The Voice of Podiatrists

Serving Over 13,000 Podiatrists Daily

September 28, 2011 #4,265 Publisher-Barry Block, DPM, JD

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Apple Cider Vinegar Effective for Bromhidrosis: NY Podiatrist

Thought to be an all-natural cure for just about everything (from digestive issues to weight loss), apple cider vinegar's ability to tame smelly feet is one home remedy that's doctor-approved. “Apple cider vinegar kills bacteria and dries excess sweat, the two main causes of foot odor,” says New York City-based podiatrist Johanna Youner, DPM.  

Dr. Johanna Youner

“It’s a really good, effective and cheap cure,” she adds. This pantry staple's bacteria-killing power comes from its abundant levels of acetic acid and phenolics, a chemical compound with high acidity content. To remove foul odors from your feet, add a ½ cup of apple cider vinegar to a quart of lukewarm water and soak feet for 20 minutes; repeat twice a week, if necessary.

Source: Woman's Day

EpiFix® Amniotic Membrane Allograft Receives APMA Seal of Approval

MiMedx Group, Inc. an integrated developer, manufacturer, and marketer of patent-protected regenerative biomaterials and bioimplants processed from human amniotic membrane, has announced that the American Podiatric Medical Association (APMA) has granted its Seal of Approval for the Company's EpiFix® Amniotic Membrane Allograft.

Dr. Matthew Garoufalis

"A major goal of APMA is to raise awareness by identifying products of exceptional quality that are manufactured with the consumer's comfort and safety in mind," said Matthew Garoufalis, DPM, Vice President of the APMA. "The APMA Seal of Approval is only granted when evidence of safety and effectiveness of a product has been established by an appropriate recognized laboratory, and/or clinical investigation applicable to the therapeutic (medical) agents under our consideration." 

Source: WAFF TV 48 Huntsville, AL

FL Podiatrist Moderates Diabetes Forum

The 6th Annual Forum on Diabetes Prevention and Management: Reaching Diverse and Underserved Populations, was hosted by Florida State University's College of Medicine and moderated by Dr. Chet Evans, chair of the Florida Diabetes Advisory Council and VP for Medical Education and Program Development at LECOM in Bradenton. "The three co-sponsors of this program" said Evans, "FSU College of Medicine, The Florida Alliance for Diabetes, and Tallahassee Memorial Hospital, are to be lauded for the quality of the speakers and the program content." 

Dr. Chet Evans and Florida Surgeon-General Dr. Frank Farmer

The multiple-track program received accolades from the attendees who were pleased to hear opening remarks from Florida Surgeon-General, Frank Farmer, MD, PhD. Dr. Farmer expressed his commitment to addressing the needs of Florida citizens who are afflicted with, and are affected by, diabetes. In his closing remarks, Dr. Evans also thanked Florida Department of Health chronic disease staff for their critical assistance and expertise in the development of the forum.

ACP Voices Concern About SGR Replacement

The American College of Physicians has added its 132,000 members' voices to the chorus of those in other medical groups expressing their opposition to replacing the much-maligned sustainable-growth-rate Medicare payment formula with a series of reimbursement cuts for specialists and a pay freeze for primary-care doctors. The SGR replacement was proposed during a meeting of the Medicare Payment Advisory Commission last week. If a suitable alternative is not found, a 29.4% cut in Medicare payments to providers is scheduled to take effect in January.

Instead, the ACP proposes a two-stage process, which opens with a five-year "stabilization and improvement" period during which physicians could qualify for higher payments based on participation in medical homes, accountable care organizations, and other new reimbursement models. This would be followed by a transition period in which reimbursement is based on evaluation of new payment models determined to be the most effective replacements to the SGR.

Source: Andis Robeznieks, Modern Physician [9/26/11]

Voicemail Greetings Are First Impressions

Welcome callers with a professional voice-mail greeting. Script and practice your message before recording it. Tell callers exactly what information to leave in their messages. Finally, check your greeting by calling your line from another phone.

Source: Adapted from “Voicemail Greetings Are First Impressions,” Charlie Gilkey, Productive Flourishing via Communication Briefings

Tune up Your PC

Windows PCs seem to develop plaque over time  The visible result is your PC seems to run slower over time. That plaque is the result of the various programs the average user installs, knowingly or unknowingly, while using the PC. Updates, website add-ins, etc. all add software to your PC. By far the cleanest solution is to back up everything, erase your hard disk, re-install Windows and the applications, and restore your data.  But for many PC users, finding all the installation CD’s can be challenging enough to keep them from doing a real scrubbing.

There are a number of free tools to let you address some of the issues (e.g., registry bloat, hard drive fragmentation, etc.) A useful commercial all-in-one software package is called System Mechanic10.5.  Its advantage is that it combines a number of separate functions into a single software package that simplifies tuning up your system without resorting to scrubbing it. If you are not a computer geek, having a program like System Mechanic to help optimize your system is a good idea.

Source: Gregg Marshall

Query: Social Media Policy

I would like to know what policy guidelines my colleagues use concerning employees getting on Facebook, Twitter, Internet, phone texting, etc.  I express to my employees that when they use social media during work hours, they are stealing time from me -  I am paying them. One employee was recently discharged for this abuse. Any suggestions?

James E. Rogers, DPM, Nashville, TN

Query: Code for Fenestration

The doctor performed a modified McBride bunionectomy and a second procedure listed as "fenestration microfracture 1st metatarsal head." What is this and is there a procedure code for the fenestration? The diagnoses included hallux rigidus, degenerative joint disease 1st MPJ, and osteochondral fracture 1st metatarsal head.

Laurie Bodo, Lake Orion, MI
 
Response: Fenestration microfracture is a smoothing down of the cartilage of the first metatarsal head and drilling holes to create microfractures. The microfracture technique, at least in theory, is designed to stimulate a reparative reaction. The technique is used in larger joints like the hip, knee, ankle, etc.

The addition of this component procedure would be included in the allowance of the primary procedure. In your case, the modified McBride bunionectomy would include the value of metatarsal head drilling.

Harry Goldsmith, DPM, Cerritos, CA

Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

RE: Support DPM Candidates for Congress (Alan Sherman, DPM)
From: Walter W. Strash, DPM
 
I commend Dr. Lee Rogers for his courage to pursue a political career; however, I recommend caution on aligning political views merely based on professional kinship.
 
While the statement made by George Bernard Shaw may have some merit from a medical point of view, the statement came from a man who was a Fabian Socialist (a group committed to advance the principles of democratic socialism). The context or situation in which Shaw was quoted is important. At a medical meeting it makes some sense. Words used by Shaw in a political speech have connotations for the support of socialism. Words are important and define who we are.
 
While Dr. Rogers has contributed to our profession and is an accomplished podiatrist, we know little about his politics at this early stage (leerogers2012.com/). He states on his website, "Congress doesn't have the right priorities. Let’s focus our tax dollars on America." I cannot agree with the first statement as the election last November was a referendum on the Democratic Congress and our current President. The second statement is a broad one and not specific. Being an accomplished podiatrist and an accomplished political leader are mutually exclusive. One is not a guarantee of success in the other. While Dr. Sherman is sure that Dr. Rogers "will represent us well in Congress", I am not. We need to wait and learn about Dr. Rogers' politics before supporting him.
 
Walter W. Strash, DPM, San Antonio, TX, podcanuck@aol.com

RE: Outrageous Shoe of the Day

Here's what to wear to a Rolling Stones concert. 

Designed by Kobi Levi

Source: Submitted by Dr. Stuart Steinberg

SUB LEASING TIME on MRI (NYC)

.31 tesla extremity MRI in state-of-the-art midtown Manhattan office location. Lease time on magnet in compliance with the Stark laws. This magnet is the only one that will be accepted by Medicare and all other insurance as of 2012. Why not bill out for your own MRI's??? Email today dri@myfcny.com

EQUIPMENT FOR SALE - CLASS FOUR LASER

I have a class four pain laser for sale. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

PRACTICE FOR SALE - NORTH DALLAS, TX

Great opportunity; 26 year old solo practice, reasonably priced. General practice consisting of hospital surgery, office surgery, orthotics, children, adults, geriatrics. Turn-key office located in medical building inside Loop 635. Will consider owner finance with down-payment.dallasfootdr@yahoo.com

ASSOCIATE POSITION - TAMPA, FLORIDA

Immediate position for busy surgery practice looking for BQ/BC by ABPS in RRA candidate for associate position.  Bilingual a plus. Must be comfortable in complex reconstructive ankle and hindfoot cases. Ankle replacement certification a plus but not necessary. email CV and samples of RRA cases done recently to: susmitad86@yahoo.com

SOUTHEAST GEORGIA & SOUTH CAROLINA

Seeking associate physician to join practice to cover nursing home facilities. Comprehensive package including Salary, Travel and Bonus benefits. Email cover letter and CV to melissafoot@pol.net.

ASSOCIATE POSITION - DAYTON, OH

Join a Well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and current photo to Ohiodoctors@aol.com

ASSOCIATE POSITION - MANHATTAN

Well-established successful Park Avenue podiatry practice is recruiting an In-Network, skilled and well-trained DPM with a minimum of 3 years of experience. Must be experienced in rear and forefoot reconstruction. Must be self-motivated and great with patients. Practice facilities and technologies include: in-office Physical Therapy, digital x-ray, diagnostic ultrasound, and Electronic MedicalRecords. MRI, and Private Operating Room. Please E-mail CV tosjohnson@parkavemed.com 

ASSOCIATE POSITION  - FLORIDA/N.W. FLORIDA- TALLAHASSEE AREA
 
Home of Florida State University. Great university town!  Well established full scope solo physician with busy practice. Looking for a full time associate leading to partnership in a short time. Great general practice with 2 locations. Staff privileges with 2 local hospitals and 2 surgery centers. Offering competitive salary, health insurance. Will need forefoot and rearfoot surgical competency. Friendly office with fun staff that’s easy to work with. Call/Text – 850-510-4371.

ASSOCIATE POSITION - EAST TENNESSEE

30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. Extremely competitive base salary with bonus incentives and benefits. Knoxville is consistently ranked in top 5 places in U.S. Post-residency experience a plus. Please send resume to ddavidphawk@yahoo.com

ASSOCIATE POSITION - PORTLAND, OREGON

Busy office with good steady referral sources looking to expand. Areas of expertise wanted: wound care, surgery of all aspects, knowledge of running an office. Please come with good personality and hard work ethics. New main and satellite offices. mail: office.pfac@gmail.com

ASSOCIATE POSITION - UPSTATE NEW YORK

Outstanding Opportunity. Our medical surgical group is recruiting a well-trained licensed podiatric physician. Located in Beautiful upstate NY. Full hospital privileges, as well as working with two residency programs. Must be highly motivated and great with patients. Opportunity for growth. Competitive salary and benefit package. Please send CV to associateinfoot@yahoo.com

ASSOCIATE POSITION – IOWA CITY AREA

FULL-TIME ASSOCIATE POSITION – NORTHEASTERN PENNSYLVANIA (LEHIGH VALLEY)

Well-established, rapidly growing practice with multiple offices. Motivated, ethical and personable with well-trained PSR-24/36. Modern office’s with complete EMR, digital radiography, diagnostic ultrasound, and laser. Competitive salary/benefits package with partnership opportunity. If interested please fe-mail your CV, letter of intent and references to: Pafootdocs@gmail.com

EQUIPMENT FOR SALE - ULTRASOUND, CRYO-PAC, FLOUROSCAN

Ultrasound w/printer, Cryo-Pac w/two probes, Flouroscan w/printer. There may be other surgical equipment as well. Please contact Jolene as young_jolene@yahoo.com

SPACE AVAILABLE - NYC & LI

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