The Voice of Podiatrists

Serving Over 14,601 Podiatrists Daily

August 12, 2013 #4,846 Publisher-Barry Block, DPM, JD

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We encourage you to participate in this year's important annual survey podiatrym.com/survey Completing this anonymous survey provides us with valuable data, which we will publish in the February 2014 issue of Podiatry Management. It also makes you eligible to win thousands of dollars of valuable prizes. Enter by completing this confidential survey. The earlier you enter, the more chances you have to win.

Lower Extremity Biomechanics

This week's prize is a copy of  Lower Extremity Biomechanics by Drs. Stephen F. Albert and Sarah A. Curran  (Value - $110)..

This is also your opportunity to vote for the next DPM and Non-DPM inductees into the PM Podiatry Hall of Fame.

AZ Podiatrist Named as 2013 Raine Visiting Professor

David G. Armstrong, DPM, MD, PhD, Professor of Surgery and Director of the University's Southern Arizona Limb Salvage Alliance (SALSA) was named as a 2013 Raine Visiting Professor to the University of Western Australia (UWA). The award, which selects top international scholars in their respective fields to devote time in collaborative seminars, keynotes, research and workshops, has never before been given to a podiatric surgeon. 

Dr. David Armstrong

Armstrong begins his series of more than a dozen clinics, student seminars, lectures, dinners and appearances at the end of August in Perth.

TX Podiatrist Comments on Annuities

When I asked Dr. David M. Schwartz, a podiatrist who also works in retirement and tax advisory services, to comment on annuities, he was kind enough to send me an email with some worthy comments:  “Since annuity contracts and subsequent disbursements are expressly exempt from litigation (in Texas), there may be a useful role in the protection of your client's assets. There may also be a beneficial role in estate preservation, for an annuitant or beneficiary who may require guaranteed structured payments.”

Dr. David Schwartz

Schwartz does specify the disclaimer that he is not an attorney nor does he provide legal advice.
 
Source: Shirley Mueller, MD, Physician's Money Digest [8/8/13]

Query: Complete HealthCare Solutions EMR

Is anyone familiar with Complete HealthCare Solutions EMR? If so, what are the pros and cons?

Janay Harper, DPM, Canton, MS

RE: Staged Procedures for Digital Deformities
From: Barry Mullen, DPM, Charles Morelli, DPM 

I agree with a 1st MTP fusion. I would likely choose a Clayton-Hoffman procedure over multiple metatarsal osteotomies which, if selected, would likely need plantar plate repairs for 2 and 3. Lastly, digital fusions seem appropriate for PIPJ 2,3 and DIPJ 4. If the blood flow is adequate, then I don't see the need for staging, unless multiple osteotomies are selected.

Barry Mullen, DPM, Hackettstown, NJ, yazy630@aol.com

I agree with your approach, but would make the following comments regarding the toes only. Consider not using implantable devices here and opt for simple K-wires. In addition to the Weil osteotomies to assist in correcting the adducted digits, consider adding a mini Akin osteotomy to the base of each proximal phalanx in addition to the IPJ arthrodesis. The K-wire will then stabilize the IPJ as well as keep the Akin closed, and you can also drive the wire into the metatarsals (slipping by the Weil screw), and keep the toes rectus. Leave the wires in for at least 5-6 weeks. If you remove them sooner, the toes will drift back in to adduction.

Charles Morelli, DPM, Mamaroneck, NY, podiodoc@gmail.com

RE: Staged Procedures for Digital Deformities (Tip Sullivan, DPM)
From: Barrett E Sachs, DPM

I have to disagree with Dr. Sullivan's comments that the only reason not to do staged bilateral procedures is financial. I have been doing bunion surgery (all types) for over 30 years and do NOT like to do bilateral cases, as most of the time you will not get optimum results on one foot. When you do bilateral cases, the patient does not have that one foot to off-load onto, and thus one foot suffers. In the perfect world, if that patient were totally non-weight-bearing, then maybe better results would occur. I respect Dr. Sullivan's opinion, but to say it's a totally financial decision seems to be off base to me.

Barrett E Sachs, DPM, Plantation, FL, uncletenose@aol.com

RE: Obtaining Reports from Uncooperative Specialists
From: Elliot Udell, DPM

In this new medical environment where physician's offices are being bought up by corporations and hospitals, doctors are becoming salaried employees. One of the problems we are facing is that many  specialists who were eager to send me written reports so that I would continue to send them new patients, no longer care if I do or don't. One infectious disease group in my area that used to chase after every referral now pre-screens potential patients, and someone on staff decides whether they will even see a new patient.

Needless to say, if an infectious disease doctor or vascular specialist does not communicate with me about a mutual patient, I am placed in medical-legal risk. Even worse, the patients often call me to ask if I received a report, and I have to keep saying "no." In one case, I called an office supervisor and "read him the riot act" and the doctor called back letting me know that she has difficulty with the new EMR system and can't send written notes. In other cases, even after calling, I have gotten no response.

The seemingly simple solution is to find different specialists; however, every day more and more specialty and general medical practices are being gobbled up by corporations. The doctors are not paid well, are overworked and not inclined to be responsive. Has anyone else encountered this problem?

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Vasculara Use (John Scholl, DPM)
From: Salvatore J. Galluzzo, DPM, RPh

I've tried Vasculara on three patients with some success, but the results are difficult to assess. The improvement is seen by decreased appearance of spider-type veins, decrease in venous acidosis, which in turn decreases inflammation to venous tissue, thus decreasing edema, ulceration and  possible DVTs.

You might try it if your patients don't mind paying for it. It's a medical food product, not a drug; therefore, it's not covered by most insurance carriers. You could also try Hesperiden complex, magnesium hydroxide, and calcium carbonate (all available in your local pharmacy for 1/10th the price). 

Salvatore J. Galluzzo, DPM, RPh, Clifton Park, NY, sal.j@aol.com

RE: Diagnostic Ultrasound (Michael Forman, DPM)
From: Stanley Beekman, DPM

Early in my career, I found my injections were not very effective. Later in my career, I  injected using a peppering technique, thinking that the small holes that I made would help with revascularization and healing. This technique worked better. Last year, after 35 years of thinking that I knew exactly where the plantar fascia was, I started to perform ultrasound-guided injections. There were two things that I noticed. First is that I was not close to the inflamed part of the plantar fascia (as I had to redirect my injections from a location that was distal and superior), and secondly they helped the patients much more than any technique that I used prior.

The thickness of the inflamed plantar fascia is around 6mm, and knowing from experience exactly where I need to inject does not guarantee an accurate injection. In fact, I find that I have to redirect in the majority of injections. 

With the majority of patients requiring surgery showing mucoid degeneration of the plantar fascia (from chronic inflammation) on MRIs, it would seem that the prudent treatment is to stop the chronic inflammation as soon as possible in an attempt to avoid surgery. Hoping to give the proper injection and risking my patient’s foot is not something I choose to do.

Stanley Beekman, DPM  Cleveland, OH, sbkmn1@gmail.com

RE: Vasyli Medical Affiliates Program  (Eric Simmons, DPM)
From: Brandon Noble

Regarding the concern of the legality of the Orthaheel referral program and the referral bonus paid – we at Orthaheel have performed our due diligence researching law and discussing the program with governing bodies of healthcare professionals before launching the program to ensure we are providing a legal and ethical program to our valued customers. 

The goal of the Orthaheel referral program is to reward physicians for referring patients to Orthaheel with the goal of creating a great experience for both the patient and physician. If any of you have concerns or question regarding the program, we would be happy to answer them. Please feel free to contact us at bnoble@vionicgroup.com for more information.

Brandon Noble, CO, LO, Director of Medical SalesVionic Group, bnoble@vionicgroup.com

RE: Newspaper Columnist Has High Praise for GA Podiatrist
From: Jon Purdy, DPM

Kudos to Dr. Byrne! A little known fact is that all injections can be done painlessly with proper technique. Maybe it is not taught or maybe some don’t care to take the time. I have worked with other podiatrists where it was a frequent occurrence to hear people yelling in pain due to an injection. No one in my office has ever heard a patient in pain from an injection.

Jon Purdy, DPM, New Iberia, LA, podiatrist@mindspring.com

NEW PRECEPTORSHIP POSITION NOW OPEN

Philadelphia based multi-doctor practice offering preceptorship. Unique practice blending ‘traditional’ podiatric services with acupuncture, sports medicine and podiatric pain management. Individual must be motivated, personable and have strong computer skills. Please respond by email with resume and  CASPR application. Selection process will be completed quickly, so please respond timely if you are interested. ediamond7@comcast.net

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.

EQUIPMENT FOR SALE - NEXUS LASER

Nexus 10W laser for sale, 1 year old still under warranty with option to extend. Portable with battery, excellent condition. Has soft tissue ablation head and bio-stimulation head. Built-in protocols. Best offer e-mail tmacklin.podiatrygroupofga@live.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 - MAINE

30 year, full service practice in Bangor, Maine. Cooperative and appreciative patients. A wonderful community to practice in and recreate during your free time. Owner is semi-retired, now ready to fully retire but will stay for transition. mainefootdoc@yahoo.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

PRACTICE FOR SALE - STAMFORD, CONNECTICUT

Well rounded general and surgical podiatry practice in beautiful Stamford, CT. 35 years. Walk to the hospital and OR. $350k gross / 4 days per week. May lease present office space. Super office manager. Practice offered @ $100k. jefre1@msn.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

ASSOCIATE POSITION - NYC METRO AREA  

Must participate with HealthFirst, Affinity, Fidelis health plans (2 of 3 OK). Preferably on staff at Bronx or Manhattan hospitals or surgicenters. Excellent opportunity for quick partnership. email CV to rrranch7@yahoo.com

ASSOCIATE POSITION – NORTHERN CALIFORNIA/SF BAY AREA

We’re seeking a podiatrist to join multi-office practice. Must have great people skills, great bedside manner, and positive demeanor. California license required. No nursing home visits. Prefer private practice experience. Send CV and cover letter to: ebpod2008@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 TEXAS- NORTH DALLAS AREA.

Great opportunity for the right individual. Seeking well trained (PSR 24+), ethical, hard working, motivated individual. Full scope of podiatry including office, hospital and surgery center work.  Partnership opportunity available for the right individual. Well rounded practice with competitive salary/benefits package. Seeking an individual with superior surgical and personal skills to join our two location, two doctor practice. Please send letter of intent and CV to DPMopening@gmail.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 - BRITISH COLUMBIA, CANADA

Beautiful Victoria, British Columbia, Canada on the Ocean, fast growing area, Associate for Multi-office full scope practice Reply to dr.cole@shaw.ca

ASSOCIATE POSITION – VIRGINIA

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

ASSOCIATE POSITION - CALIFORNIA

Associate wanted for multi-office, multi-doctor practice. Full Time, Self-motivated, highly skilled team player with surgical, wound care and palliative skills. Offices in Northern California Coast, CA License necessary, salary negotiable with possibility of partnership in future. Send CV and letter to: srfctysc@gmail.com

ASSOCIATE POSITION - CENTRAL FLORIDA

Associate position for busy practice in Central Florida. Competitive salary with complete benefit package available. Please send resume to cmedders@atlanticpodiatry.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

ASSOCIATE POSITION - CENTRAL PA

Looking for an associate with 3-year surgical residency. The physician will provide all aspects of podiatric practice, including sports medicine, wound care, and foot and ankle surgery. Competitive compensation package. Partnership opportunity for right person. To apply, please email, letter of intent and CV to stringernyc@hotmail.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

OFFICE AVAILABLE - TACOMA, WA

Podiatry clinic available for podiatrist one or two days a week. Current doctor does no bone surgery. Perfect for someone wishing to supplement a current office or a new practitioner looking to get his foot in the door in the Puget Sound area. Email CV and cover letter to 4MYFEET@sbcglobal.net.

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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