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| PM News | |
The Voice of Podiatrists
Serving Over 15,677 Podiatrists Daily
December 10, 2013 #4,937  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2013- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL | |
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| APMA COMPONENT NEWS | |
APMWA Announces 28th Annual Student Writing Competition
The American Podiatric Medical Writers Association has announced its 28th Annual Student Writing Competition.
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All papers MUST be non-technical in nature. Appropriate subjects include practice management, ethics, law, education, or any topic that would be suitable for a lay publication.
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There is no word limitation. Papers will be graded for content, style, grammar, neatness, and overall impact.
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First prize will be one thousand dollars ($1,000), sponsored by an APMA Educational Foundation endowment from Dr. and Mrs. Steven Berlin, and recognition in the APMA NEWS and the APMWA Newsletter. Honorable Mention Certificates may also be awarded.
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This competition is open to ANY enrolled podiatric student.
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Entries must be received by 4/15/14 via e-mail at bblock@podiatrym.com
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Entries become the property of APMWA, which may arrange publication of the entry.
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| INTERNATIONAL PODIATRISTS IN THE NEWS- PART 1 | |
Armenian Podiatry Consultant Uses 3-D Scanner
Podiatry is quite new in Armenia. Consultant physician and podiatry specialist Dr. Hasmik Aguzumtsyan told NEWS.am Medicine about the modern technologies and treatment methods. With the help of plantography, it is possible to identify biomechanical deviations (disorders) when walking, i.e., you can see what happens in the process of human walking, and make devices to correct problems. A 3-D scanning of the foot is conducted to get an imprint of the foot, on the basis of which a model is made, and then individual orthopedic insole, shoes, and braces.
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Dr. Hasmik Aguzumtsyan |
As the doctor explained, there are cases, when disturbed walking biomechanics can be regulated just with the help of insoles. Wearing shoes with insoles ensures proper distribution of body weight on the foot, the foot is in the neutral position and lightens the load on the musculoskeletal system.
Source: Armenian News [12/7/13]
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| INTERNATIONAL: PODIATRY IN THE NEWS - PART 2 | |
UK Patients Hit by Foot Treatment Delays
The National Health Service (NHS) contract to help patients with foot complaints is being reviewed because people are waiting too long for treatment. The contract states that 95 per cent of patients should be seen by a foot specialist within three weeks of being referred by their GP. But latest figures for October show the NHS trust was hitting just 70 per cent – with 79 people waiting more than 10 weeks and three of them delayed for around four months.
The podiatry service treats patients with conditions ranging from arthritis and bunions to corns and hard-to-cut toenails. The treatment is carried out in clinics or people's homes. The crisis has been blamed on an increase in referrals. But it comes just two years after more than 11,000 people were dumped from patients' lists following an assessment of all 43,000 people waiting.
Source: The Sentinel [12/7/13]
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| SUCCESS TIPS FROM THE MASTERS | |
Bret Ribotsky: What was the key to earning the respect of orthopedists in the Department of Orthopedics at the Penn State Hershey Bone and Joint Institute?
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Dr. Jarrett Cain |
Jarrett Cain: It all started with developing trust. With time and with the treatment of many patients, this trust was earned by performance. This opened up increased scope and respect not just of me, but for our profession.
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Dr. Lee Rogers |
Meet the Masters will return on Tuesday night. This week's guest will be Dr. Lee Rogers Medical Director at Amputation Prevention Center at Sherman Oaks Hospital and candidate for U.S. Congress in California's 25th District.. You can register for future events by clicking here
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| QUERIES (CLINICAL) | |
Query: Painful Foot Lumps
My patient is a 47 year old lady with a history of diabetes mellitus type 2, hypertension, and a thyroid condition with a several year history of "lumps" on the legs, and more recently her feet (dorsally and medially). The lumps start out hot, red, and painful. Over the course of two to three months, they resolve, appearing like a bruise before they go away.
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Red lumps on the foot of a diabetic patient |
They appear in groups more often than not. I'm considering a diagnosis of erythema nodosum, but would appreciate if someone would comment on her condition.
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| QUERIES (NON-CLINICAL) | |
Query: Selling An X-Ray Processor on eBay?
Has anyone sold their x-ray processor machine? Can it be sold on eBay?
Joe Borden, DPM, Reseda, CA
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| RESPONSES/COMMENTS (CLINICAL) - PART 1 | |
From: Dennis Shavelson, DPM
My advice relates to the impact of closed chain function and shoes upon dermatological entities. I call this Closed Chain Dermatology®. You mention the foot type, but I wonder what foot type diagnosis you have made? In functional foot typing, this foot type is known as the rigid rearfoot, flexible forefoot functional foot type. It is characterized by a weight-bearing pressure print in line with the callus pattern of your patient.
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Rigid Flexible Mat Print |
An STJN cast, intrinsically posted, forefoot posted orthotic in the modern podiatric style will not provide much pressure relief.
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| RESPONSES/COMMENTS (CLINICAL) - PART 2A | |
RE: First Ray Instability
From: Don Peacock, DPM
Judging from your patient's weight-bearing lateral x-ray, it does not appear that a hypermobile first ray is the issue. Her first metatarsal declination angle and talar tilt are relatively parallel on your weight-bearing lateral. Based on this x-ray, she appears to have a stable rear foot and a flexible forefoot. This type of case can be confusing because on the AP x-ray, she appears to have a long first ray. This could be that she, in fact, does have excessive dorsiflexor movement in the first ray which would appear as a long ray on an AP x-ray. However, it does appear that she is not overly flexible in the first ray based solely on the lateral x-ray.
A biomechanical exam will determine how flexible her forefoot is. She most likely has a rigid or stable rearfoot and flexible forefoot. If this is the case, then your surgical ideas would make perfect sense. A decompression osteotomy of the first ray along with orthotic use should suffice. Other options would be to perform a subtalar joint stabilization procedure if her forefoot is flexible. Both options would give advantage to the peroneal longus tendon, allowing for plantarflexion of the first ray. It is also important that you determine whether or not equinus is present.
Perform a distal metatarsal osteotomy in a decompression fashion and an osteotomy in a Bonney-Kessell style in the hallux. I would not address the mobility of the first ray unless there was true flexibility in the biomechanical exam or if she has gastroc equinus.
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| RESPONSES/COMMENTS (CLINICAL) - PART 2B | |
From: Keith L. Gurnick, DPM
The obliquity and spreading at the 2nd metatarsal-1st cuneiform joint is indicative of her joint instability. She also has a larger semi-facet at the lateral aspect of the base of the 1st metatarsal than might normally be found, even as a normal variant; but there is early x-ray evidence of splaying at that joint site. In addition, she has a rounded 1st metatarsal head and an increased metatarsus adductus angle (normal range 10-20). I do not agree with your lesser tarsus bisector line and reference points placement, look at the base of the 2nd metatarsal as an indicator of the elevated metatarsus adductus angle.
Options: A head osteotomy may still be the procedure of choice due to the fact that the post-op recovery should be easier and shorter than a Lapidus or whatever else you might be contemplating more proximally, which has a longer healing period, 2 incisional sites, and also more potential complications. No guarantees can be made that either procedure will yield a permanent correction, or will lead to recurrence; however, I would discuss the options with the patient ahead of time, discuss your reasoning for each option, and then tell the patient what you feel is the best option at this time for her situation.
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| RESPONSES/COMMENTS (NON-CLINICAL) | |
From: David Secord, DPM
One of the more interesting and simple approaches to medical mistakes (and one which I have never heard discussed outside of the original forum) was proposed by Roger Bone, MD and Jeremy Swan, MD (inventor of the Swan/Ganz thermodilution cardiac catheter). In this forum, these doctors proposed simply compensating all untoward medical outcomes. No courts, no malpractice action, no NPDB entry and….(the reason it never saw the light of day)….no lawyers. It's simple and cost-effective. Obviously, it's too simple for our tort system, as it cuts the lawyers out.
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 1A | |
From: Robert Kornfeld, DPM
Dr. Raducanu, I am not coming from an "extreme" opinion. Quite the contrary. The movement in medicine is toward patient-specific diagnosis and treatment. The fastest growing sub-specialty among MDs and DOs is integrative medicine. The literature on anti-inflammatory diets is easy to find.
Empirically, you need to know that omega-6 fatty acids in excess will promote default into chronic inflammation, while omega 3 fatty acids build the pathway of detoxification and repair. The average American consumes...
Editor's note: Dr. Kornfeld's extended-length letter can be read here.
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 1B | |
From: Jeffrey Kass, DPM
"The profession at large deserves it, and we owe it to our current and recent graduates from whom we now demand three years of post-doctoral medical and surgical training."
The above is a quote in response to a discussion on podiatry treating systemic effects. Personally, I feel the quote could have ended before the first comma. I don't care how many years of post-graduate training any of us had, particularly when there are many who did not have an opportunity to do a program, and many who are struggling to find one now.
The simple answer is the profession at large deserves it! We should know what we can and cannot do. There should be no ambiguity. If we can't do something and want to, we need to find a pathway to achieving our goals as a unified profession. Self-respect is joy.
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MEETING NOTICES - PART 2
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| CLASSIFIED ADS |
EQUIPMENT FOR SALE – USED PINPOINTE LASER
EQUIPMENT FOR SALE - PADNET
Padnet vascular testing machine with updated security software (purchased in 2012). Perfect condition only used for training. We do not have the patient population to provide this valuable diagnostic tool. Purchased for 20K, asking 12K (and we will pay for shipping costs). Please contact vcrismali@gmail.com
EQUIPMENT FOR SALE - USED CUTERA GENESISPLUS LASER
Purchased new July 2011, new handpiece, updated software and re-calibrated in September 2013. This is a great laser for treating toenail fungus, scar reduction & warts. $33,500.00 OBO. Please email dman1hansen@gmail.com or call 801-870-4161
PART-TIME PRACTICE FOR SALE - NYC
Great Opportunity! Retiring podiatrist selling part time (18-20 hrs/wk), fully equipped, multi-disciplinary practice upper West Side of Manhattan. Densely populated, street level location near subway. 27 years at location. Option available to expand to full time or to share with eventual purchase. Reply tokappy105@yahoo.com. In subject please write: West Side Office.
PRACTICE FOR SALE – GLENDALE, CA
Retiring from part-time practice averaging 15 hours a week practice, grossing well over $130,000 a year. No HMO, PPO or hospital surgeries (but located 20 minutes from 5 major area hospitals). Only accepting private insurance, Medicare and cash. Not participating in the diabetic shoe program. Unique practice specializing in off label liquid SILICONE injections (no insurance…cash only), Cryoneuroablation, x-rays, ultrasound imaging, Lixiscope, soft tissue surgeries, and some palliative care. In same great location, in the center of everything for the past 43 years. Unlimited potential. Call 818-384-2479.
ASSOCIATE POSITION - NEW YORK/ NEW JERSEY
Looking for experienced podiatrist or 2013 residency graduate who is currently seeking to run a practice within a multi-specialty practice(s). Must currently be on Medicare and at least three to five insurance plans or have been accepted by those plans. Should be motivated and committed to be part of a healthcare team. Extremely competitive salary with the long term relationship in mind. Must have a minimum of one full day per week available and could be up to five days. Opportunities in several areas of NY and NJ areas with new opportunities becoming available. Podiatry8888@yahoo.com
IMMEDIATE ASSOCIATE POSITION AVAILABLE IN THE HEART OF CENTRAL FLORIDA.
Largest podiatry group in Polk County featuring EMR, muscle laser therapy, digital x-rays, vascular and NCV studies, ultrasound machines, shockwave therapy, and much more. We are a very busy office so expect patients the day you start and a competitive salary with bonuses. E-mail CV tocontactus@flfootandankle.com
ASSOCIATE POSITION – CONNECTICUT (HARTFORD AREA)
Available immediately. Looking for a Board Certified Surgeon with strong RF and ankle skills. This 20 year established practice offers EHR, digital x-ray and Noveon laser. All dues, malpractice and health insurance paid as well as 401K available. Excellent compensation. email lynnleblanc@cox.net
ASSOCIATE POSITION - CENTRAL FLORIDA
Associate wanted for well-established practice in central Florida. Experienced support staff, malpractice coverage and health insurance provided. Excellent opportunity for a promising future. To apply please go to www.yourcareerinpodiatry.com
ASSOCIATE POSITION - BOSTON SUBURB
Excellent opportunity to join a well-established practice. Located in western suburb of Boston. Office includes EMR, digital x-ray, orthotic scanner. Seeking personable, enthusiastic, motivated associate with goal to become partner. Practice includes surgery, sports medicine, general podiatry. PSR 24/36. Send CV to: jstewartdpm@comcast.net
IMMEDIATE OPENING - SOUTH JERSEY
Exceptional opportunity for a full-time, surgically trained podiatrist to join a busy, well rounded practice covering all aspects of podiatry including; surgery, wound care, and sports medicine. Must be highly motivated, personable, and have good communication skills. The practice is affiliated with a hospital residency program. Opportunity for future buy-in/partnership. Please send cover letter and CV tosuperstarstaff1@gmail.com. In the subject line, please write, "I am your next associate."
ASSOCIATE POSITION - SOUTHERN CALIFORNIA
Very busy, two location group practice seeking a full-time, self-motivated and hard-working podiatry associate. Competitive salary offered. Please email CV to: podiatrists@icloud.com
ASSOCIATE POSITION –OH
Group practice in Ohio seeks a well-trained surgeon, PSR24/36 preferred. Our practice provides all of the latest technology needed to provide patients with the best care, including Lasers, PAD Testing, DME, EMR and Digital X-ray. Competitive compensation package including salary and bonus. Please send CV to: DPMgroup1@yahoo.com
ASSOCIATE POSITION – LONG ISLAND, NY
Looking for an experienced ethical, board certified/qualified podiatrist, must be personable, energetic and highly motivated. Well rounded practice incorporating all phases of podiatry including general podiatry, surgery, wound care, orthopedics. P/T, F/T position available, excellent salary. Please email CV to:jobke@aol.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 - TAMPA BAY AREA
Excellent opportunity to join a well-established multi-office group practice in the beautiful Tampa Bay area starting July 2014. We are seeking a highly motivated, ethical and outgoing physician with Florida license to join our growing practice. Competitive salary, excellent benefits, bonus structure with partnership opportunity. Please email CV to Kpontious9@yahoo.com
ASSOCIATE POSITION - ARKANSAS
Ethical, highly motivated, enthusiastic associate needed to join successful, well-established practice located in Northwest Arkansas. Certified/qualified by ABPS with rearfoot training preferred. The practice has an excellent working relationship with a high referral base from local PCPs and other specialists. Well-rounded practice incorporates general podiatry, surgery, wound care, and sports medicine. Salary plus excellent bonus potential for the right individual. Send CV to: footdocmanager@yahoo.com.
PART-TIME ASSOCIATE POSITION – CHICAGO, IL
part-time opportunity in Chicago to provide treatment to homebound patients. You can create your schedule- logistical support provided. Reimbursement is 40% of collection. If interested, please call 312-375-6430.
PM News Classified Ads Reach over 15,500 DPMs 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 15,500 DPMs. for details, click here or write to:bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $119 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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| 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.
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- Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.
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