The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

December 01, 2012 #4,627 Publisher-Barry Block, DPM, JD

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WI Podiatrist Killed by Motorcyclist in Thailand

Family, friends and patients in Fond du Lac and surrounding communities are mourning the loss of well-known foot and ankle physician and surgeon Dr. Ian Furness. Furness, 58, was vacationing in Bangkok, Thailand. While walking on Friday, Nov. 23, he was struck by a hit-and-run motorcyclist. Furness died on Monday morning, Nov. 26, according to a news release issued Wednesday by Agnesian HealthCare.

Dr. Ian Furness

Furness was an active member of the Wisconsin Society of Podiatric Medicine and served as its president from 1991-93. He was appointed by the Governor to serve a third term on the Podiatry Affiliated Credentialing Board for the State of Wisconsin. At the time of his death, he was serving as board chair.

Source: Coleen Kottle, Fond du Lac Reporter [11/29/12]

Toe Shortening Should Only be Performed When Medically Necessary: NY Podiatrists

After Dr. Hillary Brenner completed a toe shortening procedure for a patient who was constantly in pain, she noticed an influx of women asking her to provide toe shortening services for themselves -- for completely cosmetic purposes. She has turned them all down. "I only do surgeries for people having pain," Brenner, a podiatric surgeon with Tribeca Private Medical Group and a member of the American Podiatric Medical Association, said to CBSNews.com. "If you're not (in pain), you don't have surgery."

Drs. William Spielfogel and Hillary Brenner

There are some acceptable reasons that women would opt to get cosmetic surgery on their feet, including painful bunions or deformities, Dr. William Spielfogel, the head of podiatry at Lennox Hill Hospital in New York and a member of the New York State Podiatric Medical Association, said to CBSNews.com. In Brenner's patient's case, the especially elongated toe was causing corns and ulcers that could get infected. Both doctors said that when they decide to take on foot surgery patients, it is because there is a medical need.

Source: Michelle Castillo, CBSnews.com, [11/28/12]

Minimalist Shoes are Well-Suited to Cross-Training: DC Podiatrist

Here’s the good news, especially for CrossFit and P90X addicts: While the jury is still out, one local podiatrist says minimalist shoes work just as well for cross-training in general as for running. “The bottom line is, the minimalist shoes have become the shoe for cross-training,” says Dr. Howard Osterman, a spokesperson for the American Podiatric Medical Association and team podiatrist for the Washington Wizards and Mystics.

Dr. Howard Osterman

Osterman says minimalist shoes offer our feet more flexibility than typical cross-training shoes. “Historically, what happened with the cross trainer is we enforced the forefoot and rear foot, with a cutout in the middle [of the shoe],” he explains. This allows the foot to move laterally and to pivot, which is ideal when playing sports like basketball or tennis.

Source: Melissa Romero, Washingtonian.com [11/29/12]

PAL Health Technologies CEO Dies  

On November 28, 2012 PAL Health Technologies chairman and CEO, Jeff Schoenfeld passed away at his Naples, Florida residence. He was 64.  Jeff was a founding member of PAL Health Technologies in 1974. Within 38 years, he led his team to develop a comprehensive catalog of corrective foot devices including custom orthotics, diabetic and accommodative inserts, and ankle braces. In the last decade, PAL proved itself to be one of the most technologically advanced orthotic labs in the world with the development of XtremityOne, a digital foot imaging software system allowing for electronic storage of foot scans and ordering of custom foot orthoses.

CT Podiatrist Charged With Medicare Fraud

David B. Fein, United States attorney for the District of Connecticut, has announced that Samir Zaky, 37, of Brookfield was arrested today (Nov. 29) on federal healthcare fraud charges. On Nov. 27, a federal grand jury sitting in New Haven returned an indictment charging Mr. Zaky with 14 counts of healthcare fraud and 14 counts of making false statements relating to healthcare matters. According to the indictment, the government is also seeking to forfeit more than $29,000 in cash found during a search of Mr. Zaky’s residence in August 2010.

Source: Housatonic Times [11/29/12]

Query: Online Stores for Podiatric Supplies

Can anyone recommend a good online store for purchasing podiatric supplies?

Sara Suttle, DPM, Southlake, TX

Query: Which Code is Appropriate?

Which code would be appropriate for excision of a 2.5 cm - 3.0 cm rheumatoid nodule from beneath the 1st metatarsal head, extracapsular?

Jonathan Kaplan, DPM, West Newton, MA

Response: I recommend the following coding options based on your description:

CPT 28090 - excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (e.g., cyst or ganglion); foot or
CPT 28041 - excision, tumor, soft tissue of foot or toe, subfascial (e.g., intramuscular); 1.5 cm or greater or
CPT 28039 - excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater.

Choose the most appropriate.

David Freedman, DPM, CPC, Silver Spring, MD

Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

RE: 1st MTPJ Fusion or Lapidus for Severe HAV (Mark Aldrich, DPM)
From: Charles Morelli DPM

Clearly, there is more than either a Lapidus and/or MPJ fusion for a "severe" HAV deformity. For the past few years, I have been utilizing an opening base wedge osteotomy with plate (Arthrex) for this deformity. The procedure has been modified a bit which makes this a remarkably strong and stable construct. Special thanks to my friend and colleague Lester Dennis, DPM for showing me this. This fixation is so stable that my patients are allowed to weight-bear immediately and are placed in a CAM walker for the first 2 weeks, and then allowed to gradually progress to a sneaker.

Opening Base Wedge Osteotomy with Plate (Arthrex)

As you can see, one of the screws is crossing the osteotomy at an angle and, by doing this, it is able to purchase all three corticies. This one screw makes this correction very strong and very stable. The medial eminence is also chopped up into appropriate sized pieces and placed in the opening wedge. If desired, you can also add stem cells, Grafton, PRP, Trinity, or any other substance to assist in healing. At conference lectures, everyone states that patients need to be NWB for 4 weeks, and then in a CAM walker for two weeks. You may agree or disagree with this, but immediate weight-bearing is permitted and possible. After doing this procedure in this manner for a number of years now, I have quite a few patients who have done well with it, and never have had a complication.

Charles Morelli DPM, Mamaroneck, NY, podiodoc@gmail.com

RE: Source for Accuzyme and Panafil (Jim Fisher, DPM)
From: Robert Wunderlich, DPM

As a point of clarification, neither Panafil nor Accuzyme were ever FDA-approved drugs. These products existed because their active ingredient (papain) was in use prior to Congress amending the original Food and Drug Act in 1938 (which required manufacturers to demonstrate safety of new drugs). Thus, manufacturers did not have to demonstrate safety and efficacy of any marketed product containing papain as its active ingredient. It's a loophole that exists for thousands of other drug products as well, i.e. colchicine, as previously mentioned in this discussion.

The FDA ordered companies to stop marketing unapproved drug products that contain papain in...

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

RE: CMS to Now Cover Obesity Counseling (Robert Bijak, DPM)
From: Jon A. Hultman, DPM, MBA

Dr. Bijak feels that the role of DPMs in fighting the obesity epidemic should be to “learn it in a medical school.” When I graduated in 1970, medical schools were teaching MDs to write prescriptions for amphetamines to help patients lose weight. Today, medicine has advanced to lap bands and gastric by-pass surgeries. Most physicians I have worked with readily admit they learned little about nutrition while in medical school. Between 1970 and today, the percentage of obesity has doubled, and this is in spite of the fact that MDs are taking all the requirements Dr. Bijak feels to be necessary in order to better understand obesity. This clearly isn’t working as a solution.
 
As an alternative suggestion, I would focus on the fact that the majority of medical research points to 30 minutes of walking each day as an essential “treatment” needed to reduce the complications related to obesity, even if there is not a substantial weight loss.  It is not too great of a leap to envision how a specialty that “keeps people walking” would be highly relevant in the area of obesity counseling or even play a major role to help reverse the obesity epidemic. I don’t see this scope of practice as a “needing more training” issue; I see this as a “being able to fully utilize the education and training we already have” issue without artificial constraints.

Jon A. Hultman, DPM, MBA, Los Angeles, CA, jhultmaned@calpma.org

RE: NY Podiatrist Discusses "Shoe-icide" via High Heeled Shoes
From: Dennis Shavelson DPM

Dr. Brenner makes many important points as to the ills of high-heeled shoes and represents our profession well in doing so. She could have deepened her argument by adding that studies reveal that eventual knee arthritis is married to high heel use by women.

However, stating, “When it comes to winter boots for teen girls, it's best to keep the heel FLAT and sturdy,” is not biomechanically sound. Since the rigid rearfoot functional foot type is by far the most common biomechanical foot type, the general advice from a biomechanically-oriented DPM should be that a 1-1.5” heel is probably the best heel height advice for the average woman heel contact gait walker or runner to wear. A functional foot typing by a podiatrist would closer reveal the best heel height for any individual for custom care.

Dennis Shavelson DPM, NYC, drsha@lifestylepodiatry.com

EQUIPMENT FOR SALE - X-CELL X-RAY MACHINE

X-Cell floor x-ray machine for sale, just calibrated as well. Model P-700. KVP 50-70, MA 10 & 15. Located in Boston, will drop off if within 50 miles. Call 617-974-3338 (Best reasonable offer accepted)

EQUIPMENT FOR SALE - USED Q-CLEAR LASER

Still under warranty . New laser head just added. First Best Offer. Marketing and training included. Dr. Zuckerman will train you. e-mail with questions to mook863@comcast.net

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 PODO2345@AOL.COM 516-476-1815.

ASSOCIATE POSITION - CALIFORNIA, ORANGE COUNTY

We are a three physician group with two offices and a well rounded practice with all types of pathology encountered. Our EMR is fully implemented. If you are surgically trained and want to join a growing practice in beautiful Southern California email your resume to jibennett1@msn.com.

ASSOCIATE POSITION - PUERTO RICO

Looking for a well motivated surgically trained podiatrist for a 20 year old hospital-based multi office practice . Candidate must be personable, ambitious, and knowledge of SPANISH language a must. Hospital surgical privileges available with heavy load of high risk diabetic foot patients. This position leads to PARTNERSHIP, and eventually ownership. Offices located near San Juan Metro area near Beaches, great schools, and major shopping malls. Please send CV to medicopodiatra@aol.com

ASSOCIATE POSITION - EASTERN SHORE OF MARYLAND

Seeking highly motivated, ethical, enthusiastic associate to join successful, well-established practice located in close proximity to Maryland and Delaware beaches. Certified/qualified by ABPS with rearfoot experience preferred. The practice incorporates surgery, wound care, sports medicine and general podiatry. Fully equipped office with diagnostic ultrasound, fluoroscopy, vascular testing, radio frequency ablation, six treatment rooms and three satellite offices. Main office has accredited ambulatory surgery center. This opportunity has excellent salary potential with benefits for the right individual. Send CV to dpmkthomas@gmail.com.

ASSOCIATE POSITION - NASSAU COUNTY, NEW YORK

Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to: Podiatryoffice@doctor.com

ASSOCIATE POSITION - CT (GREENWICH, FAIRFIELD, AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to Dr.Kassaris@yahoo.com

 ASSOCIATE POSITION - KANSAS CITY

Kansas City may be the perfect move for you and your family. I am looking for an entrepreneurial minded associate who wants to grow and then own part of an already successful practice. If you are the right candidate for this associate position, you will enjoy a competitive compensation package and you will be working with a doctor who is as committed to your success as he is to his own. Go to: www.YourFutureInPodiatry.com for full details.

ASSOCIATE POSITION - PORTLAND, OREGON

Busy office with good steady referral sources looking to expand. Areas of expertise wanted: wound care, surgery of all aspects, knowledge of running an office. Please come with good personality and hard work ethic. New main and satellite offices. Email: office.pfac@gmail.com

ASSOCIATE POSITION NEW JERSEY - PASSAIC COUNTY

Associate Position Available leading to Practice Purchase. 25 year old well established general, well rounded practice seeking residency trained, ABPS eligible/certified podiatrist. Must be able to perform general foot procedures/surgeries without assistance. Well equipped office with digital x-ray, ultrasound, Doppler, 3 treatment rooms. Hospital Privileges available. Must be logical, Ethical and hard working. Pay commensurate with performance. Call 201 986-1900 ToeBizCenter@Yahoo.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 12/24 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

PRACTICE FOR SALE - SOUTHWEST FL

Multilocation multidoctor practice in beautiful Southwest Florida . Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to : practiceforsaleswfla@gmail.com.

 PM News Classified Ads Reach over 14,000 DPMs 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 14,000 DPMs. Write to:bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 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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