The Voice of Podiatrists

Serving Over 14,601 Podiatrists Daily

August 13, 2013 #4,847 Publisher-Barry Block, DPM, JD

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PM News to Highlight Unmatched Graduates

If you are an unmatched graduate, PM News wants to help you obtain a residency position or other opportunities. Simply send us a short description of your qualifications (100-word limit) along with a color headshot (optional) to pmnews@podiatrym.com  We'll post it in PM News for residency directors and other interested parties to view.

CA Podiatrist Discusses Heel Pain and Achilles Tendonitis

According to Rebecca Baril, doctor of podiatric medicine at Fenton Foot Care, two of the more common problems for people are heel pain and tendonitis. “If you have pain around the heel, it can shoot up though the arch and radiate through it,” Baril said. “Causes of pain we see in the summer time are flip-flops and other footwear shoes that don’t support the arch, running, or a job that requires a lot of standing and not moving.”

Dr. Rebecca Baril

Achilles tendonitis, an inflammation of the tendon, is often noticed as pain at the back of the heel. “The pain can be caused by running, or a bone spur on the heel itself with the shoe rubbing on the area. It can be caused by a tight tendon if you are not doing enough stretching,” Baril said.

Source: Ryan Tackabury, Tri County Times [8/11/13]

FL Podiatrist Joins Foot and Ankle Clinic

Dr. Joe Li has joined Health Park Podiatric Foot and Ankle Clinic. “We are pleased that Dr. Li has joined our growing team,” said Health Park Podiatric owner Dr. James Militello. “Dr. Li has serviced level-1 trauma patients and performed a wide range of surgeries, providing him with vast amounts of surgical experience that will benefit our patients,” he added.

Dr. Jo Li

Dr. Li earned a bachelor's degree in biological sciences from the University of Guelph, in Ontario, Canada, and his doctorate in podiatric medicine from Barry University in Miami.

Source: Daytona Beach News Journal [8/10/13]

Bret Ribotsky: What suggestions do you have for starting or improving a podopediatrics practice?

Dr. Russell Volpe

Russell Volpe: Realize that when treating the pediatric patient, you can treat and resolve many conditions before they become permanent problems. Begin with getting to know your local pediatricians, as well as physical therapists, orthotists, and chiropractors who treat children. Remember referrals are the key.

Dr. Ben Wenstrup

Meet the Master wil be taking a two-week hiatus. When we return, the guest will be Dr. Brad Wenstrup, U.S. Congressional Representative. You can register for future events by clicking here

Query: Severe Heel Pain After Plantar Fasciotomy

My patient is a 46-y/o, non-smoking, healthy man. He was treated with orthotics in the past with limited success for mid-central plantar fascial pain of the left foot. He then underwent several injections  which failed to remedy the problem. He subsequently had a plantar fasciotomy performed February 2013 with resulting severe, persisting  plantar left heel pain whenever weight-bearing. He was subsequently treated with immobilization and non-weight-bearing for several weeks, and a steroid injection in May. He also tried chiropractic treatment and acupuncture, all to no avail. He has found temporary improvement with reflexology massage. He currently takes Vicodin and Lyrica with very little, temporary relief. There are no atrophic/CRPS changes in the left foot.

He came to me recently with severe pain on palpation at the plantar fascial origin and plantar medially at the heel. Radiographs were negative for bone changes. Recent MRIs demonstrated thickening of the plantar fascia at the heel, along with some slight edema within the plantar calcaneus, but no evidence of stress fracture, abscess, or bone infection.  I'm seeking any suggestions.

Mark Aldrich DPM, Antigo, WI

RE: The Passing of Bruce Block, DPM

It is with great sorrow that I report on the passing of one of our beloved attendings, Dr. Bruce Block, DPM. Dr. Block was an attending in Kew Gardens, NY since 1976 and has been an attending at Forest Hills hospital for many years. He graduated NYCPM in 1974. Dr. Block was the kind of podiatrist that many of us aspire to be. He was great to patients and was an amazing teacher to residents. It is truly a loss for Queens, NY as well as for the profession of podiatry. He will be missed.

Aleksandr Titiyevskiy, DPM, PGY-3 Forest Hills Hospital, NY

RE: Staged Procedures for Digital Deformities (Barrett E Sachs, DPM)
From: Ivar E. Roth DPM, MPH

While Dr. Sachs' claims that he would get better results by performing surgery one foot at a time, that is a wives' tale. It all comes down to training and doing a proper surgical repair in the first place. I have been doing bilateral forefoot surgery since the beginning of my career, thirty years, and have not had any problems whatsoever. Of course, I perform it only where and when it is appropriately indicated. I have observed and heard through my podiatry contacts that the most common reason to operate on feet at separate times is purely financial.

The results of staging surgery is not what is best for the patient, having them pay twice for services and go through anesthesia twice, etc. Let’s be honest - most podiatrists use this story about patient safety for one purpose only, and that is to make more money. Those doctors who really believe one foot should be done at a time either are not doing adequate surgical correction or believe a wives' tale that just is not true.
 
Ivar E. Roth DPM, MPH, Newport Beach, CA, ifabs@earthlink.net

RE: Obtaining Reports from Uncooperative Specialists (Elliot Udell, DPM)
From: Paul Kesselman, DPM

Elliot's remarks are unfortunately becoming more and more true. In speaking with a Medicare official, I was advised to try the following:

1) After you have exhausted the usual letter-writing and requests, get your patients involved and have them sign a records release;
2) If that does not work, have the patient (if possible) go the physician's office and demand a copy of their record;
3) If that fails, threaten the practice with notification that you will be notifying the state (or municipal) board of medical practice and the state's Attorney General's Healthcare Fraud Bureau.

I have usually had to resort to #1 and #2. I've only had to resort to #3 verbally, and that was with the staff who then referred me to the doctor himself. Then the records were magically produced (unfortunately in that case the record I needed was unintelligible and of little use). Bear in mind, for the most part, most physician practices are usually pretty compliant.

Paul Kesselman, DPM, Woodside, NY, drkesselmandpm1@hotmail.com

RE: Maximalist Running Shoes are In, Minimalist Running Shoes are Out
From: Kevin A. Kirby, DPM

Over the last five years, there was a rise in interest in barefoot and "minimalist" running, along with an increase in runners getting injured by trying to transition into barefoot and/or minimalist shoe running. Two years ago, here on PM News, I mentioned a new shoe that I had run in, the Hoka One One, which I had thought represented a new design breakthrough and a new shoe category, the "maximalist shoe".  Hoka One One running shoes have much thicker and more cushioned midsoles and have become increasingly popular, especially in the ultra-marathon and trail running community.
 
Recently, other running shoe manufacturers have taken notice of the popularity and success of the Hoka shoe and are now jumping on the "maximalist shoe bandwagon" with their own form of thick-soled, highly cushioned midsole running shoes. Most notable in this category is the newly released Brooks Transcend shoe, which has a much thicker, cushioned midsole, like the Hoka.
 
At the same time, minimalist shoes, such as the Vibram FiveFinger shoe, are on closeout specials throughout the country as runners are increasingly voting with their feet and wallets to move away from the much-hyped, questionable benefits of barefoot and minimalist shoe running. I suggest all podiatrists who do treat runners to go to their local specialty running shoe stores and inspect and test-wear both the Hoka and Brooks Transcend running shoes that will likely represent the latest trend in running shoe design: the maximalist running shoe.
 
Kevin A. Kirby, DPM, Sacramento, CA, kevinakirby@comcast.net

RE: Diagnostic Ultrasound (Michael Forman, DPM)
From: Bryan C. Markinson, DPM

I recently treated a patient who had 10 ultrasound-guided injections of steroid into a golf ball size ganglion on the dorsum of the foot. The patient came to me when he woke up one morning with a red, hot oozing mass of necrosis requiring surgical debridement. This is an example of clearly inappropriate use or worse of this modality.

We all know those common ganglions on the dorsum of the foot. If you need ultrasound to inject it, you shouldn't be treating the patient in the first place. Also, it may be prudent to establish the diagnosis before committing your patient to such an assault. A simple aspiration with cytology would document that you are actually treating a ganglion. Malignant fibrous histiocytoma, no stranger to the foot, looks just like a ganglion. But that is for another day. I have another question regarding the ultrasound-guided technique for plantar fasciitis. After the proponents do what they claim is a far superior injection than that without ultrasound, what happens to the fluid injected when the patient gets off the chair and bears weight on the heel for the rest of the day or night?

I would welcome a study where radiopaque dye was injected to show that whether you use ultrasound or not, in a few minutes of weight-bearing, what happens to that fluid? Does it stay where you put it? Or does it diffuse around to the points of least resistance, making the use of the guidance moot. I wonder.

Bryan C. Markinson, DPM, NY, NY, Bryan.Markinson@mountsinai.org

RE: Podiatric Residency Conclave (Bryan Markinson, DPM)
From: Bret Ribotsky, DPM

Here's an update on the proposed CONCLAVE to deal with the residency crisis. I sent invitations to all of organized podiatry on August 1st. I have received over 150 email responses, many from concerned DPMs offering suggestions, 3th and 4th year students, and many of the 80+ graduates without any programs. I have not received a single response from any of the stakeholders. Why has APMA, ACFAS, ABPS, ABPM, ASPS, COTH, AACPM, CPME, NPME, and all the rest remained silent? 

I see two major issues that need to be dealt with: 1) what changes can be done NOW for the 80+ without training opportunities and the 150+ next year 2) how do we fix this problem from EVER happening again. I again ask everyone to ask the leaders of our profession, what's being done, and why  have you remained silent about having an open discussion with everyone invited (organized, of course) to work on this issue? 

Kudos to Alan Sherman, DPM as he is taking the first steps to progress by taking a few hours from his PRESENT Residency Summit in August to have an discussion with over 50 residency director, and to Pennsylvania Podiatric Medical Association's Executive Director, Michael Davis, JD for offering to assist with the logistics of my proposed CONCLAVE. If you have an idea or suggestion, please send it to PodiatryConclave@gmail.com

Bret Ribotsky, DPM, Boca Raton, FL, ribotsky@gmail.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.

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 - 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

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

ASSOCIATE POSITION - SOUTHEAST MICHIGAN (MI LICENSE REQUIRED)

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 CV to: cfsdr@yahoo.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 – 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

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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