The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

December 06, 2011 #4,324 Publisher-Barry Block, DPM, JD

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MO Podiatrist Offers Holiday Foot Care Tips

Dr. Kyle Fiala, a podiatrist at the Missouri Orthopaedic Institute, said that there are a number of things people can do at the end of the day to keep their feet happy. “There was a survey from the American Podiatric Medical Association that found moisturizing was the number one way that women soothed their feet during the holiday seasons,” Fiala said. 

Dr. Kyle Fiala

Additionally, stretching and massaging can provide some relief. “Point or flex the toes up and down to work out stiffness in the toes. Rotate the ankles to work out range of motion,” Fiala said.

Source: Caroline Dohack-McCrary, Columbia Daily Tribune [12/4/11]

AZ Podiatrists Keynote at Italian Limb Salvage Symposium

Dr. Robert G. Frykberg, Chief of the Diabetic Foot Clinic at the Phoenix VA Medical Center and David G. Armstrong, Professor of Surgery and Director of the University of Arizona's Southern Arizona Limb Salvage Alliance (SALSA) led a multi-national contingent of physicians, surgeons, and researchers at the International Diabetic Foot Symposium held outside of Naples in Italy this weekend. 

(L-R) Dr. Robert Frykberg, Prof. Armstrong, Symposium Co-Chair - Dr. Giacomo Clerici, and Prof. Marco Romanelli

"It is appropriate that this meeting is being held on the slopes of Mount Vesuvius," noted Dr. Armstrong, "We are continuing to feel the rumblings of what will no doubt be a major eruption of complications from diabetes in Europe and throughout the world."

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

Bret Ribotsky: If you could alter the podiatric educational experience at the residency level, what would you change?

Dr. Steven Spinner

Steven Spinner: I just would love the residencies be more entrenched in all of these large multi-facility academic teaching centers where the clinical volume is just over the top, and there is just much more accessibility to different specialties in an academic environment. Obviously, we have lots of that in our profession. I think that we need to make more of a thrust in getting into those academic types of triage centers where our education is fundamentally improved through numbers and through exposure to different specialties.

Dr. Gerard Saponara

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's guest is Dr. Gerald Saponara, Past President of the American Board of Podiatric Orthopedics and Primary Podiatric Medicine. You can register for future events by clicking here

Query: Post-Injection Hyperemia

I recently performed a heel injection under ultrasound guidance, using 1 ml of 0.5% Marcaine plain and 1 ml of Kenalog 10. Prior to this injection, I performed a posterior tibial nerve block. I did not hit the nerve directly, and did not hit a vein. I aspirated frequently to ensure this. The following day, her foot is still numb, and her entire foot is extremely warm and red from the ankle distally. Elevation of the limb produced a better color, but no temperature change. I sent her for ultrasound, with a negative DVT result. She is currently elevating the limb and using ice. I am waiting for the Marcaine to wear off. Any suggestions would be welcome.

Mark Edmunds, DPM, Hopkinsville, KY

Query: Naval Medical Reserve

I am interested in learning more information about serving in the Naval Medical Reserve. I would appreciate it if a podiatrist currently serving in this capacity could comment. 

Gerald Mauriello, Jr., DPM, MA, Freehold, NJ

RE: Hair Loss and Lamisil (Brian W. Fullem, DPM)

I had a patient experience hair loss on Lamisil. Stopping the medication stopped the problem. I also had another patient experience the loss of taste, which also returned once the medication was stopped.

Robert Hilkemann, DPM, Omaha, NE, rjhilkemann@gmail.com

RE: Terbinafine Overdose (Eric Edelman, DPM)
From: Edmond F. Mertzenich, DPM

Review the Novartis website pharma.us.novartis.com/product/pi/pdf/Lamisil_tablets.pdf, "Clinical experience regarding overdose with oral terbinafine is limited." Doses up to 5 grams (20 times the therapeutic daily dose) have been taken without serious adverse reactions." It would seem there is a good chance of not having an adverse outcome. Because terbinafine is long-acting, I would hold off use of the medication for a couple of weeks, run another set of liver function tests, and see those results. If there are no problems, maybe one more round of the medication would be warranted. 

I don't know how the overdosing would affect the accumulation of the medication in the nail tissue. Maybe at the end of treatment, run another liver function test. This is an unusual case. As for patient instructions, type out the instructions in large font letters and have the patient read it back to try to ensure understanding of the instructions.

Edmond F. Mertzenich, DPM, Rockford, IL, doctoreddpm@frontier.com

RE: Life-Long Maintenance Regimen for Onychomycosis (Evan Meltzer, DPM)
From: Daniel D. Michaels, DPM, MS, Andrew Shapiro, DPM

The best thing I have found for disinfecting shoes is the SteriShoe shoe horn. It is found at sterishoe.com and has studies that support it killing 99.9% of bacteria, fungus and virus. I used to recommend Lysol spray or Tineacide shoe spray, but the problem is that they don't work that well and no studies have been done to confirm they work. Additionally, these sprays leave behind chemicals that the patient's foot will absorb when wearing the shoe. This could cause problems. I use the SteriShoe for people with fungus of nails and skin, and for people with warts. It could be used for diabetics at risk for ulcers as well. People with onychomycosis are not resistant to fungus, so will need to do something life-long to help prevent recurrence, and this is one of the items I use for this.

Daniel D. Michaels, DPM, MS, Frederick, MD, danieldm@pol.net

Preventing re-infection is a challenge. Studies show that many fungi (and other micro-organisms) harbor in the materials of the inside of shoes, and need to be eradicated effectively to prevent re-infection. An effective adjunctive measure is the SteriShoe ultraviolet shoe sanitizer. The product, designed as a shoetree, safely sanitizes the inside of shoes using germicidal ultraviolet (UVC) light. A 45-minute treatment kills 99.9 % of bacteria, fungi, and viruses. This is especially effective in chronic fungal infections, including onychomycosis.

Disclaimer: I am an advisor to Shoe Care Innovations, makers of the SteriShoe ultraviolet shoe sanitizer.
 
Andrew Shapiro, DPM, Valley Stream, NY, Drshapbark@aol.com

RE: Return Shipping Charges for Shoes (Alan Berman, DPM)
From: Ron Bar, Joe Boylan, DPM

A few companies that offer diabetic shoes, including Orthofeet, offer free returns on shoes – no questions asked.

Ron Bar, Orthofeet, Inc., Northvale, NJ, orthofeet@aol.com

We have been using Safestep for about 8 years. Safestep provides a return shipping UPS label that we use once a month, if needed. We place all returns in one box and send monthly. Our goal in the office is to keep the returns to a minimum. 

Joe Boylan, DPM, Ridgefield, NJ, Drb0327@aol.com

RE: Who Gets to Cast (Barry Mullen, DPM)
From: Robert Scott Steinberg, DPM

Dr. Mullen makes my case. His assistants can't perform a biomechanical exam, and I say that disqualifies them from making casts, period. His rationalization is that it's okay because it's good practice management. I say it is bad patient care. I have asked him how he bills for his assistants doing the cast. He has avoided revealing that.

If you do not respect the profession, and you feel your office does not have to offer a higher level of care than a patient can get at the pseudo foot doctors out there, then by all means, follow Dr. Mullen's practice management style.

Robert Scott Steinberg, DPM, Schaumburg, IL, doc@footsportsdoc.com

RE: Why This Country is Going Broke (Dale Smith, DPM)
From: Ivar E. Roth, DPM,MPH

Shocking. Contact  the Dept. of Human Services immediately or, better yet, the newspaper to do an undercover story. This is appalling, yet no one seems to speak up and stop this abuse. The authorities should be alerted to the relatives that are also doing this. They should be turned in along with the doctor who approved their application.
 
Ivar E. Roth, DPM,MPH, Newport Beach, CA, ifabs@earthlink.net

RE: MN Podiatrist Supports Statewide Single-Payer Health Insurance System
From: Randall Brower, DPM

Dr. DeBrule was spotlighted in the Dec. 2nd PM News stating that he is for single-payer healthcare. He says, "call it communism, call it socialism, I'm all for it because I'm a humanitarian." Wow. What a statement. We all give free or reduced cost care to our patients out of kindness. Why is getting paid a fair amount for a professional service not humanitarian? So, is the lady who cuts my hair not humanitarian? Is the gas station owner who gladly accepts my Visa card for gasoline not humanitarian? Is Safeway that carries my groceries for a set price not humanitarian?

If Dr. DeBrule is so humanitarian, he should...

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

PRACTICE FOR SALE – NANAIMO, BRITISH COLUMBIA, CANADA

Have you ever dreamed of owning a practice where...you can see 0-50 patients daily * average 100 new patients monthly * have zero accounts receivable * gross $480K per year * live in a beautiful community with skiing, hiking, fishing, and boating on your doorstep. This could be yours! If interested contact pistone@telus.net or call 250-754-4192.

RESEARCH AND SURGICAL FELLOWSHIP PROGRAM: BOSTON UNIVERSITY MEDICAL CENTER
 
Join our team and become an expert in limb preservation, tissue repair, and wound healing. This is a unique accredited multidiscipline fellowship program at a major teaching hospital. Fellows will be expected to significantly contribute to clinical research, surgical procedures, teaching and innovation with a world renowned expert team. Requirements: Completion of a two or three-year surgical residency; ACLS certified. Candidate must possess a commitment to an academic career in podiatric medicine and surgery. Program begins 7/1/12. Submit a CV and letter of interest to: Erin Springhettierin.springhetti@bmc.org and the Director Dr. Vickie Driver,Vickie.driver@bmc.org. If questions call 617-414 6821.

EQUIPMENT FOR SALE - SUPERPULSE 45 WATT PEAK POWER LASER (LUMIX2)

Superpulse 45 watt peak power Laser (lumix2) used once or twice. This is a real superpulse 910nw up to 100,000 HZ. Great Laser Used in the super bowl by the Green Bay Packer Why am I selling? I have too many lasers in my office now ( six) This is a great laser for plantar fasciitis. Achilles tendonitis. Lightweight portable. easy to use, fully programmable Sold to first person under $$12,000 You will NEVER get a laser like this at this price. Enjoy. it I just have too many lasers. David Zuckerman DPM  footcare@comcast.net

EQUIPMENT FOR SALE - CLASS FOUR LASER- USED K-LASERS

I have used K-laser for sale. Still in Warranty. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargeable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

ASSOCIATE POSITION - NAPLES, FLORIDA

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. Candidate should have the skills and desire to perform rearfoot/ankle surgery. Florida has a great scope of practice law and we rotate for ER call. Candidate needs to be ethical and motivated. Established practitioner or new practitioner. In a cover letter tell me why you should be selected for the team. Email cover letter and CV with subject line "I am your new team member." to Drgordon@gulfcoastfootcare.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 24-36 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 Diane Coulter, Office Manager.

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 - TEXAS

We are looking for a reliable and enterprising podiatrist who will assist in growing our practice. People skills, clinical/surgical skills and good behavior will be a plus also Texas license required. forward your CV to "divinefootcarecenter@yahoo.com or you can also contact us at 972-790-2800, fax number 972-790-2803. 

PART TIME PODIATRIST NEEDED- LOS ANGELES, CALIFORNIA
 
Busy podiatrist looking for assistance with treating home-bound patients. Flexible hours, independence, and great compensation. If interested, email CV to homefootcare@hotmail.com

ASSOCIATE POSITION - SOUTHEAST GEORGIA - SAVANNAH

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking associate or new residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

ASSOCIATE POSITION - DAYTON, OH

Join a well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and to Ohiodoctors@aol.com

ASSOCIATE POSITION - EAST TENNESSEE

30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. $160,000 base salary with bonus incentives and benefits. Post-residency experience a plus. Please send resume to ddavidphawk@yahoo.com

ASSOCIATE POSITION - TEXAS

Well established, expanding podiatric medical and surgical practice with multiple locations Northeast of Dallas, Texas. Modern offices with EHR, digital radiography, Padnet vascular studies and laser. We offer a competitive salary and benefits package for a motivated, ethical, personable and well trained PSR/36 or board equivalent. This individual will also assist managing the residency program. Send resume (CV)to northtexaspodiatry@yahoo.com along with a letter of intent

ASSOCIATE POSITION - MARYLAND

Multi-office group seeks highly trained surgical associate to join us. Prefer person with frame and trauma experience. Our practice is state-of-the-art and has all modalities: EMR, PadNnet, on-site billing, diagnostic US, PRP, digital x-ray, etc. Excellent salary, bonus structure and benefits with partnership available. Please forward CV and letter of intent to docsbnb@aol.com

ASSOCIATE POSITION - TAMPA BAY AREA

Excellent opportunity to join a well-established multi-office group practice in the beautiful Tampa Bay area starting July 1, 2012. We are seeking a highly motivated, ethical and personable physician with a Florida license. Competitive salary, excellent benefits and partnership track. Please email or fax CV to  thesykeshome@aol.com (813) 254-8262

ASSOCIATE POSITION - MARYLAND

Looking for 3rd associate. Must be personable, well trained and highly motivated. Great locations in Southern Maryland, including an Ambulatory Surgical Center. We currently have EHR, digital radiography, dispensing center and PADNet. Looking for immediate hire! Please send CV to: myfeetfeet@aol.com

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 516 476-1815 PODO2345@AOL.COM

PODIATRY OFFICE TO SHARE - SEATTLE, WASHINGTON

Fully equipped podiatry office in North Gate area of Seattle. Office located in medical professional building near I-5. Office has 3 treatment rooms, 3 physical therapy rooms, direct digital x-ray, PAD- net, NCV testing equipment, physical therapy equipment. Please contact us: website Tel. 425-643-8901 isbinc2006@gmail.com

PM News Classified Ads Reach over 13,500 DPM's 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 13,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 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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