full-time podiatrist in a multi practice location in the Chicago land and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

IMMEDIATE OPENING - MINNEAPOLIS, MN

Associate leading to partner in well-established practice. Seeking personable, skillful, and attentive podiatrist. No nursing homes, evenings or weekends. Competitive compensation package including health insurance, malpractice, short term disability, 401(k), generous vacation, paid holidays, and excellent salary plus bonus! E-mail cover letter and CV to jbremer@associatedpodiatrists.com or fax to (612) 866-5875 attn: Jennifer Bremer

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. 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

SEEKING RESIDENT FOR PSR-24 POSITION: BALTIMORE, MD

Mercy Medical Center Position for a highly motivated individual who desires a surgical residency or an individual wishing additional surgical training in a well-established Podiatric Residency Program. Busy metropolitan hospital with high surgical numbers and inpatient care. Resident is integral member of multidisciplinary team. Begins mid June 2008. Includes competitive salary/benefits. Send inquiries to rsher18@yahoo.com

ASSOCIATE POSITION - WILMINGTON, DE

Busy 25-year old state-of-the-art Four-Dr. Practice, -Three offices/ Two Hospitals - PSR 24/36 preferred - Need energetic/motivated DPM proficient in EMR/Computers - Fax CV with cover letter to Brandywine Podiatry, Attn: Dr. Christopher Savage -Fax # 1-302-658-7646

X-RAY PROCESSOR FOR SALE

Konica qx-70 automatic processor in perfect working condition. Has been maintained professionally on a monthly basis. Office is going digital priced for quick sale. Must be picked up - Long Island, NY. Send inquires to soledr@aol.com

CASE CONSULTING

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

PART-TIME ASSOCIATE POSITION - INLAND EMPIRE, CA

Ethical hard working physician for long term care practice. Send CV with salary requirements to dtoedoc@earthlink.net

PRACTICE FOR SALE - VENTURA, CALIFORNIA

Selling satellite office, fully furnished and equipped. Existing patients and room for more growth. Inquire at tkhk@sbcglobal.net

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