The Voice of Podiatrists

Serving Over 9,800 Podiatrists Daily

September 10, 2007 #3,036 Editor-Barry Block, DPM, JD

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Congratulations to Dino Kyramarios, DPM of St. Charles, MO, our weekly survey contest winner, who has won a Oral-B Professional Care 9100 Triumph by Braun (Value $89). .

Waikoloa Village Resort Hotel, Kona, The Big Island of Hawaii

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NY Podiatrist Disputes Fitness Claim of Flip-Flop Maker

Many people sport flip-flops during warm weather, but did you know they can actually give you a workout when you walk? A new style called 'Fit' Flops have three densities of foam that provide cushion and speed. The makers claim the shoes can tone your buns, hamstrings and calves.

Dr. Suzanne Levine

Foot doctors question how well they work. "What you're really doing is you're walking around with a sandal that just has extra weight on it, so you're going to burn more calories, but it's not going to work out a particular muscle group more than another," Dr. Suzanne Levine, podiatric surgeon, said.

The company has sold 20,000 pairs of fit flops in just two months. They cost $45 a pair and you can only buy them online.

Source: WDAF-TV, Kansas City, (MO) [9/7/07]

“A Silent Tsunami of Diabetic Amputations Are Hitting the Pacific Rim”- Armstrong

Every 30 seconds an amputation is performed somewhere in the world due to diabetes. Growth in this disturbing trend appears to be most acute in the rapidly developing world, most notably the Pacific Rim, reported Professor David G. Armstrong, Director of Scholl's Center for Lower Extremity Ambulatory Research at Rosalind Franklin University of Medicine and Science in Chicago in his plenary address to the Asian Wound Healing Association of Singapore this weekend.

Dr. David G. Armstrong

"Most of the data that we see suggest that, while we are fighting this tidal wave of misery, a difference can indeed be made." Professor Armstrong reported on several recent studies that suggest wide variations in care of the diabetic foot in similar urban area, pointing to the potential for intervention in the specific problem centers. "We need to target failing systems of care like we want to treat failing schools. In all candor, no foot or leg should be left behind."

First Aid Squad Asks Court To Reject Plea Deal Offered to NJ Podiatrist

Ronald Sollitto and Michael Casale, who were indicted by a grand jury on charges of conspiring to steal the estate of former Spring Lake resident Madeleine Stockdale, have been offered a plea deal by the Monmouth County Prosecutor’s Office that would require no jail time. After a two-month trial that ended in May, Dr. Sollitto was acquitted on two lesser charges but the jury deadlocked on the rest of the criminal charges— conspiracy, theft by deception, forgery, falsifying records and neglect of an elderly person, resulting in a mistrial. John Furlong, the attorney for Dr. Sollitto, a podiatrist, is seeking to have the indictment against his client dismissed.

Dr. Ronald Sollitto

William J. Gearty, attorney for the Spring Lake First Aid Squad, has filed a motion that asks Judge Ira E. Kreizman to reject the plea bargain offer for Dr. Sollitto and Mr. Casale by the Monmouth County Prosecutor. According to a letter from Assistant Prosecutor John F. Loughrey to Mr. Gearty, Dr. Sollitto rejected the plea deal.

Dr. Sollitto and Mr. Casale had been charged with manipulating the late Mrs. Stockdale, in the last months of her life, into changing her will to make Dr. Sollitto, 55, the heir to the bulk of her estimated $6 million estate. She sold Dr. Sollitto her home the day she signed a new will — a will which forgave the balance of the mortgage she held for Dr. Sollitto upon her death.

Source: Mikki-Jean Burzon, Manasquan Coast Star & Ocean Star (NJ) [9/7/07]

Senators Want Disclosure of Industry Gifts to Docs

Drugmakers and medical-device manufacturers would be required to disclose how much money they give doctors through direct payments, gifts, honoraria and travel if a group of influential senators has its way. “Right now, the public has no way to know whether a doctor (has) been given money that might affect prescribing habits,” Sen. Chuck Grassley (R-IA), ranking member of the Senate Finance Committee said in a written statement. “Whether it’s dinner at a restaurant or tens of thousands of dollars or more in fees and travel, patients shouldn’t be in the dark about whether their doctors are getting money from drug and device makers.”

Grassley, along with Sen. Herb Kohl (D-WI), chairman of the Special Committee on Aging, have sponsored a bill that would levy fines of up to $100,000 against manufacturers that do not publicly report the payments. The bill is backed by senior Sens. Edward Kennedy (D-MA) and Charles Schumer (D-NY), as well as freshman Sens. Claire McCaskill (D-MO) and Amy Klobuchar (D-MN).

The bill would apply to manufacturers with $100 million or more in gross revenue, and would require HHS to create and maintain a Web site that lists the payment information in an easy-to-understand format. “It has been estimated that the drug industry spends $19 billion annually on marketing to physicians in the form of gifts, lunches, drug samples and sponsorship of education programs,” Kohl said. “But as the largest payer of prescription drug costs, the federal government has an obligation to examine and take action when companies unfairly or illegally attempt to manipulate the market.” –

Source: Matthew DoBias, Modern Healthcare [9/6/07]

Query: Out-of-State Malpractice Claim

How do you handle an out-of -state malpractice claim? I never saw the patient, never treated the patient, was not in the state during the entire time the patient was treated, and I have no Idea who this patient is. The only link I have to this patient is that my ex-partner used an old form in the chart with my name on it. At the time the patient was being treated by my ex-partner, I did not have malpractice coverage because I was opening up a new practice and wasn't seeing patients. The plaintiff’s attorney wants $2,000 to let out of the suit, and all the Florida lawyers I called want $2,500+ to defend it. Is there anything else that can be done? It feels like extortion.

Randy Bernstein, DPM, Dearborn Heights, MI

Editor’s comment: PM News does not provide legal advice. It is customary for a plaintiff’s attorney to name anyone (and everyone) on a chart or an operative report. It costs the lawyer very little, and prevents any statute of limitations problem which could arise later. Generally, incidental defendants such as yourself are eventually dismissed from these suits. The problem is that if you do not put in an answer, you risk a default judgment against you.

Paying $2,000 to the plaintiff’s lawyer is also problematic, because unless a release is properly drafted, you could wind up with a reportable settlement on your record. Hiring an attorney to represent you is usually the best option.

RE: Low Medicaid Payments
From: Gregory B. Nellis DPM

The article about physicians getting over $20 for a Medicaid visit inspires me to ask a lot of questions: Does anyone outside of New York realize the abuse podiatry is taking in New York? We are excluded from the Medicaid program except for special article clinics. There is no private office coverage (except for children who get a physician referral). Even if there were, the fee schedule was supposedly created in 1967, and the visits are much lower than $10, not $20. The Medicare/Medicaid dual-eligibles are "covered", but we are ordered to write-off 80% of the Medicaid part. This is despite the fact that it would be illegal to routinely do the same for any other circumstance.

And the killer is that nobody seems to put up a fight. The state podiatry society, and even the state medical society never mention any fight to get the full dual-eligible payment back.

So in light of all the above, I would like to know if there is any financial benefit whatsoever to Medicaid calling us physicians. I do not understand how our profession can be so stomped on, and why getting anybody to care seems so hopeless. Our efforts go to expanded scope, and physician labels, and meanwhile we are going broke from lack of payment and/or coverage for our skills and hard work.

Gregory B. Nellis, DPM, Gloversville, NY, gbndpm@yahoo.com

RE: Implant Removal (Bruce Lebowitz, DPM)
From: Multiple Respondents

I have had experience removing a Biopro implant. It was actually quite easy – was able to use a periosteal elevator to free the implant from the base of the phalanx and it slipped right out. Removing it will not be the problem. With the x-rays submitted, follow-up with such a short first ray will be the difficult problem.

David M Davidson, DPM, Buffalo, NY, ddavidson7@verizon.net

I have had to remove two of these in the last two months. They were implanted by different surgeons. I found using a freer/elevator worked quite easily. I, too, had trepidation about how to remove these serrated implants, but because of the pathology surrounding them, they were quite easy to remove. If you suspect osteomyelitis, I would be especially careful with the cortical bone of the proximal phalanx.

William T. Vondette, DPM, Alma, MI, freelandfootclinic@sbcglobal.net

While I don't have an answer for this, I think the take home message is to always have a disaster plan for everything you do, especially surgery. When I want to use a new product, I always have a sit-down with a company rep. When it comes to surgical hardware and implants, I always discuss the complications of removal, should I ever have to. I do a handful of Biopro hemi great toe implants each year and I can say that I have never had to remove one. I always use the non-porous coated stems, rather than the porous coated issue we are dealing with in this query, and I have never had any problems with proper seating at any time post-op by using the smooth stems. I don't see the reason to use the porous coated ones at all. The stem distally and opposing metatarsal head proximally should hold things in place just fine.

Marc Greenberg, DPM, Dayton, OH, tripperdpm@yahoo.com

IN-NETWORK PODIATRIST WANTED – MANHATTAN

Busy Manhattan Office (2 locations) needs IN-NETWORK PODIATRIST, Can start immediately-Do not reply unless you are in with all plans Plz respond to gelus07@yahoo.com

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City. Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

INDEPENDENT CONTRACTOR WANTED - KANSAS CITY, MO

Immediate opening for podiatrist as independent contractor. Flexible schedule. All phases of podiatry. Knowledgeable and dedicated support staff. Must be compassionate and personable physician with good podiatric skills. Wonderful place to live and work. Please email CV and letter of interest to: Dr.Fine@FineFootCareCenter.com

PODIATRY ASSOCIATE WANTED – YONKERS, NY - ASAP

P/T-3 days per week for busy Yonkers and White Plains location-
Surgical training a plus, but not mandatory. Please fax resume to 9149939031 or call 914 325-9198 for more details.

ASSOCIATE POSITION SANTA FE, NEW MEXICO

Immediate opening for PSR 24/36 individual in three office practice. We are looking for an ethical, hard working, well trained Podiatrist. Partnership available. Please Fax CV to sfpodiatry@aol.com

ASSOCIATE POSITION – LOUISVILLE, KY

Immediate opening for multi-office podiatric practice specializing in general podiatry, high volume orthotics, surgery, and advanced wound care. Looking for a motivated, surgically trained podiatrist. Partnership opportunity. Competitive starting salary, benefits, and pension. Please submit: CV, letter of intent and references to: jbroyles23@yahoo.com

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