The Voice of Podiatrists

September 12, 2006 #2,687 Editor-Barry Block, DPM, JD

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Ann Rotramel, DPM

Dr. Ann Rotramel

Dr. Rotramel of Saint Peter, MN died last week at the age of 97. Dr. Totramel was a radiology tech for 30 years before going to podiatry (chiropody) school in Chicago. She graduated in the class of 1948. She was very involved in the politics of podiatry, and was instrumental in the effort to include podiatrists in the Prescription Drug Law and Blue Cross Insurance.

Dr. Rotramel was the first woman member of the American College of Foot and Ankle Surgeons. In 2003, she was honored by the Minnesota Podiatric Medical Association for her lifetime of achievements.

PM News policy is to request that memorial donations be made to the APMA Educational Foundation Student Endowment Fund, 9312 Old Georgetown Road, Bethesda, MD 20814.

For Shoes, Women Still Choose Fashion Over Comfort: AL Podiatrist

"A lot of the women's shoes are not made for comfort - they're made for pure fashion," said Dr. John Roberson Jr., a podiatrist at Birmingham Podiatry. He once operated on a woman's hammertoe most likely caused by shoes that squeezed her toes. When she came back to the office for a post-surgical check-up, she walked in on stiletto heels and pointy-toed shoes. She shrugged off his advice, saying she had to go with what looked good.

Dr. John Roberson Jr.,

That's nothing new to Roberson, who said some women tell him they have to wear heels for their jobs. "I see women that are working on these marble floors all day and wearing those high, high heels," he said. Stiletto heels pose the most problems because they don't provide stability for the foot. Foot sprains and fractures are common in those type shoes, Roberson said.

Another culprit in women's shoe fashion is a tightly fitting toe box. "Anything that goes into a triangle at the end is going to cause a problem," Roberson said.

Source: Anna Velasco, The Birmingham News, [9/11/06]

Medicare Costs to Rise for Wealthier People

Higher-income people will have to pay higher Medicare premiums than other beneficiaries next year, as the government takes a small but significant step to help the program remain viable over the long term. The surcharge is a major departure from the traditional arrangement under which seniors have generally paid the same premium. It is expected to affect 1 million to 2 million beneficiaries: individuals with incomes exceeding $80,000 and married couples with more than $160,000 of income. For individuals with incomes over $200,000, the premium, now $88.50 a month, is expected to quadruple by 2009.

Source: Robert Pear, New York Times[ 9/11/06]

Query: Profit-Sharing in Large Podiatry Practices

I was wondering if anyone could explain how profits and overhead are usually shared between partners in large multi-practitioner practices. It's obviously easier when all partners are equal and work a similar amount of time and produce similarly, but I would assume in these large practices some partners may be more equal than others and there may be several layers of associates.

Arden Smith, DPM, Maspeth, NY, digitiquinti@aol.com

RE: Best Mixture for Spider Veins?
From: Michael McCormick DPM, Eugene A. Batelli, DPM

There is no one "best" mixture for spider vein or varicose vein therapy. I have solutions made up for use that range from 0.1% to 3% STS. The use will depend on the diameter of the veins, the type (reticular, telangiectases, spider, varicose).

Be very careful with the use of hypertonic saline as extravascular injection will cause ulcerations that take a long time to heal and can leave a hypopigmented scar. Polidoconol is no longer available or FDA-approved and medico-legally should not be used.

It's not hard to make a condition worse with sclerotherapy if there is underlying superficial insufficiency. If there is any bulging present in the vein segments in question then you are obligated to determine the underlying status through duplex ultrasonography and deal with any insufficiency through endovascular procedures or ultrasound guided compression sclerotherapy.

I highly recommend at least a basic course of study or textbook review before embarking on what is actually a far more complex subject matter than appears.

Michael McCormick, DPM, Venice, FL, mmccormick@cyberstreet.com

I have received a few e-mails asking for information where i learned how to sclerose spider veins. The International Aesthetic Foot Society does a very nice class and they are very podiatry friendly. The American College of Phlebology also does a good job. As far as references, I use a book entitled Sclerotherapy by Goldman and Bergan. I purchased it from the Podiatry Institute at one of the conferences. This book gives great protocols, techniques, consent forms, and post-op instructions.

Eugene A. Batelli, DPM, Naples, FL, ebatelli2001@yahoo.com

EQUIPMENT WANTED - X-RAY Machine

I am looking for a used x-ray unit, preferably no older than 15 years. EXCEL units or units of this type are appropriate for my needs. If you have a unit, with or without the stand, please e'mail a picture and relevant information to me at drkarendpm@aol.com I can also be reached at 619-892-3549. Shipping would be to Southern CA.

ASSOCIATE POSITION – NEW ENGLAND

Opportunity in growing New England practice. Well established and respected practice with large office and surgicenter, latest technology, great staff, loyal patients and solid referral base. Close proximity to hospitals, full scope practice. Opportunity for partnership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and contact info to: Footdoc-office@usa.net

ASSOCIATE WANTED - SOUTH FLORIDA

Miami-Dade and SW Ft. Lauderdale, well established surgical practice needs part-time podiatrists to assist in surgical cases and patient volume. Email response to podfootdocs@aol.com

PRACTICE FOR SALE/ASSOCIATE/PARTNERSHIP - WASHINGTON, DC

A 26 year old practice for sale in hospital's attached medical building. Fully equipped. All aspects of podiatric medicine;surgery. Large diabetic practice with wound care clinic. Large referral base with loyal patients. Charcot, forefoot, rearfoot, orthopedics. Residency required for privileges. Moving but will stay for transition. Associateship until purchase. Will finance sale with adequate down-payment. Serious inquires only. Contact scottr0666@yahoo.com

ASSOCIATE POSITION IN TEXAS, DFW AREA

PSR-24 trained podiatrist seeking a FT associate position with possibility of future partnership. Trained in all aspects of podiatric medicine including forefoot and rearfoot surgery, and diabetic limb salvage. Email: fixfeet@hotmail.com

ASSOCIATE POSITION-INDEPENDENT CONTRACTOR – FLORIDA

Florida License / Medicare and Medicaid numbers in effect and active. High income potential for hard working, ethical and honest DPM great for semi-retired. Transportation a must. FAX CV or Resume to 1-727-785-4697.

HOUSE CALL PRACTICE FOR SALE – SOUTHERN CALIFORNIA

House Call practice for sale which includes approx. 400 patients and continued referrals. Perfect for solo practitioner. Extremely easy and profitable practice to run. Yearly gross of over $200K. Current DPM is retiring. Financials will also be provided. Please contact ccipinc@ccipinc.net

ASSOCIATE POSITION - NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

PRACTICE FOR SALE – SOUTHERN INDIANA

Established, respected solo podiatry practice immediately available in scenic southern Indiana. Fully equipped attractive building conveniently located on an active corner with great staff, loyal patients and excellent referral base. Includes relationships with local assisted living and nursing homes. Practice and building available for $200,000. Serious inquiries preferred e-mail to: dhall@cmbuck.com

PRACTICE FOR SALE - BERKELEY CALIFORNIA

Well-established office in professional medical building; Biomechanics, Geriatrics and General Podiatry; Excellent growth potential for surgery; Payor base MC, PPO, and self-pay (NO HMOs); Reliable referrals from local physicians; Electronic billing in-house; Transition terms negotiable. Send letter of intent to: foot4sale@sbcglobal.net

ASSOCIATE POSITION - AUSTIN TX MOBILE PRACTICE

Full or part-time; Texas license. Fine working conditions with excellent support staff and pay. Mobile podiatry clinic and House calls. http://www.footmobile.com Fax CV 210.495.6484

ASSOCIATE POSITON - SOUTHEAST TENNESSEE/ NORTH GEORGIA

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

ASSOCIATE POSITION – NEW ENGLAND

Opportunity in growing New England practice. Well established and respected practice with large office and surgicenter, latest technology, great staff, loyal patients and solid referral base. Close proximity to hospitals, full scope practice. Opportunity for partnership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and contact info to: footdoc@usa.net

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