The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

June 29, 2011 #4,193 Publisher-Barry Block, DPM, JD

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NC Podiatrist Discusses Dropfoot

Sometimes experts don't have to see you walk -- they can hear you coming down the hall. A condition called "foot slap" or "drop foot" is when your foot literally slaps the ground as you walk. "It's caused by muscle weakness of the anterior tibial muscle or the peroneal muscles," says podiatrist Jane E. Andersen, who has a practice in Chapel Hill, North Carolina, and is a past president of the American Association for Women Podiatrists. 

Jane Andersen, DPM

A healthy stride starts with a heel strike, then the foot slowly lowers to the ground, then it lifts from the toe and slings back to your heel. But with drop foot, muscle control is lost and the foot can't return slowly to the ground. Instead, it "slaps" the ground. "This could be a sign of a stroke or other neuromuscular event, or of compression of a nerve," Andersen says. A ruptured disk in the back is a common cause, since it can compress a nerve that travels down the leg. A rare cause of drop foot is simply crossing your legs, Andersen says, if the common peroneal nerve is disrupted from the pressure.

Source: WCYB.com [6/27/11]

Debate Remains Over Best Way to Achieve Physician Parity

Barry Block, DPM has advocated for 30 years that podiatry give up the doctor of podiatric medicine degree and transition to MD and DO degrees. "I believe it's inevitable that podiatrists will eventually be in the same tent as other allopathic specialties. We're currently discriminated against because of our degree," he said. 

Drs. Barry Block and Glenn Gastwirth

Though there is agreement within the profession that podiatrists should be on par with physicians, Glenn Gastwirth, DPM said there is debate about whether that requires a degree change. "What we are looking for is to be recognized as physicians within the area of our education, training, and experience," he said.

Source: Carolyne Krupa, amednews.com [6/27/11]

Wearing Proper Footwaer Can Help Prevent Arthritis: UK Podiatrist

Arthritis rates are increasing due to the aging population and rising obesity levels. Foot experts are warning that many people are putting themselves at increased risk by wearing poor footwear and that people are missing out on vital treatment due to arthritis in the feet being fundamentally neglected. 

Professor Anthony Redmond

Professor Anthony Redmond, a podiatrist and arthritis reasearcher from The Society of Chiropodists and Podiatrists says: "Although you are more likely to develop arthritis as you get older, it can occur at any age, and the good news is that there are simple things you can do to help prevent and treat arthritis. Choosing the right footwear will help minimize the stress placed on the feet and joints during everyday activity and helps reduce the risk of injury and joint damage."

Source: Taryn Davies, Make Extra [6/27/11]

OH Podiatrist a Serious Contender for House Seat

So far, it has been rather easy for Rep. Jean Schmidt and her supporters to write off Dr. Brad Wenstrup's plans to challenge her in the May 2012 Republican primary as a minor inconvenience, a flea to be flicked off without a second thought. But Brad Wenstrup is serious. Two years ago, when the Republican Party was desperately searching for a fall guy to take on Mayor Mark Mallory in the heavily Democratic city of Cincinnati, Wenstrup was the one who stepped up to the plate to take one for the team. 

Dr. Ben Wenstrup

Wenstrup  was a complete unknown, the kind of candidate who not only had to introduce himself to the voters but to the party leadership and the business types who fuel the party's bank accounts. A podiatrist by profession, he had a certain likeability, with his lantern-jawed good looks - "Dr. Dreamy" was the tag hung on him - and, even better, he was a major in the U.S. Army Reserves and served a tour of duty in Iraq at the Abu Ghraib prison hospital.

Source: Howard Wilkerson. Cincinnati.com [6/25/11]

Become a Better Mentor

If you mentor others or hope to do so, you can improve your effectiveness in the role by thinking of yourself as a “resource broker” instead of as a mentor.

Reason: As a resource broker, you will be less tempted to offer your own advice. Instead, you will send those you mentor to other people, sources and material to find the information they need.

Source: Communication Briefings [June 2011]

Query: Failed Keller

This 80 y/o female underwent what appears to be a Keller arthroplasty with excessive resection of the proximal phalangeal base about three years ago by another surgeon. Her hallux does not purchase the ground, and her main complaint is severe pain under the 1st metatarsal head.  

Failed Keller Bunionectomy

I would appreciate any advice on the best way to revise this surgically, as conservative care (dancer's pad) provides only minimal relief.
 
Judd Davis, DPM, Colorado Springs, CO

Query: Transition to TrakNet
 
Presently, we are using Medisoft and Medinotes. We would like to know if anyone switched to TrakNet and how sucessful the transition process was.
 
Siggi Rosenfeld, Brazos Valley Foot Care

Query: Substitute for Colchicine

One of my patients reported that her primary physician is ordering colchicine from Canada and dispensing from his office. I would appreciate info on any reputable Canadian site to purchase same.

Bill March, DPM, Cherry Hill, NJ

Query: Coding When Billing X-Ray Studies

When billing x-ray studies (for example, CPT 73630 to examine hallux abductovalgus [ICD-9 735.0]), do I need to add modifiers? Do I have to add "-TC", "-26" and/or "-LT" or "-RT", or just CPT 73630 alone?

Erik Ploot, DPM, Kalispell, MI

Response: You just need "RT" or "LT".

David J Freedman DPM, CPC, Silver Spring MD

Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

RE: Where Is Organized Medicine? (Arden Smith, DPM)
From: Robert Kornfeld, DPM

Dr. Smith echoes the sentiments of nearly every podiatrist I speak with. I hear the same from pediatricians I know. I imagine that every doctor, no matter the specialty, has a lot to say about his/her shrinking income and ever-expanding expenses. I also know when I go to buy anything in any store, the price continually rises to reflect their increasing expenses. Only medicine reflects consistently shrinking fees. Only medicine has consistently increasing demands with lower and lower reimbursements.

Last weekend, I spoke at the Florida Podiatric Medical Association meeting in Boca Raton. I asked the group of about 150 podiatrists to raise their hand if they are happy being podiatrists. Only...

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

RE: Who Says Accidents Don’t Take Place in the OR? (Paul Kesselman, DPM)
From: Jeffrey Kass, DPM

I would like to share this story in the hopes it will prevent it from occuring to anyone else. A few months back, I had the unfortunate experience of being on the end of a surgical knife which impaled my thigh. I was performing a housecall on a sweet old lady. We were in her kitchen and she placed her foot up on a kitchen chair, and I was on one knee in front of the chair. the woman had an ulcer secondary to gouti tophi and I was debriding the wound.

I, stupidly, placed the scalpel on the chair (thinking this was my "table") As I turned to my doctor's bag, to reach for an alcohol prep, she kicked her foot against the chair as she "ouched" that she had a cramp. Under my pants, I felt blood seeping down my leg, and that scalpel standing perfectly straight up. I stared at the scalpel in amazement at how it stood straight up, and it actually took me a few seconds to realize it was in my freaking thigh.

Please, please, please, do not keep any sharp instrument on the same structure as the patient's foot. Oh, and in case anyone was wondering...after nonchalantly pulling the knife from my thigh, I excused myself to the bathroom, where I cursed myself out, and wrapped my thigh in paper towel. When I made it home, I shot my thigh with lidocaine and was the proud owner of my first few stitches ever.
 
Jeffrey Kass, DPM, Forest Hills, NY jeffckass@aol.com

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

ASSOCIATE POSITION – IOWA CITY AREA

Modern practice seeking a well-trained (PSR 24/36) associate. Excellent opportunity for an energetic, hardworking individual with strong surgical and medical skills. Solid referral network and 13 years of growth. Come live in the Iowa City area and enjoy the quality of life and stability of a Big Ten University community. Competitive salary and benefit package available. If interested, fax CV to 319-354-1014 or e-mail to dave@341foot.com

ASSOCIATE POSITION - CENTRAL NEW JERSEY

Seeking associate for busy, growing practice located in Toms River, Ocean County. Looking for PSR 24/36, board eligible doctor. Basic podiatry a must. Practice has a up-to-date EMR and practice management program. Digital x-rays, ultrasound, laser, vascular studies. Excellent opportunity for highly motivated and ethical DPM. Send CV to toesec@aol.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 - 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 - 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 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

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

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.

EQUIPMENT FOR SALE- DIAGNOSTIC ULTRASOUND UNIT

Biosound Esaote, 12” monitor, printer, portable stand, carrying case, especially useful for podiatric musculoskeletal. Excellent condition, one owner. (only used for 2 years) See photos on request. Can be shipped. Contact Dr. Jim Cancilleri at 609-364-4862 (South Jersey) or via email at DrCancilleri@aol.com, Great buy at $3595.

PRACTICE FOR SALE - NANAIMO, BRITISH COLUMBIA, CANADA
 
Have you ever dreamed of owning a practice where... you can see 0-50 patients daily .. .average 100 new patients monthly  have zero accounts receivable ... gross $480 M per year .... live in a beautiful community with skiing, hiking, fishing and boating on your doorstep. This could be yours! If interested contact pistone@telus.net or 250-754-4192.
 

PRACTICE FOR SALE - MISSOURI

Well established, but still growing. Grossed over $300,000 last year. Located in a thriving medical community. Good payer mix. All aspects of podiatry needed in the area. Do not let this opportunity to own your own practice pass you by. Contact footdoc2002@yahoo.com for more information.

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 - DENVER, COLORADO

Very low overhead in a multi-disciplinary setting within medical building at a prestigious hospital. Young patient population. Low purchase price/immediate availability. Tremendous growth potential. Present doctor will stay for transition. Perfect for family person or new practitioner. Contact podpracsale@hotmail.com

PRACTICE FOR SALE - KENT, WASHINGTON

Established satellite practice, easily expandable to suite your needs. One day/week $50K gross, low overhead!! Includes reupholstered Midmark 417 (4 position keypad), Excel X-ray, Processor, Ritter M9, Miltex/Bianco instruments, Lakeside cart, cast cutter, etc. Shared office with 2 Referring Family Practitioners. Price $25K. Reply: practiceforsale18@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 - 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

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