The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

August 20, 2011 #4,238 Publisher-Barry Block, DPM, JD

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Congratulations to Tip Sullivan, DPM of Jackson, MS, winner of a copy of Recent Advances in Orthotic Therapy by Dr. Paul Scherer (Value - $129.95).  We encourage you to participate in this important survey at www.podiatrym.com/survey Completing this anonymous survey provides us with valuable data, which we will publish in the February 2012 issue of Podiatry Management. It also makes you eligible to win thousands of dollars of valuable prizes. Enter by sending Question #43 (no answer is necessary) to bblock@podiatrym.com along with your name and address.

Lobby, Kensington Park Hotel

This week's prize is a two-night stay at the Kensington Park Hotel in San Francisco (Value - $456.00)..  

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

FL Podiatrist Discusses Gout

Gout is a form of arthritis that occurs when there's too much uric acid in the blood. The acid crystallizes and forms deposits in the joints, causing painful inflammation, most commonly in the fingers, wrists, knees, elbows and toes. "The crystals are like having small spikes in the joints," said Dr. Federico Auger, a podiatrist at the Ankle and Foot Center in Carrollwood. He typically sees gout patients during an initial bout, when they don't yet know they have the disease.

Dr. Federico Auger

The affected joint - often the big toe - suddenly becomes hot to the touch, red, swollen and intensely painful. Why is the big toe affected? Extremities are the coolest parts of the body, and lower temperature is thought to be associated with flare-ups. "An attack can be so painful that they can't even put a sheet on their foot," Auger said. "It can be red all the way to the ankle."

Source: Irene Maher, St. Petersburg Times, [8/17/11]

OCPM Voluntarily Reduces First Year Class Due to Residency Shortage

The Ohio College of Podiatric Medicine (OCPM) voluntarily reduced its 2011-2012 first year class by over 10% in response to the residency shortage within the podiatric community. OCPM enrolled 97 first year students into its program this year. According to Thomas V. Melillo, DPM, president of OCPM, "This was a strategic effort made by the college for our students. We want to continue providing our students an excellent opportunity to be accepted into residency programs." 

Dr. Thomas V Melillo

Dr. Melillo also stated, "With the shortage of residency programs, we felt we needed to enact this measure for this class year. If the profession manages to increase the number of quality residency programs in the near future, the college will go back to accepting its full class allotment." This past year, the Ohio College of Podiatric Medicine has successfully placed all of its eligible graduates into residency programs, as it has for the past 19 consecutive years.

OR Podiatrist Honored by OPMA

Dr. Andrew "Andy" Schink was honored last week at the semi-annual meeting of the Oregon Podiatric Medical Association (OPMA) in Portland for his years of service to OPMA and to the profession. 

(L-R) Drs. Thomas Mellilo, OPMA President, Andrew Schink, and Gerard Peterson, APMAPAC Chair

Schink has been president of the Association, serving two terms. He has been a delegate and alternate to the APMA House of Delegates for OPMA and has been the APMAPAC coordinator for 25 years. Every year, he brings in 75-85% participation and 300-400% of the state's monetary goal.

2011 CLEAR-ANKLE Summer Research Symposium at Scholl

On August 12, Rosalind Franklin University of Medicine and Science hosted the 2011 CLEAR-ANKLE Summer Research Symposium attended by faculty, staff, and students. ANKLE, the podiatry student interest group at Loyola University, has been working with CLEAR researchers at the Scholl College of Podiatric Medicine on novel research designs. 

Loyola student and ANKLE member Samar Khan presents his research concerning novel objective assessments of the effect of orthostatic hypotension upon balance and neuromuscular control. Khan was mentored by Scholl student Michael Roum and CLEAR member Associate Professor Dr. Bijan Najafi.

Scholl students who worked as NIH-funded research trainees this summer served as the primary mentors for the Loyola students, while receiving support from other CLEAR faculty and RFUMS research centers. To culminate the experience, ANKLE students presented their research progress to Scholl College faculty, including Dean Nancy Parsley and Dr. Karona Mason, as well as other Rosalind Franklin University faculty members.

Query: Blister-like Lesions on Toes
 
This 47 year old female has a documented history of Lyme disease with a recent history of babesiosis and previous infection of ehrlichiosis. She has been on antibiotics and recently on Mepron for its anti- protozoal effect. Three days after stopping Mepron, she developed the lesions seen on her toes. Today the "blister" lesion is on the dorsum of her third toe. 

Blister-like Lesion on Dorsum of Toes

Does anyone have experience with this? Is it a reaction to sun exposure from Mepron? It almost looks like hand-foot-and-mouth disease, but she has no oral lesions or symptoms. The toes burn and sun exposure exacerbates this. Any input would be is appreciated.

Alan Berman, DPM, Carmel, NY

Query: Diabetic with History of Amputation ICD-9

What is the ICD-9 code for a diabetic patient with a history of amputation? This is one of the qualifying diagnoses for diabetic shoes/inserts.

Jane Koch, DPM, Evansville, IN

Response: In ICD-9, the status post-amputation codes are part of the "Supplementary Classification of Factors Influencing Health Status" or "V" codes.

You would look under V49.7x - lower limb amputation status - for the most appropriate code:

V49.70 - Amputation lower limb, unspecified level
V49.71 - Amputation,m great toe
V49.72 - Amputation, other toe(s)
V49.73 - Amputation, foot
V49.47 - Amputation, ankle
V49.75 - Amputation, below knee
V49.76 - Amputation, above knee
V49.77 - Amputation, hip

Paul Kinberg, DPM, Dallas, TX

Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

RE: Epidermolysis Bullosa (Dean Clement, DPM)
From: Wm. Barry Turner, BSN, DPM

EB is a tough one. I tend to use topical steroids (triamcinolone), but then you need to be aggressive to prevent infections. Sometimes, I rotate the topical steroid with an antimicrobial (usually silver, but recently I started trying SilverKlenz/Silverion - a new product). I use a non-adhering dressing that is semi-occlusive. There is an EB support network (mdjunction.com/epidermolysis-bullosa). You also need to be careful with shoe wear! You want to do all you can to reduce trauma.

If I use the topical steroid regularly, I do cultures seeking quantitative values to determine if I should prescribe oral antibiotics. With EB patients, regardless of the clinical presentation, if the culture comes back with large amount of growth, I treat systemically. As I am sure you already know, steroids can mask or hide the cardinal signs of infection. These patients need a lot of TLC. Holding a patient and allowing them to cry is not uncommon and frequently required. If anyone knows of any better treatments, I am listening.

Wm. Barry Turner, BSN, DPM, Royston, GA, claret32853@gmail.com

RE: Kudos to Prolabs
From: Sarah Park

As a member of the APMSA House of Delegates, I want to express the most sincere appreciation for ProLab Orthotics for their generous expressions of student support. ProLab graciously hosted a reception at the historic Lenox Hotel during the APMA National in Boston. This served as an opportunity for students to network and develop relationships with distinguished leaders in the podiatric community. It is an incredible privilege to be on the receiving end of such strong support and encouragement. I look forward to the day that I can pay it forward.   

Sarah Park, SCPM Alternate Delegate, Class of 2014

RE: Legality of Maximalist Running Shoes (Robert Bijak, DPM)
From: Karen Malley Banks, DPM

It would seem to reason that the extra “spring” in the steps of runners wearing these shoes should be treated exactly like the high-speed swim suits that are allowed in the Olympics. I just wish the old movie Flubber was real so I would invest in that stuff.  There are many days I could use an extra boost.
 
Karen Malley Banks, DPM,  Thomasville, GA, kmbwwjd@rose.net

RE: Doughnut Tourniquet (Scott Shields, DPM)
From: Conway McLean, DPM

The devices you refer to are sold by the Ellman company and work quite well. This is the company that manufactures the Surgitron, which produces high intensity radiowaves for various types of soft tissue surgery. The tourniquets are fairly inexpensive, easy-to-use, and reusable.

Disclosure: I have no affiliation with the Ellman company.

Conway McLean, DPM, Chicago, IL, drcmclean@gmail.com

  EQUIPMENT FOR SALE - CLASS FOUR LASER

I have a class four pain laser for sale. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

EQUIPMENT FOR SALE – PRE-OWNED DIGITAL X-RAY SYSTEMS

Currently in use Reina-20/20 Extreme CR scanner (OEM iCRco) systems for sale. System includes CR scanner, 4 cassettes/imaging plates, and image acquisition software. Perfect for the low-medium volume practice or satellite office. E-mail Melanie Murdock for details and pricing.melanie.murdock@2020imaging.net 

PRACTICE FOR SALE  - CALIFORNIA

Golden opportunity for recent graduates. Beautiful practice located in San Bernardino county. Very reasonable price. For details contact: podiatry-practice4sale@hotmail.com

RRACTICE FOR SALE - BOSTON AREA

8 miles north of Boston with sublease available in a modern medical building. Presently working 3 days/week, grossing $300,00 annually with easy potential for full-time. All office and podiatric equipment, instruments, digital x ray, furniture, etc. are included. Turn-key operation. Please e mail footdoc71@aol.com or call 781 279-2332.
 
ASSOCIATE POSITION - NEW YORK CITY & QUEENS

High Income Potential. One of the fastest growing podiatry practices in New York City and Queens seeks a hard-working podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Preferably a Spanish-speaking podiatrist. Contact me at Podocare@aol.com

ASSOCIATE POSITION – IOWA CITY AREA

Established podiatric clinic looking for an associate to join our team, 4 offices located around the greater Seattle, WA area. Great base salary, benefits and friendly work environment. Please send resumetoseattlefootdoctor@yahoo.com

ASSOCIATE POSITION - NORTHWEST FLORIDA BEACHES

Excellent opportunity for an energetic, compassionate, hardworking individual with superior surgical and medical proficiency. Recent graduate or experienced practitioner. Excellent salary, benefits and partner-buy in offered, full admit privileges and surgical scope. Fax CV to Ecpodiatry@aol.com ASSOCIATE NEEDED -  SO. CAL 

ASSOCIATE NEEDED -  SO. CAL 

Position open for podiatry associate in Southern California. Applicant must be highly motivated and available for long term employment. This practice is extremely busy and requires a hard work ethic and desire to practice in a group practice environment. Excellent salary and benefit package offered. Please e-mail resume to footcare4all@aol.com

ASSOCIATE POSITION - CENTRAL FLORIDA
 
Busy surgical practice is looking for an experienced surgically trained podiatrist to join 3 others. Must be highly motivated and a team player. Excellent salary/bonuses with huge professional potential for the right person. Experience preferred. Beautiful Central Florida. E-mail CV topodiatryresume@gmail.com

ASSOCIATE POSITION – ANNAPOLIS, MARYLAND

Incredible opportunity for the right person to integrate long-term into a well established practice. Must be personable, highly motivated and bright individual with outstanding surgical and non-surgical ability. Excellent salary and benefits. Email CV and salary requirements to Marylandfootcare@live.com.

ASSOCIATE POSITION - CHICAGOLAND AREA, IL

Well-established podiatric practice in Elgin, IL seeking full-time associate with future partnership opportunity. Practice is state-of-the-art, medical and surgical, has established patient base with room for growth. Email resume to Kenneth Jacoby, DPM atkenjacoby18@gmail.com

ASSOCIATE POSITION - HUDSON VALLEY REGION, NY

Unique opportunity for the right person! We are a high-volume, diversified, multi-office practice utilizing state-of-the-art modalities. Ample growth opportunities for a personable and highly-motivated DPM. Please forward CV to: healthyfeet4ever@yahoo.com
 
ASSOCIATE POSITION -CENTRAL VALLEY/SOUTHERN CA

Seeking associate with partnership availability. Must be highly motivated and have good patient skills and personality. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Compassionate and well-trained for immediate position. Surgery Center and hospital based with no HMOs/no rest homes. Bilingual in English and Spanish preferred. Offering a permanent position/partnership in a multi-million dollar hi-tech practice with Partnership also in Surgery center. Please e-mail CV and short bio to: Tonya@wetreatyourfeet.com

SUB LEASING TIME on MRI (NYC)

.31 tesla extremity MRI in state-of-the-art midtown Manhattan office location. Lease time on magnet in compliance with the Stark laws. This magnet is the only one that will be accepted by Medicare and all other insurance as of 2012. Why not bill out for your own MRI's???  Email today dri@myfcny.com.

PM News Classified Ads Reach over 12,500 DPM's and Students

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