The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

November 29, 2011 #4,318 Publisher-Barry Block, DPM, JD

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GA Podiatrist Believes in Strong Team Approach to Limb Preservation

According to Jeffrey Frenchman, DPM, director of limb preservation at the Atlanta VA Medical Center, patients often hold fatalistic views about wound care or feel they created an unavoidable outcome of limb loss by diet, smoking, or failure to notice wounds quickly.

Dr. Jeffrey Frenchman (Photo: Advanced Biohealing, Inc.)

The best way to approach the care and possibility for closing wounds often draws on veterans’ strong team mentality. Frenchman believes in an involved approach—ranging from at-home care to dermagraph solutions — and avoidance of the blame-game for saving limbs.

Source: Wendy Taylor, Media Planet [November 2011] via USA Today

CA Podiatrist Works With Student Volunteers at Free Clinic

Nearly 80 teenagers volunteer as interns at the Westminster Free Clinic in Thousand Oaks. They immerse themselves in a healthcare oasis where the uninsured come because they don't know where else to go.

Dr. Stefan Feldman

"They find out if they have the stomach," said Dr. Stefan Feldman, a podiatrist who volunteers at the clinic. "It's one thing to say you want to be a doctor. Until you have to deal with the situations, you don't know if you're cut out for it."

Source: Tom Kisken, Ventura County Star [11/27/11]

FL Podiatrist Becomes a Physician's Assistant

An unlikely threesome, Maj. Gen. Burn Loefke, podiatric surgeon Dr. Michael Paritzky, and Naples resident Amy Steinhour had a common goal. They all wanted to become physician assistants. And they did. The general, the foot surgeon, and Steinhour joined the profession that U.S. News and World Report has consistently declared to be one of the very best and fastest-growing careers in the United States. 

Dr. Michael Paritzky

Paritzky had been a foot surgeon for 20 years when he suffered progressive nerve damage in his arms and was forced to give up surgery. But he would not be forced to retire. After many discussions with his family and medical colleagues, at age 57 he decided to become a PA and applied to Miami Dade College's physician assistant program. Paritzky just graduated in August and will be working in internal medicine. He is thrilled with his new career choice.

Source: Jack W. Foard, Naples News [11/27/11]

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

Bret Ribotsky: What do you think podiatrists should be doing now to prepare for our changing healthcare environment? 

Dr. Edwin Harris

Edwin Harris: I think that one of the things that we need to do is to look very carefully at extraneous expenses in our practices, and also in what we do for our patients so that we can actually do something to help contain the cost of the delivery of healthcare. I think that that’s one positive thing that we could all do and look very carefully at what we ordered and why we order it. We need to go back to looking at patients and thinking about them the way before we introduced multichannel laboratory testing. We should say, “Okay, this person has got this set of clinical symptoms. I am going to order this test to confirm or refute what I’m thinking, and cut down on the number of modalities that are used that really don’t do anything for the patient’s care and immediately just add to the treatment expense.”

Dr. Steven Spinner

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's guest is Dr. Steven Spinner, Past President of the American Board of Podiatric Surgery. You can register for future events by clicking here

Nix Triggers

Avoid triggering a defensive reaction when you discuss a performance problem with an employee. Script what you want to say without using these phrases:

•  “I’ll be totally honest.”
•  “I hate to say this, but …”
•  “This is for your own good.”
•  “I understand.”
•  “I’m sorry.”
•  “You must …”
•  “You cannot …”

None of those phrases will make the conversation better. Instead, reframe your remarks to focus the employee on what he or she can do to succeed.

Source: Adapted from How to Tell Anyone Anything, Richard S. Gallagher, AMACOM via Communication Briefings

Query: Dealing With a Specialist Who Refuses to Send a Report
 
A patient presented to me with a history of an ulcer and osteomyelitis. Over the years, he had been treated by at least five doctors. One wanted to amputate his digit. I sent him for a consultation to a leading infectious disease specialist in my greater locality. This man has a very good reputation and is very well known and respected for his work with bone infections. He is also very busy. 

My problem is that no matter what I do, he will not send me a report of his findings and treatment plan. The patient is doing very well. The doctor called to let me know how things were progressing, but he said that he is too busy to dictate a report. Short of going to his office and standing on my head, I will not get a written report from him. Because I am dealing with osteomyelitis, a condition fraught with litigation, it is in my best interest to have something written which I can put in the  patient's chart. What approach can I take?
 
Elliot Udell, DPM, Hicksville, NY

RE: Wavelengths for Laser Treatment of Onychomycosis (George Stephen Gill, DPM, MBA)
From: Bryan C. Markinson, DPM

Dr. Gill reports use of the Pinpointe Laser with "consistent positive results and patient acceptance." Obviously, this is another claim from which we can make no conclusion. He goes on to say that his patients also get a 90-day course of terbinafine along with the laser treatment, and recommends strict adherence to several other adjunctive measures. I think he is on the right track. Indeed, we really do not know at this point that use of the oral therapy in concert with laser treatment may alter the typical course of treatment of either one alone. I hope Dr. Gill (or anyone) is looking at this.

However, nothing in development of onychomycosis therapy has even come close to the results we have seen from oral terbinafine therapy in tens of millions of uses worldwide, re-infection notwithstanding. Since most users of laser therapy state unequivocally that avoidance of oral therapy is the key motivation for laser acceptance by patients, Dr. Gill presents what I have been calling for since the introduction of therapy. We need to continue to develop it as a therapy in long-term management and find the best adjuncts.

However, you cannot credibly report the efficacy of laser therapy on any level when you are giving patients a time-proven systemic therapy at the same time. I am curious what those who have used the laser extensively have to say about this.

Bryan C. Markinson, DPM, NY, NY, bryan.markinson@mountsinai.org

RE: Who Gets to Cast? (Robert Scott Steinberg, DPM)
From: Michael Forman, DPM

I was trained in biomechanics by Dr. Merton Root over forty years ago.  While there have been changes in biomechanical theory, the one thing that hasn' t changed is the importance of a good cast. I hesitate to say "neutral." I guess I can be classified as a Root purist, yet in my practice, I have trained two of our floor assistants to take impression casts. I personally check each cast before the patient leaves the office. It works for me.
 
Michael Forman, DPM, Cleveland, OH, IM4MAN@aol.com

RE: Podiatric "Physician"
From: Robert Bijak, DPM

Nails grate across a chalk board when I read the term "podiatric physician".  Not that I don't think we should be, but it's an oxymoron - like dental physician. We can't just add a word and imply an increased scope! I said "imply", not "practice."
 
Webster's Dictionary defines a physician with 3 subtitles, 1. a medical doctor, 2. a general medical practitoner, as distinguished from a surgeon and 3. (where we may slip in) any person or THING who heals, relieves, or comforts. My point is, denotatively, we can fit in the third definition, so can an aspirin, a prostitute, and a lot of allied health fields. But, connotatively, it is commonly accepted as being an MD/DO or someone who treats the entire body and is not limited in scope.

We have some podiatrists who are naturopathic physicians. They treat the whole body with herbs and nutraceuticals. To me, that's pushing it just like the MDs see us trying to appear more than we are. My real point is, let us stop the euphemisms like physician, limb salvagers, leg surgeons in an effort to retain the limited DPM with the implication that it is more. The profession is "busting" with the desire to increase its scope. Assuaging your own ego by aggrandizing your title fools only you. An MD after your name is all you need. Changing to this should be the one and only thrust of the podiatric politicians. Then you can honestly call yourself a physician.

Robert Bijak,DPM, Clarence Center, NY rbijak@aol.com

Codingline & PM News
In conjunction with AAPPM Present
The Greenbrier Coding & Practice Management Workshop
(Following the 2012 APMA Annual Meeting in Washington, DC)  August 20-22, 2012

The Greenbrier

EARLY BIRD DISCOUNT ENDS THIS THURSDAY

Click Here for information  or  to Register

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

PODIATRY OFFICE TO SHARE - SEATTLE, WASHINGTON

Fully equipped podiatry office in North Gate area of Seattle. Office located in medical professional building near I-5. Office has 3 treatment rooms, 3 physical therapy rooms, direct digital x-ray, PAD- net, NCV testing equipment, physical therapy equipment. Please contact us: website Tel. 425-643-8901 isbinc2006@gmail.com

CPME-CERTIFIED WOUND CARE FELLOWSHIP

Open position available Jan.31, 2012. St. John`s Episcopal Hospital, Far Rockaway New York. State-of-the-art wound care center. All aspects of wound care including hyperbaric oxygen & reconstructive surgery. One year, excellent salary & benefits. Must have completed approved residency and passed boards. Contact Mariann (718) 869-7256

EQUIPMENT FOR SALE - CLASS FOUR LASER- USED K-LASERS

I have used K-laser for sale. Still in Warranty. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargeable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

EQUIPMENT FOR SALE - SUPERPULSE 45 WATT PEAK POWER LASER ( LUMIX2)

Superpulse 45 watt peak power Laser (lumix2) used once or twice. This is a real superpulse 910nw up to 100,000 HZ. Great Laser Used in the super bowl by the Green Bay Packer Why am I selling? I have too many lasers in my office now ( six) This is a great laser for plantar fasciitis. Achilles tendonitis. Lightweight portable. easy to use, fully programmable Sold to first person under $$12,000 You will NEVER get a laser like this at this price. Enjoy. it I just have too many lasers. David Zuckerman DPM footcare@comcast.net

PRACTICE FOR SALE – NANAIMO, BRITISH COLUMBIA, CANADA

Have you ever dreamed of owning a practice where...you can see 0-50 patients daily * average 100 new patients monthly * have zero accounts receivable * gross $480K per year * live in a beautiful community with skiing, hiking, fishing, and boating on your doorstep. This could be yours! If interested contact pistone@telus.net or call 250-754-4192.

ASSOCIATE POSITION - BRONX, NY

Excellent hospital-based opportunity. Outpatient Care in busy clinic. Large diabetic population. Competitive salary and benefit package. Email CV and letter of interest to nealblitz@gmail.comASSOCIATE POSITION - SOUTHEAST GEORGIA - SAVANNAH

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking associate or new residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

ASSOCIATE POSITION - BAKERSFIELD, CA

Busy surgically-oriented group in Bakersfield, CA searching for 4th doctor. Wound care center privileges. All 3 current surgeons have 3+ years post-graduate training. Send letter of interest with CV to: aghams2@aol.com

ASSOCIATE POSITION - EAST TENNESSEE

30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. $160,000 base salary with bonus incentives and benefits. Post-residency experience a plus. Please send resume to ddavidphawk@yahoo.com

ASSOCIATE POSITION - TEXAS

Well established, expanding podiatric medical and surgical practice with multiple locations Northeast of Dallas, Texas. Modern offices with EHR, digital radiography, Padnet vascular studies and laser. We offer a competitive salary and benefits package for a motivated, ethical, personable and well trained PSR/36 or board equivalent. This individual will also assist managing the residency program. Send resume (CV) to northtexaspodiatry@yahoo.com along with a letter of intent

ASSOCIATE POSITION - MARYLAND

Multi-office group seeks highly trained surgical associate to join us. Prefer person with frame and trauma experience. Our practice is state-of-the-art and has all modalities: EMR, PadNnet, on-site billing, diagnostic US, PRP, digital x-ray, etc. Excellent salary, bonus structure and benefits with partnership available. Please forward CV and letter of intent to docsbnb@aol.com

ASSOCIATE POSITION - TAMPA BAY AREA

Excellent opportunity to join a well-established multi-office group practice in the beautiful Tampa Bay area starting July 1, 2012. We are seeking a highly motivated, ethical and personable physician with a Florida license. Competitive salary, excellent benefits and partnership track. Please email or fax CV to thesykeshome@aol.com  (813) 254-8262

ASSOCIATE POSITION - CENTRAL VALLEY/SOUTHERN CA

Seeking associate with partnership availability. Must be highly motivated and have good patient skills and personality. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Compassionate and well-trained for immediate position. Surgery Center and hospital-based with no HMOs/no rest homes. Bilingual in English and Spanish preferred. Offering a permanent position/partnership in a multi-million dollar hi-tech practice with Partnership also in Surgery center. Please e-mail CV and short bio to: Tonya@wetreatyourfeet.com

ASSOCIATE POSITION – NORTHERN CALIFORNIA / BAY AREA

We’re looking for someone entrepreneurial who can help grow our practice. Must have great people skills, clinical/surgical skills, and positive demeanor. California license required. Send your CV and cover letter to cvpodiatrist@gmail.com

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 24-36 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977 Diane Coulter, Office Manager.

ASSOCIATE POSITION - SOUTH/CENTRAL PENNSYLVANIA

PSR-24/36 trained individual for busy practice in family-friendly college town. Seeking personable, ethical, motivated individual to join our well established practice providing all aspects of podiatric care. Competitive salary and benefits package. Reply with letter, CV and photo to Jagerone@aol.com.

ASSOCIATE POSITION - DAYTON, OH

Join a well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and to Ohiodoctors@aol.com

ASSOCIATE POSITION - MARYLAND

Looking for 3rd associate. Must be personable, well trained and highly motivated. Great locations in Southern Maryland, including an Ambulatory Surgical Center. We currently have EHR, digital radiography, dispensing center and PADNet. Looking for immediate hire! Please send CV to:  myfeetfeet@aol.com

PM News Classified Ads Reach over 13,500 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 13,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 for a 50-word ad 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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