The Voice of Podiatrists

Serving Over 14,502 Podiatrists Daily

July 26, 2013 #4,832 Publisher-Barry Block, DPM, JD

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County Commissioners to Assist Popular FL Podiatrist to Get on Healthcare Plan

County commissioners Tuesday morning wrapped up a day-long budget workshop continued from last week by doing what they said all along they planned to do – give the 165 county employees more pay for the upcoming fiscal year. Commissioners voiced concern that two of the county’s most popular healthcare providers, cardiologist Dr. Shezad Sanaullah and podiatrist Dr. Tamara Marsh, were not on the CHP network. They said they planned to assist in any way possible in getting the two on the network.

Dr. Tamara Marsh

“I think we need to send the message that CHP is great healthcare,” said Commissioner Pinki Jackel. “I know it’s a change and we all resist change. That’s just human nature somehow.”

Source: David Adlerstein, Apalachicola Times [7/24/13]

Dressing Can Improve Healing While Lowering Costs: PA Podiatrist

Alliqua Inc. recently concluded a post-marketing study that showed positive results for its SilverSeal dressing, designed for post-surgical wounds from foot and ankle surgery. According to the company, the dressing was shown to have a lower incidence of incision complications, including infection, and a greater reduction in scar length compared to standard petroleum-based dressings.

Dr. Stephen Brigido

“The results from this study are consistent with our preliminary findings reported earlier this year and indicate SilverSeal has potential to not only improve post-surgical incision healing but to reduce healthcare expenditures related to incision complications,” said Stephen A. Brigido, DPM, director of the foot and ankle fellowship at the Coordinated Health Foot and Ankle Center in Pennsylvania and a primary investigator in the study.

Source: Orthopaedic Design & Technology  [7/23/13]

Diabetes-Linked Amputations Declining, Study Finds

Fewer foot and leg amputations are being performed on people with diabetes, even as rates of the disease are rising in the United States, a new study finds. Drastic diabetes-related amputations were cut by nearly half over the past decade, researchers report in the July issue of the journal Foot & Ankle International. Because of long-term nerve damage, people with diabetes face up to a 25 percent lifetime risk of amputation, according to prior research. For this study, researchers reviewed Medicare claims from 2000 to 2010 to see who had leg, feet, and toe amputations and why.

The results surprised them. "The trend was so clear and more obvious than I thought it would be," said senior author Dr. Phinit Phisitkul, an assistant clinical professor at the University of Iowa department of orthopedics and rehabilitation. The rate for upper and lower leg amputations fell 47 percent among people with diabetes over the decade, and the rate of lower extremity amputations alone declined about 29 percent during that time period.

Source: WebMD News via Dr. Lanny Rubin [7/19/13]

Query: Economical Digital X-Ray System or Processor

What would be the recommendation for an economical digital x-ray system or processor? 

Birute Balciunas, DPM, Kenosha, WI

Query: Security Risk Analysis Cost

We all know a security risk analysis for our EHR system is important, and an element of meaningful use attestation. I would like to know how much my colleagues are paying for this risk assessment. The quote I received was $2,700 for their lowest level of vulnerability and penetration testing. A thorough, valid assessment is necessary, but at what price, particularly since these assessments need to be conducted periodically?

Mark Aldrich, DPM, Antigo, WI

RE: Chronic Pruritic Lesion (Arthur Gudeon, DPM)
From: Todd Lamster, DPM, Robert Bijak, DPM

It certainly looks like psoriasis, but it could also be lichen planus. Try a combination of clobetasol and ammonium lactate. Try to convince her again of biopsy as the ONLY surefire way to obtain a definitive diagnosis.
 
Todd Lamster, DPM, Scottsdale, AZ, tlamster@gmail.com

It looks like lichen planus. Refusing a reasonable request like a biopsy should suggest an underlying mental problem. Anxiety is common in lichen planus. Steroids and anti-anxiety medicines may help. The lesion is above the ankle, and in New York, you have to send her to a dermatologist. 

Robert Bijak, DPM, Clarence Center, NY, rbijak@aol.com

RE: Death By Podiatry
From: Michael Cohn, DPM

This week, my friend and classmate Larry Rogers died, in large part from the stress of podiatry. He was 66. He was near the top of his class and did not get a residency. He took and passed the written part of the APBS board exam the first time he took it, because he really knew his stuff. He failed the orals several times, because he froze up in this artificial situation. He never got board certified.

For the next 30+ years he struggled. He was often behind on his taxes and his bills. I say the stress contributed a lot to his early demise. I want all of you successful podiatrists who are ...

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

RE: Fabco Product or Substitute (Billie A. Bondar, DPM)
From: Avi Kornbluth

The First Aid Bandage Company has stopped making Fabco. I asked them why, and the response was that only podiatrists were using it, and not enough of them, so it did not pay for them to continue manufacturing it.

The replacement is made by General Bandage, Inc. known as Gauzetex - it is NOT exactly the same. The main difference which I hear from podiatrists is that FABCO was softer. Otherwise, it is basically the same. We sell it in 1/2", 1", and 1-1/2" - packed the same way as Fabco.

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

RE: Source for Accu-Mold Substitute (Joan Schiller, DPM)
From: Robert Teitelbaum, DPM

Otoform-K, offered by Alimed Co., and seen in some other "sports medicine" catalogues is my alternative of choice. It is manufactured in Unna, Germany (as in Unna boot). Unna is stamped on the tub.
 
Robert Teitelbaum, DPM, Naples, FL, Mfvandange@aol.com

RE: Missed Follow-ups a Potent Trigger of Lawsuits
From: Michael Forman, DPM

Yes, failure to document follow-up on broken appointments is one factor that can work against the physician involved in a malpractice suit.
 
The written policy in our office is to place a call when a patient is 15 minutes late. If you reach them, allow them to blame you for their missed appointment. Don't be accusatory. We say, "Mrs/Mr. Patient, did WE make a mistake on  your appointment? We had your name down at 3:15 PM today." We have never had a patient say it was our fault. Then you must memorialize this conversation in the patient's record! Even if they show up in 20 minutes, the fact that they are reminded at home that they were late for an appointment is beneficial.

Document late appointments as well as broken appointments. I have been asked how many times must you call a patient who broke an appointment. I don't think there is any specific answer. I recall a case where the plaintiff's attorney brought up the fact that the office only called once. What the heck, they could bring this up even if you called 15 times. Again, there is no good answer. My advice is to remind your staff to call and DOCUMENT that the office attempted to reach the patient.

Michael Forman, DPM, Cleveland, OH, im4man@aol.com

RE: NY Podiatrist, 70, Allegedly Fondled and Harassed 22-Year-Old
From: Michael Forman, DPM

I was distressed to read about the podiatrist who was accused by one of his podiatric assistants of inappropriate  behavior. I was distressed for both the doctor and for the assistant. First, the charges are just charges until he is proven guilty. PM News, by re-publishing this story, defames the physician and besmirches his name. If he is guilty - shame on him. If he is innocent, shame on his assistant and shame on PM News.
 
Michael Forman, DPM, Cleveland, OH, im4man@aol.com

Editor's comment: PM News did not originate this story. We hate to print such stories and do so only to warn podiatrists of the potential legal minefields that exist in today's environment. Responsible media generally use the "probable cause" standard in deciding which stories to publish. Of the hundreds of legal stories we have republished in the last 19 years, only two alleged charges we are aware of have been disproven, meaning an accuracy rate of over 99%. Unfortunately, there is no way to guarantee 100% accuracy in anything. We are always happy to print stories of exonerated podiatrists.

RE: Charles Lombardi, DPM's Discussion on "Meet the Masters"
From: Thomas Ortenzio, DPM

I agree with Dr. Lombardi on the genesis of the residency crisis.  This problem was brought on by the decisions made years ago at the APMA HOD. The delegates were encouraged by the leadership to expand our residency programs to 3 years so that we could reach a level of parity with allopathic medicine. The problem was that the delegates were led to believe that our current residency programs would be able to absorb the third year without creating the crisis we have now. I truly believe that anything that has been done, can be undone. I believe that the best solution to this problem would be to go back to a mandatory 2-year residency for all graduates. Make the third year an optional fellowship year for those who want to do complicated rearfoot and ankle surgery. 

I am not sure that this would totally solve the problem, but it should certainly make more slots available. Maybe someone with knowledge of the slots available could do the math and let us all know if this is a viable solution. If it is viable, let's take such steps as are available under the Bylaws of APMA to conduct an immediate open discussion to seek a solution to this important problem. 

We can all sit around and talk about this problem, or we can do something about it. Let's get moving! If anyone else has a better idea that can be implemented now, let's look at that too. We can no longer kick our new unmatched graduates down the road.

Thomas Ortenzio, DPM, York, PA, footfan@comcast.net

EQUIPMENT FOR SALE - DIOWAVE 15 WATT, PORTABLE 980 LASER

This is a used multiple function laser, plantar fasciitis, Achilles tendonitis, joint pain. nerve pain, post surgical, warts, toenail  problems, two-year plus warranty, MSRP: $25,000. E mail Dr. Zuckerman at footcare@comcast.net. for questions and pricing.

ASSOCIATE POSITION - FLORIDA

Associate wanted for an established 25 year old practice. PSR24 or 36 would be preferred. Excellent opportunity. Please send CV or letter to bafamt@aol.com.

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Very busy, two location group practice seeking a full-time, self motivated and hard working podiatry associate. Competitive salary and benefits are offered. Please email CV to: footcare4all@aol.com

ASSOCIATE POSITION - HUDSON VALLEY NY

Part time position in busy practice leading to f/t. Looking for well trained minimum PSR-12 with great technique and people skills for part time leading to f/t position in fast growing practice. Competitive salary with huge growth potential. Send cover letter, CV and work experience to: PodassociateNY@gmail.com

ASSOCIATE POSITION – PENNSYLVANIA

Associate Wanted for busy, multifaceted podiatry practice in Chester and Delaware counties, Pennsylvania. Seeking PSR-24/36 trained podiatrist for full/part time associate position. Two offices and hospital privileges. Send CV and letter to: 123bunion@gmail.com

POSITION AVAILABLE - MASSACHUSETTS

Boston Medical Center. Full-time career opportunity: surgery, diabetic foot care, wound care, general podiatry, resident training & research. Split position: (90%) on-site BMC and (10%) off-site health center clinics Boston University School of Medicine Academic appointment. Requirements: Completion of 24-36 month surgical residency. Please forward CV and letter of interest to: Erin.walker@bmc.org

ASSOCIATE POSITION - EASTERN SHORE OF MARYLAND

Seeking highly motivated, ethical, enthusiastic associate to join successful, well-established practice located in close proximity to Maryland and Delaware beaches. Certified/qualified by ABPS with rear foot experience preferred. The practice incorporates surgery, wound care, sports medicine and general podiatry. Fully equipped office with diagnostic ultrasound, fluoroscopy, vascular testing, radio frequency ablation, six treatment rooms and three satellite offices. Main office has accredited ambulatory surgery center. This opportunity has excellent salary potential with benefits for the right individual.  Will consider preceptor. Send CV to dpmkthomas@gmail.com

ASSOCIATE POSITION- DAYTON, OHIO

Join an established group practice in Dayton, Ohio excellent reputation, large referral base.  Base Salary$120,000, benefits and bonus structure. EMR;diagnostic ultrasound; Padnet; CO2 and Cutera Laser for nails, all aspects of DME. We need well trained personable PSR24/36 surgeon. Future Buy-in available. Please send CV to Ohiomedical@aol.com

ASSOCIATE POSITION - SF BAY AREA

East SF Bay Area associate wanted for 3-office practice. CA License and PSR-24 minimum. All aspects of podiatry. Need to be highly motivated, a self-starter and be able to start Aug. 1, 2013. Salary BOE. Send CV to drscivally@sbcglobal.net
 
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 - SOUTHERN NEW JERSEY

Excellent opportunity for a full time podiatrist to join busy group practice! Surgery, wound care, sports medicine. Affiliated with residency program. Personable and great communication skills a must! Competitive salary, bonus, benefits package. Send CV to footdoc22@gmail.com

ASSOCIATE POSITION - CENTRAL FLORIDA

Associate wanted for well-established practice in central Florida. Experienced support staff, malpractice coverage and health insurance provided. Excellent opportunity for a promising future, this position will provide for the possibility of partnership in the future. To apply please go to www.yourcareerinpodiatry.com

ASSOCIATE PODIATRIST WANTED: CHICAGO

4 Days per Week Chicago Practice - will perform all phases of podiatric medicine Accredited JCAHO Surgical Suite. Benefits will cover Malpractice and Health Insurance. Six Figure Base Salary. Inquiries:  email your CV to Dr. J. B. Jenkins - yanagandb@gmail.com

ASSOCIATE POSITION - HUDSON VALLEY REGION, NY

Unique opportunity for the right person! We’re a high-volume, diversified, multi-office group practice utilizing state-of-the-art modalities. Great growth for a personable and motivated DPM. Please forward cover letter with CV to healthyfeet4ever@yahoo.com.

ASSOCIATE POSITION - MARYLAND

Associate position for podiatry office on Maryland’s Eastern Shore. Certified ambulatory surgery center on-site.  Will consider preceptor. Please fax letter and CV to 410-749-6807

PRACTICE FOR SALE - DEBARY, FLORIDA

Turn-key operation; 1,200 sq. ft. Suite, $56,000 for immediate sale due to illness in family; everything included; aggressive young podiatrist can triple gross income; www.DeBaryFamilyFootCare.com ; Email sweisman@cfl.rr.com 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

PM News Classified Ads Reach over 14,500 DPMs 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 14,000 DPMs. 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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