The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

August 26, 2008 #3,333 Editor-Barry Block, DPM, JD

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FL Podiatrist Dispels Some Common Foot Health Myths

According to the American Podiatric Medical Association, three out of four Americans experience serious foot problems in their lifetimes. "From the time we spend on our feet to the shoes we wear to hereditary and medical issues, all of these can impact our feet," said Dr. Jacqueline Brill, a podiatrist on Miami Beach. In the search for relief, Brill said many consumers look to products with big promises. "I'm stunned sometimes by the claims," Brill said.

Dr. Jacqueline Brill

A popular product called Yoga Toes promises to ease tired feet and eliminate bunions. "There is nothing, not even the old bunion splints, that can change this toe deformity," Brill said. She added that using Yoga Toes would be a good way to stretch out tired feet. "They will relax the toes, which is nice at the end of a long day," Brill said. Another product called "Kinoki Foot Pads" didn't score any points with Brill. Wearing the foot pads overnight is supposed to cleanse the body of toxins. "This is patently absurd," Brill said. "The liver cleanses the body, not the skin."

Brill said consumers need to buy with a skeptical eye and should disregard some common foot-care myths. "It's a myth that shaving calluses makes them grow back faster or thicker," Brill said. "Reducing calluses, as long as you don't go too far, is actually good for your feet."

Source: WPLG-ABC Local10.com - Miami and Fort Lauderdale (FL) [8/22/08]

MD Podiatrist Collects Shoes for Children of Darfur

Sixty-four years ago, podiatrist Alex Kor’s Mother Eva Mozes Kor arrived at the Auschwitz-Birkenau Nazi death camp, a prisoner and subject of Dr. Mengele’s infamous experiments on twins. Within four months, the shoes she arrived in had fallen apart from walking the vast grounds of the camp where so many of her fellow Jewish prisoners perished in the Nazi genocide.

In 1984, Kor founded CANDLES, an organization dedicated to preserving the memory of the Mengele Twins. In that same year, a nine-year-old boy in Nigeria was given a pair of shoes by an American tourist. It was the first pair of shoes Manny Ohonme had ever owned in his life. That gift would eventually provide the way for Manny to come to America on a basketball scholarship.

Now, Kor and Ohonme are teaming up to help collect 1 million pairs of shoes for impoverished children in the war-torn Darfur region of Sudan. The memorial shoes will be worn by children in Darfur, many of whom have faced the deaths of family members as the government of Sudan wages genocide against them. Kor’s son Alex, a podiatrist in Washington, DC, appeared at the press conference on August 23, along with his father Michael Kor, also a Holocaust survivor.

Source: Provocate.org [8/23/08]

OIG Claims That CMS’s Fraud Savings are “Misleading”

CMS's assertions in 2006 that it reduced the number of fraudulent and improper claims, saving billions, were "misleading," according to a draft HHS Office of Inspector General (OIG) report obtained by The New York Times. "In calculating the agency's rate of improper payments, Medicare officials told outside auditors to ignore government policies that would have accurately measured fraud,"

The Times reported Aug. 21. More than a third of spending on medical equipment — or about $2.8 billion — was improper, says the newspaper, citing other Medicare reports. CMS officials told The Times that they agree with OIG's findings, but that the $2.8 billion figure is "unsupportable." The report is expected to be made public this week.

Source: Report On Medicare Compliance [8/25/08].

Faux Pas Fixer

Here's an awkward situation: You sent in an RSVP to a formal event, but to your chagrin, you forgot about the event and failed to attend.

Short-term remedy: As soon as you realize your mistake, call the host to express your sincere regret. Follow up by sending a gift, such as flowers, along with a note expressing your disappointment about missing the event.

Long-term fix: You probably need a better system of keeping track of your commitments.

Source: Adapted from One Minute Manners by Ann Marie Sabath.

Query: Course on Manipulation Prior to Casting

I've been to a lot of conferences over the years and I have yet to see a conference that teaches foot manipulation prior to casting. I have seen Dr. Dananberg give a few informal demonstrations at the annual PFOLA meeting. There is no lack of interest from what I've been able to tell. I would appreciate if Dr. Dananberg would comment on this and then be kind enough to post some resources (conferences, workshops, pertinent literature) where we can go learn this procedure.

James M. Petko, DPM, Falls Church, VA

RE: Standard of Care Soft Tissue Masses (Judd Davis, DPM)
From: Bryan C. Markinson, DPM

The discussion surrounding the care of soft tissue masses since the report of a low grade fibrosarcoma on this listerv raises appropriate concerns and rightly recommends involvement of a musculoskeletal oncologist. However, a very important point is being missed, and it is the most important one. The complete removal of a soft tissue mass of uncertain diagnosis that leads to a biopsy report of a malignancy that was unexpected is practice below the level of standard. It’s not the podiatric standard, it’s the oncology standard that applies. If you are dealing with a plantar fibroma, or ganglion, or neuroma, I would agree and say that there ARE consistent enough signal characteristics on MRI of these lesions to remove them. ALL OTHER LESIONS REQUIRE OPEN INCISIONAL BIOPSY WITH FROZEN SECTION DIAGNOSIS AFTER PLAIN FILMS AND MRI WITH CONTRAST HAS BEEN DONE. For a full explanation of this, please refer to the February, 2007 Podiatry Management article entitled "So You Want to Be a Tumor Surgeon." I would be happy to send a .pdf version of it to anyone that asks.

Lastly, it does not matter what podiatry school you went to, or how many years of residency you did, or how many trips to Russia you have made. You are not sufficiently trained in the management of soft tissue tumors. The same is true for most orthopedic surgeons, vascular and general surgeons. There are only a handful of musculoskeletal oncology surgeons in the country.

Except for the lesions I mentioned above, our involvement should be over when one of two things occur: 1) When the pathologist gives you a benign frozen section diagnosis and you go on to remove the entire lesion. 2) When the pathologist tells you that you have a malignancy, you leave the tumor where it is, close the skin and make the appropriate referral. These procedures should never be done in an office, except when the diagnostic procedure is a trocar-type needle biopsy.

Bryan C. Markinson, DPM, NY, NY, Bryan.Markinson@mountsinai.org

RE: Staff Vacation Time (Scott Werter, DPM)
From: Lynn Homisak, PRT

The fact that you put this question “out there” will result in your getting a lot of different opinions from individuals based on their own circumstances and experiences. That’s fine – but keep an open mind. What may work well for one does not necessarily work well for another and it is impractical to assume that there is one nationwide cookie cutter solution to suit everyone. Also, I would warn you not to fall in the trap of generalizing employees desires, for their needs and wants are as different and individual as they are. In truth, only YOU can answer your question and to determine what works best in your case, I suggest initiating open discussion with your staff and consider setting policy with their input. We craft many office manuals and when it comes to addressing time off benefits, each one varies to meet the needs of that particular group. We work with each office as a team.

One model that we recommend offers a progressive type plan – with a monthly accrual that increases with their years of service, for example…

Editor's note: the complete text of this extended-length letter appears at: http://www.podiatrym.com/letters2.cfm?id=21525&start=1

Lynn Homisak, PRT, SOS Healthcare Management Solutions, LLC, LynnPRT@msn.com

ASSOCIATE POSITION - WV/KY

Huntington WV - Ashland KY area Associate wanted leading to partnership; All aspects of podiatry. No bank loan necessary for buy-in you earn it via equity Nice salary with incentives, Great oppurtunity for an established practioner looking to relocate or Residency graduate, The support structure is intact Respond to GreatTeaysPodiatry@google.com

ASSOCIATE POSITION - NORTH TX

North Texas practice looking for motivated, hardworking, personable individual with minimum PSR/24 training. The practice has been well-established in the community for over 20 years. Our practice offers a large self owned office, State-of-the-Art Surgery Center, excellent hospital involvement, and competitive salary with profit sharing. Send CV with references to info@ntfootcare.com, or fax to 903 868-2975.

MINNESOTA - IMMEDIATE OPENING

Well-established practice with 8 offices in the Minneapolis metro area seeking a highly motivated PSR 24/36 trained podiatrist for a full time or part time associate position. ABPS certified, qualified or eligible preferred. Excellent income potential with benefits including health insurance, malpractice insurance, relocation expense, association dues, license fees, hospital dues, continuing education expense. Possible buy-in or buy-out in future. Heavy emphasis on surgery and sports medicine with minimal RFC. Please e-mail CV to footandankledoc22@hotmail.com

PRACTICE FOR SALE - MINNESOTA

Minnesota-2 well established prime office locations for sale in the Minneapolis suburbs. Great income potential with large MD referral base .Can purchase one or both offices together. 175k gross/ each office. Owner will help with transition. Please e-mail minnesotadpm@live.com

EQUIPMENT FOR SALE - DOPPLERS

Selling 2 brand new Dopplers by Hadeco. 1 Hadeco Smartdop-30EX and 1 Hadeco Smartdop-45 Dopplers. Both come with their default accessories included, have never been used and are fully functional. Please email alinka345@gmail.com all inquiries.

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

ASSOCIATE POSITION AVAILABLE- NEW YORK

Full-time associate position in our well-established Midtown Manhattan and Forest Hills practices. Well-rounded practice with hospital based surgery and all phases of podiatric care. We are seeking PSR 24/36 trained podiatrist with good surgical background. Compensation to also include malpractice expenses. Forward CV to slurie@papapc.net or Fax to # 212-753-3521

ASSOCIATE POSITION – ILLINOIS

Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings available. If interested fax curriculum vitae to 312 225-9366 or e-mail feetwork@aol.com

IMMEDIATE POSITION AVAILABLE TN/GA

We're in search of a motivated, well-trained DPM who is great with patients. Our well-established multi-doctor, multi-office practice is located in Southeast Tennessee/North Georgia. Must have Tennessee or Georgia license. Please reply via email to ikraus@sprynet.com

ASSOCIATE POSITION - BOSTON, MA

Associate wanted, Full-time or part-time, for busy long time, well established, and well rounded practice. Good mix of general podiatry and surgery. Office will generate approximately 100+ surgical cases per year. Must have surgical background for this practice, ABPS Qualified minimum needed to obtain hospital privileges. Associate position is open for partnership or purchase. Contact robert.nunberg@comcast.net

Christie Clinic is a large Multi-Specialty Group practice located in Champaign, Illinois. We are seeking a PSR-36 ABPS Board Certified or Board Eligible podiatrist to join a well-established Podiatry department. Must be competent in all phases of podiatric care, Surgical and Conservative. This position will involve rotating through multiple office locations with surgical privileges available at two medical centers and two outpatient surgery centers. Very competitive salary, bonus plan, vacation, and health/mp insurances. Forward CV to wpierce@chrisiteclinic.com

ASSOCIATE POSITION - WEST CENTRAL MN

Associateship possibly leading to equity ownership. Compensation package of $100,000. Option for partnership or purchase as soon as associate feels ready. 260 402-7490.

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