The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

July 30, 2009 #3,609 Publisher-Barry Block, DPM, JD

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IA Podiatrist Appointed Chair of ADA Foot Care Interest Group

Lee C. Rogers, DPM has been appointed Chair of the Foot Interest Group for the American Diabetes Association. He will serve in this position for two years and will be responsible for chairing the panels on diabetic foot complications at the ADA’s Scientific Sessions which draw over 15,000 scientists, physicians, and other health professionals. Dr. Rogers published an editorial in the Journal of the American Podiatric Medical Association in 2008 which estimated that $30 billion was spent on diabetic foot ulcers and amputations in the previous year alone.

Dr. Lee C. Rogers

Dr. Rogers has authored over 50 publications, including several book chapters on diabetic foot disorders and has been an investigator on more than 20 clinical trials. He is currently the Director of the Amputation Prevention Center at Broadlawns Medical Center in Des Moines, IA.

CA Podiatrist to Publish Chapter in Orthopedic Text

Amol Saxena, DPM has a chapter on Endoscopic Gastrocnemius Recession being published in the upcoming text "Minimally Invasive Surgery in Orthopedics" (published by Springer).

Dr. Amol Saxena

Saxena was recently awarded "Distinguished Faculty" status at this year's Midwest Podiatry Conference. He works for the Palo Alto Medical Foundation's Sports Medicine Department and serves as a member of the U.S. Track and Field Sports Medicine medical staff.
 

Podiatrist Takes "Halibut Honeymoon" in Alaska

Some people choose to board a luxury ship after their wedding. Not so for this Alaskan couple. Their circumstances are best described as a kind of "Halibut Honeymoon"  since Captain Matt Musslewhite, 34, had just married his new bride, Kelly Moxley, 32, five days earlier.

Dr. Kelly Moxley

Moxley, a podiatrist by profession, took on first mate chores for the week. Fresh off their wedding ceremony (held in the shadow of the Mendenhall Glacier in Juneau), the newlyweds invited other wedding guests to join a fishing party.

Source: Tom Tatum, Daily Local News [7/28/09]

Alleged Unnecessary Surgery (New York)

Facts: On Feb. 11, 2002, plaintiff Susette Ryniec-Schilia, 51, a chemist, presented to defendant complaining of worsening pain in her right foot. She had had pain on and off for five years. Defendant ordered an x-ray, diagnosed hallux rigidis and mild hallux valgus, and advised her that the only definitive way to treat the condition was surgery. On March 14, 2002, defendant performed a Waterman osteotomy with a chielectomy. Ryniec-Schilia's pain became severe three months later.

Ryniec-Schilia sued defendant, alleging that he failed to treat her conservatively and that he negligently performed an unnecessary surgery. She said that he had not told her of any alternative to surgery. She claimed that defendant should have treated her first with orthotics, a shoe change, physical therapy, steroid injections, and pain medication. According to her later treating surgeon, Dr. Michael Parentis, defendant should have operated only if those measures did not provide relief and even then should have performed only a chielectomy, not an osteotomy.

Suspecting a non-union, Parentis operated on Sept. 18, 2002, and he discovered that the bone had begun to fuse but was not completely fused. While performing surgery, Parentis fused Ryniec-Schilia's metatarsal phalangeal joint near the osteotomy site. Over the following years, while she continued to treat with Parentis, Ryniec-Schilia continually complained of nerve-damage symptoms, including numbness, tingling, pain and hypersensitivity. On Jan. 21, 2004, Parentis excised a neuroma. In support of Ryniec-Schilia's case, Parentis testified at trial that during the 2004 surgery he had found the dorsal medial cutaneous nerve severed and had found the neuroma proximal to the osteotomy site. He said that he believed the neuroma was present after and was caused by defendant's surgery.

Defendant argued that he had properly advised the plaintiff of her options and that the surgery he performed was not unnecessary. He denied departing from any standard of care. He said that she had told him that her pain had recently become constant, which the plaintiff disputed. The defense disputed Parentis' claim at trial, noting that he had not mentioned in his operative report that the dorsal medial cutaneous nerve was severed. According to the defense, the joint fusion during Parentis' first surgery had nothing to do with defendant's osteotomy, since it was above the osteotomy site.

Result: Defendant's Verdict

Plaintiff's podiatric expert: Joseph Carbone, DPM; Rochester, NY
Defendant's podiatric expert: Charles Coyle, DPM; Rochester, NY

Source: VerdictSearch New York Reporter Vol. 26, Issue 41
 

Anti-Bully Tactics

Stand up to bullies without attacking them, and they often will back down. Use their names to gain their attention, maintain eye contact, and use assertive body language rather than looking down or turning your body away.

State your opinions firmly without arguing, apologizing or disparaging the bullies’ points of view: “It looks as if we have a difference of opinion.” If bullies interrupt you, turn the tables by interrupting right back: “You interrupted me. I was about to say …”

When you stand your ground, bullies will stop pushing you around.

Source: Adapted from “Coping With Difficult People,” by Nancy Gerber via Communication Briefings

Query: Online Scheduling for Multiple Offices

We are having difficulty finding an online appointment scheduler that multiple offices can access online and schedule patients for each office. We would love to find an online scheduler in which all offices appear on the same screen with the capability of allowing each office to schedule patients independently yet be able to view what the other offices have scheduled. I am trying to find an online program rather than to have all offices networked. Suggestions?

Mark Wolpa, DPM, Berkeley, CA
 

RE: Measuring Wound Depth (Roody Samimi, DPM)
From: Jeffrey Kass, DPM, Martin Wendelken, DPM

I measure old-school style the way Dr. Samimi described, with a sterile cotton tip applicator using the wood portion measured up against the ruler. I would like to point out there is more "high tech" way for those interested using Pictzar software. You can check it out at podiatricultrasound.com/pictzar.htm

Disclosure: I have no financial interest in the company; it just looks like an excellent way to document if you see a fair share of wound care.
 
Jeffrey Kass, DPM, Forest Hills, NY jeffckass@aol.com

Wound depth measured using a cotton-tipped swab as described by Dr. Samimi may be best utilized by making several measurements and taking the average. This is performed by taking depths in the wound center and then at 12, 6, 9, & 3 o'clock, respectively.  Calculating the average of those five points will give you a much better depth measurement.  In addition, the linear length x width measurements should be perpendicular to each other (Smith & Nephew manufactures a sterile cotton tipped swab that is also a ruler.) . 

It is well established in the literature that accurate monitoring changes in surface area alone can predict wound closure. For example, if the surface area of a diabetic foot ulcer reduces in area by 50% or greater in 4 weeks, there is a 90% probability of wound closure at 12 weeks. Digital planimetry software can be used to obtain, record, and monitor accurate measurements from digital photographs non-invasively.

Disclosure: I am a principle owner of PictZar digital planimetry software.

Martin Wendelken, DPM, RN, Elmwood Park NJ, drmew@optonline.net

RE: Swimmer with Cramps in Arches (Alan Mauser, DPM)
From: Amol Saxena, DPM

I treat a lot of tri-athletes that come from a running &/or cycling background. It is common to get foot (& even hand) cramps when beginning swimming. Some of it may indeed be due to electrolyte imbalance, but I believe more often than not, it is due to the new foot position that is needed to be a swimmer. The 18 muscles on the bottom of the foot will always beat the one dorsal one; this results in arch cramps when not enough ankle plantarflexion is available.
 
This gradually goes away with time. If not, then electrolyte testing may be warranted.
 
Amol Saxena, DPM, Palo Alto, CA, Heysax@aol.com

RE: "Vision 2009"
From: Barry Finkelstein, DPM

I recently read a comment written by a fourth year podiatric medical student who lamented the fact that some/ many in the general medical community still belittle our training, erroneously  thinking that our didactic training extends only up to the ankle, disregarding the true breadth of our schooling (gross anatomy, physiology, etc.) and complexity of our post-graduate training.  While her comment is unfortunately accurate, I am proud to emphasize the reality of the situation.
 
I am involved peripherally with three separate residency programs in NY and NJ. In this capacity, I routinely participate in their journal clubs, learn from their attending, and invite their residents to scrub my cases. All of the residents are training in multiple-year surgical programs that involve trauma, reconstruction, limb salvage, elective surgery and intense on-call/ “in-house” patient management responsibilities. I was also fortunate to have completed such a program, yet I am continually amazed by the knowledge of my academic colleagues and inspired by the excitement of their residents and students. 
 
I am eagerly anticipating the implementation of Vision 2015 (and would gladly contribute anything I can to the process), but the vision of 2009 looks pretty good also.
 
Barry Finkelstein, DPM, Bronx, NY, NYNJfootandankle@aol.com
 

RE: X-Ray Processor (Brian Kiel, DPM)
From: Wm. Barry Turner, BSN

I agree with Dr. Brian Kiel. The digital processor does offer a practice better quality and more options. I recognize the increased expense is intimidating, but overall, you will save money in rent not using a "dark room" for developing. I have my processor by the front desk. My receptionist runs the x-ray through while she is answering the phones.

Wm. Barry Turner, BSN, DPM, Royston, GA, claret32853@gmail.com

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 – 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.

ASSOCIATE POSITION - WASHINGTON — WEST PUGET SOUND

Well-established, two-doctor practice in all phases of treatment looking to replace associate who is leaving the area. Looking for energetic, affable, surgically-trained DPM to take over associate position leading to partnership. Satellite office and adjacent multi-disciplinary ASC available for use and possible partnership. Silverdale rated 92nd in best 100 locations in Money/CNN 2009 poll. See link . Contact and résumé at pwa@kitsappodiatry.com

PRACTICE FOR SALE - ALABAMA, GULF COAST 
 
Established 26 year old practice. Owner desires to sell and relocate. Operated 25 hours per week. Mixture of surgery and general podiatry. MD referrals. Surgery center and hospitals in close proximity. Highly profitable. Priced to sell. Will lease office to buyer. Call Mike Crosby at 888-776-2430 or email mcrosby@providerresources.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 

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.

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

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 ourwebsite

PM News Classified Ads Reach over 11,500 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 11,500 DPM's. Write to  bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 Ext 110

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