The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

August 14, 2010 #3,931 Publisher-Barry Block, DPM, JD

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Congratulations to Jacqueline Chen, DPM of Waynesville, MO, winner of an autographed copy of Podiatric Marketing and Practice Management by Barry Block, DPM, JD.   

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Cosmetic Foot Surgery Gaining in Popularity: TX Podiatrist

Forest Park Medical Center podiatrist Reza Mobarak said aesthetic foot surgery is growing in popularity--especially for women whose second toe is longer than the big toe. Doctors can shorten the toe by shaving down the knuckle bone. "A lot of times when they are having that long toe--it's hard to wear the shoes that women want to wear when they crunch their toe in the tip of the shoe, so if we shorten the toe, it will alleviate the problem," Dr. Mobarak said.

Dr. Reza Mobarak

Dr. Mobarak says bunion removal is the most popular procedure because it narrows the foot. The American Podiatric Medical Association has come out against cosmetic foot surgery--but Dr. Mobarak said he's filling a void. "We're just accommodating the patients who want to wear certain shoes is what we're doing and there is a need for it, and for us as foot surgeons, we're willing to do that for our patients," Dr. Mobarak said.

Source: Barry Carpenter, KDAF-TV [8/10/10]

OCPM Provides Foot Aid Stations at Cleveland Susan G. Komen 3-Day Cure Event

Marie M. Blazer, DPM, Class of 2004 and Larry Osher, DPM, Class of 1982, supervised evaluation and treatment of walkers at the Susan G. Komen 3-day for the Cure on Saturday July, 31, 2010. The 3-Day for the Cure route covers approximately 15-22 miles each day for three days in a row, totaling approximately 60 miles.

OCPM volunteers at Cleveland Susan G. Komen 3-Day for the Cure

The foot aid station was at the end of the 40 mile marker and consisted of twelve volunteer students and one resident. There were approximately nine hundred walkers. The major conditions treated during the race were blisters and subungual seromas.

Cross-Trainers Not a Good Choice for Runners: MN Podiatrist

Logic suggests that cross-trainers are all-purpose exercise shoes, but they are actually designed for activities that require directional changes, like tennis, racquetball, and aerobics classes. So while they have excellent side-to-side stability, cross-trainers also have a denser mid-sole and less cushioning than running shoes. This could put you at risk for shin splints, sore feet, and other lower-body injuries.

Dr. Paul Langer

“Runners take up to 1,500 steps per mile, far more than you would take in your average aerobics class,” says Paul Langer, author of Great Feet for Life, and director of the American Academy of Podiatric Sports Medicine. “Each time you land, the impact is two to three times your body weight. You need shoes that protect the body from the pounding and give support for straight-line motion.”

Source: Kimberly Goad, Fitness Magazine [July/August 2010]

Two of Atlanta’s Largest Surgical Practices Consolidate

Georgia’s largest foot and ankle surgical practice, Village Podiatry Centers, today announced a merger with Foot and Leg Healthcare Specialists. The joining of the two practices expands Village Podiatry Centers to 26 Georgia offices, 32 podiatric surgeons, and three ambulatory surgery centers.

(L-R) Drs. David Helfman and Doug Elleby

Village Podiatry Centers was founded in 1992 by Dr. David Helfman. The practice provides specialized treatment and surgery for the foot, ankle, and lower leg in metro Atlanta and the middle Georgia region. Foot and Leg Healthcare Specialists was founded in 1977 by Dr. Douglas Elleby. He, along with Dr. Barron Elleby and Dr. Stephanie Michael, currently staff six offices. As part of the merger process with Village Podiatry Centers, there will be consolidation of several clinic locations.

Medicare Pay Board Would be Repealed Under GOP Bill

A group of key Republican senators have introduced a bill that would repeal the Medicare Independent Payment Advisory Board, a new federal panel created by the health system reform law whose mission will be to propose how to extend the program's solvency. Several physician organizations, including the American Medical Association, have been opposed to the Medicare pay board. They say it could lead to yet another level of mandated cuts to doctor pay on top of any rate reductions that are already required by the Medicare statute.

The opponents of the new board said passage of their bill, the "Health Care Bureaucrats Elimination Act," ultimately will protect seniors' rights. Sen. John Cornyn (R-TX) on July 27 introduced the legislation, which is co-sponsored by Sens. Orrin Hatch (R-UT), Jon Kyl (R-AZ), Pat Roberts (R-KS), and Tom Coburn, MD (R-OK).

Source: Chris Silva, AMNews [8/9/10]

Query: Tarsal Coalition

My patient is an 11 year-old female referred by her family physician for mild right foot and ankle pain. This child has no supination in the right foot. Radiographs demonstrate a tarsal coalition between the calcaneus and navicular.

Tarsal Coalition in 11 Year Old

If the coalition is surgically removed, what is the best material to interpose between the cut surfaces of bone? Is this the appropriate age to correct this anomaly? If this was your daughter, or your granddaughter, what would you do?
 
James W. Clark, DPM, Salinas, CA

Query: E-Prescription Incentive Bonus

Has anyone received the Medicare incentive payment for the 2009 electronic prescription reporting? We had heard that checks would be sent to providers in June or July, but, as of today, we have not received any notification from Medicare on when to expect our reimbursement.

Gary Adsit, DPM, Marion, IN

Response: The checks for PQRI and Electronic Prescribing should be mailed out in October, and you should receive them in October or November.

Michael Brody, DPM, Commack, NY

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RE: S/P 2nd Toe Arthroplasty, 3 Months with Swelling at the PIPJ (Mak Yousefpour, DPM),
From: Multiple Respondents

Try an injection of Xylocaine and Kenalog 10.

Arnold Ross, DPM, Los Angeles, CA, asross1@juno.com

1. Take a post-op x-ray. Is there a fragment of bone left? Did you resect "enough" bone when you did the procedure? You can go back and fix this.
2. Did you use a dissolving suture? There could be a sterile abcess. Did you use a non-dissolving suture? There could be a knot irritating the tissue.  You can also go back and fix this.
3. Is there a low level infection that now could improve with antibiotics?
4. Is there suture going through a digital nerve, causing a traumatic neuroma? You can try a nerve block if it's painful, and then go back and fix this.
5. Is your 83 year old patient wearing a snugly fitting shoe that compresses the toe between its neighbors? You can encourage a wide shoe/sandal/etc...., at least for a little while.

I'm sure others will chime in with other things to consider, but those would be my top 5.

Eric Edelman, DPM, Syracuse, NY,  ericedelman@gmail.com

1) Even when all is done properly, some patients swell more than others and for a prolonged period of time.
2) I advise against further steroid injections as the first was not helpful.
3) If you have ruled out infection (you may want to send for MRI and/or repeat your x-rays), send her for physical therapy. Swelling can take up to a year to resolve in some patients, and she should have been told this ahead of time.
4) If it does not go away, you may have to go back in and do a fusion at the PIPJ site. This should work, but I would not rush in right away. I would give this time to resolve first.

Keith Gurnick, DPM, Los Angeles, CA keithgrnk@aol.com

RE: Plantar Fasciitis and Ultrasound Guidance (Bob Kelsey, DPM)
From: Dennis Shavelson, DPM

During my 40 years in practice, I have had 90% personal success diagnosing and treating neuromas without the use of ultrasound, using medical care and biomechanics, and I have rarely, as an ABPS surgeon, needed to excise neuromata. I learned and subsequently taught my ETOH treatment from its innovator, Marvin Steinberg, DPM. Early in practice, indemnity plans paid $300-$500 for ETOH injections and $300-$500 for orthotics, until about 15 years ago. Then over the years, HMOitis reduced an injection to $75-$150 and orthotics to $150-$200 or less.

I wonder if the entire physician and hospital community has been led astray by accepting the fate HMOitis has dealt them by the insurance companies that is forcing a never-endingly need to find new ways to recoup the income that has been diverted to corporate barons so that they can fly in helicopters.

Let’s be honest: guided injections, in some cases, may prove effective with increased success (unproven as Dr. Turlik suggests), but if ultrasound reimbursement was reduced to $25, there would be a glut of machines on the assembly line. I suggest we fight disease with true advances and counter HMOitis by educating the public as to how their system has been perverted and by dropping out of insurance plans in order to cure the disease. 

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

RE: Appointment Reminder Calling Services (Timothy B. Maclin, DPM)
From: Fay Mushlin

Our office has been using Medi-Call from Tel-Tek Systems for the last two years. It is saving our staff at least 3 hours a day 5 days a week to confirm appointments for our four doctors. These hours are now spent in a more productive manner. This system integrates with many practice management software programs. It is user-friendly, and our staff learned how to navigate the system in one afternoon.

When we were manually making the confirmation calls, in most instances, we were just leaving a voice mail message on the patients' answering machines. The program will inform the patient of the day, date, time and location of their appointment. If you have multiple offices, that is a very nice feature. You can track the length of call, whether answered by the patient or an answering machine. It also gives the patient the option to confirm. The contact person at Tel-Tek is Jody Sherman. 1-800-291-0206 X 204. The company will do a demo for you remotely, and it will give you the opportunity to see how the system works.

Disclosure: I have no financial interest in this company.

Fay Mushlin, Practice Administrator, Newtown Square, PA, teegee46@gmail.com

Query: Doctor, Can't You See That I'm Busy

I have a high tolerance for patients who want to use their cell phones when in my office. In some instances, it actually helps by diverting a patient's attention away from what I might be doing. This morning, however, something happened which takes the cake.
 
A  patient presented with a possible fracture. When I entered the treatment room and started to examine her foot, I saw her pressing the keys of her small cell phone. I palpated an area and asked if it hurt. She looked up at me and said, "excuse me doctor, I am busy texting my daughter who is on vacation in South America."
 
Elliot Udell, DPM, Hicksville, NY

EQUIPMENT FOR SALE

2 PDM electric chairs- Philips Oralix x-ray on mobile stand-- x-ray processor-Wall lights & mobile OR light  assorted cabinets --  All in excellent shape- Immediate discount available before all gets placed in storage! NY-Tri State area, just above Westchester County respond to podassociate@aol.com for prices.

ASSOCIATE POSITION - FREDERICK, MARYLAND

Fredericks premier group practice is located only 45 minutes from both DC and Baltimore. Immediate opening for a minimum PSR 36 Podiatrist for full time position. We have it all: EMR, digital x-ray, ultrasound, ASC, etc. Excellent salary with bonus structure and benefits. Please email resume to docsbnb@aol.com

PRACTICE FOR SALE - DALLAS, TX

Prestigious North Dallas location; 24 year old practice; excellent mix of hospital surgery, office surgery, orthotics, general podiatry, web site, electronic claim submission. Retiring owner will stay for transition. Owner financing available. dallasfootdr@yahoo.com

ASSOCIATE POSITION - SW FLORIDA

Golf, Boating and Beaches - Great opportunity to join a well established Podiatry Practice. Excellent mix office/surgery, motivated experienced staff. Seeking full time Associate PSR 12-36. Excellent salary & benefits, early buy-in for the right hard-working, personable candidate. Email resume to capecoralpodiatry@live.com or fax to 239-573-9201

ASSOCIATE POSITION - SUBURBAN PHILADELPHIA AREA

Full-time associate with opportunity for partnership with group practice. Candidate must be trained in all phases of podiatry including wound care, surgery, and routine podiatric care. Candidate must have a positive and energetic attitude with a desire to grow in our practice. If interested please email your CV to BergD@readinghospital.org

FULL-TIME ASSOCIATE NEEDED FREDERICK/HAGERSTOWN, MARYLAND

Reconstructive Foot & Ankle Institute, LLC needs full-time DPM at least PMS 36 to join premier group in Frederick/Hagerstown, MD. ASC, EMR, DR-digital radiography and ultrasound, Vascular/nerve testing, DME, retail store, strong hospital affiliations, salary, bonus and benefits. Respond to drmichaels@rfainstitute.com

PRACTICE FOR SALE – MASSACHUSETTS

Solo Practice Grossing over $700K yearly 4 days a week. Mostly surgical with heavy emphasis on peripheral nerve patients and pediatrics. General bread and butter podiatry as well. No Medicaid very little Medicare. Very modern office. 30 minutes north of Boston. Modern new equipment (digital x-ray, ultrasound, computer network, etc.). Great referral network. Website included. Option to buy the condo 3500sq ft. Have PICA practice evaluation to show you. Call 978-944-7789 for details.

PRACTICE AVAILABLE - WESTERN WASHINGTON

General Podiatry practice in Port Townsend, WA. Nice community, 25+ year old practice, busy 3 days a week with growth potential. Owner leaving area, needs someone to take over the practice, lease and equipment. Contact Jessica at ptpod@yahoo.com or 925-519-0624.

ASSOCIATE POSITION – NEW YORK

Busy, well-established for 35 years, multi-site practice in upstate New York looking for licensed podiatrist who is ready for a thriving practice. Must be highly motivated, personable and great with patients. Competitive salary and benefit package. Send CV or letter of interest to associateinfoot@yahoo.com or fax 607-723-1567.

ASSOCIATE POSITION – WEST VIRGINIA

Parkersburg orthopedic group seeks established podiatrist or a 24-36 surgically-trained physician. Group offers stability, autonomy and a collaborative environment. Comprehensive benefits and competitive salary starting at $105K with production bonus. Send CV to Mary-MOR@columbus.rr.com 

ASSOCIATE POSITION – LONG ISLAND, NY

Associate full-time. Well-established, busy, well-rounded podiatry practice looking for a motivated podiatrist. Suffolk Co. LI NY. Board eligible, Board certified PSR-24/36 trained. Fax resume to 631-581-0857.

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION -CT (FAIRFIELD AND NORTH HAVEN)

Great opportunity. Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices. Electronic medical records, digital x-ray, diagnostic ultrasound, Padnet vascular studies, nerve conduction studies, pinpoint and CO2 lasers, electrical stimulation and ultrasound therapies. Seeking a well-trained, personable, and highly motivated individual. Please send resume and current photo to dr.kassaris@yahoo.com

PRACTICE & STATE LICENSED ASC FOR SALE (MARYLAND, DC SUBURB)

38 yr old general podiatry practice grossing over $550K. Fully equipped with digital x-ray, diagnostic ultrasound, 2 orthotic scanners, computer network and well-equipped surgical suite. Retiring owner will stay on as needed. Email - dpmpracticeforsale@yahoo.com

FULL-TIME ASSOCIATE NEEDED FREDERICK/HAGERSTOWN, MARYLAND

Reconstructive Foot & Ankle Institute, LLC needs full-time DPM at least PMS 36 to join premier group in Frederick/Hagerstown, MD. ASC, EMR, DR-digital radiography and ultrasound, Vascular/nerve testing, DME, retail store, strong hospital affiliations, salary, bonus and benefits. Respond to drmichaels@rfainstitute.com

MANHATTAN MEDICAL SPACE AVAILABLE

Multispecialty Medical Building with 24/7 doorman. Prime Luxury Building and Location, Gramercy, Stuyvesant, Peter Cooper Area. 305 Second Avenue (17th-18th). Prior tenants past 23 years; podiatrist, dentist (plumbing/electric intact), internist. Ideal for podiatry, co-share with dentist, MD, etc. (flexible lease terms). E-Mail; jbdrun@aol.com Phone; 480-951-2480.

TN PRACTICE FOR SALE (LAWRENCE COUNTY)

Active, established practice includes office building and property ( appraised at 110k) with all equipment and shelf stock included. Great referral network with an excellent scope of practice. Patients on schedule 1 day/ week grossed over 250k last year. 125k OBO Call 931-446-5724 or email mchad500@gmail.com for more information.

ASSOCIATE POSITION - NEW JERSEY - JERSEY SHORE REGION

Part-time associate wanted. Looking for a motivated and ethical practitioner. Competitive salary with incentives. Tuesday AM - Thursday PM - 2 Saturdays/month. Please respond to: NJSHOREFOOTDOC@aol.com

PM News Classified Ads Reach over 12,000 DPM's and Students

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