The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 25, 2011 #4,215 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2011- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Toning Shoes Can be Helpful for Arthritis of the Foot: MN Podiatrist

Foot doctors for years have been prescribing shoes with unstable soles to help patients with foot or ankle arthritis, but can they also get you a few steps closer to firmer thighs? Podiatrist Dr. Paul Langer of Twin Cities Orthopedics in Minneapolis said that although muscles likely do work harder to overcome the instability of the shoes, he is skeptical that it's to the extent that it will actually burn fat and boost muscle tone.

Dr. Paul Langer

What they can do, Langer said, is redistribute the pressure on your foot, alleviating stress and strain on the joints, which is helpful for people suffering from arthritis in the foot. People should treat the shoes like fitness tools, Langer said. The most problems he sees are from overuse.

Source: Alexia Elejalde-Ruiz, Chicago Tribune [7/20/11]

MI Podiatrist Appointed to State Board of Podiatric Medicine and Surgery

Gov. Rick Snyder today appointed Dr. Kevan Krietman to the Michigan Board of Podiatric Medicine and Surgery. "I am confident that Dr. Kreitman will apply his knowledge and skills to help provide the best care for the health and well-being of Michiganders," Snyder said.

Dr. Kevan Krietman

Krietman, of Birmingham, is a physician and partner with Shores Podiatry Associates P.C. in Roseville. Before that, he operated private practices in southeast Michigan for 13 years. Krietman earned a bachelor's degree in biology from the University of Michigan, a doctorate in podiatric medicine from the Pennsylvania College of Podiatric Medicine and completed his residency at the former North Detroit General Hospital. He represents podiatrists and replaces Dr. Tara L. Scott.

OPEIU Pushes Legislation Supporting Podiatric Physicians

As Congress works to bring down the cost of healthcare delivery and reduce the budget deficit, Senator Charles E. Schumer (D-NY) and Chuck Grassley (R-IA) have introduced critical legislation that would increase access to podiatric care and save billions of dollars in the process. The Equity and Access for Podiatric Physicians Under Medicaid Act (S. 1309) would identify podiatrists as physicians under Title XIX (the Medicaid Provision) of the Social Security Act, making it easier for low-income individuals to get the foot care they need. 

Dr. John Mattiacci

 "The most cost-effective healthcare system is one that helps people stay healthy in the first place. S. 1309 would go a long way to improving access to necessary care for millions of Americans, and Senators Schumer and Grassley should be commended," said Michael Goodwin, International President of the Office and Professional Employees International Union (OPEIU). "Seeing a podiatrist saves lives and limbs, and coverage of podiatry under Medicaid would provide easier access to care for patients while saving the government money," said Dr. John Mattiacci, Dean of Temple University School of Podiatric Medicine.

Source: Interest! ALERT [7/21/11]

Chronic NSAID Use Doubles CV Deaths in Elderly

Older patients with hypertension and coronary artery disease who use nonsteroidal anti-inflammatory drugs (NSAIDs) chronically for pain are at significantly increased risk of cardiovascular events, a new post hoc analysis from the International Verapamil-Trandolapril Study (INVEST) demonstrates. The research is published in the July 2011 issue of the American Journal of Medicine.

"We found a significant increase in adverse cardiovascular outcomes, driven by an increase in cardiovascular mortality," lead author Dr. Anthony A. Bavry (University of Florida, Gainesville) told heartwire. "This is not the first study to show there is potential harm with these agents, but I think it further solidifies that concern."

Source: Lisa Nainggolan, Medscpare Family Medicine [7/19/11]

Build Trust By Your Actions, Not Words

Build trust by never committing what executive coach John Hamm calls an “adulterer’s guarantee.” That occurs when you assure colleagues that they can trust you, although they see you lie to others.

Source: Adapted from Unusually Excellent: The Necessary Nine Skills Required for the Practice of Great Leadership, John Hamm, Jossey-Bass ,via Communication Briefings

Query: Concerns About Off-The-Market Dexamethasone

After receiving a fax from a compounding pharmacy (Lee Pharmacy), I just purchased this off-the-market item and am concerned about the inert ingredients. I have used the American Regent product for more than 20 years, but it is still off the market. It has "dexamethasone sodium phosphate 4.37mg (equivalent to 4mg of dexamethasone phosphate), sodium sulfite 1mg, benzyl alcohol 10 mg, sodium citrate for isotonicity, pH adjusted with citric acid and/or sodium hydroxide. 
 
The replacement product has "creatinine 8mg, sodium citrate 10mg, sodium bisulfite 1mg, benzyl alcohol .01ml, dexamethasone sodium phosphate 4.37, pH 7.0-8.5." I don't understand why the pH is not static/exact. There was recently a lengthy discussion on increasing pH. Would anyone else have concerns about injecting this replacement product? Has anyone used this compound?
 
George Jacobson, DPM, Hollywood, FL

Query: Discharging Patient

I have a patient whom I first saw in the hospital while on call. She has a diabetic wound that she walks on, gets wet and filthy, and in general she does not take care of her limb or herself despite all of my best efforts to properly educate her on the risks of not actively following medical advice. After an initial period post-hospital discharge in which she maintained her follow-ups, she relapsed and has now missed five out of ten appointments. My staff hasn't been able to reach her in over a month.

1) Where would I even send a formal discharge notification? Given HIPAA, I would hesitate to send said notice to her case worker. Do I send it to the false/defunct address she gave and then just keep the sealed envelope on file when it comes back "return to sender"? 2) What rights do I have after discharging a patient from my practice if she ends up back in the ER and the ER staff calls me?

Name Withheld

RE: Hemostasis (Ivar E. Roth DPM, MPH)
From: Dock Dockery, DPM, Avi Kornbluth

I have been lecturing for years on the use of topical Drysol (aluminum chloride) for hemostasis following minor procedures like small biopsies. It is clear, odorless, inexpensive, and works well. Many dermatologists use this solution routinely.
 
Dock Dockery, DPM, Edmonds, WA, gdockdockery@aol.com
 
Monsels solution (ferric sulfate) is still available and still used.

Avi Kornbluth, Henry Schein Medical, avi.kornbluth@henryschein.com

RE: Hemostasis (Ivar E. Roth DPM,MPH)
From: Joseph Greenberg, DPM, Jeffrey Kass, DPM

Try "WoundSeal Powder" made by Biolife. I have been using this product for about 5 years and am happy with the results. It is available from Henry Schein. Here is the link to the product website: (biolife.com/Occupationalfirstaid.html)

Joseph Greenberg, DPM, Seattle, WA, mobilepractice@gmail.com

I like Styptocaine...it is a Pedinol product, available at 1-800-pedinol, great for when debriding mycotic nails and you get a little nick or cut.

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

RE: Employee Working at Home Under HIPAA (Elliot Udell, DPM)
From: Dan Michaels, DPM, MS

HIPAA is a concern for you in this situation. So too is protecting yourself from your employee stealing from you by claiming hours worked when they were not - another important point to consider. These situations I have found do not work well at all. Having billing staff in the office is important as they can assist, answer phone calls, field questions, and assist your other team members with billing questions right there on the spot.

Dan Michaels, DPM, MS, Frederick/Hagersotwn, MD, danieldm@pol.net

RE: Medicare Number and Moving (Pete Harvey, DPM)
From: Don R Blum, DPM, JD
 
The direct deposit of your Medicare funds continue; however, Medicare sends an EOMB to the "old address" which will not be forwarded to the "new address" and is returned to Medicare. Once it is returned, Medicare will send a letter which will stop payments until the "new address" process is completed and approved.
 
Additionally, one cannot bill Medicare DMERC until the change has been approved. Each office address must be registered with DMERC for billing purposes.
 
Don R Blum, DPM, JD, Dallas, TX, donrblum@sbcglobal.net

EQUIPMENT FOR SALE – ULTRASOUND AND HYFRECATOR

Ultrasound, Biosound Esaote Aguila Model # 410853 w/printer and printer paper.  Hyfrecator Plus, ConMed Corporation Model 7-797. Both devices are portable and in good condition. Email Catherine Yack, DPM at cpod52@bellsouth.net for more information.

ASSOCIATE POSITION- DAYTON, OH

Join a Well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and current photo to Ohiodoctors@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 – 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 - 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 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

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

RESIDENCY OPPORTUNITY - MASSACHUSETTS

Mount Auburn Hospital, a teaching hospital of Harvard Medical School (HMS), Cambridge, MA is immediately seeking candidates for a new CPME approved three-year residency in Podiatric Medicine and Surgery Residency (PMSR) with additional Reconstructive Rearfoot and Ankle (RRA) credentialing. The emphasis of this PMSR-RRA well-rounded high volume program includes surgery (particularly complex reconstructive forefoot, rearfoot, and ankle surgery, sports medicine, and trauma), academics, and research. Interested applicants should immediately contact Emily A. Cook, DPM, MPH, CPH atMAH.Residency@gmail.com. Candidates must: start October 1, 2011, have completed a podiatric doctorate, passed parts 1 & 2 of the NBPME.

 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.

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.