The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

November 06, 2009 #3,694 Publisher-Barry Block, DPM, JD

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IL Podiatrist Discusses Morton's Neuroma

If you have burning in the ball of your foot, it could mean that you've got Morton's neuroma. This thickening or enlargement of the nerves in your foot, usually between the third and fourth toes, feels a little like you're walking on a stone at first--but it may develop into a chronic jabbing pain if it's not treated. What's the culprit? Two common causes in women are high heels or high arches, says Marlene Reid, a podiatrist in Naperville, IL, and a spokeswoman for the American Podiatric Medical Association.

Dr. Marlene Reid

"Foot pain is never normal," Reid says, so don't just grin and bear it. If it is a neuroma, which can be diagnosed with a physical exam and possibly an ultrasound or MRI, switch to shoes with a lower heel and a wider toe box. Arch supports can help take the pressure off the foot, but custom orthotics may be necessary down the road. Some doctors administer cortisone shots to reduce the swelling of nerve tissue. And in extreme cases patients may need surgery.

Source: Kimberly Holland, CNN [11/3/09]

Many African-Americans With Diabetes Delay Treatment: APMA Study

New national survey results show that nearly 40 percent of African-Americans with diabetes delay a visit to a podiatrist -- a critical member of a diabetes management team -- because they cannot afford the necessary medical care, according to the American Podiatric Medical Association (APMA).

The nationally balanced sample, which included 400 African-American men and women with and without diabetes, found that 38 percent of respondents with diabetes put off a visit to a podiatrist because they could not afford care, had no insurance, or care was not covered by their insurance plan. Additionally, while nearly all respondents (98%) agreed that proper foot care is vital, almost half (48%) admitted that they have never been to a podiatrist for a diabetic foot examination or treatment. African-Americans are twice as likely as Caucasian-Americans to develop diabetes.

Source: Earthtimes [11/3/09]

MO Podiatrist Must Go to Trial in Sex For Pills Case

A judge has ruled that a St. Louis podiatrist must go to trial over allegations that he provided prescription pills in exchange for sex.

The Park Hills Daily Journal reported tuesday that St. Francois County Associated Circuit Judge Thomas Ray has determined there was sufficient probable cause in the case against Dr. Dave Dai Quang Pham. He is charged with distribution of a controlled substance, possession of a controlled substance with intent to distribute, and misdemeanor patronizing prostitution. Pham was arrested earlier this year at a motel in Bonne Terre.

Source: Associated Press [11/3/09]

Query: Does EMTALA Prohibit Podiatrists From Taking ER Call?

I'm currently in the midst of a situation where my client is possibly going to be denied privileges to take ER calls at a small regional hospital in Central Virginia.  It's the classical turf battle between my client (who will do it for free) and the orthopedic group which charges the hospital $250,000 a year to "make itself available" for ER calls.  No one is questioning my client's competence to handle ER calls.  He is double board certified, and had substantial trauma experience in his residency.
 
The basis for rejection of his application is an opinion letter from hospital counsel. Her opinion is that placing podiatrists on the hospital's ER on-call roster is a violation of the Emergency Medical Treatment and Active Labor Act (EMTALA) Her position is that EMTALA doesn't include podiatrists within the definition of "physician" and that they cannot, therefore, be used for ER calls.
 
I wonder if any PM News subscriber has ever fought this problem and won it.
 
Richard W. Boone, Sr., Fairfax, VA, Health Care Attorney

RE: Orthotics For Hallux Limitus (Alan Mauser, DPM)
From: Jack Glick, DPM, MHA

The key word of your posting is "flexible." I would strongly urge you try the Rational orthotic, which is made over a non-corrected casting of the prone, relaxed foot. The "negative" casting is  filled and measured and corrected in the orthotic fabrication facility. The resulting orthotic controls the position of the foot during NWB and resists the foot's deformation when it is weight-bearing. The lab's corrections would more than likely increase the inclination of the calcaneal area and the inclinations of ALL the metatarsals.

Disclosure: I operate an orthotics laboratory.
 
Jack Glick, DPM, MHA, afolab@att.net

RE: Tightrope Complication  (Adam Cirlincione, DPM)
From: Lowell Scott Weil, Sr., DPM

Contrary to popular belief that the almighty "hypermobility" will overcome any bunion operation except for a Lapidus is just wrong and not supported by any evidence.

Surely, you understand that podiatric surgeons have been performing bunion operations on high IM angles, loose ligamented feet (hypermobility?), and recurrent bunions for decades without having to resort to a Lapidus bunionectomy. I remember a series of articles by Oloff, et al. in JFAS several years ago that showed excellent results on high IM angle bunions corrected with a carefully performed Austin bunionectomy.

Still others who face high IM angles have had good results with the long arm chevron (Kalish and Vogler (independently); the Ludloff (Myerson et al.); the Scarf (Gudas - Barouk - Borrelli-Weil), and of course, the closing wedge performed for many years by the Podiatry Institute. It has been said that surgery is both an art and a science; bunion surgery may be more art than science!

Lowell Scott Weil, Sr., DPM, Des Plaines, IL, weil4feet@aol.com
 

RE: Compression Socks/Stockings (Tamara Allen, DPM)
From: Fay Mushlin

You can contact Aetrex. They sell compression socks/stockings. We carry them in our office. For men, the colors they have are black, brown and tan. Women’s colors are black and tan.

Fay Mushlin,Newtown Square, PA,  teegee46@gmail.com
 

RE: Danger at TSA Check Points

I think it's time that the APMA take a stance against removing shoes and or going barefoot through their check stations at airports. Last week, I had a patient who is neuropathic and HIV positive pick up his belongings on the other side of the x-ray unit only to find that he had cut his big toe. Not only did he put others at risk with his blood, but he also was at risk for serious infection himself! It's time to figure out a better system!

John Mozena, DPM, Portland, OR, jlmozena@aol.com
 

RE: Alan Schor, DPM (Steven Berlin, DPM)
From:  J.C. (Chris) Mahaffey, MS

In a recent issue of PM News, the passing of Dr. Allan Schor was noted.  The submission stated Dr. Schor was a past president of ACFAS.  While Dr. Schor was a life Fellow member of ACFAS, he did not serve as president of the College. The College joins the podiatric community in extending its sympathy to Dr. Schor’s family.
 
J.C. (Chris) Mahaffey, MS, CAE, Executive Director, American College of Foot and Ankle Surgeons, mahaffey@acfas.org
 

RE: Medicare Compliance
From: Lawrence M.  Rubin, DPM

The recent article in PM News about Dr. Beltre’s indictment for Medicare fraud and the photograph of him in a jail cell was shocking. He is innocent unless proven guilty, but this should remind us that Medicare has a whole set of enforced rules that must be followed when...

Editor's Note: Dr. Rubin's extended-lenght letter appears at: http://www.podiatrym.com/letters2.cfm?id=30216&start=1

ASSOCIATE POSITION – MINNESOTA

Well-established podiatry clinic located in the Twin Cities area has an immediate opening for a full-time podiatrist. The clinic is located just minutes from a surgery center as well as 2 major hospitals. Associate position is also open for partnership or purchase. Please email CV and inquires to rmccoy@associatedpodiatrists.com

ASSOCIATE POSITION - NW IOWA (SIOUX CITY AREA)

Well-established, diverse, growing practice. Excellent referral base. Seeking an ethical, hardworking, motivated, caring podiatrist to fill a full-time position. Multiple hospital affiliations. Generous income with room for growth, leading to partnership for the right candidate. See our community www.siouxlandchamber.com. Fax CV, resume, three references to 712-258-9977.

OFFICE SPACE/ MRI RENTAL – NYC, LI

Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, Hicksville and/or Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITIONS - INDIANA/OHIO

PrimeSource Healthcare is a leading provider of mobile, on-site healthcare services at long-term and skilled nursing facilities. Our exceptional growth has created an immediate need for traveling, independent contractors of podiatry services in Indiana/Ohio. Earn between $175k and $225k per year. E-mail CV to kwright@pshcs.com. Visit us at pshcs.com.

PRACTICE FOR SALE- SEATTLE, WA

Beautiful office for sale in the heart of Seattle, WA. Newly renovated, 2,500 sf, new digital x-ray, vascular lab, state of the art physical therapy equipment, paper-less system, all new podiatric furniture and equipment, popular podiatric products store and beautiful diabetic shoe display. Office is located in the medical building and open 3 days a week. Great opportunity for expansion to full-time. Please send us a letter of interest to the: podiatrygroup@yahoo.com

ASSOCIATE POSITION FULL-TIME - SUBURBS OF CHICAGO

PSR 36 - month-trained podiatrist needed for busy suburban Chicago practice. Office and diagnostic equipment state-of-the-art. Full benefit package included. If interested, please fax your curriculum vitae to 847.352.0270 or email to foot1st@yahoo.com

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 a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to fmassuda@footexperts.com

ASSOCIATE POSITION - PHOENIX, ARIZONA 
Part Time/Full Time well-trained, ethical and hard working graduate of a PSR 24+/36 Residency to join our growing multi-location practice. Good mix of Surgery/Pediatric/General Podiatry. ER/Hospital Call a must. Very modern offices with EMR, U/S, Digital X-Ray, ESWT, Vascular Testing. Excellent referral base, and a well-trained staff. Base salary, bonus structure, benefits. Current AZ License a Must. Please e-mail CV and references to azpodiatrists@hotmail.com

DIABETIC RURAL OUTREACH PROGRAM - FLORIDA AND GEORGIA

Seeking DPM to join our program due to a high demand for Podiatric Care to off-site settings in SNF, ALFs and House Calls. Applicants must be willing to travel and must have experience. Current State License, Medicare and Medicaid numbers required. Seeking highly motivated individuals who can be team players, yet work independently. Must have strong work ethic and excellent communication skills. APPLY: Fax CV to: 866-258-9993 include 3 professional references. Please provide the geographic area where you can provide services. Further information call 800-779-8551 or email: info@DROPInternational.org. Visit our website

ASSOCIATE POSITION – RESEDA, CA

Podiatrist needed in Reseda, CA office 2-3 days/wk, 6hrs/day @ $375/day to senior community. Please have an active Medicare #. Position starts immediately. Please email CVs to coasttocoastpodiatry@yahoo.com

ASSOCIATE POSITION - FREDERICK, MD

Well-established and growing 2 office state-of-the-art practice located in medical/professional buildings. EMR, Digital X-ray, Ultrasound, DME provider, etc. Competitive Base Salary plus bonus, malpractice, health insurance, etc. PSR 24 minimum/Board Qualified or Certified with ability and desire to take ER call. If interested, forward CV to DOCSBNB@aol.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

ASSOCIATE POSITIONS – MARYLAND

Are you motivated, personable and enjoy working with the elderly? We are offering full or part-time positions in Maryland. Our group, Podiatry Management Services, provides care to the elderly in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your c.v. to drhprosen@comcast.net or fax to 410-486-2049 or call Dr. Herbert Rosen at 410-580-0255.

ASSOCIATE POSITION – BROOKLYN, NY

Busy medical office in Brooklyn seeking part-time podiatrist. Good conditions. (718) 259-6666 phone (718)259-7000 fax, email zg0109@yahoo.com

PODIATRISTS 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 Jake Shimansky, Director of Physician Recruitment. Phone-773-342-5221 FAX 773-486-3548-E-Mail jshimansky@homephysicians.com www.homephysicians.com

ASSOCIATE POSITION-SOUTHERN CALIFORNIA, INLAND EMPIRE

2-office multi-doctor practice looking for ethical, dependable doctor to work 3-4 days per week. State-of-the-art, long established practice. Needs a team player which may lead to buy-in for the right doctor. Must be ABPS BC/BE. High surgical volume. Send cover letter and CV to bkatzman2@earthlink.net

ASSOCIATE 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

PM News Classified Ads Reach over 11,500 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 11,500 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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