The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 26, 2011 #4,216 Publisher-Barry Block, DPM, JD

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Laser is Highly Effective for Fungal Nails: IN Podiatrist

One of the biggest foot problems facing women right now is fungus on toenails. Many woman are walking around with thick, discolored nails, and the problem might be coming from your nail salon. “That's a very common way for patients to pick up things like fungus to toenails, thickness, yellow and discoloration within the nails,” says Jeff  Agricola at Prestige Podiatry.

Dr. Jeff Agricola

Agricola says the days of taking prescriptions that are hard on your liver may be a thing of the past. He uses a laser called Cutera Genesis. He says it’s highly successful and FDA-approved for toenail fungus.

Source: Angela Ganote, Fox59 [7/21/11]

NYCPM Professor Conducts Pelvic Band Study  

Dr. Barbara Resseque began her band and strap systems study in 2010 with the intention of documenting the short-term effects of the pelvic band on children with moderate to severe in-toe. Children ranging from 18 months to 6 years with a functional problem causing a severe in-toe are most eligible to participate in the study. These children experience an extensive amount of tripping and falling throughout their daily activities.

(L-R) 4 Year Old Child Before and After Pelvic Band

A pelvic band strap is custom-formulated for each child to be worn six to eight hours each day. Gait measurements are taken prior to putting on the pelvic band, right after the band is put on the child, and a few months after the child has been using the band. The pelvic band works by putting a gentle stretch on tight muscles that are creating the in-toe, particularly the medial hamstrings.

Source: Adisa Mujkic, NYCPM Student Alumni Report (Summer 2011)

Medicaid Error Rate is 40 Percent: ME Podiatrist

The state's recently approved budget assumes that Maine will receive nearly $17 million if it can get its Medicaid billing system to meet federal standards. Since it switched computer systems in 2005, and again last year, the state has not been able to gain federal certification. That's important because it has been costing the state money for several years. 

Dr. Daniel Benson

For years, Paula Benson, who handles the MaineCare accounts at the Achilles Foot & Ankle Center in Augusta, has struggled to get claims handled properly in a timely manner. In January, she and her husband Daniel Benson, a podiatrist, signed up for one of Gov. Paul LePage's Saturday meetings with the public to express their concerns about the system. "We showed him our error rate was at 40 percent," she said.

Source: Susan Cove, Maine Sunday Telegraph [7/24/11]

CO Podiatrist Finds Satisfaction on Many Levels

Dr. Kayse Lake began practicing in Cortez, CO July 1 after moving to the area from St. George, Utah. It was a move that brings a great deal of satisfaction on several levels. I have family in Farmington," the 31-year-old said. "After graduation from my training, I was looking for employment in my area and wanted to be closer to family.

Dr. Kayse Lake

The timing was right for Dr. (Terry) Cook to bring on somebody else." Cook is the existing podiatrist at the office. The two doctors will travel to reservation clinics around the Four Corners area.

Source: Reid Wright, Cortez Journal [7/24/11]

MO Podiatrist Advances in Tennis Tournament

Karl Niebuhr and Dr. Doug Spitalny took on each other and the heat in a two-hour, 33-minute clay-court duel in the opening round of the Men’s 45 Singles division of the 43rd annual Tri-County Tennis Tournament. Spitalny survived, 6-7 (3-7), 6-1, and 1-0 (10-1 in the tiebreaker).

“We broke each other’s serve every time in that first set,” said Spitalny, a podiatrist in the U.S. Army. “We’re thinking, ‘What are we doing out here?’ I whined a little bit about the heat and got through it. I’ve waited years to get into this age group, and this match. What a welcome to the division it was for me.” His reward is a second-round match Tuesday against No. 1 seed Bobby Humbles.

Source: Dave Eminian, Journal Star [7/23/11]

The Value of a Good Apology

Apologize well and you do more than protect your reputation; you build it. Show you understand your mistake by quickly stating what you did and why it was wrong. Don’t offer excuses.

Source:  Adapted from “The Artful and Effective Workplace Apology,” Art Petty, Management Excellence via Communication Briefings

Query: Dumped by Disability Carrier

20 years ago, I enrolled in a disability policy from Nationwide Insurance and made quarterly payments. Three years ago, I received notification that Nationwide had changed its administrator for this policy to Disability Insurance Associates.  I continued to pay the quarterly premiums in a timely fashion. In November 2010, I received a notice of cancellation from Nationwide stating that my policy had been terminated due to nonpayment of premium. I promptly called them and insisted that I had not received a bill. They informed me that they had sent out a bill and later a warning letter, neither of which I received. They went on to cancel a policy. I was told by an attorney and two independent insurance agency owners that this practice of "dumping" policyholders is common. Has anyone else had this experience?

Lewis Wolstein. DPM, Bronx, NY

RE: Hemostasis (Ivar E. Roth DPM,MPH)
From: Art W. Simonetti

Dr. Roth asks about methods to use when a patient bleeds from a nick, etc. A styptic pencil used to be a “must have” along with your razor for nicks after shaving, especially on those pesky little “dermal lesions” or “moles” that seem like they will never stop bleeding. It does burn for a minute but it beats leaving the house with little toilet paper fragments on your face. Also consider the QR (Quick Response) hemostatic powder or similar type products. Being on anti-coagulant treatment myself, I take a styptic pencil whenever I travel. Quick, convenient and VERY effective.

Disclaimer: I have no financial relationship with QR.

Art W. Simonetti, Research Director, Amerx Health Care, Clearwater, FL, aws@amerxhc.com

RE: Hemostasis (Ivar E. Roth DPM,MPH)
From: Chris Browning, DPM

Silver nitrate sticks are a good alternative to Lumicaine to obtain hemostatis. The sticks can be purchased from most medical supply companies and come in tubes of 100 sticks. The application is fast and effective and, in my opinion, is more versatile than Lumicaine. A typical stick contains 75% silver nitrate and 25% potassium nitrate.  
 
There are hundreds of articles available on the use of silver nitrate in medicine as an antiseptic and hemostatic agent. Some literature suggest that the sticks have antimicrobial properties against Gram +/- and even Candida. The major side-effect is brown/black staining of the skin which some patients do not like.  Another major side-effect is that in the sensate patient, the application of silver nitrate causes a painful, burning sensation which is relatively transient.
 
Nonetheless, it is very effective, can be used on granulomas, proud flesh, warts, and is widely used to control epistaxis, apthous ulcers, granulomas around stomas, and more.  It is particularly useful along the distal nail groove where an offending spicule was removed and there is a micro-bleed present.  
 
After applying this substance to thousands of patients, I have seen NO adverse effects but have received one phone call from a panic-stricken patient who thought that she had "gangrene."  Remember, warn the patient about the skin discoloration!
 
Chris Browning, DPM, Port Arthur, TX, chrisbrowning@att.net

RE: Duty to Report G Code
From: Alan L. Bass, DPM

E-prescribing and the reporting of G codes are independent of each other. You must report G8553 on your Medicare claims in order for Medicare to know that you in fact e-prescribed for a Medicare patient. These things are independent of each other. The fact that the system knows you e-prescribed is important in order to capture the meaningful use data needed for Core Objectives # 1 and 3.

Alan L. Bass, DPM, Manalapan, NJ, abassdpm@optonline.net

RE; Migraines and High Heels

In a summer of unusually heated political turmoil and mudslinging from both sides of the aisle, the medical issue that has unexpectedly become caught in the crossfire seems somehow appropriate — migraines. Fueling chatter on the issue was the report, confirmed to the New York Times by Michele Bachmann's son, Lucas Bachmann, a medical resident at University of Connecticut, that his mother has observed an association between her migraines and wearing high-heeled shoes.
 
Although there have been no prominent studies linking high-heeled footwear with migraines, most experts agree that the suggestion is not beyond the fray, and that just as migraine headaches affect individuals in varying degrees, their triggers can also run the gamut from certain foods, such as chocolate, to levels of light and even physical stressors, such as wearing high heels.

Source: Nancy Melville, Medscape News [7/22/11] via Paul Kesselman, DPM

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.

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

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