The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

July 19, 2012 #4,518 Publisher-Barry Block, DPM, JD

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AOL Problem Fixed

Some AOL subscribers may not have received the complete PM News dated 7/17/12 and 7/18/12. If you did not receive the entire issue on either of these two dates, please click  http://www.podiatrym.com/pmnewsissues.cfm?pubdate=07/17/2012 for the 17th and http://www.podiatrym.com/pmnewsissues.cfm?pubdate=07/18/2012 for the 18th. My apologies for this inconvenience.

Flip-flops Offer limited Protection from Melanoma Danger: NY Podiatrist

Dr. Bryan Markinson

Few people understand or think of the foot as a place where skin cancer can arise. Result: Foot melanoma can be deadly. Mount Sinai podiatrist Dr. Bryan Markinson reports a sharp rise in foot melanoma among his patients. Alert to sandal wearers: Remember to apply sunscreen to your feet!

Source: The Saturday Evening Post [7/17/12]

NY Podiatrist Discusses Causes and Treatment of Blisters

Blisters are most commonly caused from wearing shoes without socks — leading to excessive friction on bony areas of the foot — as well as wearing ill-fitting shoes,” said Dr. Cindy Resnick, noting that sweating in warm weather adds insult to the injury. “It’s always best to see a podiatrist so measures can be suggested to properly treat blisters and avoid reoccurrence,” Dr. Resnick noted.

Dr. Cindy Resnick

Whether from wearing ill-fitting shoes or spending too much time on their feet, most people have experienced the painful, small pockets of fluid known as blisters. Don’t wait to break in new footwear to prevent blisters from forming, the podiatrist said, adding that new shoes should feel comfortable right away. If you have a blister, she said, properly treat problem areas to avoid infection.

Source: Keely Mohin, Staten Island Advance [7/16/12]

OH Podiatrists Publish Chapters in New Surgical Text

The next generation of orthopedic and podiatric surgeons around the world may be studying from a textbook written in part by a pair of Youngstown-area podiatric physicians, Drs. Lawrence A. DiDomenico and Thomas Groner. Both are podiatric surgeons at Ankle & Foot Care Centers here.

(L-R) Drs. Lawrence A. DiDomenico and Thomas Groner.

DiDomenico wrote three chapters in the recently published International Advances in Foot and Ankle Surgery textbook being used in medical and podiatry schools globally. Groner co-authored two of the three chapters. DiDomenico, who has authored portions of textbooks numerous times in his career, also is completing three chapters for another textbook to be published this fall.

Source: The Business Journal [7/17/12]

NY Podiatrist's Musella Foundation Awards Grant to Study Brain Cancer

The Musella Foundation For Brain Tumor Research & Information, Inc. (Musella Foundation), a non-profit organization dedicated to improving the lives of families dealing with brain cancer, today announced that it has awarded Tocagen Inc. (tocagen.com) a grant to support the clinical investigation of Toca 511 & Toca FC in patients with recurrent Grade 3 glioma brain cancer. Tocagen is a privately held biopharmaceutical company developing novel treatments for advanced cancer, with an initial focus on brain cancer.

Dr. Al Musella

This grant supports an important new opportunity for patients with Grade 3 glioma, said Al Musella, DPM, President of the Musella Foundation. It is innovations like Toca 511 & Toca FC that, we believe, may make a difference in the lives of these patients.

Source: San Fransisco Chronicle [7/17/12]

AMA Aims to Standardize Doc Reports

Seeking to make the feedback that health insurance companies provide in physician data reports more useful, the American Medical Association has developed "Guidelines for Reporting Physician Data." The guidelines promote greater format standardization and process transparency, and a higher level of detail.

More than 60 organizations have already pledged their support for the effort, which was developed with input from public and private health insurers, state and specialty medical societies, health standard organizations, and employer and consumer coalitions, according to the release. The initiative also is said to be supported by Cigna, the Midwest Business Group on Health, the National Committee on Quality Assurance, and UnitedHealth Group.

Source: Andis Robeznieks, Modern Physician [7/16/12]

Query: Certified Wound Clinic

How can we set up a certified wound clinic in our office?

Andre Williams, DPM, Port Charlotte, FL

RE: Botox for Over-active Tibialis Posterior (Sean S. Ravaei, DPM)
From: Howard Dananberg, DPM

Be careful with Botox. In cases such as this, the hyperactivity of the posterior tibial may actually be related to an inhibited status of the peroneus longus. If you inject the posterior tibial muscle to essentially paralize it, your patient may not be able to walk for an extended period of time. Peroneal inhibition is, in most cases, related to equinus of the ankle caused by the inability of the fibula to normally translate during gait.   

Manipulation of the ankle may be a simple solution to the issue.  For more information on this method of care, please review my September, 2000 article in JAMPA on ankle manipulation* and you can also go to the Vasyli Medical website (vasylimedical.com) for videos on this technique.  
 
*Dananberg, HJ, Shearstone, J, Guiliano, M “Manipulation Method for the Treatment of Ankle Equinus, “Journal of the American Podiatric Medical Association, 90:8 September, 2000 pp 385-389.

Disclaimer: I am a consultant to Vasyli Medical.

Howard Dananberg, DPM, Bedford, NH, hdananberg@gmail.com

RE: Botox for Over-active Tibialis Posterior (Sean S. Ravaei, DPM)
From: Dennis Shavelson, DPM

From afar, your diagnostic picture does not make clinical sense and should be revisited before Botoxing the PT. I suspect that your patient has an inhibited peroneus longus muscle engine that is allowing its compensators to overwork trying to perform the job of the peroneus. I also suspect a rigid rearfoot, flexible forefoot FFT (you have not given us any structural or positional biomechanical diagnosis using Root, Wellness Biomechanics® or TS school of thought).

As I find it rare to have an overactive posterior tibial muscle in these cases, and even if it were overactive (in the face of normal neurological evaluation), it would develop some level of PTTD and not be capable of inverting the foot as you suggest.

I suggest a functional...

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

RE: "Press Ganey" Surveys (Marjorie C. Ravitz, DPM)
From: Pam Thompson

Press-Ganey is a patient satisfaction survey vendor used by almost 40% of the hospitals in the U.S. The hospitals sometimes try to grade associated physicians using P-G surveys. Press Ganey was the vendor used in the Bridges to Excellence (BtE) program and the Integrated Healthcare Association’s (IHA) P4P initiative in California (7 million enrollees, 215 physician groups with 45,000 doctors, most organized in IPAs) several years ago, sending surveys to patients asking them about their impressions of facilities, staff, and physicians.

It was my understanding at the time that the patient satisfaction surveys used during those P4P studies by IHA and BtE (CMS was heavily involved, BTW) were to provide 40% of a physician's "grade", which was to be used to mete out performance bonuses from payers, and later to determine reimbursement rates for CMS and most commercial payers. 20% of the physician's grade was determined by meeting technical metrics (read EHR), and the last 40% was determined by the physician's adherence to clinical guidelines (whose, I don't recall).

Press Ganey remains the largest patient satisfaction vendor in the U.S., as far as I know. Not surprisingly, there have been recent studies showing that...

Editor's note: Ms. Thompson's extended-length letter can be read here.

RE: Dr. Markinson's Commencement Speech at the NW Podiatric Residency Graduation (Michael M. Rosenblatt, DPM)
From: Michael Lawrence, DPM

My regard for Dr. Bryan Markinson continues to skyrocket. Besides his obvious clinical expertise, he has, in my opinion, become a voice of reason. His wisdom as far as where our profession is currently and where it should go, is profound. He's kind of like the Walter Cronkite of podiatry. Every time he speaks, I listen intently and learn. His graduation address published in this forum is eloquent, yet straight forward, refreshingly so but expected from the source. I really don't know of a current equal, and I truly appreciate his insight.

Michael Lawrence, DPM, Chattanooga, TN,  ftdoc@joimail.com

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PRACTICE FOR SALE - NEW ROCHELLE, NY

Flexible terms. Stable location, medical co-op, 24 year practice with a stable established patient base. Great opportunity for a self motivated podiatrist wanting immediate income and future stability. Call 551-574-0776 for details.

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 - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact: podiatrypracticesale@gmail.com

ASSOCIATE POSITION - MANHATTAN

Well-established successful Park Avenue podiatry practice is recruiting skilled and well trained DPM with a minimum of 3 years of experience.  Must be experienced in rear and forefoot reconstruction. Must be self- motivated, and great with patients. State-of-the-art practice facilities and technologies  which include: in-office physical therapy, digital x-ray, diagnostic ultrasound, and electronic medical records. MRI, and private operating room. All interested candidate email CV to elautin@gmail.com

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 - 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, and other Medicaid plans. Contact me at: Podocare@aol.com

ASSOCIATE POSITION - NASSAU COUNTY, NEW YORK

Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to: Podiatryoffice@doctor.com

ASSOCIATE POSITION - LOUISVILLE, KY

Immediate position for established practice in excellent location with option to buy. All phases of podiatry with good mix of patients. Two local residency programs with foot and ankle and trauma privileges. Office has EMR qualifying for meaningful use in the first year. PADnet vascular testing. Send resume to: samuel10530@yahoo.com.

ASSOCIATE POSITION - SEATTLE, WA AREA

Established podiatric clinic looking for an associate to join our team, 5 offices located around the greater Seattle, WA area. Great base salary, benefits and friendly work environment. Please send resume to: seattlefootdoctor@yahoo.com

ASSOCIATE POSITION - WEST COAST, FLORIDA

Outstanding opportunity for PSR-36 graduate to join successful group podiatry practice. Seeking a sociable, articulate graduate who is confident in rearfoot and ankle reconstructive cases but also enjoys all phases of podiatry. Long-term opportunity for the right candidate with generous pay and benefits. Reply to: jwicks@cortezfootandankle.com

HOUSE CALL PODIATRIST NEEDED - BRONX, NY

Immediate opportunity for a hardworking and motivated podiatrist to make house calls in the Bronx, part-time. Perfect opportunity for young practitioner just starting out, or experienced podiatrist looking to downsize from private practice. Make your own hours and schedule patients at your convenience. Excellent compensation. We will provide for you all that is required including instruments (if needed), and supplies, EMR charting, billing, and scheduling. 914.584.1434 Email information to Podiodoc@gmail.com

ASSOCIATE POSITION - YONKERS, NEW YORK

Immediate part time associate position now available. Appx: 3 1/2 days per week with room to grow. Practice is a good balance of all aspects of podiatric foot care, including surgery. Perfect opportunity for new graduate, or experienced podiatrist. Looking for the right person to transition into vacancy that will be left by current associate leaving the area and you will have an immediate, full schedule of patients. Over 25 year well-established practice with large referral base, and both hospital and surgery center privileges available. Interested persons please forward CV and brief summary of surgical log to: Podiodoc@gmail.com914.584.1434

ASSOCIATE POSITION - BIRMINGHAM, ALABAMA

Immediate opening. Strong established group practice. 30-40 office patients per day to start. Surgery available, but not required. Base salary, production bonus, benefit package, relocation assistance. Aggressive work ethic a must. Email resume and cover letter to:  dwh101@bellsouth.com

ASSOCIATE POSITION - BAKERSFIELD, CA

IMMEDIATE OPENING: Office and hospital-based podiatry group in Bakersfield, CA seeks highly trained surgical associate to join us. Prefer surgeon with trauma and Charcot reconstructive experience. Staff privileges with 5 local hospitals. Offering health insurance, CME allowance and competitive salary. Must be PSR 24/36 trained, ethical and thoughtful when treating patients. Please forward CV and letter of intent to modpm@aol.com.

ASSOCIATE POSITION - OHIO

Ohio practice with excellent reputation and patient base seeks to hire a Podiatric Surgeon. The offices are state of the art including Digital X-Ray, EMR, Diagnostic ultrasound, Padnet Vascular Testing, CO- 2 Lasers all aspects of DME. The base salary is $120,000 with a bonus structure and benefits also would like to have this individual buy into the practice eventually. Please send CV to: Ohiopodiatrist@aol.com

ASSOCIATE POSITION - NJ

Immediate opening for full-time or 2 part-time DPMs for diversified practice that features most all phases of podiatric medicine and surgery. Full-time candidate must be ABPS Board Certified in Foot Surgery or PSR 24/36 Bd Qualified in RRF. Competitive salary and bonus. Great working conditions and area. Realistic Partnership opportunity. Send resume to: MonmouthDPM@aol.com

EQUIPMENT FOR SALE - USED PODIATRIC LASERS

Great price, great outcome. Stop wasting money on expense lasers. Personally owned and used few hours in my office,. 10 and 30 watts lasers. Two handpieces in one. First one for plantar fasciitis, Achilles tendonitis, arthritis, pain, inflammation. 2nd handpiece for surgical ablation and fungus toenail conditions. Portable fast and very cost-effective.footcare@comcast.net

EQUIPMENT FOR SALE

Retiring from practice. Equipment For sale. Mini x-ray. One year old Ultrasound with MS arterial/venous X-ray plates. Great condition Ritter chairs. Drills, surgical tools. So much. Just ask, I probably have it: Footcare@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

PM News Classified Ads Reach over 13,500 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 13,500 DPM's. 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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