The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

July 30, 2010 #3,918 Publisher-Barry Block, DPM, JD

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IL Podiatrist Discusses Foot Health for Seniors

One of the most common health problems for seniors is their feet, experts say. "In seniors, I see a lot of bunions, hammertoes, corns, calluses, thick and/or ingrown toenails, blisters and warts," said Dr. Bryan Hersh, a podiatrist at the Chicago-based Center for Podiatric Medicine. "The foot is always changing like the rest of the body, so as you age, you should always be measured for your shoe size. Just because you've had the same size for 20 years, doesn't mean you'll always be that size," said Hersh.

Dr. Bryan Hersh

Foot experts say that there are more than 300 foot ailments. However, medical conditions aside, the reasons most older adults experience foot problems is because they're wearing the wrong socks and poor-fitting shoes. Hersh advises seniors to practice good foot care. "Do a daily inspection of your feet. It's important to look at the top and bottom and between toes. As you age, it's harder to bend down, so use a mirror, or have a family member or caregiver take a look," Hersh said.

Source: Celeste Busk, The Beacon News [7/28/10]

NJ Podiatrist Wins Three Medals in National Irish Dance Competition

Riverdance anyone?  Dr. Maureen Jennings competed at the annual National Irish Dance Competition in Washington DC. The competition is referred to as a "Feis" - the Irish word for dance. Jennings danced in the adult competition, for those over 18. The adult competition included two hard shoe dances- the hornpipe and the treble jig. The competition was fierce since Jennings competed in the advanced category. 

Dr. Maureen Jennings

Jennings won first place in both fast-moving dances. She also competed in the soft shoe advanced competition known as the slip jig and won second place. “Irish dancing is really tough on the feet. So, I make sure I do both feet and lower extremity stretching before and after each dance,” said Jennings.

Position Matters

Sit strategically during meetings. At a rectangular table, claim a seat at either end or a middle seat on either side. The people who sit in those places interact more with others and have more opportunities to contribute their thoughts.

Source: Adapted from We’ve Got to Start Meeting Like This, Roger Mosvick and Robert Nelson via Communication Briefings

Query: Orange Nails

The gentleman is a 49 y/o IDDM, diagnosed in 2009. He has lived in his house since 1997 and had a well water problem then. The water was orange and they had a water-purifying system installed, and that cleared the problem, until 3 weeks ago. The enamel in the tub turned orange and so did his toenails. His teeth or fingernails did not. He is the only one affected this way in his family.

Orange Toenails

I recommended that he fix the water filtration system. I asked the patient what was in the well water when he first had the problem, but he did not remember. Since I have never seen orange toenails, I am hoping someone can shed some light on this issue.

Joan E. Schiller, DPM, Euclid, OH

Query: Questions to Ask Before Buying an EMR System

This question is posted for those docs who already have EMR in their offices. My office is currently looking into it, and we are talking to numerous companies about their systems. 1. What do you now know that you have EMR that you wish you knew when you were looking into systems? 2. What questions do you wish you had asked your company before you invested, but did not think to, or did not know were important?

Lisa LaRocca, DPM, Smithtown, NY

Query: Painful Erythematous Markings (Harry Cotler, DPM)
From: Thomas Graziano, DPM, MD

Dr. Cotler stated that the patient reported that "all labs are normal." What exactly were the labs that were ordered? It would be prudent at least to start with a CBC w/ diff, comprehensive metabolic, and rheumatoid profile. With the limited information presented, it’s difficult to pin it down, but think about erythema nodosum. If that's the case, oral prednisone would be of benefit. You might want to try a week course of it, and then wean it down. Please let the readership know what you find and how she makes out, so that we can all benefit from the case.

Thomas Graziano, DPM, MD, Clifton, NJ, TGrazi6236@aol.com

RE: Multiple Verrucae (Gary Bjarnason, DPM)
From: Lloyd Nesbitt, DPM, Jim Ricketti, DPM

As we all know, these lesions are very frustrating for the patients and the practitioners. Liquid nitrogen on the plantar aspect of the foot is usually ineffective. It is then that patients present to podiatrists. Over the years, I have become dissatisfied with the results of my CO2 laser treatment because of recurrences, or in some cases, there are too many large areas to treat. I have been prescribing Aldara to be applied qd, for a minimum of four months. Sometimes, it works like magic, and in resistant cases, patients have had to be on it for longer periods. It's easy for the patients to be compliant.

Lloyd Nesbitt, DPM, Toronto, Canada, lloydn@rogers.com

Another treatment for the multiple verrucae patient is the Monocete EZ Swabs (Pedinol). One or two treatments will create an allergic response to the verrucae, and a good resolution is obtained.

Disclaimer: I am a consultant for Pedinol.

Jim Ricketti, DPM, Hamilton Sq, NJ, drj4foot2002@netscape.net

RE: Source for Custom Birkenstock Shoes (Jennifer Ryder, DPM)
From: Cam White

Michelangelo Scafidi, C.Ped has specialized in making custom Birkenstocks for years for patients across the country. I have personally seen his work, and know one of his clients. Here is his contact information: Michelangelo's Foot Comfort & Pedorthic Shoppe, 8344 W Lawrence Ave, Norridge, IL 60706  michelangelocped@aol.com, (866) 337-4637.

Cam White, Austin, TX, camwhite.shoes@gmail.com

RE: Criminalizing Doctors - Yet Again (Robert Kornfeld, DPM)
From: Stephen Bennett, DPM 

It is absolutely a double standard. Large insurers have all the cards regarding reimbursement. I recently was trying to find information on out-of network fee schedules and found:
 
Non-Participating Provider Benefits: When you do not use the services of a participating provider, GHI provides coverage for the services of non-participating providers. Payment for these services is made directly to you under the NYC Non-Participating Provider Schedule of Allowable Charges (Schedule). The rate at which you will be reimbursed for a particular service is contained within the Schedule. These reimbursement rates were originally based on 1983 procedure allowances, and some have been increased periodically. The reimbursement levels, as provided by the Schedule, may be less than the fee charged by the non-participating provider. Please note that certain non-participating provider reimbursement levels may be increased if you have the optional rider. The subscriber is responsible for any difference between the fee charged and the reimbursement, as provided by the Schedule. A copy of the Schedule is available for inspection at GHI.

Can I get the fee schedule? I have tried but they don't release that information to non-participating providers. Reimbursement rates are based on 1983 allowances! Do patients understand that their copay is often the lion share of any payment that the doctor may receive? How can medical costs be sky rocketing! What can we do to influence reimbursement? If we would all bill our real charges instead of what the insurance company pays, then the usual and customary average would be higher (a lot of doctors bill what they expect to be paid so that their billing books are more easily reconcilable). Our association should publish true usual and customary fees alongside the insurance companies determination of benefits, and legal action should be taken to force more reasonable reimbursement.

Stephen Bennett, DPM, NYC, NY, drsteve5@verizon.net

RE: Substitute for DPM Crème? (Joan E. Schiller, DPM)
From: Jim Ricketti, DPM

A substitute for DPM Cream is Lactinol HP (Pedinol) cream, sold out of my office. It makes good money for the practice. 

Disclaimer: I am a consultant for Pedinol.

Jim Ricketti, DPM, Hamilton Sq, NJ, drj4foot2002@netscape.net

RE: Passing of Godfrey Viegas, DPM

Godfrey was one of those folks that one encounters who almost immediately makes one want to be a better professional and a better person. He was a Renaissance man with a keen mind and equally keen desire to share his gifts. If immortality is at least partially defined as the persistence of someone in memory, then his place is rightfully secure.

David Armstrong, DPM, Tucson, AX, armstrong@usa.net

PART-TIME/FULL-TIME POSITION – MASSACHUSETTS 
 
Looking for extremely energetic physician for nursing home and assisted living facility. Very generous compensation package. Great opportunity for extra cash. Future  potential for part-time work in our practice and/or in house call practice as well. Please call immediately (978) 794-8406 and ask for Blanca for an interview.

ASSOCIATE POSITION – LONG ISLAND, NY

Associate full-time. Well-established, busy, well-rounded podiatry practice looking for a motivated podiatrist. Suffolk Co. LI NY. Board eligible, Board certified PSR-24/36 trained. Fax resume to 631-581-0857.

PRACTICE & STATE LICENSED ASC FOR SALE (MARYLAND, DC SUBURB)

38 yr old general podiatry practice grossing over $550K. Fully equipped with digital x-ray, diagnostic ultrasound, 2 orthotic scanners, computer network and well-equipped surgical suite. Retiring owner will stay on as needed. Email - dpmpracticeforsale@yahoo.com

ASSOCIATE POSITION - SOUTHEAST GEORGIA

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking associate or new residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

ASSOCIATE POSITIONS – MULTIPLE LOCATIONS

Looking for podiatrists to join group to work in nursing facilities in: Texas (Ft. Worth, Dallas, Houston) Washington, DC, Philadelphia, Northwest Pennsylvania, Delaware, Upstate New York, Massachusetts (Brockton). Please respond to: doconcall02@aol.com

ASSOCIATE POSITION - FREDERICK, MARYLAND

Fredericks premier group practice is located only 45 minutes from both DC and Baltimore. Immediate opening for a minimum PSR 36 Podiatrist for full time position. We have it all: EMR, digital x-ray, ultrasound, ASC, etc. Excellent salary with bonus structure and benefits. Please email resume to docsbnb@aol.com

POSITION AVAILABLE - SOUTHERN CALIFORNIA

Very well established, multiple location group practice has immediate opening for associate doctor. Attractive compensation and benefit package offered. E-mail resume to mrsmcmackin@aol.com

PODIATRISTS NEEDED NATIONWIDE

Podiatry referral company has thousands of diabetic patients nationwide in need of immediate service. We are looking for podiatry practices interested in joining our network to receive referrals. Email coasttocoastpodiatry@yahoo.com

ASSOCIATE POSITION - SUBURBAN PHILADELPHIA AREA

Full-time associate with opportunity for partnership with group practice. Candidate must be trained in all phases of podiatry including wound care, surgery, and routine podiatric care. Candidate must have a positive and energetic attitude with a desire to grow in our practice. If interested please email your CV to BergD@readinghospital.org

FULL-TIME ASSOCIATE NEEDED FREDERICK/HAGERSTOWN, MARYLAND

Reconstructive Foot & Ankle Institute, LLC  needs full-time DPM at least PMS 36 to join premier group in Frederick/Hagerstown, MD. ASC, EMR, DR-digital radiography and ultrasound, Vascular/nerve testing, DME, retail store, strong hospital affiliations, salary, bonus and benefits. Respond to drmichaels@rfainstitute.com

PRACTICE AVAILABLE - WESTERN WASHINGTON

General Podiatry practice in Port Townsend, WA. Nice community, 25+ year old practice, busy 3 days a week with growth potential. Owner leaving area, needs someone to take over the practice, lease and equipment. Contact Jessica at ptpod@yahoo.com or 925-519-0624.

ASSOCIATE POSITION - NEW JERSEY - JERSEY SHORE REGION

Part-time associate wanted. Looking for a motivated and ethical practitioner. Competitive salary with incentives. Tuesday AM - Thursday PM - 2 Saturdays/month. Please respond to: NJSHOREFOOTDOC@aol.com

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