The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

December 04, 2012 #4,629 Publisher-Barry Block, DPM, JD

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Treat Plantar Fasciitis Before it Becomes Chronic: CO Podiatrist

"Plantar fasciitis is the most common cause of heel pain I see," said Dr. Scott Taylor, podiatrist at Estes Park Medical Center Specialty Clinic. "While heel pain is estimated to comprise 10 percent of athletic injuries, it is common in different groups of people, including runners and other athletes, people who have jobs that require a fair amount of walking or standing (especially if it is done on a hard surface), and in some cases, it is seen in people who have put on weight for a variety of reasons including pregnancy."

Dr. Scott Taylor

"If you don't treat plantar fasciitis, it may become a chronic condition," said Dr. Taylor. "You may not be able to keep up your level of activity and you may also develop symptoms of foot, knee, hip, and back problems because of the way plantar fasciitis changes the way you walk.

Source: Kerrie Hill, Estes Park Trail Gazette [11/30/12]

Bigger Children Mean Larger Shoe Sizes: Aussie Podiatrist

So what happened to our children? Back pain, anxiety, depression, obesity, mood swings, and diabetes are front and center of the close-up snapshot of many Queensland boys in 2012. Junk food, sugar-laden drinks, technology overload, heavy school bags, a lack of sleep and a lack of outdoor activity have all played a part.

Brenden Brown

It is not only waistlines that are growing. Feet too are sprouting with the average 12-year-old wearing a size 10 shoe. "Twenty years ago, boys of that age would typically wear size eight or nine," podiatrist Brenden Brown said. "But I suppose as children are getting taller, it is only natural their feet will get bigger. Today's children usually get a few pairs of shoes per year, but decades ago it was typical to have the same shoes for years or get hand-me-downs that didn't fit properly."

Source: Jackie Sinnerton, The Sunday Mail [12/2/12]

Editor's Note: PM News is proud to present excerpts from Meet the Masters

Bret Ribotsky: What is best practice management tip for 2013?

Dr. Barry Block

Barry Block: Enhance your Internet presence. Make sure that you have a website which is optimized to be patient-friendly, but loaded with lots of information on your hours, the insurances that you accept, and a photos of you and your staff. Adding a video to your website will raise your profile for search engine optimization. Besides a website, you should establish Facebook and Twitter accounts, as an increasing number of potential patients are utilizing social media.  

Dr. David Mullens

Meet the Masters is broadcast each Tuesday night at 9 PM (EST). This week's  guest is podiatrist/attorney Dr. David Mullens. You can register for future events by clicking here

Query: Botox for Plantar Fasciitis?

I was just contacted by a potential new patient who has tried "everything" for her plantar fasciitis. In her email, she asked if I had any knowledge of using Botox for PF. I'm looking for a little guidance on the subject. 

David Kahan, DPM, Sacramento, CA

RE: Verrucous-Looking Lesions on a Seven Year Old (Dennis Shavelson, DPM)
From: Neil Levin, DPM, Seth J. Steber, DPM

Blunt curette the lesion for biopsy; then laser the base as usual.
 
Neil Levin, DPM, Sycamore, IL, DRFEET1@aol.com

I use a high-temp cautery pen in the office setting to circumscribe the lesion and then evacuate it with a curette. This leaves the lesion intact for the pathologist to fully evaluate. It also allows preservation of the dermal layer so no scar tissue forms. Closure with sutures is not necessary and not recommended - let it heal by secondary intention. This method works as well as using CO2 and KTP/Yag lasers.

Seth J. Steber, DPM,  Lehighton, PA, acpwc@ptd.net

Editor's note: To see the original note and photo, click on the subject line.

RE: Verrucous-Looking Lesions on a Seven Year Old (Dennis Shavelson, DPM)
From: Elliot Udell, DPM

If you are not sure of the nature of the lesion and it is too large to do an excisional biopsy, why not do one or two 2 mm. punch biopsies of the lesion and send them to a dermatopathology lab? If it comes back indicating that it is indeed a verruca, then there are many non-surgical choices that you can employ. One treatment we use that is "kid friendly" is called cryoprobe. There are many others.
 
On the other hand, if the pathology report indicates that the lesion is something other than a benign lesion, then surgical excision might be necessary. If removal would leave a "crater" too large to close, you might need to do a graft, and it would probably be best to call in a plastic surgeon as a consultant.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: CMS to Now Cover Obesity Counseling (Michael Rosenblatt, DPM)
From: Robert Creighton, DPM

The contributors to this thread have made substantive remarks in response to Dr. Rosenblatt’s “plea” (my term) for some direction regarding podiatric education in the area of obesity counseling and what this means in a podiatric medical context.

It is true that most physicians know they have minimal education on the subject of diet and exercise. There was a recent article regarding how poorly trained physicians are to address the obesity epidemic...

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

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

If “walking to prevent or reduce obesity” is not a “medical solution,” as Dr. Bijak asserts, then I probably don’t understand “medicine,” or a physician’s role in prevention or in keeping people healthy. Apparently, Robert E. Sallis, MD, originator of the “Exercise is Medicine” movement, may also not understand that exercise isn’t a medical treatment either! The same with AMA's "Walk with a Doc initiative." Medicine is supposed to focus on reducing risk factors and a sedentary life-style is a major risk factors for obesity and cardiac disease. Walking at least 30 minutes a day is a significant part of the “cure.”

“Obesity counseling” is no different than counseling a patient to stop smoking. A DPM would certainly include a referral to a cardiologist or endocrinologist in counseling, when indicated.  I doubt most people need cardiac screening simply to walk. Like breathing, eating, and sleeping, walking is a normal human function. It’s the way humans were intended to get around. Sedentary people slowly become obese and, over time, may develop diabetes type II, ischemic heart disease, hypertension, osteoporosis, and decline in functional capacity as they age. These sedentary patients are all seeing physicians throughout their lifetime of decline; yet, in spite of all that counseling and medical “treatment,” the epidemic worsens. I think DPMs have a big role in reversing the obesity trend because the outcome of their care is that patients walk better and walk more often. Isn't that good medicine?

Jon A. Hultman, DPM, MBA, Los Angeles, CA, jonhultman@gmail.com

RE: Family of MA Podiatrist Seeks Justice From Accused Embezzler
From: Michael Forman, DPM

Reading about Dr. Snyder's financial loss due to his office manager brought back some very unpleasant memories for me. I too, was "taken" by an "office manager - friend." Believe me when I say that the actual financial loss may not be the greatest loss you suffer. I have never been the same person after my experience. Let me just leave you with two gems I learned. 

Gem one: Doctors are hit by this crime all of the time. Often the crime isn't reported for one of two reasons. First, the doctor may be involved in activities in his practice that he/she may not want to publicize. Second, there may be inappropriate relations between the doctor and any of the staff. With either of these two instances, the doctor can easily be blackmailed into not reporting the loss.

Gem two: If you find you have been embezzled, DO NOT attempt to make a deal with the thief where you will not prosecute if they make reparations. This can be construed as extortion, making you criminally liable.

Michael Forman, DPM, Cleveland, OH, im4man@aol.com

RE: WI Podiatrist Killed by Motorcyclist in Thailand
From: Michael K. Fairbanks, DPM

I remember Ian Furness as a best friend and classmate in our years at ICPM. A true gentleman from a loving English family. He will be missed.

Michael K. Fairbanks, DPM, La Mesa, CA

RE: PAL Health Technologies CEO Dies
From: Lee Rogers, DPM

I had the pleasure of working with Jeff Schoenfeld at PAL in development for 4 years. Jeff was a visionary who helped revolutionize digital casting and quick delivery of orthotics to podiatrists around the country. The company's recent concentration on diabetic foot software and products was, in no small part, due to Jeff's understanding of the market and demography of the average podiatrist's patient base. Jeff will be missed.

Lee Rogers, DPM, Los Angeles, CA, lee.c.rogers@gmail.com

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Welcome to paradise! Immediate opening in a busy, multi-location practice. Six figure income potential possible for the motivated individual in the first year. Surgical training a plus. Hospital privileges available, depending on training. Must be Florida licensed. Great benefit package. Send CV and cover letter to 1foot.ankle@gmail.com.

ASSOCIATE PODIATRIST - NEW YORK CITY / BROOKLYN

Full time office locations. Excellent opportunity for a motivated, ethical and enthusiastic associate to join a successful, well established hospital affiliated practice. Must be residency trained PSR 24/36.Board eligible/certified by ABPS preferred. Must be competent in forefoot and rearfoot surgery. Competitive salary with incentives. Email CV to DRSTEVEMENNA@GMAIL.COM

ASSOCIATE POSITION – VIRGINIA

Two office practice, hospital and surgery center privileges, trauma call, modern offices, EHR, digital x-rays. Excellent compensation package. Position may lead to partnership. Candidate needs to be experienced in foot and ankle reconstruction, trauma, external fixation, and ankle replacement surgery. Email letter of interest and CV to Dr. Joe Disabato at jdisabato@vfasa.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 - 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 - 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.

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.

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