The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

August 17, 2010 #3,933 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2010- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Unstable Rocker Shoes Can Strengthen Glutes and Lower Back: CA Podiatrist

Shoes that reduce cellulite? It sounds too good to be true, but experts say those promises may not be too far-fetched, as basic fitness principles meet the latest in physiological technology. But can Shape-ups, and the similarly designed MBT shoes, really deliver.

Dr. Victoria Foley

Yes, said Dr. Victoria Foley, a Long Beach podiatrist. Rocker-bottom shoes such as Shape-ups and MBTs have been around for years, prescribed mainly as medical devices for people with heel pain and arthritis. The design works the gluteal muscles and helps strengthen the lower back, Foley said. "It's like being on a wobble board. You're constantly contracting your muscles," she said.

Source: Renee Moilanen, Daily News (Los Angeles) [8/11/10]

Wound Care Center Staffed By NY Podiatrists Closes

After six years of providing treatment to those in need, the Columbia Memorial Hospital Center for Wound Care closed its doors at the end of last month. Although the center is gone, Dr. David Nussbaum and Dr. Lori Lundberg — the former a certified wound care specialist, and both of whom are board certified podiatric surgeons — will continue, however, to provide podiatric wound care at both their Catskill and Hudson offices.

Dr. Mark Schilansky

The center was formed back in 2004 by Dr. Mark Schilansky and the late Dr. Luis Jacome, with Schilansky and Nussbaum the primary surgeons managing foot wounds during the past four years, and hundreds of patients being treated for chronic wounds since the beginning.  Schilansky said Tuesday that he looks back with pride and fondness on those years. “I am very proud of the work that Dr. Nussbaum and I did at the Center for Wound Care,” Schilansky said, “and the amputations that our care prevented.”

Source: Jim Planck, Hudson-Catskill Newspapers [8/11/10]

AZ Podiatrist Keynotes at South African Diabetic Working Group Meeting

The devastating consequences of diabetes were on full display at the South African Diabetic Foot Working Group in Cape Town this weekend. Keynote Lecturer David G. Armstrong, summed it up "In this continent ravaged by acute problems, this most sinister chronic condition is now front and center and can no longer be ignored."

(L-R) Dr. David G. Armstrong and Lynne Tudhope, MD, Working Group Chairperson

Delegates from around Africa and Mauritius participated in workshops, seminars and plenary lectures. Armstrong went on to note "It is an inspiration to be here with leaders like Lynne Tudhope, our Chairperson, who has worked so diligently with her colleagues in podiatry, endocrinology, orthopaedics and vascular surgery to make a difference in amputation prevention. I think the working group serves as a model not only in Africa but worldwide."

Large Attendance at Physician’s Business Academy Workshop

58 physicians and podiatrists attended the 3rd Physician’s Business Academy Workshop last week in Atlanta. The Physician’s Business Academy was started five months ago by Dr. David Helfman, the founder and CEO of Village Podiatry Centers, LLC. Dr. Helfman wanted to transfer  intellectual capital to the physician marketplace. “Knowledge is only an asset if you can transfer it to others,” says Dr. Helfman.

Attendees at Physician's Business Academy hear presentation by Doug Curling, the COO of Choice Point

Attendees of the two-day conference heard a variety of presentations on the nuts and bolts of practice mergers from a diverse group of experts, including  Doug Curling, the COO of Choice Point.

Battle Burnout with Questions

Asking staffers to do more and more, with ever-fewer resources, opens the door to exhaustion and burnout. You can avoid negative consequences, however, if you keep your finger on the team’s pulse. At least once a quarter— once every month is better— offer each worker opportunities to open up to you. Say:

•  “Tell me about a time in the past month or so when you felt demotivated.” You can substitute words like “frustrated” or “burned out” or similar, depending on your team’s situation.
•  “Tell me about a time in the past month or so when you felt motivated.” Use whatever positive words come naturally to you, such as “excited” and “pumped up.”

You can listen to staffers’ answers without promising to solve every problem. Asking those questions shows that you care, and you may be able to identify quick solutions that allow staffers to work more productively.

Source: Adapted from Hundred Percenters: Challenge Your Employees to Give It Their All and They’ll Give You Even More, Mark Murphy, McGraw-Hill via Communication Briefings

RE: Tarsal Coalition (James W. Clark, DPM)
From: Neal M. Blitz, DPM

It is important not to have tunnel vision when it comes to tarsal coalition, and recent research has suggested that an associated flatfoot and any secondary effects of such (i.e., calcaneal fibular remodeling - CFR) may be contributing to the pain cascade. Surgeons should consider a coalition concomitant flatfoot as a pathologic entity and treat accordingly on a case by case basis.

The coalition itself is not often the primary source of pain, especially when completely osseous.  Fibrous coalitions are essentially pseudoarthroses and may be directly painful. In my experience, reasons for recurrent symptomatic CN coalitions are : 1) incomplete (subtotal) resection -- most common reason, 2) not adequately interposing the EDB muscle, and/or 3) not addressing a concomitant flatfoot. 

Therefore, with primary resections, it is important to take a large resection. Using bone wax in conjunction with EDB interposition is an additive measure to limit regrowth. A technique tip to gain length from the EDB muscle is to transect the longitudinal septa/fascia, which will allow the muscle to be effectively lengthened - allowing for deep interposition.

Neal M. Blitz, DPM, Bronx, NY, nealblitz@yahoo.com

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

I agree with most of the suggestions being made to correct this common problem. One thing we instruct our patients to use preventatively is Coban with gradient pressure to the digit, once the sutures have been removed. When applied in the morning and removed at night, the incidence of edema is greatly reduced.

We always educate the patient on the stages of healing and the expected inflammatory phase of healing, which peaks at 6-8 weeks. Coban dressings are used 10 weeks. If the patient complies, there is much less frustration with the healing process.

Jerry Cosentino, DPM, Tampa, FL, drcosentino@tampabay.rr.com

RE: The Doctors Company Malpractice (David E. Gurvis, DPM)
From: Michael Levi, DPM, Steven Moskowitz, DPM

I have used the Doctors Company for the past 21 years. They are an excellent company. They are based in Napa Valley California and are an A-rated company.

Michael Levi, DPM, Santa Monica, CA, mlrjlevi@sbcglobal.net

I have been insured with the Doctors Company for over five years. I have not had any suits during this time, but I can say that they have been very helpful with any questions I have had regarding patient care. I switched to them when my insurance premiums became too high to justify, and the Doctors company was about half the price for the same coverage. Only after I switched, did I ask some M.D. friends if they had heard of this company, and to my surprise, about half of them were insured by them.
 
Steven Moskowitz, DPM, Houston, TX, SSSSmosk@aol.com

 RE: Two of Atlanta’s Largest Surgical Practices Consolidate (Robert Bijak, DPM)
From: Jack Sasiene, DPM

I'm sure Dr. Bijak is not alone with his sentiments. I have strived to fulfill the same objectives with my practice over the last twenty years. However, it has become apparent that our industry is not safe from the normal effects of a maturing business model. Sadly, it appears that payers, hospitals, and other large companies have benefited from the ongoing fragmentation and internal competition within our specialty.  As long as we remain as small one and two person practices, we have a lower probability of dealing with the goliaths effectively. History has proven, for other specialties, that combining practices in a region offers a powerful business advantage.

Unfortunately, the increasing amount of regulation and management responsibilities for a solo practitioner have become overwhelming for many to tackle appropriately. Currently, it appears that our government is actually pushing things the other way...into one big government monopoly. Some would argue that we gave up our autonomy when we started signing contracts to work for insurance companies 20 years ago.

There are many groups forming across the country to deal with these issues. Here in Houston, Foot Doctors of Texas, LLC has formed to involve everyone interested in the grouping vision. We have accepted all sizes and profiles, abiding by all state and federal laws. Our strategy was simple, the ideal way to survive in our area was to merge together to lower overhead, practice more efficiently and leverage our size and quality to produce results-based medicine from a single billing/EMR platform. This will enable us to adequately prove to insurance companies that we can save them dollars through quality outcomes and advanced patient care.

Disclosure:  Member of Steering Committee, Foot Doctors of Texas, LLC

Jack Sasiene, DPM, Texas City, TX, Sasiene@aol.com

RE: Two of Atlanta’s Largest Surgical Practices Consolidate (Robert Bijak, DPM)
From: David N. Helfman, DPM

The future of healthcare is moving into integrated models, whether horizontal or vertical. Unfortunately, it was the HMO’s that started the IPA movement in the early 1990’s for the solo practitioner to access managed care plans. Now, with the future of healthcare moving into the current direction, it’s vital that these graduates learn the benefits of the group healthcare model. You can either ignore it and just watch the train go by, or you can be proactive and help build the train. I can vouch for 100% of our group members in Village Podiatry that it was the best career move they have ever made, for many reasons. Every model has obstacles but you are much stronger in a group model than a solo model. You can stay solo and there will always be that opportunity, but the solo practitioner is losing out on all kinds of opportunities by not integrating with fellow colleagues. I have personally witnessed life changes from solo practitioners joining a group model that is fair and run properly.

It sounds more like you are fearful that you could be left out of this path healthcare is taking. Fear is a motivator, and I am a firm believer that you will need to integrate with a larger healthcare organization, whether single or multi-specialty to thrive in the future. Most of the residents that are trained in Atlanta are already prepared to join a group practice. Why? They don’t want to deal with all the complex issues of managing a practice, and they want to capitalize on all opportunities afforded to the group practice.

David N. Helfman, DPM, Atlanta, GA, DHelfman@villagepodiatrycenters.com

RE: Two of Atlanta’s Largest Surgical Practices Consolidate (Robert Bijak, DPM)
From: Marc Katz, DPM

I have no problem with these groups forming. Some may offer a wider variety of services to patients, and others may provide substandard care because they are a factory. In either case, as Americans in a capitalist society, we certainly have the right to form any practice type that we desire. Now, of course, if our current administration has its way, there will be "podobama" Foot and Ankle Clinics employing us and run by the government!

I'm a solo practitioner and enjoy being surrounded by larger groups. I get all of their disgruntled patients because they are tired of being treated poorly. As a matter of fact, I have capitalized on the fact that there are plenty of people who enjoy quality care. So, I've dropped certain insurances and have moved a large portion of my practice to cash, and will continue to head in that direction.  Patients are craving alternatives. So, instead of complaining, make the best of the situation!

Marc Katz, DPM, Tampa FL, dr_mkatz@yahoo.com

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.

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.

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 – 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.

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.

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

PM News Classified Ads Reach over 12,000 DPM's 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 12,000 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.