The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

November 01, 2010 #3,998 Publisher-Barry Block, DPM, JD

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CA Podiatrist Discusses Treatment of  Fungal Toenails

If you notice your toenail looks yellow, has white marks on it or contains debris underneath, chances are a fungus is hanging out under your nail. “It’s a highly contagious infection that’s transmitted from foot to foot, particularly in germy hotbeds like nail salons and gyms,” says Carolyn McAloon, DPM, spokeswoman for the American Podiatric Medical Association. Usually it’s not painful, although wearing a shoe that’s pressing on the infected area can irritate it, she says.

Dr. Carolyn McAloon

To prevent fungi from taking hold, wear shoes made of breathable fabrics, like leather or canvas, and be sure to take off your socks and shoes to air out your feet after exercising or working all day. A fungus can be treated by trimming and filing any loose areas of the nail, soaking feet in water that contains a few drops of tea tree oil (which is a natural antifungal), using a topical antifungal treatment (if necessary) and bleaching the shower to kill any lingering fungus, says Dr. McAloon.

Source: Jennifer Tzeses, WomansDay.com [10/18/10]

OCPM Research Director and Librarian Attend OHRP Forum

Dr. Jill Carroll, Director of Research, and Donna Perzeski, Director of Library Services and OCPM IRB member, attended a research community forum, offered by the HHS Office for Human Research Protections (OHRP) in order to assist the OCPM IRB in remaining up-to-date and compliant on regulatory issues.  The forum, held in Cleveland, OH in September was entitled "Building Harmony: Enhancing Human Subject Protections through Coordinated Regulatory Oversight." 

Dr. Jill Carroll

Sessions of interest included Fundamentals of Reviewing and Approving Human Research, The Optimal Consent Process, Exempt and Expedited Determinations - Understanding the Flexibility Permitted by the HHS Regulations, Understanding the Complexities of Event Reporting, FDA IRB Inspections and Common Findings and Conducting Research on the Internet. The information gathered at this forum will be incorporated into and implemented by the human research subject protections program at OCPM.

Source: OCPM Footsteps [October 2010]

FL Podiatrist Lectures at Men’s Health World Congress

Over 70 countries sent representatives, as over 2,500 physicians, scientists, and thought leaders converged on Nice, France today as the Men’s Health World Congress got started at the Nice Acropolis Palais des Congres et des Expositions. The Men’s Health World Congress’ mission is to advocate and promote men’s health and empower men all over the world to pursue healthier lives. The title of the 2010 Men’s Health World Congress “How to overcome the challenges?” truly reflects the turning of attention from the problem to the solutions.

Dr. Bret Ribotsky at Men's Health World Congress

"It will be the great educational opportunity, that nobody interested in men’s health could afford to miss," says Prof. Ridwan Shabsigh, President of the International Society of Men's Health (ISMH). “It is great to see my friend, Dr. Bret Ribotsky share his knowledge on 'Unique Strategies to Keep your Feet'. He is always an audience favorite,” says Shabsigh. 

CO Podiatrist Sues Over Purchase of Meth-Contaminated Mansion

Wealthy neighborhoods and sprawling homes aren't immune from society's ills. Just ask the prominent Colorado Springs couple that purchased a beautiful villa in a prestigious community only to discover methamphetamine contamination. A 5,800-square-foot Italian villa-style home was purchased for more than $1 million on July 29 by Bryan Groth, a Colorado Springs podiatrist, and his wife, attorney Kimberly Gielarowski.

Mansion bought by Dr. Bryan Groth

The couple is now locked in a legal battle with the home's previous owner, Brian Marshall. If Marshall knew the house was contaminated with meth residue, he was legally obligated to disclose that to the buyers under Colorado law. The take-home message is to test a home for meth use before buying it.

Source: Kyle Clark, KUSA NBC 9 Denver [10/29/10]

Query: Tail Coverage

Can anyone with experience in buying tail coverage provide some insight.  Also, is there any risk with purchasing an inactive status policy for one year instead?

Elizabeth Marilynn Feltner, DPM, Kenova, WV 

RE: Web-Based EMR Systems (Kevin McDonald, DPM)
From: Richard A. Simmons, DPM,

The most obvious advantage of a web-based EMR system is that charting can be done from anywhere there is Internet access; however, with programs such as PC-Anywhere, one can access an office-based server just as easily. Another advantage is that one does not need to keep and maintain a server, which is usually independent of the expense of maintaining the EMR software. Typically, the web-based systems have multiple servers in the event one goes off-line. Another advantage is that your office personnel are hardly capable of crashing or infecting a web-based EMR due to their ineptness or ignorance of computer technology. From an expense standpoint, you....

Editor's Note: Dr. Richard A. Simmons' extended-length letter can be read here.
 
Internet-based computing is also known as "Cloud computing." With an Internet-based system, you still need a computer infrastructure. You will need to share printers and use other software in your office not related to the cloud software, so you will need a network anyway - a network that you will have if you use an office-based system.

Storage of Data: The contract will probably not say where your data will be stored and for all you  know, your data may.... 
 
Editor's Note: Dr. Charles Morelli's extended-length letter can be read here.

RE: Yellow Pages Listings in South Florida
From: George Jacobson, DPM

Here, in Florida, we have a new assault on our practice that seems have gone unnoticed by the profession. DPMs have historically, from the beginning of time, been listed in the Yellow Pages after "Physicians & Surgeons DO" and before "Physicians & Surgeons MD". So, the placement of "Physicians & Surgeons DPM" was the natural alphabetical listing of all "Physicians & Surgeons (DO, DPM, MD)." We have to decide on our 2011 listings now for the new book that comes out in April. I had no warning that our profession's listing location was going to change. Why would I expect anything different after 25 years of listings?

In addition to the soft economy, I believe that this change has damaged the profession. Patients can't find us. When they went to...

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

RE: Pharmaceutical Companies Detailing Podiatrists (Michael B. DeBrule, DPM)
From: Robert Boudreau, DPM, Narmo L. Ortiz, Jr., DPM

I am pleased that Dr. DeBrule has so much free time to do that kind of research. I don't. With a busy practice and an active home life, my time is limited, and I am sure most of our colleagues can concur.  Pharmaceutical reps serve a specific purpose, and that is to bring in new products, information, and samples of medication which can be dispensed with new Rx's and to indigents. It infuriates me for people to insinuate that physicians are so gullible as to be bought off for a sandwich and an ink pen.
 
How about this? After Dr. DeBrule has done all the research that he does on each new drug, do us all a favor and write a synopsis, post it on PM News, and then we'll all be up to speed. I look forward to reading those.
 
Robert Boudreau, DPM, Tyler, TX, rbftdoc@aol.com

It never ceases to amaze me how cynical and hypocritical are the political and regulatory systems of medicine and licensing in this country. While doctors are prohibited from any kind of payouts, gifts, hand-outs, etc., supposedly to "protect the public at large" from special interest issues, what are the politicians, lawmakers and regulators doing? They are, in fact, accepting such payouts, gifts and hand-outs from special interest groups, i.e., pharmaceutical companies! Oh my! Who are we really protecting from whom?

Narmo L. Ortiz, Jr., DPM, Cape Coral, FL, nlortizdpm@embarqmail.com

RE: New Twist on Podiatric Privileges (Ivar Roth, DPM, MPH)
From: Myron Bergman, DPM

My hospital is dealing with a similar issue. The Joint Commission recently came through with their periodic survey and  told us we were lacking in making sure that the surgical staff was keeping current on their procedures, and we needed to create a methodology regarding surgeons doing infrequent procedures. I am on the credentials committee of my hospital, and I can tell you that this is a continuing problem. My suggestion to Dr. Roth is to:
1. Have the bylaws of the hospital changed, making podiatry a separate section directly under surgery and not under orthopedics.
2. Present to your credentials committee a reasonable plan for ensuring that the members of your section are capable and up-to-date on the procedures they wish to perform.
3. Have a methodology in place to police yourselves.

If you go into an operating room to do something you haven't done in a year or two or five (the length of time should be specific for each procedure and decided by the podiatry section), bring someone in with you who has done the procedure more frequently. Your biggest problem is that you are under the thumb of the orthopod who is in financial competition with you. You can't change the JCAHO requirements, but you can get yourself out from under the thumb of the chief of orthopedics.

Myron Bergman, DPM, Bridgewater, NJ, mbergmandpm@aol.com

RE: The Future of Medicine (Daniel Grapel, DPM)
From: Bob Kornfeld, DPM, Peter A. Wiggin, DPM

Thank you, Dr. Grapel, for articulating precisely what I am talking about. The first issue is that you devalue positive thinking and refer to it as "exaggerated". Maybe someone should tell that to Bill Gates, Warren Buffet, Donald Trump, Howard Schultz, Mark Zuckerberg, and others like them. The second issue is that you truly believe that you are a victim of a failing and corrupt system. Both of these issues are echoed by the greater majority of DPM's whom I have spoken with. So, I ask Dr. Grapel, if he were to suddenly...

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

I too have become extremely concerned regarding the future of medicine, and podiatry in particular. I have personally seen the downfall of comprehensive medical care and have found myself more and more becoming a primary care physician of the lower extremity. My community has lost numerous family practice physicians, and the remaining have dropped their admission privileges at our local hospital, transferring all in-patient care to the hospitalist. The unscrupulous acts on the part of many insurance companies are also seen with unscrupulous acts of individual practitioners. The issue that I want to present in this forum involves out-of-network providers using the term "accepts most insurance" in their advertisements. I have had numerous patients... 
 
Editor's Note: Dr. Peter A. Wiggin's extended-length note can be read here.

RE: Devolution of Healthcare (Neil H. Hecht, DPM)
From: Ron Werter, DPM

I find Dr. Hecht's theory of the history of healthcare quite innovative. I wonder if he teaches this subject at an MPH program or business school. I would like to see the historical data and course syllabus that backs this up. It's amazing how a system that has "evolved" over 70 years can be destroyed in only a few months by a "bad" leader. That's real power.
 
Ron Werter, DPM, NY, NY, hawkwyedpm@aol.com

RE: PA Podiatrist is Among Doctors Paid By Pharmaceutical Companies on Posted Database
From: Alan Sherman, DPM, Jeffrey Kass, DPM

In regard to the article from the Philadelphia Inquirer about fees received by Warren Joseph, DPM for the teaching that he has done, my only comment is that he is, with this crass publicity, paying the price of leadership. The nature of this article really gets me angry. Dr. Joseph has taught an entire generation of podiatrists and many other medical professionals infectious disease and diabetic limb salvage. Every clinician that he has touched is richer for it.

The politically correct public wants it all. Their sense of entitlement, the expectation that good medical care is a right purchased by their citizenship, is creating victims. No one has a right to be treated by a clinician taught by Dr. Joseph?. Nor does he have an obligation to do that teaching for free. Does the public want to fund medical education? I think not.

Alan Sherman, DPM, CEO, PRESENT e-Learning Systems,
asherman@presentelearning.com

It seems a little counter-intuitive for Pfizer to pay a podiatrist i.e., Warren Joseph, DPM thousands of dollars for speaking fees, yet decide to stop detailing podiatrists (as reported by a podiatrist on yesterday's PM News.)

While Dr. Joseph is probably speaking about Zyvox, and the podiatrist in yesterday's PM News was complaining about not being detailed for Celebrex, it does not make a difference to me, as invariably I would still connect the two to Pfizer. I would like to add that there are drug companies that do detail our profession and still give samples for NSAIDs, and I think it is important (patient care first) that we support those who support us. 

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

RE: Patient Balances and Rescheduling Office Visits (Name Withheld)
From: Shari Lee, PMAC

I would also discourage using statements of any kind referencing rescheduling appointments due to non-payment. I also agree that this should be handled on a case-by-case basis, and you must follow the same reasoning for each case so you do not violate your contracts. First, what is the patient being treated for? This is of the upmost importance since you cannot turn away anyone from active treatment. We collect all balances and co-pays prior to seeing the doctor, except for active treatment; so, it cannot come back and bite us the in $#*. 

If the patient is one who comes once a year, or every three or four months for nail care, mostly routine, then do not schedule that next appointment if the balance is not paid. We do this by knowing all our insurance allowances up front, so we can figure the amount due once the doctor has marked the charges. If there is ever a question as to active treatment or not, I would advise going with active so as not to put yourself in a position of potential malpractice. It can be done, but the decision of turning away or not scheduling patients should be left to management to make the decision.

Shari Lee, PMAC, Columbia, SC, midlandspodiatry@bellsouth.net

ASSOCIATION POSITION - MARYLAND AND DC

Immediate opportunity to join our group in Maryland and DC. Will consider full or part-time. Our practice is general podiatric care with a heavy slant on sports medicine/orthotics. In-office ASC. Must be PSR 24-36. Send cover letter and CV to hgodpm@verizon.net

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 - 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.

ASSOCIATE POSITION - SOUTHERN MI (NOT DETROIT!)

Associate To Partner Position-Salary/Bonus/ Benefits. Part of podiatrist group. All phases of surgery, forefoot/rear foot/ankle…whatever you want. Great chance of obtaining all cases needed for board certification in your first year! Area has lots of lakes, change of seasons, within a couple hours of Chicago. If interested email: paulapmac@gmail.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

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

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

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 - CONNECTICUT

Outstanding solo practice for sale in northern Fairfield county, CT.  Shared space with other medical professionals. Very low overhead.  Grossing almost $300K on 30 hours per week. Referrals from three different primary care physician offices. If interested e-mail CTPodiatry@gmail.com

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.

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