The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

October 15, 2008 #3,374 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2008- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Technical Problem Prevented Some Readers From Receiving PM News dated 10/13/08 & 10/14/08

Due to technical difficulties with our ISP, some subscribers did not receive the past two issues of PM News. If you did not receive either of these issues, we encourage you to click here to read yesterday's issue. You can then click on "previous issue." We believe this problem is now resolved and apologize for any inconvenience.

NY Podiatrist Stresses Importance of Shoes and Socks for Diabetics

Shoes and socks for diabetics are key components to good foot care. Making sure you are wearing clean socks and comfortable supportive shoes is imperative. Wearing clean socks may require changing your socks twice or three times a day, depending on what the weather is like where you live or work. If your feet sweat a lot, you may need to change socks more frequently as well.

Dr. Marc Brenner

Podiatrist Marc A. Brenner, D.P.M., past president of the American Society of Podiatric Dermatology stresses the importance of good, clean care for diabetics. He suggests Thor-Lo socks and a good pair of walking or running shoes to help with your diabetes foot care. Make sure your shoes fit well.

“Seventy five percent of the time when someone loses a leg, they lose the other leg within five years. Developing foot consciousness is essential to better health. As a diabetic you must watch those feet. Look for bruises or infections and take care of them now,” said Brenner.

Source: WSOS (FL) [10/14/08]

Evans Appointed Chair-Elect of Governor’s Diabetes Advisory Council

The Barry University School of Podiatric Medicine is pleased to announce that Dr. Chet Evans, vice president for medical affairs and dean, has been appointed to a two year term as the chair-elect of the Florida Governor’s Diabetes Advisory Council. Dr. Evans has served as a member of the Diabetes Advisory Council for the past eight years.

Dr. Chet Evans

The Diabetes Advisory Council serves to advise the Florida State Department of Health, the Surgeon General of the state, and the Florida legislature on this critical healthcare issue. It provides statewide leadership to improve the lives of Floridians with diabetes and reduce all aspects of the burden of the disease.

In addition, Dr. Evans serves on the editorial board of the journal Diabetes Care, published by the American Diabetes Association. The journal for the health care professional is intended to increase knowledge, stimulate research, and promote better management of people with diabetes.

WI Podiatrist Runs for State Legislature

Rene Settle-Robinson, a podiatric surgeon with Aurora Medical Group and a Democrat, is trying for the second time to go to Madison as a member of the Legislature to push for healthcare reforms. Settle-Robinson has 25 years of experience as a physician and is comfortable discussing her criticism of health insurance and Medicaid. But she is quick to acknowledge her lack of familiarity with a number of other issues facing the state.

Dr. Rene' Settle-Robinson

“I don’t like what is happening with healthcare in this country,” Settle-Robinson said. Particularly, insurance companies should not be allowed to delay or deny care by requiring prior authorization of treatment or deny payment because of a pre-existing condition, she said. And Medicaid should boost payments to physicians who treat any patient —the disabled, older adults, pregnant women and young children — who meet the financial requirements for Title 19, she said. “That is why you can’t find enough doctors willing to care for these patients,” she said.

Source: Don Behm, Milwaukee Journal Sentinel [10/14/08]

Physicians Brace for Medicaid Payment Cuts in 2009

Physicians nationwide are bracing for lower Medicaid payments in 2009 because of the weak economy, increased state spending and reduced tax revenues for the programs, according to American Medical News, the Wall Street Journal's "Health Blog" reports. AMNews, published by the American Medical Association, cites a recent survey released by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured that found Medicaid spending by states increased nationwide by 5.3% in fiscal year 2008 and enrollment increased by 2.1% largely because of the continuing economic downturn (Rubenstein, "Health Blog," Wall Street Journal, 10/13).

The survey also found that in FY 2009, Medicaid enrollment is projected to increase by 3.5% and state spending is projected to increase by 5.8%. More than two-thirds of state Medicaid directors said there is an even chance they will experience a budget shortfall in FY 2009 (American Health Line, 9/30). According to AMNews, "Doctors' fees could be on the chopping block if states can't cover their costs."

Source: Cited sources via American Health Line [10/14/08]

Eliminate Office Clutter

Eliminate office clutter by asking this question: "If I had 20 minutes to evacuate my office, what would I take with me?" That helps you realize that most items aren't very important - and helps you identify which ones really are.

Source: Communications Briefings

RE: OsteoMed Screws (Greg Caringi, DPM)
From: Narmo L. Ortiz, Jr., DPM, Sloan Gordon, DPM

I have been using Osteomed screws, both regular and headless, for the past 3 years. Their quality and ease of use is exceptional, along with a very good customer support.

Presently, most fixation hardware are very similar in quality and durability, but a product is as good as the vendor that represents it, and I have been very fortunate with my Osteomed representative.

Your ultimate choice should be based on quality, ease of use, and good customer support.

Narmo L. Ortiz, Jr., DPM, Cape Coral, FL, nlortizdpm@embarqmail.com

I have been using the OsteoMed screws for about 2 years. I find the headless screws to be just outstanding for 1st metatarsal osteotomies, phalanx osteotomies and fixation of Weil's osteotomy. They are extremely well-constructed, they are easy to use, their K-wires are quite rigid which facilitates temporary fixation, measurement, etc. easily. I generally don't countersink the heads nor over-tighten them as they don't need it. I've been very pleased and for some reason, the post-operative edema with this screw seems minimal to non-existent. (Note: I do not receive any compensation from this company).

Sloan Gordon, DPM, Houston, TX, sgordondoc@sbcglobal.net

RE: Weil Osteotomy w Cheilectomy (Stuart W. Kushel, DPM)
From: Charles Reilly, DPM, Ira Baum, DPM

Please review the publication in "The Journal of Foot and Ankle Surgery"-Volume 43 /issue 6/November-2004 -"The Modified Hohman Osteotomy: an Alternative Joint Salvage Procedure For Hallux Rigidus." This time-honored procedure has proven to be an excellent alternative procedure for not only mild to moderate hallux limitus, 1st ray elevatus, long 1st metatarsal length, but also severe degenerative joint disease of the 1st MPJ. The procedure addresses not only the structural and biomechanical components of the deformity, but also the fixation techniques that provides a stable osteotomy.

Charles Reilly, DPM. Chicago, IL, pododoc1@msn.com

I've used the Weil configured osteotomy 10 times over 2 years. I base the decision to use the Weil-like osteotomy on both the clinical and radiographic findings. Basically, I use it if the joint is mild to moderately painful with mild to moderate DJD to the joint (with or without osteophytes). In the moderate cases, age plays an important role in the decision process whether or not to use an osteotomy or a joint replacement procedure.

I also inform the patient that it could take 6 months or longer to realize benefit from the procedure. Always inform patient procedure may or may not be successful due to DJD already present and there may be a need for additional surgery if the symptoms do not respond. I always use two screws for fixation and an Orthowedge shoe for four weeks followed with a soft Plastizote insert, usually heat-molded to foot to modified stress across the osteotomy, as it strengthens for about 8 weeks. I then place the patient in orthotics. Although early ROM is beneficial, I place the patient in forefoot cast to protect the osteotomy. I instruct patient on isometric exercise in cast, and ROM exercise are performed during post-op visits.

Results: Usually there is a reduction of symptoms with minimal increase with ROM (depends on degree of DJD). Repositioning the joint with reasonable amount of cartilage noted intra-operatively should be beneficial over time as opposed to cheilectomy without decompression or realignment of joint.

Ira Baum, DPM, Miami, FL, ibaumdpm@bellsouth.net

RE: Orthotic Lab With Fast Turnaround Time (Loren Schneider, DPM)
From: Brian Kiel, DPM

I have used Precision Orthotic lab for over 20 years. Their service is excellent.

Brian Kiel, DPM, Memphis, TN, Footdok4@gmail.com

RE: Fulminating Onychobreadosis?

RE: Fulminating Onychobreadosis?

Only Known Cure: Butter and Mastication B.I.D.

Submitted by Arthur Gudeon, DPM

PODIATRISTS NEEDED - CHICAGO -- NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. 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

EQUIPMENT FOR SALE – PAD SYSTEMS

2 SensiLase 3000 PAD Systems used for Skin Perfusion Pressure (SPP) & Pulse Volume Recording (PVR) tests for micro and macro-circulatory assessment. I’m selling because podiatrists no longer qualified to do studies and get reimbursed in Colorado. Paid $24,390. Sell for $20,000 each. Purchased from Vasamed. Call or e-mail Jack Burgin A Step Ahead Foot & Ankle Center 2001 S. Shields St., Bldg. F, Fort Collins, CO, 80526, (970) 232-1717 jack@asafoot.com

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 full-time podiatrist in a multi practice location in the Chicagoland and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

PODIATRISTS NEEDED – DALLAS/ FT WORTH – TEXAS AREA

Texas Home Footcare Associates, a podiatry exclusive company specializing in house calls and visits to facilities for the elderly, is looking to hire podiatrists. We are located in the Dallas area. Full and part-time positions are available. Immediate Openings Available. Must have a Current Texas license. Competitive Compensation Package. If interested fax curriculum vitae to 972 931-4819 or e-mail gjmdpm@tx.rr.com. For further information, call 972-380-8028.

ASSOCIATE POSITION - NORTHERN VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes.Top hospitals. Fax CV with references to 703-491-9994

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

turn-key operation grossing $570,000 annually based on one full-time doctor; practice is in a growing retirement area in the center of the state. Option to purchase or lease real estate. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours, so it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725 for details and ask for Lee.

WEEKLY SPECIAL - One week of ads (5x) for $89 One month of ads (20x) for $340 .

PM 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 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 Ext 110.

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.