The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

October 10, 2011 #4,275 Publisher-Barry Block, DPM, JD

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Not All Bunions Require Surgical Correction: IL Podiatrist

If you have a bunion, does that mean that you will need surgery? "It depends," says Marlene Reid, DPM, spokesperson for the American Podiatric Medical Association. "Bunions in the early stages can be treated with anti-inflammatory medications, physical therapy, and rest." However, if you notice a change in symptoms (like increased irritation, redness, or pain), it's usually time to consider surgery.

Dr. Marlene Reid

Get the best care by seeing a podiatrist. He or she will be trained in the latest treatments and can prescribe a follow-up plan, using custom orthotics, if you do opt for surgery.

Source: Megan Bingham, Family Circle [10/7/11]

TX Podiatrist Discusses "Black Toenails" in Runners

This month, as runners across the country put the finishing touches on their marathon-training regime, thousands will share the experience of losing a toenail. Also known as "black toenail" and "runner's toe," it's a harmless occurrence, according to Dr. Marybeth Crane, a Texas podiatrist and board certified foot surgeon who has run dozens of marathons and triathlons over the past 32 years.

Dr. Marybeth Crane

Crane calls black toenails "one of life's minor annoyances" that can be avoided by keeping toenails clipped, buying long-distance shoes a half-size larger and ensuring that the toe box accommodates your foot properly. Though losing a toenail poses no harm, Crane has two important cautions. First: No bathroom surgery. Second: If your toenail develops a dark line that does not grow out or disappear, see a doctor right away. "There is a very rare form of melanoma that will happen underneath the toenail" that can be deadly if left untreated.

Source: Niki Reading, The Body Odd (MSNBC) [10/7/11]

ME Podiatrist in Mentoring Program for Entrepreneurs

A charitable foundation that has committed $50 million to spurring entrepreneurship nationwide is launching a $3 million initiative in Maine. The Blackstone Charitable Foundation is officially unveiling the Blackstone Accelerates Growth initiative at Brunswick Landing on Friday. It will be managed by the Maine Technology Institute and will support and expand existing entrepreneurial initiatives including the Innovation Engineering project at the University of Maine and the Top Gun program at the Maine Center for Entrepreneurial Development. 

Dr. Todd O'Brien and Osteotomy Guide

One of those entrepreneurs is Dr. Todd O’Brien, a podiatrist practicing in Lincoln who has developed several medical devices over the past few years, and wants to build a viable business around his latest innovation. Working with UMaine engineers, he developed an electronic device that mimics a tuning fork that podiatrists traditionally use to determine the health of tissue in a diabetic’s foot. He’s in the current class of Top Gun, a program that hooks up Maine entrepreneurs with experienced mentors and provides them with a series of workshops and classes that school the innovators in all aspects of running and growing a start-up.

Source: Matt Wickenheiser, Bangor Daily News [10/7/11]

AL Podiatrist Indicted on Drug Charge

An Athens podiatrist remained jailed today after being formally charged with conspiracy to commit a controlled substance crime for allegedly prescribing painkillers to a third party that were really used for his wife. Dr. Kevin “Scott” Uren was arrested Wednesday on a warrant issued following his recent indictment by a Limestone County Grand jury. He is accused of prescribing narcotic painkillers, Lorcet and Mepergan, and a muscle-relaxant, Soma, to a man and then collecting the medications from the man after he had them filled at Walmart, according to the complaint filed by Athens Police Investigator Greg Parnell.

Source: Jean Cole, The News Courier [10/7/11]

IA Health Department Suspends Podiatrist's License for Unsanitary Office

The Iowa Department of Health (IDPH)  suspended the license of a Waterloo podiatrist with what it calls an "emergency adjudicative order" after complaints from a patient. An IDPH investigator visited the Waterloo office of John Redenius, after complaints from a patient. In the report, the investigator lists several incidents, including: exam rooms in disrepair, dirty exam rooms, to the point of being unsanitary, foul odor, and expired supplies.

Source: KCRG-TV News [10/6/11]

MedPAC Offers Painful Path to SGR Repeal

Ten years after first recommending that Congress replace Medicare's sustainable growth-rate formula, a divided Medicare Payment Advisory Commission suggested ways to pay for such a repeal. The proposal, approved 15-2, would repeal the SGR, cut and then freeze most physician fees, and cut a variety of other provider payments to cover the estimated $200 billion cost.

The physician component—reducing the 10-year SGR cost by about $100 billion—would freeze Medicare rates for most primary-care physician services while cutting other physician services by 5.9% for three years and then freezing those rates for seven years. The largest savings in the nonphysician component of the SGR replacement plan—worth about $220 billion over 10 years—include 34% from drugmakers, 15% from beneficiaries, 11% from hospitals, and 6% from durable medical equipment cuts.

Source: Rich Daly, Modern Healthcare [10/6/11]

Query: Plating System for Fractured 5th Metatarsal

My patient is a 45 year old smoking diabetic with neuropathic manifestations who presented to my office with erythema, edema, and pain. The patient was put in an Unna boot and told that surgical intervention is necessary.

Fracture of 5th Metatarsal

The patient understood my instructions, but related that he couldn't stop working. My plan is to plate it (1/3 tubular) over the fractured 5th metatarsal.and put him in a forefoot off-loading shoe for eight weeks. I'm interested in knowing if anyone is familiar with a better plating system.

Name Withheld

RE: Painful 1st MTPJ (Name Withheld)
From: Brian Timm, DPM

I believe the best surgical answer in this clinical scenario (even without a lateral film to analyze) is a first MPJ fusion. This is the most reliable answer, and given the level of activity and age of the patient, this is probably the best answer. I would get a consent for this procedure and a Youngswick as a second option only because you mentioned the crepitus of the joint, which may indicate that the cartilaginous damage is quite considerable. If the cartilage appears reasonable intra-operatively, and the sesamoids are not adhered to the plantar capsule, this may be the next best option.
 
Brian Timm, DPM,  Naples, FL, drtimm@familyfootandlegcenter.com

RE: Is Podiatry Turning Away from Biomechanics? (Dennis Shavelson, DPM)
From: Susan Bartos
 
I have read Jason Kraus’ article, and have been following its thread in PM News. Jason went out on a limb in an effort to promote discussion on biomechanics, and the need for the colleges to continue to provide their students an unabbreviated, thorough, biomechanical education. This should include current and accepted methods, processes, and materials used by today’s orthotic labs. Hand-making rubber-butter or rohadur orthotics doesn’t accomplish this. 

OCPM has addressed this by requiring that their students spend time at Earthwalk, with a defined curriculum for their rotation, in addition to their classroom/clinical studies. Dr. Shavelson brought shady lab practices in to this discussion that I agree should be scrutinized, but really don’t have a place in this particular forum.  Many of us do not employ these practices, and do an honest job of providing a quality product to podiatrists and their patients; taking pride in being part of the healing process. I did not surmise from Jason Kraus’s article that he was laying blame on the schools, labs, or students. Rather, his intention was to bring to light that, in an environmental shift in contemporary curriculums to produce highly trained surgeons, the significance of a solid biomechanical knowledge base needs to be underscored.
 
Susan Bartos, President, Earthwalk Orthotics, Inc,  eworthotics@neo.rr.com

RE: OH Court Rules That Podiatrists Need ABPS Certification for Staff Privileges
From: Kevin K. Lam, DPM

As someone who has just gone through the ABPS foot and RRA oral exams, I can say that it is not an easy exam, but it also gives a person pride that you have been able to achieve this certification. ABPS' written and orals are both challenging. Most of those individuals who told me either test was easy have failed. I do agree that our board should conform to the 5 year rule that other boards have, which may require a change in the amount and variety of cases that ABPS requires. I don't think the exam should be any easier, but rather our programs should teach the residents and guide them to passing these exams. Perhaps ABPS can allow residency/fellowship cases to be used for the boards? The stats of failures on our ABPS boards appears high to me. 

I love being a podiatrist, but hate having to explain to patients how I am doing a triple arthrodesis while my colleagues just referred them to a foot and ankle orthopedist. If we, as a profession, continue to refer out the cases to foot and ankle orthopedists who have a hang nail of respect for DPMs already, what are we telling the general medical community? Refer to a DPM no matter how far or close you want to send them.

Kevin K. Lam, DPM, Naples FL, klamdpm@hotmail.com

RE: Outrageous Shoe of the Day

Ideal Shoes for S&M Parties

Source: Submitted bt Azia Rasoolim, BUSPM Class of '15

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 – NANAIMO, BRITISH COLUMBIA, CANADA
 
Have you ever dreamed of owning a practice where...you can see 0-50 patients daily * average 100 new patients monthly * have zero accounts receivable * gross $480 M per year * live in a beautiful community with skiing, hiking, fishing, and boating on your doorstep. This could be yours! If interested contact pistone@telus.net or call 250-754-4192.

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 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

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

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.

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 - 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 associate to potential partnership available for a surgeon that is BQ/BC by ABPS. Must be a PSR 24 or PM&S 36  graduate. Salary with bonus. Email CV and samples recent 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

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.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

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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