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| PM News | |
The Voice of Podiatrists
Serving Over 15,793 Podiatrists Daily
November 01, 2013 #4,904  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2013- No part of PM News can be reproduced without the
written permission of Barry Block
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| STATE PODIATRY NEWS | |
Shortage of Podiatrists Seen in Maryland
Most Marylanders are not aware of the shortage of one type of medical specialist that will affect healthcare availability for decades: podiatrists. With the aging of our population and the explosion in diabetes, we're likely to see more diabetic foot conditions. Major studies have substantiated the beneficial effects and economic efficiencies of having podiatrists as part of the treatment team. They show that podiatrists provide preventive treatment and reduce the amputation rate.
Due to complex budgetary and regulatory changes, the last non-federally funded podiatric residency training program closed in 2005. The Veterans Administration program was to be closed this year but has gained a one-year reprieve and will most likely close next year. According to the State Board of Podiatry, there were 467 podiatrists in Maryland in 2008, but that's down to 436 in 2013. At the same time, the state's population has grown and aged, making the access disparity worse.
Source: Dan Morhaim, Catherine Pugh, and Enzo J. Leone, Baltimore Sun [10/29/13]
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| PM NEWS QUICK POLL | |
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| FIP NEWS | |
NY Podiatrist Receives 2013 FIP International Humanitarian Award
Patricia Nicholas, DPM has been awarded the 2013 FIP International Humanitarian Award. Nicholas was born in Haiti and immigrated to the USA in 1982 and graduated from the New York College of Podiatric Medicine in 1993. Following the devastating earthquake in 2010 in Haiti, she immediately flew down to Haiti and assisted in relief efforts.
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Dr. Patricia Nicholas |
Eventually, she founded the "Kindest Hearts Foundation", a charity to better help the people of Haiti. She continues to operate the podiatry clinic she established by frequently travelling to Haiti.
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| PUBLISHED PODIATRISTS | |
NY Podiatrist's Article Featured in Forensic Magazine
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Dr. Bryan Kagan |
New York forensic podiatrist Dr. Bryan B. Kagan's study, "Comparing Dynamic Shod Foot Impressions with Dynamic Barefoot and Shod Foot Impressions" was recently the featured article in Forensic Magazine. The study raises awareness that there are plantar pressure distribution changes due to soft tissue and osseous positional changes when wearing shoes of different sizes. These changes must be considered when comparing shoe insole foot impressions with barefoot impressions during forensic examinations.
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| HOSPITAL PODIATRISTS IN THE NEWS | |
MN Podiatrist Joins Essentia Health St. Joseph’s-Brainerd Clinic
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Dr. Rebecca DeHart |
Dr. Rebecca DeHart, a podiatrist, has joined Essentia Health St. Joseph’s-Brainerd Clinic. DeHart has a particular interest in caring for diabetic patients, who are often at a greater risk for serious foot problems. She graduated from the Ohio College of Podiatric Medicine in Independence, OH and completed a residency in podiatric medicine and reconstructive foot and ankle surgery at Providence Hospital and Medical Center in Southfield, MI.
Source: The Lake Country Echo [10/29/13]
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| QUERIES (CLINICAL) | |
Query: Subchondral Fracture of the 3rd Metatarsal
A 58 year old healthy appearing Caucasian woman was seen with a complaint of "severe pain" in the area of the 3rd metatarsal, of over two years duration. She gave a history of having a neuroma excised in the 3rd interspace two years ago. After continued pain for 4 more months, she agreed to another "neuroma surgery" in the 2nd interspace on the same foot. Both pathology reports came back "fibrofatty tissue with no evidence of a neuroma". I sent her for an MRI, and a diagnosis of a subchondral fracture of the 3rd metatarsal was made with no definite evidence of an AVN. Post-op injections, orthotics, etc. from her previous doctor produced no relief.
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Subchondral Fracture of the 3rd Metatarsal |
I hesitate doing any further surgery since she now has diminished capillary return to the 3rd toe after two side-by-side surgeries. The patient is in constant pain when ambulating at this point. Assuming the subchondral fracture was there from the beginning, could any of my colleagues recommend a course of therapy to afford her any relief? Would a bone stimulator be of any use at this point?
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| QUERIES (NON-CLINICAL) | |
Query: Reputable Podiatry Billing Service
Can you please recommend a reputable podiatry billing service?
Robert M. Liesman, DPM, Charlotte, NC
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| RESPONSES/COMMENTS (CLINICAL) - PART 1A | |
From: Ron Raducanu, DPM, Andrew Cassidy, DPM
If the patient has equinus, that could explain the continued symptoms if this wasn't addressed in the operating room. Many times, if I have even a slight inkling that the patient has a tarsal coalition, I will order an MRI before putting in a subtalar implant. Are the patient's symptoms at the implant site? Were the exact symptoms present pre-operatively?
Consider CPRS (RSD) as a potential etiology. Look for any color/temperature changes. Is the pain in the affected foot out of proportion? I see several children a year with this problem. Start with a topical cream for pain and send the patient to a pediatric neurologist. If this is the problem, several desensitization techniques such as letting water flow over the affected extremity in the shower, acupuncture, and mirror therapy (where a mirror is placed in front of the affected foot to see an image of the non-affected foot and try to imagine the affected foot looking and feeling like the non-affected one). Not all pain is hard-wired.
Dr. Donald Rhodes in Corpus Christi TX has developed a type of neurostimulator called the Vecttor which works for this type of pain. I had a patient use this for RSD and she noticed a difference in 48 hours.
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| RESPONSES/COMMENTS (CLINICAL) - PART 1B | |
RE: Subtalar Arthroeresis Gone Bad?
From: Michael M. Rosenblatt, DPM
In regard to juvenile (and even adult) flatfoot diagnosis and procedures, Dr. E. Dalton McGlamry stated that the clinician must evaluate for gastrocnemius and gastro-soleus equinus in all patients who are considering a flatfoot procedure. Consider adding a procedure to lengthen the posterior tendon complex, depending on the cause of the "shortness."
I'm not suggesting that the patient in question has this as a co-diagnosis, but rather that if this is a problem, then chances are any repair procedure that ignores it is probably doomed to fail. If a patient has this co-diagnosis, it does take time to explain the issue to the family and/or the patient, on why an additional procedure is also necessary.
The time spent to do a thorough biomechanical examination on any patient you are considering for a serious orthopedic surgery is well spent. An added benefit is documentation, should the procedure not go as expected.
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| RESPONSES/COMMENTS (CLINICAL) - PART 2 | |
From: Ben Pearl, DPM, Charles Morelli, DPM
Dr. Sullivan expressed it well. PRP may enhance an environment for healing in certain situations, but it has not been used as a substitute for primary repair. The Arthrex suture pass technique changes the surgical approach for plantar plate repair, and would seem to be more reasonable.
After 23 years in practice and now having done a fair amount of surgery and having performed every procedure for a plantar plate tear, including the Arthrex scorpion device, I find myself returning to simply doing nothing more than a Weil osteotomy. I also perform hammertoe repair when necessary. It's simple, removes pressure from the tear and, combined with a custom orthotic, this seem to work quite well almost every single time.
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| RESPONSES/COMMENTS (NON-CLINICAL) | |
RE: Reflections on Superstorm Sandy
From: Len Thaler
On this the first anniversary of the horrific Superstorm Sandy, let us reflect on:
SOLIDARITY - we have demonstrated with the more than 30 podiatrists in New York who lost their offices or homes, a disaster unprecedented in the history of podiatry;
GRATITUDE - we express for the vision and strong sense of...
Editor's note: Mr. Thaler's extended-length letter can be read here.
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| RESPONSES/COMMENTS (CODINGLINE CORNER) | |
From: Howard Lepolstat, DPM
In the attempt to determine who is and is not a diabetic, it might be of some value to look at the degree of metabolic syndrome the patient exhibits. When the level of serum glucose does not rise to a definitive diagnosis, perhaps the degree of complications and side-effects of the diabetes might be of greater value in treatment approach. Also, giving the diabetic label to someone is a big (and detrimental) step. Once given, it cannot be taken back. If it is justified by definitive glucose levels, then the label is warranted. However, when those levels are really borderline, if there is little or no metabolic syndrome present, then will the treatment really change, and is the label really necessary?
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MEETING NOTICES
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PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
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Choose any or ALL (50 CME Contact Hours) from the 30+ CME Category-1 articles posted
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| CLASSIFIED ADS |
PRACTICE FOR SALE – GLENDALE, CA
Retiring from part-time practice averaging 15 hours a week practice, grossing well over $130,000 a year. No HMO, PPO or hospital surgeries (but located 20 minutes from 5 major area hospitals). Only accepting private insurance, Medicare and cash. Not participating in the diabetic shoe program. Unique practice specializing in off label liquid SILICONE injections (no insurance…cash only), Cryoneuroablation, x-rays, ultrasound imaging, Lixiscope, soft tissue surgeries, and some palliative care. In same great location, in the center of everything for the past 43 years. Unlimited potential. Call….818-384-2479.
EQUIPMENT FOR SALE - 10 WATT LASER
10 watt laser. Hardly ever used 9K Still under warranty. E mail Dr. Zuckerman at: footcare@comcast.net. for questions and pricing .
ASSOCIATE POSITION - PENNSYLVANIA
Associate Wanted for busy, multifaceted podiatry practice in Chester and Delaware counties, Pennsylvania. Seeking PSR-24/36 trained podiatrist for full/part time associate position. Two offices and hospital privileges. Send CV and letter to: 123bunion@gmail.com
ASSOCIATE POSITION – BROOKLYN
Podiatrist needed for busy Brooklyn practice. Must be at least Board Qualified. Surgical background, personable and able to travel to different offices in Brooklyn. Part-time to start, with the potential for full time and partnership. Please email CV to evangbreth@gmail.com or fax to 718-840-0653.
PART-TIME PODIATRIST WANTED - SUFFOLK COUNTY, NY
Approximately 25 hrs/per week Must be reliable and punctual. Must have excellent chair-side manner and be highly skilled in conservative care. Offering $50/per hour. No other benefits. bombbustr7@aol.com
ASSOCIATE POSITION - CENTRAL FLORIDA
Associate wanted for well-established practice in central Florida. Experienced support staff, malpractice coverage and health insurance provided. Excellent opportunity for a promising future. To apply please go to www.yourcareerinpodiatry.com
HOME FOOT CARE, INC. - LOS ANGELES, CALIFORNIA
Looking for reliable, honest, and motivated podiatrists to join our group to assist with house calls to patient’s home residences, and some group facilities. Candidate must be willing to drive throughout the San Fernando Valley and the greater Los Angeles area. Part/Full time, flexible hours, independence, great compensation! If interested, please email resume to: homefootcare@hotmail.com
ASSOCIATE POSITION - CT (GREENWICH, FAIRFIELD AND NORTH HAVEN)
Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to: Dr.Kassaris@yahoo.com
ASSOCIATE POSITION - FLORIDA
Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. Florida has a great scope of practice law and we rotate for ER call at all 4 hospitals. Candidate needs to be ethical and motivated. Established practitioner or new practitioner OK. Base salary, percentage, benefits including 401K. Fax CV to (239)566-8778 or Email CV to Drgordon@gulfcoastfootcare.com.
ASSOCIATE POSITIONS – PENNSYLVANIA
We are looking for podiatrists to see patients in nursing homes in the following parts of Pennsylvania: Scranton/Wilkes-Barre, State College, Pittsburgh, and the Greater Philadelphia Area. Please contact doconcall02@aol.com.
ASSOCIATE POSITION - DAYTON, OHIO
Join an established group practice in Dayton, Ohio excellent reputation, large referral base. Base Salary$120,000, benefits and bonus structure. EMR;diagnostic ultrasound; Padnet; CO2 and Cutera Laser for nails, all aspects of DME. We need well trained personable PSR24/36 surgeon. Future Buy-in available. Please send CV to: Ohiomedical@aol.com
ASSOCIATE POSITION – TX
Are you looking for a permanent practice home? Do you have great biomechanics skills and maybe not so interested in ankle surgery? Are you highly motivated and ready to work in the Grapevine, Keller or Bedford area? If you answered yes to any of these questions, email: newfaantassociate@yahoo.com Put Hire Me in the subject line.
CENTRAL KENTUCKY DIABETES MANAGEMENT FELLOWSHIP
Directed by Dr. Jonathan Moore of Cumberland Foot and Ankle Centers of Kentucky, this non-accredited, 1-year fellowship starts in July and offers a wide variety of training opportunities that focus on diabetes, but span a wide variety of pathologies and unique training opportunities. Work hands-on with our office administration team to learn ICD-10. Our on-staff certified orthotist, physical therapist, shoe store staff, MRI director and other team members will make this the most valuable training year of your career. Generous stipend, benefits, and free housing. Learn more at www.myhappyfoot.com (click the Fellowship Tab). Send CVs to jmoore@aappm.org.
RECONSTRUCTIVE FELLOWSHIP POSITION – SOUTHWEST, FL
R U a SuperStar? PM&S36 or PSR24. prerequisite. Hardworking w/o Ego. ABPS BC/BQ required RRA. 1 year Fellowship will entail Ring, Rods, complex reconstructive planning/procedures and practice management. Research projects and posters to present at yearly fellowship conference. Send CV, Tell why you are a superstar. mny1029@gmail.com
DEAN - KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
The College of Podiatric Medicine at Kent State University invites applications and nominations for the position of Dean. The Dean of KSU’s College of Podiatric Medicine (KSUCPM) will lead the college, with complete line responsibility for personnel, general administration and management, budget, academic, and development functions. Interested candidates should have a DPM degree and academic credentials appropriate for appointment to the rank of full professor. Inquiries, nominations and applications are invited. Interested candidates should submit confidentially, a curriculum vitae and letter of interest to: Dr. Jett Pihakis, KentStatePodiatry@russellreynolds.com (202) 654-7800 Kent State University is an Affirmative Action/Equal Opportunity Employer.
PRACTICE FOR SALE - NASSAU COUNTY, NEW YORK
60 year old practice currently operating only 16 hours per week. Plenty of room for growth. Stable lease. Grossing 100k priced for quick sale at 65k. Three complete treatment rooms plus O.R. staff in place. Turn-key operation. Respond to footman007@aol.com
PM News Classified Ads Reach over 14,500 DPMs 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 14,500 DPMs. for details, click here or write to:bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $119 for a 50-word ad. 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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