The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

October 22, 2010 #3,990 Publisher-Barry Block, DPM, JD

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PA Podiatrist Discusses Causes and Signs of Warts

Warts, which are caused by a subtype of the human papilloma virus, form as a result of a rapid growth of cells on the outer layer of the skin as the body tries to wall off the virus, said Dr. Amber Treaster of Harrisburg Foot and Ankle Center, which has offices in Harrisburg and Mechanicsburg. “Once you have the virus, you can’t get rid of it, so you are more likely to get warts again,” Treaster said.

Dr. Amber Treaster

Often a telltale sign of a wart is little black dots that appear within it, which are actually small clotted blood vessels that bring nutrients to the warts, which is why they can bleed when disturbed, Treaster said.

Source: Pennlive.com [10/19/10]

NYCPM Honors Three at Centennial Convocation

The New York College of Podiatric Medicine got an early start on its centennial year celebration by honoring three distinguished individuals at a convocation and testimonial luncheon held at the New York Academy of Medicine. Proceeds from the luncheon benefit the College's student scholarship fund.

(L-R) John A. Romans, George A. Cioe, and Dr. Eric R. Braverman

The college bestowed the degree of Doctor of Humane Letters on Eric R. Braverman, MD, Founder and Director of PATH Medical and the PATH Foundation (hooded by Stanley H. Kornhauser, PhD); George A. Cioe, Executive Vice-President of The Tetra Corporation (hooded by Patricia A. Cioe, MS, RNP); and John A. Romans, President and CEO of BioMedix Vascular Solutions, Inc. (hooded by Thomas J. Fogerty, MD). 

PinPointe FootLaser Receives FDA Clearance for the Treatment of Onychomycosis

PinPointe USA, Inc., a leader in podiatric light-based therapy, announced today that the PinPointe^tm FootLaser^tm received clearance from the U.S. Food and Drug Administration (FDA) for the treatment of nail fungus (onychomycosis). "PinPointe submitted clinical evidence to the FDA demonstrating that after a single treatment, between 68 percent and 81 percent of patients experienced increased clear nail at six and 12 months, and 81 percent of all patients had sustained improvement at 12 months," says John Strisower, founder and Chief Executive Officer of PinPointe.  

Dr. Adam Landsman

"Toenail fungus is an incredibly embarrassing, chronic condition affecting millions of people worldwide that genuinely impacts a person's quality of life. For some with diabetes or immune disorders, nail fungus can lead to serious health problems," said Dr. Adam Landsman, Assistant Professor of Surgery at Harvard Medical School and Chief of the Division of Podiatric Surgery at Cambridge Hospital in Massachusetts. "With the clearance of the PinPointe FootLaser, patients finally have a pain-free treatment option that is more successful than topically applied antifungal drugs, safer than oral medication, and less painful than surgical removal of the nail." 

Source: Sys-Con Media [10/20/10]

NJ Podiatrist Steps in to Save 1,500-pound Champion Steer

At farm shows and 4-H fairs, when an animal becomes Grand Champion, it is often sent to auction to the highest-bidding butcher. For the youngsters who breed, raise, work with, and show the animals, it can sometimes be a tough reality to accept. They often become close with the animals, like any child would with a family pet. So when Winchester, a beloved steer owned by 16-year-old Julie Poliskiewicz, was facing such a fate, Dr. Amanda Richline, a Belvidere podiatrist, wanted to save the 1,500-pound animal.

Winchester with Julie Poliskiewicz

Dr. Richline sent Julie's mother, Michele, to bid on her behalf, instructing her to bid at whatever level it took to save Winchester. The bidding got intense: grand champion beef is sold for top dollar at butchers and meat counters. Michele kept at it though, and in the end, Winchester was again Julie’s, saved from slaughterhouse with an all-time record high bid. Dr. Richline said she is happy to have given Winchester back to Julie and delights in knowing that Julie plans to work towards a degree in medicine. “When I heard about the 4-H policy to send champions off to auction, I decided to make Winchester one of the lucky ones,” she said. “I love knowing that he’s living out his days on Del Brook Farm and enjoying his life with Julie.”

Source: Andrea Lovas, NJ.com, [10/20/10]

Teamwork Training Tied to Lower Mortality Rates

Training operating room staff in teamwork, communication, and safety strategies is associated with lower rates of surgical mortality. That was the conclusion of a new study published in the Journal of the American Medical Association that assessed rates of surgical deaths following hospitals' implementation of a training program modeled after practices from the aviation industry.

For the study, researchers analyzed patient data from 108 Veterans Health Administration hospitals. In 2006, following a successful pilot project, the VHA implemented a national team-training program for operating room personnel in all of its hospitals. The program includes a two-month planning and preparation period, a day-long educational conference, and one year of quarterly follow-up interviews. Risk-adjusted mortality rates fell 18% in facilities that had received the training, compared with a 7% drop in non-trained facilities, according to the study.

Source: Maureen McKinney, Modern Healthcare [10/20/10]

Dealing with Difficult People

One of the most challenging tasks a doctor faces is dealing with all the different types of patients you treat. You may not like them all. Regardless, you need to work effectively with them. Follow these suggestions to make that easier:

•  Recognize your own strengths and weaknesses. Accept that you are sometimes right and sometimes wrong. That mindset prepares you to listen, present your point of view and find ways to look together for solutions everyone can live with.
•  Examine your responses. When someone you have labeled as “difficult” engages you, take a deep breath. Ask yourself: Is the person deliberately antagonizing you or simply unaware that you are annoyed? As you look beyond the surface behavior, ask yourself if you are part of the problem. How could you adjust your behavior to improve your relationship?
•  Add emotional distance to your encounters. Make a commitment to yourself that no matter what happens, you will stay calm and keep your temper. Refuse to be drawn into the ineffective behavior, and you can be sure that you are not contributing to the problem in that way.

   Source: Adapted from Shortcuts for Smart Managers, American Management Association via Communication Briefings

RE: Bilateral "Burning" Heel Pain (Howard Gale, DPM)
From: Multiple Respondents

When a condition is bilateral, with a history of the problem starting at the same time in both feet, systemic or neurological pathology needs to be ruled out. Your differential should include: 1) A connective tissue disorder (which the rheumatologist may have already ruled out.) 2) Vitamin deficiencies such as  B1 and B12, and 3) A  herniated disc or even an occult fracture of  the spinal cord. Neurological testing should be done on this patient to rule out a problem coming from the spinal cord. The radiographs that show large calcaneal exostoses and the other tests which point to enlarged or inflamed plantar fascia might be a red herring which could lead to a misdiagnosis.
 
Thyroid problems alone can also lead to bilateral burning in both feet, and many of our colleagues have diagnosed hypothyroidism in the course of working patients up who present with symptoms of peripheral neuropathy, especially burning sensations. Temporarily taking the patient off of Vitorin (which is a statin combined with Zetia) was a good idea, but by and large the side-effects associated with  Zocor and Zetia cause pain in the large muscles and not the tendons of the feet. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

Burning heel pain unrelieved by weight-bearing almost always is a nerve entrapment. Given the history, I would rule out an HLA-B27 enthesiopathy and any other medical issues, including radiculopathy.  I would also aggressively treat the plantar fasciosis with 30-40 mgs of Kenalog in an ultrasound-guided injection and see how the pain responds.  If it gets 90% better, then it is mostly a plantar fascia issue, but if the pain returns in a few days, then it is most certainly a nerve involvement, and  I would focus on palpating the medial calcaneal nerve and the tarsal tunnel.

Plantar fasciosis pain rarely ever hurts when sleeping unless the patient was on the feet all day. I would even try a diagnostic nerve block of the medial calcaneal nerve with 2cc of lidocaine, away and proximal from the plantar fascia.
 
Peter J Bregman, DPM, Tewksbury, MA, footguru@comcast.net

It sounds as if the patient's pain may be neurologically-based. I suggest clinically checking lower nerve tunnels (i.e., common peroneal, tarsal tunnel, and dorsalis pedis) for pain with palpation and percussion. If positive, you may want to consider steroid injection of the affected nerves. Try lower down if the pain seems to be more on the medial edge of the calcaneal tuberosity. Check a little higher up on the medial wall to see if the medial calcaneal nerve is tender. If so, you can try a diagnostic cortisone injection there. and if successful, perhaps follow that up with a radiofrequency ablation of that nerve. 

Dr. Gale also mentioned that she had low back pain too. Was a work-up for spinal radiculopathy performed? NCV's perhaps? Lastly, consider closer evaluation of the FHL tendon distally and proximally. I often see burning as a result of significant tenosynovitis and its anatomical proximity to the PTN. This doesn't typically respond to standard conservative care. 

Paul V. Ledesma, MS, DPM, Scottsdale, AZ, ledesmadpm@gmail.com

RE: Applying for EMR Incentive Payments (David T. Weiss, DPM)
From: Alan Bass, DPM

You need to wait to register through CMS in January 2011 in order to receive the first of the incentive payments.
 
Alan Bass, DPM, Manalapan, NJ, drbass@basspodiatry.com

RE: Help for Class of '10 Graduates Without Residencies

For those 2010 graduates not currently doing a residency, there are several podiatrists throughout the country who are offering their help. For the remaining months before starting your residency, you can spend time doing a full-time podiatric practice management preceptorship.  The purpose is simple: to learn all aspects of what it takes to run a successful practice. Compensation will be provided, but preceptors will not be able to obtain a NJ podiatry license during the program. 

I currently have a Class of 2010 graduate working in my office. He is looking to start his residency in July 2011, and it is working out great. He is so excited to develop the personal and professional skills necessary for success. This is a voluntary activity on behalf of the American Academy of Podiatric Practice Management. Those interested in this program should e-mail me. 

Hal Ornstein, DPM, Howell, NJ, Hornstein@aappm.org 

RE: Doctor (DPM) Doctor?
From: Mr. Jeff Root

As the son of a pioneering podiatrist and as the owner of an orthotic laboratory that has served podiatry for thirty-six years, I continue to listen to the DPM/MD discussion with great interest. I can appreciate valid points on both sides of this debate. There are two issues that seem lacking from this discussion. First, what differentiates podiatry from other specialties in terms of education and, ultimately, in terms of the scope and nature of the practice of podiatry?Secondly, how might a degree change benefit podiatric patients?

The concept of parity seems very ambiguous to me. If parity means total equality, then those who want parity with MD’s, DO’s and orthopedists can only achieve parity by acquiring the exact same degree. If parity means...

Editor's note: Mr. Root's extended-length letter can be read here.

RE: Orthopedists are Obstacle to Improving Scope of Law: NY Podiatrist
From: Alan G. Shier, DPM

Sadly, the truth is that the orthopedic surgeons "know" that we have the right training, and they are afraid our expertise will impact on their bottom line. 

Alan G. Shier, DPM, Little Falls, NJ, dragshier@aol.com 

RE: Maybe They Should Quit Their Day Jobs

These singers are all dental nurse anesthesiologists in Minnesota and they can really sing. They are also funny. Here they sing "Waking Up is Hard to Do."

Source: Submitted by Dr. Robert Steinberg

ASSOCIATE POSITION - CALIFORNIA

Busy, surgically-oriented practice in Bakersfield, CA seeks ABPS qualified/certified surgeon to join our existing two surgeons. Must be hard-working and honest. Strong reconstructive surgical practice with trauma privileges and wound care center/diabetic limb salvage center. Starting in December or January. E-mail CV to aghams2@aol.com

ASSOCIATE POSITION - BROOKLYN, NY

Podiatrist needed Part-time: Established practice in Bay Ridge, Brooklyn. Practice encompasses all aspects of podiatry. Please send resume to: hfasdpm@gmail.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 - NORTHERN NEW MEXICO

Associate needed for a dynamic group practice in Northern New Mexico. We are looking for a well-trained 3-year surgical resident to help us build our practice leading to partnership. In New Mexico we have a leg law. Besides a great professional experience, we have the mountains for skiing, fishing, hunting, and horseback riding. Ideal for an experienced podiatrist looking for a location change. Please send a resume to FootandAnkleAssociates@comcast.net

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

ASSOCIATE POSITION – NORTH, CENTRAL & SOUTHERN ILLINOIS
 
Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings are available. If interested, fax curriculum vitae to 847-674-2113 or e-mail to feetwork@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.

PART-TIME / FULL-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

PART-TIME ASSOCIATE PODIATRIST WANTED - CENTRAL NEW JERSEY

Growing practice in need of an outgoing, hard-working associate. House calls, nursing homes and a busy, well-established office setting. At least a PSR12 preferred. Fax CV to 732 699 1901.

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

TRAUMA FELLOWSHIP - FOOT & ANKLE

Broadlawns Medical Center in Des Moines, IA is currently accepting applications for its 12 month trauma surgery fellowship beginning August 1, 2011. Fellowship to include advanced techniques in all foot and ankle surgery with an emphasis on lower extremity trauma, reconstruction & total joint replacement. Residency training required. Competitive salary and benefits. Please submit a letter of interest, CV, and 3 letters of recommendation to: Ben Olsen, DPM, Director: Foot and Ankle Trauma Fellowship, Broadlawns Medical Center, 1801 Hickman Road, Des Moines, IA 50314, 515-282-7927, bolsen@broadlawns.org

SPORTS MEDICINE FELLOWSHIP

The Palo Alto Medical Foundation Surgical/Sports Fellowship Aug 1, 2011 thru July 31, 2012. APPLICANTS MUST BE ABLE TO OBTAIN A CALIFORNIA LICENSE. Responsibilities include assisting in all types of foot and ankle surgery (approximately 500 cases), seeing patients in the sports clinic and completing 2 papers/research projects. Benefits include salary of $56,500/yr, medical, dental, malpractice, and CME allowance. Interviews at the Midwest Podiatry Conference Mar 3-5, 2011 & ACFAS Mar 8-10, 2011, but on-site visit is preferred. Minimum 24-month surgical residency training pre-requisite. Send a letter of interest, CV and three letters of recommendation to: Amol Saxena, DPM. HeySax@AOL.com

ACTIVE PRACTICE FOR SALE - NEW YORK CITY

Part-time practice available Mid-town Manhattan. Doctor is retiring. (212) 247-5148.

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

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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