The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

October 25, 2010 #3,992 Publisher-Barry Block, DPM, JD

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Seven Times More Pressure From 3" vs. 1" Heels: IL Podiatrist 

Dr. Melissa Hong, a Crystal Lake podiatrist, said women’s foot pain often comes from dress shoes. She added this is because dress shoes tend to have a narrower mold than loafers or athletic shoes. “Dress shoes have a low profile and they’re not as deep,” Hong said. “So you don’t get support and you have crowding within the toe box. This leads to hammertoes and blisters.”

Dr. Melissa Hong

Hong said hammertoes, the bending of the toe at the first joint so the toe resembles an upside-down “V,” and blisters are a couple of the many problems that wearing ill-fitting shoes, particularly those with heels, can cause. “When you switch from a 1-inch heel to a 3-inch heel, there is seven times more pressure on the ball of your foot,” she said. Hong added she’s seen cases of tendonitis, ankle sprains, hammertoes, blisters, ingrown toenails, and fractures from high heel wear.

Source: Kirsten Tellam, Medill Reports [10/21/10]

Barefoot Runners Can Develop Shin Splints: NY Podiatrist

Studies have found that running barefoot might be better for your body over the long run than running in shoes. A 2009 study found that compared to going barefoot, running shoes put more pressure on the hip, knee, and ankle joints and concluded that running shoes could put athletes at greater risk for osteoarthritis of the knee. Earlier studies found that running shoes could increase the risk for plantar fasciitis and ankle sprains.

Dr. Karen Langone

But podiatrists urge caution before running without shoes. “I tell my patients it’s a great thing to try,” said Dr. Karen Langone, a sports fitness podiatrist in Southampton, NY. “But it’s not for everyone, and it should be gradually incorporated into your running program.” Some people require the mechanical support that a running shoe offers. “I saw quite a few patients this summer who had developed shin splints from running barefoot,” she said.

Source: Lesley Alderman, The New York Times [11/22/10]

DC Podiatrist Elected Secretary of NAP

Dr. Harold Glickman of Washington, DC has been elected secretary of the National Academies of Practice (NAP) for the 2010-2012 term. NAP is an organization of distinguished practitioners representing 10 different healthcare professions, working together to advance coordinated, accountable, accessible, affordable healthcare for all.

Dr. Harold B. Glickman

Dr. Glick, a distinguished practitioner in the podiatric medicine academy, is past-president of the American Podiatric Medical Association.

TX Podiatrist Named to D Magazine's Best Doctors List 

Dr. Leon Brill has again been named to D Magazine's Best Doctors List. Best Doctors is a peer-review voting process. D Magazine relies on the doctors’ expertise to determine who deserves to be on the list, just like a doctor would recommend a patient to a specialist. This year, they mailed a letter to 7,196 local doctors inviting them to vote, using an online ballot on their website.

Dr. Leon Brill

Dr. Brill is director of the Limb Salvage Center at the Brillstone Building in Dallas, where he diagnoses and treats foot and ankle problems associated with high-risk diseases such as diabetes and vascular disease. He is past chairman of the department of podiatric surgery at Presbyterian Hospital in Dallas.

Source: D Magazine [November 2010]

NY Podiatrist Running For Assembly Vows No New Taxes

Some of the Republican and Democratic candidates for Assembly, state Senate, and Congress shared their views with residents at the Ozone Park Civic Association candidates night on Tuesday. Several of those running in local races did not attend the event. In fact, the only race where voters got to hear from both candidates was in the 23rd Assembly District, where incumbent Audrey Pheffer (D-Ozone Park) is facing Republican Harold Paez, a podiatrist who resides in the Rockaways.

Dr. Harold Paez

Paez told the audience that he is running for Assembly because he wants to bring a significant change to the “dysfunctional” way Albany operates. Paez noted the $9 billion state deficit as proof of the legislature’s reckless spending. “That is not a good position for any state to be in,” he said. Paez said despite being in one of the worst economic times since the Great Depression, the state government still had spending increases the last two years. Paez said he supports a cap on property taxes, and pledged to vote against any new taxes if elected.

Source: Bryan Yurcan, Queens Chronicle [10/21/10]

KY Podiatrist Indicted on 23 Counts of Medicaid Fraud

A Kentucky podiatrist has been indicted on 23 counts of Medicaid fraud. Attorney General Jack Conway announced today that a Franklin County grand jury indicted Dr. Richard E. Skrip. Skrip is a podiatrist in London.  The indictment follows a criminal investigation conducted by the Attorney General's Medicaid Fraud and Abuse Control Unit into Skrip's billing practices.

Skrip, who has offices in several locations in south central and south eastern Kentucky, is charged with defrauding the Kentucky Medical Assistant Program by submitting claims for payment of services totaling approximately $25,000. The indictment alleges Skrip submitted claims for services that he did not perform related to 26 patients between May 2001 and May 2008.

Source: WKYT [10/22/10]

Query: Merging Podiatry Practice into Internal Medical Group

I have recently been offered an opportunity to join/merge my solo podiatric practice into a large (15-doctor) internal medical group in the next building. Any thoughts pro or con? The greatest challenge at this point is coming up with a reasonable percentage number below my current true overhead that would make sense. Any thoughts?

Name Withheld

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

This sounds like a wonderful candidate for a trial of 4% ethanol in Marcaine injections. If you are not familiar with them, please go to Northwest Podiatry Foundation. Much excellent research in the podiatric and medical communities substantiates the validity of this treatment, as does literature in podiatric, medical, and radiological journals.

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

Let's not be fooled into thinking that because a patient got temporary relief from a local injection of dexamethazone, the pathology is local to the foot and not systemic. An injection of a steroid anywhere in the body will affect other parts of the body. A portion of it is systemically absorbed. Very often patients presenting with pain and inflammation in multiple joints will say that the injection they received in the foot alleviated the aches and pains in other parts of their body.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

Dr. Gale has provided the patient a great variety of treatments without success. I do not believe that the use of soluble corticosteroid injections is helpful, since it is resorbed too quickly to provide any lasting effect. You may want to try an insoluable steroid instead. My experience with most OTC orthotics in the treatment of plantar fasciitis has been poor except for Super Feet Orthotics.

My most successful treatment has always been custom rigid functional orthotics made from...

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

RE: Help for Class of '10 Without Residencies (Hal Ornstein, DPM)
From: H. David Gottlieb, DPM

It is fortunate that progressive thinkers are finding ways to help members of the Class of 2010 who did not match with a residency last March. Unfortunately, it will take more than a handful of podiatrists to help this year's Class of 2011. At last check, there were only 6 states/territories out of 52 that did not require a residency program for licensure.

Last year, there were 12 more graduates than there were available entry-level residency positions. This year the estimated number is 60. Plus there are older graduates who never had the opportunity for a residency program or who now find that their one-year program no longer meets their hospital requirements. I believe that when the numbers of people who are eligible to be able to participate in this year's residency matching process are compared to the number of entry level positions available, there could be a shortfall of 80 or more positions.

I don't know the answer to this problem. OCPM thinks it's to limit class size for now, and maybe they are right. I feel bad for the participants in this year's residency match process who won't match. Existing residency programs can't just expand willy-nilly.  I just hope the doctors who are working on helping those left out will be able to expand their good deeds to accommodate the coming deluge.

H. David Gottlieb, DPM, Baltimore, MD, hdavidgottliebdpm@gmail.com 

RE: Doctor (DPM) Doctor? (Len Levy, DPM, MPH)
From: Tilden H. Sokoloff,  DPM, MD

Kudos to Len. As usual, he hit the nail on the head. We have had articles, special editions in our journals, and a lot of discussion, all centering around the issue of an MD/DO degree change. The solution is right in front of our noses, as Len stated well, a national referendum on the topic and put it to bed once and for all. The frustration about our education and the lack of parity or equality is heart-wrenching. Podiatric medicine and surgery is a great specialty and a needed one. It is time to step it up a notch. It kills me to see our graduates go without a residency slot when the residencies in our country go to foreign medical graduates.

Our colleges would be stronger if there were a portal to all medical and surgical fields. Those who choose to stay in podiatric medicine and surgery would be better paid, and the training would be available to all who wanted it. Our profession is much more than biomechanics; that is a unique niche, but we have the ability to serve the greater needs of our patients and then some. Our political leaders are here to promote its members' agendas. Let's see where we can take it.

Tilden H. Sokoloff, DPM, MD, IUHS School of Medicine, docsok@healthsearches.com 

RE: FDA Laser Clearance for Treatment of Onychomycosis (Keith Gurnick, DPM)
From: H. David Gottlieb, DPM, Adam Landsman, DPM, PhD

We have a phrase in our clinic regarding onychomycosis: "Phenol cures fungus." We, as podiatrists, are a surgical specialty or we are not. If our patient does not choose for permanent 'cure' of his infection [and chronic infection it is], then we are not obligated to treat it. It is a choice of treatment, and all choices need to be acceptable to both doctor and patient. My patients are free to go elsewhere if they do not choose a true cure. I don't like to provide anything less.

If you want to be palliative podiatrists [i.e., chiropodists], [and we can provide the best palliative foot care around] then embrace it and fight over who owns territorial rights to a modality you couldn't get. If you want to call yourself a surgeon, then be one. Phenol cures fungus, and yes, so does a terminal Symes.

I believe that the right of a manufacturer to enforce territorial limits for their device is legal. Deal with it, live with it, but please, I'm tired of hearing people complain about something they now regret not haven't been involved in early enough. I regret not having bought the last winning lotto ticket, but oh well, I go on with my life.

H. David Gottlieb, DPM, Baltimore, MD, hdavidgottliebdpm@gmail.com

I would like to have the opportunity to respond to the questions raised about the recent FDA clearance of the PinPointe FootLaser for the treatment of onychomycosis. By way of introduction, I would like to clarify my role in this process. I participated in the FDA clearance...

Editor's note: Dr. Landsman's extended-length letter can be read here.

RE: FDA Laser Clearance for Treatment of Onychomycosis (Keith Gurnick, DPM)
From: Marc Katz, DPM

Here is the bottom line with these treatments and approvals. I spoke with a source at the FDA. There will be several other companies FDA-approved very shortly. There are three levels of FDA approval for this type of treatment. Pinpointe currently has obtained the lowest level. When 510Ks are submitted, many companies will obtain the same approval because the level of evidence is minimal, and stronger studies are not needed. Some may or may not get higher levels of FDA approval. To obtain the other higher levels, there will need to be very solid studies. However, in real life, it's the actual patient results that count.

We all know that there is no cure for onychomycosis. There is a real chance of recurrence. We also know that more than one treatment is necessary as evidenced by the statement, 68-81% of patients experienced "increased clear nails at 6 and 12 months. Increased clear nails? Is that 95% increased clear nails or 5% increased clear nails? I can obtain some clearing of nails at 12 months with a cream. I believe Penlac has an "8% cure rate." We must be up-front with our patients when providing these treatments. I hope that all DPM's want their patients to have amazing results that require several treatments, not some clearing and then cash in the pocket. That's a no-win situation.

Another thing that we all know is that these FDA approvals are to be taken with a grain of salt when it comes to evaluating effectiveness of treatment. They are basically just making sure that the laser is safe. So let's be real with ourselves and our colleagues, honest with our patients, and realistic about what these FDA approvals really mean.

Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

RE: These Socks Cost an Arm and a Leg

This is one pair you don't want to lose in the dryer. These $500 multicolored hand-crocheted socks from Rodarte -- the most expensive leggings in the world -- are an extreme example of how the once-lowly cotton sweat sock has risen to the height of fashion this fall.

Rodarte Socks (model: Renee/APM Models)

The high price is due in part to the materials -- a combination of silky mohair yarn and soft alpaca wool -- and to a designer label favored by the likes of First Lady Michelle Obama, Natalie Portman, and Kirsten Dunst.

Source: Susannah Cahalan, NY Post [10/17/10] via Dr. Bret Ribotsky

ASSOCIATE POSITION - PHILADELPHIA, SOUTHERN NEW JERSEY

Seeking motivated, independent foot & ankle surgeon to join large practice. Our multi-office practice covers all aspects of foot and ankle pathology, including heavy hospital volume. Offering competitive salary and benefit package. Send CV and two references to bleich5252@yahoo.com

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 -  WHIRLPOOL AND WHIRLPOOL CHAIR

Professional, Whitehall brand 15 gallon Podiatry Whirlpool and Whirlpool Chair. In excellent condition. $2000.00. Please contact fergusondpm@aol.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

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

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