The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

August 02, 2012 #4,530 Publisher-Barry Block, DPM, JD

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TX Podiatrist Discusses Bunions

Though they can also be hereditary, bunions usually form and are aggravated by daily use of tight or narrow-toed shoes. "When they start wearing heels in their 20s, that's when the shoe itself will force the toes together," podiatrist Dr. John Gouin said. "It's going to get worse over time." Gouin explained that eventually, the pinky toe may overlap the next toe in line, and that toe will start rubbing against the shoe.

Dr. John Gouin

Gouin said if you're noticing a bunion, the first thing you need to do is see a podiatrist. And for pregnant women, Gouin said the best way to deal with a bunion is with orthotics, or wait to have surgery until after you have your baby.

Source: KIII-TV [7/31/12]

New Bunion Procedure Provides Alternative For Younger Patients: UK Podiatrist

The latest treatment for bunions is with specially designed surgical screws that are buried in the bone and do not need to be removed, meaning a lower risk of infection and a more comfortable recovery. In another operation, the surgeon cuts a wedge from the inside of the long foot bone that’s swinging out, so it sits straight again. The removed wedge of bone is attached to the outside of the bone and acts like a buttress, reinforcing and preventing it from moving out again.

Ralph Graham

Again, this means no wire, and also avoids fusing the joint. "This offers an excellent alternative for younger patients with bad bunions as it keeps all the foot joints intact," says podiatric surgeon Ralph Graham, of Kent Community NHS Trust, who devised the procedure.

Source: Carol Davis, The Daily Mail [7/30/12]

NY Podiatrists Join NY Senator Schumer

(L-R) Dr. Andrew Shapiro, Sen. Charles Schumer, Dr. Gary Stones

NYSPMA Legislative Chair and Trustee, Andrew Shapiro, DPM, and NYSPMA President Gary Stones, DPM  recently joined NY Senator Charles Schumer at a Yankees-Red Sox game, benefiting Senators Schumer's Leadership PAC. Senator Schumer is a co-sponsor of Senate bill (S1309), Equity and Access for Podiatric Physicians Under Medicaid Act. Sen. Schumer is a senior member of the Senate Finance Committee, which has jurisdiction over Medicaid. Many APMA members in NY were instrumental in helping to get the Senator to take the lead on the legislation.

NJ Podiatrist and NYCPM Students Volunteer at Lake Placid Ironman

On July 22 in Lake Placid, NY, the foot care of over 2,300 Ironman triathletes was in the good hands of Josh White, DPM, CPed, president of SafeStep.

Dr. Josh White (center) and NYCPM Students

Assisting him were second year NYCPM students, top row from left to right: Innjea Park, Adam Nowland and Shane Reynolds; bottom row, Adam Rozenstrauch and Orli White (class of 2028?).

FDA Declines Rilonacept for Gout Flares

The U.S. Food and Drug Administration (FDA) yesterday issued a complete response letter to Regeneron Pharmaceuticals regarding its supplemental biologics license application for the interleukin 1 inhibitor rilonacept (Arcalyst) for the short-term treatment of gout flares, according to a press release issued by the company.

This decision follows an 11-to-0 vote by the FDA's Arthritis Advisory Committee in May recommending rejection of the supplemental biologics license application for rilonacept. In its decision, the advisory committee members expressed concerns regarding the long-term safety and efficacy of rilonacept for gout flares.

Source: Joe Barber Jr, PhD, Medscape News [7/31/12]

Query: Chronic Diabetic Ulcer

This 55 year old male was a type-2 diabetic for 16 yrs and type-1 for the past 8 years. The initial problem started as a blister after a long walk and has progressed to the present state. He has had a chronic history of a recurrent right pinch hallux callus that continually breaks down after healing for short time periods. With the exception of his diabetes, his PMH is uneventful. His only meds are Lantus and Humulog. NVS is WNL.

Diabetic Ulcer of Right Hallux

Over the past few years, I have Rx'd, at different times, Cephelexin 500, and a combo of Flagyl 500 and Clavulin 500. He is also using Amerigel topically. I have placed him on crutches for 4 weeks at a time. This resolves the problem. Once weight-bearing occurs, the problem recurs. He is wearing orthotics with a RFVr-4 deg, FFVg-5 deg with FHL extension, and a rigid polypro device (He is 6'2", 255 lbs.). I constructed a Berkoplast toe crest. His x-rays are unremarkable. Any suggestions?

Kel Sherkin, DPM, Toronto, Ontario

RE: Failed Phenol Procedures
From: Chuck Ross, DPM

I just wanted to send a brief thank-you note to my colleagues who responded in a timely and very educated fashion about my previous post on phenol nail procedures. All have been useful. I have now begun utilizing a tourniquet (noting a significant lack of bleeding during the procedure) and have returned to one phenol application with the phenol stick, as well as the use of NaOH. I am doing my own in-office research.
 
Thank you, Dr. Block for having this medium available to all of us.
 
Chuck Ross, DPM, Pittsfield, MA, cross12@nycap.rr.com

RE: Affordable Care Act (Obamacare) Perk (Brian Kiel, DPM)
From: Jon Purdy, DPM
 
I’m hoping the world I live in is the same as the one that was founded in 1776, although that certainly seems to be changing. My hope is that I live in a country where capitalism, the economic force that made the poor of this country the richest in the world, still reigns as the purveyor of prosperity.
 
Private companies in the United States are free to make as much profit as they can, pay whomever what salary they want, and deny any services in the product they sell. If the people paying for the policies don’t drop them for another insurance company, or the healthcare providers keep taking that insurance, then they have been given our approval.
 
Since doctors are still free to choose which patients they see and what insurances they accept, I would think one would be hard pressed to blame their success or failure on those insurers.  Insurance companies can’t decrease your profits; you have to let them. If you don’t get paid what you feel you deserve, then stop taking the insurance. Do you see dentists or plastic surgeons complaining about insurance? If the so-called Affordable Care Act is so “affordable”, exactly why is the president giving out exemptions? I think you may find this is a force that actually will decrease your profits without your say so.
 
Jon Purdy, DPM, New Iberia, LA, jpurdy@mindspring.com

RE: Affordable Care Act (Obamacare) Perk (Jon Purdy, DPM)
From: Joel Lang, DPM

Let’s not weep too long or too deeply for the ‘oppressed’ healthcare industry. Over the past 3 years, their stock prices have soared (ex: United Health Care $20-$55, Humana $32-$75, HealthCare REIT $30-$60, etc.). In addition, there is no correlation between dropping plastic surgery rates (if that’s actually true) and healthcare premiums which have also soared. The salaries of health corporate executives have progressively increased, while more care is being denied and medical fees are being cut. The Affordable Care Act has multiple benefits for the general public.
*Children will be covered under their parents' insurance to age 26.
*Children under 19 cannot be denied coverage for pre-existing conditions.
*Lifetime benefit limits have been eliminated. Companies can’t cancel...

Editor's Note: Dr. Lang's extended-length letter can be read here.

RE: CA Podiatrist Says Team Approach Saves Limbs and Lives (Allen Jacobs, DPM)
From: Lee C. Rogers, DPM

Would the good Dr. Jacobs like to argue the opposite, that the "team approach" makes no difference in limb salvage or prolongation of life? The referenced quotation is from a newspaper article, not a scientific manuscript. I provided an interview to the author, but did not write the article or the title.  Moreover, the titles of newspaper articles are sometimes not written by the article author either. Large newspapers usually have a headline writer to create catchy titles to entice a reader. Regarding the amputation mortality statistics, Dr. David Armstrong has reviewed the manuscripts reporting 5-year relative mortality after amputation, which is 48-74% in various studies (references below). I am in complete agreement that the cause of the increased mortality is multifactorial. 

In my opinion, which one is generally allowed to opine in editorials and newspaper interviews, the increased mortality after amputation in many cases has a similar natural history to the increased mortality after hip fracture - hastened by the more sedentary lifestyle. As for the factual basis for risk of earlier death from inactivity, a Google search of "sedentary lifestyle death" reveals many scholarly articles and over one million results.

Bharara, et al. Diabetes and landmine-related amputations: a call to arms to save limbs.  WJ 2009;6:2-3
Armstrong DG. Are diabetes-related wounds and amputations worse than cancer? IWJ 2007;4:286-7

Lee C. Rogers, DPM, Los Angeles, CA, lee.c.rogers@gmail.com

RE: Some Patients are "Different"

This actually happened today in my office.

Doctor to patient: "Did you know that you have two different shoes on your feet?"

Patient to doctor: "Yes, that's because I have two different feet."

She also had two left shoes on.

Joseph Borreggine, DPM, Charleston, IL

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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

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 516 476-1815PODO2345@AOL.COM

WANTED LOCUM TENENS - CAPE COD, MASSACHUSETTS

Busy general group practice in beautiful Brewster Massachusetts in need of help. We are one practitioner down due to medical leave during our busy season. Stay one month or three offering housing and top salary.  Possibility to lead to full time Associate/Partnership. Please email your interest to:  ltboudreau@gmail.com

ASSOCIATE POSITION - MANHATTAN

Podiatrist needed for busy state-of-the-art offices in Manhattan. Offices are located near Penn and Grand Central Station. 10+ years experience only and an out-of-network doctor for most insurances. Please forward your information and CV to: roni@myfcny.com

ASSOCIATE POSITION – NORTHERN CALIFORNIA/BAY AREA
 
We’re looking for someone entrepreneurial who can help grow our practice. Must have great people skills, clinical/surgical skills, and positive demeanor. California license required. Send your CV and cover letter to cvpodiatrist@gmail.com

 ASSOCIATE POSITION - YONKERS, NY

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 - 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 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.

ASSOCIATE POSITION  WEST COAST FLORIDA

Outstanding opportunity for PSR-36 graduate to join successful group podiatry practice. Seeking a sociable, articulate graduate who is confident in foot and ankle surgery but also enjoys all phases of podiatry. Long-term opportunity for the right candidate with generous pay and benefits. Reply to: jwicks@cortezfootandankle.com

ASSOCIATE POSITION – BROOKLYN, NY

Full-time position available with excellent salary in a state-of-art-office. Please email your resume to:  irenefootcare@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 - SEATTLE, WA AREA

A well-established, solo-physician practice seeking a Full-Time Associate Podiatrist. Applicant should be: well trained physician,  personable and motivated individual with sound surgical skills.  Applicant must have completed a 24-36 month residency. Practice offers a state-of-the-art practice setting, with a good general mix of all aspects of podiatric medicine and surgery. Competitive salary and benefits. Partnership opportunities available. E-mail your letter of interest with 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:   institutebeaute885@gmail.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 - 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.com

ASSOCIATE POSITION - NJ

Immediate opening for full-time or 2 part-time DPMs for diversified practice that features most all phases of podiatric medicine and surgery. Full-time candidate must be ABPS Board Certified in Foot Surgery or PSR 24/36 Bd Qualified in RRF. Competitive salary and bonus. Great working conditions and area. Realistic Partnership opportunity. Send resume to: MonmouthDPM@aol.com

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: Podocare@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.

EQUIPMENT 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

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.net

PM News Classified Ads Reach over 13,500 DPM's and Students

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