The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

October 23, 2009 #3,682 Publisher-Barry Block, DPM, JD

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Barefoot Runners Need to Exercise Caution: MT Podiatrist

Dr. Ronald Ray, a Great Falls podiatrist and physical therapist, said barefoot running is not new. He said where he grew up in Southern California, barefoot running on sand and grass was commonplace. "We ran in the soft sand on the beach and grass all the time. It creates a lot of activity in the arch of the feet and it has huge benefits in strengthening your muscles. "There has been a surge, at least in part, fueled by the Nike Free Shoe — that is the concept of that shoe, to create a shoe that provides protection but yet has little or no stability. So, the foot needs to do extra work to function."

Dr. Raymond Ray

Ray urged that runners be cautious in adopting barefoot running. "Barefoot running is a good idea, to cross train your foot, but if all of a sudden you decide you want to barefoot run, it is going to be great for my business. You need to start slow and be conservative because you don't want to overload that foot," he said. "You would want to start once a week and run short distances, maybe not more than a quarter to half a mile. I might stay at one level for three or four weeks. "You never have a problem when you are conservative," Ray said. "You will have a problem if you make big jumps.

Source: Michael Babcock, Great Falls Tribune [10/15/09]

NYCPM Professor Elected a Fellow of the New York Academy of Medicine

NYCPM Professor of Podiatric Medicine Mark A. Kosinski, DPM, was elected a Fellow of the prestigious New York Academy of Medicine at a regular meeting of the New York Academy of Medicine (NYAM) Board of Trustees on October 13, 2009. 

Dr. Mark A. Kosinski

The Fellows of the New York Academy of Medicine embody the highest levels of achievement and leadership in the fields of medicine and health, as well as science, social work, nursing, education, law, and research. Fellows are an elite group of physicians, academicians, and other health professionals of the utmost distinction who, taken together, comprise a body of knowledge, expertise, and commitment that is the foundation of the Academy’s strength. They are a group of leaders in thought, action, and vision who have dedicated their lives and careers to working to improve the health of the public.

NY Podiatrist Celebrates 100th Birthday

After more than seven decades of practicing podiatry, Dr. Harry Sperer is grateful to the person who advised him to become a podiatrist. A lover of art and design, after completing technical high school in Toronto, young Harry  planned to study architecture in college. But, this was during the Great Depression, and someone wiser told him that if he studied to become a podiatrist, he would be able to make a nice, stable living. And so he took that advice, and enrolled in The First Institute of Podiatry (now known as The New York College of Podiatric Medicine) in 1930.

Dr. Harry Sperer receives Pioneer in Podiatry Award (Dr. Roy DeFrancis in background)

“When I started practicing, I treated the basic foot problems including corns, calluses and bunions and also furnished orthotics if necessary,” he said. “As the years progressed, the practice of podiatry progressed, and we developed surgical practices. We became experts in treating all phases of foot problems.”

A member of NYSPMA, Sperer joined in 1934 and was a member until his retirement in 2003, at the age of 94. In 2000, he was given NYSPMA’s Lifetime Achievement Award. And in 2006, he received the Pioneer in Podiatry Award. “The biggest benefit of being a member of NYSPMA was the camaraderie between all of us,” he said. “I really enjoyed the conventions and seminars, and special courses I was able to participate in as a member over the years.”  For full story, click here 

 Source: Kate Lewis Torok

House Unlikely to Back Stabenow Bill: Hoyer

The House is unlikely to approve stand-alone legislation being considered in the Senate to revamp the Medicare doctor payment formula as it is currently written, House Majority Leader Steny Hoyer (D-MD) told reporters.

Hoyer's cautionary message makes good on a letter he and House Speaker Nancy Pelosi (D-CA) wrote in April indicating they would reject any Senate bills on four items—including the sustainable growth-rate, or SGR formula in Medicare and various tax issues—if those bills didn't contain statutory “pay-as-you-go” language, or if the bills' costs were not offset in some way.

These guidelines aren't being applied in the Senate, however. The legislation to revamp the SGR formula that Sen. Debbie Stabenow (D-MI) wants considered on the Senate floor has no specific offset, such as a tax increase.

Source: Jennifer Lubell, Modern Healthcare [10/20/09]

How to Respond to Crticism

Learn more from criticism by showing the critic that you are willing to listen and eager to learn. Find something to agree with about the criticism, even if that is only the idea behind it.

Example: You may not agree that you provided poor service, but you can agree that providing exceptional service is your No. 1 goal.

Source: Adapted from “The ARTS of Criticism: Giving and Taking,” The Confidence Center via Communication Briefings

Query: Failed TMA Flap

This 54 y/o diabetic male is under good control and compliant. He has PVD with recent successful endovascular intervention and has had a contralateral AK amputation. He recently required a TMA, but in order to get that, we had to use a flap from the hallux and medial aspect of the forefoot to rotate in. The original TMA flap failed, or at least partially failed with dehiscence.

Failed TMA Flap

The wound center then started wound care, HBO, etc., and most of the flap survived and made a great granular bed. We then decided to try a DPC. I used a Sureclosure to get the best coverage, freshened up the edges, and removed some, but not all of the granulation tissue on the flap, and closed it without significant tension.The flap has failed again and the wound center suggests simply removing the flap and letting it heal. I hate to lose that much skin for coverage. Any suggestions would be helpful.
 
Tip Sullivan, DPM, Jackson MS

RE: Traumeel or Zeel Injectable (John D Lanthier, DPM)
From: Steven Subotnick, DPM

Some of the podiatrists in the Bay Area, where I practice, use Traumeel for peri-tendinous injections, and bursitis, and joint arthritis. I use Zeel for tendinitis and fasciitis and joint arthritis since...

Editor's note: Dr. Subotnick's extended-length letter can be read at: http://www.podiatrym.com/letters2.cfm?id=29837&start=1

RE: Source for Evaluating EMRs (John Moglia, DPM)
From: Michael L. Brody, DPM, Zac Childress

There is no source available at this time. Certification for "Meaningful Use" has just begun, and NO software package has gone through that certification as of today. Once software products are certified, they will be listed at the CCHIT website.

Please remember, in order to "qualify for the government subsidy," you not only need to have software that meets the government requirements, but you must use the software in a "meaningful manner."

From what I understand, the NJ Podiatric Society is having a meeting in November where there will be a number of software vendors talking about their products. I recommend attending that meeting. Contact the Association for more details.

Michael L. Brody, DPM, Commack, NY, mbrody@tldsystems.com

In order to qualify for government funding by adoption of an EMR, the American Recovery and Reinvestment Act of 2009 spells out that eligible providers need to be using a "certified" EMR in a "meaningful way." In order to demonstrate meaningful use, your system may have to include a number of features that might be considered bells and whistles. Use of these features could make the difference in whether your practice qualifies for the funding. System certification standards have not yet been finalized, so by definition, no system has attained government certification to date.
 
Contact your state association. They may have resources for you regarding this topic.
 
Zac Childress, Oxford, MI, zac@godarwintech.com

RE: Hill Chairs (Gary Trent, DPM)
From: David Tarr,  DPM

I ordered a Hill chair two years ago. The foot rest doesn't collapse. It is made rather flimsy, and if a patient accidentally sits on it, there's a good chance it'll break and cause chair and/or patient injury. Hill does have some chairs where the foot rests folds down.  I've had problems several times with the tray collection area under the foot rest, and I have had to do several repairs. The good news is that Hill’s service department is helpful, but I’d rather not have to deal with them so often. They are cheaper chairs, but you get what you pay for. I have some old Midmark Chairs. They are more expensive, but much more durable, and in over 20 years, I have had to repair them only once.

David Tarr, DPM, Lowell, MA, tarrdpm1@aol.com

RE: Obama’s Healthcare Plan  (Jason Kraus)
From: Multiple Respondents

Healthcare as a "right" vs. a commodity: We doctors have each spent a decade to a decade and a half obtaining the ability to diagnose and treat illness. We spent countless hours studying, deferred any life rewards and indebted ourselves for this education by multiple methods (and are most probably still paying off the loans). We have complied with the innumerable requirements placed by society on the practice of medicine prior to providing care to the citizens of that society. We are not society's enemies, despite the insurance industry's best efforts to characterize us in that light.

No one has a "right" to the sweat of an individual's brow unless we have repealed President Lincoln's Emancipation Proclamation. "Life, liberty and the pursuit of happiness" are "rights". If society wishes to pay for our labor, so be it. If I decide to provide care to an individual without charging a fee, that is my ethical/moral decision and a gift. BUT, we are not slaves and healthcare is not a "right."
 
Harry A. Harbison, DPM,  Long Beach, CA, harbih@verizon.net

Editor’s Note: Additional letters by Dr. O'Heir and Dr. Purdy appear at: http://www.podiatrym.com/letters2.cfm?id=29832&start=1

PODIATRISTS CHICAGO/NW IND/BALTIMORE/WASHINGTON, DC

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Jake Shimansky, Director of Physician Recruitment. Phone-773-342-5221 FAX 773-486-3548-E-Mail jshimansky@homephysicians.com  www.homephysicians.com

ASSOCIATE POSITION - AUSTIN AND SAN ANTONIO AREAS

Seeking well-trained ABPS board certified/qualified foot surgeons for surgical practice with national foot/hand/orthopedic surgery group. Excellent salary/benefits. Email CV and cover letter to: slb99@pdq.net

ASSOCIATE POSITIONS - INDIANA/OHIO

PrimeSource Healthcare is a leading provider of mobile, on-site healthcare services at long-term and skilled nursing facilities. Our exceptional growth has created an immediate need for traveling, independent contractors of podiatry services in Indiana/Ohio. Earn between $175k and $225k per year. E-mail CV to kwright@pshcs.com. Visit us at pshcs.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 a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to fmassuda@footexperts.com

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- SEATTLE, WA

Beautiful office for sale in the heart of Seattle, WA. Newly renovated, 2,500 sf, new digital x-ray, vascular lab, state of the art physical therapy equipment, paper-less system, all new podiatric furniture and equipment, popular podiatric products store and beautiful diabetic shoe display. Office is located in the medical building and open 3 days a week. Great opportunity for expansion to full-time. Please send us a letter of interest to the: podiatrygroup@yahoo.com

ASSOCIATE POSITION-INLAND EMPIRE, CA

Busy 2 office multi doctor practice looking for dedicated, dependable, honest doctor to work 3-4 days per week. Must be ABPS BC/BE. Send cover letter and CV to bkatzman2@earthlink.net

ASSOCIATE POSITION FULL-TIME - SUBURBS OF CHICAGO

PSR 36 - month-trained podiatrist needed for busy suburban Chicago practice. Office and diagnostic equipment state-of-the-art. Full benefit package included. If interested, please fax your curriculum vitae to 847.352.0270 or email to foot1st@yahoo.com

ASSOCIATE POSITION - FREDERICK, MD

Well-established and growing 2 office state-of-the-art practice located in medical/professional buildings. EMR, Digital X-ray, Ultrasound, DME provider, etc. Competitive Base Salary plus bonus, malpractice, health insurance, etc. PSR 24 minimum/Board Qualified or Certified with ability and desire to take ER call. If interested, forward CV to DOCSBNB@aol.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

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