The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

July 31, 2012 #4,528 Publisher-Barry Block, DPM, JD

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CA Podiatrist Says Team Approach Saves Limbs and Lives

The Amputation Prevention Center at Valley Presbyterian's campus in the San Fernando Valley is the only one of its type in California. It is run by a wry, veteran vascular surgeon and a baby-faced podiatrist who contend that their team approach has saved the limbs of some 94 percent of the patients they see with wounds, infections, or related ailments. "This is a unit where we all practice together," said Dr. Lee C. Rogers, a podiatrist and co-medical director of the APC. "We've often heard … the shock from patients: 'I just saw six doctors in 30 minutes. I just can't believe that I saw that many doctors.'"

Dr. Lee Rogers with patient whose former doctor had recommended an amputation (Photo: Jill Connelly). Rogers' treatment saved his foot.

Rogers said APC is so focused on saving limbs because 68 percent of leg amputees die within five years, in part because of the sedentary lifestyle patients often are left with. And amputated limbs are a major factor in forcing many people to leave the independence of their own homes and live out their lives in institutions.

Source: Herbert A. Sample, Sacramento Bee [7/29/12]

NYCPM Alumni Association Presents 5th Annual Bruce J. Frankel Award

The New York College of Podiatric Medicine’s Alumni Association has announced that Adisa Mujkic has been awarded the Fifth Annual Bruce J. Frankel Alumni Scholarship. This award, given in memory of Dr. Frankel, long-time NYCPM Dean of Students, is given to the entering 4th year student who has done the most for the college and the profession.

(L-R) Drs. Debra Weinstock & Arthur Gudeon, Adisa Mujkic, Drs. Terry Spilken & Steven Plotka

Adisa is the NYCPM student representative from the class of 2013. She also serves as the Editor-in-Chief of NYCPM's Podiatric Medical Review. Adisa was presented with a five hundred dollar scholarship by Arthur Gudeon, DPM, NYCPM Alumni Association president.

Landmark Long-Term Study Reveals Data on Amputation and Death From Diabetes

A landmark longitudinal study published this weekend reveals increasingly good results for patients receiving care for diabetic foot wounds. However, the data aren't all rosy. "It's good and bad", notes Dr. David G. Armstrong, the senior author on the study. "What we can see is that limb-salvage for people presenting for care with a diabetic foot wound is really quite good. However, mortality is very, very high in these patients." Armstrong, a Professor of Surgery and Director of the Southern Arizona Limb Salvage Alliance (SALSA) at the University of Arizona, went on to say, "The frequent analogy we make to cancer is definitely confirmed by the results of this study."

Dr. David G. Armstrong

In the study, while only 15% of patients presenting with a wound received a major amputation over a decade, some 70% died over this period, dramatically accelerated by vascular disease and kidney  disease. "What we don't need is another gadget," noted Armstrong. "What we need is the collective courage to counsel our patients with wounds and amputations. When the wound is open, it is like cancer. When they're healed, it is not healing -- it is remission." The results of this study, led by Stephan Morbach, are published in the online edition of the journal Diabetes Care.

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: What are your thoughts about changing the name of the American Board of Podiatric Surgery to the American Board of Foot and Ankle Surgeons? 

Dr. James Stavosky

James Stavosky: I don’t agree with it. I like being a podiatrist. I have no problems being identified as a podiatrist. I would be okay with the American Board of Podiatric Foot and Ankle Surgeons. I don’t think a name change is going to help us at all in terms of what we do and what goes on in my hospital. If this change is being made to get reimbursed better, then we’re talking about others doing the same procedures that we do. That’s parity, and I am all for that.

Meet the Masters is broadcast each Tuesday night at 9 PM (EST). Meet the Masters will be on vacation hiatus for the next two weeks. You can register for future events by clicking here

Bargaining Tactics That Work

To be a top negotiator, hone your interpersonal skills. Practice these techniques:

•  Don’t be afraid to ask. Some people worry about rejection and disapproval if they ask for anything out of the ordinary, so they simply accept an offer and hope for the best. However, top negotiators understand that everything is negotiable. They politely and confidently ask for any price or term remotely within reason.
   
•  Learn how to respond. React to counter-offers with shock and disappointment. Appear hurt, as if someone just said something cruel. Ask “Is that the best you can do?” and then remain silent, waiting for an answer.
   
•  Ask repeatedly and in different ways. Example: Try to shake up the other person’s confidence by indicating that you may walk away from the negotiation. Imply that you can receive a better deal somewhere else.
   
•  Keep practicing. Some negotiations end in successful transactions and others fall through, but take every opportunity to bargain because most prices aren’t written in stone.

Source: Adapted from “How to Negotiate: Using Business Communication and Interpersonal Skills to Get What You Want,” Brian Tracy, Brian Tracy International via Communication Briefings

Query: Chemgon System

Is anyone using the Chemgon system to combine fixer and developer to form a solid that can be disposed of as regular waste? If so, what have your experiences been?

Daniel Chaskin, DPM, Ridgewood, NY 

RE: Independent Auditor for Billing Company (Name Withheld)
From: Bob Hatcher, DPM

You might consider Triangle Medical Mgmt at 919-632-8994.

Disclosure: TMM is run by my wife who has had 35 years of experience in all types of medical insurance billing and coding, including family practice, urology, neurology, and neurosurgery.

Bob Hatcher, DPM, Raleigh, NC, boboffice@nc.rr.com

RE: Affordable Care Act (Obamacare) Perk (Brian Kiel, DPM)
From: James E. Rogers, DPM

I am in total agreement with Dr. Kiel. I am as busy as I have ever been, yet , every year my gross income declines. I am sure that healthcare executives don't see a decline in their salaries!

James E. Rogers, DPM, Nashville, TN, drjimbob@comcast.net

RE: Best Laser for Onychomycosis (Daniel Waldman, DPM)
From: Marc Katz, DPM

The best laser for onychomycosis is purely subjective and depends on what works best in your hands. We still have no idea what is ideal with regard to wavelength. Most companies have not come up with appropriate standards and protocols and need to do so. Podiatrists will need to do studies that are not connected to the laser company pushing their product.

I personally developed my own protocol and I'm happy with the results. I can tell you that you need to remember the company that took advantage of podiatrists at the start of lasers for onychomycosis. Their goal was to make tons of money at our expense and they did! I have no ties to that company or any other laser company.

The FDA clearance proves nothing when it comes to...

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

RE: CMS Contractor Begins Meaningful-Use Audits
From: Marv Boren, DPM

According to Ober Kaler, attorneys that represent providers who are involved in the EHR Incentive Program, the auditor is asking for four types of information:

* Documentation from the ONC showing that the provider used a certified EHR system for meaningful use attestation.

* The method used to report emergency department admissions, which affects some of the required measures.

* Supporting documentation for the completion of the attestation regarding the core set objectives and...

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

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

PRACTICE FOR SALE - NEW ROCHELLE, NY

Flexible terms. Stable location, medical co-op, 24 year practice with a stable established patient base. Great opportunity for a self motivated podiatrist wanting immediate income and future stability. Call 551-574-0776 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.

PRACTICE FOR SALE - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact: podiatrypracticesale@gmail.com

ASSOCIATE POSITION - TUCSON (SOUTHERN ARIZONA)

Accepting applications for an associate position. Applicant must have completed surgical residency and be Board Qualified/Certified. Our practice involves multiple office locations and looking to expand. We offer all aspects of foot and ankle medical and surgical care.  Hospital and Surgery Centers privileges. Competitive salary and benefits. Partnership opportunities available. email resume to: drdafac@gmail.com

ASSOCIATE POSITION - SEATTLE, WA AREA

Established podiatric clinic looking for an associate to join our team, 5 offices located around the greater Seattle, WA area. Great base salary, benefits and friendly work environment. Please send resume to: seattlefootdoctor@yahoo.com

ASSOCIATE POSITION - MANHATTAN

Well-established successful Park Avenue podiatry practice is recruiting skilled and well trained DPM with a minimum of 3 years of experience. Must be experienced in rear and forefoot reconstruction. Must be self- motivated, and great with patients. State-of-the-art practice facilities and technologies which include: in-office physical therapy, digital x-ray, diagnostic ultrasound, and electronic medical records. MRI, and private operating room. All interested candidate email CV to elautin@gmail.com

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 - 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, and other Medicaid plans. Contact me at: Podocare123@gmail.com

ASSOCIATE POSITION - NASSAU COUNTY, NEW YORK

Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to: Podiatryoffice@doctor.comASSOCIATE POSITION - NORTHERN VIRGINIA

Small, high-volume, non-surgical conservative care practice in Northern Virginia looking for hard-working, caring full-time podiatrist. Must enjoy, respect benefits of palliative care, diabetic foot care, foot biomechanics. Experience good. Great attitude better. Must be team player, practical, flexible problem-solver. Looking for someone committed to grow practice. Not looking for equity partner now, but if you prove yourself with great performance and attitude, a partner would be welcome. Send resume and CV to karenafp@gmail.com

ASSOCIATE POSITION - LOUISVILLE, KY

Immediate position for established practice in excellent location with option to buy. All phases of podiatry with good mix of patients. Two local residency programs with foot and ankle and trauma privileges. Office has EMR qualifying for meaningful use in the first year. PADnet vascular testing. Send resume to: samuel10530@yahoo.com.

ASSOCIATE POSITION - BIRMINGHAM, ALABAMA

Immediate opening. Strong established group practice. 30-40 office patients per day to start. Surgery available, but not required. Base salary, production bonus, benefit package, relocation assistance. Aggressive work ethic a must. Email resume and cover letter to: dwh101@bellsouth.com

ASSOCIATE POSITION - OHIO

Ohio practice with excellent reputation and patient base seeks to hire a Podiatric Surgeon. The offices are state of the art including Digital X-Ray, EMR, Diagnostic ultrasound, Padnet Vascular Testing, CO- 2 Lasers all aspects of DME. The base salary is $120,000 with a bonus structure and benefits also would like to have this individual buy into the practice eventually. Please send CV to: Ohiopodiatrist@aol.com

ASSOCIATE POSITIONS – MARYLAND

Are you motivated, personable and enjoy working with the elderly? We are offering part-time positions in Maryland. Our group, Podiatry Management Services, provides care in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your CV to:drhprosen@verizon.net or fax to 410-486-2049 or call Dr. Herbert Rosen at 410-580-0255.

ASSOCIATE POSITION - YONKERS, NEW YORK

Immediate part time associate position now available. Appx: 3 1/2 days per week with room to grow. Practice is a good balance of all aspects of podiatric foot care, including surgery. Perfect opportunity for new graduate, or experienced podiatrist. Looking for the right person to transition into vacancy that will be left by current associate leaving the area and you will have an immediate, full schedule of patients. Over 25 year well-established practice with large referral base, and both hospital and surgery center privileges available. Interested persons please forward CV and brief summary of surgical log to:Podiodoc@gmail.com 914.584.1434

ASSOCIATE POSITION - BAKERSFIELD, CA

IMMEDIATE OPENING: Office and hospital-based podiatry group in Bakersfield, CA seeks highly trained surgical associate to join us. Prefer surgeon with trauma and Charcot reconstructive experience. Staff privileges with 5 local hospitals. Offering health insurance, CME allowance and competitive salary. Must be PSR 24/36 trained, ethical and thoughtful when treating patients. Please forward CV and letter of intent to modpm@aol.com.

EQUIPMENT FOR SALE

Retiring from practice. Equipment For sale. Mini x-ray. One year old Ultrasound with MS arterial/venous X-ray plates. Great condition Ritter chairs. Drills, surgical tools. So much. Just ask, I probably have it: Footcare@comcast.netEQUIPMENT FOR SALE - USED PODIATRIC LASERS

Great price, great outcome. Stop wasting money on expense lasers. Personally owned and used few hours in my office,. 10 and 30 watts lasers. Two handpieces in one. First one for plantar fasciitis, Achilles tendonitis, arthritis, pain, inflammation. 2nd handpiece for surgical ablation and fungus toenail conditions. Portable fast and very cost-effective. footcare@comcast.net

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