The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

November 01, 2011 #4,294 Publisher-Barry Block, DPM, JD

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Podiatrists Prevent Amputations, Reduce Healthcare Costs: NY Podiatrist

For those who have or are at risk of diabetes, a podiatrist can detect signs and symptoms of the disease and provide treatments that help to prevent lower-limb amputations. The Thomson Reuters Healthcare Study concludes that doctors of podiatric medicine are critical to saving limbs from amputation, which can happen as a result of untreated complications from diabetes.

Dr. Vito Rizzo

Additionally, the Thomson Reuters Study also addresses the saving of healthcare dollars, with patients who saw a podiatrist incurring lower costs as well as fewer amputations. “If you extrapolate the results from the study, in one year $1.97 billion could be saved in the commercial insurance group, and $1.53 billion could be saved in the Medicare group,” said Vito J. Rizzo, DPM, president of the New York State Podiatric Medical Association.

Source: WBGH NBC-TV - 34 (Binghamton, NY) [10/31/11]

NYCPM Students Assist Runners at First Rock ‘N’ Roll Sporting Event in New York City

On Saturday, October 22, thirty NYCPM students provided medical support for the Rock ‘N’ Roll 10K in Prospect Park in Brooklyn, NY. The students, coming from the classes of 2013, 2014, and 2015, treated a variety of medical problems, from muscle strains to blisters. The podiatry volunteers were able to gain experience in sports medicine while taking a break from their studies. 

NYCPM Student Volunteers at the first Rock 'N' Roll Sporting Event

NYCPM was also represented by two student runners, Joseph Schmidl and Rene Kafka. This was the first Rock ‘N’ Roll event held in New York City, and is expected to return next year as a half marathon. Podiatry volunteers worked under Robin Lenz, the Podiatry Captain.

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: We used to do 5 minute pre-op scrubs. Now, we just paint the site with an alcohol-type of prep. Is there a real difference?  

Dr. Warren Joseph

Warren Joseph: The scrubbing action has been shown to bring out bacteria from deeper in the skin layers, so that was the reasoning behind not doing a scrub; just not only prepping the patient’s limb but also prepping yourself. Recommendations now basically just call for alcohol and alcohol foams - things along those lines between cases. We always used to shave our patient the other night before, but don’t do that anymore because you cause micro-abrasions. Next, it can then start growing bacteria and, just like the scrubbing, bring deeper bacteria to the surface.

Dr. Nicholas Sol

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's guest is author, inventor, and biomechanics expert Dr. Nicholas Sol. You can register for future events by clicking here

Find Solutions in Minutes

Draw solutions out of your brain with the “10-Minute ‘Storm” exercise. Here’s how:

• Define the problem that you want to solve.
• Grab a pen and a piece of paper, not your computer keyboard.
• Set a timer for 10 minutes.
• Write whatever comes to mind about the problem during the entire 10 minutes. If your mind is blank for a moment, write “I don’t have a thought right now.” Just keep writing.
• Analyze what you have written. Circle the points that stand out. Look for patterns and connections. That will lead you to the solution.

Source: Adapted from Jeff Henderson, “How to Train Your Brain”, International Leadership via the Organized Executive.

RE: Excellent Article on MRI Over-Usage in Sports Medicine (Rich Rettig, DPM)
From: David E. Samuel, DPM

This is an excellent article. We should all thank Dr. Rettig for bringing it to our attention. It should be sent to every one of our residents and students, not to mention PCPs. We have a very busy hospital-based practice within a large teaching facility, and it is scary that MRIs are almost standard of care to most of the medical community in "diagnosing" osteomyelitis. We see hundreds of diabetic wounds and infections yearly, and unless we are the admitting team, most get useless MRIs looking for osteo. I might as well try explaining the theory of relativity, (not that I can) vs. explaining that a non-probing sub 1 ulcer has had a significant amount of pressure to develop, that will now show marrow edema that is also present in osteo and numerous other potential diagnoses.

Radiologists tend to say osteo when...

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

RE: Service to Determine Deductibles and Co-Pays? (Chuck Ross, DPM)
From: Shari Lee

There is no service as good as the staff in your office. We use our staff, who in checking all insurance of patients prior to their appointments, also learn valuable information about how insurance plans work as well as what a patient truly owes. We use many venues to get this information, from the insurance websites to using the trusted telephone. Nowadays most insurance companies have websites you can log into to check co-pays and deductible status. However, not all are accurate or give you enough detail to tell you if x-rays and surgical procedures are covered under co-pays or deductibles, so phone calls are made as back-ups. We have done this for years, and our billing is minimal.

We collect as much up-front as possible. Before patients leave, they are told they will have to pay before they leave if they have a deductible that has not been met. They are also told how much the co-pay or deductible is expected to be based on what they are being seen for. I have found that most patients are not aware of what their insurance pays for specialists; they only know that for their PCP care.

Shari Lee, Office of Bryan Davies, DPM, Columbia, SC

RE: The Allopathic Podiatrist
From: Paul Kruper, DPM

The loss of Medicaid coverage for podiatry in many states is a greater problem than just the loss of a few poorly paid services. It is a manifestation of the government attitude that podiatry is a redundant superfluous service. This incorrect perception will not be changed with objective arguments and will spread to other states in a poor economy. Medicare has adopted a similar attitude by eliminating coverage for many podiatric services, and more cuts are inevitable. Changing that attitude is impossible, so we need to become less of a target by becoming primary care allopathic providers. However, I have no interest in becoming a DO just for an allopathic license.

Hopefully, the California Association’s parity study will result in a pathway for podiatrists to complete an education to qualify for an allopathic license. That is the best scenario. Most DOs I know provide very little osteopathic care, and many provide none. However, the allopathic podiatry practice will always be high percentage foot care. How many applications would be received by a podiatry school offering an allopathic-level DPM degree?

Paul Kruper, DPM, Kingsburg, CA, prkruper@yahoo.com

RE: Early Diagnosis of Bunions Can Prevent Surgery: CA Podiatrist
From: Brian Kiel, DPM

I must respond to the article by the podiatrist stating that since women have most of the bunions, their footwear must cause them, and the use of orthotics can prevent them. This is nonsense. First of all, how many times do we see unilateral bunions? To the best of my knowledge and experience, people wear the same shoe on both feet; therefore, there should be no unilateral bunions. 

Hallux valgus deformity is the result of mechanics and function determined at the moment of conception. To think that a shoe worn for a few hours each day could cause this deformity is absurd and doesn't take into account bunions seen in men and juveniles. Orthotics are important, but only to affect the mechanics, which may alleviate some or all of the pain, but in no way can they prevent the progression of hallux valgus. I think it is time we quit propagating this misinformation to the public.

RE: WesternU Inaugural Class Achieves 100% Pass Rate on APMLE Part I
From: Alan Sherman, DPM

I would like to offers kudos and my congratulations to Drs. Harkless, Shapiro, Satterfield, Nouvong, Labovitz, Christman, and the rest of the faculty of the Western University for their inaugural class of 2013 achieving a 100% pass rate on Part I of the APMLE exam. This is a tremendous achievement that validates their innovative problem-based teaching method and the skills of their fine faculty.

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

RE: Defendant's Experts Deserve a Medal (Pete Harvey, DPM)
From: Edwin J. Harris, DPM

Having reviewed depositions made by all members of the healthcare profession, as well as expert testimony both for the plaintiff and the defense, I feel qualified to weigh in on this discussion. There is no question that there are cases that have merit and cases that do not. The problem is experts (more often for the plaintiff’s case than for the defendant's case) who make really outlandish statements that are not borne out by acceptable medical facts. This happens with astonishing regularity. These experts use the credibility of their license to practice as well as the reputation of the Board that credentials them. Some even blatantly misrepresent their credentials. 

I suspect that these experts feel that they are immune from discovery and personal repercussion, but every deposition and every testimony is made under oath and becomes public record. The time has come for state licensure bodies and certifying boards to police these actions. Boards might consider making reporting of malpractice testimony a requirement for continued certification – just as demonstrating competency by examination is a requirement – and a committee should be established to hear complaints and deal with expert witness misconduct on both sides of the table by censuring diplomats or withdrawing diplomat status.

Edwin J. Harris, DPM, Hackensack, NJ , eharrisdpm@aol.com

RE: The Hottest Lecture I Ever Gave

PRACTICE FOR SALE - NORTHERN NJ

Well established, part-time practice is for sale in Northern NJ. Digital X-rays, EMR, located in a medical condo building. Surgery 35%, Routine 30%, Average Gross is $130K on 2 half days per week. Priced for quick sale. Real estate available for purchase. Please call 800-983-4194, or e-mailcontactus@podiatrypracticeconsultants.com

PRACTICE FOR SALE – NANAIMO, BRITISH COLUMBIA, CANADA

Have you ever dreamed of owning a practice where...you can see 0-50 patients daily * average 100 new patients monthly * have zero accounts receivable * gross $480 M per year * live in a beautiful community with skiing, hiking, fishing, and boating on your doorstep. This could be yours! If interested contact pistone@telus.net or call 250-754-4192.

PRACTICE FOR SALE/LEASE - NORTHERN, NJ

Part-time practice for sale or lease. Flexible terms, will consider lease with option for sale. Structured for a fast sale, first option on real estate. Great opportunity for a start-up or satellite with immediate income. Call 201-573-0555 or 551-574-0776 billfeet@aol.com

ASSOCIATE POSITION - SOUTHEAST GEORGIA - SAVANNAH

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking associate or new residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

ASSOCIATE POSITION - EAST TENNESSEE

30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. Extremely competitive base salary with bonus incentives and benefits. Knoxville is consistently ranked in top 5 places in U.S. Post-residency experience a plus. Please send resume to ddavidphawk@yahoo.com

ASSOCIATE POSITION - FLORIDA/N.W. FLORIDA- TALLAHASSEE AREA

Home of Florida State University. Great university town! Well established full scope solo physician with busy practice. Looking for a full time associate leading to partnership in a short time. Great general practice with 2 locations. Staff privileges with 2 local hospitals and 2 surgery centers. Offering competitive salary, health insurance. Will need forefoot and rearfoot surgical competency. Friendly office with fun staff that’s easy to work with. Call/Text – 850-510-4371.

ASSOCIATE POSITION - NORTHERN, NJ
 
Well-rounded practice. No Nursing Homes or House Calls. All phases of foot and ankle care. Must have good surgical skills and like treating patients. Applicants must take care when doing both Surgery and/or Routine Foot Care. Must be ethical, logical and thoughtful when treating patients. This position can lead to purchase of practice. Send CV to ToeBizCenter@Yahoo.com

ASSOCIATE POSITION - MARYLAND

Multi-office group seeks highly trained surgical associate to join us. Prefer person with frame and trauma experience. Our practice is state-of-the-art and has all modalities: EMR, PadNnet, on-site billing, diagnostic US, PRP, digital x-ray, etc. Excellent salary, bonus structure and benefits with partnership available. Please forward CV and letter of intent to docsbnb@aol.com

ASSOCIATE POSITION - SOUTH WEST FLORIDA

Full-time associate positions for an established group practice in Southwest Florida. Willing to train the right new graduates. Job will involved all aspects of podiatric care. You must be ambitious, hard-working and should have good people skills. Please e-mail your resume/CV to contactus@ankleandfoot.net

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Immediate position for associate to potential partnership available for a surgeon that is BQ/BC by ABPS. Must be a PSR 24 or PM&S 36 graduate. Salary with bonus. Email CV and samples recent cases done recently to: susmitad86@yahoo.com

ASSOCIATE POSITION - NYC and SW CONNECTICUT

If you are hard-working, motivated, loyal, honest, well-trained, have some common and business sense, and have good interpersonal skills, I have a good job for you. Position is PT to start in NYC, and full-time w/CT license (or when you obtain CT license). Must be ABPS certified/ qualified. We treat from skin-to-bone and from toe-to-ankle. Work w/ nursing homes, multi-specialty medical, and orthopedic practices. Well-respected by the medical community for what we do as DPMs. Potential long-term stable career position for the right person. $50/h to start ($104K for 40h week). Email CV & letter of interest to DPMAssociate@gmail.com

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM
   

 Fully equipped podiatry office in North Gate area of Seattle. Office located in medical professional building near I-5. Office has 3 treatment rooms, 3 physical therapy rooms, direct digital x-ray, PAD- net, NCV testing equipment, physical therapy equipment. Please contact us: website Tel. 425-643-8901 isbinc2006@gmail.com

FOOT SKELETONS FOR SALE

The Anthropology Department at St. John Fisher College (Rochester, New York) has many sets of specimen-quality, disarticulated human foot (and hand) skeletons. The department (NYDOH licensed) is selling them to institutions that will use them in medical research or instruction to support an endowed fund for a lectureship series. Contact:  Dr. John Rhoades, Chair, Anthropology Department, St. John Fisher College, Rochester, NY 14618 jrhoades@sjfc.edu

SUB LEASING TIME on MRI (NYC)

Don't refer out $$ when they can go into your pocket. Beautiful state-of-the-art 5th Avenue medical office is offering lease time on a .31 tesla Esaote extremity MRI, complaint with Stark laws. This particular magnet is the only one accepted by insurances and Medicare as of 2012. For more information email dri@myfcny.com.

EQUIPMENT FOR SALE -  REVO VASCULAR SYSTEM

REVO vascular system for sale, 3 years old, excellent condition, all probes and digit sensors in excellent working condition. Asking $4,000 or best offer. Please contact drkhoury@nefas.us

EQUIPMENT FOR SALE – 2 MICROVAS UNITS

2 used Microvas units (approximately 5 years old) for sale at $6,,000 each plus shipping. Each unit includes 1 carrying case, 8 flex cable leads, 1 battery charger. Paid $16,000, for each machine. Great way to add therapy modality to your practice. Contact: DrBlatstein@comcast.net

EQUIPMENT FOR SALE - (2) MICRO-VAS UNITS
 
Less than one year old. Barely used and in excellent condition. We have seen remarkable improvement in Diabetic neuropathy, tendonitis, fibromyalgias, and atypical neuropathies. Also works great to reduce limb edema. Can be used for acute & chronic conditions. Selling $10K each, or both for $17.5K. Contact: coastalmgr@gmail.com

EQUIPMENT FOR SALE - CLASS FOUR LASER

I have a class four pain laser for sale. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

EQUIPMENT FOR SALE - ENTIRE PUTNAM COUNTY, NY OFFICE

Moving from location. 3 PDM chairs, 3 cabinets, sterilizer, waiting room chairs, surgical light, Stryker power equipment, x-ray view boxes, and all other office furniture. Priced to sell. Available after December 23rd. email marshall39@hotmail.com

EQUIPMENT FOR SALE - CRYOPAC, LASER UNITS

1 Cryopac unit for cryosurgery with 3 probes for sale at $1,000 - 1 Class III ML830 nm laser for sale $1,000 - used for pain management and inflammation control, great cash generator.. Contact: klamdpm@hotmail.com

PM News Classified Ads Reach over 13,500 DPM's and Students

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