The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

October 12, 2010 #3,981 Publisher-Barry Block, DPM, JD

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We've just posted an article on our website www.podiatrym.com titled "Eight Methods of Improving Orthotic Outcomes" by James Clough, DPM.

Dr. James Clough

You can read this informative article by clicking here. 

Women Don't Need to Put Up With Foot Pain: TX Podiatrist

The foot is a complex system of 26 bones plus networks of ligaments, tendons and soft tissues for walking, running, pivoting, holding weight, and being the foundation of our upright bodies. "It's very complicated, how the foot and ankle work," says Joel W. Brook, a Dallas podiatrist. "When something is out of kilter, it can cause problems up the chain – not just your feet, but your knees, hips and back."

Dr. Joel W. Brook

For women, shoes are the No 1. culprit for foot problems. "The big thing is that pain in feet and ankles is not a normal thing," Brook says. "Women don't need to put up with that."

Source: Daphne Howland, The Dallas Morning News [10/5/10]

Failure to Replace Running Shoes Can Be Very Costly: AAPSM

It hurts and defies logic, really, to shell out $100 or more for new shoes when your current pair still looks good. You can probably get away with holding onto dress shoes a little longer but clinging to an old pair of athletic shoes too long can cost you plenty.

The American Academy of Podiatric Sports Medicine reports that if runners don't replace their shoes every 350 to 500 miles, they face a potential litany of injuries, including stress fractures, plantar fasciitis, shin splints and heel spurs. Exactly how long shoes will continue to provide the needed level of protection depends on individual size and weight.

Source: Jeff Waddle, ManOfTheHouse.com via KNDO/KNDU [10/7/10]

AZ Podiatrist Meets with Joint Chiefs of Staff to Discuss Wound Healing

Admiral Michael Mullen, Chair of the U.S. Joint Chiefs of Staff, was recently a guest at the University of Arizona. During the visit, one of his primary goals was to emphasize care of the wounded warrior and veteran. This aspect of care falls under the aegis of Colonel David W. Sutherland, Director of Warrior and Family Support in the office of the Joint Chiefs. This interest has led to exploring methods of working with leading institutions, including the University of Arizona's Southern Arizona Limb Salvage Alliance, or SALSA, toward innovation in care and healing.

Prof. David G. Armstrong, Director, SALSA and Col. David W. Sutherland

"We're grateful to the Admiral and to Colonel Sutherland for their interest and support of warriors -- both in theatre and after they return home," noted David G. Armstrong, Professor of Surgery and SALSA's Director. "Exploring new ways to partner in fostering innovation and making a difference in care is a shared goal-- and one that we think holds great promise in the years ahead."

MD Podiatrist Wins Jewish Literary Festival Writing Competition

Alex Kor, DPM of Temple Hills, MD recently won first place in the Hyman S. & Freda Bernstein Jewish Literary Festival Writing Competition for his essay titled, "A Stranger in Strange Land: A Purdue Fan in the Hoosier State." Kor will receive one thousand dollars and be recognized on Opening Night of the Festival, Sunday, October 17.

Dr. Alex Kor (R) with his father.

Kor's moving essay decribes the story about how his father survived the Holocaust, was liberated by American Troops, and eventually re-settled in Terra Haute, Indiana.

GA Podiatry Practice Adds 3 More Podiatric Surgeons

Village Podiatry Centers has added three podiatric surgeons to its new office near WellStar Kennestone Hospital. Michael Bednarz, Suzanne Clous, and Allen Lazerson are established physicians in the Marietta community providing treatment and surgery for the foot, ankle and lower leg.  All three earned their doctorates at the Ohio College of Podiatric Medicine in Cleveland and were previously with Marietta Podiatry Group.

(L-R) Drs. Michael Bednarz, Suzanne Clous, and Allen Lazerson

Bednarz completed his surgical residency at the VA Medical Center and Jackson Memorial Hospital in Miami. He is board certified in foot surgery by the American Board of Podiatric Surgery, has more than five years of private practice experience and was formerly with Foot and Leg Health Care Specialists.

Clous completed her primary residency at The Cleveland Clinic Foundation and her surgical residency at Western Pennsylvania Hospital/Temple University School of Medicine in Philadelphia. She is board eligible in foot surgery and has more than five years of private practice experience.

Lazerson completed his surgical residency at Atlanta Hospital and Medical Center. He is board certified in foot surgery by the American Board of Podiatric Surgery and has more than 20 years of private practice experience.

Source: The Marietta Daily Journal [10/9/10] 

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

Bret Ribotsky: When is a frozen section something podiatrists need to consider doing?

Dr. Bradley Bakotic

Brad Bakotic: Frozen sections are something that I can pretty confidently say are under-utilized by most of doctors in our profession. It actually is really useful when you are excising something and you need to know whether it is completely out. A great example would be when we diagnose a lot of basal cell carcinomas for docs, squamous cell carcinomas, and even melanomas. This is especially true for the carcinomas.

If you want to excise a lesion and you do not want to take large margins, or if the tumor is occurring on the foot where you simply cannot get closer if you take a wide margin, then it is a good thing to take that patient to a hospital OR. If a surgical center happens to have a frozen section capability, you can take a narrow margin sample while the patient is on the bed and send that ellipse in for frozen section. The pathologist can look at it and make sure it is entirely out right there, stat.

Dr. Kathleen Stone

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). The next segment  will feature APMA president, Dr. Kathleen Stone. You can register for this event by clicking here

Gill Podiatry Expands

Gill Podiatry Supply and Equipment Company has announced its acquisition of Meyer Podiatry. This acquisition further demonstrates Gill's commitment to the podiatric market place and to its customers.

Gill Podiatry

Gill is known for its friendly customer service, knowledgeable staff, and extensive product line. Gill Podiatry will continue to offer the same quality service and products that have made them a mainstay in the industry since 1932. The staff at Gill Podiatry is working to make this transition as seamless as possible.

Query: Hemangioma

I have a patient with a hemangioma on the plantar aspect of the hallux, confirmed by MRI. Is there any specific precautions that should be undertaken when excising this type of tumor?  

Brent Rubin, DPM, Bradenton, FL

RE: Loss of Privileges (Ivar E. Roth DPM, MPH)
From: Craig Breslauer, DPM

I suggest a careful review of your hospital’s bylaws. There should be clear language as to how credentialing for advanced surgical privileges needs to be documented. For instance, if a certain number of a given procedure are not performed within the reappointment period, you may be able to document proficiency via an advanced training course/CME.

Since you have not performed an ankle fusion recently, you should be able to document proficiency by taking a cadaver course or perhaps assisting in a couple of cases with another surgeon.

I recently had my privileges for total ankle replacement removed due to financial constraints. Essentially, the hospital decided that the cost of the ankle implants was too high compared to the reimbursement. I have not decided on my next step, if any.

Craig Breslauer, DPM, Palm City, FL, cbdpm@bellsouth.net

RE: Loss of Privileges (Ivar E. Roth DPM, MPH)
From: John Chisholm, DPM

This is another reminder of the importance of belonging to our state and national associations. Members of APMA and CPMA don't have to go it alone when hospitals, insurance companies or regulatory agencies run amok like this. In the past here in California, CPMA committed all their resources, including legal, to members who have experienced similar issues.
 
Dr. Roth and I both attended the recent Podiatry Institute seminar in San Diego. On two separate occasions, I overheard colleagues talking about how they had recently dropped their APMA membership. "Times are hard; I just can't afford it". I wonder how much time, energy, and yes, money on legal fees they may face in the future if they have to fight this kind of fight alone at their hospital.

Years ago here in San Diego, a podiatrist just out of training wanted to join an orthopedic group. He joined CPMA and they fought a legal battle for two years to ultimately enable him to assist on non-foot and ankle cases and have expanded privileges at his hospital. He now has an excellent practice with this group. He dropped his APMA and CPMA membership the year after he won his battle and refuses to rejoin. Go figure. 
 
John Chisholm, DPM, Chula Vista, CA, dr_triguy@yahoo.com

RE: Loss of Privileges (Ivar E. Roth DPM, MPH)
From: Bryan Markinson, DPM, Chris Robertozzi, DPM

Dr. Roth is lamenting the loss of ankle implant surgery privileges due to insufficient number of cases. I can attest that this has nothing to do with DPM vs. MD or orthopod vs. podiatrist, and is definitely not arbitrary. The Mount Sinai School of Medicine has just completed new credentialing for all orthopedic staff, and according to the medical staff affairs office, the templates we used are going nationwide and there will no longer be blanket privileging for surgeons of any specialty. For example, joint replacement surgeons who have never done a bunion will not be able to do them.

Dr. Roth is lucky he had three years of residency. For the masses of his colleagues with no training, one year, and two years spread out all over the country in the past 30 years, the tougher problem we will have is that many of us will find ourselves totally de-credentialed unless the chief of the podiatric service is willing to go to the mat for his colleagues (as I just did a few months ago) to explain that the inequity of training experiences does not mean "unqualified."

This argument does not impress anyone who is not a podiatrist - so I expect many more experiences like Dr. Roth's in the future. In my specific instance, I had any mention of duration of surgical residency requirements removed from the credentialing documents for podiatrists. This was done to protect those who have operated here without problems for many years. At the next credentialing cycle, the powers that be may not be so persuaded.

Bryan C. Markinson, DPM, NY, NY, Bryan.Markinson@mountsinai.org

Assuming from Dr. Roth's post that podiatry is in the Department of Orthopedics and not the Department of Surgery, the Chief of the Department can apply that standard to you as long as he applies it to everyone else in the department, including the orthopods. First, I would find out who is doing 10 ankle fusions per year. Chances are good that not everyone, including the orthopedists, can meet that requirement. 

Armed with this knowledge, I'd...

Editor's Note: Dr. Robertozzi's extended-length letter can be read here.

RE: Loss of Privileges (Ivar E. Roth DPM, MPH)
From: Gregory B. Nellis, DPM

I have been a member of my hospital's credentials committee for a good number of years and served as its chairman for about two and a half years. Our policy manual states that the Chairman of the Credentials Committee is supposed to notify you of the general tenor and possible recommendations for change in your privileges, and you are to be invited to meet with the committee. Any adverse recommendation by the committee entitles you to a Fair Hearing. Should there be a delay in action by the board, your current privileges continue until the matter is settled.

My hospital is relatively small, but this idea of counting numbers has begun to surface. The way to combat this, and protect our rights to practice, is with...

Editor's Note: Dr. Nellis' extended-length letter can be read here.

RE: Dealing With Medicare Carrier’s Incompetence (Jeanne Arnold, DPM, Mark Block, DPM)
From: Paul Kesselman, DPM

A recent posting by a colleague noted he did not get assistance w/audits and had to hire an attorney to assist him. I echo Mark Block’s comments and suggest that those who have experienced this type of situation often are likely not members of APMA. Statistics often reveal that it is the non-members who end up in these type of situations more often than not; or they are members who ignore the resources APMA has to offer.

Additionally, many malpractice carriers and state components provide an audit protection plan for only a few hundred dollars. These plans can provide you with an attorney which might otherwise cost you tens of thousands of dollars.

I also suggest that every podiatrist...

Editor's Note: Dr. Kesselman's extended-length letter can be read here.

PART-TIME/FULL-TIME PODIATRIST NEEDED - INDIANA

Part-time full-time Podiatrist needed for our Indiana offices. Must have Indiana license. Must have completed two years of surgical residency. If qualified email to  f-massuda@footexperts.com

ASSOCIATE POSITION – LONG ISLAND

FT/PT Associate position available with busy multi-office podiatry group on Long Island. Our practice is state-of-the-art, and encompasses all phases of podiatric care. We welcome new practitioners, or someone who would be open to merging a smaller practice with ours, and benefitting from our practice management overlay. We also invite residents graduating in 2011 who want to practice on Long Island to apply for this position. Compensation includes competitive salary and bonuses. Vacation pay and malpractice insurance are also offered with a full time position. Please send your CV by fax (631) 293-3462 or e-mail to mets724@gmail.com

ASSOCIATE POSITION - WEST CENTRAL FLORIDA 
 
A great opportunity to join a very busy, well established, diversified practice in Clearwater, Florida. We are seeking an Associate who is BC/BE and highly motivated, minimum PSR24+. We offer a competitive salary and benefits. Please send your resume to Jaye@fdn.com

ASSOCIATE POSITION – LONG ISLAND, NY

Associate full-time. Well-established, busy, well-rounded podiatry practice looking for a motivated podiatrist. Suffolk Co. LI NY. Board eligible, Board certified PSR-24/36 trained. Fax resume to 631-581-0857

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

ASSOCIATESHIP - MARYLAND

A great opportunity to join and gain ownership interest of a well established, diversified practice in Maryland. 2-year residency needed, EHR, ultrasound, ASC, hospital close by with wound care center. Fax resume to 410-749-6807.

ASSOCIATE POSITION - TEXAS

Established podiatry practice in Houston, TX has an opportunity for a well-trained associate to start immediately. Great opportunity for a new graduate or established solo practitioner looking to join a successful practice with a fast track to partnership. Practice is modern and offers all of the latest equipment and technological advances available in podiatry. Aside from seeing patients and providing outstanding care, individual must be personable, passionate, and willing to help market themselves to referral sources as part of a plan implemented by our business development coordinator. Salary with bonus and benefits available. Send cover letter, CV and 2 letters of reference to houstonpod@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

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION - DAYTON, OHIO

Join a well-established modern practice with an excellent reputation and referral base. Base salary $100,000 and benefits with a bonus structure. EMR, diagnostic ultrasound, all aspects of DME, Padnet vascular studies, and CO2 lasers. We seek a surgeon that is well trained, personable and motivated to join our group of 3 Podiatric Surgeons. Would like this individual to buy in the practice eventually. Please send resume and photo to Ohiodoctors@aol.com

ASSOCIATE POSITION - NYC, NY

Part/time, full/time associate for busy, well established multi-doctor, multi-office NYC group. Seeking motivated, ethical, NYC licensed DPM with excellent office management and clinical skills in all phases of Podiatry. Board Qualified/Certified preferred. Salary plus incentives, pension/medical/dental. Partnership potential. Fax CV to 631-369-6570.

ASSOCIATE POSITION - ST. LOUIS, MO 
 
Leading group practice looking to add one podiatrist to established location. Group's podiatrists enjoy incentive compensation plan (production and sharing group profits), benefits including health and malpractice, and supported with integrated practice management and EMR systems. Perfect opportunity for solo practitioner to join group setting. Could also be part time opportunity for the right individual.  Please forward CV to StlPodGroup@gmail.com

PART-TIME PODIATRIST NEEDED ASAP CHICAGO

Part-time podiatrist needed for 2 offices in Chicago with an average of 20 hours/week. Must have Illinois license. Must have completed 2 years of surgical residency. If qualified, email to f-massuda@footexperts.com

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

PRACTICE FOR SALE - NORTHERN CALIFORNIA
 
Rare opportunity. Busy all around practice, including pediatrics. Hospital guarantee of $200,000 for first year. Ready to retire. Will stay on for transition. Low price of $130K. E-MAIL tracy.podiatry@comcast.net or call: 209.835.4276 

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

PM News Classified Ads Reach over 12,500 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 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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