The Voice of Podiatrists

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July 14, 2008 #3, 297 Editor-Barry Block, DPM, JD

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Numerous Factors Affect Foot Position: CA Podiatrist

Numerous factors -- including the structure of your hip and leg, whether you have flat feet, and even the shoes you wear to work out -- may affect the position of the foot during activities, says podiatrist Neil B. Mansdorf, president of the Orange County Podiatric Medical Assn. In fact, 15 degrees of external rotation of the foot is considered normal.

Dr. Neil B. Mansdorf

Sometimes the hip is positioned so that the leg turns outward naturally when walking, says Mansdorf. Excessive external rotation may be helped by the use of orthotics. Rarely is surgery necessary.

"The compensation for a lack of external rotation of the lower leg may result in the heel twisting outward from beneath the leg." This could cause a flattening of the arch and external rotation of the forefoot. This type of compensation will also give the appearance of a foot that is turned out.

Source: Janet Cromley, Los Angeles Times, [7/14/08]

WY Podiatrist Running for Congress as a Libertarian

Candidates for the Wyoming's open U.S. House seat would like to see the Cowboy State expand its role in providing the nation with energy. Besides energy independence, the six candidates talked about the Wyoming Range and other issues at a town hall forum Thursday evening at Casper College's Aley Fine Arts Center. Michael Holland, Bill Winney, Cynthia Lummis, and Mark Gordon are seeking the GOP nomination.The only Democrat running is Gary Trauner of Wilson. W. David Herbert of Cody is running as a Libertarian.

Dr. W. David Herbert

Herbert, a Riverton podiatrist, said the price of gas is related to the weakening of the American dollar. The Libertarian solution would be to go back to a gold standard and balance the budget.

"One thing I propose is we stop any branch of government from any type of taxation on privately held real estate, so the average citizen would be able to protect themselves against inflation," Herbert said.

Source: Jasa Santos, Caspar Star Tribune [7/11/08]

Bush Intends To Veto Physician Pay Patch Bill

President Bush intends to veto legislation (HR 6331) that would delay a 10.6% reduction to Medicare physician fees that was scheduled to take effect last week, despite the measure passing both chambers by veto-proof majorities, the Los Angeles Times reports. The Senate on Wednesday approved the measure after it failed to receive enough votes for cloture on June 26. CMS provided Congress with more time to act on blocking the fee reduction, freezing physician fee rates until July 15 through an administrative measure.

The bill is similar to a measure (S 3101) proposed by Senate Finance Committee Chair Max Baucus (D-MT) that did not pass in the Senate. White House spokesperson Tony Fratto on Thursday said that Bush will veto the measure because it would reduce payments to providers of Medicare Advantage plans. "Taking choices away from seniors in order to pay for the reimbursement for physicians is the wrong way to pass this bill and to extend the reimbursements that we want to see physicians get," Fratto said

Source: Nicole Gaouette, Los Angeles Times via American Health Line [7/11/08]

Writing an Effective Press Release - Part 2

Use the third person. Write your press release as if it were coming from an objective outsider and not from yourself. So instead of writing "We are announcing that....., " write " The Podiatry Center of New York has announced that..."

Source: Adapted from 6 Proven Secrets to Writing a Trash-Proof Press Release by Bill Stoller.

Query: Papilloma Viruses Outside the Body

Does anyone know how long the human papilloma viruses that can cause pedal warts (types 1,2 and 4) can live outside the body (i.e., on bathroom floors, tile, pools)?

Lori S. Weisenfeld, DPM, NY, NY

Query: E-Prescribing

The congress passed the Medicare bill which (if they override the President's veto) gives a bonus if we electronically send prescriptions. Does anyone currently send prescriptions this way and what system do they use? Also ease of use, expense, etc?

Dennis Hershey, DPM, Brooklyn, NY

RE: APMA Wins Medicare Victory (Paul Kesselman, DPM)
From: Multiple Respondents

Let’s not celebrate too soon. According to press reports, President Bush remains steadfast in his threat to veto HR 6331. According to the article, the President while wishing to eliminate cuts in Medicare fees does not wish to do so at the expense of the Medicare Advantage Plans. Already some Republican Senators have suggested they would vote to override a Presidential veto. Republican Lamar Alexander remains non-committal on whether he would vote to support the President’s veto.

If the President as promised does veto this bill, immense pressure should continue on all Senators or Congressmen who initially voted against the measure or whose position seems tenuous. According to Senate Majority Leader Harry Reid (D-NV), anyone who changes their vote in support of a veto, does so at their own political peril.

In essence, now is not the time to back down. All physicians and patients should continue to stay in touch with their elected officials and continue to ask them to pressure President Bush to sign HR 6331 into law.

Paul Kesselman DPM, Woodside, NY, pkesselman@pol.net

Let us not forget that "WE" are the APMA. APMA is not some nebulous group of people. Everyone of us needs to talk, write, email, visit our legislators. We need to make our demands known APMA is doing a great job for us but it is WE who need to also put forth the effort.

Rob Frimmel, Sarasota, FL, rfrimmel@hotmail.com

I am thrilled that the APMA helped us win that legislation. If you look at it this way, we are in fact all members of the APMA, even though some do not pay their dues. It is about time for us all to "officially" belong to the APMA so they can continue to finance their stellar work!

Diane Branks, DPM, Baldwin Park, CA, diane.d.branks@kp.org

RE: Using a Table In Lieu of a Podiatry Chair (Eric Baskin, DPM)
From: Multiple Respondents

I have been using Hill podiatry chairs for years, and when I shared office space with an internist, he loved the chair. Not only does it lie entirely flat, allowing for exams, it accommodates up to 500-pound patients, and the chair costs less than $4,000. They are very durable and work well. They also are very comfortable.

Marjorie Miller-Khawam, DPM, Long Beach, CA, footssy@aol.com

At my satellite location, we use the MIT Podiatry chairs. At this location, they are also used by pain management, plastic surgeons and orthopedists. They are wide, rugged, and easily convert to a bench with power controls. They also have adjustable hand rails.

Joe Boylan, DPM, Ridgefield, NJ, Drb0327@aol.com

I work with a large orthopedic group as their only podiatrist, and I asked this same question a few years ago. I received about ten e-mail replies from other podiatrists in similar positions. The responses were all over the map. Some successfully argued with the MDs for podiatric chairs. Some lost the battle. Some became comfortable with the tables. I even looked into creating a piece of office furniture like a footstool accessorized for palliative care, eventually dropping the idea as too expensive and esoteric to get enough sales.

For now, I sit my patients in a chair and prop their feet up, one at a time if necessary. I use a smaller stool to get low enough to see and treat the foot palliatively. All injections and procedures get the table. The hidden benefit I found comes from sitting in chairs with the patient. I find that they are not in the subordinate patient position as much, not intimidated, and participate more easily in their own care and decisions. I also think that more and more podiatrists will be working with MD's and trying to adapt to their furnishings.

Matthew J. Connolly, DPM, Ft. Thomas, KY, mjcdpm@fuse.net

PODIATRIST POSITION – SOUTHERN CA

Medical group in Southern CA seeking a residency trained DPM. Practice includes general podiatry, biomechanics, wound care, surgery, diabetic feet, trauma. Part-time position available may lead to full-time. Excellent salary/benefits. Position available in mid July 2008. Please reply to E-mail: slowed2@yahoo.com; 4476 Tweedy Blvd, South Gate, CA 90280.

ASSOCIATE POSITION - NEW JERSEY

Established practice in Ocean County seeks hardworking, ethical, energetic and well-trained (PSR 24/36) individual. Must be willing to do all aspects of podiatry! Base salary $100,000 to start plus benefits package. Hospital & surgical center privileges. E-mail CV to NJFeet@aol.com

EQUIPMENT FOR SALE

Recently closed practice looking for quick sale on equipment: one Midmark 117, 2 Midmark 417, stools and an x-ray processor. Please email SeanRosenblum@optonline.net with any questions.

ASSOCIATE POSITION - NORTHWEST CHICAGO AREA

Immediate opening for full-time podiatrist in busy practice, potential for partnership. This practice has been established for over seventy-five years, with current owner for over twenty-five years, and treats a wide range of pathology ranging from conservative through surgical care. Hospital and surgical center privileges are available. Applicant must have 3 year residency, ABPS qualified, hardworking, and enthusiastic. Anyone interested and qualified for this phenomenal opportunity should send resume to gkjaco@aol.com and mark subject "podiatry position."

EQUIPMENT FOR SALE – MIDMARK CHAIR

Midmark 417 Chair, pea green. Bought approximately 8 months ago as an extra chair, barely used, perfect condition. Retail price (new) is $5,500. Offered for $3,500. Please email institutebeaute@aol.com with queries, or call 212-535-0229.

BIOMECHANICS FELLOWSHIP – NEW YORK

Neoteric Biomechanics (patent pending) Nine-Month Fellowship: At The Foot Typing Center® in New York City. Practice, Research, Publish and Credentialize Yourself In This New Paradigm. $36,000 Stipend. New York License Required.Fax Interest to: 212 288 3034 or apply to Dr. Shavelson @ drsha@lifestylepodiatry.com.

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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