The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

November 06, 2008 #3,393 Editor-Barry Block, DPM, JD

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Diabetics Need Comprehensive Foot Care Plan: CT Podiatrist

November is Diabetes Awareness Month and doctors want to remind people of their risks for contracting the disease and also what they can do to prevent further complications."It is really a bigger health problem than most people realize," said Dr. Harris Greenberger, a podiatrist and podiatric surgeon and the director of Sound Foot Care Center of Connecticut, located in Norwalk, CT. "The World Health Organization expects the number of new cases to double from 135 million to nearly 300 million during the next 25 years."

Dr. Harris Greenberger

Greenberger said there are several factors, including the aging population, unhealthy diet, obesity and a sedentary lifestyle, that could contribute to the increase of newly diagnosed individuals.

"It's really important that those with diabetes have an aggressive and comprehensive foot care plan established with their doctors to avoid amputation," Greenberger said.

Source: Jill Bodach, The Hour (CT) [11/4/08]

NJ Podiatrist in Dogfight in Passaic Mayoral Race

Campaign headquarters are almost up to full strength several hours before real estate developer Jose Sandoval, physician Alex Blanco, code enforcement inspector/School Board President Vinny Capuana, bail bondsman Carl Ellen and landlord/City Councilman Joe Garcia head to the local Baptist Church for a final collective prayer on the eve of Election Day.

Dr. Alex Blanco

It looked three weeks ago like a two-man race between Capuana and Blanco. The former has served for 26 years on the School Board, knows everyone there is to know, and commands a citywide base. A craggy, 72-year old Sicilian immigrant, he also has a homespun Passaic quality that’s hard to resist when he points at Blanco and tells a debate audience, “I’m proud of this man right here,” as a product of the Passaic City school system.

A lot of people are proud of Blanco, a 36-year old podiatrist in the city who runs with the blessing of Acting Mayor/Assemblyman Gary Schaer, whose 3rd Ward allies start lining up to vote on Election Day at 7 a.m. But a Herald News endorsement of Sandoval last week coupled with dreadful front page headlines for Capuana and Sandoval’s own pedal-to-the-metal organizing have catapulted Sandoval back into the race, according to city sources.

Source: Max Pizarro, PolitickerNJ.com [11/4/08]

Court Blocks White House Push on Medicare Expenses

A federal court has blocked the Bush administration’s effort to save money on Medicare by paying for only the least expensive treatments for particular conditions. Congress sets Medicare payment rates and never intended to give officials broad discretion to alter them, the court said in an important test case on Oct. 16. Judge Henry H. Kennedy Jr. of Federal District Court said the policy of paying for only “the least costly alternative” was not permitted under the Medicare law.

The administration’s position would give the health and human services secretary “enormous discretion” to determine the amount paid for every item and service covered by Medicare, without reference to the detailed formulas set by Congress, Judge Kennedy said. “This flies in the face of the detailed statutory provisions,” he added.

Over the years, Medicare officials have often tried to adopt regulations that allow them to consider cost in deciding whether the program should cover various goods and services. Healthcare providers, manufacturers and some patients’ advocates have resisted these efforts, saying that coverage decisions should be made based on clinical effectiveness and not cost.

Source: Robert Pear, New York Times [11/3/08]

Reverse Employee Turnover - Part 3

The cost of replacing an employee averages between one and two times the person's salary plus benefits. Worse, the loss of productivity can be devastating. Use exit interviews as a way to stem the flow of employee talent. Ask open-ended questions like these:

• "What words would you use to describe the work environment here?" Remember that departing employees may offer candid responses; they may also seek to justify their decisions to go.
• "What is the best thing about working here?" Follow-up question: "What is the worst thing about working here?' Note the responses and ask your remaining employees if they concur.
• "What changes would you recommend we make?" Give departing employees one final chance to leave a positive impression. Follow-up question: "What other issues would like to make us aware of?"

Source: Communications Briefings [December 2008]

Query: Draining S/P Excision of Cyst

A 58 year old female flight attendant presented with a large fluid-filled cyst on the dorsal aspect of her foot around the cuboid-cuneiform joint. Approx. 2-4 cc. of sticky, yellowish ganglionic-type fluid was drained several times over a 3-month period and she was able to regularly express fluid herself at home at the site. It was drained with an 18 gauge needle. Two-plus weeks ago, I went in surgically and completely excised a large pearly cyst measuring 2.5x2.5x1cm. An underlying defect in the soft tissue was sutured together. The path report came back as a synovial or bursal cyst rather than a ganglionic cyst.

The problem is that 8 days after surgery, she came in with localized swelling and the same type of fluid (2-3 cc.) was expressed from the wound. There was no erythema, warmth or pain. She has been seen twice again in the past week with continued localized swelling and pressure. Fluid was drained each time and a compression dressing applied. Will this run its course? Do I need to open the incision up again, inspect the area and pack Gel Foam into it? Any suggestions would be appreciated.

Tom Silver, DPM, Minneapolis, MN

RE: Bleomycin for Warts (Michael H. Warheit, DPM)
From: Ira Meyers, DPM

I have used bleomycin on approximately 25 patients and I cannot recall ever having a new lesion recur after using it.

Ira Meyers, DPM, Huntingdon Valley, PA, idmrun@aol.com

RE: Dennis Arnold, DPM
From: Marybeth Crane, DPM, Steven Goldstein, DPM

I am truly saddened by the passing of my colleague Dennis. In 1997, when I moved to Tarrant county, he was warm and welcoming, even helped me with my golf game! He was one of the positive guys in our profession. I will truly miss him.

Marybeth Crane, DPM, Grapevine, TX

As a member of the class of 1980, I am truly saddened to learn about the passing of Dr. Dennis Arnold. As class president, I got to know most of my classmates quite well and Dennis was a kind and gentle man. He will be missed by all who knew him and loved him. My condolences to the entire Arnold family.

Steven Goldstein, DPM, Royal Palm Beach, FL

RE: Non-Payment to Associate (Name Withheld)
From: Name Withheld1

I was in a similar situation as Name Withheld. I lost more than 3 months in back pay salary when I refused to renew my contract for another 3 years with this group. I worked on a percentage of collection. I lost way more money than this. Be grateful that you still possess a skill were you can make way more money than you just lost. When you are an employee, whether you have a contract or not, your employer can easily find some reason to say why he did not pay you. He can say you breached your contract. My advice is to take this on the chin and move on. Your employer will most likely not pay you without a long, dragged out fight. He will do this to prove to his other associates that work for him that he is not to be messed with.

Name Withheld1

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for full-time podiatrist in a multi practice location in the Chicagoland and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

POSITION - NORTHERN VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes.Top hospitals. Fax CV with references to 703-491-9994

ASSOCIATE POSITION –GEORGIA

A well-established practice in South Georgia seeks a full time PSR-24/36 trained podiatrist. Excellent benefit package. Please send CV to agriffin@southernpodiatry.com. For more information, visit our website

ASSOCIATE POSITION- NEW YORK

We’re in search of a motivated, well-trained DPM who is great with patients. Our well-established multi-doctor, multi-office practice is located in the scenic Hudson Valley region of New York State. All DPM´s in our group are board-certified and there is a residency program affiliated with our practice. This is a special opportunity for the right person(s), with an excellent compensation package available. Please reply to HVFA, PO Box 3300, Kingston, NY 12402-3300; or email CV and cover letter to: jobs@hvfa.com.

PODIATRISTS NEEDED - CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

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