The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

December 05, 2012 #4,630 Publisher-Barry Block, DPM, JD

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On January 15, 2013, Medscape will discontinue all pol.net e-mail addresses. If your address ends in pol.net, please send us an alternate e-mail address. If you need to establish a new e-mail address, we recommend a gmail.com address.  

ACFAS & AAWP Hold Suture Workshop at NYCPM

Recently, the American College of Foot and Ankle Surgeons (ACFAS) Surgery Club and American Association for Women Podiatrists (AAWP) Club joined forces and offered a hands-on suture workshop at the New York College of Podiatric Medicine (NYCPM). A total of 26 students participated in the workshop, which was led by PGY-2 residents Dr. Giannin Perez and Dr. Jamie Chaffo.

Dr. Jamie Chaffo, resident, demonstrating proper suture technique.

During the workshop, Dr. Perez and Dr. Chaffo taught enthusiastic students different suture techniques used in primary closure of wounds, such as simple, horizontal mattress and vertical mattress sutures. “They [the student participants] were all very grateful for the opportunity to practice their technique,” states ACFAS president Todd Chappell (2014).

Source: Prema Hampapur, NYCPM Alumni Report [Fall 2012}

AZ Podiatrist Urges Caution on Use of Statins For Diabetic Wound Healing

Using a statin, a cholesterol-lowering drug, as an ointment may hold promise for helping people with diabetes, a study suggests. The new study found that the topical application of simvastatin accelerated wound healing in genetically diabetic mice. The findings were published in the December issue of The American Journal of Pathology. Though the work was done in mice, the researchers hope the benefits will apply to humans as well.

Dr. David Armstrong

Dr. David Armstrong, a professor of surgery at the University of Arizona College of Medicine, urged caution. "It is very premature to draw a broad conclusion based on this study. It is a mouse study." Armstrong, who was not involved in this experiment, said seeing whether this study can be replicated and taken to the level of human trials could further test this approach.

Source: Cathy Payne, USA TODAY [12/1/12]

APMA and AAPC Team Up at SAM

The American Podiatric Medical Association (APMA) and the American Academy of Professional Coders (AAPC) will be providing a 1-2 punch at SAM in Orlando, Florida. On Friday, January 18, the APMA will be presenting the Advanced Foot & Ankle Coding Workshop covering a wide variety of toe to lower leg coding and documentation scenarios and discussions. The workshop will be presented by Harry Goldsmith, DPM and Paul Kinberg, DPM, both Certified Surgical Foot & Ankle Coders.  NOTE: This is a separate track from the APMA Coding Seminar presented Wednesday, January 16, included in the SAM doctor registration.
 
On Saturday, January 19, AAPC will be hosting a specialty coder certification examination – Certified Surgical Foot & Ankle Coder (CSFAC™) for podiatrists, orthopedists, staff, and coders. For more information/registration for the APMA Advanced Foot & Ankle Coding Workshop, click here. For more information/registration for the AAPC CSFAC™ exam, click here.

AAFAS Meeting at LSU Features 3-D Surgical Videos

The Academy of Ambulatory Foot and Ankle Surgery held a meeting at LSU Medical School in New Orleans Nov 8-10. The meeting was attended by podiatrists and other surgeons from Australia, Canada, Latin America, Spain, and the United States. The meeting was limited to 60 attendees. The emphasis was on teaching sophisticated minimally traumatic surgeries using fluoroscopic guidance to correct major surgical deformities. 3-D computer videos of surgical procedures were also featured.

The Canadian and Spanish delegations at the Louisiana State Medical School cadaver lab.

The biomechanics of MIS surgery along with orthotic control was also discussed. Other topics included evaluation of major nerve pathologies. Attendees were able to hone in on the surgical skills by using the state-of-the-art LSU cadaver facilities. The next AAFAS meeting will be in June, 2013.

Query: Top Doctors

I was contacted by Top Doctors concerning advertising on television stations. I would like to know if anybody has dealt with this company in the past, and if so, what have been your experiences?

Ade Adetunji, DPM, Largo, MD

Query: Excision of Fracture Fragment Distal Tibia

What is the correct code for excision of a fracture fragment from the distal tibia? Any insight would be appreciated.

Kristie Moore, Office of Paul D Brooks, DPM, Pensacola, FL

Response: The procedure being described, whether from a fracture fragment or otherwise (e.g., exostosis), is an ostectomy of the tibia.

The correct coding would be CPT 27640 - partial excision (craterization, saucerization, or diaphysectomy) bone, tibia

Howard Zlotoff, DPM, Camp Hill, PA

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

RE: Botox for Plantar Fasciitis? (David Kahan, DPM)
From: Jeffrey Kass, DPM

I do not think Botox would be an effective treatment (I have not tried it) for plantar fascitiis. Usually, the purpose of the Botox is to paralyze a muscle so that it renders it ineffective. Plantar fascia are not muscles. Unless, one feels that paralyzing the intrinsics that originate in the heel are a component of this process, I fail to see how it would work. Of course, the mere fact that a needle is penetrating the fascia could enable a positive outcome, but that would be achieved with or without the expensive Botox.

Jeffrey Kass, DPM, Forest Hills, NY! Jeffckass@aol.com

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

The photo of the lesion you presented along with the brief history suggest the likelihood of them both being verruca lesions. Unless the lesion in the web space is causing pain/discomfort, I would treat it conservatively. If you are adamant about biopsy, biopsy the contralateral side if strategically practical. Not every lesion needs to be biopsied. If it looks, acts, feels like a verruca, it most likely is. Don't try to outsmart yourself.

Stephen Musser, DPM, Cleveland, OH, ly2drmusser@gmail.com

I like to use Canthrin and an aperture pad with salinocaine ointment. Leave dry for 24 hours, then remove and start soaks in concentrated black tea 15 mins twice daily. Medicate for pain, and follow-up in 2 weeks. You should be able to then I&D the lesion.

Dan Klein, DPM, Fort Smith, AR, toefixer@aol.com

RE: CMS to Now Cover Obesity Counseling (Robert Bijak, DPM)
From: Elliot Udell, DPM

Dr. Bijak is correct when he implies that prior to starting an aggressive exercise program, cardiac pathology should be ruled out by the patient's internist or cardiologist. Walking, however, can be part of a "medical solution" to obesity. Weight Watchers International has just invested millions of dollars into a new program and participants are asked to wear a monitor all day long which will record the amount of walking each participant does over a week-long span. If it is low, the person can then increase his or her movement by increasing daily walks. In addition to scheduled exercise workouts, the medical experts at Weight Watchers who developed this program feel that increasing walking throughout the day, along with diet control, comes a long way at reducing obesity.

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

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

It is a relief that legendary physician, Elliott Proctor Joslin, MD, did not have the same contempt for podiatry that Robert Bijak, DPM apparently has. Dr. Joslin took it as a matter of almost religious importance that care of diabetes mellitus be a professional group-project. In Dr. Bijak’s attack against Dr. Jon Hultman, DPM, MBA, Dr. Bijak suggests that Dr. Hultman would not first obtain cardiac clearance before suggesting an exercise program.

It is common and accepted practice for professionals who recommend exercise programs, including walking as therapy, to obtain cardiac clearance first. More to the point, podiatry has a great deal to offer diabetic patients at risk of ulceration and gangrene. Our profession, (from Dr. Dennis Shavelson and others who are experts at biomechanics) has recommended that diabetic patients obtain podiatric evaluation for their specific “foot typing” so that risks of damage from walking/exercise can be minimized.

That type of evaluation, treatment, and counseling is firmly within DPM licensure and complements diabetic care. I can see Dr. Joslin enjoying the contribution of biomechanical foot typing in his life-long pilgrimage to be inclusive of multi-specialty diabetic care, as well as knowledgeable counseling on exercise programs, even if by podiatrists. 

Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

RE: WI Podiatrist Killed by Motorcyclist in Thailand
From: Ivar E. Roth DPM, MPH

I got a gut punch in my stomach when I read about the untimely death of Ian. I remember him well as a very nice compassionate student/doctor when we were students in Chicago. May he rest in peace.
 
Ivar E. Roth, DPM, MPH, Newport Beach, CA

RE: PAL Health Technologies CEO Dies
From: Steven Selby Blanken, DPM

I was a former consultant for PAL and want to offer my condolences to Jeff's family and his employees during this very hard time.

Steven Selby Blanken, DPM, Silver Spring, MD

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 - SOUTHWEST FLORIDA

Busy multi office practice with latest in technology EMR, digital X-rays. Looking for BQ/BC by ABPS. Must be able to handle rearfoot / ankle trauma and reconstructive cases. Paid vacation, health insurance and partnership available. New or experience practitioners welcomed.  Email resume to: mny1029@gmail.com

ASSOCIATE POSITION - NC PIEDMONT

Excellent opportunity for highly motivated, ethical, and personable PSR 24/36. This well established, 3-physician practice has excellent rapport with physician community, multiple office locations, and hospital privileges. Intent is an associate leading to partnership for the right individual. Competitive salary & benefits. Email CV to dpmassociatenc@gmail.com.

ASSOCIATE POSITION - SOUTH FLORIDA

Busy multi office practice needs 3 year surgically trained Podiatrist to join five doctor practice. Benefits include Salary, Bonus, Health Insurance, Pension Plan and CME. Digital x-Ray and EMR in all offices.  If interested please send a CV and letter of interest to alvatore1@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 - 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 - 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

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