The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

June 14, 2010 #3,883 Publisher-Barry Block, DPM, JD

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MO Podiatrist Discusses Flatfeet

Dr. John Holtzman of Missouri Foot and Ankle says that flatfeet are usually hereditary and are only a problem if they are symptomatic. In other words, if they’re not painful, leave them alone. “The majority of flat feet, if they are hereditary, don’t cause any problems,” Holtzman says. “The podiatrist might recommend an orthotic to prevent problems down the road. They are more prone to arthritis later on, so a softer low-arch orthotic can realign the foot and head off arthritis.”

Dr. John Holtzman

Holtzman says that if one foot suddenly goes flat, it could be the posterior tibial tendon rupturing. A flat foot plus sudden pain should send you right to a podiatrist. Most traumatic flat feet are one-sided, and will probably need surgery to repair. But my toddler granddaughter has very flat feet. Should I be concerned? He says that toddlers start out that way, but usually grow out of it. “Small children begin to develop an arch at about age 2 or 3. All the parent usually has to do is provide good support in a well-fitting shoe. If the flat feet don’t resolve by age 8 or so, they may need treatment.”

Source: Mary Jo Blackwood, RN, MPH. Ladue News [6/10/10]

OR Podiatric Lectures at AAPC Conference

John Hahn, DPM of Portland, OR spoke at the American Association of Professional Coders (AAPC) at their national conference June 6-9, 2010 in Jacksonville Florida. Hahn spoke to a group of approximately 1,800 professional billers and coders on foot anatomy and on common foot and ankle pathologies.

Dr. John Hahn

He also instructed them on how to properly code for various podiatric procedures. AAPC is a very receptive group to podiatry.

VA Podiatrist Fears Consequences of Proposed Senate Payroll Tax

The Senate provision, part of a broad bill that extends jobless benefits and renews expired tax cuts, would subject more of the profits of lawyers, accountants, and other professionals to a 2.9% Medicare tax. There are about 4 million s-corporations in the U.S., not all of which would be subject to the new taxes. The taxes would apply only to certain professionals including doctors, lawyers, athletes, performing artists, and investment advisers.

Dr. Joseph G. Smith

Dr. Joseph Smith, a Virginia podiatrist, said he could pay an additional $6,000 in payroll taxes as a result of the change. He paid himself a salary of $71,500 in 2009, and took an additional $48,500 as a dividend. His accountant, Nick Potocska, said Smith's salary is not unusual since he works almost exclusively with Medicare patients, who pay less than patients covered by private insurance.

Source: Margaret Vaughan, Dow Jones [6/10/10]

Draw Lost Listeners Back in

While speaking to a group, you notice that many people are staring into space, doodling or surreptitiously checking their smart phones. Do not make the mistake of continuing in hopes that they will tune back in on their own.

Better: Laugh and smile as you say, “I must have been speaking too long; I think I have lost a few of you.” That grabs listeners’ attention right away. Once you have their attention, ask where you lost them. Say something like this: “We seemed to be okay until I started talking about X. Is that where I lost you?”

Listen to the feedback you hear and learn why you lost them. That way you can turn to another subject or address their concerns, and deliver the message you intended to deliver.

Source: Adapted from How to Talk So People Listen, Sonya Hamlin, Collins via Communication Briefings

Query: Getting My Groove Back

I am 55 yrs. old, and have been in private practice (solo) for 25 years. I did a respected two yr. surgical residency and had a well-rounded practice for years. Approximately 10-12 yrs. ago, I decided to stop doing surgery for awhile to take a break from it, and focus on my non-surgical sports practice. A few years has turned into 10+ years.

For the past year, I have wanted to get back into surgery to diversify the practice and add more challenge to my professional life. In some ways, I feel the surgical part of our profession has passed me by. I am simply amazed at some of the things my colleagues are doing now. What options does a guy like me have? Any suggestions on how to get my groove back?

Name Withheld

RE: Traumeel as an Analgesic
From: David Secord, DPM

I am interested to hear from folks such as Bob Kornfeld for their take on papers such as the one just listed in Medscape, entitled: "Traumeel S ® for Pain Relief Following Hallux Valgus Surgery: A Randomized Controlled Trial" by Shepherd Singer, et al., posted: 06/02/2010; BMC Clin Pharmacol. 2010;10:1-23. 

The conclusion: "Traumeel was not superior to a placebo in minimizing pain or analgesic consumption over the 14 days of the trial, however, a transient reduction in the daily maximum post-operative pain score was observed on the day of surgery." I'm guessing that there will be the obligatory condemnation of statistical method or "you can't evaluate this through double-blind study" or some other whimsy. I'd love to hear comments though.

David Secord, DPM, Corpus Christi, TX, david5603@pol.net

RE: Beware of Internet Scams
From: Larry Kosova, DPM

Yesterday morning very early, my wife Marlene Reid's computer got a virus that sent out an e-mail to everyone on her contact list. It said something like she was in the United Kingdom, held at gun point, and that  she needed money to pay for a hotel. If you answered it, it sent another auto-response saying it was true, and gave a Western Union number.
 
We have been getting calls from people on the list since 5:30 am yesterday, and had our answering service tell anyone calling that this was a hoax. If anyone gets this type of e-mail, never send money. Try to contact the person by phone, or friend, spouse, etc. Never forward the e-mail (this happened all day yesterday as people were forwarding it to me) since this will just have a potential to spread the virus. Hit the spam button to notify the correct people at Yahoo, Google, etc. so the sender can be traced.
 
I  suggest to have anyone getting this e-mail to scan their computers with their anti-virus program. Eset Nod 32 also recommends malwarebytes.org/.  It is a free program and will eliminate the viruses that other programs will not. Also update your computer with Microsoft update or Apple update. Rescan the computer afterward. 

Larry Kosova, DPM, Chicago, IL, lkosova@yahoo.com

RE: iPhone Apps for Podiatry (Mark A. Lambert, DPM)
From: Bret Ribotsky, DPM

Return the phone ASAP. The new iPhone 4 comes out June 24, and it is reported to be significantly improved.

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

RE: Filing For PECOS (Susan M Loiselle)
From: Daniel Chaskin, DPM

I believe that almost ever podiatrist is capable of completing the PECOS application without outside help. I have set up the following website for those who feel that they could use additional assistance. This website also includes a short video, but be patient as it takes a few minutes to load and play.

Daniel Chaskin, DPM, Ridgewood, NY, podiatrist1@optonline.net

RE: Obama and Amputation Rates (Ron Renzi, DPM)
From: Lawrence M. Rubin, DPM, Jon Purdy, DPM

Dr. Renzi makes an important point in his post, "Consistent primary care and meticulous foot care decrease amputations." To help accomplish this, a 501(c)3 non-profit organization has been formed. The Lower Extremity Amputation Prevention (LEAP) Alliance is well on its way to creating amputation-prevention collaborations among area hospitals, primary care physicians, and podiatrists in the Las Vegas, Nevada area. If this pilot program is successful, we hope to replicate it in other areas of the country.

Lawrence M. Rubin, DPM, Las Vegas, NV, lrubindoc@aol.com

Dr. Renzi brings up a great point that preventive care is some of the best care one can receive throughout a lifetime. The disconnect I see, is his direct linking of primary care to insurance coverage and amputation rates. I think we can all agree that if everyone had free healthcare, doctors were compensated well, and the doctor to patient ratio was extremely favorable in all areas of the country, the amputation rates would drop. However, wanting, doing, and reality do not always sync with one another. What price are we willing to pay? How does a government “force” people to value their lives and take care of themselves while at the same time convincing physicians to accept more liability, higher administrative costs, and decreased reimbursements?

Are we certain that...

Editor’s note: Dr. Purdy’s extended length letter can be read here.

RE: Reaction Mixed to Allscripts, Eclipsys Deal (Michael Brody, DPM)
From: Eliot Udell, DPM
 
Thank you Dr. Brody for reminding us about how Eclypsis took over Medinotes. Eclypsis is now sunsetting Medinotes, forcing 30,000 doctors like myself to go scrambling for a new EHR program. Allscripts is now taking over Eclipsys. Will Allscripts close down Eclisys's programs forcing all of its clients to now buy an expensive new program from their company?
 
The EHR vendor program is in such a state of flux that it is not possible to know from day to day if a program for which a doctor pays 12 to 20 thousand dollars, will remain a viable program or will be shut down due to a take-over, bankruptcy, or merger. The federal government wants all of us to buy EHR programs and may even reimburse us for going that route, however, there are no federal controls in place to protect doctors who invest heavily in a new program only to find it put out of business. I hope the government wakes up and puts some laws into place to protect us before the next catastrophe happens. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: You Got to Be Kidding

A picture is worth a thousand words...and this says it all!!

Source: Joseph Borreggine, DPM

PRACTICE FOR SALE – EASTERN OREGON

Recent poor health requires sale of busy 30+ year old practice in Eastern Oregon. Good mix of surgery and general podiatry. Pleasant community with year round outdoor recreation. Major metropolitan center 50 miles away. Current staff and doctor will stay on as needed. sparris@fmtc.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

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

EQUIPMENT FOR SALE –  PODIATRY CHAIRS

2 podiatry chairs - used Midmark 117 and a Ritter 317. Great condition. $950 each Greenwich, NY Call:518-466-3287. Pick up only.

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

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 – 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

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