The Voice of Podiatrists

Serving Over 14,601 Podiatrists Daily

August 24, 2013 #4,857 Publisher-Barry Block, DPM, JD

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Congratulations to Dock Dockery, DPM of Seattle, WA, winner of a Fossil Men's Watch (Value - $95). We encourage you to participate in this year's important annual survey at podiatrym.com/survey Completing this anonymous survey provides us with valuable data, which we will publish in the February 2014 issue of Podiatry Management. It also makes you eligible to win thousands of dollars of valuable prizes. Enter by completing this confidential survey. The earlier you enter, the more chances you have to win. Please complete the entire survey.

The Boulders Resort

This week's prize is a Three Days/Two Nights stay in a Deluxe Casita at  the Boulders Resort (A Waldorf Astoria Collection) in Arizona plus Two Rounds of Golf for Two at the Boulders Club (Value $522).

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

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Quick Poll
What percentage of your patient encounters are for the following conditions ?
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CA Podiatrist Discusses Bunion Surgery

"The most important advice I can give patients with bunions (and other conditions of the foot) is to seek treatment in their earliest stages," said Los Angeles podiatrist Dr. Kamran Jamshidinia. "Bunions progress over time, and the longer a patient waits to start treatment, the more likely that surgery will be needed to correct it."

Dr. Kamran Jamshidinia

Dr. Jamshidinia also advises patients to make sure they can take time off from work or other daily activities to ensure the most successful recovery from bunion surgery.

Source: Digital Journal [8/22/13]

UK Podiatrist Uses Laser to Treat Onychomycotic Nails

“Many of the patients we see are embarrassed to show their toes in public and have lost all hope of getting rid of their toenail fungal infection,” said Fiona Patterson, a partner and podiatrist at Beauchamp Foot Care.

Fiona Patterson

“The toenail fungus laser treatment we offer has some excellent benefits and can help sufferers get rid of their toenail fungus completely.” The treatment is fast, safe, and shows impressive results for patients.

Query: Pain, Plantar Right Met Head

A 37 year old female patient presented with a complaint of pain plantar 1st right met head after utilizing an elliptical machine. She wears appropriate sneakers and has orthoses with a 1st ray cut-out. Approximately 2 years ago, she suffered an injury which caused complete resorption of the tibial sesamoid. She is fully functional and pain-free in all other aspects of activity other than the elliptical which she may be over-utilizing. There are no underlying medical issues.

I suspect the imbalance is due to the absent sesamoid and would be interested to hear of possible solutions - biomechanical or otherwise. Previous injection of cortisone worked well for a short period of time (2 months),  but I do not like to give multiple injections in this area.

Charles F. Ross, DPM, Pittsfield, MA

Query: Compensation for Deposition

I have been asked to perform a deposition for a patient that is suing her former employer. How much is a reasonable compensation for my time?
 
Mario Dickens, DPM  Chattanooga, TN

Editor's comment: PM News does not provide legal advice. Compensation should be approximately equal to the amount of money you would  earn in your practice in the time allotted for the deposition. Recent reported amounts range from $350-$600 per hour. Be sure to secure a retainer in advance, as many of these cases are settled just prior to your scheduled appearance.

Query: Diabetic Shoe Dispensing

One of the most common denials for my diabetic shoe dispensing is criteria 3 (indication of an in-person visit by the certifying physician during which diabetes management is addressed within 6 months prior to delivery of shoes/inserts). For this criteria, I submit a note stating the criteria that is met on physical exam of this patient and have myself and the patient's MD/DO sign it. A copy is kept in both our files. For some reason, this does not seem to fulfill the criteria. Does anybody  have  any other ideas to fulfill this criteria?

Charles Baik, DPM, Tustin, CA

Response: At the present time, the only way to satisfy the LCD's requirement to document that patients have diabetes is to actually submit a copy of the MD/DO's chart note which illustrates that the patient is under a comprehensive plan of care for diabetes (e.g., the medical records could include medications, labs, diet orders, etc.).

Paul Kesselman, DPM, Woodside, NY 

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RE: Traumatized Hallux Nail in 9 Year Old (David E. Gurvis, DPM)
From: Dan Klein, DPM

Unfortunately, when a heavy object drops on a toe involving the toenail, permanent soft tissue changes will occur. In this case, a young person's toe was involved with apparent soft tissue changes. I believe these changes are permanent, but over time as this person grows, the changes will become less obvious. With regard to the toenail, the growth plate may also have been permanently damaged, producing a permanent change. The analogy I have used in practice is to compare the trauma with a bowling ball dropping on a tomato. The tomato will never look the same.

Dan Klein, DPM, Fort Smith, AR, toefixer@aol.com

RE: Wart Treatments (Dusty McCourt, DPM)
From: Paul Kesselman, DPM

Over the last few years, I have stopped almost all surgical and office-based chemical care for verrucae (even mosaic). If a few treatments of OTC chemcals fail to make any headway, I send the patient to the pharmacy with an Rx for 1 ml of Candida antigen. The cost is ~$125 and will last approximately ten treatments. The candida is mixed 0.1 cc, with an equal amount of lidocaine (with or without epi) and I inject this directly into the verrucae. As this may be painful, the area must first be anesthetized with lidocaine/epinephrine.

With mosaic verrucae, I choose the largest "mother" wart. The treated area is re-evaluated every two to three weeks. I have rarely had to inject a verruca more than three times. Your patients (and you) will be amazed at the results. Two little known articles can be read on this subject and may be found online at: altoonafp.org/full.htm and podiatryinstitute.com/pdfs/Update_2012/2012_05.pdf

Prior to embarking on this regimen, one should obtain a good medical history and be sure your patient has no history of yeast sensitivities or previous fungal infections.

Paul Kesselman, DPM, Woodside NY, drkesselmandpm1@hotmail.com

RE: Unmatched Residency Placements Currently Stand at 80
From: Ron Raducanu, DPM

I wrote a blog about this which was largely ignored. What I proposed was that we re-instate the one-year residencies run by those in practice who can offer a "real" podiatry experience (including office and hospital work, as well as surgical exposure) and have it initially funded by the APMA. The APMA has a $10M "emergency fund", and I believe this would qualify.

Yes, graduates can practice in select states without a residency, but that's not really the point. Make these one-year "programs" only available to those who didn't match. This will give them the one year needed to attain a license and earn money in most states.

They got through the curriculum. They deserve to at least make a living, pay back their student loans, and feed their families, maybe even prosper beyond what some of us can imagine. Give them the chance at least.

Ron Raducanu, DPM, Philadelphia, PA, kidsfeet@gmail.com

RE: I Want to Work as a Podiatrist (Sarah Montgomery, DPM)
From: William Deutsch, DPM

How is this situation different from any other scam?  Enroll into a school to get a degree, then find you can't get a license or insurance because the implied continuation of that education, a preposterous three year residency requirement, is illusory. The length of the residency is preposterous for performing most of what podiatry care comprises.

The 3-year residency requirement has become an educational, but more a political solution to counter the lack of acceptance by allopathic medicine. But does any podiatrist really think an orthopedist is...

Editor's note: Dr. Deutsch's extended-length letter can be read here.

RE: I Want to Work as a Podiatrist (Sarah Montgomery, DPM)
From: Brian Kiel, DPM

I write this opinion with great hesitation, but I think it must be said. The letter from "Sarah", who has been trying to get a residency since 2010 was quite depressing in several ways. Obviously, it is sad that someone has put in the time, effort, and expense to attain a DPM degree and is unable to use it. It is also very sad that she is not an isolated case. However, there is another issue that must be faced. Perhaps being a podiatrist is not the right profession.

I have to question what is the issue when someone cannot get a position after 3 years of...

Editor's note: Dr. Kiel's extended-length letter can be read here.

RE: Human Feet Still Built for Life in Trees, Like Our Ape Relatives
From: Brian Lee, DPM

Ape relatives? Really? I didn't realize that old school of thought was still getting traction. All the supposed "missing links" and bones discovered over the years have all turned out to be either actual primates (not transitional forms) or outright falsifications. Someday maybe, the scientific community will catch up to the Bible which says, each were created according to "its kind".

Brian Lee, DPM, Mt. Vernon, IL, sifootcare@charter.net

ASSOCIATE POSITION - PENNSYLVANIA

Associate Wanted for busy, multifaceted podiatry practice in Chester and Delaware counties, Pennsylvania. Seeking PSR-24/36 trained podiatrist for full/part time associate position. Two offices and hospital privileges. Send CV and letter to: 123bunion@gmail.com

 ASSOCIATE POSITION - CENTRAL PA

Looking for an associate with 3-year surgical residency. The physician will provide all aspects of podiatric practice, including sports medicine, wound care, and foot and ankle surgery. Competitive compensation package. Partnership opportunity for right person. To apply, please email, letter of intent and CV to stringernyc@hotmail.com

ASSOCIATE POSITION - PLAINFIELD, IL 

Associate wanted for established practice in the suburbs of Chicago, self motivated and patient oriented a must. We will provide you with a state of the art facility, experienced support staff, $100,000+ salary, 401K with match, bonus and flexible hours. Please forward cover letter and CV to chrisbaileydpm@sbcglobal.net or fax 815-230-4925.

PODIATRIST WANTED - LONG ISLAND, NY

Busy Nassau County NY office, experienced in all phases of podiatry, preferably board certified, excellent salary, email CV to jobke@aol.com

ASSOCIATE POSITION - DAYTON, OHIO

Join an established group practice in Dayton, Ohio excellent reputation, large referral base.  Base Salary$120,000, benefits and bonus structure. EMR;diagnostic ultrasound; Padnet; CO2 and Cutera Laser for nails, all aspects of DME. We need well trained personable PSR24/36 surgeon. Future Buy-in available. Please send CV to Ohiomedical@aol.com

ASSOCIATE POSITION - NYC METRO AREA

Must participate with HealthFirst, Affinity, Fidelis health plans (2 of 3 OK). Preferably on staff at Bronx or Manhattan hospitals or surgicenters. Excellent opportunity for quick partnership. email CV torrranch7@yahoo.com 

ASSOCIATE POSITION - CENTRAL FLORIDA

Busy two doctor practice seeking the help of an ambitious associate to help handle the patient load. Position will lead to partnership for the right individual. Two office practice with hospital, surgery center and wound care center privileges. Good mix of surgery, wound care and general podiatry. Great salary with incentives, benefits, malpractice. Must have FL license. Suburban setting, close to attractions. Please send cover letter, CV and copy of surgical log to;  footpainbegone@gmail.com.

ASSOCIATE POSITION - CONNECTICUT

Looking for an associate with 3-year residency training for a practice in Connecticut. Interested in all aspects of podiatry including  foot/ankle surgery and wound care. Hospital located close by with appointment to staff readily available. Will lead to partnership Please send CV to:dsharnoff@hotmail.com

ASSOCIATE POSITION - FLORIDA

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. Florida has a great scope of practice law and we rotate for ER call at all 4 hospitals. Candidate needs to be ethical and motivated. Established practitioner or new practitioner OK. Base salary, percentage, benefits including 401K. Fax CV to (239)566-8778 or Email CV to Drgordon@gulfcoastfootcare.com.

ASSOCIATE POSITION - NYC and QUEENS, NY

We need a podiatrist (recent grads. welcome) for participation in NYC and Astoria Queens to learn and treat fungal nails with PinPointe laser. Perfect to pick up money in your spare time. Please respond to hansfeet@aol.com.

ASSOCIATE POSITION - CENTRAL FLORIDA

Associate position for busy practice in Central Florida. Competitive salary with complete benefit package available. Please send resume to cmedders@atlanticpodiatry.com

ASSOCIATE POSITION - CALIFORNIA

Associate wanted for multi-office, multi-doctor practice. Full Time, Self-motivated, highly skilled team player with surgical, wound care and palliative skills. Offices in Northern California Coast, CA License necessary, salary negotiable with possibility of partnership in future. Send CV and letter to:srfctysc@gmail.com

 EQUIPMENT FOR SALE - DIOWAVE 15 WATT, PORTABLE 980 LASER

This is a used multiple function laser, plantar fasciitis, Achilles tendonitis, joint pain. nerve pain, post surgical, warts, toenail  problems, two-year plus warranty, MSRP: $25,000. E mail Dr. Zuckerman at: footcare@comcast.net for questions and pricing.

EQUIPMENT FOR SALE - Q-CLEAR LASER

Brand new Light Age Q-Clear laser. This is a very unique one time opportunity. Recent special purchase permits sale of only a few units at the largest discount available. Rapid return on investment. Complete system with warranty and expert training included. Contact Dr. Holfinger at 216-390-9757.

PRACTICE FOR SALE - STAMFORD, CONNECTICUT

Well rounded general and surgical podiatry practice in beautiful Stamford, CT. 35 years. Walk to the hospital and OR. $350k gross / 4 days per week. May lease present office space. Super office manager. Practice offered @ $100k. jefre1@msn.com

PRACTICE FOR SALE - CONNECTICUT

Well-established, 35-year-old reputable practice/condo with approx 2,500 Square ft. Grossing approximately $450,000. Outside Hartford area. All phases of podiatry. Contact drsch52@hotmail.com

PRACTICE FOR SALE - MAINE

30 year, full service practice in Bangor, Maine. Cooperative and appreciative patients. A wonderful community to practice in and recreate during your free time. Owner is semi-retired, now ready to fully retire but will stay for transition. mainefootdoc@yahoo.com.

PRACTICE FOR SALE - QUEENS, NY

37 year practice.  7 years left on lease (transferable) - includes utilities. High traffic location, right near subway.  Selling practice as-is. 3 treatment rooms with chairs and x-ray equipment. Looking for quick sale. Price negotiable. Contact josh.block@gmail.com

PRACTICE FOR SALE - HUNTINGTON PARK, CA

46 years same location. Unsurpassed visibility on corner of major intersection. 3 fully equipped treatment rooms. Perfect opportunity to build a strong practice. Must retire due to age. Selling price $30,000 firm. (323) 588-1179 MTWF. evaonofre@hotmail.com

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

BUSINESS FOR SALE - TOE-FOOD CHOCOLATES & CANDY

Toe-Food Chocolates & Candy (www.toefood.com ) is an established candy company specializing in creative foot-themed chocolates that has supported the podiatric community for over 30 years. Ideal opportunity for family member to run in house. Serious inquiries only please. Email:   MwolpaFootDoc@yahoo.com

PM News Classified Ads Reach over 14,500 DPMs 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 14,500 DPMs. for details, click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $119 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.

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