The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

December 12, 2011 #4,329 Publisher-Barry Block, DPM, JD

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Don't Mistake An Ankle Fracture for an Ankle Sprain: OH Podiatrist

Mistaking an ankle fracture for an ankle sprain has serious consequences when the foot does not heal correctly. The American College of Foot and Ankle Surgeons reminds patients to seek correct diagnosis to ensure proper recovery, especially in the cold-weather months when most ankle injuries occur. "Sprains are very commonplace so people want to believe that is what is going on, but prolonged pain and bruising should trigger awareness that it might not be just a sprain," says Georgeanne Botek, DPM, FACFAS, a Fellow of the American College of Foot and Ankle Surgeons practicing in Cleveland.

Dr. Georgeanne Botek

Dr. Botek adds that pain and ability to walk are not good tests to determine if it's a sprain or a fracture because walking is still possible with less-severe injuries. Telltale signs of a fracture include bruising, blisters, significant swelling, or bone protruding through the skin. In addition to bone, ankle fractures can also involve cartilage surrounding bones.

Source: WXVT 12 [12/6/11]

Zumba Can be Hazardous to Your Foot Health: VA Podiatrist

The patient was a healthy young woman who came into a Washington-area emergency room this year because of severe heel pain, which turned out to be a potentially serious injury known as “compartment syndrome.” The syndrome is typically caused by high-impact accidents, like something involving a motor vehicle. The patient had not been in a car accident. The patient had been in Zumba. 

Dr. David Pontell

“I have seen some interesting things,” says Dr. David Pontell, the Virginia podiatrist who ultimately treated the injury. “That was one of them.” Some 12 million people worldwide are taking part in the cardio dance bonanza that is Zumba. And some of them are getting injured.

Source:  Monica Hesse, The Washington Post [12/9/11]

Most Athletes Should Stick to Wearing Shoes: South African Podiatrist

At a recent sports science conference in London, hundreds of participants, many of them shod but a few daringly barefooted, flocked to a two-hour discussion about the merits or otherwise of running without shoes. 

Simon Bartold

Simon Bartold, a South Arfican sports podiatrist and international research consultant for the sports brand Asics, says most athletes, amateur or otherwise, should stick to wearing shoes. "I'd come down pretty heavily in favor of footwear," he said. "It does offer some real protection and some real performance advantages over barefoot."

Source: Reuters [12/9/11]

IL Podiatrist Speaks at Dine with a Doc Program

Dr. Joseph Borreggine recently spoke at a “Dine with a Doc” luncheon program held at Mason Pointe Senior Assisted Living and Rehabilitation Center in Sullivan, IL on Dec 6, 2011.Dr. Borreggine spoke on foot health issues related to peripheral vascular disease (PAD) and arthritis. He has been a featured speaker in the past in other locations through East Central Illinois. 

Dr. Joseph Borreggine

Dr. Borreggine enjoyed speaking to over 50 seniors from the Sullivan area on these topics. Afterward, Borreggine answered numerous questions from the audience. Dr. Borreggine has practiced over 20 years in Charleston and Effingham, IL. He looks forward to his next “Dine with a Doc” luncheon program which will be held in Marshall, IL some time early next year.

Query: Botox for Spastic Contractures

I have a patient with Parkinson’s and spastic hammertoes, who is interested in whether Botox will work to paralyze his spastic extensor muscle group. I have no experience with this therapy, and wondered if anyone has tried this for Parkinsons or similar spastic contractures.

Ray McClanahan, DPM, BS Ed, footdr@nwfootankle.com

RE: Life-long Maintenance Regimen for Onychomycosis (Carl Solomon, DPM)
From: Bryan Markinson, DPM

Dr. Solomon laments the lack of studies for exactly how little terbinafine we can give and still achieve efficacy. This has been beautifully done and published in 2004 in a very well known study on onychomycosis in the dermatology world but little known in podiatric medicine. I say “little” because even though I have written about it in several different venues for several years, podiatrists still react incredulously. I encourage all to read the following: Nardo Zaias, MD; Gerbert Rebell, MS, The Successful Treatment of Trichophyton Rubrum Nail Bed (Distal Subungual) Onychomycosis With Intermittent Pulse-Dosed Terbinafine. ARCH DERMATOL/VOL 140, JUNE 2004.
 
The study concludes that one 250mg tablet daily for seven days, repeated at three months intervals,(total of 28 250mg doses annually), is virtually as effective as 90 day continuous dosing. That’s 70% less drug and a two month and three week holiday between pulses. I will e-mail a copy of the study to anyone requesting it.
 
Bryan C. Markinson, DPM, NY, NY, bryan.markinson@mountsinai.org

RE: Post-Injection Hyperemia (Khurram Khan, DPM)
From: Philbert Kuo, DPM

About ten years ago, I  heard about this same problem with injecting the posterior tibial nerve with Marcaine. Since then I've only used Lidocaine.

Philbert Kuo, DPM, Chesapeake, VA, philbear@pol.net

RE: Exchange of Health Information Test (David Weiss, DPM)
From: Brad Shollenberger, DPM

I ran into a similar problem. Create a CCD file. I recommend using a fictitious "test patient." Email it to me at nohav@aol.com. I am currently using GE's CPS 9.5, which is certified. I'll try to import the data and let you know what happened.  Presto....EHR test.

Brad Shollenberger, DPM, Reading, PA, nohav@me.com

RE: Starting a Practice (Nicole Rubackin-Hayward, DPM)
From: Robert S. Schwartz, CPed, David Helfman, DPM
 
An excellent source of potential referrals is the pedorthists and comfort footwear retailers in your community. For the list of credentialed pedorthists, go to abcop.org and bocinternational.org. They will happily work with and refer to any podiatrist who demonstrates an interest in conservative pedorthic care.
 
Robert S. Schwartz, C Ped, NY, NY, rss@eneslow.com

I recommend that you find a mentor or mentorship program. Don’t try to figure this out on your own. It’s well worth the money to invest in your business education. I have invested well over $200,000 in business education. The Physician’s Business Academy will be holding 6 boot camp conferences. I have personally developed a mentorship program for new physicians that will be released next year in January.

What you are doing is not rocket science. It’s like your first bunion; it’s not easy, but once you get the knowledge, the rest will come. The key is to find a mentor or accountability partner who will hold your feet to the fire. I started a practice from scratch and I will give you a very secret ingredient and tip: “When you are not seeing patients, you should never be in your office sitting and thinking; you should be marketing 100% of the time!” That is what helped me get from zero patients to what I have created today and is the reason for my success. Call me on my cell 404-509-5454 and I can share with you my pearls that were the ingredients for my success!

David Helfman, DPM, Atlanta, GA, DHelfman@villagepodiatrycenters.com

RE: Why This Country is Going Broke (Dale Smith, DPM)
From: Todd Rotwein, DPM

In reference to my colleagues who have seen fit to comment on the issue: I think that their ire would be better directed towards the bankers who destroyed our economy with their subprime mortgages and credit default swaps.  You know, the ones who are still making eight- and nine-figure incomes. And once we're finished with them, we could then turn our attention to hospital CEOs, whose seven-figure salaries are subsidized with federal Medicare and Medicaid funds. Once those situations are under control, then by all means go after the poor who are gaming the system.

Todd Rotwein, DPM,  Hempstead, NY, drdpm@aol.com

RE: MN Podiatrist Supports Statewide Single-Payer Health Insurance System (Michael DeBrule, DPM)
From: David Secord, DPM

Besides the fact that the number of uninsured in this country was actually between 2 million and 6 million before Obamacare was instituted—since then, a considerable number of individuals have lost coverage due to the massive increase in cost—and not anywhere near fifty million is the absurdity that “healthcare is a basic human right” claim. Besides the long discussion, we could have over what constitutes a “right” versus a privilege, there is the obviousness of the reductio ad absurdum argument that if healthcare is a basic human right, certainly food, shelter, and clothing are basic human rights. According to the trolls at the UN, Internet access is a basic human right as well.

More to the point is that, in every instance where competition is eliminated, prices rise, production falls, quality suffers and inefficiency reigns. That is obvious, and we need go no further than the numerous examples in the federal government for ample proof. Also obvious is how the current (and past) level of over-regulation is deleterious to our economy. Expanding that to healthcare would give us the debacle that is Canada and England. Socialists love socialism and will continue to do so despite all evidence to the contrary.

David Secord, DPM, Corpus Christi, TX, david5603@pol.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 516 476-1815 PODO2345@AOL.COM

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 contactpistone@telus.net or call 250-754-4192.

EQUIPMENT FOR SALE - LASERSCOPE LASER SYSTEM

Laserscope Model Lyra i YAG Laser system with 3 handpieces, eyewear  sets, calibration unit, complete manual, foot control and video information, for fungus nails, vein therapy and hair removal.  The unit has the attached cooling system and all accessories. flpodiatrist@tampabay.rr.com

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 DPMfootcare@comcast.net

ASSOCIATE POSITION - ALBANY/CAPITAL DISTRICT AREA

Immediate position available with generous salary, fringe benefits and percentage. All phases of Podiatry. For more information please contact Dawn at (518) 828-6516 or fax your resume to(518) 828-9510.

ASSOCIATE NEEDED - NORTHERN CINCINNATI, OHIO (FAIRFIELD)

Lead to partnership &/or buy practice. Well-established, reputable & successful (700K collection annual) 25+ year practice. Newer 2k sq.ft office condo & w/5 tx rooms, Aver.80 new patients monthly, full hospital privileges, DME, Padnet, digital x-rays. Inquires to email: gsherwood@cinci.rr.com.

ASSOCIATE POSITION - BRONX, NY

Multi-office group seeks highly motivated, hard-working full-time associate. All phases of podiatry are performed (Surgery, Orthotics, NCV's, Vascular Examinations, DM Shoes, House Calls) in this well rounded practice. Competitive salary + malpractice insurance + bonus. Send CV to: bronxpodiatrist1@gmail.com

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 - 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 - SOUTHWEST FLORIDA

Immediate position for associate to partnership for a surgeon that is BQ/BC by ABPS. Must be a PSR-24 or PM&S-36 trained. 100K start. Must be ethical, self-starter, hard worker ,team player. Willingness to learn / work as part of a team. Great ancillaries & surgery facility. Must be proficient in rearfoot/ankle surgery. Email CV and recent cases to: susmitad86@yahoo.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

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

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