The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

June 30, 2011 #4,194 Publisher-Barry Block, DPM, JD

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Runners Who Wear Minimalist Shoes Should Wear Orthotics: IL Podiatrist

Some people can’t get used to the running foot strike required with the Vibram FiveFingers, said Dr. Duane Brown, podiatrist with Brown Podiatric Medical Centre in Springfield, IL. Brown, who’s been in practice 39 years, has a caveat. “I just still think that an orthotic (supportive device) should be used in it,” said Brown, who added that getting feet in total alignment through orthotics makes the body more efficient. 

Dr. Duane Brown

“I have a lot of cyclists that I have orthotics in. I have to make the orthotics really thin because of those really tight shoes they use for cycling. You put an orthotic in, and the cyclists have so much more power.” Orthotics should give complete control. Because feet work hard, they need to be in balance, Brown said. Brown said people who get FiveFingers will “be better off” if supported correctly.

Source: Tamara Browning, GateHouse News Service [6/27/11]

CPM Dean Honored with Trailblazer Award by NPMA

The National Podiatric Medical Association (NPMA) recently awarded Western University of Health Sciences’ College of Podiatric Medicine Founding Dean Lawrence Harkless, DPM, with its Trailblazer Award during the association’s Annual Scientific Conference in Costa Mesa, CA.

Dr. Lawrence Harkless

NPMA executive director Debbie Burton said board members wanted to acknowledge Dr. Harkless’ accomplishments as a podiatric physician, especially for his wisdom in the field of wound care and diabetes and his more than 35 years of mentoring young doctors while a member, and as past president of the organization.

Wearing Poorly Fitted Shoes May Lead to Osteoarthritis: UK Podiatrist

A poll of 2,000 people for the Society of Chiropodists and Podiatrists found that footwear, such as high heels and even ill-fitting trainers, could be behind a surge in cases of osteoarthritis, a condition that causes pain and stiffness in the joints of the foot. "Such research isn't straightforward – older people are asked how often they wore high heels in their 20s; I'd find that quite difficult to remember – but I do agree with the broad thrust, says podiatrist Jill Halstead.

UK Podiatrist Jill Halstead

"We know that wearing high heels increases the pressure on the ball of the foot, and that this can lead to foot pain and, possibly, to osteoarthritis. What most people don't think about, though, is that shoe width is as important as the height of the heel – wearing shoes that are too narrow can lead to bunions and hammertoes. From around the age of 20, most of us don't even think about changing our shoe size, but the size of your foot does change – so it's important to keep getting your feet measured," says Halstead.

Source: Laura Barnett, The Guardian [6/27/11]

FL Podiatrist Re-Appointed to Board of Podiatric Medicine

Governor Rick Scott today announced twelve re-appointments to nine Department of Health licensing boards throughout the state. Among those re-appointed was Dr. Chet A. Evans to the Florida Board of Podiatric Medicine.

Dr. Chet Evans

Evans, of Winter Garden, is a vice president for medical education and program development for the Bradenton College of Medicine. He is re-appointed for a term ending October 31, 2012.

HHS' ‘Mystery Shopper' Project to Launch in Fall?

Pending approval of the project by the White House Office of Management and Budget, the HHS “mystery shopper” physician availability project should launch around August or early fall, according to Sherette Funn-Coleman in the HHS Reports Clearance Office.

The project will consist of making two calls to 4,185 primary-care physicians, with one call made by someone pretending to have private insurance and another by someone pretending to be a publicly insured patient. The plan is to contact 465 physician offices in each of these nine states: Florida, Hawaii, Massachusetts, Minnesota, New Mexico, North Carolina, Tennessee, Texas, and West Virginia.

Source: Andis Robeznieks, Modern Physician [6/27/11]

RE: The Passing of Howard Marshall, DPM

The “Podfather,” Howard Marshall, DPM, passed away Sunday, June 26. He was a mentor, teacher, advisor, and friend to many of you. Howard dedicated his life to podiatry, and especially the advancement of lower extremity biomechanics. He graduated from podiatry school in 1960, serving over 30 years in the CPMA House of Delegates and ten years on the California Board of Podiatric Medicine, including two as the chair.

In addition to raising a family, he built a successful clinical practice. As Chief of the Podiatry Section, Dept of Orthopedics, at County/USC Medical Center, Howard developed a highly successful education and residency program with the California College of Podiatric Medicine… the list goes on and on. He will be dearly missed by all who knew and loved him.

Scott Marshall, scottmar@klmlabs.com

RE: Failed Keller (Judd Davis, DPM)
From: Jeffrey Kass, DPM, Gary S Smith, DPM

Assuming the patient is up for another surgery and medically sound to handle it, I think an arthrodesis might be the best way to go. Arthrodesis of the first MPJ seem to heal well. The patient would be able to ambulate in a surgical shoe immediately. If you chose this route, I would recommend many of the cone and reamer systems out there to minimize any more shortening.
 
Jeffrey Kass, DPM, Forest Hills, NY jeffckass@aol.com

Besides the excessive base removal, there are two main reasons for the failure. I always do an extensor hallux lengthening procedure on every Keller. If you don't do it, the hallux will dorsiflex eventually. If this is the case, you can treat it by simply cutting the extensor tendon in the office with a small stab incision, or take the patient to the OR and do a lengthening.

I have seen Kellers that look like this (as referrals). The  cause was accidental cutting of the flexor tendon during bone resection. If this is the case, I would still try cutting the extensor tendon (in an 80 year old), but you may end up with a fusion.
 
Gary S Smith, DPM, Bradford, PA, penndoc@verizon.net

RE: Transition to TrakNet (Siggi Rosenfeld)
From: Brooke Weaver

We transitioned from Medinote/Lytec to Traknet on December 1 of 2010. It was great having trainers who were familiar with Medinotes who were able to explain things in terms we would understand. They were very helpful on how to “bring over” our templates by just making some simple changes with in the Medinotes template so it was compatible with Traknet. 

I am happy to say that we never missed a beat, even with the change in the clearinghouse to Gateway. Everyone was very helpful and supportive.  We were able to attest in May, and with their meaningful use guide, we were able to make sure we hit all the points to qualify. I am now getting ready to work on the inventory system, which is the last portion of the software we need to learn. I had put it off until after meaningful use was complete as I wasn’t ready to take on the task yet.

Disclaimer:  I have no affiliation with TrakNet or BioMedix

Brooke Weaver, Practice Administrator, Central Kansas Podiatry, Brooke@ksfootdoc.com

RE: Where Is Organized Medicine? (Robert Kornfeld, DPM)
From: Dan Waldman, DPM

Dr. Kornfeld explained the sad state of podiatry and the medical professions in his latest post. I recently spoke at a public seminar and was asked by an attendee why his insurance did not cover certain services. I responded by asking the audience, "Who thinks the insurance companies are in business to pay for your healthcare?" A few uncertain hands went up.

I opined, "They're not in that business really. Their business is collecting your premiums to invest in...

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

RE: Who Says Accidents Don’t Take Place in the OR? (Paul Kesselman, DPM)
From: Dwight L. Bates, DPM

In September of 1980, I was a first year resident at UTSA. I was assistant surgeon and scrub tech for Dr.  Larry Harkless who was performing a bunionectomy. The patient was numbed with local anesthesia and was wide awake. I placed the Bard Parker scalpel on  the Mayo stand in a manner more appropriate for a dinner plate. When the Mayo stand was moved, the scalpel fell from the table and stuck into Dr. Harkless' foot at a 90 degree angle.

The chief resident in family practice was there observing, and crawled across the floor to remove the knife, mop up the blood from Harkless' brand new Lucchese boot, and  put a pressure dressing on Dr. Harkless' foot. Neither Dr. Harkless nor I had broken aseptic technique. We completed the surgery, and as far as the patient knew, that is the way we did it every time.   

Dwight L. Bates, DPM, Athens, TX

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 - 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

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 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.

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