The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

November 12, 2008 #3,398 Editor-Barry Block, DPM, JD

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Neuropathy Common Among Diabetics: MI Podiatrist

“About 60 to 70 percent of all patients that develop diabetes in their lifetime will have some form of neuropathy, which is the loss of protective sensation, and therefore, increases their risk of having a foot problem,” says Crystal Holmes, D.P.M., a certified wound specialist and podiatrist at the University of Michigan Health System.

Dr. Crystal Holmes

Typically, people become aware of many health problems when they begin to feel pain. But with diabetic neuropathy, the inability to sense pain could postpone treatment, allowing for a little problem to become a big problem. “Something that normally would cause a person to stop, notice that there’s an issue and seek help, that whole event is delayed in someone who has neuropathy and diabetes,” says Holmes.

“We know now that people that have diabetes are living longer, healthier, more productive lives but that is because they’re working with their physicians and taking care of themselves more,” says Holmes. Some simple changes to a daily lifestyle could quite possibly save your health from dangerous diseases such as diabetes.

Source: eMaxHealth [11/10/08]

Ohio College of Podiatric Medicine Hosts Inaugural Vino Casino Night

The Ohio College of Podiatric Medicine (OCPM) hosted the inaugural Vino Casino Night Benefit on Friday, October 24, 2008 at the OCPM Campus in Independence, Ohio. Guests spent the evening enjoying delicious wines courtesy of Heidelberg Distributing and E-ville Wine and Spirits, as well as sampling an array of delicious hors d'oeuvres from the area's premier restaurants: Corleone's, Dante and Delmonico's. Guests were also able to enjoy an evening full of gambling for chances to win various prizes, including an Apple iPhone, Nintendo Wii, and 42" Plasma TV.

Dr. Paul Lieberman (jacket) and others place bets to help OCPM

The inaugural OCPM Vino Casino Night was sponsored by Fifth Third Bank, the Northeast Ohio Academy of Podiatric Medicine, Taft Stettinius & Hollister, BNY Mellon, The Fedeli Group, Saltz, Shamis & Goldfarb Financial Services, and many others. Over 200 guests helped the college raise $16,000 to benefit the OCPM Student Scholarship Fund.

Medicare Rated as Poor Performer During Debut of Pay-For-Reporting

Even as Medicare's Physician Quality Reporting Initiative approaches the end of its 2008 run, many doctors are still trying to figure out what went wrong with the 2007 PQRI.

Confidential physician feedback reports from last year's initiative, which for the first time offered Medicare bonuses for successfully reporting quality measures, became available to participating practices starting in August. Since then, many participants have been struggling to make sense of the information that they received -- if they were able to access it at all.

Only about 20% of 408 physicians surveyed in September by the American Medical Association were able to download their 2007 feedback reports, which told each doctor whether he or she reported enough measures to qualify for a bonus. Nearly 60% of those who sought assistance from the Centers for Medicare & Medicaid Services in accessing the confidential reports said they received little to no help from the agency. For physicians who persisted and were able to get past the stringent security measures, fewer than half said they found the data instructive.

Source: David Glendinning, AMNews [11/17/08]

Advice: Should You Take it? - Part 2

Everywhere you turn, people are willing to hand you some advice. However, not all advice is good advice. Use the following pointers as you decide which advice to take and which to leave on the table.

• Is the advice timely? Some advice is timeless, especially when the topic is is a perennial concern like personal fulfillment. But beware of advice based on outdated information. Someone who succeeded at door-to-door sales, for example, may have little wisdom to offer if you are selling on the Internet.
• Is the advice based on theory or practice? Theoretical advice can be valuable. Yet, advice based on actual experience is often more credible. Ask this question: "Have you ever done that?" The most valuable advice comes from in-the-trenches experience.

Source: Adapted from Year to Success by Bo Bennett

Query: CR vs. DR X-ray Systems

We are investigating CR vs. DR x-ray systems for a solo practice. Are there any reliable non-drum CR systems for less than $18,000? I would appreciate hearing any DPM experiences with DR vs. CR regarding technique or image quality.

Mark K. Johnson, DPM, West Plaines, MO

RE: Unexplained Bruising (Neil A Burrell, DPM)
From: Howard Stone

Though the area clearly appears bruised, I suspect Raynaud’s phenomenon due to the coolness of the skin. The skin needs to be re-warmed with bid soaking in Jacuzzi temperature water or with a heating pad on the warm setting. The skin will slough and normalize in about two weeks.

Howard Stone, DPM, Glenview, IL, drstone@nspodiatry.com

Since there are so many patients taking nutritional and herbal supplements who are afraid to tell their doctors what they are doing, this should be in the differential. There are many natural medicines out there that can cause vascular fragility when used inappropriately.

Bob Kornfeld, DPM, Lake Success, NY, Holfoot153@aol.com

RE: Painful Callused Heels (Shari Kaminsky, DPM)
From: Barry Mullen, DPM

I've read the prior postings and tend to agree that the etiology is likely repetitive, mechanical microtrauma from long-standing open back shoe wear. However, this individual is overweight and has a history of pre-existing autoimmune disease. Therefore, with this setting, I'd recommend ruling out hypothyroidism. Do a thyroid assay because a percentage of those patients may present with various forms of thyroid acropachy (affecting the skin and nails).

Locally, skin debridement with keratolytic ointment application under occulsion and rubber heel cups with closed back shoe wear generally helps. Systemically, your patient may be in need of thyroid supplements.

Barry Mullen, DPM, Hackettstown, NJ, yazy630@aol.com

RE: AAPPM Presents Inaugural Egerter Award
From: Hal Ornstein, DPM and Jeffrey Frederick, DPM

The American Academy of Podiatric Medicine had many great moments at our meeting this past week but nothing as notable as presenting the inaugural B.C. Egerter Award of Excellence to Dr. Barry H. Block.

Many see all the monumental things Barry does for our profession but as those who work hand-in-hand with him on many projects and initiatives we can best describe him with one word…passionate. His passion to use the written word to bring podiatry to the next level is incredible and he looks for any and all opportunities to do so.

We would be remiss to not thank his lovely wife for her support and allowing lending a large amount of his time to all his colleagues. Barry’s contribution to podiatry goes so far beyond PM News. If you ever have the opportunity to speak with Barry, you will see that his heart is his driving force for all he does. Barry, once again thank you for being you. Congratulations!

Editor's Note: We wish to thank the academy for this great honor.

Hal Ornstein, DPM, Howell , NJ and Jeffrey Frederick, DPM, Berkley, MI

ASSOCIATE POSITION – MASSACHUSETTS

Excellent opportunity for a highly-motivated, entrepreneurial individual to join a very successful, rapidly growing multi-office practice, North of Boston. Seeking a PSR-24/36 trained podiatrist to join our group. We offer a competitive salary/benefit package with the opportunity of partnership after one year, for the right individual. Send CV and letter of interest to drfleishman@nefootankle.com

ASSOCIATE POSITION AVAILABLE-MIDTOWN MANHATTAN

Looking for Full-time associate to work in well established practices in midtown Manhattan and Forest Hills. Immediate opening for PSR 24-36 surgically trained Podiatrist. Great opportunity with competitive salary along with malpractice benefits. Please send CV to slurie@papapc.net

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

PRACTICE FOR SALE - CALIFORNIA

Podiatry practice for sale, including all equipment. Doctor has spent 46 years building this successful practice in the wonderful community of Redlands, California. This is an incredible bargain for a young podiatrist. Come continue the legacy that the doctor has spent decades building. Email: syzygydoc1@yahoo.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

PRACTICE / BUILDING FOR SALE - CENTRAL ILLINOIS

Practice and office building for sale. Full-time very busy practice with well built stand-alone office building. Podiatrist wishes to retire. High patient volume. No need for second office. Midsize town with University and Industry. Call 217-778-4465 for more details.

EQUIPMENT FOR RENT - EXTREMITY MRI

Now you can rent an extremity MRI, have the scan performed, read by a board-certified radiologist and derive all the income. two convenient locations, Manhattan East 60th street between Park and Lexington, and Plainview, Long Island. Conforms to the Stark amendment; call for information (516) 476-1815.

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