The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

September 20, 2010 #3,962 Publisher-Barry Block, DPM, JD

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APMA and SVS Release Joint Journal on Amputation Prevention

The Journal of the American Podiatric Medical Association (JAPMA) and the Journal of Vascular Surgery (JVS) have partnered to release a first-time joint publication focusing entirely on the importance of amputation prevention in people with diabetes. Released on Thursday, September 16, the joint issue of the journal (September/October 2010) features articles authored by both podiatrists and vascular surgeons—two of the medical specialists integral to a patient’s diabetes management team.

APMA / JVS Joint Issue

The issue is also available to non-members of APMA. “This collaborative effort between the APMA and SVS is only the latest example of how two medical professions are working together to save limbs and lives,” said APMA President Dr. Kathleen Stone. “We look forward to continuing this successful partnership and important discussion regarding diabetes limb salvage.”

PA Podiatrist Drafts Post-Concussion Guidelines for HS Athletes

10-year-old Nick Young, of the Peters Township Indians has missed five consecutive games: Three already this year because of a sprained medial collateral ligament in his left knee, and the final two last season because of a concussion. Rick Young watched Nick, his son, miss those final two games of 2009 -- amid e-mails from the coach pleading, "Can he play this weekend?" --and then endure two months of concussion-induced emotional and academic turbulence in the fourth grade. That experience motivated Dr. Young, a podiatrist, to become an at-large board member and safeguard the association's 225 young brains.

Dr. Richard Young

To bring awareness home, Dr. Young attended the Duquesne University symposium that attracted national concussion experts in March. He collated data about ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing), the process overseen by UPMC and used by the National Football League, the National Hockey League, and others. He drafted the association's policy and steered parents to UPMC Sports Medicine's South Side headquarters, where almost half the Peters kids took the baseline test that could prove beneficial in the event of a brain injury.

Source: Chuck Finder, Pittsburgh Post-Gazette [9/19/10]

CA Podiatrist Competes for Best Rock Doc

On Sunday, five bands of doctors – from neurosurgeons to podiatrists to obstetricians – vie for the title of Best Rock Docs in Orange County. Open wide and say ... "Free Bird!" It's a good old battle of the bands – of doctors!

Dr. Jeffrey Haupt

"We got our start in college doing party rock anthems," says Dr. Jeff Haupt, a podiatrist who fronts the band "Velicious" wearing eyeliner, several rings and, occasionally, an 80s' big-hair wig. "Some of my older patients are not sure what to make of it. One said, 'Do you play jazz?' I'm like, 'No. Not quite.'"
 
Source: Leonard Ortiz, The Orange County Register [9/17/10]

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky:  Do you have a recommendation about picking an EMR company or product?

Dr. Larry Kosova

Larry Kosova: I think that you have to evaluate the programs the way that you think. With most programs, you have to think the way they tell you to think to do your job. I would rather have it the other way. Say, "Mr. EHR company, this is the way I do my notes. Can you change your program to the way that I do it?" A lot of companies care; it is called customization, and most of them can do it on the fly, but there are too many products out there that are telling you this is the way that you should think, so that is the number one thing. Number two to me is ease of use. If you have to go through 15 steps to complete an H&P, something is drastically wrong. You know it should really be two or three steps to get to your template, call it up, and send us your note. 

Dr. George Vito

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). The next segment  will feature podiatric surgeon Dr. George Vito who will discuss podiatric malpractice, asset protection, and the federal court system. You can register for this event by clicking here 

Step in to Keep Peace on Your Staff

If one employee routinely offers unsolicited advice to co-workers, you may need to intervene. While you can leave petty squabbles for staffers to handle on their own, sometimes you have an obligation to step in.

Example: when one employee makes inappropriate comments about another’s appearance or personal relationships. Even when the comments are relatively inconsequential, you should speak up when you notice a pattern that is affecting morale. Say something like this: “I sometimes notice you making comments that come across as judgmental. I imagine your intent is to be helpful, and I think you may not be aware of how offensive it actually can be. Let me give you an example. When you said _____, the effect was _____. I wanted to make you aware of how your words come across, because I believe your intentions are positive.”

Source: Adapted from Meryl Runion’s SpeakStrong via Communication Briefings

Query: LFTs for Lamisil

I am curious about what evidence-based medicine is saying about monitoring healthy patients who are taking Lamisil tabs. It is routine to get liver function tests (LFTs) before starting the treatment. What about blood work throughout the course of the three months? I have heard both sides of the argument. Is it standard of care to get LFTs multiple times during treatment? Are there a lot of patients who have stopped therapy due to elevated levels?

Doug Mason, DPM, Kingston, NY

RE: Recalcitrant Ingrown Nails (Jordan Sheff, DPM)
From: Multiple Respondents

Several years ago, I had a patient complain to me that her ingrown nail had returned. I explained that it does happen occasionally. She persists in her disappointment. To make a long story short, it turns out that she had the original procedure done over 30 years before. So, before anyone else claims that they get less than 1% recurrences, give it some time. In about 1980, I also was concerned that I was getting too many recurrences. My thought was that the phenol was not completely penetrating the matrix. Over a period of a few months, I developed a technique of excising the matrix with a 62 blade, then applying the  phenol directly to the exposed bone. The first couple I did bled excessively, so I started packing the void with cotton and then saturating the cotton with 1 to 1000 epinephrine. Guess what! I have had close to 100% success, AND no lost toes.  

Art Hatfield, DPM, Long Beach, CA, Afootjob@juno.com

Regrowths are common with the P&A procedure because the phenol is old and that's why you need three applications per border. With the PHENOL EZ Swabs, the phenol is always fresh and only one application per border is needed. I wonder if the good doctor who failed 6 times used the old bottle technique or the fresh PHENOL EZ swab?

Disclaimer: I am the inventor of the Phenol EZ swab [Pedinol Pharm}

Jim Ricketti, DPM, Hamilton Sq, NJ, drj4foot2002@netscape.net

In medicine, what we learn through clinical experience is exactly why medicine is considered as much an art form as a science. Alas, there are many ways to "skin a cat". As such, all aforementioned techniques have their place in the treatment of recalcitrant ingrown toenail surgery. What is needed, for any surgeon, is the formation and adherence of treatment protocols for each condition one encounters. They should be logical, medically appropriate, and necessary. They create consistency, especially...

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

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

We have turned this into a simple process in our office.  At checkout, we have what is called a “Studies Log.” This is a log book that is used to track all studies we send patients out for. This includes referrals, cultures, biopsies, CT, MRI, ultrasound, and any other diagnostics. This log is checked on a daily basis. When we note that a study is overdue, we begin the investigative process, first starting with the patient. If the study has been performed, we call to locate it. If our staff runs into an issue in acquiring it, the doctor makes the next call.

I can’t remember the last time we were not able to obtain a report. We maintain excellent notes in the patient chart on our progress in obtaining information. Should it be refused, we would simply send a letter, as well as send the patient to obtain the results and document the attempts.

I have had similar experiences such as Dr. Markinson's. Depending upon the patient and the case, I have both intervened as well as deferred.  In the case of the patient who had no interest in standing up for their own care, and a history of poor compliance, I have sent the patient back to the physician who felt the need to “try” a little surgery.  In the case of the patient who has a complete understanding of the condition and concerns, I have taken over the care from the doctor who was “tinkering” with the problem medically and surgically. 

As doctors in the clinical setting, we are not obligated to surgically intervene, nor to pick up where someone else left off. It is done on a case-by-case basis, and many times these are gut calls.

Jon Purdy, DPM, New Iberia, LA, podiatrist@mindspring.com

RE: The Passing of Michael Marino, DPM
From: Joe Addante, DPM

The obituary recently posted regarding Dr. Marino brought back student memories. I was fortunate enough to be a school-mate and fraternity brother. He was fun and a good friend in the fullest sense. I am proud to add my name to all the accolades already accorded to his memory. I will remember him as a contributing proud member of our profession. He is one of those who left the profession better than he found it. Thank you Mike, and God bless.

Joe Addante, DPM, Fitchburg, MA

RE: Foot Surgery by CA Podiatrist Saves H.S. Baseball Career
From: Charles Reilly, DPM

It seems we are reading more and more self-serving "Podiatrists In The News" articles. I do not need to read about an egotistical colleague performing a procedure - probable excision of an os tibiale externum or similar pathologic condition that is routinely performed by members of our profession without hyping it as an "above and beyond" procedure performed, seemingly, by that individual. We, as a profession, should be promoted to the community.

I would hope experienced editors could decipher individual grandstanding from true professional and informational reporting. Otherwise, the credibility of your "news" is an insult to your readers' intelligence.
 
Charles Reilly, DPM, Chicago, IL, pododoc1@msn.com

Editor's response: The story in question was excerpted from a longer story primarily focusing on the high school athlete. The article only mentioned the podiatrist's name parenthetically, so it is hard to understand why Dr. Reilly would characterize this story as self-serving. Most PM News features are not sent directly to us for aggrandizement, but are excepted from national or local sources. We then request a photo from the quoted podiatrist or use a photo found on the Internet. 

We can all promote the profession by being featured in the media. Stories published under "Podiatrists in the News" are not intended for professional development, but rather to illustrate how some podiatrists are promoting the profession.  PM News encourages others to do the same.

RE: 22 Barry Students Receive APMA Educational Foundation Scholarships
From: Lloyd S. Smith, DPM

When people wonder what APMA does for the profession, the APMA Educational Foundation is a shining example. The APMA has always given financial, intellectual, and emotional support. Without the support of the APMA Board of Trustees and executive staff leadership, the Foundation would never have been started, would have failed many times, and would not be in the solid financial shape it is today. I can recount many stories, many criticisms, and many doubters. The critics were wrong, and we have the APMA to thank for these scholarships.  
 
Lloyd S. Smith, DPM, Newton, MA, lloydpod@yahoo.com

ASSOCIATE POSITION - TEXAS 
 
IMMEDIATE OPENING for motivated podiatrist with good people skills.  Associateship leading to PARTNERSHIP for the right applicant. Northside San Antonio Texas practice. Attractive office and beginning income. Current TEXAS license a must. CV and letter of interest to sadpmoffice@gmail.com

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 - 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 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

PART-TIME, LICENSED PODIATRIST - WEST BLOOMFIELD, MICHIGAN 
Immediate opening for treating patients in a nursing facility setting.  If interested, please e-mail drteetime@aol.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(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

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.

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

AMBULATORY SURGICAL CENTER PRIVILEGES AVAILABLE - NJ

Privileges available in a new 2 ORs. New certified multi-specialty 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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