The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 12, 2011 #4,204 Publisher-Barry Block, DPM, JD

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Correction

In yesterday's PM News, we reported that a 5% discount was available to PICA policyholders who attend a PICA Insurance penary session. The extra 5% is only for those APMA members who are PICA policyholders and who attend a separate PICA risk management program.

FL Podiatrist Discusses Syndactyly

Celebrity Ashton Kutcher is no stranger to a good sense of humor. Ashton has publically announced having been born with webbed toes! Ashton was born with a condition called Syndactyly. Syndactyly is a condition in which two or more digits, fingers or toes, are fused together. Instead of functioning individually, they function as one unit because the skin between the digits is fused. There is no visible separation between the affected digits, and the digits may resemble a “webbed foot” or a “webbed toe.” 

Dr. Kelly Malinoski

"Syndactyly usually is not a symptomatic condition, rather, a cosmetic concern, says podiatrist Dr. Kelly Malinoski. "There are surgical options available to reconstruct webbed toes in some cases. Ironically, there are other cases in which surgeons purposely syndactylize digits! Usually the middle and ring fingers are the most prone to syndactyly. Surgical repair is usually successful with the creation of two normal looking fingers or toes," says Malinoski.

OH Podiatrist and Son Return from Medical Mission In Cambodia

Dr. Roger Hamm of the Louis Stokes Cleveland VAMC and his son Nathan Hamm, 4th year student at the Ohio College of Podiatric Medicine went on a medical mission with Vets with a Mission vetswithamission.org. From June 15-30, 2011, a group of 25 people including physicians, nurse practitioners, physician assistants, nurses, pharmacists, and non-medical personnel conducted clinics in Phenom Phen, Siem Reap, and Anglong Veng.

Dr. Roger Hamm (R) with Son Nathan in Cambodia

During the clinics, the group treated almost 2,800 patients. At one clinic, 471 patients were treated in one day. Several patients were sent to local hospitals (at VWAM expense) for various surgeries. VWAM also funded the completion of a project at one of the clinic sites. This is the third trip Dr. Hamm has participated in with VWAM. On a previous trip, he had the opportunity to lecture and perform surgery at the College of Medicine and Pharmacy, Hue, Vietnam.

Boy with Prosthetic Leg Rides Bike Given by FL Podiatrist

Though Tyler Manning is only 12, he has been to countless doctors, has undergone numerous tests and even major surgery to amputate part of his right leg below the knee after being diagnosed with a rare cancer. He now has a prosthetic leg, but that didn't stop him from swimming with dolphins in the Gulf of Mexico. 

Tyler Manning and Dr. David Haile

When he's not swimming or playing his favorite video games or learning about guns using his seven iPhone application, Tyler has learned how to run, and recently how to ride a bike that was given to him by his podiatrist, Dr. David Haile. "He gave him the bike at Christmas-time and said, 'I want to see you ride that bike,'" said Mrs. Manning.

Source: Jessica Tuggle, Hometown News [7/8/11]

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: If you could alter our educational experience, what would you change?

Dr. Anthony Poggio

Anthony Poggio: I think a lot of our graduates know the academics, but they don’t know the business part - and medicine is a business. They need to learn how to practice, and how to be efficient in practice. In  residencies, they should be given some education on proper billing just so they don’t pick up a bad habit, and the next thing you know is they’re getting audited. When they do get audited, they just say, “I’m totally ignorant of this” and they are. 

Drs. Barry Block, Glenn Gastwirth, Jon Hultman, Franklin Kase, and Michael King

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). The next segment will feature podiatric leaders discussing the California licensing initiative. You can register for this event by clicking here

Shortage of Physicians, APNs, PAs Predicted for 2025

Advanced practice nurses (APNs) and physician assistants (PAs) are frequently touted as the solution to the physician shortage, but there will not be enough of all three professionals combined to meet the nation's healthcare needs in 2025, according to a study published in the June issue of the Journal of the American College of Surgeons.

Lead author Michael Sargen, a medical student at the University of Pennsylvania in Philadelphia, and co-authors write that although the United States needs to expand the workforce of these three types of "advanced clinicians," healthcare personnel with less training must assume more patient care responsibilities, especially as more Americans gain insurance coverage under the Affordable Care Act.

Source: Robert Lowes, Medscape News [7/11/11]

RE: Silastic Implant Complication
From: Gino Scartozzi, DPM

A discussion of the complication would not be complete without the benefit of the pre-operative and the most recent post-operative radiographs. In light of this limitation, several reasons I would consider that may have accounted for implant failure/fracture as described would be:

1. The bone stock of this patient was compromised and osteopenic pre-operatively. Selection of a first metatarasl-phalangeal joint prosthesis may not have been an ideal procedure for this patient with such bone stock;

2. The surgical technique in the reaming to fit the implant may have created a "stress fault" for the implant to break through the cortex, especially if...

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

RE: NaHCO3 with Local Anesthetic (Ivar Roth, DPM, MPH)
From: Robert Eells, DPM, John D. Gilfert, DPM

I have been using a 10% solution of Lidocaine and NaHCO3 for over ten years, and it works great to reduce the burning during the numbing of a toe. I just withdraw and discard 5 mL from the 50 mL lidocaine bottle and add 5 mL of NaHCO3. There is a noticeable reduction in patient discomfort. Try it.

Robert Eells, DPM, Des Moines, IA, rgeells@gmail.com

I routinely mix lidocaine and Marcaine with sodium bicarbonate  to ease the burning pain that the acidic local anesthetic causes during injection. This mixture, combined with ethyl chloride spray to the skin prior to injection, often makes for a totally painless or near painless injection of local anesthesia, especially useful for pediatric patients or the anxious type.

The sodium bicarbonate must be added immediately prior to the injection and cannot be mixed in advance, or the local will be rendered inactive. I merely draw up a small amount of sodium bicarbonate into the syringe and then fill the remainder with the local - perhaps at a 1:10 ratio.

John D. Gilfert, DPM, Camp Hill, PA, gilfertzgg@comcast.net

RE: Credit Card Processing for Physicians (Ronald Werter, DPM)
From: Howard Roesen, DPM

We had also received  a charge from our old  Merchant Services company because we were not PCI-compliant. Retriever Medical is not the only company that can make you compliant as we found out later. Our experience with Retriever was not a good one. Please feel free to e-mail me before signing any contracts with them.
 
Howard Roesen, DPM, Newport News, VA, HRoesen@cox.net

RE: Reconciling Daily Depositis with TrakNet (Steven Block, DPM)
From: Brooke Weaver

We reconcile the front desk by the unapplied payments found under the view menu. This allows the front desk to compare all receipts and payments before billing applies the payments. The other reports we use are in the report menu. We view both the Activity Report in summary and detail, as well as the Payments on Charges Report that show, again both in summary view and detail view. With EFT received usually a day or two before the funds are actually deposited, we do not download or apply them from the Gateway until we confirm deposit with the bank by checking on-line. 

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

RE: Repair of Spring Ligament CPT Code (Amol Saxena, DPM)
From: Harry Goldsmith, DPM

I disagree with Dr. Saxena’s choice of CPT 28555 - open treatment of tarsal bone dislocation, with or without internal or external fixation, for the isolated soft tissue repair of a ruptured spring ligament. I also question that the imbrications would be analogous to repairing the deltoid ligament. There is no frank dislocation present and the joint types involved about the spring ligament are not similar to the ankle joint.

There is no CPT code for an independent soft tissue repair or imbrication of a ruptured spring ligament. The correct code is unlisted foot/toe procedure, CPT 28899.

Harry Goldsmith, DPM, Cerritos, CA, hgoldsmith@codineline.com

RE: How Would Life be Different With an MD Degree
FROM Paul Kruper, DPM

More important than an MD is a DPM full-scope license. I prefer to be a podiatrist over an MD. With a full scope DPM license, I could remain a foot specialist but, at the same time, use my education and skills to treat medical and surgical problems in the entire body. I could treat the diabetic foot ulcer and the disease itself; remove warts from the feet and hands; excise a cyst from the arm and the foot. Those blank spots on my schedule would be filled with patients seeking care for many problems. The DO profession never coveted the MD, and they still learn and practice manipulation, while providing full-scope medical care. They also have more career opportunities.

Paul Kruper DPM, Kingsburg, CA prkruper@yahoo.com

Editor's Note: This topic will be discussed on Tuesday night's Meet the Masters. You can register for this event by clicking here

RE: Acquitted CA Podiatrist Responds
From: Matthew H Sciaroni, DPM

The story concerning my trial in May 2008...accused of sexual misconduct, lewd and lascivious contact with a minor...needs to be updated. Not only was I acquitted of all counts against me...a decision the jury made in less then one day, but The California Podiatry Board dismissed all accusations against me. To any thinking person out there, this case should never have gone to trial. The mother of the supposed victim was in the room, as was my chaperone, and was a convicted felon for insurance fraud.

The daughter, after turning 18 y.o., not only wanted to work in my office as an intern, but was soliciting on Craigslist. Believe me when I write that everyone is a target for these scams. It doesn't help that the BPM is corrupt. I am now helping other podiatrists in California in fighting the Board, besides continuing to practice my speciality. I'm a wealth of information.

Matthew H Sciaroni, DPM, Fresno, CA, drhunt1@comcast.net

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

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.

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.

EQUIPMENT FOR SALE - CLASS FOUR LASER

I have a class four pain laser for sale. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net 

ASSOCIATE OPPORTUNITY – SOUTHERN NEW JERSEY

Searching for the “perfect” associate for our busy and rapidly growing practice; EMR, ultrasound, vascular studies, and DME. We have advanced surgical and admitting privileging at multiple teaching hospitals. You must bring strong medical and surgical skills to a practice that is sincere about teaching you success in private practice. Hardworking and personable doctors only! Partnership track. If we sound like your “perfect” practice, email CV, letter of recommendation, personal introduction of yourself, why you are passionate about podiatry (like us) and want to live in Southern New Jersey to doctor@sjfootdrs.com

ASSOCIATE POSITION - CANADA
 
Beautiful Victoria, B.C. Canada on the ocean, fast growing area. Associate for multi-office full scope practice. Reply to dr.cole@shaw.ca

ASSOCIATE POSITION - NEW YORK CITY & QUEENS

High Income Potential. One of the fastest growing podiatry practices in New York City and Queens seeks a hard-working podiatrist who participates with HealthFirst, Fidelis, Metroplus, and other Medicaid plans. Preferably a Spanish-speaking podiatrist. Contact me at Podocare@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 POSITION – NEW YORK
 
Busy, well-established for 35 years, multi-site practice in upstate New York looking for licensed podiatrist who is ready for a thriving practice. Must be highly motivated, personable and great with patients. Competitive salary and benefit package. Send CV or letter of interest to associateinfoot@yahoo.com

ASSOCIATE POSITION - TEXAS

San Antonio, Texas. Prefer an experienced practitioner in all phases of podiatry; will consider PSR36 trained resident, with good people skills. This opportunity will lead to full partnership for the right person. Good starting salary and benefits in modern office in Northeast Medical Center. Fax CV to 210-495-6484 or email footcenter1@sbcglobal.net

ASSOCIATE POSITIONS - NW INDIANA

2 Full-Time positions open - One for Northwest Indiana. 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/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 – 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 - 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

 PM News Classified Ads Reach over 12,500 DPM's 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 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 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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