The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

October 29, 2010 #3,996 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2010- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

New Maximum Length of Letters is 250 Words 

The maximum length for letters posted directly on PM News has been reduced to 250 words.  This change has been made to make PM News more readable. Letters over 250 words will still be accepted, but the full-length version of the letter will appear on our website and will be clickable from PM News. 

Best Heel Height is Between Flats and Stilettos: Canadian Podiatrist

Dr. Robert Chelin, past president of the International Federation of Podiatrists, says a heel height somewhere between flats and stilettos is best if you want to dance the night away.

Dr. Robert Chelin

"When you go flat, you have no support. You can have back and tendon issues. When you're really high, there are problems with the knee and the balls of the feet. If you wear a moderate heel instead of a high heel, you're probably in the best position."

Source: Francine Kopun, Toronto Star [10/26/10] 

Inaugural OCPM Clambake Raises $15,000 for Student Scholarship Fund

The Ohio College of Podiatric Medicine welcomed 145 guests to the Inaugural OCPM Clambake Benefit on Saturday, October 9, 2010 at the OCPM Campus in Independence, Ohio. Guests spent the evening enjoying delicious specialties from the area's premier restaurants: Delmonico's and LockKeepers, a clambake feast provided by Rockway Catering, and tasty wine and beer courtesy of Heidelberg Distributing!

Dr. Steven Berlin, Judi Melillo, Dr. Henry Green, and Paula Pitts.

The evening raised $15,000 for the Student Scholarship Fund thanks to all of the sponsors, guests, donors, staff, and volunteers who helped make the event a success, especially event Co-Chairs Donna Bloom-Schwartz and Dr. Kelly Whaley for their leadership with this event.

Source: Footsteps [October 2010]

VPMA Sues to Recover Embezzled Funds

Sometimes the people hired to prevent malfeasance are the very ones up to no good. That seems to be what happened to a local association of physicians. The insurer for the Virginia Podiatric Medical Association is trying to recover more than $100,000 the trade group lost as the victim of a two-year embezzlement scheme, according to a lawsuit filed in Richmond Circuit Court on Oct. 13. The scheme, according to the suit, was perpetrated by a former employee of the Keeney Corporation, a Richmond-based association management and lobbying firm that at the time handled VPMA’s financials.

According to the suit, VPMA hired the Keeney Corp. in July 2007 to provide executive and financial management. That included the collection of membership dues, maintenance of bank accounts, and producing financial reports. But while the money was coming in, a Keeney Corp. employee was lining her own pockets. “From August 2007 through June 2009, Chris Stitler, an employee of the Keeney Corporation, conducted a scheme to defraud the VPMA of its funds,” the suit asserts.

Source: Michael Schwartz, Richmond BizSense [10/25/10]

HyProCure® Stent Celebrates Six Years

Just a few short years ago, the HyProCure sinus tarsi stent, a small titanium implant no longer than a paper clip, was an inspiration on a sketch pad and a dream to help people live a life free of debilitating foot pain. At that time, Dr. Michael E. Graham, the podiatric surgeon and creator of HyProCure, was searching for a better way to help his patients suffering from a very common and often devastating foot condition known as talotarsal dislocation syndrome (TDS). Graham worked on a model and refined it over time so that this new implant would produce better results than any of its predecessors in the industry. The result was lifelong correction that rebalances the ankle on the heel bone, putting the body back in alignment, and eliminating the resulting painful, and often unbearable symptoms.

Dr. Michael Graham

Six years later, HyProCure and its parent company, GraMedica, have helped thousands of foot pain sufferers in the U.S. and around the world. The company, now headquartered in Macomb Township, Michigan, has grown dramatically, adding staff, engaging in research and development, and refining physician training and marketing tools to support the hundreds of surgeons worldwide certified to perform the HyProCure procedure.

Query: Long-Standing Tumor

This 28 y/o male presented with pain in the arch area of his right foot, only on pressure. After clinical evaluation, I concluded that his pain was from a large os navicularis, and not the obvious tumor. He has had this tumor for more than ten years. He claims that he has not had trauma or surgery. On palpation, the tissue is fatty-like and there are multiple foci around the foot. X-rays show an unusual os navicularis and a stalk-like osseous projection from the plantar calcaneous.

Long-Standing Tumor

The plan is to send him for an MRI first, to access the extent of the tumor and help decide the surgical approach: limited incisional biopsy soft tissue and bone with future staged reduction vs. single-stage excisional biopsy requiring Mohs with potential complicated soft tissue coverage. I would appreciate any recommendations.
 
Tip Sullivan, DPM, Jackson, MS

Query: Golf Shoes

Sometime in the past, there was a discussion of golf shoes. One of the participants contacted me regarding a special shoe and I forgot the name of it. It may have been for diabetics or just for extra depth. Can anyone recommend such a shoe? It was not a name brand like Nike or Puma.

Bryan C. Markinson, DPM, NY, NY 

RE: Bilateral "Burning" Heel Pain (Elliot Udell, DPM)
From: Peter Bregman, DPM

While I do not want to get into a back and forth here about what is significant and what is observable, I will defend what I said. When I used the word significant, I meant that it would not have any permanent or long-standing effects. I am well aware that a little bit of steroid will elevate blood glucose, but so what? So blood glucose goes up 25% for two days - is this really a contraindication to making a diagnosis, and/or alleviating pain?

Dr. Udell also cites articles that refer to ophthalmology. I admit I am not a physiologist but I think injecting into the foot with all of the fat and other tissue present would diminish the effects of the steroid which is diluted with local anesthesia. So, I think if you want to compare, you must compare apples to apples. Again, I never mentioned blood glucose because the effects of raising blood glucose with that amount of steroid is not deleterious, and I always tell my patients that their sugar will go up and they need to more diligent with their carbohydrate intake for the next several days if diabetic. Thousands of diabetics in my state of MA elevate their blood sugar all the time way beyond what 4 mg of a diluted Decadron injection would do when they leave Dunkin Donuts.

Peter Bregman, DPM, Tewksbury, MA, Footguru@comcast.net

RE: Employee Tests (Frank DiPalma, DPM)
From: Kevin McDonald, DPM, Chris Majewski, DPM

I recommend Jay Henderson at Top Line Perfomance (919-518-2793) for employee testing.

The 20-minute test is done online with an e-mailed report and phone consultation with the doctor. The test identifies the strengths and weaknesses of the candidates and provides insights into how to deal with them as people ($99). 
 
Kevin McDonald, DPM, Concord, NC, mickeyfeets@yahoo.com

I have used the Kolbe 'Right Fit' system successfully: (kolbe.com/improveYourBusiness/hire-successfully.cfm).
 
Chris Majewski, DPM, Germantown, MD, christofeet@yahoo.com

RE: Pfizer No Longer Detailing Podiatrists?

My practice is in a large medical building with more than 50 physicians and two other podiatrists. I recently ran into the Pfizer representative for Celebrex who used to detail my office. I  mentioned that she had not been by in some time. She informed me that Pfizer has a policy of no longer detailing podiatrists. Has anyone else experienced the same?

Lesley Wolff, DPM,MS, San Francisco, CA, hydedoc@pacbell.net

RE: New Twist on Podiatric Privileges
From: Ivar E. Roth, DPM

My local hospital where I have FULL foot and ankle privileges recently bought a competing hospital about 20 minutes away. The new hospital will be opening in less than a month and has now, at the last moment, sent a letter stating that the hospital that I am staff on will no longer offer any surgery for the foot and ankle, period.  All foot and ankle surgery henceforth will have to be done at the new hospital that is co-owned with the orthopedists. The letter goes on to state that if I want to operate, I will have to apply for privileges at the new hospital.

As I mentioned last month, the orthopedists are now coming up with restrictive practices for surgical procedures, i.e., I have to have done ten ankle fusions to apply for total ankle privileges. Not only will the orthopods make money off our cases in the joint venture, but they have stripped away our current privileges by not allowing ANY elective surgery to be performed. They will now make up new rules to operate. This seems illegal. Any thoughts? Where do I file a complaint at the local, national, and federal level?

Ivar E. Roth, DPM, MPH, Newport Beach, CA, ifabs@earthlink.net

Editor's comment: PM News does not provide legal advice. Members of the APMA can enlist the power of their state component to help battle issues such as this. Non-members need to hire an attorney and go it alone. 

RE: The Future of Medicine (Deborah Wehman, DPM))
From: Elliot Udell, DPM
 
Let's acknowledge Dr. Wehman for citing that we as doctors have a moral responsibility to help the poor and indigent. In our practice, many patients who have lost their jobs and insurance plans have become  pro-bono patients. We won't turn anyone away because of  inability to afford our services, and we have had to make major cutbacks in many areas of our practice.  On the other hand,  none of us practices in a vacuum. We can decide, as I  have, to not charge the poor and indigent but when that patient needs a referral to a radiologist, pharmacy, blood lab or even a hospital, we have no control over how those institutions will respond when that same patient walks through their doors.
 
We are also observing  another unscrupulous act on the part of many insurance companies.  Many plans have raised co-payments very high and pay doctors close to nothing for visits which, in essence, is rendering patients cash payers. I was appalled when I went for an eye examination this past summer and found that my insurance company paid my doctor four dollars and change for a very intensive examination. Yet, I am paying close to six hundred dollars a month for that policy. The salt on the wound was when a letter came in the mail from the company saying that they can't make ends meet and will have to raise my monthly premium. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: The Future of Medicine (Bob Kornfeld, DPM)
From: Joel Lang, DPM

While I agree in principle with much of Dr. Kornfeld's opinions about opting out of insurance contracts, and I admire his courage and faith in his convictions, it is necessary that each practitioner assess his/her own unique situation. Dr. Kornfeld practices in a more wealthy community, an advantage not everyone enjoys. 

In addition, while it relieves his stress in not having to deal with third-party carriers, the thought of giving up a stable source of income and 'roll the dice' on an individual's future professional and financial security may not be appropriate and create even more stress - even to the breaking point.

Individual considerations such as current and future financial obligations, the presence of an emergency fund, the presence of a "life happens" fund, the years left in practice, the health of the practitioner, the socio-economic status of the community, marital status, the presence or absence of another household income, the risk-tolerance of the practitioner, and a host of other factors must be considered. Even the best of cures is not necessarily for everyone.

Joel Lang, DPM (retired), Cheverly, MD, langfinancial@verizon.net

RE: The Future of Medicine (Multiple Respondents)
From: Bob Kornfeld, DPM

I appreciate Dr. Ortiz's comments about my post, but I am not sure if he understood exactly where I was coming from. I actually was not referencing the parity issue, but rather that many podiatrists (as well as MD's) are walking around in a trance of disempowerment. Doctors who possess a positive attitude toward work and see it as a place to self-actualize while creating value for others will have a very different experience than those with a negative attitude toward work who see it only as a necessity to pay bills.

I believe this attitude is the only thing standing between...

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

RE: CA Podiatrists Discuss RUC’s Evaluation of CPT Codes
From: Don R Blum, DPM, JD

I am not sure I understand Dr. Rogers' point regarding regarding the time required to apply the Dermagraft product and payment received - 7 minutes!

Let's see if I can sum it up?

At first consider - cost of undergraduate college, DPM school, residency, and many years in practice prior to treating wound care patients that one does get reimbursed for!

Each patient takes a longer time due to...

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

RE: CPMA Well-Represented in the First Modern House Call for Women (Robert Bijak, DPM )
From: David E. Gurvis, DPM

Once again, Dr. Bijak has taken a news release and turned it to the proverbial glass half empty rather than half full. It begs the question of "is he able to take pride in anything we, as a profession, do"? Now, he has added misogyny to the mix, it seems, by stating two strapping young podiatrists (men) have to " need the woman's signature to cut a hazardous toenail because she's a DO and we're DPM's." I don't read that in the article at all.

It was an event for women, innovatively thought out by a woman, Maria Shriver, under the direction of another woman, Jan Winter. I don't see where they required the signature of a woman in order to trim a toe nail.  Since it was attended by the Orange County Podiatric Medical Society, it is obvious the writer could have simply called them podiatric medical physicians. It is what writers do. Not everything in print is a slam to your profession, Dr. Bijak. 

David E. Gurvis, DPM, Avon, IN, deg1@comcast.net

ASSOCIATE POSITION - FREDERICK, MARYLAND

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.

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

IMMEDIATELY AVAILABLE- PHOENIX, AZ

A great opportunity to join and gain ownership interest in a well- established, diversified practice in Phoenix, AZ. Seeking motivated, ethical, well trained, personable AZ licensed DPM with excellent office management and clinical skills in all phases of Podiatry. Practice is state-of-the-art and encompasses all phases of podiatric care. New and established practitioners are welcome, or someone who would be open to merging a smaller practice with ours. Board Qualified/Certified required. Please send CV email phxpod@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 - 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 - SOUTHWEST FLORIDA

Immediate opening for the right candidate. Join a well-established podiatric group in Southwest Florida. We are a multi-office practice with EMR, Digital x-ray, and more. Seeking full-time associate that is PM and S-36 trained, personable, independent and highly motivated individual. Must be BC/BS in rearfoot and ankle with confidence in complex reconstructive cases. Full benefits package, competitive salary, excellent lifestyle. Please respond to JLH459@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

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

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

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

PRACTICE FOR SALE - WEST VIRGINIA

Immediate opportunity for podiatrist to have your own practice without a loan. I have an 8 y.o. primary care practice with two offices that avg. between 110-135 pts/week. CPED on staff, established diabetic shoe business as well as braces, orthotics, etc. We do CDFE, PADNET(ABI with PVR) exams, and have Traknet DPM EMR system. Both offices are nicely equipped. Ample space for surgery suite, physical therapy, etc. You are set up and ready to go with a full patient load. You can pay me 7% of your gross for 10 years and its all yours. (304)523-3338, (304)453-5458, (304)617-7665, jmfeltner@yahoo.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

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.

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.