The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

November 30, 2011 #4,319 Publisher-Barry Block, DPM, JD

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AK Podiatrist Discusses Prevention of Warts and Fungal Infections

Since our feet sweat, wearing non-breathable shoes or even regular shoes all day can be problematic. The moisture that accumulates creates an ideal habitat for fungi that cause athlete’s foot and toenail fungus. “I would say that 80 percent of people here in Southeast Alaska have the fungus,” commented Dr. Anh T. Lam, the podiatrist at the Southeast Foot and Ankle Center. Lam, who also has a clinic in Ketchikan, observed that in small communities, many people share the same public spaces such as gyms, pools, and locker rooms. 

Dr. Anh T. Lam

“It’s good to protect your feet in these communal areas,” he said. Warts and fungi can be picked up easily in these places. “Children are particularly susceptible to the viruses that cause warts,” he said. “Their high metabolism allows the warts to spread quickly.” Wearing a pair of clean flip-flops in public places is a simple way to put a barrier between the feet and potentially contaminated surfaces.

Source: Jennifer Nu, Juneau Empire [11/27/11]

GA Podiatrist Appointed to State Board of Examiners

Governor Nathan Deal has appointed Dr. Leonard R. LaRussa to the Board of Examiners for Podiatrists. LaRussa has been in private practice serving the community of Americus and surrounding counties since 1996. He is a board certified podiatrist by the American Board of Podiatric Surgeons.

Dr. Leonard LaRussa

Dr. LaRussa serves on the board of directors of the Georgia Podiatric Medical Association and as a Carrier Advisory Committee representative to Medicare.  He is a diplomat of the American Professional Wound Care Association. LaRussa earned a bachelor’s degree from Montgomery College, a medical degree from New York College of Podiatric Medicine and completed his surgical residency at the University of Pennsylvania.

GA Podiatrist Goes Peacock Bass Fishing With Former President Bush

Besides being a podiatrist at Village Podiatry in Atlanta, Dr. Gary Laden is a world-class peacock bass fisherman and editor of Peacock Bass Adventures, a semi-monthly e-publication. One of his most memorable stories is about the time he organized a fishing trip in Venezuela for former U.S. President George H.W. Bush. 

(L-R) Dr. Gary Laden with Former President George H.W. Bush

"The president was a most engaging and approachable individual, as were his daughter and nephew. All had a passion for fishing and were eager to learn the techniques needed to catch Ventuari and Orinoco River peacock bass," says Laden.

NIH Proposes Ethics Survey for Surgeons

Surgeons may soon have a way to report the ethical dilemmas they face in the workplace. The National Institutes of Health's Department of Bioethics is proposing a 29-item survey that will assess surgeons' experience with ethical issues as well as their use of hospital ethics consultation services.

According to a notice in the Nov. 28 Federal Register, the results from the survey could be used to shed light on factors that affect utilization patterns for ethics consultation services. It could also help to identify ways to improve such services for surgeons, the NIH said in the notice.

Source: Maureen McKinney, Modern Physician [11/18/11]

Docs Write Too Many Scripts: Consumer Survey

More than half of Americans responding to a telephone survey said that doctors write too many drug prescriptions, according to new findings from polling company Poll Position. Among survey participants, 52% said doctors prescribe too many drugs; 25% said they do not; and 23% said they had no opinion on the issue.

Poll Position, which launched its website in September, conducted the telephone survey Nov. 22 and reached 1,168 registered voters. The company, which describes itself as a "non-partisan news, polling, and social-media company," claims a margin of error of plus or minus 3%.

Source: Ashok Selvam, Modern Physician [11/28/11]

Query: Dropbox and HIPAA (Hal Ornstein, DPM)
From: (Jay Seidel, DPM)

Dr. Ornstein remarked about the convenience and versatility provided by the Dropbox application. My only concern is potential HIPAA violations. Does the security level provided by the company allow for inclusion of patient-sensitive information and documentation?

Jay Seidel, DPM, Baltimore, MD

Editor's comment: PM News does not provide legal advice. While the data with files using Dropbox is encrypted, unfortunately, the name of files can be seen by Dropbox. So, if you name the file SallyJonesHIVResults.doc, Dropbox would be able to see the name of the file. Seeing the name is one of the Personal Health Information (PHI) items that needs to be protected under HIPAA. Therefore, Dropbox is not HIPAA-compliant and should not be used to store medical records of any kind.
 
Source: Dropbox.com

Query: DME Dispensed at a Wound Center

Our new associate will be treating patients at a local hospital wound care clinic on a part-time basis. We will be billing for the services provided - E/M, debridements, DME, etc. The wound clinic wants her to fit and supply the patients with diabetic shoes, AFOs, and apply total contact casts as needed.

Our practice has a DME number and has been dispensing DME for 3.5 years at two office locations. The wound care clinic does not have a DME number. Can our new associate fit and dispense DME at the wound clinic under our DME number? What changes/applications will need to be made when she (new associate) becomes a partner?

Ginny Morgan, PMAC, Office Manager, Owasso, OK
 
Response: Your new associate will be required to obtain a DME provider number. The new associate will need to re-assign their payments to the group practice, and the new location would need to have its own PTAN.

Not noted in your posting was whether the group had different PTANs at each location (this is requirement) or what the financial relationship is between your group and the wound care center. It would seem from your brief posting that the wound clinic should be the entity which should be dispensing and being paid for DMEPOS. Since you have raised so many issues, I suggest that you contact an expert in these areas for more advice specific to your enrollment issues. There is obviously much more which needs to be addressed.

Paul Kesselman, DPM, Woodside, NY

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RE: Non-Healing Ingrown Toenail (Malignant Melanoma)
From: David Weiss, DPM

I have just treated a 52 y/o WF for a "non-healing" ingrown toenail. She presented to my office with a "paronychia" that had been unsuccessfully managed with three courses of antibiotics by her PCP. Her x-ray showed a mild subungual exostosis. I recommended a nail bed biopsy and an exostosis resection. Her biopsy results revealed a highly invasive malignant melanoma (Clark 5), vertical growth phase. Here is a photo of the toe as she presented. 

Malignant melanoma

She has now been referred for PET scan, sentinel node biopsy, and amputation of the toe. Considering the presentation and the implications of the diagnosis, I am grateful that we as podiatric surgeons are trained to be suspicious "whenever something does not look or sound right." This is my second malignant melanoma diagnosis in 2 years on the nail bed.

David Weiss, DPM, Richmond, VA, podmed@mac.com

RE: Laser Treatment of Onychomycosis (George Stephen Gill, DPM, MBA)
From: Alan Silverstein, DPM

Dr. Gill published an excellent letter concerning his laser treatment of onychomycosis. I have no issue throwing everything there is, including the kitchen sink, all at once to help resolve a problem. Of course, this treatment regimen could never be subject to rigorous analysis. I also have no issue asking the patient to do three separate treatments at the same time.

My belief is that topical therapy is of limited usefulness except in the very early stages of nail infection. I just wonder how Dr. Gill 'sells' the laser for additional fees at the same time he is prescribing oral therapy? Again, I think this can be an acceptable approach. If most people opt for laser because of their concerns about systemic effects, I just wonder how he broaches this with the patient. Can he elucidate?

Alan Silverstein, DPM, NY, NY alel@optonline.net

RE: Dealing with Specialist Who Refuses to Send Consultation Report (Eliot Udell, DPM)
From: Gino Scartozzi, DPM
 
The specialist who refuses to send a consultation report at the request of a referring doctor, in my opinion, seems to exhibit a "short-sightedness" in regard to meeting the medical needs of the patient and the referring practitioner. A consultation report, especially when requested from the referring doctor, is an opportunity for the specialist to ensure continuity of patient care, provide proper medical documentation of all parties concerned, avoid miscommunications affecting patient therapy, and provide a future opportunity for that specialist to secure additional referrals.

Any telephone conversations regarding the patient course and treatment should be duly noted within the patient's medical record along with the refusal of the "specialist" to send a consultation report. In the future, I would seriously seek another specialist for referral if consultation reports are not forthcoming from this "busy" specialist. In my opinion, "busy" is just "lazy."
 
Gino Scartozzi, DPM, New Hyde Park, NY, Gsdpm@aol.com

RE: Who Gets to Cast? (Robert Scott Steinberg, DPM)
From: Richard Stess, DPM

I would like to invite Dr. Steinberg to the lecture “Improving Your Casting Technique” that I will be presenting to the assistants track at the Midwest Podiatry Conference. Since introducing various STS casting socks for our profession, I have had the pleasure of giving countless workshops to both podiatric physicians and their assistants. What I have learned over the past 15 years is that crush boxes account for 35% of the devices provided. This percentage seems to be increasing despite the inaccuracies in the negatives.

The responses that I often hear from the DPM is that “it is good enough” or that they don’t want to spend the extra minute or two taking a good cast. The practitioners state that although they have no statistics to support the comment, the outcomes are better or “ it just doesn’t seem to make a difference.” I have seen no significant juried articles supporting...

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

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 – 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 - 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.com

ASSOCIATE 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 - 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 - 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

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. 425-643-8901isbinc2006@gmail.com

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.

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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