The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

October 06, 2011 #4,272 Publisher-Barry Block, DPM, JD

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MT Podiatrist Discussed Bunions

Podiatrist Ronald Ray, DPM of Great Falls, MT, recently discussed a common foot condition. "A bunion is when your big toe points toward the second toe. This causes a bump on the outside edge of your toe. Bunions occur more commonly in women and can sometimes run in families. People born with abnormal bones in their feet are more likely to form a bunion," said Dr. Ray. 

Dr. Ronald Ray

According to Ray, "Wearing narrow-toed, high-heeled shoes may lead to the development of a bunion. The condition may become painful as extra bone and a fluid-filled sac grow at the base of the big toe."

Source: Medical Minute, KRTV.com [9/30/11]

Aussie Podiatrists Call on Government to Increase Coverage for Diabetics

Morley podiatrists Nic and Rachel Lange are concerned about the impact on hospitals of patients with diabetes-related foot problems. They say it is not uncommon for diabetes patients to experience foot problems, however, they also say these problems can be avoided. October is National Foot Health Month, and the Australasian Podiatry Council of WA, of which Nic is a board member, is calling on the government to improve foot care for diabetes patients. 

Nic and Rachel Lange

“We are calling on the Federal Government to increase the number of Medicare services for people with diabetes to a minimum of 12 podiatry visits. It’s really important that a patient with diabetes visits their podiatrist regularly,” Mr. Lange said. “It’s the best way to avoid foot health complications, which can lead to amputation or even death.

Source: In My Community [10/4/11]

WI Podiatrist Forms Breast Cancer Organization

She's a pretty, vibrant 42 year old with a warm personality. And looking at her, it's hard to believe that she's recovering from a potentially deadly disease. After a biopsy, the news was not good for Fox Point resident Dr. Regina Flippin. Not only did she have breast cancer, she had one of the most aggressive types, triple negative breast cancer. 

Dr. Regina Flippin

So Flippin, who is also a podiatrist, is on a mission to educate others. Dr. Flippin has formed a fund to help other women. It's called Flippin to a Cure. She's working with the Leroy Butler Foundation to sponsor a ball to raise money for cancer patients. Flippin explains, "I also want to support breast cancer survivors financially and emotionally so they can focus on healing rather than the financial aspects of the disease."

Source: WTMJ-TV and JSOnline.com [10/3/11]

CT Podiatrist Completes English Channel Swim

Dr. Marcy MacDonald, a podiatrist from Manchester, CT became the first and last person to complete a crossing of the English Channel this year, finishing the approximately 21-mile swim from Dover, England, to France on Sunday in 11 hours, 51 minutes. MacDonald, 47, of Andover, was the first person to cross in June, in 10 hours, 34 minutes, 34 seconds. 

Dr. Marcy MacDonald

MacDonald has now completed 12 crossings of the Channel, starting with her first in 1994, and has the most crossings by an American woman. She has her sights set on the American record (14, owned by Peter Jurzynski, who is from Naugatuck, CT).

Source: Hartford Courant [10/3/11]

A Little Reading Each Day Adds Up

Reading just five pages a day will result in self-improvement and growth. Five pages daily totals 1,825 pages in one year and 18,250 pages in 10 years. The American Academy of Podiatric Practice Management has a recommended reading list, Here's five recommended by Dr. Hal Ornstein:
 
1. Keys to Success. The 17 Principles of Personal Achievement by Napoleon Hill
2. One Minute for Yourself by Spencer Johnson
3. Marketing Your Clinical Practices: Ethically, Effectively, Economically, Fourth Edition by Neil Baum, MD
4. Focus on the Good Stuff.  The Power of Appreciation by Mike Robbins
5. Love Is the Killer App: How to Win Business and Influence Friends by Tim Sanders

RE: Painful 1st MTPJ (Name Withheld)
From: Barry Mullen, DPM

What you describe, is a functional hallux limitus (HL). The hypermobile 1st ray causes a functional met primus elevatus which jams the 1st MTP during propulsion. You mentioned that conservative treatments failed, but did not elaborate what those were. Pending the etiology of the overpronation, I've had modest success in early HL stages with functional orthotics w/ kinetic wedge accommodation. The crepitus, however, may indicate the problem has progressed beyond conservative care.

X-rays were not provided, but surgical success in stage 2 and early stage 3 HL has been achieved via cheilectomy and shortening/plantarflexory 1st metatarsal osteotomy ala Youngswick. Of course, in any HL surgery, there is a step-wise approach: i.e. 1) cheilectomy  2) sesamoid release and 3) if 1st MTP motion still restrcited, 1st metatarsal osteotomy. Aggressive PT, including continuous passive 1st MTP ROM shortly after the procedure is performed, yields optimum results.

If the joint is severely damaged, then consideration for a hemi-implant or MTP fusion should be considered, but I try to avoid this in 50 year old active individuals whenever possible. Subchondral drilling of the metatarsal head is indicated if at the time of surgery, defects are encountered. 

Barry Mullen, DPM, Hackettstown, NJ, yazy630@aol.com

RE: Podiatrist Lands on Front Page of AARP Convention Issue
From: Michael M. Rosenblatt, DPM

To my great dismay and embarrassment, a podiatrist was on the front page of the AARP Newspaper in September for Medicare fraud. This was not just an RFC issue. This doctor had billed  Medicare for patients who were dead or had no extremity upon which he billed. This was a "showcase" article for AARP on Medicare fraud. According to the article, he faces prison and will soon be sentenced.
 
Even though I disagree with many political stances taken by AARP, my wife and I did go to the convention in LA. Their newspaper was all over the place. I don't know what its circulation is, but I assume it is in the millions. This was very sad and made me feel uncomfortable. Of course, other doctors commit fraud. Recently, a large group of MDs from Florida were indicted. This was not mentioned by AARP.
 
AARP is not without fault either. They hype their insurance plans very aggressively, and signing up for them can be confusing and poorly disclosed. One of our personal friends ran into trouble on this issue and ended up paying for an expensive operation herself. She had thought she was covered. I assume AARP gets a nice cut from their insurers, or at least gets hundreds of millions in advertising fees. I don't expect AARP will publish the letter I sent in describing my regret for this podiatric tragedy or their own areas of suggested improvement.
 
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

RE: Is Podiatry Turning Away from Biomechanics? (Jason Kraus)
From: Dennis Shavelson, DPM

Mr. Kraus, I also believe it is better to inspire productive debate than to have only a pedestrian interest in biomechanics. Let’s debate the impact of orthotic labs on podiatry as another reason for biomechanical demise.

1. Why do labs accept “post-to-cast” prescriptions, reducing need for busy DPM’s to hone their biomechanical skills while promoting other professions to “practice” podiatry?

2. Why do orthotic labs accept prescriptions from other professionals whose...

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

RE: Medicare Foot Orthotic Billing (Tony Poggio, DPM and Alan Silverstein, DPM)
From: Paul Kesselman, DPM
 
As usual, the customer service representative provided the wrong information. Patients may submit claims to Medicare under certain limited circumstances. For example, services covered by Medicare and performed by a healthcare provider not enrolled in Medicare or for services which are not covered by Medicare may be submitted by the patient. These types of claims do not require the provider to have an NPI.

Foot orthotics provided by a provider not enrolled in Medicare as a supplier would certainly qualify under this type of exemption. The forms and the instructions may be found at: cms.gov/cmsforms/downloads/cms1490s-english-instructions-dme.pdf
 
I strongly urge you to assist your patients by having your biller complete the form for patients, provide them with a bill and have them pay you upfront for the foot orthotic services. Using this form, a claim may be submitted without a supplier NPI and for services not covered by Medicare (foot orthotics). The claim will of course be rejected, and you would then file a claim with their secondary insurance which is also likely to be rejected (Federal BC BS is one gleaming exception which will likely pay).
 
Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net

RE: OH Court Rules That Podiatrists Need ABPS Certification for Staff Privileges
From: Jeffrey Kass, DPM

I think this sets a very dangerous precedent for our profession. I am sorry the podiatrist involved lost the case. I had a number of colleagues who graduated from PSR programs submit their cases to ABPS, but  were turned down because their cases did not show enough "variety." Why is it that ABPS can deny case logs due to variety when the cases demonstrated reflect what one was taught during residency?

If a PSR program can graduate a resident whose logs mainly revealed (for example:) Austin bunionectomies and Kellers with a Reverdin or two thrown in, then if that resident performs those procedures after he graduates, he should be allowed to take the exam. If not, then why was he allowed to graduate the program?

It should be mandated that a resident has to perform a certain variety of cases, and not just a certain amount of first ray procedures. Is it better for the "newly minted surgeon" to go do a "Scarf bunionectomy" just to gain variety and then have the first met collapse on him and end up in deeper water? 

Jeffrey Kass, DPM, Forest Hills, NY jeffckass@aol.com

RE: Outrageous Shoe of the Day

Here's how to walk the dog in style. 

Designed by Kobi Levi

Source: Submitted by Dr. Philip J. Shapiro

SEEKING ASSOCIATE POSITION - SUBURBAN DETROIT

ABPS certified podiatrist with several years experience seeking part-time position in suburban Detroit. On staff at area hospitals. Excellent clinical, surgical, and practice management skills. Please respond to michpod@hotmail.com

SELL OR MERGE YOUR PRACTICE - SOUTH FLORIDA

Looking for an exit strategy? If you would like to discuss options such as phasing out, selling your practice, or merging with a larger group in South Florida, please email your interest and contact info to foot369@yahoo.comSPACE AVAILABLE - NYC & LI

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

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

PRACTICE FOR SALE - SOUTHERN OH

Busy, well-established, full-time home visit practice. 100% referral-based. Wound care, pain management, routine care & DME’s. Excellent income, low overhead. Great opportunity for husband/wife business team. DPM relocating out-of-state for family. Contact:nanetter@zoomtown.com

PRACTICE FOR SALE - NORTHERN NJ

Well established, part-time practice is for sale in Northern NJ. Digital X-rays, EMR, located in a medical condo building. Surgery 35%, Routine 30%, Average Gross is $130K on 2 half days per week. Priced for quick sale. Real estate available for purchase. Please call 800-983-4194, or e-mail contactus@podiatrypracticeconsultants.com 

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 - NORTH CENTRAL NJ

Well established busy solo physician seeking a well trained podiatrist (PMS 36) to join our growing practice. Bilingual English Spanish a big +. Competitive salary/benefits package. Send CV to fax 732-520-6468 or send to fjr20032003@yahoo.com.

ASSOCIATE POSITION – IOWA CITY AREA

ASSOCIATE POSITION - SOUTHWEST 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 - OCEAN COUNTY, NJ

Immediate opening for 8 year old established practice. Two offices and nursing homes. Surgical privileges at local hospitals available. FT/ PT or coverage doctor. Flexible days/hours. Close to the beach and boardwalks. Inquire at chirokid2@yahoo.com or call 216 401 7285.

ASSOCIATE POSITION - SOUTH WEST FLORIDA

Full-time associate positions for an established group practice in Southwest Florida. Willing to train the right new graduates. Job will involved all aspects of podiatric care. You must be ambitious, hard-working and should have good people skills. Please e-mail your resume/CV tocontactus@ankleandfoot.net

FULL-TIME ASSOCIATE POSITION - SOUTHERN NEW HAMPSHIRE

Well-established, rapidly growing practice. Motivated, ethical and personable with well-trained PSR-24/36. Modern office with complete EMR, digital radiography, diagnostic ultrasound, and laser. Competitive salary/benefits package. If interested please email your CV, letter of intent and references to: NHFootDoc@yahoo.com

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 - NASSAU COUNTY, NY

Podiatrist needed in Nassau county to start immediately. Flexible hours 2 days a week. Please email pittpod@gmail.com with inquiries.

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.

PM News Classified Ads Reach over 13,500 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 12,500 DPM's. Write tobblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 for a 50-word ad THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451

ASSOCIATE POSITION - MARYLAND/WASHINGTON, DC

Well-established busy group practice is expanding and seeking a minimum PSR 24 trained podiatrist. Progressive practice with 2 office-based ASC's and hospital privileges. Opportunity toward partnership. Fax resume to 301-926-7787 or email mlmltm@aol.com

ASSOCIATE POSITION – IOWA CITY AREA

ASSOCIATE POSITION - SOUTHWEST 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 - OCEAN COUNTY, NJ

Immediate opening for 8 year old established practice. Two offices and nursing homes. Surgical privileges at local hospitals available. FT/ PT or coverage doctor. Flexible days/hours. Close to the beach and boardwalks. Inquire at chirokid2@yahoo.com or call 216 401 7285.

ASSOCIATE POSITION - SOUTH WEST FLORIDA

Full-time associate positions for an established group practice in Southwest Florida. Willing to train the right new graduates. Job will involved all aspects of podiatric care. You must be ambitious, hard-working and should have good people skills. Please e-mail your resume/CV tocontactus@ankleandfoot.net

FULL-TIME ASSOCIATE POSITION - SOUTHERN NEW HAMPSHIRE

Well-established, rapidly growing practice. Motivated, ethical and personable with well-trained PSR-24/36. Modern office with complete EMR, digital radiography, diagnostic ultrasound, and laser. Competitive salary/benefits package. If interested please email your CV, letter of intent and references to: NHFootDoc@yahoo.com

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 - NASSAU COUNTY, NY

Podiatrist needed in Nassau county to start immediately. Flexible hours 2 days a week. Please emailpittpod@gmail.com with inquiries.

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- NASSAU COUNTY, NY

Experienced, preferably board certified podiatrist, wanted for diversified growing practice located in Nassau County, New York. Energetic DPM. Please send CV to jobke@aol.com

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 - TEXAS (HOUSTON AREA)

Become a “SUCCESS”! Multi-professional podiatric practice seeks personable, talented, enthusiastic physicians with expertise in any of these areas: 1. Biomechanics 2. Geriatrics 3. Pediatrics 4. Trauma. Send CV and letter of intent to: sierrajip@gmail.com

ASSOCIATE POSITION - NORTH CENTRAL NJ

Well established busy solo physician seeking a well trained podiatrist (PMS 36) to join our growing practice. Bilingual English Spanish a big +. Competitive salary/benefits package. Send CV to fax 732-520-6468 or send to fjr20032003@yahoo.com.

SPACE AVAILABLE - NYC & LI

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

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

PRACTICE FOR SALE - ARKANSAS

Busy, well established practice of 13 years grosses 160K/year for the past 5 years, while working 3.5 days/week. Nursing homes available. 50% Medicare, average of 15 new patients/week. Doctor retiring. Please call 800-983-4194 for more details, or e-mailcontactus@podiatrypracticeconsultants.com

PRACTICE FOR SALE - SOUTHERN OH

Busy, well-established, full-time home visit practice. 100% referral-based. Wound care, pain management, routine care & DME’s. Excellent income, low overhead. Great opportunity for husband/wife business team. DPM relocating out-of-state for family. Contact:nanetter@zoomtown.com

PM News Classified Ads Reach over 13,500 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 12,500 DPM's. Write tobblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 for a 50-word ad 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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