August 08, 2006 #2,649 Editor-Barry Block, DPM, JD

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PM News is being sent to you directly from the APMA Scientific Meeting in Las Vegas. Based on pre-registration, this promises to be the most attended APMA podiatric meeting ever. A high level of energy permeates this year's event as manefest by packed events such as the breakfast symposium, the hilarious performance by comedian Gabe Kaplan, and the first-ever evening session of the exhibit hall. More news will be printed in the next issue of PM News.

Plaque Excision Procedures Helps Diabetics Heal: FL Podiatrist

Sacred Heart Hospital is the first hospital in Florida and among the first in the nation to offer a new technology to treat patients suffering from clogged arteries in the lower legs and feet.
Using a device called the SilverHawk DS, physicians at Sacred Heart are able to remove blockages in tiny arteries as small as 1.5 millimeters that ordinarily would go untreated. Thanks to the device, physicians can now restore blood flow to the feet in order to restore mobility, heal wounds and help patients avoid amputation of lower limbs.

"We're using this procedure on a varied class of diabetic patients, particularly those with peripheral arterial disease," said Dr. Joseph Kiefer, a Pensacola podiatrist. "It has really helped in the healing process of our diabetic patients, and we've been able to avoid more invasive procedures because of it."

Kiefer added: "I have been referring my patients for this procedure increasingly on preventive basis, because it is so effective. It helps us intervene at an earlier stage because it is less invasive."

Source: Pensacola News Journal [8/6/06]

VA Podiatrist “Selfless Lifesaver” in Philippines

Dr. David Kanuck might not agree, but he is a rock star, a truly selfless lifesaver to dozens of patients he may never see again. Kanuck recently traveled to Cabanatuan, a city of nearly 230,000 people located in the province of Nueva Ecija in the Philippines, to help perform podiatry-related surgery to the poverty-stricken.

Dr. David Kanuck

“Despite the less than ideal surgical environment, (he) exhibited selfless sacrifice and endurance by treating as many patients as possible,” Dr. Philip Cruz said. I had to literally force him to take a break and eat at times. I guess he found fulfillment in treating these patients whose sole reason for not having their condition treated earlier was their poor financial status.”

“This type of work grounds you,” Kanuck said. “In today’s ever-changing medical climate where physicians are overwhelmed with paperwork, the business of medicine, concerns about litigious activity and insurance reimbursement, there is a place to go where the purity of practicing one craft has not been corrupted, violated or its value diminished. The level of thankfulness is unparallel among the people who are treated, and that makes me feel good about what I am doing and the many sacrifices I made to get to this point in my life.”

Source: Pamela Kulick Cunningham, Culpeper News [8/6/06]

Editor’s note: PM will be running a comprehensive story by Dr. Kanuck in an upcoming edition.

Pagliano Part of 10K Race For 25 Years

Rolling Hills Estates (CA) came alive once again Saturday at 8:30 a.m. for the 25th annual Hills Are Alive 10K as runners of all ages pushed their legs to the limit, or at least to a comfortable pace.

"I kind of look forward to this every year because I get to see all the people I run with," said Rolling Hills Estates resident John Pagliano. "It's the same group of people -- I'd say that 80 percent are return runners. It's really a lot of fun. It's kind of like a social gathering too."

Pagliano would know. He was there from the start. Pagliano, a podiatrist, has been involved in the race one way or another for 25 years and will look to participate again this year in the 65-and-up age group.

"I think it's more competitive now, especially with the kids," he said. "The kids are competitive with each other. They don't want to come in 10th; they want to come in first or second. We'll see some good rivalries develop."

Source: Henry Truc, Daily Breeze [8/4/06]

Query: D.F. Night Splint For 4 Y/O

I have a 4 year old child who is a habitual toe-walker. She has developed moderate achilles tendon tightness. Does anybody have a resource for a D.F. night splint to fit a child's foot. She measures a children's size 12.

David Gutierrez, DPM, DOCG2100@aol.com

RE: Rising Gas Prices and Employment (Bob Levoy)
From: Richard A. Simmons, DPM

When employees want a raise many will say most anything. Today's mantra is high gasoline prices. If your employees are productive and contributing to the growth of your practice then they should be compensated. If not then they need to be counseled or terminated. For all of us the price of gasoline is but a part of the more complex equation of our family's income and our family's expenses and the choices that we make. For instance, we can choose to pack our lunch or dine out. We can make our purchases at Walmart or Macy's. We can drive alone in our car or we can carpool or even use mass transportation.

Because an employee needs more money is not the reason to give him/her more money. Your office should have a policy that states what is expected of the employee and what the employee can do to earn more money. When goals are met, the employee should be financially rewarded.

Richard A. Simmons, DPM, Viera, FL, RASDPM32822@aol.com

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RE: Malignant Melanoma (R. Denis Russell, DPM)
From: Cosimo A. Ricciardi, DPM

1.78 mm is serious business. Beyond 1.5 mm the regional lymph nodes are involved, and you no longer have a local process. What do the cbc, chest x-ray, CT scans, LFT's say? If you must manage this case I can't see how you would be faulted for doing a 5th ray resection and sentinel node biopsy. But then what?

In your case, with a melanoma 1.50 to 2.49 millimeters in depth, survival rate is 60 percent. With that in mind, I personally would be uncomfortable following this patient for liver, lung and brain mets. You've played a vital role in saving this patient's limb. Refer while you're still the patient's hero.

Cosimo A. Ricciardi, DPM, Ft. Walton Beach, FL, Ecpodiatry@aol.com

I would like to thank everyone for their comments. The patient is seeing an oncologist as well as a general surgeon for the sentinel node biopsy. I thoughtyou all might like to see what the melanoma looks like.

Malignant Melanoma

R. Denis Russell, DPM, Fountain Valley, CA, rdenisr@sbcglobal.net

RE: Custom-Casted Tennis Shoe for Diabetics (Steven S Melek, DPM)
From: Robert S. Schwartz, C. Ped Eneslow makes custom made tennis

shoes. We can also take a ready-made athletic shoe and remake it to fit the patient's feet. Select a style. Make sure it is long enough, at least 1/2" longer than the longest toe. Take an outline of the feet. Provide circumference measurements around the heel to the instep, around the arch and instep, and around the first and fifth metatarsal heads. To order a custom pair, do the above plus take a cast of the feet and extend it four inches above the ankle, semi-weight-bearing. We suggest a bivalve cast or STS sock rather than a wrap cast.

Robert S. Schwartz, C. Ped., New York, N Y, rss@eneslow.com

PRACTICE FOR SALE - BERKELEY CALIFORNIA

Well-established office in professional medical building; Biomechanics, Geriatrics and General Podiatry; Excellent growth potential for surgery; Payor base MC, PPO, and self-pay (NO HMOs); Reliable referrals from local physicians; Electronic billing in-house; Transition terms negotiable. Send letter of intent to: foot4sale@sbcglobal.net

ASSOCIATE POSITION - GULFCOAST OF FLORIDA

Great opportunity in rapidly growing practice for a PSR- 24/36 BE/BC podiatrist with strong surgical skills. Hospital privileges available at 548-bed hospital system, new hospital is being built and multiple surgical centers. Candidate should perform rearfoot & ankle surgery, including Charcot reconstruction. Candidate needs to be ethical and motivated and must have a current Florida license. Established practitioner or new practitioner OK. Salary + percentage + benefits including insurance and 401K. Fax CV to (239) 566-8778.

POSITION AVAILABLE-RETIRED OR DISABLED PODIATRIST-DELRAY BEACH FLORIDA

Full or part time position in start up pharmaceutical company. Duties would range from answering phones to publishing scientific papers. Please contact: rhm123@gmail.com

Southeast Florida Podiatrist Needs Top Notch Candidate

South Florida podiatrist looking for an astute, personable, extremely well trained podiatrist with excellent clinical skills and acumen. My practice is busy, rapidly growing, and referral based. Looking for a full time associate to start immediately. Partnership opportunity available. I require someone who can work independently and wants to help elevate this practice to a new level. Email your resume to podiatry49@hotmail.com

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

HOUSE CALL PRACTICE OPPORTUNITY- CHICAGO / NORTHWEST INDIANA

Chicago-Home Physicians specializes in house calls to the elderly homebound. Full and part-time positions available in Chicago/Northwest IN. Competitive Compensation, including malpractice. Contact Scott Schneider. Phone-773-292-4800. Fax-773-486-3548. E-mail sschneider@homephysicians.com www.homephysicians.com

ASSOCIATE POSITION - NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

ASSOCIATE POSITION- SOUTH CAROLINA

Associate position available in South Carolina south of Charlotte. Two office practice, with two podiatrists, in a growing area. Well-rounded practice with all aspects of podiatry. Opportunity for future partnership. Please send CV to cathykop@hotmail.com or fax it to 803-396-8657.

HOUSE CALL PRACTICE FOR SALE – SOUTHERN CALIFORNIA

House Call practice for sale which includes approx. 400 patients and continued referrals. Perfect for solo practitioner. Extremely easy and profitable practice to run. Yearly gross of over $200K. Current DPM is retiring. Financials will also be provided. Please contact ccipinc@ccipinc.net

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