The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

June 20, 2009 #3,576 Publisher-Barry Block, DPM, JD

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Not So High Heels Not So Bad: HI Podiatrist

“Wearing a half-inch to 2-inch heel in moderation can actually help a lot of foot problems because it helps support the arch a little bit,” shares Dr. Greg Morris, a podiatrist and board certified foot and ankle surgeon at The Queen’s Medical Center. “But if it’s a higher heel, such as a higher stiletto heel, you’re a little more unstable so you’re more at risk for spraining your ankle.

Dr. Greg Morris

“Also, if you’re in high heels for a long time, your Achilles and calf muscles can tighten up over time. You’re also putting more pressure on the ball of your foot and that extensive pressure can aggravate conditions such as bunions and hammer toes, and can cause conditions such as metatarsalgia and neuromas.”

Source: Yu Shing Ting, Midweek [6/10/09]

OH Podiatrist Has New Prescription for Cincinnati City Hall

Until recently, Brad Wenstrup thought his toughest task would be trying to restore the trust between detainees and their U.S. captors at the Abu Ghraib prison near Baghdad. A podiatrist and surgeon, Wenstrup was assistant deputy commander and responsible for ensuring that prisoners’ healthcare needs were met. “We knew what our mission was and what we were up against,” Wenstrup says. “We’re in a prison hospital, we’re taking care of the enemy. Our main mission is detainee healthcare.”

Dr. Brad Wenstrup

Once back from Iraq, Wenstrup accepted an assignment that some observers think is actually tougher to accomplish. The Hamilton County Republican Party asked Wenstrup to challenge Cincinnati Mayor Mark Mallory in November’s election. Mallory is a relatively popular politician, a Democrat in a heavily Democratic city who’s seeking a second term.

Despite the mayor’s impressive connections, Wenstrup isn’t intimidated. “I don’t think it’s any secret about how well he polls,” Wenstrup says. “I’m up to the challenge. It’s a chance to raise some issues and bring some awareness to things. If that’s enough to get me elected mayor at the end of the day, then that’s where I’m supposed to be.”

Source: Kevin Osborne, City Beat [6/17/09]

Disagree Tactfully

Let someone know you disagree without raising the person’s hackles.

Instead of saying “I think you’re wrong,” say “Another way to look at it is …”

Source:  Adapted from “Win-Win Conversations,” Timely Tips for Teams, via Communication Briefings

Query: Liquid Nitrogen for Verruca

I would be interested to hear from anyone who uses or who has used liquid nitrogen in their practice. I have used verruca freeze, pedi freeze, CO2, with no real success in getting a cold enough result for treating plantar warts or porokeratosis. What are the maintenance costs? What is the frequency and cost of gas delivery? What is the clinical protocol of application and patient prep and follow-up? Is there an instructional course available?

John Moglia, DPM, Berkeley Hts, NJ

Query: PICA Demutualization Check

I work for a clinic that pays my malpractice premiums. When the PICA checks were distributed, the clinic that I worked for cashed the PICA check. I've contacted PICA and they have told me that the W-9 and 1099 will be in my name. I haven't received any of the money from the clinic that I work for. My other situation is that I had the PICA policy before joining this clinic. My question is have others been in this situation and what have been some of the solutions that you have come up with in regards to this situation?

Theresa Hughes, DPM, Galesburg, IL

Editor’s Comment: PM News does not provide legal advice. Employers generally provide malpractice coverage as an employee benefit. The employer receives a tax deduction for this benefit. When the PICA check was written, it was to you, the insured employee, who must pay taxes on it. Other than the existence of specific contract language to the contrary, the employer has no right to this payment. The clinic should not have been able to cash a check written to your name. We recommend that you contact an attorney.

RE: The Importance of Biospies
From: Bradley Bakotic, DPM, DO

The notion that podiatrists perform too many skin biopsies is simply untrue. Our numbers are eclipsed by nearly every other medical specialty, despite the fact that some tumors, such as melanoma, are actually over-represented in the foot. In some instances, there is a misunderstanding of the meaning of the word “biopsy”. Recently, I spoke to a wife/office manager of a podiatrist in GA who informed me that her husband did all his “biopsies” in their surgical center. Unknowingly, she informed me that neither she, nor he, knew what a biopsy was. Clearly, taking a 1.5 minute skin biopsy to a surgical center would be over-utilization in every sense of the term.
 
An earlier post related a story of 8 dermatologists who witnessed a case where, what appeared to be a benign nevus, turned out to be a melanoma. The author claimed that the dermatologists did not change their manner of practice. I believe they almost certainly did change their manner of practice; however, the change was likely subtle. A dermatologist’s starting point is often already one of near zero tolerance for anything away from the “norm.” They pay profound attention to detail and maintain an incredibly high index of suspicion. After being faced with a case such as the one described, there would be little room for those dermatologists to become more aggressive. The words of Charles Morelli, DPM could not be more accurate. As a profession, we in podiatry often have an entirely disparate perspective. Many of us do biopsies to confirm clinically obvious malignancy, rather than to rule it out when the diagnosis is less obvious. In podiatry, many of us would have substantially more room to change our manner of practice if faced with such a case. 
 
As an aside, I have many clients, who diagnose malignant skin lesions on a weekly basis. They do this because they carry a high degree of suspicion and sample the subtle lesions along with the obvious. I know of many other podiatric physicians who go months or years between doing biopsies. Who is practicing better medicine? 

Bradley Bakotic, DPM, DO, Alpharetta, GA, Alpharetta, GA 

RE: Tropical Foot Condition?

When queried by my patient about what was in between her 4th and 5th toes, I responded, " A heloma molle." To which she replied, "Oh, that sounds Hawaiian."

Dave Rizzo, DPM, Fullerton, CA

PRACTICE FOR SALE - WASHINGTON STATE: BELLINGHAM 

With Medicare-Approved ASC, located by hospital and in medical community. Seller will consider financing. This is an exceptional value. Bellingham is rated in national magazines as one of the most desirable places to live or retire. 386 597-5766 or 260 402-7490.

OFFICE SPACE/ MRI RENTAL – NYC, LI   
 
Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, Hicksville and/or Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITION/WASHINGTON, DC/SILVER SPRING, MD 
 
Excellent opportunity to join a multi-doctor practice with its own Certified Surgical Center. Practice is full-scope with an emphasis on sports medicine. Competitive salary plus bonus structure. PSR 24+ only. Send CV to hgodpm@verizon.net

ASSOCIATE POSITION WITH POTENTIAL FOR PARTNERSHIP - NJ

Associate needed for multiple location practice in Bergen County N.J. Full or Part-time hours available. Reply by E mail to dr_toefu@hotmail.com

EQUIPMENT FOR SALE -- OFFICE CLOSING

All equipment is 3 years old and in excellent physical and working condition. 1 MTI chair model #524 blue ridge color with matching stool; 2 Midmark M7 Speedclaves; and 1 All-Pro 2010 x-ray processor (2 lightboxes and an older X-cel mid base model will be included). e-mail nefootandankle@optonline.net for further info and pricing.

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS 

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 Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

ASSOCIATE POSITION AVAILABLE-MIDTOWN MANHATTAN 
 
Looking for Full-time associate to work in well established practices in midtown Manhattan and Forest Hills. Immediate opening for PSR 24-36 surgically trained Podiatrist. Great opportunity with competitive salary along with malpractice benefits. Position includes Saturday office hours. Please send CV to slurie@papapc.net

PRACTICE FOR SALE – NEW YORK CITY

NY Manhattan, prime location. Upper East Side, 23. Y.O. practice, high visibility-traffic area next to post office, street level, All phases of Podiatry, NO surgery, retiring due to disability. call 516-759-4062 or Paulfxfeet@aol.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

1-YEAR PODIATRIC SPORTS MEDICINE FELLOWSHIP

Monrovia, California. Applicant must be a licensed podiatrist and have completed a podiatric residency program. Monthly Stipend $4,000 to $5,000. Please email your curriculum vitae to victoriamanagers@gmail.com Thank you for your interest in our Program.

EQUIPMENT FOR SALE

 Amfit Orthotic Making System. Includes new computer, recently updated digitizer, and orthotic mill, and $2,500.00 in supplies (which would generate about $20,000.00 in orthotics). skip the middleman. Cost $35,000.00. Asking $23,000.00 OBO AMERICAN FOOT CLINIC 405-733-2783 OR 405-820-6887 americanfoot@email.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 a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

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