The Voice of Podiatrists

Serving Over 10,000 Podiatrists Daily

December 03, 2007 #3,107 Editor-Barry Block, DPM, JD

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CA Podiatrist Offers Cold Weather Foot Care Advice

Cold weather can take a toll on your feet, so the California Podiatric Medical Association suggests making your feet the center of attention this winter. Daniel Altchuler, a board certified podiatrist, said, "The big thing about winter is that people go from a summer sandal to a more enclosed shoe, and the biggest problem people face is that their shoes do not always fit properly."

Dr. Daniel Altchuler

Altchuler finds the most common foot problems in winter are dry and cracked skin and chilblains- small itchy red swellings on the skin, which can become increasingly painful, can swell and then dry out, leaving cracks in the skin which expose the foot to the risk of infection. The answer, says Altchuler, is to moisturize at least once a day using a good quality cream. He recommends keeping a tube by the bed and making it a part of your bedtime routine.

"If you are going outside in the winter, even if it's just to bring in the paper or put the garbage out, make sure you have shoes and socks on," Altchuler said. "Wearing only dry footwear is also important," he said. "If you have been out in the rain or snow and your socks or shoes get wet, make sure they have thoroughly dried before you wear them again."

Source: Simi Valley Acorn [11/30/07]

Retired PA Podiatrist Has Influenced The Health And Lives Of Many

When Jacob Ortenzio had a heart attack in the 1980s, podiatrist Jerry Kaspar organized a team of colleagues to keep Associated Foot & Ankle Specialists in Springettsbury Township running until Ortenzio could return. When Camp Hill podiatrist Rebecca Faerber was growing up, Kaspar fixed her broken toe and gave her cortisone shots as needed while she was involved in high school sports. When Philadelphia-area podiatrist Steven Chen expressed an interest in medicine as a child, he left Kaspar's office with a medical dictionary to read.

Dr. Jerry Kaspar (Photo Jason Plotkin)

These days, Kaspar, who lives in Manchester Township, struggles with an ailment he doesn't know how to fix - Alzheimer's disease. The 80-year-old doctor's memory may be faded in places, but those he helped haven't forgotten how he influenced their health and careers.

Faerber recalled Kaspar telling her that podiatry was a great field for a girl with medical ambitions to get into because it didn't require as many odd hours and on-call time as other specialties. "Back in the '70s and '80s, there weren't many women in the field in this area," she said. "But he gave me the idea."

Source: Jennifer Vogelsong, York Daily Record [11/19/07]

OH Podiatrist Dies The Day After Seeing His Son Married

Dr. Glenn Meyer, an Ohio podiatrist, died Friday – a day after his son and now daughter-in-law were married at Bethesda North Hospital so that he could attend. Meyer, 59, of Montgomery, had been battling liver cancer.

His son, Christopher Meyer, and Suzanne Pittner had planned to marry in January but moved their wedding date up and exchanged their vows at the hospital chapel Thursday.

After the ceremony, Meyer called it the “most meaningful thing my kids have ever done.” He died the next day at noon.

Source: Cincinnati Enquirer [11/30/07]

Query: Medical Marijuana

I have a bunion surgery scheduled for a conservative-looking pillar-of-the-community type guy coming up. He told me that what works best for his pain is medical marijuana. In California, we have such suppliers and some laws allowing this, but I have no idea how to write this prescription (1 doobie BID PRN pain?) or even if I should get involved in prescribing marijuana at all. If anyone can give me some suggestions on how to not look foolish writing the Rx. I would appreciate it.

Michael Zapf, DPM, Agoura Hills, CA

Query: Digital Imaging

We are looking to switch to digital imaging and are looking for recommendations. Price and support are important so any shared experiences in either of those areas is appreciated. It seems that the major players are 20/20 (formerly Reina) and the unit from Stone Podiatry. Any experiences with either of those companies is appreciated as well.

Josh Prero, DPM, Rockville Centre, NY

RE: Radiesse (Bret Ribotsky, DPM)
From: Elliot Udell, DPM

According to the company "Radiesse is made of unique calcium-based microspheres that are suspended in a water-based gel and injected into the skin through a simple, safe, and minimally invasive procedure." It is used for facial wrinkles and as a facial filler. There are many such products on the market being used by plastic surgeons, dermatologists, ophthalmologists and even dental surgeons. All of these are designed to alleviate cosmetic problems on the face.

There are obvious differences between the foot and the face. For one, people are willing to spend massive amounts of money, out of pocket to correct facial imperfections but might skimp on paying us to correct a painful foot condition with the same expensive medication. The obvious other difference is that the face is not weight-bearing. If you are charging a person five hundred dollars for an injection and you are placing it in either a weight-bearing area such as beneath an IPK or even on the lateral side of a fifth toe that is subject to shoe pressure, you want to know in advance that the substance will hold up for a long period of time.

I used Keragen when it first came out and some of my patients loved it. Their infatuation waned when after several months the material dissipated under pressure and they needed to spend an additional several hundred dollars for another injection. Ultimately, the product was discontinued.

The bottom line is that just because a big arm of the medical profession is doing financially well with a cosmetic facial product, it does not mean that using the same product for a foot problem will yield our profession long-term success. Further research and study is necessary.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Practice Assistants
From: Lloyd S. Smith, DPM

I would recommend that anyone using an assistant to provide services that are typically provided by physicians or podiatrists, get a written response from their insurance carrier to determine if that is acceptable. Medicare can be highly punitive in cases where an assistant is providing these services. However, policies at each carrier can differ a great deal.

Lloyd S. Smith, DPM, Newton, MA, lloydpod@yahoo.com

RE: Use of Dental X-Ray Machines (Dang H. Do, DPM)
From: Elliot Udell, DPM

For over twenty five years one of my xray machines has been a dental unit. It's my better unit. You don't need that much radiation to take a good foot and ankle radiograph. Some of the dental x-ray companies may make attachments designed to convert their unit to take foot and ankle xrays. Those accessories allow you to take a wider field than the field required to take one quadrant of teeth. You have to ask the company. Those attachments are critical. If they don't supply those attachments or don't offer the name of a company that makes such attachments, don't buy the unit. You won't be able to use it.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Office Dictation Systems (Syed Ahmed DPM)
From: Multiple Respondents

I have been using Dragon for about 6 years, since version 3. With a new computer it is about 98-99% accurate. Choice of the right microphone makes a big difference. It is not the price of the microphone, some just work better. Dragon is still not perfect and there is an add-on program for around $100.00 that makes DNS even better. Go to the website Knowbrainer.com. Not only can you get that program, but they guarantee you the best price on DNS and microphones. Lunis, who owns the site, is an incredible resource and knows the program better than anyone. By the way, with the new version, it only takes about 10 minutes to train it. One more hint: There is no need to buy the medical module. Knowbrainer has a medical dictionary. Also DNS can read most documents and not only learn your style of speaking, but add new vocabulary words. If you have any letters or transcriptions on your computer, you can have it read them.

Jack Reingold, D.P.M., San Diego, CA, footdoc@san.rr.com

There are a lot of options. Some Dragon software is specifically marketed to medical professionals and is pre-loaded with a lot of medical terminology. This makes "training" the software easier and faster. You will, however, pay a premium. I am currently using the regular Dragon version 8, which is compatible up to windows XP, not Vista. This software did require a bit more training but I found it easy to use and that it, in fact, did have a fair amount of medical terminology loaded on it as well. Pronunciation is key to effective training. If you have a thick accent of any kind you will spend a lot of time initially, correcting errors.

Scott Giaimo, DPM, New Boston, OH, footman28@yahoo.com

I use Dragon 9 preferred. I would not recommend paying the extremely inflated price for the professional version, because after dictating some notes and op reports, you will have added most of the words that you normally use. There is also a feature that lets you spell the word into a note, which also adds it to your vocabulary. I spent some time training it, and created quite a few macros that I bring up with a single voice prompt. Then you can add anything you want, wherever you want it. Generally, I am very happy with it and get through notes very quickly. Version 9.0 was a big improvement over 8.0 as far as accuracy. It is not 100% accurate, but for regular office notes it's fine. For letters going out, I proof read pretty carefully. Bottom line, I save thousands over dictation costs.

As for the Olympus recorder, I used to use it, and still do for house calls, but the conversion is far less accurate. I normally just dictate into a quality headset that I bought at headsets.com

Peter Smith, DPM, Stony Brook, NJ, ps84@bc.edu

PARTNER WANTED FOR GROUP PRACTICE LOCATED 1 1/4 HOURS NORTH OF NYC

BE AT THE RIGHT PLACE AT THE RIGHT TIME. YOU CAN'T BEAT THIS OPPORTUNITY. Respond to: mhudes@footcaregroup.com

PART-TIME PRACTICE FOR SALE - FLUSHING, NY

40 year old part time practice for sale. Priced for quick sale. Please contact me at footdoc60@gmail.com. Serious inquires only please

PRACTICE FOR SALE - SOUTH CAROLINA

Upstate SC practice of 25 years. Retiring. High Volume. 65% routine foot care, 35% surgery. Several nursing homes. Plenty of opportunity for growth. Grosses over $450,000.00 yearly. Hospital and Surgery Center privileges. Financials available upon request. Serious inquiries only! Beautiful area. Contact: Carolinafootdoctor@yahoo.com

ASSOCIATE POSITION - SOUTHERN ILLINOIS

Tired of Nursing Home Care? Ready to join a well-established practice with 2 Board Certified Foot Surgeons? If you are a personable, ethical and responsible, hard-working podiatrist with interest in conservative care, including sports medicine, this may be the position for you. Competitive salaries, 401-K, health insurance, paid vacation and more. Please forward CV with references to nrussell@neondsl.com

ISO SOUTH JERSEY AREA OPPORTUNITIES

ABPS Certified with 20 years of experience looking to relocate to South Jersey/South Central Jersey. I am looking for a practice that appreciates and understands the value of experience and integrity. I am willing to discuss ALL options, including employment, partnerships, buy-ins, practice purchases, etc. All info will be kept confidential. E-mail panel32@comcast.net

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City . Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. 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 -- www.homephysicians.com

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