The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

August 24, 2012 #4,548 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2012- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Congratulations to: Dr. Vera Stern of Richardson, TX , winner of a copy of A Podiatric Practitioner's Biomechanic and Surgical Guide by Thomas E. Sgarlato, DPM (Value $120).We encourage you to participate in this important survey at www.podiatrym.com/survey Completing this confidential survey provides us with valuable data, which we will publish in the February 2013 issue of Podiatry Management. It also makes you eligible to win thousands of dollars of valuable prizes.

SugarMill Suites, Tobago, WI

This week's prize is a six night stay for up to four persons in an upper floor of a 2-bedroom bungalow with hot tub at the SugarMill Suites in Tobago, the West Indies (value $1,680)

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

AAPSM Elects New Officers

At the American Academy of Podiatric Sports Medicine Annual Meeting held last week in Washington, DC, the AAPSM elected Robert M. Conenello, DPM, a sports medicine podiatrist in private practice in Orangeburg, NY as its new president. Dr. Conenello also serves as Global Clinical Advisor of the Fit Feet Program of Special Olympics International.

(L-R) Dr. Rob Conenello Receives Gavel from Dr. Jamie Yakel

Elected along with Dr. Conenello were:  President-Elect- Paul R. Langer, DPM, Minneapolis, MN; Vice-President - David Jenkins, DPM, Glendale, AZ; Secretary/Treasurer– Dianne Mitchell, DPM, Sacramento, CA and newly elected Director Brian Fullem, DPM, Tampa, FL. Jamie Yakel, DPM, Brighton, CO serves as Immediate Past President. Rita J. Yates serves as AAPSM Executive Director.

Final Rule on Stage 2 of EHR Incentive Program Issued

The final requirements that hospitals and other providers must meet to receive funding under the second phase of the federal electronic health record incentive program were issued Thursday. The Stage 2 meaningful-use requirements that providers must satisfy to receive payments under the program that provides incentive payments to Medicare and Medicaid providers who adopt qualifying EHRs will go into effect in early 2014, according to a final rule  issued by the CMS and the Office of the National Coordinator for Health Information Technology.

The final rule adds  new "core objectives" to the Stage 2 reporting requirements for physicians and hospitals. The first requirement, for physicians, is to use secure electronic messaging to communicate relevant health information with patients. The rule also lowered the requirement that providers submit summaries of care from 65% of “transitions of care and referrals” to just 50%.

Source: Rich Daly, Modern Healthcare [8/23/12]

Query: Recurring Forefoot Pain in a Cyclist

My patient is a 47 y/o man who bikes 30+ miles several times a week. I successfully treated his plantar left 2nd metahead pain 2 years ago with foot orthoses. Pain only occurred during biking. He has a FF valgus with very mobile 1st ray and compensatory pronation of both feet. He was doing well until early June with return of the same pain. He has not changed biking shoes, pedal set-up, or the bike.

Radiographs are negative. A trial metapad and posting adjustment did not help. He is now having the same pain in the right FF. If he keeps the ride easy and less than 10-15 miles, he has no pain at all, and has no pain during ADLs. He relates no numbness/tingling in his feet. His orthotics are 3/4 length. Is his bike/pedal set-up or shoes possibly the cause, or would a full-length rigid orthotic be indicated?

Mark Aldrich, DPM, Antigo, WI

Query: Right Time for an Associate?

How do you know when it's time to hire an associate? I am seeing 30-45 patients a day three days a week in one office, and the same in another office on the other two days (20-30 of them are new). I have to squeeze in surgeries (three every other week). I now have an opportunity to participate in a wound care center. Is the answer that obvious? Suggestions please. I am afraid of diluting my patient load.

Name Withheld

RE: Treating a Diabetic with an Inversion Sprain (Philip McKinney, DPM)
From: Barry Mullen, DPM

In a word, NO, you are not being too cautious; I believe many clinicians still under-treat inversion ankle sprains. When the ATF is suspected of being torn, allowing the foot to dangle in a supinated position allows that ligament to heal elongated. This can contribute to long-term instability. Our protocol is that when an ATF tear is suspected, the foot is immobilized in a fracture boot in ankle neutral for 3 weeks. Aggressive PT (to patient tolerance) is initiated at that time for proprioreception education and gait training since those receptor sites are often damaged at the same time the ligament tears. I believe this is the most important component of ankle sprain therapy. This protocol transcends diabetes.

The ONLY concern in a diabetic might be delayed ligament healing, dictated by the patient's LE vascularity and nutritional status. Other than that, check the history to learn whether the fall occurred without a trauma history and check the nervous system. Neuropathy often causes unsteady gait, so stability bracing, such as a Moore balance brace, might be needed long-term. 

Barry Mullen, DPM, Hackettstown, NJ, yazy630@aol.com

RE: History & Physical Exam Course for DPMs
From: Nicholas Sol, DPM

For those of us who still rely on others to perform admissions H&Ps, the continuing education office at the Scholl College of Podiatric Medicine has 13 interested DPMs for their History & Physical Exam course. This is the first step to having the privileges to perform your own admission H&Ps on your own patients at your local hospitals and surgery centers. I’ve put my name on their “interested” list, and I hope several of my colleagues will, too. To put your name on their “interested” list, please contact Ms. Ellie Wydevan at the Scholl College office of continuing education (847-578-8410) and let her know that you want to attend this course. No date has been set and there is no obligation to attend. They will schedule the course once the list exceeds 20 interested DPMs.
 
Nicholas Sol, DPM, Colorado Springs, CO, drsol@thewalkingclinic.com

RE: 25,000 Hours (Hal Ornstein, DPM)
From: Art Gudeon, DPM, Gayle S. Johnson
 
I'd like to add my thanks to TWO giants of the profession...both Barry Block AND Hal Ornstein have given so much of their lives, and made podiatric life for all of us so much more interesting, fruitful, and FUN. It's probably why I'm still enjoying my "work" after 52 years... so far. Keep up the good work guys, I don't want to retire!

Art Gudeon, DPM, Rego Park, NY, afootdoc@hotmail.com

Thank you, Barry, for investing so much of your time and yourself to bring PM News to us all. I doubt that many people understand what it takes to produce even a small fraction of what you have done. It is inspiring, and greatly appreciated. And thanks to Hal for bringing it to our attention.

Gayle S. Johnson, Edmonds, WA, Gayle S. Johnson

RE: Terminating an Office Manager (Name Withheld)
From: Lynn Homisak

It is not uncommon in many offices to find that a doctor will take their very functional, long-time “assistant” and move her up… into a management position, when in fact, she has had no management training for that position. If employees are not given the proper tools to succeed, they cannot. So while she may be an excellent assistant, she will inevitably fail as a manager. It's not entirely her fault. Considering the stress, expense, and general upset that replacing an employee involves, your first thought should not be to dismiss her, but instead assess what qualifications she lacks and whether or not investing in her training and education would make her a BETTER manager, one who aligns with your definition of excellence.

If you are absolutely sure that she can’t cut it as a manager, recognize that you may be adding insult to injury by asking her to stick around to train another person to take her place. Her negative and hurtful resentment may turn to revenge and, admittedly, she would be in the perfect position to do some serious damage. In this case, I suggest making a clean break. Place an ad, interview some applicants, and when you find one who is promising, thank your current manager for her service, give her all her accumulated benefits, two weeks pay, and say goodbye. PS- Hopefully, you have documented her unsatisfactory performance!

Lynn Homisak, Federal Way, WA, lynn@soshms.com

RE: Microphone for Dragon Med 11 (David Kahan, DPM)
From: Gerald Peterson, DPM

Just a heads up. No matter what microphone you get, just make sure it is FULLY Bluetooth and not Bluetooth tied to a base, as you will only be able to use that one with the computer it is coupled to. You want to make sure it is completely wireless, so you can use it with your phone, your computer, and other computers, etc. They are the way to go no matter which brand you choose. The cheaper ones usually don’t have noise cancelling functionality. I like to listen to music when I am at the office late dictating. The less expensive ones will hear the background ”noise” and cause more errors.
 
Gerald Peterson, DPM, West Linn, OR, DRP@ifixft.com

RE: Scope of Practice (Kevin Kirby, DPM)
From: Robert Bijak, DPM

I have a different opinion from what others have said on this issue. Dr. Kirby feels it necessary to "counsel" podiatrists on BMI errors, etc. If "treatment of obesity education" was part of our curriculum initially, and our competence to do so was tested on a license exam, he wouldn't have to tell us this. This makes the point that most podiatrists have not had the training or basic knowledge to give any more advice than to say "see someone about your weight; it can affect your feet."
 
Dr. Udell mentioned a lecture on obesity at a seminar. If all we needed was to attend a seminar to increase our scope, I dare say we wouldn't be contributing to political campaigns to do so. I'm sorry to point out this obvious though unpopular reality: podiatry as presently constituted is not competent to speak medically on this systemic condition. I wish we were.

Robert Bijak, DPM, Clarence Center, NY, rbijak@aol.com

RE: Two Tests for Posterior Tibial Dysfunction
From: Terrance J. Mueller, DPM

I was happy to see Drs. Grattolino and Haggerty make mention of a time-tested, orthopedic clinical test for PTTD. I understand Dr. Mueller's response, but disagree with him. From my podiatric and orthopedic training, the key to the "raising up on the toes" (Jack's Test) test is the "inversion of the rear foot" that normally occurs with the PTT intact. The PTT is the dominant force in this movement, with ancillary help by the FDL and FHL. In 31 years of clinical experiences, I cannot think of a time when the "too many toes" and "raising up on the toes" tests, when performed consecutively, have failed in our assessment of suspected PTTD, including partial rupture.

These two tests are also very easy to explain to the patient and family member concerning the PTTD. I have read the articles noted by Dr. Mueller and applaud his interest in PTTD, but to suggest that the tests mentioned by Drs. Grattolino and Haggerty are outdated ignores the clinical examinations performed on millions of feet over the past several years. The orthopedic tests described by my colleagues are in fact time-tested and still have relevance. In fact, these tests are standard when discussing PTTD with orthopedic surgeons and podiatric surgeons.

Joe Agostinelli, DPM, Ft. Walton Beach, FL, jmpa21@cox.net

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.

PRACTICE FOR SALE - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact: podiatrypracticesale@gmail.com

PRACTICE FOR SALE - NEW ROCHELLE, NY

Flexible terms. Stable location, medical co-op, 24 year practice with a stable established patient base. Great opportunity for a self motivated podiatrist wanting immediate income and future stability. Call 551-574-0776 for details.

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815  PODO2345@AOL.COM

ASSOCIATE POSITION - CHARLOTTE, NC

Charlotte, NC practice with excellent reputation and patient base seeks to hire a podiatric surgeon. Looking for an associate with partnership potential to join our team serving 5 offices located in Charlotte metro area. Please send resume to Charpodiatry@gmail.com.

ASSOCIATE POSITION – NORTHERN CALIFORNIA/BAY AREA
 
We’re looking for someone entrepreneurial who can help grow our practice. Must have great people skills, clinical/surgical skills, and positive demeanor. California license required. Send your CV and cover letter to cvpodiatrist@gmail.com

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. Contact me at: podocare123@gmail.com

ASSOCIATE POSITION – NEW YORK

Great opportunity to share “state-of-the-art” offices and equipment in mid-town Manhattan and White Plains with Board Certified podiatrist. Out-of-network or participating providers welcome. Please call 212-704-4310 for additional information and fax your CV to 212-704-4311 or email to: ifanelli.hms@verizon.net.

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 12/24 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977

ASSOCIATE POSITION – SUFFOLK COUNTY, LI

Well-rounded podiatry practice. A business-oriented, mature board eligible/certified podiatrist who is not just looking for a job, but a secure future. Equity position possible. 2 hospitals available. No nursing homes. Competitive package. Please send CV to 631-581-0857.

ASSOCIATE POSITION - SACRAMENTO, CA

Associate position available immediately. Full or Part time. Opportunity for buy-in and full partnership. Full scope of practice with hospital and surgical privileges available. Please call 310.854.0203 or fax 916.732.2280.

ASSOCIATE POSITIONS – MARYLAND

Are you motivated, personable and enjoy working with the elderly? We are offering part-time positions in Maryland. Our group, Podiatry Management Services, provides care in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your CV to: drhprosen@verizon.net or fax to 410-486-2049 or call Dr. Herbert Rosen at 410-580-0255

ASSOCIATE POSITION - MINNEAPOLIS/ST. PAUL

Contract podiatrist. Doctors By Your Side, a high quality team serving senior communities. Are flexible, work as little as 2 days monthly. Good compensation, expenses and all administrative capabilities (scheduling, billing and EMR) provided. To learn more, please send CV and availability to: john@doctorsbys.com or call 763-390-9276.

ASSOCIATE POSITION - NORTHERN, NJ

Part-time or-full time. This position can and will lead to purchase of practice if so desired. Well-equipped modern office. Digital x-ray, ultrasound, etc. Individual must be well-trained and be ABPS Qualified/Certified. Must be competent in general foot care and be able to do routine foot surgery without help. Call: 201-986-1900.

ASSOCIATE POSITION - WASHINGTON, DC

Prominent two office (3 practitioner) podiatric medical group seeking well rounded, personable individual with good medical and surgical skills. Must be 24/36 month trained, board qualified or certified foot and ankle surgeon. Salary with benefits package. Serious inquiries to ponyrunner66@gmail.com 

ASSOCIATE POSITION - NASSAU COUNTY, NEW YORK

Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to:Podiatryoffice@doctor.com

ASSOCIATE POSITION - MANHATTAN

Podiatrist needed for busy state-of-the-art offices in Manhattan. Offices are located near Penn and Grand Central Station. 10+ years experience only and an out-of-network doctor for most insurances. Please forward your information and CV to: roni@myfcny.com

EQUIPMENT FOR SALE

Retiring from practice. Equipment For sale. Mini x-ray. One year old Ultrasound with MS arterial/venous X-ray plates. Great condition Ritter chairs. Drills, surgical tools. So much. Just ask, I probably have it: Footcare@comcast.net

EQUIPMENT FOR SALE - PINPOINTE LASER

PinPointe Laser for sale. All accessories included. In service since 2008. Service policy in place, fully transferable. $35,000. tatarb@verizon.net.

PM News Classified Ads Reach over 13,500 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 13,500 DPM's. 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.

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 12/24 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977

ASSOCIATE POSITION – SUFFOLK COUNTY, LI

Well-rounded podiatry practice. A business-oriented, mature board eligible/certified podiatrist who is not just looking for a job, but a secure future. Equity position possible. 2 hospitals available. No nursing homes. Competitive package. Please send CV to 631-581-0857.

ASSOCIATE POSITION - SACRAMENTO, CA

Associate position available immediately. Full or Part time. Opportunity for buy-in and full partnership. Full scope of practice with hospital and surgical privileges available. Please call 310.854.0203 or fax 916.732.2280.

ASSOCIATE POSITIONS – MARYLAND

Are you motivated, personable and enjoy working with the elderly? We are offering part-time positions in Maryland. Our group, Podiatry Management Services, provides care in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your CV to: drhprosen@verizon.net or fax to 410-486-2049 or call Dr. Herbert Rosen at 410-580-0255

ASSOCIATE POSITION - MINNEAPOLIS/ST. PAUL

Contract podiatrist. Doctors By Your Side, a high quality team serving senior communities. Are flexible, work as little as 2 days monthly. Good compensation, expenses and all administrative capabilities (scheduling, billing and EMR) provided. To learn more, please send CV and availability to: john@doctorsbys.com or call 763-390-9276.

ASSOCIATE POSITION - NORTHERN, NJ

Part-time or-full time. This position can and will lead to purchase of practice if so desired. Well-equipped modern office. Digital x-ray, ultrasound, etc. Individual must be well-trained and be ABPS Qualified/Certified. Must be competent in general foot care and be able to do routine foot surgery without help. Call: 201-986-1900.

ASSOCIATE POSITION - WASHINGTON, DC

Prominent two office (3 practitioner) podiatric medical group seeking well rounded, personable individual with good medical and surgical skills. Must be 24/36 month trained, board qualified or certified foot and ankle surgeon. Salary with benefits package. Serious inquiries to ponyrunner66@gmail.com

ASSOCIATE POSITION - NASSAU COUNTY, NEW YORK

Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to: Podiatryoffice@doctor.com

ASSOCIATE POSITION - MANHATTAN

Podiatrist needed for busy state-of-the-art offices in Manhattan. Offices are located near Penn and Grand Central Station. 10+ years experience only and an out-of-network doctor for most insurances. Please forward your information and CV to: roni@myfcny.com

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. Contact me at: podocare123@gmail.com

ASSOCIATE POSITION - WEST COAST FLORIDA

Outstanding opportunity for PSR-36 graduate to join successful group podiatry practice. Seeking a sociable, articulate graduate who is confident in foot and ankle surgery but also enjoys all phases of podiatry. Long-term opportunity for the right candidate with generous pay and benefits. Reply to: jwicks@cortezfootandankle.com

ASSOCIATE POSITION – NEW YORK

Great opportunity to share “state-of-the-art” offices and equipment in mid-town Manhattan and White Plains with Board Certified podiatrist. Out-of-network or participating providers welcome. Please call 212-704-4310 for additional information and fax your CV to 212-704-4311 or email to: ifanelli.hms@verizon.net.

EQUIPMENT FOR SALE

Retiring from practice. Equipment For sale. Mini x-ray. One year old Ultrasound with MS arterial/venous X-ray plates. Great condition Ritter chairs. Drills, surgical tools. So much. Just ask, I probably have it: Footcare@comcast.net

EQUIPMENT FOR SALE - PINPOINTE LASER

PinPointe Laser for sale. All accessories included. In service since 2008. Service policy in place, fully transferable. $35,000. tatarb@verizon.net.

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.

PRACTICE FOR SALE - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact: podiatrypracticesale@gmail.com

PRACTICE FOR SALE - NEW ROCHELLE, NY

Flexible terms. Stable location, medical co-op, 24 year practice with a stable established patient base. Great opportunity for a self motivated podiatrist wanting immediate income and future stability. Call 551-574-0776 for details.

PM News Classified Ads Reach over 13,500 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 13,500 DPM's. 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.

• 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.