The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

December 01, 2008 #3,413 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2008- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Canadian Podiatrist Discusses Prevention of Bunions

While both men and women can develop bunions, women develop them more often because of their choice in footwear, explains Dr. Hartley Miltchin, a Toronto-based podiatrist. Not surprisingly, high heels are the major cause. "We're meant to walk on flat feet so that our body weight is distributed equally between the ball and the heel of the foot," says Dr. Miltchin. "When we wear heels, 90 per cent of the weight is on the big toe joint."

Dr. Hartley Miltchin

Dr. Miltchin recommends that you buy custom orthotics. Like your eyes, no two feet are identical, so buying off-the-shelf orthotics may not prevent bunions. "The success rate for an off-the-shelf orthotic is low because it's not formed to your foot," says Dr. Miltchin. While custom orthotics aren't cheap (most range from $500 to $700), they will last many years. Though no orthotics will fit in every pair of shoes you own, they will fit in most – including sneakers, golf shoes, low heels and flats.

Source: Chantel Simmons, Canadian Living [11/28/08]

AZ Podiatrist Continues Holiday Tradition of Sock Collection

Dr. Stanton J. Cohen gets extra mileage out of the pairs of socks he collects from other people. First the Yuma podiatrist uses the socks to decorate the Christmas tree in his office. Then as the holiday draws near, he takes them down and passes them on to Crossroads Mission, which, in turn, gives them to those staying in its homeless shelter.

Dr. Stanton J. Cohen

Cohen has been collecting the socks for the needy for more than a decade, and he's doing it once again this year. Cohen said he decided to ask for sock donations because people tend to wear them out sooner than other clothing items. Plus, socks keep feet warm and dry and help prevent foot infections. In a previous interview with The Sun, Cohen said the number of sock donations he has received has grown every year since he began the tradition. In 2006, he was able to donate more than 600 pairs to the mission.

Source: Yuma Sun [11/28/08]

Query: E-Prescribing Software

With the new Medicare incentive for e-prescribing, I wanted to know if anyone can provide some information concerning stand-alone e-prescribing software that would be Medicare-compliant.

Adnan Shariff, DPM, Okeechobee FL

RE: Surgical Management of Hypercoagulable Syndrome (Dan Methuselah, DPM)
From: John Cappa, DPM, Art Hatfield, DPM

I just had a case like that, although I was quite concerned about doing the surgery. I had her see her hematologist; he recommended stopping the Coumadin 1 week before surgery, and started her on Lovenox subq hs. She did this up until the night of surgery. That night after the bunionectomy, he had her restart the Coumadin. She had no post-op complications.

John Cappa, DPM, Valhalla, NY, johncappa@optonline.net

The best way to manage Coumadin is to leave it to someone else. Coumadin is the most litigious drug there is. Even in the hands of the best and most qualified, it can get out of control and cause a multitude of problems. I would only treat a patient like this as an in-patient. Likely, the internist will convert the patient to Heparin which is much easier to control and then back to Coumadin when the wound is stable.

Art Hatfield, DPM, Long Beach, CA, afootjob@juno.com

RE: Botox For Recalcitrant Plantar Fasciitis (Loren Miller, DPM)
From: Steven H. Goldstein, DPM

I am puzzled as why any podiatrist would have to resort to Botox when we are the experts in treating heel pain. We have so many different treatments to offer that this seems rather foolish to me. With all the latest technologies, such as cryosurgery, Topaz, RF, EPF refinements in orthotic technologies, to name but a few, where does Botox fit in? Leave that to someone else. It can be dangerous as others have alluded to if not used properly. One should know all the potential risks and side-effects before injecting anything into the foot, let alone Botox.

Steven H. Goldstein, DPM, Royal Palm Beach, FL, stevefootdr1@cs.com

RE: Inheriting Employees (Name Withheld)
From: Michael M. Rosenblatt, DPM

Unfortunately, our own academic and clinical training provides us with limited or no business or management experience. It’s more than a “matter of treating employees using the Golden Rule.” You have a responsibility to make sure that the practice continues to succeed and thrive. Without that, nobody has a job. The best place to start is with an employee policy manual. You can write it yourself, or obtain one, making modifications you feel necessary. Of course you can ask for suggestions from your employees. But you are under no obligation to accept them.

Openness, directness and honesty are always the best policy. Most new managers don’t make specific changes the first few months if “things are already going well.” If not, all bets are off. Since practice management skills are the bedrock of podiatric practice survival, that will have to take front seat. Periodic PM seminars should be the bedrock of educational development, along with board certification and maintenance of skills.

Periodic employer interviews and evaluation of your employees helps to maintain a climate of employer/employee relationship. It feels strange at first, but maintenance of your employer status is important. Don’t worry too much about “offending” prior colleagues. If you purchased the practice, you have bills and a payroll to maintain. If you are fair and open, chances are they will stay. But you sign the checks.

Michael M. Rosenblatt, DPM, San Jose, CA, ROSEY1@prodigy.net

RE: "Dremelite" Attachment
From: Robert D. Teitelbaum, DPM

The Micro-Mark catalog (Micro-Mark 1 800-225-1066, or micromark.com), which specializes in small tools, drills, and other hobbyist stuff is selling a "Dremelite" attachment for battery-operated and corded drills. The end housing is replaced by a housing that has two LED's which add light to the area that one is drilling (or debriding).

"Dremelite" Attachment

The cost is reasonable (less than $20) and is also available through Amazon.com or directly from the Dremel company. I haven't had this much fun debriding nails in years. I have no monetary interest in the catalog nor Dremel drills.

Robert D. Teitelbaum, DPM, Naples, FL, mfvandange@aol.com

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

PODIATRIST NEEDED—SEATTLE, WA

Established podiatric practice in Seattle, WA is looking for licensed podiatrist for part-time leading to full-time position. Need help with Adult Family Homes and Nursing Homes as well as in the office. Flexible schedule and attractive compensation. For all details please call 206-661-9644.

ASSOCIATE POSITION –GEORGIA

A well-established practice in South Georgia seeks a full time PSR-24/36 trained podiatrist. Excellent benefit package. Please send CV to agriffin@southernpodiatry.com. For more information, visit our website

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 part-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.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

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

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.

PM Classified Ads Reach over 11,500 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 11,500 DPM's. Write bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 Ext 110.

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.