August 14, 2006 #2,653 Editor-Barry Block, DPM, JD

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NJ & OK Podiatrists Provide Hot Weather Foot Care Advice

Like other areas of the country, average high temperatures in New Jersey for July and August are 80-90 degrees, but last week's heat wave set new records in Newark and Atlantic City. Lawrenceville, New Jersey podiatrist Dr. Bruce Bitcover says that means people need to exercise caution when it comes to foot care.

Dr. Derek Smith of Stillwater, Oklahoma, agrees. While Oklahoma residents are accustomed to triple-digit temperatures in summer, Dr. Smith says, "Heat can make certain foot problems worse. Unlike armpits, feet are usually wrapped up in containers (shoes), so perspiration is a bigger problem. Skin reabsorbs moisture, making skin soggy and unhealthy. In that environment, there's little protection from microbes and the tendency to develop blisters is much greater. Also, heat increases friction, causing problems such as eczema, psoriasis and callus to become much worse."

Along with other podiatrists, Drs. Bitcover and Smith recommend taking certain steps to prevent heat-related foot problems. They recommend:

• Wearing sandals or "open" style shoes that allow feet to breathe
• Using a foot powder, such as Zeasorb, to help keep feet dry
• If wearing socks, using socks that wick away moisture
• Washing feet at least once a day, being sure to dry well between toes
• Rotating socks and shoes more often - up to several times a day
• While staying hydrated, being careful not to overdo fluids which can cause extremities to swell.

Source: PRWeb, [8/10/06]

La Rose Re-Appointed to CA Podiatry Board

James La Rose, 61, of Claremont, has been re-appointed to the Board of Podiatric Medicine. He has served on the Board since 2002 and has been a sole-practitioning podiatric physician in Upland, CA since 1975.

Dr. James La Rose

In addition, La Rose serves as a consultant to the California Board of Podiatry, chair of the Interdisciplinary Committee at Chino Community Hospital, quality medical evaluator for the State of California and Council on Podiatric Medical Education for the American Podiatric Medical Association.

Source: Los Angeles Jewish Observer (CA) [8/12/06]

WI Podiatrist Relishes His Role at City Historian

Thursday night, Gordon Yadon, Delavan's 83-year-old city historian, took about 20 locals on a barhopping tour through the Delavan of yesteryear. His audience listened intently and added their own reminisces as he and two others led the program for the Delavan Historical Society's monthly meeting, "Taverns on Delavan Lake."

Yadon has worked as a Navy medical corpsman, podiatrist, postmaster, and city arborist. But Yadon's favorite job doesn't pay. For the last 20 years, he has served as city historian, "kind of an honorary thing," he said, following an appointment by then-Mayor Peter Dantone.

Today, Yadon focuses on his passion for history. He writes a weekly historical column for the Delavan Enterprise; offers cemetery tours focusing on war veterans, circus folk or local artists; and speaks regularly at Delavan Historical Society meetings. The city even named an east side park after him.

But Yadon remains humble. He wasn't too keen on the park naming because, he said, "anyone you name a park after, people wonder, 'what makes him so deserving?'" And Yadon can't think of a better place to practice his passion than Delavan. "There was never anything outside Delavan that interested me," he said. "I always felt fortunate to live in a place that has so much to offer."

Source: Stacy Vogel, Janesville Gazette, WI [8/12/06]

Query: Buying a Practice Without a Lease

The practice I am considering buying has lost its lease and is being forced to move. The owner essentially wants to move and immediately sell the practice. There will be no practice history at the new location, although it will be (hopefully) within a mile of the present locale. How do I work that into the evaluation?

Name Withheld

Editor’s Comments: The location and lease are key components of any practice. It is difficult enough for patients to adjust to a new doctor. Add in a change in the location of the office and the chances of maintaining the patient base are further diminished. Buying a practice under these circumstances is problematic at best. The only positive would be that the new office would likely be more modern than the existing office.

We suggest that you employ the services of an experienced practice appraiser to access the value. Because of these unusual circumstances, your offer should be at a significant discount to the “book” value of the practice based on income tax records.

RE: Hypopigmentation Following Intralesional Steroid Injections (Greg Cohen, DPM)
From: Russell O. Lewis, DPM

Hypopigmentation has been long considered on the side effects of intralesional injection of corticosteroids. It may at times be accompanied with skin atrophy which may be permanent. The hypopigmentation is reversible over a period of time which could take up to two years. Is probable due to lymphogenous spread of the steroid suspension. There is no definitive treatment that I know of except for time itself. It is always prudent to warn patients of this possible side effect. A similar problem may take place following intra-articular cortico-steroid injections. In addition, crystals may develop within articular areas and may not be detected until x-rays are taken for another problem.

Russell O. Lewis, DPM, Warsaw, VA, Russue8@aol.com

RE: Congress May Reduce Physician Reimbursement (Mark Levine, DPM)
From: David M. Schwartz, DPM, RPh

As a younger practitioner in solo practice, this is one of the reasons why I have begun my studies in pursuit of a law degree. I have learned, with a legislator's pen, we could lose our livelihoods. Ironically, I returned to school for increased professional stability and security. During my podiatry school matriculation, I distinctly remember certain professors and deans assuaging my classmates concerns regarding this very subject, stating "there will always be a need for foot care" and patients will come to you without regard to insurance status – this was not (and is still not) true.

If podiatry practice becomes too prohibitive, I will certainly practice within another professional venue. I will be eligible to take the bar in approximately three years.

David M. Schwartz, DPM, RPh, Rockwall TX, txfootdr@yahoo.com

Editor’s comments: There is an apt expression “The grass is always greener on the other side of the pasture.” We believe that Dr. Schwartz may find that the life of a lawyer is no more secure than that of a podiatrist. In fact, the average income of a podiatrist is higher than that of an attorney. Many law students never even pass the bar exams or go into practice. Others are offered teacher-type salaries in the public sector.

We believe that if you love podiatry and gather the proper practice management skills, you can achieve an above-average income, and enjoy a enjoyable career. If you are not happy in this profession, find a profession that you enjoy. After all, we all have but one life to live.

RE: HMOitis (Jeff Oster, DPM)
From: Dennis Shavelson, DPM

Dr. Oster reinforces the unfortunate role the healthcare provider plays in HMOitis. My place in patient advocacy is not in providing the best possible care for my patients after factoring in costs, insurance profits, and government regulations. It is in providing the best care for my patients, period. Dr. Harkless teaches that you should design a plan for excellent patient care and then stick to it. If the patient refuses or cannot afford your care, reduce your fees for that care or let the patient go elsewhere. If not, you will be dealing with the iatrogenic complication created by your second-rate care.

Dr. Marvin Steinberg taught me to deliver care as if it was to my mother, sister or child. I would never use a pin or a cheaper implant on them. There must be some practical or procedural upgrade that the $1,200 implant provides or Dr. Oster would have been using the $349 implant all along.

The fact is that the medical, hospital and surgicenter communities do not make or monitor the policies that continue to force us to deliver inferior care to our patients in order to remain in business. We are only front line delivery systems. I will not avoid new (even if more expensive) advances if they offer better and safer care for my patients.

It is not our responsibility to sacrifice patient care and rapport in order to support a system that is making most of us ill. It is our job to heal the system as we continue to care for our patients. My real concern is that in the future, if we allow HMOitis to fester, Dr. Oster will be using sterile LEGO's to do fusions as the CEO of Oxford buys an even larger yacht.

Dennis Shavelson, DPM, NYC, NY, drsha@lifestyelpodiatry.com

RE: Fascists and Fasciitis

In light of the current events going on, I'd like to relay a humorous patient encounter. A sweet elderly woman walked into my office with a chief complaint of severe heel pain for the last 2 weeks which "kills her when taking the first few steps out of bed." I informed this woman it sounded like she had a common problem and I began to talk to her about heel spurs and plantar fasciitis.

She responded "I knew it was the anti-Semitic heel spur." I looked at her confused and asked her if she could repeat what she had just said. She responded I heard about the anti-Semitic heel spur and the Islamic fascists. I started laughing....and assured her that plantar fasciitis and Islamic fascists had nothing to do it each other and that her heel pain did not discriminate.

Jeffrey Kass, DPM, Forest Hills, NY

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

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

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

Seeking an experienced podiatrist versed in all aspects of podiatry with current AZ License. The right person will join as a salary associate leading to partial ownership in the group practice. Podiatry practice is well established over 25 years, successful and a large volume in the Phoenix metro area. Position available immediately. Email CV and inquiries to:pprac4sl@cox.net

EQUIPMENT FOR SALE

Ritter X-Ray machine, Mayo stand, Oxygen mask and tank, Polaroid 8X10 X-Ray processor and cassette, Ritter Clave autoclave, Whitehall JO-140 portable whirlpool, Glass bead sterilizer, Foredom cord drill with hand piece, JanL model 100 nail dust extractor, 3 podiatry cabinets, Polaroid 545 3X5 X-Ray developer, 3 8X10 X-Ray cassettes. The equipment is located in NY. Please call 845-359-1070.

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

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

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