The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

November 19, 2009 #3,705 Publisher-Barry Block, DPM, JD

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APMA to Present Awards of Excellence

APMA has announced that the following podiatrists have been selected to receive the Award of Excellence. The formal presentations of these honors will occur at the 2010 APMA House of Delegates in Washington, DC.

Craig M. Gastwirth, DPM

Dr. Craig Gastwirth

John F. Grady, DPM

Dr. John Grady

Harvey Lemont, DPM

Dr. Harvey Lemont

Source: APMA eDaily News [11/16/09]
 

TUSPM Podiatrist Urges Recognition of Diabetic Risk Factors and Testing

Diabetes screenings are being held at hospitals across the country for World Diabetes Day and those diabetes tests are quick and easy. Temple University doctors celebrated World Diabetes Day with education and screenings.

Dr. Kathya Zinszer

"People won't actually accept the fact that they could be diagnosed with diabetes if they have a family history or they suffer with obesity," said Dr. Kathya Zinszer of Temple University School of Podiatric Medicine.

Zinszer says that it's important to be aware of the signs that someone might have diabetes. "We usually call it a triad where there's an excessive amount of thirst, excessive urination or excessive loss of weight." She urged folks to learn their risk factors and get tested for diabetes.

Source: Hadas Kuznits, KYW Newsradio [11/14/09]

DiBacco Presented with PPMA's Pioneer of Podiatry Award

Richard DiBacco, DPM, a PPMA member from Erie, PA, received the Pioneer of Podiatry Award at PPMA’s House of Delegates banquet held at the Loews Philadelphia Hotel, Philadelphia, PA, on Saturday, November 14. Dr. DiBacco has been a member of the Pennsylvania Podiatric Medical Association (PPMA) since 1968 and received his DPM from the Ohio College of Podiatric Medicine in 1967. He is a Fellow of the American College of Foot & Ankle Surgeons and an Associate of the American Academy of Podiatric Sports Medicine.

Dr. Richard DiBacco

Dr. DiBacco is a national consultant for diabetic footwear, and in this way has aided in being a vital part of the diabetic management team. He has been spreading the word on the diabetic foot since the 1980s, giving numerous lectures on the subject, as well as other foot and ankle topics.

The Pioneer of Podiatry award is given to a PPMA life member who has contributed ‘above and beyond’ to the advancement of the profession throughout his or her career. Contributions will be solicited in Dr. DiBacco’s name for the Krausz/Schultz Scholarship Fund.

Groups Push Lawmakers on Doc-Payment Fix

Congress will lose credibility if it fails to swiftly approve legislation that will fix Medicare's troubled payment system for doctors, said Nancy Nielsen, immediate past president of the American Medical Association, during a teleconference. Lawmakers promised Medicare seniors that they will continue to have access and choice, said Nielsen, who joined leaders from AARP and the Military Officers Association of America in the teleconference. “If they fail to fulfill that promise, it calls into question Congress' ability to fulfill future commitments on [health] reform,” she said.

The House as early as Wednesday will begin consideration of the Medicare Physician Payment Reform Act of 2009, a measure that would prevent a scheduled 21.2% rate decrease set to take effect next year by revamping Medicare's sustainable growth-rate, or SGR, formula, which sets payments for doctors under the program. Such a reduction would force doctors to limit the number of Medicare and Tricare patients they treat, Nielsen said.

Source: Jennifer Lubell, Moderm Healthcare [11/17/09]

How to Avoid Arguments

End arguments before they begin, by taking time out.

Say: “This conversation does not feel constructive” or “I am too upset to listen right now.” Then agree on a time to resume.

Source: Adapted from “Stop Destructive Arguing Before Bad Things Happen,” via Communication Briefings

Query: Candidal Injections

I have a patient who has had 2 injections of candid antigen for a chronic wart. The wart was previously surgically excised and biopsied. It is under the hallux IPJ and has chronic pain.  After the second injection, the patient developed swelling of the entire foot with mild heat and pain. There has not been any fluctuance or drainage. He was placed on a Medrol dose pak with little benefit and then started on Levaquin for 2 weeks.

His CBC and Sed rate were both WNL. After the Levaquin, the foot edema has mostly resolved, but now 5 weeks s/p injection, he still has a swollen hallux with pain mostly at the IPJ. I have ordered a uric acid level and MRI. The patient takes pain meds for a kidney stone, Prevacid for a recently endoscopied GERD, and cholesterol meds. Any additional information or ideas would be appreciated.

Lynn LeBlanc, DPM, Bloomfield, CT

RE: Website for Wide Shoes (Joel Morse, DPM)
From: Doug Mason, DPM

We had a patient send us to a catalog and store that specializes in large shoes. It is called Hitchcock Shoes. We get several catalogs every month. Website: wideshoes.com

Doug Mason, DPM, Freeport, IL, drdiver@yahoo.com

RE: MIS (Michael J. Schneider, DPM)
From: Multiple Respondents

Dr. Schneider came late to this "game." In the late 70s and into the early 80s, you did not want to be a podiatrist having to be on the phone with a medical insurance company. Right or wrong, they had unabashed disdain for the field of podiatry because of MIS. And, in my many years of experiences, I never saw such "disasters" as some of the MIS post-operative feet.  I hope I never heard the words, "Shannon 44" ever again.
 
Robert Scott Steinberg, DPM, Schaumburg, IL, doc@footsportsdoc.com

Everyone has an opinion. It’s really a shame that so many of our so-called surgeons have such short sight. In the right hands, MIS was really, and is still the best thing in many situations.

I just saw a patient on whom I performed bilateral, Wilson/Aiken bunions, along with other needed surgical work, 25 years ago. After 25 years, not only was her foot perfectly aligned, but she only came to the office for a plantar fasciitis problem. There were no pins, no disability and this is just one of thousands of excellent results. Yes, maybe I had a few complications in 40 years, but be honest, we all are not perfect. 

The problems lie in doctors who hide behind others and cannot sit down and discuss other ideas besides their own. Check with one of the most credible podiatrists, Lowell Scott Weil, who I feel will tell you about the work he has now perfected because he had the foresight to accept change, and then improve it.

Whoever you are, let’s be professional and face changes that might benefit your patients. This should be our ultimate goal - patient satisfaction. This technique, MIS, is being practiced all over the world by orthopedic surgeons, as well as podiatrists. Open your minds. 
 
Stan Rosen, DPM, Tuscaloosa, AL, SRosen5730@aol.com

I hate to re-open old wounds in our profession (especially the self-inflicted kind) but the email "Wrath of MIS" needs to be responded to.

I have been practicing 30 years in the NY area and my Dad was a DPM for nearly 40 years before and with me. I have been exposed to...

Editor’s note: Dr. Adler’s extended-length letter appears at:
http://www.podiatrym.com/letters2.cfm?id=30536&start=1

RE: The Application of EBM to Orthotic Therapy (Robert Bijak, DPM)
From: Multiple Respondents

Routine foot care (and orthotics) have little to do with "pay disparities" between MD's/DO’s and podiatrists. When Medicare stopped allowing doctors to get paid for a long list of lab tests (each separately), my MD friends complained that this would reduce their income by 40%. This was the time that E and M billing was introduced, which brought about the biggest change in billing ever to occur. Actually E and M is “equal opportunity” for all doctors.
 
If you want to cure political discrepancies, you need to approach this through the legislatures, changing the DPM license to include the DO/MD degree. But even this would not cure everything. If you are doing “too much” RFC and not being paid adequately for it, then you need to widen your range of services. That’s YOUR fault, not the system's. 
 
Despite the worst economic collapse since 1929, podiatric physicians survive and thrive. (I have confirmed this in discussion with several practice brokers, who are very familiar with U.S. podiatric income).  Most American families facing job loss and recession would be shocked (and angered) to hear you complain. They would say: “You picked exactly the right place; I have no sympathy for you.” 
 
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

Editor’s Note: An extended letter by Dr. Baum appears at: http://www.podiatrym.com/letters2.cfm?id=30531&start=1
An extended letter by Mr. Root appears at: www.podiatrym.com/letters2.cfm?id=30541&start=1

RE: Podiatrists and Flu Shots (Leonard Levy, DPM, MPH
From: Kathleen Neuhoff, DPM

Leonard Levy stated that I had said that swine flu has no pedal manifestations. I certainly did NOT say this. In fact, I am currently treating 2 children whose experience with swine flu left them with severe neurological deficits in the lower extremities who require bracing to stand. My comments were directed towards administering vaccines in a non-emergency situation.

As a veterinarian, I have been well-educated in epidemiology and am familiar with swine flu. I field many questions from my podiatric patients and spend time educating them on this disease, which is my obligation as a physician. There is a potentially much more significant disease in avian influenza. There are elements of this zoonosis which give it a greater risk for becoming epidemic. If this would occur, I would certainly agree  that podiatrists would need to become involved.  However, administration of vaccines in a normal situation is, in my opinion, more suitable for nurses or assistants.

I believe the training of physicians (including podiatrists) equips us to diagnose, prescribe treatment, perform surgery, and educate patients. Giving vaccinations, like drawing blood, collecting urine samples, taking radiographs, scrubbing patients for surgery, etc. can be very effectively performed by other medical professionals who CANNOT diagnose, prescribe, or perform surgery. If we are doing their job, who is doing ours?

Kathleen Neuhoff, DPM, South Bend, IN, VETPOD@aol.com
 

ASSOCIATE POSITION - PHOENIX, ARIZONA

Part Time/Full Time, ethical and hard working graduate of a PSR 24+/36 Residency to join our growing multi-location practice. Good mix of Surgery/Pediatric/Trauma. Very modern offices with EMR, U/S, Digital X-Ray, ESWT, ABI 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

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.

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

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

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 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

ASSOCIATE POSITION - MINEOLA, NEW YORK

Full-time associate position with future partnership potential available with busy multi-office practices on Long Island. Must be proficient in all phases of podiatry with emphasis on surgery, biomechanics and RFC. Minimum standards include either a three-year PSR, or board qualified/certified status with ABPS. Existing hospital privileges with a NY based facility helpful. Interested doctors are encouraged to e-mail their CV to mets724@gmail.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 - 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

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