The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

October 23, 2010 #3,991 Publisher-Barry Block, DPM, JD

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NY Podiatrist Discusses Ideas to Minimize the Dangers of High Heel Shoes  

"The general rule of thumb is that you want to stick to a heel that's two inches or less," says Manhattan podiatrist Dr. Jacqueline Sutera. "The higher you go, the more problematic it gets."  For those who wear higher heels, the inclusion of Poron foam helps to cushion the foot from the added stress.

Another solution is Insolia insoles. "These redirect your body weight toward the back of the heel, which is how it should be," states Sutera.

Source: Dr. Oz  Show  

Blaine Labs Establishes WesternU Scholarship

Blaine Labs President and CEO Robert Blaine, DPM, has established the Blaine Labs Endowed Scholarship at Western University of Health Sciences College of Podiatric Medicine. “Dr. Blaine is truly a giver. He’s really committed to the profession and to our vision here at WesternU,” said College of Podiatric Medicine Dean, Lawrence Harkless, DPM. 

Dr. Robert Blaine

The scholarship will be awarded to College of Podiatric Medicine students based on overall grade point average, public service, leadership potential, and extra-curricular activities. Blaine Labs, based in Santa Fe Springs, California, develops and distributes dermatological products for the medical and cosmetic markets. The company identifies common medical skin problems that do not respond well to present clinical treatments.

NY Podiatrist Offers Post-Marathon Advice

While you might not be participating in the prestigious November 7th New York Marathon, runners of all shapes, sizes, and stamina levels can benefit from keeping their feet in good shape, whether it is for a leisurely jog through the park or a strenuous 26.2 mile marathon.  Podiatrist Dr. Oliver Zong, Director of Surgery at NYC FootCare offers this post-race advice.

Dr. Oliver Zong

When the race is complete, Dr. Zong says practice RICE:

• Rest your feet.
• Ice helps keep inflammation and swelling down.
• Compression with ACE wraps will also reduce swelling.
• Elevation will help your feet rest up for the next big run.

Source: Susan Brady, Health News [10/21/10]

Use Web Videos to Attract Website Visitors to Your Office

Upload professionally produced web videos to your practice website to hold potential patients on your site up to 10 times longer. Start with a personalized homepage greeting, which will convey your professional credibility while establishing a personal connection with prospective patients.

Source: Adapted from "Increasing Visitor Conversions," (www) comscore.com

                                                      Feds Break up $200 Million Medicare Scam

In yet another prosecution intended to deflate the notion that South Florida is a “haven” for Medicare fraud, federal authorities broke up a $200 million operation that they say was claiming, among other allegations, to have provided psychological counseling services to Alzheimer's patients. The 13-count indictment charges four individuals and two businesses with paying kickbacks to other Medicare providers and patients in exchange for providing billing information and making it appear that patients were eligible to receive counseling services when they were not.

The services were either not medically necessary or never provided at all. For example, American Therapeutic Corp. routinely claimed to have provided intensive mental illness treatments to patients whose dementia and diminished mental capacity would not have allowed them to benefit from psychological counseling. “Today's arrests and search warrants give notice to anyone involved in fraudulent healthcare practices that there are no ‘safe havens' for their businesses in South Florida,” FBI acting special agent in charge William Maddalena said in a news release.

Source: Joe Carlson, Modern Healthcare [10/21/10]

Query: California Radiography Supervisor Operator Permit

Can anyone tell me the best review course or study guide for the CA  Radiography Supervisor Operator Permit Exam? I am aware of the syllabus that the Department of Health Services Radiological Department provides. Are there any other good review courses or study guides?

Mafutaga S. Tagaloa-Tulifau, DPM, Lakewood, CA

Query: 2011 Extremity Diagnostic Ultrasound Code

CPT 76880 (ultrasound, extremity, nonvascular, real time with image documentation) has been deleted for 2011. What is the new replacement code?

Bob Kornfeld, DPM, Manhasset, NY

Response: As you noted, January 1, CPT 76880 (ultrasound, extremity, nonvascular, real-time with image documentation) is no more. On January 1, 2011, nonvascular extremity ultrasound will have two new codes:

CPT 76881 - Ultrasound, extremity, nonvascular, real-time with image documentation, complete.

CPT Guidelines: A complete ultrasound examination of an extremity consists of real-time scans of a specific joint that includes examination of the muscles, tendons, joint, other soft tissue structures, and any identifiable abnormality.

CPT 76882 - Ultrasound, extremity, nonvascular, real-time with image documentation, limited, anatomic specific.

CPT Guidelines: A limited, anatomic-specific ultrasound examination is performed primarily for evaluation of muscles, tendons, joints, and/or soft tissues. It is a limited examination where a specific anatomic structure such as a tendon or muscle [Moderator Note: or plantar fascia] is being assessed. The code would be used to evaluate a soft-tissue mass that may be present in an extremity where knowledge of its cystic or solid characteristic is needed.

Most ultrasound examinations performed by foot and ankle specialists would be expected to fall in the CPT 76882 - limited, anatomic specific - category.

Harry Goldsmith, DPM, Cerritos, CA  

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RE: Bilateral "Burning" Heel Pain (Howard Gale, DPM)
From: Richard Rettig, DPM, Jeffrey Kass, DPM

I think Dr. Gale correctly diagnosed plantar fasciitis (at least one should consider that as the most likely and simplest cause of this condition, considering the x-ray and ultrasound findings). He used a plethora of treatments, including a cortisone injection, which was the only treatment that provided relief. Oddly, he only used a very short-acting steroid, dexamethasone, by itself. My experience tells me that a properly injected cortisone shot works better than all the other modalities combined. I always combine Marcaine, dexamethasone phosphate, and triamcinalone acetonide in my plantar fasciitis injections.

Richard Rettig, DPM, Philadelphia, PA, rettigdpm@gmail.com

Consider tarsal tunnel syndrome, or entrapment of medial calcaneal nerve. Since there is mention of low back and knee pain, biomechanically speaking, the patient may hyperpronate and this would tighten the lacinate ligament and put pressure on the nerves.

Additionally, from the size of those spurs, It would make sense for there to be a tractional pull of the fascia. If the fascia thickens, then this also can put pressure on the nerves. Try pressing on the heel more medially, then plantarly, and see if the patient has pain there. The plantar fascia is plantar, and hence if the pain is medial, it will divulge to you a nerve situation. In the differential, you can include small nerve fiber disease. The diagnosis could be made with epidermal nerve fiber density testing.

Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com 

RE: Help for Class of '10 Without Residencies (Hal Ornstein, DPM)
From: Kathy Satterfield, DPM

While the pain of not having a residency stings now, AAPPM's offer of this preceptorship is going to pay off in huge ways when these young doctors are in practice a few years from now. They will have what we never did - business acumen.
 
As a graduate of a surgical residency program 20 years ago, no one taught me how to do billing or coding, or how to offer patients more than my medical and surgical services. These graduates will have the best of both worlds. But, of course, it is delayed gratification. Although it hurts now that you did not get a program, be smart and take Dr. Ornstein up on this valuable offer. In terms of the bottom dollar, you will fare better than those who got the best programs right out of school. Thanks, Hal. You continue to give to the profession more than you get. Thank you, friend, for your generosity and collegiality. 
 
Kathy Satterfield, DPM, Upland, CA, vksatterfield@aol.com

RE: Help for Class of '10 Without Residencies (Hal Ornstein, DPM)
From: Dennis Shavelson, DPM

I am pleased to announce that I have contracted with Devanshu Patel, DPM, a 2010 graduate of TUSPM, to begin a biomechanics fellowship (precepteeship) until he can fill a residency slot in 2011. If other DPM’s need assistance in forming this kind of program for other 2010 graduates in need of help, please contact me ASAP.

Dennis Shavelson, DPM, NY, NY, drsha@lifestylepodatry.com

RE: Doctor (DPM) Doctor? (Mr. Jeff Root)
From: Ira M. Baum, DPM

With all due respect to Mr. Root, his opinion on the DPM/MD discussion is naïve. What he thinks is lacking in the debate are: 1. What differentiates podiatry from other specialties? and  2. How a degree change will benefit patients? Podiatry is a specialty of the foot and ankle and deals with anatomy and function with relationship to the body as whole. In the U.S., the medical environment is  specialty focused, and patients benefit from specialty care. This is not a discussion comparing and contrasting specialists vs. generalists.

All physicians are taught basic science in medicine and surgery. What differentiates the specialties is the post-graduate training. Podiatric education in the U.S. is good, and the institutions do the best they can, but they don’t have the facilities and resources that many medical schools have available. It seems it should benefit podiatric students and podiatrists if podiatric medical schools melded into medical schools, and the graduate would receive one degree. One degree would open access to quality post-graduate training, and therefore improve the quality of care for patients with foot and/or ankle problems. In addition, it would help patients by having a well-established relationship with all specialties during and after training. These relationships enhance the team approach to medicine, which has proven to benefit patients. Finally, a change in degree and improved access to post-graduate training would also solve many of the political and economical disparity issues that podiatrists face today and will in the future.  
 
Ira M. Baum, DPM, Miami, FL, ibaumdpm@bellsouth.net

RE: Doctor (DPM) Doctor? (Mr. Jeff Root)
From: Leonard A. Levy, DPM, MPH

For about 40 years, I have been part of the discussion regarding such issues as pre-doctoral podiatric medical education, residency training, parity with the MD and DO community, and related issues. It is obvious to me that there now is a large but still not universal segment of the podiatric medical profession who believe the DPM needs to:

•  Also have an MD or DO degree or
•  Be granted a MD or DO degree instead or
•  Have parity with the MD and DO community

These discussions have become widespread, enhancing frustration, and creating other symptoms not conducive to professional tranquility. This will not lead to any decision as to whether change needs to occur and, if so, what the strategy to achieve such change should be. I suggest that a grassroots segment of the profession and/or the APMA once and for all conduct major national forums and strategic planning sessions to determine if change does need to occur and, if that is the case, how and when it should occur. Failure to do so leads nowhere, increases frustration, and/or continues non-productive rhetoric.

Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL, levyleon@nova.edu

RE: PinPointe FootLaser Receives FDA Clearance for the Treatment of Onychomycosis
From: Keith Gurnick, DPM

I have tried to keep informed about all the latest advances and claims in laser technology to treat toenail onychomycosis, including reading articles in podiatry magazines and any research I can locate on the Internet. I found it interesting that the preliminary published papers on the earlier studies from PinPointe showed a 79% "improvement" in appearance, yet almost every podiatrist's website I have viewed and many newspaper and radio advertisements claim an 87% "success rate" or  "cure rate." When I have phoned to ask where that number came from, I was repeatedly told it was from the laser manufacturer's study (three months on small group of patients). I also find it to be a stretch for the public to be able to understand and differentiate between the statement that the "machine is FDA-cleared" vs. the "procedure is FDA-approved." 

I have not seen this latest study published yet (if someone has it, please forward it to me or send me to the source), but if this newer intermediate-term study shows "68-81% of patients experienced "increased clear nails at 6 and 12 months", this is a far and away decreased claim as compared to an 87% success rate. I will watch to see if podiatrists around the country will revise their written and spoken claims to their patients, as further evidence may continue to show this procedure to be less effective than originally stated, and may require multiple treatments to enhance its efficacy.

Keith Gurnick, DPM,  Los Angeles, CA, keithgrnk@aol.com

RE: PinPointe FootLaser Receives FDA Clearance for the Treatment of Onychomycosis
From: Michael Tritto, DPM

The Pinpointe Laser has been a controversial topic and point of contention throughout the country based on its entry into the market and the entire issue of FDA clearance. I have been waiting for more information on results before considering using this type of technology. Now that it is FDA-approved I am still a little confused on the semantics of how this approval is worded.

I have not read the actual study submitted to the FDA and would like information on how to access that study and its data. I am confused by... 
 
Editor's Note: Dr. Tritto's extended-length letter can be read here. 

RE: Too Many Toes?

Too Many Toes

Source: Submitted by Dr. David Secord

ASSOCIATE POSITION - NASSAU COUNTY, NY

Experienced board certified podiatrist wanted for busy diversified practice located in Nassau County, New York. Energetic DPM, please send CV to JELLA810@GMAIL.COM

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 - 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

EQUIPMENT FOR SALE: PADNET SYSTEM BY BIOMEDIX

Less than 1 yr old. Two computer laptops included to allow flexibility of testing in 2 offices. Training by Biomedix included in price. Willing to sell for remainder of balance on lease. Contact by email at hassenfratz@hotmail.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

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

ACTIVE PRACTICE FOR SALE - NEW YORK CITY

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

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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