The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

October 18, 2011 #4,282 Publisher-Barry Block, DPM, JD

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CA Podiatrist Publishes New Practice Management Book

Dr. Jon Hultman, author of Here’s How, Doctor (1995), has recently published The Medical Practitioner’s Survival Handbook. The material in this new book is built upon sixteen years of practical experience, implementing the principles espoused in his 1995 book. In this new book, Dr. Hultman shows you how to position your practice for thriving in the current and future healthcare environments. 

Dr. Jon Hultman and His New Practice Management Book

The Medical Practitioner’s Survival Handbook teaches doctors and medical staff with little to no background in business or economics how to think like practice management gurus. If you want to get serious about becoming more efficient, earning more profit, raising customer satisfaction, or even bringing on an associate or selling a practice, there is no better place to start.

Parents Often Overlook Children's Flat Feet: BC Podiatrists

Parents, who are so often vigilant about things like their children's teeth, willing to resort to braces to achieve that perfect smile, will often overlook their kids' flat feet. "It's quite common for children to get their teeth, their hearing and their eyes examined," said Victoria podiatrist Dr. Marshall Baer. "But they don't routinely get their feet examined."

Dr. Marshall Baer

Victoria podiatrist Dr. Martin Cole is also cautious about flat feet, saying only a foot specialist should identify them as a problem. But in general, foot problems treated early can prevent an adult life of problems throughout the body, said Cole. "A lot of times, they will end up having to have orthotics or devices when they are in their 20s," he said. "[But] if you catch an early deformity and you can just put something in their shoe at the right time, you will keep their cartilage aligned in their knees and their back as they grow up."

Source: Richard Watts, Times Colonist [10/15/11

OH Podiatrist is The Oldest Soldier in Afghanistan.

Staff Sgt. Don Nicholas disproves the old refrain: Old soldiers do not, in fact, fade away. They re-enlist. At 59, Sgt. Nicholas is the oldest of the 6,000 soldiers in the 25th Infantry Division in eastern Afghanistan, the Army says. And he is probably one of the very few Vietnam vets now back for more in Afghanistan. He's certainly the only one who saw first-hand the ugly end of that war from the roof of the U.S. embassy in Saigon.

Dr. Nicholas, left, with a fellow soldier in Afghanistan

Nicholas left active duty in 1978 to go to college, and in 1986 graduated from the Ohio College of Podiatric Medicine. Even after he opened his own practice, he was still working out frenetically, in the hope of going back into the Marines someday. The Marines said no, but in 2004 the Army Reserve said yes. "He doesn't want the other 19-year-olds to go," Mrs. Nicholas says of her husband. But "it makes him 19 again. He finds youth in the military."

Source: Michael M. Phillips, The Wall Street Journal [10/15/11]

U.S. Podiatrists Complete International Ilizarov External Fixation Course

From September 30 to October 10, 2011, seventeen podiatrists from the all across the United States were invited to attend the International SBi Ilizarov External Fixation Course in Kurgan, Russia. The team included resident physicians to leaders in the profession, and they spent the week learning from their Russian counterparts various techniques for deformity corrections using (Ilizarov) external ring fixators. 

(L-R) Drs. Pasquale Cancelliere, Jared Remmers, Eric Naasz, Steve Laxson, John Grady, Misako McLeod, Stevan Anselmi, Justin Tidwell, Scott Denisar, Wenjay Sung, Michael Marcus, Charles Hastings, Jason Mallette, Albert Derrico, Verlan Marshall, Robert Brarens, and Victor Herrera.

Dr. Steven Laxson, residency director of the Legacy Health/Kaiser Permanente Foundation, stated, "This program is so very valuable on countless levels. I am proud to support SBI (Ilizarov External Fixation Course)."

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

Bret Ribotsky:  How would you change the podiatric educational experience?

Dr. John Giurini

John Giurini: I certainly would add research to the curriculum. I think that students need to have some research course starting from day one.  They need to be introduced to research because this is the common language that medicine understands. Very few of our residents are involved in that. I would make sure that there is some research exposure during the four years so that podiatric students understand statistics, understand epidemiology, and understand the significance of standard deviation and co-efficient of significance.

Dr. Robert Snyder

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's guest is wound care authority Dr. Robert Synder. You can register for future events by clicking here

Query: Age for Parental Consent

At what age do you not require a parent present to see a child? 16? 18? 21? Do you accept a signed note if the child is brought in by a nanny or relative (grandparent, aunt, etc.)? If the parent comes for the first visit, can you see the child for a follow-up without them? I am running into this situation more and more, and would love some guidelines.
 
David Alper, DPM, Belmont, MA 

Editor's comment: PM News does not provide legal advice. The age of majority in most states is 18. In general, a child under the age of majority should be brought in by a parent. If the child is brought in by someone else, you should make a diligent effort to assure that the parent has, in fact, consented to your examination and non-surgical treatment of the child. This should be a written authorization signed by the parent. This written authorization can cover subsequent visits in which the child presents without a parent, but you should contact the parent when the child arrives at your office.

RE: Chronic Ankle Ulcers (Jay Goldstein, DPM)
From: Pat Caputo, DPM

It sounds like most good and reasonable standard and advanced topical wound care has been attempted. You seem to be dealing with a non- ischemic ulcer, a 6 year old venous wound that is now quite fibrotic. Either choice of negative pressure wound Vac device is likely to give you the same non-healing results until you can deal with the etiology of this chronic wound. After six years, the first step is actually to take a step back, and re-evaluate the whole case. Stop nursing this wound and re-define the diagnosis and etiology!

At our hospital wound care center and in my private practice, I utilize...

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

RE: Mini TightRope for Hallux Valgus (Michael B. DeBrule, DPM)
From: Zeeshan Husain, DPM

Arthrex has a newer system that came out over a year ago with a small plate that you put on the lateral side of the 2nd metatarsal. The suture is passed through the same way and the buttons fit into slots on the plate. The idea is to disperse the stress over a larger surface area to minimize stress risers at the drill sites. Talk to your Arthrex reps, and they will provide you with the newer system.

Zeeshan Husain, DPM, Rochester, MI, zee@alum.mit.edu

RE: Plantar Fibroma
From: Ira M. Baum, DPM

I’ll throw the technique I use on occasion into the mix. Prep and drape the area. Infiltrate plain local anesthesia around the lesion.  I use a 20 guage needle and needle the mass into a disorganized, mulch-like consistency. I then infiltrate Kenalog or Celestone. This is a technique-driven procedure with several potential risks:  injuring the plantar medial nerve branch and weakening of the plantar fascia with all its consequences. I’m sure there are many other potential risks. 

Having said that, I have had good success. Good means that most patients have some degree of relief, minimal pain, some post-procedure bruising, but I have had no complete resolution of the mass. It becomes smaller and more disorganized, but does not resolve. I do remove plantar fibromas, but I haven’t had to remove any that I did the needling technique on. This procedure has been previously described in the literature. Ultrasound, if you have it, is helpful. 
 
Ira M. Baum, DPM, Miami, FL, ibaumdpm@bellsouth.net

RE: Money-Back Guarantee for Orthotics (Charles Perry, DPM)
From: Kathy Johnsen

Advantage Lab (Deer Park, NY) offers a 60-day full refund or exchange on all of our orthotics. We also offer 6 months for no charge additions/modifications.
 
Kathy Johnsen, Advantage Lab, advantagelab@optonline.net

RE: You Can't Suture That

A patient recently presented to my office with infected sutures. Approximately 11 days prior, she sustained an injury to the hallux that avulsed the toe nail. She went to the ER of a local hospital and the ER doctors decided to suture the avulsed nail back to her toe. Needless to say, the nail popped off as soon as I removed the sutures and drained the abscess. She is doing well and a new nail is growing in.
 
Elliot Udell, DPM, Hicksville, NY

SPACE AVAILABLE - NYC & LI

2 lightly used Microvas units (2010) for sale at $7,000 each plus shipping. Paid $16,000 for each machine. Great way to add therapy modality to your practice. Contact: klamdpm@hotmail.com

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 – 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/LEASE - NORTHERN, NJ

Part-time practice for sale or lease. Flexible terms, will consider lease with option for sale. Structured for a fast sale, first option on real estate. Great opportunity for a start-up or satellite with immediate income. Call 201-573-0555 or 551-574-0776 billfeet@aol.com

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 - 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 - 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 - SOUTH CAROLINA
 
Upstate practice seeking PSR-24/36 trained associate. Full-time position with partnership opportunity. Must be ethical, highly-motivated with strong surgical and medical skills. Please send CV to palpodiatry@att.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

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 - 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 - 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 – IOWA CITY AREA

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

PM News Classified Ads Reach over 13,500 DPM's and Students

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