The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

July 06, 2013 #4,815 Publisher-Barry Block, DPM, JD

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WV Podiatrist Receives AAOM Lifetime Achievement Award

A well-known podiatrist, Lenord Horwitz, DPM was recently presented with a Lifetime Achievement Award from the American Association of Orthopedic Medicine (AAOM) at their 30th Annual Conference and Scientific Seminar in Phoenix, AZ.

Dr. Lenord Horwitz

According to AAOM, while Dr. Horwitz's accomplishments during nearly over 50 years of practicing podiatric medicine have been "impressive", his work on non-surgical intervention for treating foot and ankle problems was what caught their attention.

Source: Bill Archer, Bluefield Daily Telegraph

CA Court of Appeals Reverses Elimination of Podiatry From Medicaid

The 9th U.S. Circuit Court of Appeals has ruled that a California law eliminating coverage of some healthcare services for the poor is invalid. During a budget crisis in 2009, California lawmakers limited adult dental, podiatric, optometric, and chiropractic care under the federal Medicaid program.

An association of health clinics sued to block the cuts imposed by the 2009 state law, but a lower court ruled that the limits were not in conflict with Medicaid. That decision was unanimously reversed by a three-judge panel of the 9th Circuit Court on Friday.

Source: KQED [7/5/13]

Racetrack Builds Tribute to PA Podiatrist Co-Founder

Not long ago, the horse-racing bugle call to the post was broadcast through the Pocono Raceway public address system before the traditional “Gentlemen, start your engines.” Track president and CEO Brandon Igdalsky chuckles. It was a family joke. His grandparents, Drs. Joseph and Rose Mattioli (he a dentist and she a podiatrist), were the founders and driving force of the sprawling and multi-faceted auto racing facility that sprung from a former spinach patch.

Drs. Joseph and Rose Mattioli

A fan of another form of racing, Dr. Rose never made it to Churchill Downs to watch the Kentucky Derby. So “Doc” had two steeples like those at Churchill Downs built atop the Pocono Raceway grandstand. A bugler was on hand for the unveiling.

Source: IndyCar [7/4/13]

NY Podiatrist Comments on Flip-Flops

Dr. Richard Kushner, a podiatrist in New York City, stopped just short of committing to the condemnation of flip-flops per se — though he allowed that they left the foot more vulnerable to injury, and that any thin-soled, unsupportive shoe would encourage the eventual degradation of the structures that maintain the joints of the foot: “If the foot is too flat on the ground, there’s a clawing effect that happens with the toes.”

Asked about the hygienic properties of the flip-flop as city street-wear, he replied, “That’s another matter. That’s something that I myself certainly wouldn’t …” He trailed off, joining me in a moment of anguished silence.

Source: Dana Stevens, Slate [7/3/13]

Query: Surgical Intervention in a 12 Year Old with Flat Foot

A 12 year old patient presents with a complaint of painful flat feet. The patient's mother stated that she has tried custom orthotics for a couple of years, but they're not helping anymore. The patient's mother is now interested in surgical intervention for her daughter because her activities are being affected.

12 Year Old with Flat Foot

Neurovascular status normal; significant medial arch collapse clinically and radiographically; with gastroc equinus noted. TAL, Evans, and Cotton osteotomy comes to mind for surgical intervention. Based on the patient's age, should I consider a subtalar implant in addition to the other procedures (Kidner perhaps)?

Query: Great Toe - Code 28285?

What is the correct code for arthroplasty of the 1st digit? It was not a Keller-type bunionectomy or base procedure. Do we use CPT 28285, if it was performed due to comminuted fracture?

John Taylor, DPM, Flint, MI

Response: It appears from your post that the clinical presentation was a comminuted fracture of a hallux phalanx. Your treatment was an arthroplasty which doesn't really describe the specific surgery performed. While you mentioned it was not a base procedure, you did not describe:  a hammertoe or contracture of the hallux being corrected; whether the fracture was intra-articular or involved the phalangeal shaft; or if all you did was remove portions of the fractured bone, not really treating the fracture to allow it to heal.

From your post, I assume you are removing portions of the fracture (e.g., the head of the proximal phalanx), and recommend - unless we hear otherwise from you - CPT 28124 - exostectomy, phalanx.

Tony Poggio, DPM, Alameda, CA

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RE: Freiberg's Infraction in 47 Year Old Male
From: Barry Mullen, DPM

There does not appear to be any x-ray evidence that warrants an MRI. The image provided looks like a classic Freiberg's Infraction. Arthroplasty of the 2nd MTP, with or w/out joint replacement, should eliminate pain. I recommend preserving the base of the proximal phalanx' short flexor tendon insertion to maintain digital purchase and transverse plane stabilization.

As for the 1st MTP, I respectfully disagree. It does NOT look good on x-ray. The 1st metatarsal is short. There is heterotopic bone formation along the lateral aspect of the head. There is joint space narrowing w/marked eburnation of the base of the proximal phalanx indicative of modest joint compression. These changes are consistent with a stage 2 hallux limitus deformity. What cannot be appreciated is the extent of metatarsus primus elevatus since no lateral projection was provided. If present, as suspected, a cheilectomy, sesamoid release and decompression osteotomy of the distal 1st metatarsal ala Youngswick would likely work well for this particular patient's deformity.

Barry Mullen, DPM, Hackettstown, NJ, yazy630@aol.com

RE: Freiberg's Infraction in 47 Year Old Male
From: Robert Bijak, DPM

The writer doesn't even mention the patient's race. While this may be politically correct, it has no place in science. If the 47 year old man, for example, is black, a sickle cell infarction may be an etiology. We sometimes think too often in basic biomechanical terms and seemingly neglect systemic causes. 

Admittedly, this may be an "outlier" diagnosis, but it underscores the need to maintain standards of proper history and physical taking and reporting. To me, the presentation was superficial, yet podiatrists are quick to find a surgical answer first. Remember what the "M" stands for at the end of DPM. 

Robert Bijak, DPM, Clarence Center, NY rbijak@aol.com

RE: Unmatched Residency Placements Currently Stand at 86
From: Name Withheld

The following is my personal opinion as a residency director: Just typing the letters CPME causes anxiety. I appreciate the work the members put into the profession, but they are also a source of negative PR for our profession. I have been in residency education for over 25 years and my experiences with the CPME have been terrible. They have placed our program on probation over the years for minor violations that could have simply been resolved with a letter or phone call. They routinely cite one problem and when you respond to that issue, they respond with 3 new allegations. It is humorous that in one breath they tell you that your program has issues, but then 6 months later (when they screw up positions for graduates) you can double your positions. Maybe they should be put on probation?

Staff is rude in their communications with directors and hospital administration. Their onsite teams will have you change verbiage in a contract or evaluation and the next time you are evaluated, you are told to change it back to what you had previously. Their changes in residency categories done so many times in a short period make our profession look schizophrenic. They do not take into account local politics and what it takes to keep a residency strong in an anti-podiatry setting that at times can exist. They demand changes when a hospital's legal team says they cannot put what they want into writing.  The other residencies in the hospital do not have these types of problems.

I have to stay anonymous or face the wrath at our next evaluation. I propose that if a truly anonymous survey were sent to residency directors, the majority of directors would give the CPME a failing score.

Name Withheld

EQUIPMENT FOR SALE - Q-CLEAR NDYAG Q-SWITCHED LASER

Brand new Q-Clear NdYAG Q-switched laser, direct from factory, never used with full warranty. Complete system with training provided by James Holfinger, DPM, principal investigator for 2011 FDA study gaining clearance for onychomycosis. Call Dr. Holfinger at (216) 390-9757.

EQUIPMENT FOR SALE - DIOWAVE 15 WATT, PORTABLE 980 LASER
 
This is a used multiple function laser, plantar fasciitis, Achilles tendonitis, joint pain. nerve pain, post surgical, warts, toenail  problems, two-year plus warranty, MSRP: $25,000. E mail Dr. Zuckerman at footcare@comcast.net. for questions and pricing.

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, Midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 12/24 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977.

ASSOCIATE POSITION – PLAINFIELD, IL

Associate wanted for established practice in the suburbs of Chicago, self motivated and patient oriented a must. We will provide you with a state of the art facility, experienced support staff, $100,000+ salary, 401K with match, bonus and flexible hours. Please forward cover letter and CV to chrisbaileydpm@sbcglobal.netor fax to 815-230-4925.

ASSOCIATE POSITION - CENTRAL FLORIDA

Associate wanted for well-established practice in central Florida. Experienced support staff, malpractice coverage and health insurance provided. Excellent opportunity for a promising future, this position will provide for the possibility of partnership in the future. To apply please go to www.yourcareerinpodiatry.com

ASSOCIATE POSITION - CALIFORNIA

Associate wanted for multi-office, multi-doctor practice. Full Time, Self-motivated, highly skilled team player with surgical, wound care and palliative skills. Offices in Northern California Coast, CA License necessary, salary negotiable with possibility of partnership in future. Send CV and letter to: srfctysc@gmail.com

ASSOCIATE WANTED - WESTERN NEW YORK
 
Wanted well trained podiatrist for IMMEDIATE position. Busy high volume surgical practice with multiple locations, EMR, Digital X-Rays, hospital and surgical center privileges. Good base salary with incentive, and benefits including health insurance. EXCELLENT OPPORTUNITY to grow. Send resume to: WNYDPM@gmail.com

ASSOCIATE POSITION – VIRGINIA
 
Established private practice,  immediate opening, general podiatric care, foot and ankle reconstruction and trauma management, strong referral base, ED trauma call. Hospital and surgery center privileges. Two locations with modern offices. ABPS qualified or certified. Competitive compensation package. Potential for position to lead to partnership. To apply, please email a letter of intent and CV to: vaposition@yahoo.com

ASSOCIATE POSITION - OHIO
 
Podiatrists, are you entrepreneurial, compassionate, self-starter, with excellent communication skills? Do you enjoy dealing with the elderly? We are not looking for just any podiatrist; we are looking for the right Podiatrist. Are you driven, disciplined and have a burning desire to serve? If so, call us. We are SeniorCare, Inc. We are expanding to Ohio and looking for the right Doctor. Base salary + bonuses. Call today if this describes you. Call Becky at 314-821-2600.

ASSOCIATE POSITIONS - NY
 
Generate Income in NY. Licensed NY podiatrists sought for a unique podiatric project in all geographic areas of New York. Medicare license required. You literally keep all visit charges generated or a pre-determined hourly salary, depending on the patient setting. If you are seeking an additional 4 or more hours per week of work, with no limit, contact us at: ediamond7@comcast.net

ASSOCIATE POSITION - MARYLAND
 
Associate position for podiatry office on Maryland’s Eastern Shore. Certified ambulatory surgery center on-site.  Will consider preceptor. Please fax letter and CV to 410-749-6807.
 
ASSOCIATE POSITION - TAMPA BAY, FL

Live, play and practice in the Tampa Bay area. Associate leading to partnership in a well-established, expanding group practice. Excellent salary and benefits in this dynamic medical/surgical practice. Come join our caring, compassionate, motivated staff. Position open immediately but we will also consider 2014 residency graduates. PSR-36 or PSR-24 with rearfoot/ankle training required. E-mail cover letter, CV, surgical log and references to rvalins18@aol.com

ASSOCIATE POSITION - CONNECTICUT
 
Looking for an associate with 3-year residency training for a practice in Connecticut. Interested in all aspects of podiatry including  foot/ankle surgery and wound care. Hospital located close by with appointment to staff readily available. Will lead to partnership Please send CV to: dsharnoff@hotmail.com

ASSOCIATE POSITION - KENTUCKY

Immediate opening in beautiful Southern Kentucky with 8-provider group with excellent reputation, full-time physical therapy, MRI, CPED/CO on staff along with a full schedule awaiting.  Wonderful place to raise a family, excellent schools and phenomenal quality and cost of living. Excellent compensation package, full benefits, and buy-in opportunity after 2 years. Email a letter of interest and CV: jonkim12000@yahoo.com

ASSOCIATE POSITION - SF BAY AREA

East SF Bay Area associate wanted for 3-office practice. CA License and PSR-24 minimum. All aspects of podiatry. Need to be highly motivated, a self-starter and be able to start Aug. 1, 2013. Salary BOE. Send CV to drscivally@sbcglobal.net

ASSOCIATE POSITION - SOUTHERN CALIFORNIA
 
Very busy, two location group practice seeking a full-time, self motivated and hard working podiatry associate. Competitive salary and benefits are offered. Please email CV to: footcare4all@aol.com

ASSOCIATE POSITION - PENNSYLVANIA

Associate Wanted for busy, multifaceted podiatry practice in Chester and Delaware counties, Pennsylvania. Seeking PSR-24/36 trained podiatrist for full/part time associate position. Two offices and hospital privileges. Send CV and letter to: 123bunion@gmail.com

ASSOCIATE POSITION IN SOUTHERN CALIFORNIA

Full-time, motivated, outgoing associate wanted for immediate job opening. We are a multi-office, multi-doctor practice based in Orange County and we’re looking for a hard working individual to treat wide range of patients. PSR 24 training a must and Spanish speaking a definite advantage. Email your CV to: ocpodiatryoffice@gmail.com.

ASSOCIATE POSITION - MARYLAND, DC, PA

A podiatrist is needed for the Baltimore, Washington, Pennsylvania area. Partner for the corporation. Surgery center, emergency room call and a hospital location. All areas of podiatry. Established practice. Salary and commission. Fax resume 410-857-4227 or email at butler@qis.net

ASSOCIATE WANTED - NEW YORK

Well-trained experienced surgical podiatrist for busy Bronx and White Plaines offices. Associate working for partnership, if desired. Send Resume to bronxpodiatry@yahoo.com

ASSOCIATE POSITION - BAKERSFIELD, CA
 
Office and hospital-based podiatry group seeking a highly trained surgical associate to complement our 3-doctor group. Minimum PSR-36 trained with rear-foot reconstructive experience required. Must have CA license and x-ray and fluoroscopy license. Previous practice experience is preferred. Competitive salary and benefits package. Please forward cover letter and CV to modpm@aol.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 PODO2345@AOL.COM 516-476-1815.

PRACTICE FOR SALE - SOUTHWEST FL

Multilocation multidoctor practice in beautiful Southwest Florida . Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to: practiceforsaleswfla@gmail.com

PRACTICE FOR SALE - MISSION VIEJO, CA

Relocating to Tulsa. Great opportunity to buy my office. Located at Mission Hospital. Gross income 2012 was $548,000. Approximately 1300 sq ft with 3 treatment rooms, digital x-ray and fully computerized. Will consider all offers. Call David at 949-702-1052 or david@missionviejofootcare.com

PM News Classified Ads Reach over 14 ,000 DPMs and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 14,000 DPMs. Write to: bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 for a 50-word ad. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

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