The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

October 06, 2009 #3,667 Publisher-Barry Block, DPM, JD

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We’ve just posted the October 2009 CME titled:

By Robert G. Smith DPM, MSc, RPh

 You can Earn 30 CPME-Approved CME Contact Hours Online

 Earn 15 Contact Hours for only $139

SD Podiatrist is Inventor of Product for Thick Toe Nails

Dr. Lorri Riley is  the inventor of Thin Nail, which she is currently marketing in stores and sells at her clinic. She was playing around with various ingredients to help correct thick nails. She used it on her own nails. One day a friend’s grandmother commented, “They still haven’t invented anything for thick nails.”

Dr. Lorri Riley

“In 2000, I thought I should probably get a patent,” she said. After an in-clinic survey, she decided to market her product. Along with family and friends, she started a South Dakota corporation called Rylo and finally got her patent in 2005. She then found a laboratory that could make the product for her, and it officially went on the market in 2008. The marketing and the patent were expensive.

The biggest hurdle, though, is trying to overcome the reputation of all the other products on the market that don’t work. “People think it’s just another thing that doesn’t work.” She said she should have invented her product in the 1970s when other products for thick nails were coming on the market. “But it just wasn’t my time,” she said. Currently she is working on inventing a new arch support for flat feet.

Source: Carla Dailey, Black Hills Weekly Group [10/1/09]

VA Podiatry Practice Named Small Business of the Year

A downtown podiatry practice was named the 2009 Suffolk Small Business of the Year on Monday. The 1Foot 2Foot Center for Foot and Ankle Care was named to the title by the Hampton Roads Chamber of Commerce. The award is given annually to recognize performance by small business ventures throughout the region. Companies are judged on their financial success, community involvement and ethical business practices, according to a press release from the city. The restoration of an old former movie theater building earned 1Foot 2Foot a 2007 HRACRE Design Award, and represented more than $2.5 million capital investment.

The 1Foot 2Foot Center for Foot and Ankle Care

“We’re thrilled to be recognized by the Chamber for our hard work and innovation,” Matthew Dairman, owner of the practice, said in the press release. “We hope historic downtown Suffolk continues to grow and thrive in years to come.”

Dr. Matthew Dairman

The 1Foot 2Foot center, which opened in 2006, was the first integrated foot and ankle facility in the country to include a comprehensive podiatry practice, medical spa, fashion comfort shoe store and physical therapy gym. Dairman sees more than 200 patients each week in the podiatry office alone, according to the press release. The business has since added more podiatrists and expanded into a new office in North Suffolk.

Source: Suffolk News-Herald [10/4/09]

Choose Goals Wisely

Worthy goals are designed to reduce costs, boost revenue, advance your career or improve productivity. A goal that does not do one of those things - either directly or indirectly - is probably not worth pursuing.

Source: Adapted from “Goals Worth Pursuing,” Miller Heiman Tips, via Communication Briefings

Query: Scope of Practice to Treat Obesity

I have recently become aware of some podiatric medical issues with our state board. This basically involves the rights of podiatrists to prescribe weight control medications. As the president of the state podiatric medical association, I would like to get the overall picture from other areas and get some opinions before I have to address the board. Our law here is very vague with regard to what we can prescribe. My take on it is similar to that of diabetes - we treat pedal complications of diabetes, not the disease itself. Along the same vane, we treat the pedal complications of obesity, not the disease itself. In those cases that I feel that the overall disease is not controlled well, I will discuss it with the internist or other physician who is managing the overall disease.

I would appreciate other viewpoints, enlightenments, and/or arguments.
 
Tip Sullivan, DPM, Jackson, MS
 

RE: Subtalar Joint Implants Backing Out? (Juliet Burk, DPM)
From: Gary M. Lepow, DPM, MS

If a subtalar implant "backs out", it is usually because either it was too large or the capsular tissue on the lateral aspect of the joint was not properly incised, retracted, and then well closed after insertion of the implant with confirmation of position via intra-operative fluoroscopy.

Gary M. Lepow, DPM, MS, Houston, TX, docgml@aol.com
 

RE: 11 yo Ballet Dancer with Ligament Laxity (Charles Morelli, DPM)
From: Greg Aposperis, DPM

I would consider referring her to a rheumatologist for evaluation of Ehlers-Danlos syndrome. 

Greg Aposperis, DPM, Santa Barbara, CA, santabarbarafootclinic@yahoo.com
 

RE: Orthotics Made by a Physical Therapist or Orthotist (Alan Mauser, DPM)
From: Bruce M Nigro, DPM,

Slightly changing the details in the scenario of this thread, how would my colleagues respond if the patient in question is a diabetic that you recommend/prescribe diabetic shoes and inserts for, who then chooses to present to the local C.Ped down the street for the items, and then you receive a request for a prescription from the C.Ped? Obvious differences in the 2 scenarios are: 1) covered item (shoes) vs cash item (orthotics-generally), so price-shopping is not an issue; 2) non-custom item - the exact same pre-fabricated devices are available from all the same manufacturers, essentially nullifying the quality control argument.

Can one ethically refuse to provide the competitor the prescription for the shoes/inserts since the patient can receive the exact same item in the doctor's office? Careful post-dispensing follow-up and in-office shoe/insert modifications are always made as needed, and this remains our responsibility despite the fact that the items were dispensed elsewhere. After all, if a neuropathic patient were to develop a wound from an ill-fitting shoe, care of the wound then becomes the podiatrist's responsibility regardless of who dispensed the shoes/insoles. 
 
Bruce M Nigro, DPM, Barefoot Bay, FL, barefootpodiatry@bellsouth.net

It is naïve to think that we are the only practitioners that can make a good orthotic. It is important to keep an open mind. I was just introduced to a product last week by a family who had seen a physical therapist who ordered an orthotic called the Surestep supramalleolar orthotic from an orthotist. I have been attending biomechanics lectures at podiatry conferences for over a decade and have never attended a lecture on any supramalleolar orthotics except Richie Braces and Colorado Braces and the like. I was embarrassed to say that I immediately recognized a superior product for hypermobile pediatric flat feet in this product introduced to me by a patient via a PT and orthotist.  It trumps any pediatric orthotic that I have ever made.

It seems to me that these other professions have continued to innovate in the field of orthotics research while we have patted ourselves on the back for our medial skives and Cluffy wedges and closed our eyes to other possibilities. Perhaps we have been too concerned with where the next great surgical locking plate is coming from to address innovation in non-surgical techniques. Don’t just assume that we have all the answers for our patients. I happily wrote the prescription for the supramalleolar orthotic and called the orthotist to see that I got it right. Does it surprise you that our local orthotist sends us cases for things we do best?  Seek what’s best for your patients and don’t get offended if your patient finds it in spite of you. Remember it’s all about the patient.

Juliet Burk, DPM, Muskogee, OK, juliet-burk@cherokee.org

RE: Z-CoiL Shoes (Ido Friedman, DPM)
From: Cam White

Z-CoiL shoes can be highly effective for many musculo-skeletal disorders that are sensitive to ground impact forces, including a multitude of foot, ankle, knee, hip, and back problems. The rigid, conical steel coil reduces ground impact forces absorbed by the skeletal frame by nearly 50% according to studies performed by the US Department of Energy, Los Alamos National Laboratories. The coil also returns nearly as much energy as the foot passes through the gait cycle. F-Scan studies show a significant reduction in peak plantar pressures compared with normal athletic shoes. The coil assembly is firmly attached to a fiberglass reinforced nylon orthosis that is shaped to support a neutral-arched foot. It can be heat formed for low-arched feet and bony prominences, and serves as an excellent carriage for accommodative and some functional orthoses. The forefoot cushioning provides almost 1” of resilient memory foam with a rocker design. In a nutshell, Z-CoiL shoes combine many of the best elements of orthopedic shoe design with unsurpassed impact reduction and great adjustability. Z-CoiL also provides different strengths of coils based on the weight and gait characteristics of the wearer.

There are no clinical studies that I am aware of, but the anecdotal evidence is impressive. In our experience, we have successfully fitted over 10,000 clients in Z-CoiL footwear for a wide variety of pain issues. While no shoe is the “magic bullet” for all pain issues, we have enjoyed considerable success with this brand, and it is a very important part of our business.
 
Cam White, Owner, Total Relief Footwear, Austin, TX

RE: Obama’s Healthcare Plan
From: Richard Gosnay, DPM

Insurance is risk management. The healthcare industry has ballooned into a mega-trillion dollar entity because of advancements in medicine and the ability to fund these advancements through government support, charitable support, fee for service, and insurance payments. But that's the healthcare provider industry. Insurance is different. We need to see Medicare and private insurance for what they are if we are to intelligently solve the problems that we face.

Our lives have been greatly enriched by....

Editor's note: Dr. Gosnay's extended-length letter can be read at: http://www.podiatrym.com/letters2.cfm?id=29333&start=1

EQUIPMENT FOR SALE - HISTOFREEZER H60

170 ml gas, 30 2mm, 30 5mm applicators in original box, never used. Retail $299, only $225! I have five to sell. Closing satellite office. Other items available. 30 ga 1” and ½” BD needles only $15.00/box, retail $25.00. 941 922-3840

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

EQUIPMENT FOR SALE - ORTHOTIC FABRICATION SYSTEM

Amfit Orthotic Insole Fabrication System with Footfax SL Contact digitizer- For Sale Machine, Laptop, rolling bag, small inventory of shoes, insoles, all cords, parts and hardware Asking $8k. OBO! Please contact Jeff at Jhunt@psbank.net for further information, pictures.

ASSOCIATE POSITION - AUSTIN AND SAN ANTONIO AREAS

Seeking well-trained ABPS board certified/qualified foot surgeons for surgical practice with national foot/hand/orthopedic surgery group.  Excellent salary/benefits. Email CV and cover letter to: slb99@pdq.net

PRACTICE FOR SALE - FLORIDA - ST. PETERSBURG AREA 

Part-time office, remodeled 4 years ago. Fully equiped and stocked, 2 treatment rooms, x-ray and processor, billing software. Low overhead ,good signage. Asking $40k. Contact mwftdr@aol.com

EQUIPMENT FOR SALE - AMFIT ORTHOTIC MANUFACTURING MACHINE

Includes digitizer, fabricating mill, new updates have been added and enough supplies to pay for the machine in the long run. At $200 per pair = about $28,000. Selling FOR $25,000, O.B.O, F.O.B. americanfoot@email.com or 405-733-2783.

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

PODIATRY PRACTICE FOR SALE- NEW YORK

Excellent Bayside location. Established twenty years. Fully equipped and computerized. Part-time, mostly palliative care, podiatric  medicine, and orthopedics. Very little surgery. Priced to sell. Call weekdays after 8pm...718-465-5239

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Looking for board certified/board eligible ABPS associate to join a multi doctor practice with 2 offices. May lead to eventual buy-in and purchase. Must have minimum 2-year residency and comfortable with rearfoot procedures and diabetic care, ER call. Must be dependable, honest, ethical individual. Send cover letter and CV to familyfootcenter@earthlink.net

OFFICE SPACE/ MRI RENTAL – NYC, LI

Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, Hicksville and/or Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to fmassuda@footexperts.com

SEEKING ASSOCIATE - MIAMI FL

Buy-in and purchase if you are interested. Well-rounded practice (EMR, Digital X-R) seeing 250+ pts/wk. 30 yrs same location. Competitive salary +benefits + incentives. I am winding down my practice after 30 yrs. Will feed you my surgical load until you generate your own. Send resume to doctorinhialeah@aol.com

LOCUM TENENS/ASSOCIATE—PHOENIX

Busy multi-location practice in South East Valley seeks immediate well-trained personable individual. Part time Locum position may lead to permanent part-time, full-time, and buy- in potential if desired. Please send letter of interest and C.V. to AzToesRus@aol.com

ASSOCIATE POSITION – LOS ANGELES

Well established Los Angeles-based practice seeking a surgically trained, highly motivated, well-trained podiatrist. We have a very busy multi-office practice with state of the art podiatric equipment. Must be dependable, honest, and an ethical individual. This position is available immediately. Send resume and your email address to desierec@kimfoot.com

ASSOCIATE POSITION - WASHINGTON, DC

Interested in working in Washington D.C.? Our group is looking to add a highly motivated, hard working, well trained podiatrist to our practice. Must have surgical training. We have a very busy multi-office practice. We practice state of the art podiatry with EMR and digital radiography. Associate to partner on a fast track for the right person. E-mail CV and cover letter to Washingtonpod@aol.com

ASSOCIATE POSITION (SURGICAL) – CONNECTICUT

Connecticut Surgical Group is seeking a Board-Certified podiatrist to add to our Surgical Podiatry division based in Central Connecticut. This podiatrist will provide all aspects of Podiatric care with a focus on wound and surgical care to a well-established patient base. We require PSR-36 training and board certification or eligibility, excellent surgical and wound care skills, a strong focus on providing compassionate care to our patients, and the ability to work as part of a team in a group practice setting. To apply please visit our website . EOE

ASSOCIATE POSITIONS - INDIANA/OHIO

PrimeSource Healthcare is a leading provider of mobile, on-site healthcare services at long-term and skilled nursing facilities. Our exceptional growth has created an immediate need for traveling, independent contractors of podiatry services in Indiana/Ohio. Earn between $175k and $225k per year. E-mail CV to kwright@pshcs.com. Visit us at pshcs.com.

ASSOCIATE POSITION - FREDERICK, MD
Well-established and growing 2 office state-of-the-art practice located in medical/professional buildings. EMR, Digital X-ray, Ultrasound, DME provider, etc. Competitive Base Salary plus bonus, malpractice, health insurance, etc. PSR 24 minimum/Board Qualified or Certified with ability and desire to take ER call. If interested, forward CV to DOCSBNB@aol.com

DIABETIC RURAL OUTREACH PROGRAM - FLORIDA

We are seeking ethical, motivated podiatrists to treat homebound diabetic patients in Central and North Florida. Minimal travel. Must have valid Florida License and Active FL Medicare and Medicaid numbers. FAX CV TO 866- 258-9993 or call 800-779-8551.

PM News Classified Ads Reach over 11,500 DPM's and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 11,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451

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