The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

December 01, 2011 #4,320 Publisher-Barry Block, DPM, JD

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Podiatric Involvement Means Fewer Amputations: NY Podiatrist

Podiatrist Dr. James Hanna told Patrick Taney and Ginger Geoffery on "Eyewitness News This Morning" that diabetes can sometimes be diagnosed by problems with your feet. A recent Thomson Reuters Study, “The Economic Value of Specialized Lower-Extremity Medical Care by Podiatric Physicians in the Treatment of Diabetic Foot Ulcers,” concluded that care by podiatrists prior to the first evidence of foot ulcers in patients with diabetes prevents or delays lower extremity amputations and hospitalizations.  

Dr. James Hanna

"Moreover, when compared to other healthcare professionals who treat the diabetic foot, podiatrists are more likely to reduce hospitalizations and prevent amputations. Providing access to podiatrists is an important component in ensuring quality of care. The growing epidemics of diabetes and obesity and their concurrent complications, along with the aging of the population, are among the many reasons podiatrists are necessary and important members of the physician community and demand for their services is increasing," says Hanna, citing from the study.

Source: WKBW News [11/28/11]

ACFAOM Posts Video of "Meet the Masters" Roast of PM Editor

In the event you missed the infamous roast of PM Editor Dr. Barry Block, The American College of Foot & Ankle Orthopedics & Medicine has just posted this hilarious video on their website.

Dr. Barry Block Roasts Back

In addition to the "roasting" by Emcee Dr. Bret Ribotsky, you'll hear live pokes by Drs. Brad Bakotic and Warren Joseph, as well as some videos from many well-know podiatric celebrities. Don't miss Block's retorts to the roasters.    

NBPME Seeks Volunteers for Pilot Clinical Encounter Examination

The National Board of Podiatric Medical Examiners (NBPME) has reached a critical juncture in part of its effort to address the goals of APMA’s Vision 2015. The NBPME has spent more than a year of investigation and deliberation with the assistance of the National Board of Medical Examiners (NBME) and the Educational Commission for Foreign Medical Graduates (ECFMG) in their Clinical Skills Evaluation Collaboration (CSEC) to determine the feasibility of instituting a test component for podiatric medical students comparable to that offered by CSEC to allopaths. The Board now needs the assistance of fourth-year students to participate in a pilot examination in Philadelphia next February.

Dr. Charles Lombardi

The pilot examination will involve ten patient encounters with typical podiatric presentations and will require a day to complete. The Board needs to test 100 to 200 candidates to obtain useable statistical data for consideration of whether to pursue a live examination in 2013. Students will be offered a $100 honorarium and entry in a drawing for an iPad. Interested students are asked to learn more details and obtain an application form at apmle.org. Charles Lombardi, DPM, chair of the NBPME committee reiterated the importance of this effort to the advancement of podiatric medicine. “This is an essential step in the NBPME’s contribution to Vision 2015. We hope students will take advantage of this opportunity to contribute to their profession.”

GA Podiatrist Appointed to State Board of Examiners

Governor Nathan Deal has appointed Rudolf W. Cisco, DPM to the Board of Examiners for Podiatrists. Dr. Cisco graduated from the Pennsylvania College of Podiatric Medicine in 1986 and completed a three-year surgical residency at the Hospital of the University of Pennsylvania.

Dr. Rudolf Cisco

Cisco is a Diplomate of the American Board of Podiatric Surgery and served as president of the Georgia Podiatric Medical Association from 2004-2006.

Medicare RACs to Conduct Pre-payment Reviews for Doctors, Hospitals

Medicare contractors will begin pre-payment reviews of certain Medicare claims starting in January 2012 in an effort to reduce the estimated billions in improper federal healthcare payments made each year. Physician and hospital organizations reacted warily to the announcement. Although they said doctors and hospitals understand the need to limit errors and fraud in healthcare claims, the reviews could add yet another administrative burden.

The first of the three-year demonstration programs -- all beginning in January 2012 -- will allow Medicare recovery audit contractors to conduct prepayment reviews of certain claims in 11 states. RACs currently examine claims after they have been paid.

Source: Doug Trapp, AMNews [11/28/11]

Put it in Writing

Solve problems by listing your complaints. Write down the hassles and headaches you encounter regularly at work. Then highlight those that are costing your practice time, money, and patients. Tackle those first.

Warning: If you take no action to resolve those problems, you lose the right to complain about them again.

Source:  Adapted from “Counterintuitive Problem-Solving Trick: Complain!” Jeff Haden, Owner’s List via Communication Briefings

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

Dr. Weiss’ case is not as unusual as one may think. From the photo, anyone can see that the lesion clearly is more extensive than what would be expected from an infected incurvated nail. We are looking at a subungual amelanotic nodular melanoma. I have had five cases of this in the last two years. Last year, I presented a talk at the Nail Council meeting (nailcouncil.org) entitled, “Should all instances of toenail bed granulation tissue be biopsied?” The answer, especially in the case of a non-healing nail infection (within ten days if treatment), and in the absence of recent trauma, is ABSOLUTELY yes.

This lesion is thought to grow very rapidly and become invasive quickly. Even if you are the second or third clinician seeing the patient, immediate biopsy, as was arranged by Dr. Weiss is the only way to definitively protect yourself from allegations of delayed diagnosis. An important feature of all of my cases was the attempt on the part of the patients to tie the problem to a specific incident, like a recent pedicure. That is what precipitated clinician delay in thinking about biopsy, along with absent pigmentation. In this particular instance – subungual nail bed granulation in situations described above– just do a biopsy immediately.
 
Bryan C. Markinson, DPM, NY, NY, bryan.markinson@mountsinai.org

RE: Laser Treatment of Onychomycosis
From: Joan Oloff, DPM

Laser may provide an additional tool for the treatment of onychomycosis. In addition to the nail, treating the environment where the nail spends most of its day makes perfect sense. I believe it is useless to initiate any form of treatment if the patient does not accept this as a life-long issue and agree to some form of long-term maintenance. It worries me when I am presented a financial analysis rather than a peer-reviewed study to justify purchasing an expensive modality.

It makes no sense to recommend concomitant treatment with oral, topical, and laser. If you believe this shotgun approach, then you must admit (at least to yourself) that you don't believe that laser is an effective treatment. I utilize all forms of treatment in my practice, as I believe that they all have a place at the table. I have seen good results with all three. I spend my time educating patients and allowing them to decide which form of therapy fits their lifestyle. Each treatment has its own specific pros and cons. Oh yes, in addition, some patients choose no treatment.

Joan Oloff, DPM, Los Gatos, CA, LgFootCntr@aol.com

RE: Dealing With a Specialist Who Refuses to Send a Report (Eliott Udell, DPM)
From: Michael A. Robinson, DPM, MPH, JD

I appreciate Dr. Udell's concern about receiving a written report from the consultant. However, the telephone call from the consultant should be documented in your records as I am sure he already does. The records will then show professional, interdisciplinary interaction, and better patient care. You could ask the consultant to just send a copy of his office note instead of a formal report. Then everyone will be happy.
 
Michael A. Robinson, DPM, MPH, JD, Brookline, MA, drmrob@aol.com

RE: Who Gets to Cast (Robert Scott Steinberg, DPM)
From: Barry Mullen, DPM

Teaching podiatric assistants to successfully perform Root neutral cast impressions, when indicated for given podiatric biomechanical conditions, is not difficult. When performed correctly, no compromise to the functionality of a given custom orthotic, nor its anticipated outcome, occurs. The fiscal advantage, especially for high volume practices, is the creation of parallel income when assistants perform income-generating podiatric services, while simultaneously freeing up the doctor's time units to see other patients.

Delegation of such professional tasks to the lowest salaried staff member capable of successfully performing a given service that does not compromise quality of care is the ideal in practice efficiency; something all practices should strive for, especially during difficult economic times. Likewise,...

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

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.

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 

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) 254-8262ASSOCIATE 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

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 - 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

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

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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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