The Voice of Podiatrists

Serving Over 14,509 Podiatrists Daily

August 06, 2013 #4,841 Publisher-Barry Block, DPM, JD

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75% of NYSPMA Podiatrists Polled Report Diagnosing Melanomas in Feet

When members of the New York State Podiatric Medical Association (NYSPMA) were surveyed on whether they had ever discovered melanoma or skin cancer during a routine foot examination, 75% of the foot specialist respondents answered positively. “I’ve diagnosed melanoma through routine foot exams, said Dr. Robert A. Russo, President of the New York State Podiatric Medical Association and a practicing podiatrist.

Dr. Robert Russo

“One example is a patient who came in thinking they had a plantar wart, but the biopsy I ordered proved it to be melanoma,” he added. Feet that are not regularly exposed to the sun during the year are very sensitive. Skin cancer can occur on the soles of the feet, as well as on the tops, between the toes, and under the nails. Podiatrists say that it is important to have routine foot checks to diagnose any abnormalities that could be symptoms of the disease.

NY Podiatrist and Family Win Awards at Irish Feis

Three generations of the Reilly/Fallon family recently took home awards again at the Rockland County Irish Feis. James E. Fallon, 12, a student at H.C. Crittenden School in Armonk received second place in Irish arts for oil on canvas and third place in Celtic art sketch in color. James' mother, Dr. Kathy Fallon Reilly, received first place in Irish singing and first place in Celtic art sketch in color.

Dr. Kathy Fallon Reilly (R) with family

James' grandmother, Anne Reilly, received first place in Irish arts for knitting and second place for her Irish soda bread. The Rockland County Irish Feis, in Tappan, NY, featured demonstrations and competitions in dance, bagpiping, music, soda bread baking, art and Celtic design, basketball, vocal and lilting, Irish language, children's races, Celtic cross band, sheaf throwing, massed bands, and old time waltzing.

Source: Eric Gendron, Armonk Daily Voice [8/2/13]

CA Podiatrist Demonstrates Arthroscopy and Endoscopy Procedures in Germany

Amol Saxena, DPM recently presented and demonstrated various ankle arthroscopy and endoscopy procedures at the first annual meeting of the Kieler Innovations Kongress in Kiel Germany.

Dr. Amol Saxena with Meeting Chair Dr. Christian Buell

Saxena is the editor of the Springer text Sports Medicine and Arthroscopy of the Foot and Ankle, which is being translated into Polish. The meeting was attended primarily by European orthopedic and trauma surgeons.

Bret Ribotsky:  When interviewing students for residency positions, what characteristics are the candidates who are not selected missing?

Dr. Russell Caprioli

 Russell Caprioli: Passion is often missing. I personally despise apathy. GPA is not as important as a thirst for knowledge and being well-read. Professionalism is also very important as these future doctors are the ambassadors for podiatry throughout the hospital.

Dr. Russell Volpe

This week's guest is Dr. Russell G. Volpe, Professor and Past Chair, in the Department of Pediatrics and Orthopedics at the New York College of Podiatric Medicine. You can register for future events by clicking here

Query: Bookkeeping Under the New Sunshine Act

Now that the new Sunshine Act is in effect, how do I keep track of the costs of a dinner at Ruth's Chris steakhouse? Must I now ask for a menu and tabulate the cost and divide by the numbers of attendees? How can one do this if they are serving family style? Or should I ask the drug rep for a copy of his bill. Should I also ask the drug rep who comes to my office to give me a bill for the note pads, pens, etc.?

Paul Kesselman, DPM, Woodside, NY

Editor's comment: PM News does not provide legal advice. According to a recent Medscape article, "Physicians have no legal duty to keep a tally of industry payments and gifts, but they may want to anyway. The Sunshine Act allows them to contest the dollar amounts that drug and device makers submit to CMS, especially if they think the numbers are inflated."

Query: Pre-surgery Screening Questionnaire

Is anyone aware of a pre-surgery screening questionnaire for potential psychological issues, substance abuse issues, or other problems like demographic challenges or mental disabilities. This questionnaire would help with patient selection for elective foot surgery. I searched the Internet and found a lot of information, but only regarding bariatric surgery.

Philip Larkins, DPM, San Diego, CA

RE: Diagnostic Ultrasound
From: Michael Forman, DPM

Recently, there was a PM News post about overuse of diagnostic ultrasounds of the foot. This could be. Then again, maybe not enough of us are using this modern modality. The post I read mentioned that many ultrasound-guided injections were unnecessary. I wonder how the writer knew that.

I use ultrasound-guided injections almost always for plantar fasciitis. Rather than stick a needle in a foot and hope you are in the right spot, we ultrasound the area. I marvel at the information I have at my fingertips because of this wonderful diagnostic tool given to our profession. I just saw a partial posterior tibial tendon rupture, several intermetatarsal neuromas, and thick inflamed plantar fascial origins. All of this was done without a $2,000 MRI.

My protocol is to place the needle inside the heel. I then examine the placement with ultrasound. I estimate I am not where I want to be 10% of the time. Placement is then corrected real-time. As far as neuromas, how can you expect to inject a small .4 cm. lesion without looking? I estimate that we relieve neuroma pain at the very least 90% of the time with two or three ultrasound-guided injections. That is a lot cheaper than taking the patient to the operating room.

As far as joint injections, I think these are far easier. I have never had to use ultrasound to inject an ankle or a sinus tarsi. I always try to inject an MPJ without ultrasound first and then bring it in if needed.

Michael Forman, DPM, Cleveland, OH, im4man@aol.com

RE: Treating Homeless Patients (Elliot Udell, DPM)
From: David S. Wolf, DPM

I am one of the 15 plus Houston podiatrists who volunteer every Saturday morning at a downtown homeless medical clinic. My advice is to treat the homeless patient as only we DPMs know how to do and not be concerned as to the possible medical/legal issues and follow-up appointments.

The homeless and the other uninsured are already going to overcrowded ERs and county clinics. We can, as podiatrists, make a real difference in helping those less fortunate to ambulate and get back on their road to recovery. Most homeless people today are not just psychiatric/alcoholic types, but people (and entire families) who lost their housing and employment due to the recent economic downturn.

David S. Wolf, DPM, Houston, TX, rebdovid@aol.com

RE: Documenting Radiological Findings
From: Robert Christman, DPM

Daniel Evans and I, representing the ACFAOM Podiatric Imaging Council, have developed a Standardized Radiology Report Template (available as  Microsoft Word or Adobe PDF documents; there is also a PDF version, including examples). They can be accessed by visiting ACFAOM.org, hovering the cursor over the "Healthcare Professionals" tab along the top-right of the page, then clicking "Standardized Radiology Report."

Robert Christman, DPM, Pomona, CA, rchristman@westernu.edu

RE: APMAPAC Donates $10,000 to CA Podiatrist's Campaign
From: Russell J. Barone, DPM

Since we, as podiatrists, are being urged to support Dr. Lee Rogers for United States Congress (no matter what our politics), I would like to ask two questions of him: 1) Does Dr. Rogers support Obamacare for all Americans? If he were to win the seat in Congress and he says that he supports Obamacare for all Americans, then 2) Would he continually introduce legislation that would require all government workers (including The President, The Senate, U.S. Members of Congress, The Supreme Court Justices, etc.) to accept Obamacare as their form of health insurance with no exemptions? If he supports my requirements, then I will support Dr. Rogers! 

Russell J. Barone, DPM, Hendersonville, NC, lpjrbar@aol.com

RE: Unmatched Residency Placements Currently Stand at 80
From: Joel Lang, DPM

For the past few weeks, I have read with sadness and disbelief that our profession has created a crisis in which as many as 20% of our successful graduates may never be unable to practice their profession, destined to a life of insurmountable debt and inevitable despair.

The reactive postings about this tragedy have varied from desperation, blaming our leadership and our corporate hierarchy, and even blaming the victims for not being creative enough to solve their own problems. It’s a little like blaming rape victims for...

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

RE: Unmatched Residency Placements Currently Stand at 80 (Richard Gosnay, DPM)
From: Unmatched Podiatric Graduate (KSUCPM)

Dr. Gosnay’s comment that the APMA or CPME are not to blame for the residency shortage is absolutely outrageous. The CPME is not just an accreditation arm of the APMA; it's also supposed to make sure the colleges do not take in too many students. The CPME approved the addition of a new podiatry college at the same time that it recognized the likelihood that a residency shortage was on the horizon.

At the same time, as the latest podiatry college was matriculating its charter class, the CPME allowed at least one other college to take more students than they were approved to take. Dr. Gosnay suggests that...

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

PRACTICE FOR SALE- CONNECTICUT

Well-established, 35-year-old reputable practice/condo with approx 2,500 Square ft. Grossing approximately $450,000. Outside Hartford area. All phases of podiatry. Contact drsch52@hotmail.com

PRACTICE FOR SALE - NORTH CAROLINA

Rapidly growing start up practice in rapidly growing college town in Eastern North Carolina. Excellent teaching hospital nearby with privileges available. Must sell due to health reasons. Serious inquires only. Reply to drcivatte@gmail.com

PRACTICE FOR SALE - HUNTINGTON PARK, CA

46 years same location. Unsurpassed visibility on corner of major intersection. 3 fully equipped treatment rooms. Perfect opportunity to build a strong practice. Must retire due to age. Selling price $30,000 firm. (323) 588-1179 MTWF. evaonofre@hotmail.com

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

ASSOCIATE POSITION - SOUTHEAST MICHIGAN

Seeking a quality-oriented, patient-focused PSR trained associate for a fast paced, established group practice in Southeast Michigan. This is a secure, long-term position. Emphasis on diabetic foot and wound care.  Our outstanding staff allows you to concentrate on optimal patient care without the responsibilities of practice management. Partnership possibility for the right individual. If you are highly motivated, ethical and have good communication and clinical skill, please forward you C.V. to: cfsdr@yahoo.com 

ASSOCIATE POSITION – PENNSYLVANIA

Associate Wanted for busy, multifaceted podiatry practice in Chester and Delaware counties, Pennsylvania. Seeking PSR-24/36 trained podiatrist for full/part time associate position. Two offices and hospital privileges. Send CV and letter to: 123bunion@gmail.com

POSITION AVAILABLE - MASSACHUSETTS

Boston Medical Center. Full-time career opportunity: surgery, diabetic foot care, wound care, general podiatry, resident training & research. Split position: (90%) on-site BMC and (10%) off-site health center clinics Boston University School of Medicine Academic appointment. Requirements: Completion of 24-36 month surgical residency. Please forward CV and letter of interest to: Erin.walker@bmc.org

ASSOCIATE POSITION - HUDSON VALLEY NY

Part time position in busy practice leading to f/t. Looking for well trained minimum PSR-12 with great technique and people skills for part time leading to f/t position in fast growing practice. Competitive salary with huge growth potential. Send cover letter, CV and work experience to: PodassociateNY@gmail.com

ASSOCIATE POSITION - DAYTON, OHIO

Join an established group practice in Dayton, Ohio excellent reputation, large referral base.  Base Salary$120,000, benefits and bonus structure. EMR;diagnostic ultrasound; Padnet; CO2 and Cutera Laser for nails, all aspects of DME. We need well trained personable PSR24/36 surgeon. Future Buy-in available. Please send CV to Ohiomedical@aol.com

ASSOCIATE POSITION - CONNECTICUT

Looking for an associate with 3-year residency training for a practice in Connecticut. Interested in all aspects of podiatry including  foot/ankle surgery and wound care. Hospital located close by with appointment to staff readily available. Will lead to partnership Please send CV to:dsharnoff@hotmail.com

ASSOCIATE POSITION - ROCHESTER, MN

Rochester Clinic, a multispecialty practice, is seeking a BC/BE podiatric physician. The physician will provide all aspects of podiatric practice, including sports medicine, wound care, primary care, and surgery. Rochester is the third largest city in the state, and boasts top-rated public schools. Please send resume or inquiry to Careers@RochesterClinic.com

ASSOCIATE POSITION – VIRGINIA

Established private practice, strong referral base.  Hospital and surgery center privileges. Two locations with modern offices. ABPS qualified or certified. Competitive compensation package. Potential for position to lead to partnership. To apply, please email a letter of intent and CV to Practice Administrator at: vaposition@yahoo.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Very busy, two location group practice seeking a full-time, self motivated and hard working podiatry associate. Competitive salary and benefits are offered. Please email CV to: footcare4all@aol.com

ASSOCIATE POSITION - FLORIDA

Associate wanted for an established 25 year old practice. PSR24 or 36 would be preferred. Excellent opportunity. Please send CV or letter to bafamt@aol.com

EQUIPMENT FOR SALE - DIOWAVE 15 WATT, PORTABLE 980 LASER

This is a used multiple function laser, plantar fasciitis, Achilles tendonitis, joint pain. nerve pain, post surgical, warts, toenail  problems, two-year plus warranty, MSRP: $25,000. E mail Dr. Zuckerman at:  footcare@comcast.net for questions and pricing.

PM News Classified Ads Reach over 14,500 DPMs 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 14,000 DPMs. Write to: bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 for a 50-word ad. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

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