The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

July 27, 2009 #3,606 Publisher-Barry Block, DPM, JD

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"Healthy" Shoes Not Always Healthy: NY Podiatrists

According to podiatrists Dr. Johanna Youner and Dr. Emanuel Sergi, they have seen an influx of patients complaining of foot and leg pain after overdosing on “healthy shoes.” Dr. Youner believes many patients purchase health shoes such as MBT Shoes or FitFlops in an effort to maximize the claims the companies make. Unfortunately for many wearers, the shoes can do more harm than good if they are overused.

Dr. Johanna Youner

“Shoes that claim to encourage and even contribute to weight loss, but require nothing more than walking, are all the rage and while some of those claims are valid, some are not,” says Dr. Youner. “It’s a classic case of something that sounds too good to be true actually being too good to be true.”

Dr. Emanuel Sergi

“It’s important to realize these shoes force the foot to actually function differently,” explains Dr. Sergi. “New muscles are engaged in the foot and legs and if the patient doesn’t use them correctly, they can actually do more harm than good.”

Source: HairBoutique.com [7/24/09]

CSPM Students Complete Bay Area Homeless Service Project

The first two Samuel Merritt University (SMU) students to become Albert Schweitzer Fellows (ASF) recently completed their year long community service project. Bright Chen and Analiza Mitchell, both 4th year students in the Doctor of Podiatric Medicine (DPM) program at the California School of Podiatric Medicine (CSPM), dedicated their Bay Area community service project towards foot care for the homeless in San Francisco.

Samuel Merritt students Liza Mitchell (L) and Bright Chen

Their project, appropriately titled, “Step Up for Foot Care,” involved more than 200 hours of community service each, including 100 hours of direct service. Their project consisted of three major components, including assessing the foot health care needs, educating the homeless regarding proper foot care practices, and delivery of much needed foot care products. 

Chen and Mitchell are currently analyzing the results from their project survey. Presently, there are no published studies on the podiatric health needs of the homeless population in the Bay Area.  Their CSPM faculty mentors for the Albert Schweitzer Fellowship are Assistant Professor David Tran, DPM, MS, and Professor of Department of Basic Medical Sciences and Director of Research, Peter Barbosa, PhD.

Poll Finds 1 in 4 Struggling with Coverage, Care Costs

Roughly one in four adults polled this past spring struggled to pay for health insurance or medical care in the prior 12 months, newly released survey results show. The telephone survey, by news and market research company Thomson Reuters, included roughly 3,000 households contacted in late March and another 3,000 polled in late April and early May.

Roughly 10% of those surveyed in March reported they skipped or delayed a routine doctor visit in the prior year compared with 8% of April respondents. Adults born between 1946 and 1964, the baby boomer generation, were four times more likely than those born before 1946, the silent generation, most of whom are eligible for Medicare, to report difficulty paying for medical care in the prior 12 months. Generation X, those born between 1965 and 1984, and millennials, born after 1984, were more than three times more likely to report such difficulties than the silent generation.

Those who recently lost a job were five times more likely than the employed to say they struggled with medical bills during the prior year. Households that reported job losses increased to about 14% in April from 11% in March.

Source: Melanie Evans, Modern Heathcare [7/24/09]

Dealing With Personal Attacks

Train employees to respond to personal attacks with a direct question instead of a defensive answer.

Example: “You sound angry. Are you?”

Source: Adapted from “Employee Relationships: Dealing With Difficult People at Work.” via Communication Briefings

Query: Eczema or Something Else?

This is a 4 y/o female who was brought in by her mother with a CC of painful fissuring of plantar feet B/L. She has seen her pediatrician and dermatologist who both prescribed a mid-strength steroid cream.  Her PMH is unremarkable. Mom does have h/o urticaria (idiopathic) and environmental allergies.

Eczema or something else?

As you can see, the hallux has a fissure that is bleeding. It is symmetrical except for the heel. It is the same in winter and summer, closed shoes and open. All her nails are very mildly dystrophic.  There are  no other lesions. Her mother says the creams resulted in a 50 % improvement, for what that’s worth. Is this simple eczema (the dark spot is a wart)?

Michael Munson, DPM, Columbia, SC

Query: Sharing Expenses in a Partnership

I bought into a practice a few years ago and paid a substantial amount (as the practice was grossing quite a bit) for 49%. I had worked as an independent contractor for this office for several years prior to "buying in." Through the years, my partner and I have realized that for better or worse, we have disparities across the board when it comes to the "numbers" of the business.

One of us works longer hours, one of us has a much larger malpractice premium, CME allowances seem to vary, need for support staff is unbalanced, etc. These are just a few examples of the angst that has somehow grown between my partner and me in recent years.
 
I would appreciate if PM News readers could offer some insight on how practices with two or more podiatrists operate? Do you share from the "pot" regardless of who is earning? Do you take expenses off the top, or specifically from that doctor’s collections?

Name Withheld

RE: Brachymetatarsia Surgery (Dale Shrum, DPM)
From: Douglas Pacaccio, DPM

It is difficult to tell what you could've/should've done differently to avoid medial translation of your distraction. In terms of what to do now, I would…

Editor’s note: Dr. Pacaccio’s extended-length letter appears at: http://www.podiatrym.com/letters2.cfm?id=27680&start=1

RE: Chronic Sub-Hallux Ulcer in Diabetic (Marc Greenberg, DPM)
From: Juliet Burk, DPM, Steven Goldstein, DPM

Chronic Sub-Hallux Ulcer in Diabetic Originally Submitted

Don’t forget the pre- or post-operative use of an external metatarsal bar on the shoe.  This suspends the toe of the shoe in the air, helping the patient to offload.  It’s cheaper and easier than anything I’ve heard mentioned yet.  
 
Juliet Burk, DPM,  Muskogee, OK,  juliet-burk@cherokee.org

What has worked well for me is a Keller bunionectomy, which does an excellent job in alleviating this type of ulcer. You can also ellipse the ulcer at the same time with primary closure.

Steven Goldstein, DPM, Royal Palm Beach, FL, Stevefootdr1@yahoo.com

RE: PQRI and E-Prescribing
From: Michael L. Brody, DPM

It is important to be aware of what is going on in terms of certification, and the changes that are happening as a result of the ARRA. In order to qualify for incentives, you only need to have software that is 'certified' to meet the definition of 'Meaningful Use.' Full CCHIT certification goes well beyond this. CCHIT has proposed and is in the process of developing a 'Meaningful Use' based certification that does not include many or the requirements of the traditional CCHIT certification. The ONC met recently and endorsed this idea calling the new certification 'HHS Certification.'

Many aspects of 'Meaningful Use' are not included in the 2008 CCHIT certification, and CCHIT is in the process of incorporating them into the 2009 full certification standards. The bottom line is that software currently certified by CCHIT is not certified to meet 'Meaningful Use.' Just having software that meets 'Meaningful Use' standards will not be enough; you will need to actually use the software in a meaningful manner. You need software that meets 'Meaningful Use' standards and be using it in a meaningful manner before the end of 2011 to qualify for the maximum incentive, and by 2016 to avoid financial penalties.

The final definition of 'Meaningful Use' will not be published until Dec. of this year. The certification process is in the process of change. Watch PM News and future issues of PM Magazine for more information as this unfolds. Dr. Barry Block and I will be participating in a workshop at the NYSPMA meeting in January along with other health information technology experts to review this information and much more.

Michael L. Brody, DPM, Commack, NY, mbrody@cmeonline.com

RE: Heels From Bakery Hell?

This shoe does not have the APMA Seal of Acceptance.

Source: Submitted by David Levine, DPM, Frederick, MD

ASSOCIATE POSITIONS - CALIFORNIA

Podiatrist needed for busy North Hollywood office. Part-time Monday-Friday 8am-2:30pm. No weekends and no call. Pay negotiable. New podiatrists are encouraged to apply. Please email resume and salary request to Coasttocoastpodiatry@yahoo.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

PRACTICE OPPORTUNITY - CINCINNATI, OH
 
Well-established practice located in medical/professional building minutes from hospital. Many referrals, three satellite clinics and two assisted living facilities to keep you busy. Associate leaving due to family emergency-need to either find an associate or sell ASAP. Contact bjadpm@hotmail.com for more details.

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS 

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

ASSOCIATE POSITION – ILLINOIS 
 
Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings available. If interested, fax curriculum vitae to 312 225-9366 or e-mail feetwork@aol.com

ASSOCIATE POSITION - BOSTON, MA 
 
Associate wanted, Full-time or part-time, for busy long time, well established, and well-rounded practice. Good mix of general podiatry and surgery. Office will generate approximately 100+ surgical cases per year. Must have surgical background, ABPS Qualified minimum needed to obtain hospital privileges. Associate position is open for partnership or purchase. Contact robert.nunberg@comcast.net 

ASSOCIATE POSITION – PACIFIC NORTHWEST

Russian-speaking podiatrist needed. Looking for well-rounded, recently out of residency, podiatrist. Would you like to raise your family in our beautiful Pacific Northwest? We are well-established and fast growing multi-office practice with all aspects of podiatry. Attractive compensation, malpractice and medical insurance provided. Contact Dr. Ilona Barlam at 206-661-9644.

PRACTICE FOR SALE – NEW YORK CITY

NY Manhattan, prime location. Upper East Side, 23. Y.O. practice, high visibility-traffic area next to post office, street level, All phases of Podiatry, NO surgery, retiring due to disability. call 516-759-4062 or Paulfxfeet@aol.com

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to fmassuda@footexperts.com

PRACTICE FOR SALE – WESTCHESTER COUNTY, NY

Established 30+ year old practice. Well respected podiatrist in beautiful Westchester County Owner ill and needs a quick sale. Mixture of surgery and general podiatry. Hospitals in close proximity. Will lease office to buyer. Call Mali McGrinder at 914-434-1663.

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