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August 10, 2012 #4,536 Publisher-Barry Block, DPM, JD

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We've just mailed the August 2012 issue of Podiatry Management. This 220-page issue includes  a special section on "Building Your Practice", as well as an assortment of features, including our informative columns, and a CPME-approved CME.

August 2012 Podiatry Management

Injuries From Barefoot Running Have Leveled Off: TX Podiatrist

Experts say people can successfully lose the laces. The key is to break in slowly. Start by walking around barefoot. Run no more than a quarter mile to a mile every other day in the first week. Gradually increase the distance. Stop if bones or joints hurt. It can take months to make the change. "Don't go helter skelter at the beginning," said Dr. Jeffrey Ross, an associate clinical professor of medicine at Baylor College of Medicine and chief of the Diabetic Foot Clinic at Ben Taub General Hospital in Houston.

Dr. Jeffrey Ross

A year and a half ago, Ross saw a steady stream -- between three and six barefoot runners a week -- with various aches and pain. It has since leveled off to about one a month. Ross doesn't know why. It's possible that fewer people are trying it or those baring their feet are doing a better job adapting to the new running style.

Source:  Alicia Chang, Associated Press [8/4/12]

NYCPM Students Complete Mission Trip to India

In April, Dr. Anthony Iorio and 12 students from the class of 2014 went on a mission trip to Kolkata (Calcutta), India. Upon arrival, the students and Dr. Iorio were greeted by the Cardinal and Archbishop of Kolkata, who led the way of their expedition through the Health Organization of India. The students wanted to convey the message that ”Diabetes Kills!” The team presented a Diabetic Limb Salvage Program similar to the U.S. successful models.

Participants in NYCPM’s first medical mission trip to India.

The team lectured to medical audiences of over 100 doctors who wanted to increase their knowledge of treatment options with respect to caring for the increasing population of diabetics in India. The team visited two hospitals, the first in Kolkata and the second 3 hours away in Mindepor. Incredibly, they were able to evaluate 200 patients per day.

Source: Cailin Rubino, NYCPM Student Alumni Report [Summer 2012]

Renowned Biomedical Engineer Teams With AZ Podiatrist to Study Motion 

Biomedical engineer Bijan Najafi, PhD, a renowned expert on human motion, recently recruited to the University of Arizona Department of Surgery, has brought together UA researchers, clinicians, and biomedical engineers to form the Interdisciplinary Consortium on Advanced Motion Performance (iCAMP).

(L-R) Drs. Bijan Najafi and David Armstrong.

Dr. Najafi and Dr. David Armstrong recently received research grants to study specialized socks that use high-tech fiber optics to monitor temperature, pressure, and joint angles in feet of people with diabetes. People with diabetes often lose the sensation of pain and are unaware of developing foot ulcers that can lead to amputation and death. The socks include technology to measure daily activity to help identify the area of the foot most likely to develop an ulcer.

CA Podiatrist Still Holds Free Throw Record

The man who holds the record for “most consecutive free throws made” played basketball for both Concordia and the University of North Dakota. Unlike most great free throw shooters, Dr. Tom Amberry was tall and lanky – at 6 feet 7 inches tall, he played center in college – and relied primarily on a left hook-shot.

Dr. Thomas Amberry

Amberry did not establish his record while in college or during the years he played semi-pro ball, but much later. He entered a gym on Nov. 15, 1993, and began shooting free throws while 20 other individuals kept track of how many balls went through the hoop. After he had made 2,750 in a row, he was informed that he needed to leave because the gym was closing for the night. Amberry established the new free throw record at the age of 71.

Source: Curtis Eriksmoen, Inforum [4/4/12]

Tackle Tasks

Finally complete that task you avoid or forget. Link what you should do to something that you already are doing regularly. Adopt a new work habit with one of these practices:

•  Start with it. Before you do anything else in the morning, do that task you always put off. Example: Don’t open your email until you organize one electronic folder and delete unneeded files.
•  Build on momentum. When you are making progress on your to-do list, slip in an item that has fallen to the bottom of the list. Take advantage of a natural flow of activity too. Example: Transfer new assignments to your to-do list immediately after a meeting.
•  Add a physical reminder. Put what you need to do with something you won’t forget. Example: Place the package you must send with your car keys.

Source: Adapted from “How to Get Tough Tasks Done by Chaining Them Together,” Craig Jarrow, Time Management Ninja via Communication Briefings

Query: EMR Stimulus Money

I have finished my 3-month reporting period for EMR and wish to report this to Medicare. I'm not sure the best way to do this and am seeking the help of my colleagues who have already met, reported, and received incentive money from Medicare.

Frank Lattarulo, DPM, NY, NY

RE: Painful Bunion and Hammertoe (Mario Dickens, DPM)
From: Ron Raducanu, DPM, Tip Sullivan, DPM

Consider a decompression type osteotomy (Youngswick?) which could address both the bunion deformity as well as help with the ROM issues in her 1st MPJ. Performing a 1st implant arthroplasty will likely not address her bunion deformity and has a higher chance of failure due to the malposition of the joint itself.

Ron Raducanu, DPM, Philadelphia, PA, kidsfeet@gmail.com

Many things cannot be conveyed in a forum setting, like what are the patient's goals? What is her general medical status? What are her activities of daily living? What does her gait look like? The x-rays provided do not include a weight-bearing lateral.

Well, I finally figured out that as theoretically palatable orthoses and scientifically valid studies may be, the actuality is quite different when it comes to individual patients. I can guarantee you that if I put an implant in this foot, the patient would have a fairly rapid recurrence with...

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

RE: Painful Bunion and Hammertoe (Mario Dickens, DPM)
From: Dennis Shavelson, DPM

Biomechanically, please note that the 2nd ray is widened and cortically thickened, revealing that it is supporting much too much weight. In addition, the ray is long. The weight-bearing AP suggests a rigid rearfoot, flexible forefoot functional foot type. In the OR, attention should be paid to stepping down the length of the 2nd met. In addition, plantarflexing the first ray to increase the plantarflectory moment would be of great benefit. Finally, there seems to be a high met adductus angle, which may be addressed intra-op or pre- or post-op, prn.
 
The lateral x-ray seems to be non-weight-bearing and therefore has no closed chain significance. I suggest a weight-bearing lateral and a contact open chain lateral to drive more information about the sagittal plane biomechanics of this case before proceeding.
 
Dennis Shavelson, DPM, NY, NY, drsha@lifestylepodiatry.com

RE: Pruritic Lesions, Arms and Legs (Jim Fisher, DPM)
From: Joel Morse, DPM

I would not use a super high potency steroid on the legs of an 84 year old. I would start with a mid-strength one and monitor it. When in doubt, think eczema. Eczema can also turn into cellulitis easily in an older patient, so if it is worsening, put the patient on Keflex (as long as she has no allergy).

Joel Morse, DPM, Washington, DC, Foxhallfoot@aol.com

RE: Walking: Saving Lives: Protecting People, Saving Money Through Prevention (Leonard A. Levy, DPM, MPH)
From: Robert Creighton, DPM

Dr. Levy points out an important public health role for foot and ankle specialists. His advice to “encourage walking by preventing or treating conditions causing disorders of the pedal extremities” goes back to the roots of our profession, and as podiatric physicians, we also need to take our eyes off the feet, and encourage walking, as well as other forms of exercise-movement, specifically for their potential benefits on metabolic health, including blood pressure, lipids, insulin sensitivity, weight control, etc.

The potential lower extremity vascular benefits with improved endothelial function and the musculoskeletal benefits of exercise for our aging population in an effort to prevent falls and maintain independence into senior years are other areas where we have a key role to play. ACSM’s Exercise is Medicine would be a good model for our profession to follow.

Robert Creighton, DPM, St. Petersburg, FL, rcreightonjr@hotmail.com

RE: APMA "National" and Post-Convention Greenbrier Seminar
From: Arthur Gudeon, DPM

My roommate for the "National" had to drop out, so if anyone is interested in sharing a room to split expenses, I'm registered for a double room from Wednesday night, August 15th through Sunday August 19th. Also, I'm registered for the post-convention Coding Seminar at the Greenbrier, and due to a home health situation will not be able to attend. The registration fee was $395, and I'd transfer it for 1/2 the price or best offer, whichever comes in first.

Arthur Gudeon, DPM, Rego Park, NY, afootdoc@hotmail.com

RE: The Passing of Dr. Robert Warriner, III
 
I had the good fortune of meeting and listening to Dr. Warriner last year in Houston as part of the Diversified (DCS) intensive wound care program. He was one of the finest and most dynamic speakers I have ever encountered. He leaves behind an unparalleled legacy through his research and lecturing for all of us involved in advanced wound care. As I told him on our last day in Houston, "It was an honor to be a student in your classroom." He will be sadly missed.
 
Greg Caringi, DPM, Lansdale, PA

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  516 476-1815   PODO2345@AOL.COM

ASSOCIATE POSITION – NEW YORK

Great opportunity to share “state-of-the-art” offices and equipment in mid-town Manhattan and White Plains with Board Certified podiatrist. Out-of-network or participating providers welcome. Please call 212-704-4310 for additional information and fax your CV to 212-704-4311.

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 - NORTHERN, NJ

Part-time or-full time. This position can and will lead to purchase of practice if so desired. Well-equipped modern office. Digital x-ray, ultrasound, etc. Individual must be well-trained and be ABPS Qualified/Certified. Must be competent in general foot care and be able to do routine foot surgery without help. Call: 201-986-1900.

ASSOCIATE POSITION - WASHINGTON, DC

Prominent two office (3 practitioner) podiatric medical group seeking well rounded, personable individual with good medical and surgical skills. Must be 24/36 month trained, board qualified or certified foot and ankle surgeon. Salary with benefits package. Serious inquiries to ponyrunner66@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.com

ASSOCIATE POSITION - MANHATTAN

Part-time associate position making home visits in Manhattan. Email: drmstempler@verizon.net

ASSOCIATE POSITION - NEW JERSEY

Can you handle a challenge? Associate wanted for amazingly busy practice. Must be enthusiastic, outgoing, and surgically trained, but conservatively minded. We have a wonderful environment, great team plus great pay in Oradell, Bergen County, NJ. Full-time, some evenings and Saturdays. Call 201-261-9445 or fax resume to 201- 261-0058.

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 - 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 – 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 - 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 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 - 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 - 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

EQUIPMENT FOR SALE - PADNET

Rarely used- excellent condition. Padnet for sale. Asking $10,000. Contact us at 516-220-8258.

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

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

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