The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

July 07, 2008 #3,291 Editor-Barry Block, DPM, JD

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Oscar L. "Jack" Lippard, DPM

Dr. Oscar L. "Jack" Lippard, a podiatrist who specialized in helping diabetic patients, died June 29, 2008 after a brief illness. He was 85. He was a flight instructor in the Navy in World War II. After the war, he studied at the Temple University School of Podiatry in Philadelphia. In addition to a private practice, Dr. Lippard directed the Podiatry Clinic at St. Louis University Hospital from 1951 to 1956. He also developed and directed the Diabetic Foot Clinic at Barnes Hospital, from 1956 to 1985.

He served as president of the American Diabetic Association of the Greater St. Louis Area, and wrote many articles on podiatry and diabetes and a widely used textbook, "The Diabetic Foot." Dr. Lippard had been a past president of the Tennessee Society — an all-male social club formed to honor the memory of Andrew Jackson.

PM News policy is to request that memorial donations be made to the APMA Education Foundation Student Scholarship Program, 9312 Old Georgetown Rd. Bethesda, MD 20814.

STS Company Donates Slipper Socks to Samuel Merritt

The STS Company of Mill Valley, California has reached an agreement with the Department of Applied Biomechanics of the Samuel Merritt School of Podiatric Medicine for a donation of Slipper Socks and other casting socks for the clinical use by their students for a five-year period.

Dr. Paul Scherer (seated), Chairperson of the Department of Applied Biomechanics at the CSPM in Oakland receives donation of STS Slipper Socks from Dr. Richard Stess, President of the STS Company

The donation to the California School of Podiatric Medicine is the fourth major donation the STS Company has finalized in its pledge to support colleges of Podiatric Medicine. The STS has already provided major donations to the New York , Ohio and Scholl Colleges according to Richard Stess, DPM, President of STS Company. Dr. Stess states that the STS Company hopes to assist in the overall biomechanical training of podiatry students by providing its Slipper Sock casting products for the student skills workshops and clinical uses. The founders of the STS Company, Drs. Peter Graf and Richard Stess, are both CCPM graduates.

Baucus Presses HHS to Delay Physical Therapy Payment Caps

Senate Finance Committee Chairman Max Baucus (D-MT) called on HHS to delay enforcement of certain “therapy caps,” which limit how much Medicare pays for outpatient services such as speech and physical therapy.

Congress routinely has placed a moratorium on the caps, but this year a measure that would do so has yet to pass the Senate. The cap went into effect July 1. In a letter to HHS Secretary Mike Leavitt, Baucus said that HHS should voluntarily place a moratorium on the payment limits and delay processing claims to avoid “disruption, dislocation and injury to Medicare beneficiaries.”

The caps affect an estimated 700,000 Medicare beneficiaries, many of whom reside in skilled-nursing facilities, Baucus said. “Without the exception process, their Medicare therapy benefit will end,” he added. A provision to stay the caps was part of a broader Medicare bill, which Congress failed to pass before their Independence Day recess.

Source: Matthew DoBias, Modern Healthcare [7/3/08]

Hiring Tip

Ask prospective employees to tell you about three successes and three setbacks and how they dealt with them. Then hire the person who shows the same amount of enthusiasm when describing either one.

Reason: Peak performers put as much efforts into successes as they do into failures.

Source: Dr. Charles Garfield, cited in Executive Strategies

Query: Nail Bed Inflammation

I recently saw a 19 y/o female complaining of fungal toenails. She has been on Lamisil twice and topicals without resolution. She denies pain and complains only of the cosmetic appearance of the nails. She has thick white “root-like” extension under both hallux nails, and the nails are somewhat in a pincer deformity due to the bulk of the debris. Her nail color is white to normal. Pathology samples revealed no fungal elements, but an inflammatory response of the nail bed and/or matrix. She wears mostly open-toed shoes. Any suggestions on treatment?

Dana Giacalone, DPM, Grapevine, TX

RE: EHB as a Spacer for Keller Procedure (Greg Caringi, DPM)
From: Multiple Respondents

I haven’t used the EDB procedure, but I have had good luck with the hour-glassing of the capsule with 2-0 Vicryl and, of course, the procedure recommended by the late Dr. Ganley, where a medial flap is created and used to cover the met head -- this really works the best.

Frank DiPalma, DPM, Athens, GA, Fivetoes1946@AOL.COM

It would probably be best to "hour-glass" the capsule between the met head and phalangeal base if you can. With time, it will act as a spacer and keep the phalangeal base from rubbing or eroding the met head cartilage.

Art Korbel, DPM, Coral Springs, FL, Classicboats4425@aol.com

Small bone Innovation (SBI) has an excellent product intended to be implanted into the scaphotrapeziotrapezoidal (STT) joint as an interpositional spacer between the scaphoid bone and the trapezium and trapezoid bones. The device is intended to be used in thumb disabilities caused by osteoarthritis. Although off-label, this works quite well. A tech guide can be found by clicking here.

Gerald Mauriello Jr., DPM, MA, Toms River and Lakewood, NJ, mauriellodpm@gmail.com

RE: Paronychia in a 6 Week Old Infant (Stuart W. Honick, DPM)
From: Multiple Respondents

I like using the Keralac nail stick in this type of situation. The high urea concentration keeps the nail very soft. An infant’s nail is usually pretty thin as it is, so it is much easier to trim the nail and keep it away from the distal skin. Oftentimes, the nail may be so friable it literally flakes off. The advantage of this product is it is easy to apply as well with the applicator tip.

Jeffrey Kass, DPM, DPM, Forest Hills, NY, jeffckass@aol.com

While rotating at the New London Sub Base Clinic in Connecticut during my residency, I saw this complaint more than a few times. I had the mother take the newborn to the pediatrician for administration of a sedative (delivered in their formula) before the procedure. This was usually just a simple, conservative slant back along with debridement of granulation tissue. The mothers were instructed about proper care of the newborns' nails. It was painless for me, the baby and the mother. Everyone was pleased and it was successful on a longterm basis, having been caused by the position of the fetus in utero and alleviated after birth.

Kathleen Satterfield, DPM, Boerne, TX, vksatterfielddpm@aol.com

I have seen this on many occasions. The toe is pushing against the wall of the uterus during pregnancy or the infant is placed supine on the mattress, and the toe is pushing against the mattress and creating a paronychia with granulation tissue. I am afraid the only course is to remove the granulation tissue under a 1% plane lidocaine local. I usually have the parent hold the infant in their lap while I do the procedure in the office. I use a tissue nipper to do the procedure. I also remove the edge of the offending nail plate to allow time to heal. I protect the toe by asking the parent to use a bulky sock or foot booty to protect the toe. Over time, healing occurs.

Dan Klein, DPM, Fort Smith, AR, TOEFIXER@aol.com

EQUIPMENT FOR SALE - BOVIE

New Aaron Bovie 950 + Accessories Click here (never used but no box), Floor stand, 3 button power cord control hand piece, Bipolar cord and forceps, Grounding cable, 5 tips, Dermal kit-sharp/blunt angled blades, Manual/Instructional DVD, Many other unused accessories Contact DrburtonK@aol.com 301 423-9494

ASSOCIATE POSITIONS – CALIFORNIA

Coast to Coast Mobile Podiatry Group, California's premier provider of mobile on-site health-care services is seeking hardworking, caring Associates to provide excellent health-care to the greater Los Angeles areas, Organge County, San Bernadino County, Riverside, San Diego, and Santa Barbara. Salary and benefits available. Please email you CV and salary request to coasttocoastpodiatry@yahoo.com

PRACTICE FOR SALE MN: PRIME LAKES AREA

Great place to live and raise a family. 400+K yearly gross with continued growth and potential. Good mix of general podiatry and surgery. Hospital privileges available. Fully computerized, electronic notes with capability to go completely paperless. Recently remodeled office, 5 tx/procedure rooms, well-equipped in owner occupied building (for sale or lease). 260 402-7490.

ASSOCIATE POSITION - CALIFORNIA

Central Valley/Southern CA. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Surgery Center and hospital based with no HMOs/no rest homes. Bilingual in English and Spanish. Offering a permanent position/partnership in a multi-million dollar hi-tech practice. E-mail CV to: Tonya@wetreatyourfeet.com

ASSOCIATE POSITION – CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for full-time podiatrist in a multi practice location
in the Chicago land and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

IMMEDIATE OPENING - MINNEAPOLIS, MN

Associate leading to partner in well-established practice. Seeking personable, skillful, and attentive podiatrist. No nursing homes, evenings or weekends. Competitive compensation package including health insurance, malpractice, short term disability, 401(k), generous vacation, paid holidays, and excellent salary plus bonus! E-mail cover letter and CV to jbremer@associatedpodiatrists.com or fax to (612) 866-5875 attn: Jennifer Bremer

ASSOCIATE POSITION - BOSTON, MA

Associate wanted, Full-time or part-time, for busy long time, well established, and well rounded practice. Good mix of general podiatry and surgery. Office will generate approximately 100+ surgical cases per year. Must have surgical background for this practice, ABPS Qualified minimum needed to obtain hospital privileges. Associate position is open for partnership or purchase. Contact robert.nunberg@comcast.net

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

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