The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

November 09, 2010 #4,005 Publisher-Barry Block, DPM, JD

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Burning Pain in Feet Could be Due to Narrow Shoes: FL Podiatrist

Have you ever taken off your heels after dancing the night away and been overcome with what can only be described as an inferno under your feet? If so, you can thank your shoes. “When you squeeze your toes into narrow high heels, you put pressure on the balls and sides of the feet, so the nerves between your toes get compressed, causing a burning, tingling, or numbness between the toes and in the ball of the foot,” says Amber M. Shane, DPM, FACFAS, a reconstructive foot and ankle surgeon in Orlando, FL.

Dr. Amber Shane

Shoes need to accommodate the foot so there’s room for toes to wiggle. The ideal heel height is less than two inches. However, since most women won’t go that low, a platform heel is a good compromise. This stacked heel makes full contact with the ground, which distributes pressure more evenly, says Dr. Shane.

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

NYCPM Faculty Member Presents Poster at AAMC Annual Meeting

Anthony V. D’Antoni, DC, PhD, Assistant Professor of Pre-Clinical Sciences, and Director of Anatomy, at the New York College of Podiatric Medicine, is presenting an informational poster entitled “Outcomes Assessment in a Novel General Anatomy Course: A Model for Podiatric Education” at the 2010 Annual Meeting of the Association of American Medical Colleges being held in Washington, D.C. through November 10.   

Dr. Anthony V. D’Antoni

The general anatomy (GA) course at NYCPM was recently revamped, in conjunction with the completion of a new, state-of-the-art gross anatomy lab at the College. The revamped GA course emphasizes clinical anatomy, cross-sectional anatomy, and radiology.

OK Podiatrist Co-Authors Chapter in  Gereral Surgery Textbook

Podiatric surgery was recently included in the well-known 2,000+ page general surgery textbook Greenfields's Surgery - Scientific Principles and Practice.  The new 5th Edition released in October included Bradley D. Beasley, DPM, CWS as a co-author, with vascular surgeons Matthew Sideman, MD and Kevin Taubman, MD for Chapter 96 - Lower Extremity Amputations.
 

Dr. Brad Beasley

 
Dr. Beasley is in pivate practice with offices in Owasso & Broken Arrow, OK.

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

Bret Ribotsky: What's the secret to becoming a successful entrepreneur?

Dr. William Scherer

William Scherer: Every podiatrist is capable of being an entrepreneur - you simply need to think of a solution to a problem, create or market a product that helps people, or design a website that provides information that people want to read. All too often, podiatrists focus on making money, but the most important thing is to do something that you are passionate about, and financial success will become be a by-product of your passion.

Dr. Harold Schoenhaus

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). The next segment  will feature podiatric surgery pioneer Dr. Harold Schoenhaus. You can register for this event by clicking here

Improve Your Voice-Mail Messages

Follow these rules and you will leave voice-mail messages that are informative, clear and to the point:

•  Pace yourself. Speak just a bit more slowly than your normal conversational tone. You don’t need to speak in a halting tone, but you should not rush either.
•  Provide details. Be sure to state your first and last name as well as the full name of your practice.
•  Repeat it. Always provide your contact information twice, once at the beginning and again at the end of your message. A busy contact may not be inclined to replay the message to gather missing information.
•  Know when to stop. Normally, a voice-mail message should be no longer than 30 seconds.

   Source: Adapted from Prospecting Your Way to Sales Success, Bill Good, Scribner via Communication Briefings

Query: Bunion Procedure?

I have a female patient 46 years of age with painful bunions, positive family history of severe bunions, and failed conservative care who asking for surgical repair. She is a Type-2 diabetic for ten years, is moderately overweight, with varicose veins, negative DVT ultrasound, and with no other health issues. 

Bunion in Type-2 Diabetic

X-rays show a moderate IM angle, severe HAV angle with metatarsus adductus. She has a flexible forefoot equinus and trackbound joints with manually reducible IM angle. Any suggestions regarding procedures or any treatment at all?

Angelo J. Bigelli, DPM, North Providence, RI

RE: Mortality Statistics for Charcot Surgery (Arden Smith, DPM)
From: Lee C. Rogers, DPM

There have been four or five research papers published in the past five years specifically addressing the risk of mortality in Charcot's foot. The mortality rate associated with Charcot is reported as 28-45% in 4-5 years with the largest study having over 1,000 patients (Sohn, Diabetes Care 2009 and Gazis, Diabetic Medicine 2004). Van Baal reported the life expectancy of someone diagnosed with Charcot foot is 7.9 years in the UK. TK Pakarinen studied a small sample of patients who underwent simple Charcot surgeries and reported a 29% mortality over 8 years.

One common theme in the studies is that Charcot foot is associated with a higher mortality rate than having diabetes alone, but the highest mortality rate reported is in those with a neuropathic ulcer.

Lee C. Rogers, DPM, Los Angeles, CA, lee.c.rogers@gmail.com

RE: Three Strikes and You're Out? (Arden Smith, DPM)
From: Dan Klein, DPM

The question is raised as to the recommended number of corticoid injections to give at the same site in a lifetime. During my first few years of proctored practice by my chief of orthopedics in the Air Force, the suggested maximum number of steroid injections to the same site was limited to three. He offered the concept that if the symptoms failed to respond after the third attempt using steroid injections, one should re-think or use an alternative approach to treat the patient. 

The fact is that repeated cortisone injections atrophy the soft tissue in the area injected. The potential for destroying the protective tissue to the bone is at risk. I have had the plantar fascia rupture at the site simply after one injection. I have seen surgically that the particles of steroid remain at the site for years. In general, I believe that after any given treatment that fails after using the same approach, one should reconsider the treatment approach. 
 
Dan Klein, DPM, Fort Smith, AR, TOEFIXER@aol.com

RE: Allscripts EMR (Daniel Cohen, DPM)
From: Richard A. Simmons, DPM
 
I have Medinotes, and just this week Allscripts has decided to support the Medinotes software and allow us to merge our Medinotes into a special Allscripts EHR. That said, the Allscripts program that I have seen is a general medical program, not specific for podiatry. If your office does a significant number of podiatry-specific procedures (e.g., covered routine foot care, mycotic nail debridement, diabetic shoes, etc.), you will spend extra time tweaking the program to handle your requests. If yours is mostly a surgical practice with very little podiatry-specific stuff, almost any EHR will work for you. 

If I were choosing a completely new system right now, I would choose the Sammy system (office-based server) or DOX Podiatry (Internet-based server) because both systems are podiatry-friendly, podiatry-specific, and are reasonably priced. Remember that your office staff will have to learn the EHR and systems that are automatically programmed to do podiatry-specific functions (e.g., date last seen by PCP, check Medicare deductible, etc.) to make the transition seamless. Lastly, it is more money-wise to invest in systems that do a lot than to hire personnel with advanced computer technology training.
 
Richard A. Simmons, DPM, Rockledge, FL, RASDPM32955@gmail.com

RE: Web-Based EMR Systems (From: Brock Rasmussen, MBA)
From: Marc Katz, DPM, Charles Morelli, DPM

I had to laugh when reading the response to my post. I've been using an EMR for over 6 years and have a systems bachground! I can certainly make a wise choice in a fearless fashion. My point does not involve "fear." Simply stated, make sure that your company is going to get certified before pulling the trigger, and yes - do worry about the 44K. You have a large portion of 2011 to get the correct EMR and the money.

What I have seen with friends and colleagues is this mad rush to get something; and indeed they are now less efficient and I agree it will be a tough transition. The wrong choice would be a bigger detriment to your practice than being pushed into an EMR. The point is: Make a well thought-out choice and get your 44K.

Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

I would like to dispel some myths, and address some issues that have recently been raised here. The following should answer many questions you may have regarding EHR.
 
Again, to reiterate, the $44,000 incentive is based on Medicare billing, including only...

Editor's note: Dr. Morelli's extended-length letter can be read here.

RE: Integrative Podiatric Medicine Meeting
From: Howard Dinowitz, DPM

I would like to comment on the incredible learning experience I had this past weekend at the seminar, "Podiatric Integrative Medicine and Wellness Biomechanics". The lectures were moderated by Dr. Robert Kornfeld and Dr. Dennis Shavelson, respectively. It was an eye-opener! There is so much out there that we, as podiatrists, have not tapped into yet. The entire discipline of integrative medicine is booming in every specialty except podiatry. There is so much to learn, and so much to earn ethically with tried and proven protocols. Most of these services are non-covered, and patients are already responding positively. I'm simply amazed.

Howard Dinowitz, DPM, Brooklyn, NY, drdinowitz@verizon.net

RE: Fringe Faux Pas
From: Peter J Bregman, DPM

I guess I really have a foot fetish. I was watching the show Fringe.  In a scene where the main character, Olivia Dunham was injured, she was brought back to the hospital of the future. In the room was an EKG machine and other medical tech stuff. There was an MRI of a foot sliced through the metatarsals in coronal section on a view box in the room. She did not have a foot injury! Funny that they had a foot MRI lying around? I wonder if any brain surgeons picked that up?

Peter J Bregman, DPM, Tewksbury, MA

RE: No Scientific Research That Barefoot Running Reduces Injuries: APMA
From: Ray McClanahan, DPM

I believe the APMA is wise in their counsel to be wary when considering barefoot running. This is the same counsel that is offered by barefoot running experts.

The APMA’s released statement on barefoot running was slightly more neutral than this story in PM News, as they stated, “inconclusive scientific research”, as opposed to “no scientific research, that barefoot running reduces injuries.”

There is peer-reviewed research currently available, that examines...

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

POSITION AVAILABLE -  NAPLES, FLORIDA

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office multi-doctor 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. Fax CV to (239)566-8778 or Email CV to Drgordon@gulfcoastfootcare.com

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION - DAYTON, OHIO

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 - 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 – 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

SEEKING EMPLOYMENT OPPORTUNITY - NORTHERN, NJ

Looking to relocate my current position closer to home. I am honest, ethical, punctual and hard-working. PM and S-36 trained with over four years of work experience. Seeking a full-time employment opportunity starting as an associate with the potential for partnership in the future. If interested, please contact  footdoctor36@gmail.com

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 - 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

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 - MICHIGAN - (OAKLAND COUNTY)

Outstanding opportunity for associate in well established practice, general & surgical podiatry forefoot, rearfoot & ankle (full or part-time). Well-trained, responsible, motivated with good communication skills, ABPS qualified or better. Send CV & letter of interest to: PodiatristWanted@AOL.com. All replies kept strictly confidential

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

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

EQUIPMENT FOR SALE - WHIRLPOOL AND WHIRLPOOL CHAIR
 
Professional, Whitehall brand 15 gallon Podiatry Whirlpool and Whirlpool Chair. In excellent condition. $2000.00. Please contact fergusondpm@aol.com

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