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PMNews
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| PM News | |
The Voice of Podiatrists
Serving Over 18,607 Subscribers Daily
June 23, 2018 #6,215  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2018- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL | |
Last Chance to Vote
Quick Poll
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Do you prescribe uric acid lowering drug for the management of acute or chronic gout?
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| APMA COMPONENT NEWS | |
AAPSM and German Society for Foot & Ankle Surgery Exchange Fellows
Palo Alto Medical Foundation Sports Medicine Fellowship Director Amol Saxena, DPM hosted Orthopedist Miriam Birth, MD from University of Goettingen, who won a stipend from the German Foot and Ankle Society (GFFC). Dr. Saxena's current Fellow Louie Shou, MD just returned from visits with the American Academy of Podiatric Sports Medicine (AAPSM) Honorary Members Nicola Maffulli (London), Markus Walther (Munich), AAPSM Associate Member Kaspar Gundlach, and Ralph Springfeld (Hamburg).
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(L-R) Drs. Louie Shou, Amol Saxena, and Miriam Birth |
Dr. Shou will be joining Reconstructive Orthopedics in New Jersey this fall after completing his Fellowship. This Fellowship exchange between Dr. Saxena's Fellows and the GFFC has been taking place since 2003.
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| PODIATRIC PRODUCTS AND SERVICES IN THE NEWS | |
ME Podiatrist-founded Start-up Awarded NASA Grant
ScanDx, a medtech start-up founded by Todd O’Brien, DPM, was recently awarded a NASA Space Grant in collaboration with the University of Maine’s Chemical and Biomedical Engineering Department. The aim of the project is to develop and test a smartphone-based app for assessing bone density. The instrumentation developed could be used on future NASA missions. Prior NASA studies have shown reduced bone density in flight crews due to the effects of microgravity. An in-flight method of rapidly gauging bone density will be essential in assessing exercise countermeasures and overall musculoskeletal health on longer missions.
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Dr. Todd O’Brien |
“We are thrilled to be collaborating with UMaine faculty and students on this NASA grant,” said CEO, Todd O’Brien. “If we are successful, this project could lead to an ultralight device capable of rapidly assessing bone density. A future version of this instrument could end up on a NASA mission or in your doctor’s office.”
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| PROFESSIONAL DISCIPLINE | |
WA Podiatrist Charged with Unprofessional Conduct
A Walla Walla podiatrist has been charged with unprofessional conduct. On June 11, Washington state’s Department of Health Podiatric Board charged Dr. Curtis W. Long with failure to meet the standard of care in treating two patients who developed infections, one of whom subsequently required a below-the-knee amputation and the other of whom had two toes amputated.
Long told the Union-Bulletin he has been in practice in Walla Walla for 42 years and treated more than 16,000 patients. He also served as president of the Washington State Podiatric Medical Association, he noted. These two cases, Long said, have been reviewed by two experts who found no fault in his care of those patients. “The DOH wants to fine me $10,000 and put me on two years of probation for giving appropriate care to these patients,” he said. “We feel that this is an inappropriate case, and we are moving to have the case dismissed.”
Source: Sheila Hagan, The Union-Bulletin [6/21/18]
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| PRACTICE MANAGEMENT TIP OF THE DAY | |
5 Guaranteed Ways to Get Sued - Part 1
1. Poor employer practices - While medical mistakes often get the most attention, “the biggest risks do not necessarily arise out of the role of being a doctor,” says Matthew Fisher, JD, partner and chair of the health law group at Mirick O’Connell in Worcester, MA. Instead, owning a practice may present more opportunities for errors. The absence of policies to guide interactions with staff, whether they’re other doctors, licensed professionals, or nonprofessional staff, is one primary area for concern.
Without clearly defined policies and procedures in place, everyday activities can become legal landmines. Workers may find seemingly simple tasks such as getting the time and pay they have coming to them inordinately difficult. Fisher says a suit may arise through a failure to provide the appropriate type of time off or having an outdated policy. If employees feel they’re being shorted by the practice, they could pursue a claim.
Source: Julie Knudson, Physicians Practice [6/20/18]
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| RESPONSES/COMMENTS (OBITUARIES) | |
RE: The Passing of Joseph E. Fiorini, DPM
Dr. Joseph E. Fiorini, age 84 of Sheboygan Falls, passed away surrounded by his loving family on Sunday, June 17, 2018. Joseph was a graduate of the Illinois College of Podiatric Medicine where he graduated magna cum laude in 1957. For 35 years, Joseph was a trusted local podiatrist. He retired in 1989, and moved to Lake Geneva. In 2006, he moved to Sheboygan Falls to be closer to his family.
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Dr. Joseph Fiorini |
He was an Associate in the American College of Foot Surgeons, member of the Board of Trustees of the Wisconsin Podiatry Society, Diplomate of the American Board of Podiatric Surgery, and former president of the Wisconsin Society of Podiatric Medicine and Surgery. Dr. Fiorini lectured on podiatric care throughout the Midwest. He also participated in the DOCARE Medical Mission in Mexico's Yucatan Peninsula.
Source: Sheboygan Press [6/21/18]
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| QUERIES (CLINICAL) | |
Query: Painful Tyloma Sub Calcaneus
I have a 24 year old African-American female patient with a 2-year history of painful 3 cm tyloma sub the right heel with no history of trauma. She has no health problems. She has normal skin lines upon debridement with a slight hyperchromia of the skin.
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Painful Tyloma Sub Calcaneus |
Her physical exam was normal including gait and x-rays. A sonogram shows a 1.76x 0.70cm bursa sub calcaneus. Her MRI was negative. She still has pain after callus debridement, and padding does not help. What is the possible etiology and treatment other than palliation?
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| QUERIES (NON-CLINICAL) | |
Query: Extra Depth Steel-Toed Shoes
Does anyone know of an extra-depth steel toed shoe/boot? I have a diabetic patient with hallux malleus and the top of the toe keeps ulcerating and work doesn't allow a work around other than padding his toe, which only moderately helps.
Charles Halverson, DPM, Columbus, NE
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| RESPONSES/COMMENTS (INSURANCE ISSUES) | |
RE: Fairness of United Healthcare
From: Elana B. Cibula, DPM
I am just trying to justify the fairness of insurance companies. My secretary showed me an EOB from United Healthcare ( I do not participate in UHC). Of the billed amount for CPT 99203, ($225), they allowed $63.25. Do I have to accept this?
My next patient is on United Healthcare disability Medicare. He told me that United Healthcare keeps calling him for a "free" yearly evaluation and if he participates, they will give him a $40 gift card to Walmart. Is this legal? He sees his doctor regularly anyway.
I keep getting paid less and less from Blue Cross, Humana, etc. Medicare is almost the best, Wow! Who would have thought? Insurance companies are getting richer, doctors and patients are getting less. Isn't it time to change this?
Elana B. Cibula, DPM, Naples, FL
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| RESPONSES/COMMENTS (CLINICAL) - PART 1A | |
From: Andrew Cassidy, DPM
I have found that not all physical therapy is the same. For a small spur like this, I suggest PT do aggressive soft tissue mobilization (it’s supposed to hurt but not be worse the next day) combined with phonophoresis (ultrasound with 10% hydrocortisone in the ultrasonic gel that can be compounded), as well as stretching protocols and eccentric loading exercises, maybe combined with a CAM walker.
If this fails, I would surely consider trying a growth factor, or stem cell injection in lieu of surgery. I have had many patients that failed conservative measures get complete resolution of pain with the use of biologics, which I would use in the form of PRP intra-operatively as well. The spur has been around longer than the pain. Be sure to treat the patient, not the x-ray.
Andrew Cassidy, DPM, Austin, TX
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| RESPONSES/COMMENTS (CLINICAL) - PART 1B | |
From: Robert Greenhagen, DPM
Similar to plantar enthesophytes, too much credence is given to the presence of the spur. The majority of the pain is due to the soft tissue contracture/tendon irritating the boney insertion. This is the nature of all enthesopathies.
Tallerico, et al. demonstrated that an isolated gastrocnemius recession addressed the condition regardless of the presence or absence of a posterior spur. AOFAS scores were demonstrated to be equal to that of our double row fixation (suture bridge) study that was published in 2013. This treatment option provides a low risk of complications and allowed the patients to be weight-bearing as tolerated in a walking boot immediately after surgery.
I was fortunate to assist in both studies and have used the isolated gastrocnemius recessions for treatment of posterior pain for the majority of my patients. The origin of the gastrocnemius study was an elderly patient who was not a good candidate for the suture bridge repair of the Achilles. More recently, I have also used PRP injections to the insertion in combination with the gastrocnemius recession.
Robert Greenhagen, DPM, Omaha, NE
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 1A | |
From: Ralph Graham, Larry Aronberg, DPM
In regard to the discussion about Lapiplasty, I agree with others that this is just a method for performing a fusion at the metatarsal cuneiform joint. In addition to other comments which I endorse, why on earth is it named “plasty”. The last thing it produces is mobility so it is not a sensible title.
Ralph Graham, Witham, Essex, UK
I'm concerned about the biomechanical effect of fusing the 1st ray. I have a friend in his late 50s who hikes, plays golf, and tennis. He's considering getting bilateral procedures (I would send him to another DPM since that's beyond my training). Lapiplasty may be too new for long-term results to be apparent, but Lapidus itself is not. Any comments? I can't even envision an orthotic that could compensate for a fused 1st.
Larry Aronberg, DPM, Lake Worth, FL
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 1B | |
From: Dieter J Fellner, DPM,
Dr. Borreggine succinctly provides an excellent rebuttal to the overtly enthusiastic (premature) endorsement of Lapiplasty. Meanwhile, citing the research evidence, Dr. McAleer, perhaps unwittingly, provides further ammunition to a counterpoint of view: the Lapiplasty has yet to be put to the test, for long-term outcome success. Conspicuously absent also from the literature review is the long-term outcome for Lapidus.
On the issue of frontal plane rotation: I agree that this should be evaluated pre-operatively and addressed surgically, when present. This can be easily accomplished with a regular Lapidus (and fixation of a surgeon’s preference). This problem does not specifically require the ‘Lapiplasty’ with its complex cutting rigs, an over-engineered bone clamp, two plates and a bag of screws.
While obvious to the foot surgeon, this information is lost to the Lapiplasty marketing hype. I will go one step further: frontal plane rotation can be addressed differently, much more easily and without expensive fixation. I have addressed this issue in a lecture presentation prepared for the AAFAS, New Orleans meeting June 2018. I have posted the lecture on YouTube for open access and will provide narration in the next week or so.
Dieter J Fellner, DPM, NY, NY
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoe of the Day
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Not your typical Crocs |
Source: Zita Attalai via Virtual Shoe Museum
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MEETING NOTICES
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NEED CME CREDITS FAST?
PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
You can Earn up to 50 Continuing Education Contact Hours (CECH) Online
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Choose any or ALL from 25+ CECH Category-1 articles posted
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| CLASSIFIED ADS - PART 2 - ASSOCIATE POSITIONS AND FELLOWSHIPS |
ASSOCIATE POSITION - LONG ISLAND/QUEENS
Advanced Podiatry Seeking Full Time DPM for upscale practices located at the Americana Manhasset, Huntington and Queens. Excellent work environment and company culture. Latest technology with digital x-ray, laser, EHR, Ultrasound, the latest Apple software and iPads. Must be surgically trained, motivated, with a great work ethic. Very competitive salary with significant upside. Visit www.LIFootCare.com and email eavieiradpm@gmail.com for more info.
ASSOCIATE POSITION - GREATER LOS ANGELES AREA
Join the fastest growing mobile podiatry group in California! Full time/part time, you pick your days, you pick your hours, cloud-based EHR, in house billing, dedicated support staff, excellent monthly compensation. email CV to: homefootcare@hotmail.com
ASSOCIATE POSITION – RENTON-KIRKLAND-EVERETT, WASHINGTON
This is an immediate opening for associate position. He/she must be highly motivated, hard-working podiatrist who is proficient in forefoot and rearfoot surgery. We have 3 office locations and multiple nursing home facilities. Prefer someone personable and a team player. Please email CV to seattlefootdoctor@yahoo.com
ASSOCIATE POSITION - ST. LOUIS AREA
Full time associate position immediately available in busy office. Multiple offices/locations. PSR-36 or 24 board qualified/certified foot and ankle surgeon. Competitive benefit package. Send CV to smadpm@charter.net.
ASSOCIATE POSITION - NASSAU COUNTY, NY
Exciting opportunity! Busy Nassau County, NY office seeks full time podiatrist. State-of-the-art facility. Complete EMR, digital radiograph and diagnostic ultrasound. Excellent salary and benefits. Must be board qualified. Please e-mail resume to: Medicalofficeinquiry@gmail.com, or call: 516-902-1073
ASSOCIATE POSITION WANTED - HUDSON VALLEY, NY
Full time associate position immediately availablein a busy office. Broad responsibilities including wound care, trauma call, hospital rounding, etc. Surgical based practice with privileges to local hospital and surgical center. Comparable pay. Position available Sept. 2018, will wait for right graduate. Office is located in the beautiful Hudson Valley. Close proximity to NYC as well as a multitude of outdoor activities. Please send CV in an email to hudsonvalleypodiatrist@gmail.com
ASSOCIATE NEEDED - WARREN/YOUNGSTOWN, OHIO
Ankle & Foot Care Centers operates 20 locations in Northeast Ohio. We are looking to add a full-time podiatric physician to help cover expanding office hours. Tremendous growth opportunity for a hardworking individual with an interest in reconstructive surgery and wound care. To learn more about us, visit our website at www.ankleandfootcare.com Please email your letter of interest and CV to Michael Vallas, Practice Administrator at mike@ankleandfootcare.com.
ASSOCIATE POSITION - HOBOKEN, NJ
ASSOCIATE POSITION - CENTRAL KENTUCKY
This town is home to outstanding college, an hour away from metropolitan market and has a friendly provider environment. Opportunity to build on strong patient base with surgery and in-office dispensing. Competitive salary and benefit package. Contact: MCrosby518@gmail.com
MULTI-LOCATION GROUP - CHICAGO/NEAR WEST SUBURBS
Seeking ABFAS Board Certified/Eligible associate. MINIMUM 2 year private practice experience required. Surgical/ortho patient load. Great staff. DME, Rx, Minimal Incision Sx, EMR, digital x-ray, laser, ultrasound, PRP, shockwave & MRI. PT to FT available- Top pay, associateship & practice equity available for experienced candidates. Send CV info@anklenfoot.com
ASSOCIATE POSTION - CENTRAL NJ
Associate needed for 30+ year busy private practices in Central NJ. Applicant should be personal, independent and motivated. Practice entails all aspects of podiatry. Surgery, orthopedics, wound care, primary care and sports medicine. Competitive compensation package. To apply please email letter of intent and CV to facenters1@gmail.com.
ASSOCIATE POSITION - UPSTATE NY
Rapidly growing practice seeks associate to join and become partner. Key attributes: Board Qualified/Certified, self-starter, willingness to build practice. Partnership starts beginning year 3 based on per-established criteria. Contact: docryanlee@gmail.com
MOBILE PODIATRIST NEEDED - NEW JERSEY
ASSOCIATE POSITION - MULTI-LOCATION GROUP - CHICAGO/NEAR WEST SUBURBS
Seeking ABFAS Board Certified/Eligible associate. MINIMUM 2 year private practice experience required. Surgical/ortho patient load. Great staff. DME, Rx, Minimal Incision Sx, EMR, digital x-ray, laser, ultrasound, PRP, shockwave & MRI. PT to FT available- Top pay, associateship & practice equity available for experienced candidates. Send CV info@anklenfoot.com
WOUND CARE FELLOWSHIP - NEW YORK
CPME-APPROVED 12 month fellowship beginning July 1st, 2018. Hospital and clinic environment, with onsite hyperbaric medicine. Working with infectious disease, dermatology, as well as plastic, general, vascular, and podiatric surgeons. Must have completed a PMSR residency. Please contact drarnoldhertz@aol.com or jtfootcare@gmail.com. EOE ( equal opportunity employer)
PM NEWS CLASSIFIED ADS REACH OVER 18,500 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 18,500 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com or call (215) 808-0770.
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| CLASSIFIED ADS PART 2 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICE FOR SALE IN SURROUNDING DENVER, COLORADO
Well rounded practice including general podiatry, outside wound care revenue and surgery. Existing doc will stay on for up to 1 year for transition period. Please email sqdpm@afaclinic.com for further details. Visit website: www.afaclinic.com.
OFFICE FOR SALE - NORTHERN, NJ
30 years. Modern Office. Large, off street, parking lot. Northern NJ, Passaic County. All commercial insurance . Fully equipped, 3 treatment rooms, digital x-ray. Priced To Sell. Email to Cj9996@gmail.com Please include cell phone number.
PODIATRY PRACTICE & CO-OP FOR SALE - SHEEPSHEAD BAY/BRIGHTON BEACH--BKLYN, NY
Luxury Co-op building with 24 hr. doorman. Four (4) treatment rooms; Consultation room; Large secretarial work area. Digital x-ray; EHR (Sammy) with networked computers (#5). All phases of podiatry--46 years in practice. Newly renovated. Russian speaking preferable. Contact: irat24@gmail.com
PRACTICE FOR SALE - WESTCHESTER COUNTY, NY
Are you looking to expand & add another location? This is the perfect opportunity to purchase a modern, fully equipped office with the latest technology. Favorable long lease in a medical building with on-site parking. Healthy new patient volume and hospital privileges easily attained. Willing to stay to provide a smooth transition if necessary. Let’s talk. Send letter of interest to DPM626@yahoo.com
PRACTICE FOR SALE – CENTRAL CALIFORNIA
Extremely successful, well-established solo practice (9 years old) grossing $900K for the past six years. After serving the community for 11 years, this turn-key practice is available for purchase. Doctor is relocating and ready to leave everything in place, including the fully functioning staff. Accepts all major insurances, Hospital and Surgical Center privileges, services 1 nursing home as well as volunteer work. Only serious inquiries and interested Doctors may contact toptenpodiatrist@gmail.com
PRACTICE FOR SALE - NEW YORK (BROOME COUNTY, NEAR BINGHAMTON)
RARE PRACTICE OPPORTUNITY: Well established, 38 year old practice. Patient pays for their services. I practice, “Fee-For-Service”/No Insurance. My average work week is 2.5 days. Last 3 years (2015-2017) average gross=$625K and average net=$250K. Practice emphasis is biomechanics, using Video (Dartfish) & F-Scan In-Shoe Pressure Mapping Analysis, as well as PinPointe™ Foot Laser for onychomycosis. Surgical pathology available. Quality and modern 2500 square foot office and equipment. I am ready to retire and have future plans in place and am willing to sell for less than market value. Make an offer! Reply to: uniquepractice@gmail.com
PM NEWS CLASSIFIED ADS REACH OVER 18,500 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 18,500 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com or call (215) 808-0770.
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| Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management® Magazine and Podiatry Management® Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
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distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.
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