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| PM News | |
The Voice of Podiatrists
Serving Over 22,130 Subscribers Daily
December 04, 2023 #7,641  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management https://podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2023- No part of PM News can be reproduced without the
written permission of Barry Block
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| EDITOR'S NOTE | |
PM News Advance Notice
PM News will not be publishing the week of December 25, 2023. We will resume publishing on January 1, 2024.
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| PM NEWS QUICK POLL RESULTS |
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Results of last week's poll |
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| PM NEWS QUICK POLL |
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Would you hire a medical nail tech? |
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| PODIATRISTS IN THE NEWS | |
NJ Podiatrist Discusses Benefits of an Annual Foot Exam
According to Charles Birk, DPM, "When problems with your feet go untreated, they often can become a serious issue and lead to other health conditions. For those with a condition such as diabetes, an annual foot exam can help prevent potential complications from occurring and can catch minor problems before they become severe. Not only can diabetics benefit from an annual podiatry appointment, but athletes and others who want to keep their feet healthy can as well."
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Dr. Charles Birk |
"If you are diabetic, an annual exam can help keep track of the condition of your feet and prevent problems from developing or worsening. Many diabetics experience complications such as neuropathy or foot ulcers. A podiatrist will test annually for any nerve or circulatory problems with your feet so they can be diagnosed early for effective treatment. A podiatrist will also look for any foot deformities or problems such as bunions, corns, or calluses and help correct or manage them before they turn into a serious issue," says Dr. Birk.
Source: Cape May County Herald [12/2/23]
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| PODIATRIC SUPER GROUPS IN THE NEWS | |
USFAS Expands in Washington
US Foot and Ankle Specialists (USFAS) expands with its recent acquisition of Ankle and Foot Clinic of Columbia LLC, adding a podiatry office in Longview, Washington.
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Drs. Steven Schatz and Karla Trombello |
Steven Schatz, DPM is a graduate of the Dr. William M. Scholl College of Podiatric Medicine and completed his residency at Holladay Park Medical Center in Portland, Oregon. Karla Trombello, DPM is a graduate of the California College of Podiatric Medicine and completed her residency at the University of Texas Health Science Center at San Antonio.
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| PODIATRISTS IN THE COMMUNITY | |
WA Podiatrists Join Olympic Medical Center
Podiatrists M. Jared Davis, DPM and Olga Drogomiretsky, DPM have joined the staff at Olympic Medical Center in Port Angeles and Sequim, Washington.
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Drs. M. Jared Davis and Olga Drogomiretsky |
Dr. Davis completed a residency at Southern Arizona Veterans Affairs Health Care System in Tucson, Arizona. Dr. Drogomiretsky has completed a fellowship in sports medicine at Franciscan Foot and Ankle Institute in Federal Way.
Source: Peninsula Daily News [11/29/23]
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| MEETING NEWS | |
11th Annual Richard O. Schuster, DPM Memorial Biomechanics Seminar
Close to 200 participants attended the 11th Annual Richard O. Schuster, DPM Memorial Biomechanics Seminar held November 11-12 at New York College of Podiatric Medicine. Attendees learned state-of-the-art biomechanics from a Who's Who cadre of nationally and internationally renowned speakers. Lectures, delivered via a combination live/virtual format, focused on the practical application of biomechanical principles, pediatrics, and sports medicine with a heavy dose of contemporary research.
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(L-R) Drs. Anthnoy Iorio, Kevin Kirby, Samantha Landau, Russell Volpe, Howard Hillstrom, Paul Jordan, Michael Trepal, Daryl Phillips, Joseph D'Amico, Howard Danenberg, Stanley Beekman, Paul Coffin, and Jinsup Song. |
As in past years, the Conference was chaired by NYCPM past Chair and current Professor in Orthopedic Sciences, Joseph C. D'Amico, DPM, who recruited the stellar faculty and designed the overall program. Faculty included Drs. Anthnoy Iorio, Kevin Kirby, Samantha Landau, Russell Volpe, Howard Hillstrom, Paul Jordan, Michael Trepal, Daryl Phillips, Howard Danenberg, Stanley Beekman, Paul Coffin, and Jinsup Song.
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| PRACTICE MANAGEMENT TIP OF THE DAY | |
8 Steps to Follow When Firing Practice Employees
Here are 8 things you must do to fire a practice employee.
2. Follow your instincts
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If a new employee doesn't seem to be working out, that probably won't improve with time.
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Make a change sooner rather than later, as waiting too long can negatively impact your unemployment insurance tax.
Source: Todd Shryock, Physicians Practice [11/30/23]
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| OBITUARIES | |
RE: The Passing of Steven B. Shindler, DPM
Steven B. Shindler, DPM, of Stamford, CT, died at home on November 29, 2023. He graduated from Brooklyn College of Pharmacy in 1968, with a BS in Pharmacy. He attended the NY College of Podiatric Medicine, graduating in 1976 with a DPM degree.
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Dr. Steven Shindler |
After completing his surgical residency at Park East Hospital in 1977, Dr. Shindler and his wife Karen moved to "country life" in Stamford, CT to raise a family, where they have since resided. He earned a double board certification in surgery and orthopedics and went on to open practices in both NYC and Stamford.
Source: Stamford Advocate [12/1/23]
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| RESPONSES/COMMENTS (SPORTS MEDICINE) | |
From: Allan I. Rosenthal, DPM
Dr. Udell is right; there is a new game in town since the 1960s. Pickleball was started in Bainbridge, Washington. It has grown by leaps and bounds not just here in the United States but worldwide, with hopes it can be an Olympic sport someday. I have lectured at the AAPSM on pickleball injuries in the past and have done many podcasts on this subject nationally.
I have earned the name “Dr. Pickleball” and I am a certified instructor and a consultant to a pickleball shoe company. I also have enjoyed the sport, playing both recreationally and in tournaments. It can be very rewarding to both play and treat many patients for their lower extremity ailments. It has added a new dimension to my podiatric practice. I can emphatically endorse the podiatric profession being a part of this phenomena of the growth of this sport.
Allan I. Rosenthal, DPM, Ridgefield, CT
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| RESPONSES/COMMENTS (INTERNATIONAL PODIATRISTS IN THE NEWS) | |
From: Jeff Carnett, DPM
The article cited in this piece (Medical Republic) also stated: “Despite their small number, podiatric surgeons generate a lot of complaints – they have a notification rate eight times higher than that of other podiatrists. Common concerns include inadequate or inappropriate treatments, incorrect diagnoses, and billing practices.”
Australian podiatric surgery training is not at CPME standards. In fact, there are at minimum three DPM graduates with CPME-accredited residencies who hold Australian citizenship. They have not been allowed to hold surgical rights in Australia. The surgeons subject to the public complaints and the current inquiry are all holders of bachelor degree (or less) in podiatry with no medical science...
Editor's note: Dr. Carnett's extended-length letter can be read here.
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| RESPONSES/COMMENTS (PM ARTICLES) | |
From: Janet McCormick, MS
I agree with Dr. Maleski that Medicare and insurance patients should not have services in a podiatry practice by an MNT. If a patient is in treatment, they are only within the scope of care for RFC by the podiatrist, period, and a podiatrist that is billing insurance and Medicare for services performed by an MNT is billing improperly and fraudulently. This is stated many times in the MNT program and graduates are instructed in this clearly. Sadly, some podiatrists bypass this when the client gets to the counter and bill the care anyhow to insurance or Medicare. I experienced this myself in a podiatry practice once and had to insist on paying for the RFC I had that day!
Since 1995, the patients who are eligible to have their RFC billed to insurance and Medicare have reduced in percentage dramatically due to a ruling by Medicare and have become...
Editor's note: Ms. McCormick's extended-length letter can be read here
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Morton's Toe in Art
Morton’s toe, a condition where the second toe is longer than the big toe, holds a peculiar fascination not only in podiatry but also in the realm of art and culture. From ancient sculptures to iconic monuments like the Statue of Liberty, the prevalence of Morton’s toe sparks curiosity.
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Morton's Toe in Art |
One of the most iconic examples of Morton’s toe is found on the Statue of Liberty. The deliberate choice to depict Lady Liberty with an extended second toe adds a subtle yet distinctive touch to the colossal sculpture, sparking conversations about the intention behind this artistic decision.
Source: Unique Times [11/30/23]
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MEETINGS & WEBINARS
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NEED CME CREDITS FAST?
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You can Earn up to 50 Continuing Education Contact Hours (CECH) Online
Earn 15 CECH only $279 (less than $19 per CECH)
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Partial required credits can be taken online for AZ, FL, GA, ID, KY, IL, ID, IA, MD, MN, MO, MT, NE, NH, NY*, NC, OK, PR, TN, TX, WA, and DC
Choose any or ALL from 25+ CECH Category-1 articles posted
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| CLASSIFIED ADS - ASSOCIATE AND FACULTY POSITIONS, AND FELLOWSHIPS | |
PM NEWS CLASSIFIED ADS REACH OVER 20,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 22,000 subscribers. For details, click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details.
ASSOCIATE POSITION - DURANGO, CO
Established and fast growing multi-specialty group is looking for a full-time podiatrist in the Durango Colorado area. Interested in an energetic team member who is able to manage and direct all aspects of podiatry. Salary -$150-200K based on experience. Bonus structure. Benefits. Please send your CV to nick@innovationmedgroup.com
CUSTOMER SERVICE PERSON – NORTHERN NEW JERSEY
ComfortFit Orthotics a National Podiatric Orthotic Company, located in Northern New Jersey, is looking for an experienced customer service person. Excellent pay and benefits. To pursue this opportunity email us at contact@comfortfitlabs.com
ASSOCIATE POSITION - ATLANTA , GA
We're seeking a skilled professional to provide exceptional Podiatric Care Full -Time. Enjoy a supportive environment and competitive compensation. Candidates must have strong clinical and surgical skills and be comfortable with high volume. Must have a Georgia License. Contact georgiabluefoot@gmail.com if interested.
ASSOCIATE POSITION - UPSTATE SC
Busy two-office practice with five doctors in Upstate SC seeking a full-time podiatry associate. Start date immediately. All aspects of podiatric surgery, medicine and biomechanics. Benefits include 401K, malpractice, health and dental insurance, CME, short- and long-term disability. PTO. (All other standard benefits) Please send face letter with CV to podiatryresumes@upstatefootdocs.com
ASSOCIATE POSITION – MARYLAND
Are you a licensed podiatrist in Maryland? Southern Maryland Foot and Ankle is looking for a dedicated podiatrist to join our dynamic team. We have three locations near Washington D.C./Virginia area. We provide an amazing work life balance. Monday-Thursday 7:30 a.m.– 4:30 p.m. and Friday 7:00 a.m.-3:00 p.m. We offer a competitive compensation package and a supportive work culture. Please send your CV to: Jelena@somdfootandankle.com
ASSOCIATE / POTENTIAL PARTNERSHIP– UPSTATE SOUTH CAROLINA
Established podiatry practice in beautiful Greenville/Mauldin/Simpsonville area, seeking to hire a full-time podiatrist for our well-rounded practice. We have a high-volume referral base to guarantee success for a motivated, charismatic, team player and hard-working candidate. We offer Medical, 401 K, malpractice, CME, competitive compensation with potential for partnership. Please email CV to scpodiatry@gmail.com
ASSOCIATE POSITION - DALLAS/FT. WORTH AREA
Well-established growing podiatry practice with multiple locations seeking to hire full-time podiatrist in the Dallas/Ft. Worth area. Competitive salary with bonus opportunities, PTO, CME stipend, malpractice coverage, and sign-on bonus. Candidate should be aligned with our core values, God-honoring, excellence, integrity, innovative, community-impacting, respect, and kindness. Email CV to info@nctfa.com
ASSOCIATES POSITION – NEW HAVEN COUNTY, CT
Well established multi-location podiatry practice seeking full time associate to join us in July 2024. Candidate should be personable, highly motivated and possess strong surgical and clinical skills. Competitive six figure salary and benefit package with bonus opportunities. Send CV to jesse.parks@gmail.com
ASSOCIATE POSITION – SW FLORIDA
Associate full time position in SW Florida. Full time. Must be able to perform all aspects of foot and ankle surgery without supervision. General podiatry, wound care, surgery. Position available January 2024. Email interest with CV to floridafootdoctor1@gmail.com
ASSOCIATE POSITION - CHANDLER/GILBERT ARIZONA
Seeking a motivated full time DPM to join our team at Preferred Foot & Ankle Specialists this summer. Must have current AZ state license and ABFAS or on track for ABFAS. Competitive salary and bonus structure. Send CV to anolan.pfas@gmail.com or call Amber at 480-534-7220.
ASSOCIATE POSITION - ASHEVILLE/HENDERSON NC AREA
US Foot and Ankle Specialists (USFAS), one of the largest podiatric groups in the United States is hiring! USFAS is looking for an experienced associate doctor to join our team in the Asheville/Henderson NC area. Our group of physicians use state of the art, podiatry-specific technology, and software to stay on top of today’s changing medical trends and provide our patients with the highest quality care. USFAS is an excellent opportunity for those who are seeking long-term employment. Please send a cover letter and resume to recruiting@footandankle-usa.com. Candidates must be either licensed or in the process of becoming licensed.
PODIATRIST POSITION – HAMPTON/WILLIAMSBURG, VIRGINIA
Collaborative and rewarding practice with 2 locations is seeking to hire a DPM to join our team! Candidate must have strong clinical skills, comfortable with high volume, and providing call to the local hospital. In addition, be interested in making a difference in the community with their surgical, wound care, and interpersonal skills. Our practice focuses on autotomy; you will not be micro-managed, therefore you must be ethical and diligent. Please send CVs to: domiana@hamptonroadsfootandankle.com
ASSOCIATE POSITION - SOUTHWEST FLORIDA GULF COAST
Need full or part time associate to replace retiring physician in beautiful SWFL. Full schedule with general podiatry, wounds, sports, and surgery. Unlimited growth and income potential in fast growing area. Full benefits, malpractice, and association memberships paid. Must have FL license. Hiring immediately. Email CV to SWFLpodassociate@gmail.com.
POSITION AVAILABLE – MARYLAND
Great opportunity to join a well-rounded, growing, podiatry practice in Maryland. We hire employees with high integrity, a belief in teamwork, and a passion for our brand. We strive for accuracy and consistency. We desire a physician who is centered on patient commitment. Cleanliness is a must. If You are an energetic, enthusiastic, and tenacious, email us your contact information and resume. DrHoward@HLESfootcare.com
TWO FILL-TIME PODIATRISTS – SHENANDOAH, TEXAS
Seeking two well skilled, personable, dedicated, passionate, team players to join our multi-office, multi-physician, well respected, established practice. One podiatrist with specialization in cosmetic foot care, nails, wounds, and dermatology. The other podiatrist, ABFAS BC/BQ Foot & Ankle surgeon with confident training. Live and work in one of the top communities in the US alongside professionals who value success, teamwork, knowledge sharing, and a patient-centered approach. Please send CV, current photo, and cover letter to: mbrittney97@gmail.com
ASSOCIATE POSITION – SYRACUSE, NY
Exciting opportunity for a motivated individual in a well-rounded podiatry practice. We are looking for someone who is motivated to help the practice grow and be part of our team as we continue to help the community and enjoy what we do. Expect to meet surgical numbers (for boards) after the first year of practice. Please email: docryanlee@gmail.com with resume.
ASSOCIATE POSITION – NEW YORK CITY
Group podiatry practice with 6 locations, 3 boroughs in NYC. Looking for a part time/full time podiatrist. Must be willing to travel to different locations if needed, and work on some weekends. Competitive rates, with 401k, vacation days, etc. Please contact nyjumex@gmail.com if interested.
ASSOCIATE POSITION – DELAWARE
Brandywine Podiatry the largest podiatric practice throughout the state of Delaware with seven offices is looking for a Board Qualified/Certified associate for a full time position. Multiple hospital opportunities. Multiple doctor referral patterns (both podiatry and non-podiatry). Unique opportunity for a successful career. Send CV to: Savage6026@comcast.net
ASSOCIATE POSITION - CHICAGO SUBURBS
Looking to hire Summer 2024. Thriving podiatry practice in Chicago suburbs looking for an associate to take practice to the next level. Must be highly motivated and have the ability to WOW our patient with your charismatic personality and professionalism. This is an excellent opportunity to work in a state-of-the-art office (which includes MRI) with a team-oriented culture. 3-year surgical residency required. Submit CV to jswalter@hotmail.com
ASSOCIATE / POTENTIAL PARTNERSHIP– NORTHERN CALIFORNIA SOUTH BAY AREA
Well established podiatry practice seeking to hire a full-time podiatrist. Candidate will be able to treat all aspects of foot and ankle pathology. We offer Medical, 401 K, malpractice, CME, Highly competitive based salary with potential for partnership. Please email CV to lgfootcntr@aol.com
IMMEDIATE POSITIONS – FLORIDA AND SOUTH CAROLINA
KG Health Partners is seeking full-time and part-time podiatrists to provide mobile lower extremity care to long-term care residents in Florida and South Carolina. Monday through Friday schedule, competitive wages, malpractice insurance, and benefits for full-time employees. Email CV to Kgadmin@kghealthpartners.com
ASSOCIATE POSITION – TEXAS
Join our Team! Excellent opportunity to join an established, fast-growing group practice just south of Dallas. Modern offices with high surgical numbers. Competitive 6 figure salary + bonus and full benefits. Please email resume to Podiatrysbest@gmail.com
ASSOCIATE POSITION - CT (FAIRFIELD, GREENWICH, AND NORTH HAVEN)
Full time position available immediately. A very busy schedule and competitive compensation package is being offered. Our EMR system is MacPractice and digital x-ray is 20/20 Imaging. Sonoace ultrasound, a PinPointe laser, and an EPAT by Curamedix as well. Please visit our website www.greatfootcare.com and send resume to DrKassaris@GreatFootCare.com
ASSOCIATE POSITION – MIDTOWN MANHATTAN
Looking for a full time/part time Podiatric Associate for a busy Midtown practice. Please email CV to amaltese2185@yahoo.com
ASSOCIATE POSITION – TAMPA, FL
Looking to add a podiatrist to join our growing practice in Tampa, FL. Make your own hours and can choose to do as much or as little surgery as you want. No hospital call required. Please email a cover letter and CV to DRNTFC@GMAIL.COM. Emails without a cover letter will not be eligible.
ASSOCIATE POSITION – WEST SUBURBAN CHICAGO
West suburban Chicago podiatry practice looking for FULL TIME or PART TIME associate. We are a 3 doctor practice with a mix of surgical and non-surgical opportunities, heavy in wound care. Competitive compensation package with bonus structure and benefits available. Please forward CV via email to podiatryoffice10@gmail.com
ASSOCIATE POSITION - SOUTHEAST FLORIDA
Busy group practice seeking to add a full time associate. Practice comprises a mixture of hospital, clinic and nursing home patients. Candidates must be hard working with surgical training of at least a 36 month residency. BQ/BC applicants preferred. Competitive salary and benefits. E-mail CV to eastfloridafootdoc@gmail.com
FANTASTIC OPPORTUNITY- GEORGIA
Associate (or associates if you’re a team) position available in our thriving practice outside of Atlanta. Two physician practice. Associate of four years is moving out of state, and owner getting ready to retire soon, so you will be on the fast track to ownership. Idea of perpetually working for someone else or a big group not your dream? You will not find a better opportunity to design the practice and life YOU want, on YOUR terms. Private practice is still the most satisfying and lucrative practice model. Full scope. Community leader. NO ER or hospital call. Full schedule on day one. Georgiadpm557@gmail.com
ASSOCIATE POSITION – SAN FRANCISCO EAST BAY
Join our multi-office practice. Must have great people skills, bedside manner, and positive demeanor. Must work well with staff and local medical community. Prefer private practice experience. California license required. Send CV and cover letter to: ebpod2008@gmail.com
FULL TIME ASSOCIATE PODIATRIC SURGEON POSITION AVAILABLE - BROOKLYN, NY
Great opportunity for a well trained foot and ankle surgeon to join a rapidly growing team. ABFAS board QUALIFIED/ CERTIFIED; RRA preferred. Looking for a self-motivated, positive individual willing to work hard. Competitive benefits package. Please send resume to: simonfootandankle@gmail.com
FULL TIME PODIATRIST - NEW JERSEY
Established Podiatry practice in New Jersey with multiple locations and Doctors. We are currently looking for a full-time motivated and caring doctor to join our busy practice. Benefits include: competitive six-figure salary, generous guaranteed bonus structure, health insurance (including vision & dental), paid vacation time off, paid malpractice insurance and CME time off. Great prospects for experienced doctors as well as new Associates. This is an excellent opportunity to expand your podiatric medical and surgical experience in an office-based practice! If interested, please submit your CV to DrSamofal@PodiatryCenterNJ.com
WOUND CARE FELLOWSHIP - NEW YORK
CPME=APPROVED 12 month fellowship bginning July 1st, 2024. Hospital and clinic environment, with onsite hyperbaric medicine. Working with infectious disease, as well as, general, vascular, and podiatric surgeons. Must have completed a PMSR residency. Please contact or jtfootcare@gmail.com. EOE employer.
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| CLASSIFIED ADS - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE | |
PM NEWS CLASSIFIED ADS REACH OVER 22,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 22,000 subscribers. For details, click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details.
PRACTICE FOR SALE- TREASURE COAST, FL
Treasure Coast (Martin/St. Lucie County). 40 YO part-time general practice 2 locations grossing average 200K. Please no brokers email practiceforsaleflo@comcast.net with phone number for information.
PRACTICES FOR SALE - CHICAGO
Senior partner/owner retiring. Associate(s) are looking for experienced doc. Three prime locations-Office space/buildings are fully equipped. EPATs, Ultrasound dx & tx, Lasers, Padnet, in-house P.T., DME, ortho supplies & equipment, surgery center, digital x-rays, Athena EMR.Sale includes all real estate, equipment, inventory & staff. Email resume to chicagopodpractice@gmail.com
PRACTICE FOR SALE – LANCASTER COUNTY, PA
3,000+sq.ft. beautiful podiatry office with 4 well-equipped exam rooms, digital x-ray, EMR, Q-Clear laser, enPuls radial shockwave device, diabetic shoe room, orthotic 3D scanner, outsourced billing, free parking, handicapped accessible first floor location for sale. Twenty-year-old practice with annual increasing revenue and room to grow. Part-time associate working one day per week, performing palliative and surgical care, and can stay on after purchase.This is a great office for a motivated solo practitioner, 2-physician group, or an orthopedic foot & ankle specialist. Great place to live and work. Contact PApodpractice@gmail.com
PRACTICE FOR SALE - FAR NORTHERN CA
Gross 350K on 4d/wk, mostly C & C, contract with VA, will transition, owner retiring, $185,000, cash sale, all equipment included. Office next to Hospital, available for purchase, digital x-ray/2 Midmark autoclaves, serious inquiries only. Podtexdoc@aol.com
PRACTICE WANTED TO BUY – ILLINOIS
Podiatrist seeking to purchase an established podiatry practice in Illinois. Open to practices of all sizes and locations. Seller financing requested. Please contact me at psadoctor@gmail.com
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| Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management® Magazine and Podiatry Management® Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.
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