The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

June 20, 2011 #4,185 Publisher-Barry Block, DPM, JD

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FL Podiatrist Sees Home Visits as the Next Big Thing 

Podiatrist Dr. Stanley Gabe's practice is now all home visits. "I think it's a big niche now in medicine to go back to home visits again. People like to be in their homes and have you come and treat them and take care of them, says Gabe. 

Dr. Stanley Gabe (Photo George White)

"This area has 80,000 retirees, and a lot of them do not get around at all. Lots of these people are stuck and can't ride the buses. I was always seeing people at home, but it has only been my entire business for a few months. I'll bet in the next couple of years that it's the next big thing; it will catch on and a lot more people will be doing it," says Gabe.

Source: George White, Floridatoday.com [6/16/11]

CA Podiatrists Discuss Minimalist Shoes

Minimalist shoes aren't for everybody - at least not initially, some experts say. Most Americans grow up wearing shoes. As a result, the muscles in the foot that control the toes aren't fully developed, says Dr. Bobby Pourziaee, a Los Angeles podiatrist. He recommends that those who want to wear barefoot shoes start out with 15-minute excursions and build up their stamina over time. 

(L-R) Drs. Bobby Pourziaee and Brendan Riley

Dr. Brendan Riley, a partner with the University Podiatry Group at UCLA, advises his patients to get used to the unusual footwear on a soft surface, such as a track, and to stay away from concrete sidewalks. Even then, he's not really a fan. "I cannot think of a problem I would recommend a barefoot shoe for," he says.

Source: Hilary MacGregor, St. Petersburg Times via Los Angeles Times [6/17/11]

PA Podiatric Residents Honored

The Seasons Ballroom at Mohegan Sun at Pocono Downs provided the setting for a ceremony celebrating Community Medical Center's Podiatric Medical Education Program residents. Cody Hoover, DPM, Dana Klush, DPM, Kelly Poncheri, DPM, and Noman Siddiqui, DPM, were honored on their graduation from the three-year training program. The program, under the direction of Dr. Guido LaPorta, focuses on patient care by preventing, diagnosing, and treating conditions associated with the foot and ankle. 

(L-R) Robert P. Steigmeyer, CMC, Diann Winters,Noman Siddiqui, DPM, Dana Klush, DPM, MaryAnn LaPorta, Guido LaPorta, DPM, Kelly Poncheri, DPM, Cody Hoover, DPM, Barbara Bossi, Jeff Jacobson, and Timothy Farrell, MD.

Preceptor Excellence Awards were presented by the residents to instructors Edward L. Batzel, MD, David J. Chromey, DPM, Timothy J. Siebecker, DPM, and Rohit J. Singh, MD. Dr. LaPorta, director of CMC's Podiatric Medical Education Program, was recognized by the residents with an Outstanding Program Director Award for "giving time and commitment in making our podiatry residency program stand above the rest."

Source: Times-Tribune [6/19/11]

Maryland Podiatrist Joins Cosmetic Surgery Center

Dr. Kelly L. Geoghan has joined the Cosmetic Surgery Center of Maryland, the only multidisciplinary, state-of-the-art plastic surgery practice in the Baltimore area. An expert in cosmetic podiatry, she is one of the only podiatrists in Maryland with specialized training in aesthetic foot care. 

(L-R) Dr. Kelly Geoghan

With the addition of Dr. Geoghan, the Cosmetic Surgery Center of Maryland becomes one of the first plastic surgery practices in the Baltimore area to offer cosmetic podiatry services. Dr. Geoghan has more than 14 years of experience in podiatric surgery and medicine, with advanced training in cosmetic podiatric procedures. She is board-certified by the American Board of Podiatric Surgery and is a member of the International Aesthetic Foot Society.

Source: Citybizlist [06/19/2011]

CMS Taps Northrup Grumman for Anti-fraud Project

Anyone familiar with the predictive-modeling techniques that allow credit card companies to detect suspicious charges at the cash register might wonder why the CMS couldn't do the same thing with all the blatantly fraudulent charges sent to Medicare.

Officials say the federal Medicare payer has just inked a $77 million contract to do exactly that, hiring defense contractor Northrup Grumman under a multi-year deal to develop rapid predictive-modeling methods that can analyze claims for federal payments before the bills are paid. The CMS in March implemented new final regulations, based on new enforcement techniques authorized in the Patient Protection and Affordable Care Act, that will allow the agency to withhold payments on Medicare claims when authorities have a credible allegation of fraud.

Source: Joe Carlson, modernhealthcare.com [6/17/11]

Query: Pathology Report for All Surgical Cases?

I was in surgery last week, and the scrub tech told me that I now need to send the bone for pathology as that is now hospital policy. The hospital pathologist states that all surgical specimens need to be sent. My concern is the cost; the patient/insurance will get a bill for this service.

Is this the norm and standard of practice? With the ever-increasing assessment of doctors for over-utilization, is this really required? What is the medical-legal aspect of this? Do we need normal pathology to be sent? I understand ossicles, infected bone, synovitis, etc., but what about normal pathology, e.g., the medial eminence of the head of the phalanx?

Darryl J Martins, DPM, Jackson, MI

RE:  Clinical Success with Poor Radiological Result (Tip Sullivan, DPM)
From: Sloan Gordon, DPM, Peter Bregman, DPM

While the x-ray isn't "perfect", know this: treat patients not x-rays. If the patient is happy and pain-free, as you say - you should both be satisfied with the outcome.

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

First, let me say kudos for showing a "poor" result. We don't treat x-rays, we treat patients. I think that we likely over-estimate the importance of returning the sesamoids back to under the metatarsal, as the cristae is usually gone. However, if I was being critical, I would say you should have taken the fibular sesamoid out. I have a rule that if the fibular sesamoid is in the 1st interspace and not touching the 1st metatarsal, then it comes out. Also, I would have performed an Akin to reduce the transverse forces on the 2nd and 3rd toes and provide better clinical correction.

Peter Bregman, DPM, Las Vegas, NV, drbregman@gmail.com

RE: Turf Toe Device (Matthew B. Richins, DPM)
From: Jeffrey Kass, DPM, Gayle S. Johnson, PMA

Try Dr. Jill's turf toe insoles (drjillsfootpads.com). They come as a forefoot plate or a full-length plate. They are excellent for this purpose.

Disclosure: I have no financial interest with Dr. Jill's products.

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

When our patients need such a device, we dispense a carbon-graphite plate called "Dynaflex." The manufacturer is Wrymark (wrymark.com/dynaflex.htm), a company based in the St. Louis area. I have found their staff to be very helpful and accommodating. Patient feedback is mixed - some patients love their results, and some don't like them at all.

Dislosure: Neither I nor my employers have any financial interest in Wrymark.

Gayle S. Johnson, PMA, Edmonds, WA, gaylejohnson@footzine.com

RE: NY Podiatrist's Son Held on Spy Charges in Eqypt
From: Jeffrey Kass, DPM

I opened up the local newspaper this week only to see a picture of fellow podiatrist, Daniel Grapel, DPM and his wife. The article reports his son, while helping resettle a refugee camp, was being detained in Egypt on suspicion of being a Mossad spy. Without getting into Mideast politics, I pray and hope for an unharmed and speedy return of their son.

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

RE: EHR and Productivity (Juliet Burk, DPM)
From: Joe Agostinelli, DPM

Dr. Burk's letter should be used by the APMA to illustrate to the "powers that be" in Wash. DC! She eloquently demonstrates the EHR problem that one and two person practices will have with EHR.

I am fortunate to be part of a large orthopaedic practice with 50 staff members, a few dedicated to the reporting parameters needed to receive incentive monies. I echo everything Dr. Burk has stated for the single practictioners. Each of our physicians, except me, for some reason, has experienced decreases in outpatient visits and surgeries, and our patients have experienced delays because of...

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

RE: MicroVas Therapy Coding (Victor LaRosa)
From: Larry Cohen, DPM

The use of the term "hot" usually implies stolen. I am sure that this is not the case. If the company already received $20,000+ for the original machine, and the physician no longer wants to use it, someone else should be able to buy it. The company should not be so greedy as to not help this new doctor out. Perhaps a fee of $1,000 would allow the company to assist this new physician out in the proper use and marketing of their product.

Larry Cohen, DPM, Clinton, NJ,  larrydpm2002@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 760K, most surgery is currently being referred out. Financing available. Please call 800-983-4194, or email contactus@podiatrypracticeconsultants.com

PRACTICE FOR SALE - MISSION VIEJO, CA

Relocating to Tulsa. Great opportunity. Located at Mission Regional Hospital. Sale price $205,000 including supplies. Gross income 2010 was $340,000. Gross income 2011 estimate $420,000. Approximately 1200 sq ft with 3 treatment rooms, digital x-ray and fully computerized. A/R available at 50% discount. 949-702-1052. David Stoller, DPM (Family Footcare) david@missionviejofootcare.com

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

ASSOCIATE POSITION/PART TIME - ORANGE COUNTY CALIFORNIA

Experienced podiatrist - 2-3 days/week, two office locations in beautiful south Orange County California. Exceptional opportunity for seasoned semi-retired practitioner. Fax or e-mail Resume and LOI to 949-488-0868 Info@feetfixer.com

ASSOCIATE POSITION - ST. LOUIS 

Group practice looking for podiatrist to join group and solely take over one location. Group's podiatrists enjoy incentive compensation plan (personal production and sharing group profits), benefits including health and malpractice. Perfect opportunity for solo practitioner to join group setting. Please forward CV to StlPodGroup@gmail.com

ASSOCIATE POSITIONS: NW INDIANA & CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

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

ASSOCIATE POSITIONS – NEW YORK CITY

Looking for someone with at least 2 yrs of working experience in a podiatric office. Two sessions (1/2 day) a week for July and August for Upper West Side of Manhattan. References a must. One 8 AM to 12, one 12 to 5 PM. Reply to fabienne.rottenberg@gmail.com

ASSOCIATE POSITIONS – TEXAS AND FLORIDA

Looking for podiatrists to see patients in nursing facilities in Texas and Florida. Please contact me at doconcall02@aol.com

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 - 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

STORE FRONT OFFICE SPACE AVAILABLE - NASSAU COUNTY NEW YORK

Office Space available for sublet or long-term lease. Nassau County established podiatry location for over 30 years. Fully equipped, and no investment required. Excellent Opportunity!!! Reply to: rrranch7@yahoo.com  

TURN-KEY PODIATRIC OFFICE - CALIFORNIA

Fully equipped modern suite with built-ins at Mission Regional Medical Center, Mission Viejo CA. Four treatment rooms, New Midmark chairs, x-ray/processor, phone system & much more. $45,000/assume lease. Call Jackie, 949-493-8020.

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. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. 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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