The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

September 16, 2010 #3,959 Publisher-Barry Block, DPM, JD

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'Footmapping' is All About Cushioning, Not Actual Support: IL Podiatrist

We asked Dr. Megan Leahy, a podiatrist practicing in Chicago and a spokesperson for the American Podiatric Medical Association, if Dr. Scholl's "Revolutionary Footmapping Technology" was the real deal.  "As a baseline for a foot type, it's an okay place to start," Leahy said. "The concept is good, but I don't think it can substitute for a visit to a podiatrist if you actually have pain or an issue you're concerned about."

Dr. Megan Leahy

Also, although the Scholl's machine provides only a two-dimensional representation of your feet, it purports to recommend a custom orthotic. True custom-fit orthotics are derived from a three-dimensional representation of a person's foot. That said, for those suffering from foot pain, the basic premise of Dr. Scholl's orthotic recommendations isn't a bad thing. "Everyone can benefit from a little more shock absorption," Leahy said. "Just so you realizing that you're talking about cushioning rather than support."

Source: Carol Slezak, Chicago Sun-Times [9/15/10]

Podiatrists Often First to Diagnose Diabetes, Hypertension, and Heart Disease 

Dr. Kathleen Stone

Often, the first doctor to diagnose someone with diabetes, high blood pressure or heart disease is a podiatrist. "That's because these conditions often show up in the feet first," explains American Podiatric Medical Association (APMA) president, Dr. Kathleen Stone.

Source: Imperial Valley News [9/15/10]

Feet are an Ideal Place to Start Massages: NY Podiatrist 

The best massages are the totally selfless ones. Start with her feet. "When  women wear high heels, they feel a lot more pain in the balls of the foot," says podiatrist Andrew Shapiro, DPM.

Dr. Andrew Shapiro

Ask where she's feeling the most tenderness and and start there. If the arch stings, move up and down in a straight line. She'll be putty in your hands.

Source: Men's Health [September 2010]

Health Insurance Costs Employees More, But Covers Less

Employees this year are facing double-digit increases in health insurance premiums, even though overall premiums increased modestly, 3% for family coverage and 5% for single coverage, according to an annual employer health benefits survey released Sept. 2.

On average, workers in 2010 are paying 14% more than they paid for 2009 employer-sponsored family health insurance premiums. That pushes the average family premium to $3,997 this year, according to the 2010 Employer Health Benefits Survey, released by the Kaiser Family Foundation and the Health Research & Educational Trust. Employees' average cost for single coverage grew by 15% to reach $899.

Source: Doug Trapp, AMNews [9/13/10]

Read to Remember

Improve your memory for written material with this tip: Put off reading important material. Why read a lengthy report today if you will not meet to discuss it until two weeks from now? Scan it or read the executive summary, and then note on your calendar when to read the report. The facts will be fresh in your mind when you are ready to discuss it.

Source: Adapted from “Is There a Method to Your Meeting Madness?” Dianna Booher, Booher Consultants via Communication Briefings

RE: Recalcitrant Ingrown Nails (Jordan S. Sheff, DPM)
From: Zenon Duda, DPM

Unfortunate though it may seem, at times like this, one has to systematically review how one approaches and treats something simple like an ingrown nail. It's the age of phenol, surgical technique, embarrassment at not having a successful result, etc.. All of these are good things because it teaches you not to take things for granted. For example, are your assistants laying things out properly for you? Is it really phenol you are applying. Why are you repeating something that clearly does not work already?

Early in my career, I must say I had the same problem on a patient who I still see occasionally for other matters. The solution in her case involved taking a wedge out with a Winograd and using a small round burr and debriding the surface of the bone in the affected areas, flushing, and closing primarily over gelfoam. It worked.

Zenon Duda, DPM, Cape Girardeau, MO, zenonduda@gmail.com

RE: Follow-up to Recurring Periungual Fibroma
From: Jeffrey Kass, DPM

I posed a question regarding periungual fibromas a few days ago. In response to the follow-up given -
1) There was no mental retardation associated with the patient, for the doctor who was curious about that.
2) Dr. Markinson's response was, as always, appreciated.

I performed the procedure on Monday and decided to do a modified cold steel procedure. Instead of making the traditional Frost-type incision, it was modified to ellipse out the proximal direction of the fibroma. In doing so, I had better visualization of the proximal aspect of the fibroma which possessed a stalk-like projection which went deep. The proximal aspect of the fibroma was more proximal than the nail matrix.

In my initial biopsy, I had freed up the eponychium, then freed up under the fibroma, and performed a partial nail avulsion and removed the fibroma in this fashion, most likely severing the fibroma at its stalk, allowing the regrowth to occur. This time, with clear visualization of the entire lateral aspect of the nail fold, I believe the lesion was removed in full and will not return. In time, I will let the readers know if indeed the lesion returns. Thank you, for sharing suggestions.
 
Jeffrey Kass, DPM, Forest Hills, NY jeffckass@aol.com

RE: Where to Order Traumeel Injectable? (Charles Morelli, DPM)
From: Jack Hickey, DPM, Bob Kornfeld, DPM

I buy it directly from Heel, Inc. at 800-621-7644. They sometimes fax specials.

Jack Hickey, DPM, Levittown, NY, jhickeydpm@earthlink.net

Order Traumeel direct from Heel, Inc. in Albuquerque, NM (heelusa.com).

Bob Kornfeld, DPM, Manhasset, NY, holfoot153@aol.com

RE: Dealing With Specialists Who Refuse to Send Out Reports (Elliot Udell, DPM)
From: George Jacobson, DPM

What makes the matter worse and somewhat embarrassing is when the patient comes back to your office because they trust your opinion and want your input, and you do not have the specialist's report, CT, or MRI. They are usually surprised that you don't have the report, since you sent them to a specific specialist. When our requests go unanswered, we put the burden on the patient to retrieve the report. We do the same for diabetic shoe paperwork.

Three attempts is our maximum effort. We also chart our efforts and keep copies of fax transmittal receipts in the patients' charts, as well as the patients' acknowledgment that they will or will not retrieve the report. We show patients our diligent efforts on their behalf. They usually thank the staff for their efforts and know that they haven't been ignored by us.  

George Jacobson, DPM, Hollywood, FL, fl1sun@msn.com

RE: Dealing With Specialists Who Refuse to Send Out Reports (Elliot Udell, DPM)
From: Bryan C. Markinson, DPM

From the outset, Dr. Udell should give any patient he refers a short note with a specific request such as "A report of your findings would be appreciated." This may or may not help. This problem may be more prevalent now that Medicare has stopped paying consult codes. Dr. Udell worries me when he states, "What makes the matter worse is that when I send a patient to a specialist, if the doctor does not send me a report or give me a call, I will never know if the patient even went to see the doctor." No DPM should ever find himself in this position. If the issue was important enough, the onus is on the referring doctor to find out from the patient if the visit ever took place and what the results were. I have participated in enough malpractice reviews where the DPM's lame defense was "the consultant never sent me a report."

My personal patient charts are full of e-mail requests that go unanswered, letters sent to consultants asking for reports, and when none are received, documentation of my efforts to get the information. Sometimes, I hit a stone wall. Sometimes, I get a report. As podiatrists, we may often be in a position where a diabetic is seeing you for at-risk foot care but under the care of a vascular surgeon for a post-operative amputation (done by the vascular surgeon) wound that won't heal. I have one such case now, and in spite of several e-mails and phone calls suggesting revision of the amputation site to get the wound to close, I have no response. My chart clearly shows my diagnosis and concern, and I am quite certain that if this ever gets to litigation, which I doubt, that the plaintiff's attorney is going to love my notes. The issue of whether I should assume care for that particular problem and how to exactly go about it perhaps can be discussed by those who have had similar experiences.

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

RE: Barry Students Donate to Yucatan Crippled Children’s Project 
From: Narmo L. Ortiz, Jr., DPM

As its founder and first president of Barry University's Hispanic Podiatric Medical Student Association (HPMSA) in 1993, it is with great pride and joy that I noticed the mention of the donation given by HPMSA to the Yucatan's Crippled Children's Project, of which Dr. Southerland has been very passionate and dedicated for the past 14 years. May both organizations continue to work together for many years to come!

Narmo L. Ortiz, Jr., DPM, Cape Coral, FL, nlortizdpm@embarqmail.com

ASSOCIATE POSITION(S) - SOUTHERN CALIFORNIA

Podiatrist(s) wanted for long-term care facilities. Please email reply with CV to ZbubblesZ@aol.com

ASSOCIATE POSITION - WEST COAST, FLORIDA  
 
Outstanding opportunity for PSR-36 graduate to join successful group podiatry practice in Summer 2011. Seeking a sociable, articulate graduate who is confident in rearfoot and ankle reconstructive cases 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 WANTED - DELRAY BEACH FLORIDA AVAILABLE IMMEDIATELY 
 
Rapidly growing well established practice seeking part-time leading to full-time. PSR 12-36. Great opportunity for highly motivated, personable individual. Please reply by emailing a CV to nursebsf@aol or fax (561) 498-9068.

ASSOCIATE POSITIONS – MULTIPLE LOCATIONS 
 
Looking for podiatrists to join group to work in nursing facilities in: Texas (Ft. Worth, Dallas, Houston) and Delaware. Please respond to: doconcall02@aol.com

ASSOCIATE POSITION - MASSACHUSETTS

Well established, multi-office, group practice, North of Boston, seeking a well-trained (PSR 24/36) Associate to start July, 2011. This is an excellent opportunity for an energetic, hardworking individual with strong surgical and medical skills, desiring a fast-track opportunity for partnership. Our practice is well rounded in all aspects of forefoot/rearfoot reconstructive surgery, pediatrics, sports medicine and general care. Competitive salary and benefit package available. Send a cover letter, CV, and two letters of reference to: drfleishman@nefootankle.com. Visit our website at www.nefootankle.com for more information about our practice.

ASSOCIATE POSITIONS – MARYLAND

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

ASSOCIATE POSITION (P/T) - NEW JERSEY

Podiatrist needed for nursing home and assisted living facility work in Monmouth and Somerset counties.  May lead to part-time associate position in office. Chance to supplement your income. Can be flexible on days, but must be reliable and personable. Please fax resume to (732) 866-0044. EOE.

ASSOCIATE POSITION - FREDERICK, MARYLAND

Well-established group practice is located only 45 minutes from both DC and Baltimore. Immediate opening for a minimum PSR 36 Podiatrist for full time position. We have it all: EMR, digital x-ray, ultrasound, ASC, etc. Excellent salary with bonus structure and benefits. Please email resume to docsbnb@aol.com

ASSOCIATE POSITION - BLOOMFIELD, NEW JERSEY

Part-time office, part of larger practice looking for associate with well-rounded podiatric skills. Board qualified a must. Ground position leading to partnership. Please email CV to doccapo@yahoo.com 

POSITION AVAILABLE - NEW YORK

Well-established, multi-doctor podiatry practice with offices in Putnam and Westchester counties. Compensation based on productivity. Excellent opportunity for recent residency graduate to build skills and learn practice management. Full-time preferred but right part-time candidate will be considered. Email cover letter and CV to: podiatry2011@gmail.com

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION -CT (FAIRFIELD AND NORTH HAVEN)

Great opportunity. Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices. Electronic medical records, digital x-ray, diagnostic ultrasound, Padnet vascular studies, nerve conduction studies, pinpoint and CO2 lasers, electrical stimulation and ultrasound therapies. Seeking a well-trained, personable, and highly motivated individual. Please send resume and current photo to dr.kassaris@yahoo.com

ASSOCIATE POSITION - MANHATTAN - FULL-TIME POSITION

Available for a Board certified/qualified podiatrist (PSR-24, PM&S-36 ). Located in Downtown Manhattan in a multi-specialty Orthopaedic office. We have a high-volume practice that treats routine care, trauma, sports-related injuries, hospital consults, and ER Consults. Contact fscudese@seaportortho.com

ASSOCIATE POSITION - SW FLORIDA GOLF, BOATING & BEACHES

Great opportunity to join a well established podiatry practice. Excellent mix office/surgery, motivated experienced staff. Seeking full-time Associate PSR 12-36. Salary $100 Thousand + bonus package with benefits, early buy-in available to right candidate. Email resume to capecoralpodiatry@live.com or fax to 239-573-9201

PRACTICE FOR SALE - MARYLAND, DC SUBURB

Great opportunity. Retiring after 38 years in practice at the same location. Practice is fully equipped with digital x-ray, diagnostic ultrasound, computer network, orthotic scanner and state licensed ambulatory surgical center that is fully equipped. Owner will stay on as needed for easy transition. dpmpracticeforsale@yahoo.com

PRACTICE FOR SALE – MASSACHUSETTS

Solo Practice Grossing over $700K yearly 4 days a week. Mostly surgical with heavy emphasis on peripheral nerve patients and pediatrics. General bread and butter podiatry as well. No Medicaid very little Medicare. Very modern office. 30 minutes north of Boston. Modern new equipment (digital x-ray, ultrasound, computer network, etc.). Great referral network. Website included. Option to buy the condo 3500sq ft. Have PICA practice evaluation to show you. Call 978-944-7789 for details.

AMBULATORY SURGICAL CENTER PRIVILEGES AVAILABLE - NJ

Privileges available in a new 2 ORs. New certified ambulatory surgical center in Fairlawn, NJ - 8 minutes to the George Washington bridge. Specializing in podiatric surgery. Center will pick up and return patient home. Syndication is available. Center will accommodate doctors in Manhattan, Queens, Brooklyn, Bronx, Staten Island, and long Island. Will assist in getting NJ License. Call for information (516)476-1815 e-mail podo2345@aol.com. To view center, go to FAIRLAWNASC.SHUTTERFLY.COM

MEDICAL SPACE AVAILABLE- MANHATTAN

Multispecialty Medical Building with 24/7 doorman. Prime Luxury Building and Location, Gramercy, Stuyvesant, Peter Cooper Area. 305 Second Avenue (17th-18th). Prior tenants past 23 years; podiatrist, dentist (plumbing/electric intact), internist. Ideal for podiatry, co-share with dentist, MD, etc. (flexible lease terms). E-Mail; jbdrun@aol.com

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