The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 04, 2011 #4,197 Publisher-Barry Block, DPM, JD

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Benefits of Toning Shoes Not Permanent: IA Podiatrist

Dr. Paul Coffin, a Sioux City podiatrist, points out that toning shoes manufacturers' claims of a quick and easy fitness fix are "wildly overstated." Citing studies done on the effectiveness of toning shoes, he said they "do not help you exercise more intensely, burn more calories or improve your overall muscle strength and tone." In fact, rocker bottoms shoes may result in such painful problems as plantar fasciitis (the connective tissue at the bottom of of your heel bone; peroneal tendonitis (which may impact your ankle); or Achilles tendonitis (which affects your calf muscles). 

Dr. Paul Coffin

"This isn't a new phenomenon," Coffin noted. "I remember when soft Earth shoes were the rage. A good 30 percent of its wearers ended up with Achilles tendonitis due to the shoe." While acknowledging that the shoes do force the wearer to work different muscles, he said the benefits aren't permanent because the muscle quickly adapt to the changes. In the end, Coffin said one-third of people will end up liking toning shoes, one-third will end up injuring themselves, and one-third will choose never to wear them.

Source: Earl Horlyk, Sioux City Journal [7/1/11]

Joint Commission Targets Wrong-Site Surgery

The Joint Commission has unveiled a list of potential causes of wrong-site surgery as well as customized solutions that organizations can use to prevent such events. The list is a project of the Center for Transforming Healthcare, a collaborative quality-improvement arm of the Oakbrook Terrace, IL-based accreditation organization.

National rates of wrong-site surgeries—which include wrong procedure, wrong side and wrong patient—can reach as high as 40 incidences a week, according to a Joint Commission news release. “While wrong-site surgery is not an everyday occurrence, all facilities and physicians who perform invasive procedures are at some degree of risk,” Dr. Mark Chassin, president of the Joint Commission, said in the release.

Source: Maureen McKinney, Modern Healthcare, [6/29/11]

Solve Problems in an Hour or Less

Keep problem-solving meetings brief by enforcing strict time limits on discussions. Divide meetings into these three 20-minute segments:

• 1. Define. When possible, specify the problem in advance. Then use the first 20 minutes of the meeting to identify potential root causes and to reach a consensus on which ones are the most prevalent.
• 2. Brainstorm. Designate someone to collect or record the ideas, and then you can lead the team in grouping related approaches.
• 3. Prioritize. Have the team prioritize potential solutions based on possible benefits and ease of implementation. Use an effort/benefit matrix that groups solutions into three categories: high-priority solutions (high benefit and low effort), further consideration needed (high benefit and high effort, as well as low benefit but low effort), and low-priority or rejected solutions (low benefit and high effort).

Note: The 60-minute format might not uncover every possible solution, but its efficiency compensates for that shortfall.

Source: Adapted from Matt Redmond,“60 Minutes to a Solution,”  Quality Progress via Communication Briefing.

Query: DVT Prophylaxis Protocol

What is the protocol for DVT prophylaxis? Do all post-op patients NWB, with or without co-morbidities, receive Lovenox, etc? What about closed fractures, NWB? Do you have to document that you have at least "offered" the patient to start anti-coagulants secondary to possible DVT risk? Do you then refer the patient to the primary care for anti-coagulants such as Lovenox, etc.?

Yelana Barsky, DPM, Chicago, IL

RE: Failed Keller (Judd Davis, DPM)
From: Charles Morelli, DPM

From the x-ray, it appears that the patient is quite osteoporotic and a fusion might be problematic. She's 80 years old with a contracted hallux. My suggestion (without knowing anything about this patient and reacting solely to her age and radiographic presentation) is to free up the entire joint with a McGlamry, lengthen the extensor, and begin aggressive physical therapy. Dispense a proper orthotic and consider a rocker bottom shoe (e.g., MBT/Sketcher).

Charles Morelli, DPM, Mamaroneck, NY, podiodoc@gmail.com

RE: Call for Practice Management Preceptors
From: Hal Ornstein, DPM

As a follow-up to the recent post in PM News asking for offices to participate in the practice management preceptorship, one of the challenges of the graduates is the ability to leave their current living situation (due to the cost of moving and living expenses, and with having to start paying back their student loans).

We currently are in great need of podiatrists in the following areas to join as preceptors: Des Moines, IA, Utah, Kansas City, MO, Chicago, St. Louis, Southern IL, South Carolina, Philadelphia, Virginia, Baton Rouge, North Carolina, California (Southern and SF area), Mississippi, Southern Florida, Washington State, and Cleveland..

To learn more about the PMP program, please visit aappm.org or contact Shawna at swyatt@aappm.org to sign up, and for any questions. Thank you.

Hal Ornstein, DPM, Howell, NJ, toetoe@optonline.net

RE: Where Is Organized Medicine? (Robert Kornfeld, DPM)
From: Elliot Udell, DPM

If you want to know how insurance companies are ripping off the public, look at what they are paying you as compared to the patient's co-payment. I went to the eye doctor recently. The co-payment for a rather extensive examination was 50 dollars. What the insurance company paid her was less than five dollars. I am paying close to 550 dollars a month for my insurance policy. If the company is only paying four dollars and change for a medical visit, what are they spending the majority of the 550 dollars on? Million dollar perks for executives? Huge premiums for stockholders?

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: The Passing of Howard Marshall, DPM
From: David G. Armstrong, DPM, MD, PhD

I am reading the postings and waxing nostalgically about days under "Marshall law." I think many of us who were so blessed to work with Dr. Marshall came to see his faux-authoritarian veneer as something of an inspiration. It wasn't Marshall law, it was a Marshall plan. He had a plan for all of us that served under him, and we're definitely the beneficiaries of that plan.

David G. Armstrong, DPM, MD, PhD, Tucson, AZ

RE: Bad Feet Leads to 50 Year Marriage of CT Podiatrist and Wife
From: Steven Levitz, DPM

Congratulations to Dr. and Mrs. Lawrence Stillman for being married for 50 years. Dr. Lawrence Stillman is a” very wise individual”; his learned tips on sustaining a continued female relationship is in my opinion on target.

I might add, from my own experience, that if you do not have anything nice to say, keep your mouth closed. Another difficult situation is when your female companion is rambling on about this and that and you instinctively “tune out” and just say yes/yes or yeah/yeah, you are in deep trouble.

Steven Levitz, DPM, Brooklyn, NY

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 - SAN DIEGO

Well-established practice is seeking an associate with the opportunity for a future partnership position. Great location and medical environment. Must have a California license and an interest in the full range of podiatric services. Please email resume and cover letter to ethuen@hotmail.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 – 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

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

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 emailcontactus@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 - 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.

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