The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 18, 2011 #4,209 Publisher-Barry Block, DPM, JD

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"We're All About Prevention" : IL Podiatrist

Doctors of podiatric medicine focus their practices entirely on the foot, ankle, and lower leg. Their medical education and training includes four years of undergraduate education, four years of graduate education at an accredited podiatric medical college, and two or three years of hospital residency training.

Dr. Kirk Contento

Unlike many familiar screening guidelines, like getting your first mammogram at age 40 or your first colonoscopy at age 50, there is no definite rule about when to start seeing a podiatrist. "I always suggest coming in for an initial look once you're past your 30s," says Dr. Kirk Contento of Contento Foot & Ankle Center in Palos Heights and Chicago. "We're all about preventing little problems from developing into something major later."

Source: Chicago Tribune [7/12/11]

IL Podiatrists Present at National Orthopaedic Meeting

On July 14 - 16, 2011, the American Orthopaedic Foot and Ankle Society held their annual summer meeting in Keystone, CO. Podiatrists, Brad Buzzewitz, DPM, Wenjay Sung, DPM, and Lowell Scott Weil, Sr., DPM  presented their research to the orthopedic audience. 

(L-R) Drs. Lowell Weil, Sr., Jay Sung, Christopher Hyer, and Bradley Bussewitz

"It is always a pleasure to represent the research work of podiatric surgeons to the orthopedic community. I am sure that the entire podiatric profession would be very proud of our podiatric Fellows, Brad Buzzewitz and Wenjay Sung, who both gave outstanding podium presentations," said Weil.

IN Podiatrist Labors to Complete Triathlon While Carrying 75 Lb. Boy

Dr. Paul Sommer figured he wouldn’t have too tough of a time swimming, biking, and running in the ninth annual Valparaiso sprint triathlon at Rogers-Lakewood Park. He figured wrong. The 49-year-old long-time veteran of dozens of triathlons, mini-triathlons, and even two Ironman competitions looked fresh, strong, and ready to go as he strolled to the park’s lake to begin the race around 8:30 a.m.

Dr. Paul Sommer struggles to keep a grip on 10-year-old Kyle Polhemus while transitioning from the swim to cycle portion of the Valparaiso Triathlon

To challenge himself even more, he competed while hauling around 10-year-old Kyle Polhemus, who weighs 75 pounds, has a severe form of muscular dystrophy, and the mental capacity of a boy half his age. At the finish line, it was Kyle who whispered to his mother, “He’s having a hard time. Call 911.” Sommer struggled to his feet to hug Kyle’s mother. He broke into tears. She broke into tears. The crowd applauded.

Source: Jerry Davich, The Post-Tribune [7/16/11]

CA Spa Owner Who Used Laser on Fungal Nails is Arrested

A San Jose spa owner who owns several Shiny Toes shops in the Bay Area is facing felony charges after investigators seized evidence from his office and charged him with injuring a 4-year-old child during laser treatment. Cary Silberman, 52, was arrested Monday by investigators from the Medical Board of California and was charged by the Santa Clara County District Attorney's Office with two felonies, including practicing medicine without a license and grand theft by fraud, and one misdemeanor count of child endangerment.

Silberman called the criminal case brought by the medical board "a travesty" that was sparked by an angry San Francisco podiatrist who is jealous over his success. Silberman owns a number of spas called Shiny Toes, which advertise laser treatment for nail fungus, according to the Medical Board of California. An undercover investigator, posing as a patient, gathered evidence that Silberman was diagnosing and treating people suffering from toenail fungus and using lasers to treat the ailment.

Source: Mark Gomez, Mercury News [7/14/11]

Query: Pain in Peroneus Brevis Tendon

I have a healthy 74 year old female patient with chronic pain at the peroneus brevis tendon insertion at the 5th met base from a prior inversion injury. Her pain is with direct palpation and weight-bearing. X-rays are unremarkable. I treated her conservatively over the past six months with NSAIDs, PT, Bracing, orthotics, and immobilization with a CAM walker, and even cast her.  

A prior MRI displayed a small insertional tear. Following this, we cast her for several weeks, then placed her in a CAM walker for several more weeks.  She returned to normal shoe wear for a brief period but the pain returned, I repeated the MRI for a surgical evaluation for tendon repair, and the MRI showed her having a healed tendon compared to the prior MRI.  Am I correct in assuming that there probably is still an insertional tear? Any recommendations as to repair would be appreciated.

Mark Ray,  DPM, Latrobe, PA

Query: EMR Incentive Check?

Has ANY podiatrist received the incentive money the government said they would pay doctors for investing in expensive technology that is supposed to make patient care more accurate and our work lives more pleasant?

Mario Dickens,DPM, Chattanooga,TN

RE: Verapamil (Jeffrey Kass, DPM)
From: Elliot Udell, DPM
 
In our office, we too have had some good and some poor results using the topical Verapamil compound. I would, however, be very cautious about injecting Verapamil into a patient. On the spectrum of calcium channel blockers, it affects the central cardiovascular system more than other calcium channel blockers. In essence, it has both a negative chronotropic and inotropic effect and would slow down the patient's heart rate and force of contractions. This could also cause a rapid decrease in the patient's blood pressure. None of this might be a problem unless the patient has underlying cardiac pathology. Hence, I would not inject this into a patient without clearance from the patient's internist and/or cardiologist.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Interaction Between NSAIDs and SSRIs (Greg Caringi, DPM)
From: Larry Kollenberg, DPM

As with any program on drug interactions, there are probably several different levels of interaction that are listed. For example, "minimal", "moderate", or "severe." The listing "moderate" is probably what was seen in your program. The actual DDI is based upon the effect on platelets. Both NSAIAs and SSRIs can affect platelets' ability to work in clots. Information from programs like this requires any healthcare provider to look at the benefits and risks associated with the overall health of the patient.

When providers look at DDIs to address benefits and risks, they must analyze the patient information involving age, PMH, labs, general disease states and their management, medication therapy management. If you as the provider review this, then you can reasonably make an intelligent decision on the effect of the DDI on the welfare of your patient. If you are still unsure, then consult a clinical pharmacist, and provide the above information and get a second opinion.

Larry Kollenberg, DPM, Pharm D, Baltimore, MD, lkollenberg@hotmail.com

RE: Tenosynovitis, Posterior Tibial Tendon (Hartley Miltchin, DPM)
From: Todd Lamster, DPM

Assuming that you don't want to perform surgery to remove the calcification within the tendon, I suggest platelet rich plasma injections or Traumeel injections. I have used both in the past, and I have had success with both. My personal opinion is that the PRP has a greater likelihood of actually healing the tendon, whereas the Traumeel would probably decrease the local inflammation temporarily.  I would perform the injection and then place the patient in a CAM walker for 2-3 weeks and repeat for 2-3 cycles. Usually, I have the patient go to physical therapy in between each injection. The entire regimen lasts anywhere between 6-10 weeks, depending on how the patient responds and how many injections you perform.

Todd Lamster, DPM, Phoenix, AZ, tlamster@gmail.com

RE: Voice Dictation System Compatible with Practice Fusion (Larry Dorman, DPM)
From: Richard A. Simmons, DPM

My suggestion is to use a voice dictation system that is compatible with the operating system of your computer. Create the note in your computer and simply copy/paste it into Practice Fusion. The beauty of Practice Fusion that seems to be lost on most is that you do not have to spend all that money on extra features. You will want to have a hard copy in your own server anyway, so create it there first, then copy/paste the final note.

Richard A. Simmons, DPM  Rockledge, FL  RASDPM32955@gmail.com

RE: Empower Staff When You are Away
From: Jon Purdy, DPM

I feel compelled to add to the post on empowering staff. This is a very tenuous time for a practice, and one not to be taken lightly.  Taking time away from your practice can be rewarding or extremely frustrating. Avoid a potential office breakdown by planning properly for your absence. It is essential for the practitioner and management to make a detailed list of what needs to be accomplished over the ensuing days. Activities such as catching up on back-logged work, creating new systems, and reorganizing can be rewarding.

Make sure that you are not paying employees to perform busy work.  Make it clear that no new “systems” will be created without your knowledge. Assign team leaders to oversee projects and make sure everyone in the office has well defined goals. Your team needs individualized ownership of the tasks they are to accomplish. If not done well, it can be a point of contention for all. If done properly, this can be a well needed rebooting of the office.

Jon Purdy, DPM, New Iberia, LA, jpurdy@mindspring.com

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

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 516 476-1815PODO2345@AOL.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.

ASSOCIATE POSITION - NYC, NY

Part/time, full/time associate for busy, well established multi-doctor, multi-office NYC group. Seeking motivated, ethical, NYC licensed DPM with excellent office management and clinical skills in all phases of Podiatry. Board Qualified/Certified preferred. Salary plus incentives, pension/medical/dental. Partnership potential. E-Mail CV to jermaire@aol.com

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 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 - 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 - SOUTHERN CALIFORNIA

Busy multi-office practice in L.A./Inland Empire areas in need of full-time or part-time associate for a well paid position. NO Nursing homes! Must have CA license. Medicare and DME numbers are helpful. Please send CV and contact information toscpodgroup@yahoo.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

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