The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

December 16, 2010 #4,038 Publisher-Barry Block, DPM, JD

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Patients Will See Fungal Nail Improvement From Lasers: NJ Podiatrist

For many people, toe nail fungus is embarrassing, but for Susan Herbst, it hurts. "Especially if I wear a shoe with pressure, with a sock or a stocking would catch on it and it becomes uncomfortable," Herbst said. Herbst is undergoing Pinpointe foot laser treatment. The laser uses heat to kill her toenail fungus. It's quick and pain-free. Topical creams don't have a high success rate and some oral medications come with serious health risks, including liver damage.

Dr. John Cozzarelli

Studies show the laser treatment is up to 85 percent effective. "You'll see improvement; it's just a question of how much it's improved and what the patient is looking for," said Dr. John Cozzarelli, a podiatrist. The average cost for laser treatment is around $1,000 plus follow-up treatments. Insurance doesn't cover any of it. Herbst says it's worth it.

Source: Allen Mask, MD, WRAL-TV [12/13/10]

TUSPM Organize First Annual Leadership Training Conference

This year, the student leaders of Temple University School of Podiatric Medicine opted to host their First Annual Leadership Training Conference for the voting members of the Student Council. The goal of the conference was to acquaint all student leaders with one another, facilitating a sense of community among student organizations, as over the last few years cohesion seemed to be lacking. Cohesion needs to be built from somewhere, and it was agreed that there was no better place to start than with the leaders on campus. Those individuals can then “lead by example,” and the hope was that a greater sense of community on campus would begin to grow.

TUSPM students participate in the "Crossing the River," activity which reinforced the concept of working together as a team (Photo: Jen Mulhern)

In its first year, devising a structure for the conference and organizing lectures and activities proved to be a challenge for the Co-chairs: Aaron Corfield (2012), Jordan Meyers (2011) and Jennifer Mulhern (2011). However, when the conference concluded, the feedback from involved students and lecturers was very positive and provided a good base for the conference in years to come!

Source: Jen Mulhern, Strides [Winter 2011]

MT Podiatrist Appointed to State Podiatry Board

Nathan B. Thomas, DPM has been appointed by Montana Governor Brian Schweitzer to the state's Board of Medical Examiners. Dr. Thomas also serves as the president of the Montana Podiatric Medical Association.

Dr. Nathan B. Thomas

Thomas is a 1993 gratuate of the Temple University School of Podiatric Medicine, and lives and practices in Missoula, Montana.  

Source: Strides [Winter 2011]

Judge Orders AZ Podiatrist to go Through Competency Program

Judge Howard Fell ordered Corina Hollander to participate in the jail's restoration-to-competency program Monday after learning one of two doctors who evaluated her think she's incompetent to stand trial. The Tucson podiatrist was charged with prescription fraud charges ranging from conspiracy and participating in a criminal syndicate to fraud, trafficking in the identity of another person, forgery, and acquisition of a narcotic drug by fraud.

At the time of her indictment, Assistant Attorney General Christina Vejar said Hollander progressed from writing fraudulent prescriptions for a painkiller and anti-anxiety drug for co-workers and roommates to writing fraudulent prescriptions in patients' and family members' names.

Source: Arizona Daily Star [12/13/10]

Hire the Right Person to Collect Patient Fees

You want to make sure the person you hire to make payment arrangements and follow-up collection work doesn't have misgivings about the task. A lot of people do. Consider asking job applicants: "How do you feel about asking people for money?"

You may be surprised by the number of people who, by their facial expression or words, find it distasteful. It's counter-productive to hire someone with a great resume but who can't handle the emotional realities of the job.

Source: Bob Levoy, 222 Secrets of Hiring, Managing, and Retaining Great Employees in Healthcare Practices.

Query: Neuroma in 14 Year Old

I have a 14 year old patient who appears to have a neuroma at the third interspace of the right foot. In 15 years of practice, I've never seen a patient have a neuroma at such an early age. Orthotics, injections, and met pads have not alleviated the pain. Any suggestions?

Michael Levy, DPM, Santa Monica, CA

Query: Aging Practitioner

I am an associate who is working with a 70 year old practitioner who is in failing health. He is blind in one eye, is in congestive heart failure, and is showing signs of dementia. He refuses to slow down, forgets that he has seen certain patients, and still insists on performing surgeries. I am worried that he will put himself in a precarious situation and harm a patient. Does anyone have any suggestions as to how to handle this type of situation?
 
Name Withheld (Albuquerque, NM)

Query: Miltex Cryo Solutions

Does anyone have any experience with the use of Miltex Cryo Solutions?
 
Mark Grusso, DPM, Phillipsburg, NJ

RE: Austin Complication (Barry Mullen, DPM)
From: Simon Young, DPM, Sloan Gordon, DPM

I read Dr. Jacobs' response, and although I utilize a dorsal incision, I have seen no untoward complications from colleagues who have used a medial approach. I further agree with Dr. Jacobs' suggestions to use a saw bone and create an Austin osteotomy and see what happens laterally. You definitely would be surprised ("Ignorance is bliss").

I reviewed Dr. Scartozzi's extensive letter and suggest he use an axis guide in relation to the second metatarsal. It will solve many problems and avoid guesswork with raising or lowering his arm. I usually make my axis perpendicular to the second met. and slightly plantarflexed on the frontal plane (this allows for plantarflexion with lateral translocation). You can orient the axis distally or proximally to allow for shortening or lengthening.

Simon Young, DPM, NY, NY, simonyoung@juno.com
 
I agree with the opinions expressed by Drs. Jacobs and Scartozzi, both of whom make excellent points. I would, however, add one pearl. I cut the plantar limb of the osteotomy first with an oscillating saw and make sure it's in the transverse plane. The second cut (dorsal) is made with a sagittal saw, and I feather the blade back and forth to achieve the desired amount of plantarflexion. A 'neutral' position can be maintained without the feathering, if desired. Then, I use an osteotome to free the head and any remaining soft tissue attachments. Finally, I translocate the capital fragment before using a C-arm to note the position.

In my opinion, the Austin is a very versatile osteotomy and can achieve shortening, lengthening, and even de-rotation in some instances. Those unfamiliar with the procedure should use one of the guides or templates.

Sloan Gordon, DPM, Houston, TX, sgordondoc@sbcglobal.net

RE: Austin Bunionectomy Complication
From: Multiple Respondents

I also found the comments of Dr. Mullen to be the diametric opposite of my experience of the medial approach. I'll admit that approximately 99% of the bunion deformities I encounter are handled in my hands by only three procedures: Scarf with Akin; Lapidus with Akin, and Fowler with Akin (with the occasional McKeever). All are done with a medial approach. I even do a medial approach when putting in an implant. The lateral release is done between the sesamoids and the met head, reducing dissection. Skin is closed with 5.0 Monocryl as a running subcuticular. Quarter inch Steri-strips are placed over the incision, and the sutures are allowed to resorb.

I allow partial weight-bearing immediately and allow full weight-bearing for my Scarf procedures in a soft shoe or tennis-type shoe in one week. Following recent orthopedic literature, I allow weight-bearing on the Lapidus after a period of two weeks and do the same for the Fowler. I never use a tourniquet and haven't used one since my residency--except for Charcot reconstructions--and see minimal edema and minimal pain and have never had a dehiscence since I stopped doing elective procedures on smokers.

Once healed and remodeled, most patients would be hard-pressed to point to where the incision was, and so the cosmetic result is wonderful.

David Secord, DPM, Corpus Christi, TX, david5603@pol.net

I completely agree with Dr. Jacobs, although with my fare share of patients with wound dehisence, I tend to err on the side of caution and I keep my sutures in a bit longer (sometimes three weeks), especially when using a running stitch or skin staples, as I find they tend to need the extra time.

Although I think I know what Dr. Scartozzi was trying to say, I dont agree with...

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

I would like to respectfully disagree with some points Dr. Scartozzi makes with regards to translocation of an Austin bunionectomy.
1) If the dorsal and plantar cuts are truly made at 60 degrees, I find it just as easy to translocate the capital fragment laterally whether going straight across or whether going in a medial proximal to distal lateral direction. The problem with translocation in this direction is...

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

RE: Orthoses and DUI (Name Withheld)
From: Multiple Respondents

Send the lawyer this: "There is no clear-cut podiatric medical information that would show a worn orthotic would cause an intoxicated staggering gate." Then tell him that  you'd be willing to testify to that fact.

My sympathy for the grief your daughter and her roommate's family are going through.

Michael Rothman, DPM, Oak Park, Il, michael_rothman@comcast.net

The stories that you hear never cease to amaze me. Since most readers are not attorneys, I  suggest that anything involving legal issues should involve an attorney. My non-legal viewpoint would be that  you can deny the request, telling the attorney you will not write such a letter as the request is absurd and not valid in your view.
 
Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

From time to time we all get requests from patients to assist them in justifying some element of dishonest behavior. In some cases, it's a request for a handicapped parking sticker for a patient who has a callus on his or her left fifth toe. In other cases, it's a request to document that "Joe Schmoe" is too sick to work and needs to collect disability checks, and we know that he will use his new-found spare time to be on the golf course every day. The list of requests for bogus documentation is endless.

On one hand, we feel obligated to help a patient who is loyal to us. On the other hand, we need to be moral and just. We also need to protect our own reputations. The case of the drunken driver blaming his arrest on old orthotics deserves to be under the heading "you can't make this up." There isn't a podiatrist who could ever testify in court that the pattern of  gait caused by alcoholic inebriation appears anything like an abnormal gait pattern caused by ill-fitting orthotics. Even if the guy had thumb tacks sticking through his orthotics, it would bare little resemblance to a guy swaggering out of a bar on New Year's Eve. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

ASSOCIATE POSITION  -  WILMINGTON, DELAWARE 
 
Largest Practice in Delaware - well organized eight doctor multi-office practice. Seeking PM&S36+ trained podiatrist who wants to perform rear-foot surgery, EMR/Digital X-rays/PADnet/Ultra-sound/Surgery Center, etc. Associated with a PM&S36+ residency program. Call Chris Savage, DPM 302-658-1129.

ASSOCIATE POSITION - SAYREVILLE, NJ
 
Part time position for growing second office, 8 hours a week. Potential for growth and more days/hours. PSR/36 preferred. Can start immediately. E mail CV to advancedfoot1@aol.com

ASSOCIATE POSITION - MICHIGAN - (OAKLAND COUNTY)

Outstanding opportunity for associate in well-established practice, general & surgical podiatry forefoot, rearfoot & ankle (full or part-time). Well-trained, responsible, motivated with good communication skills, ABPS qualified or better. Send CV & letter of interest to: PodiatristWanted@AOL.com. All replies kept strictly confidential

ASSOCIATE POSITION - TAMPA BAY AREA

Excellent opportunity to join a well established multi-office group practice in the Tampa Bay area starting July 1, 2011. We are seeking a hard working, ethical and outgoing physician with Florida license.  Salary commensurate with training plus benefits. Please email or fax CV. podiatryfl@yahoo.com 813-254-8262.

ASSOCIATE POSITION - NEW YORK CITY

One of the fastest growing podiatry practices in New York City and Queens seeks a podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Preferably a Spanish speaking podiatrist. Contact me at Podocare@aol.com

PART-TIME/FULL-TIME PODIATRIST NEEDED - INDIANA

Part-time full-time Podiatrist needed for our Indiana offices. Must have Indiana license. Must have completed two years of surgical residency. If qualified email to f-massuda@footexperts.com

PART-TIME / FULL-TIME PODIATRIST NEEDED ASAP - CHICAGO

Part-time podiatrist needed for 2 offices in Chicago with an average of 20 hours/week. Must have Illinois license. Must have completed 2 years of surgical residency. If qualified, email to: A-Storjohann@footexperts.com

ASSOCIATE POSITION - CT (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 and current photo to Dr.Kassaris@yahoo.com. Applications due by Jan 31st.

ASSOCIATE POSITION – LONG ISLAND

FT/PT Associate position available with busy multi-office podiatry group on Long Island. Our practice is state-of-the-art, and encompasses all phases of podiatric care. We welcome new practitioners, or someone who would be open to merging a smaller practice with ours, and benefitting from our practice management overlay. We also invite residents graduating in 2011 who want to practice on Long Island to apply for this position. Compensation includes competitive salary and bonuses. Vacation pay and malpractice insurance are also offered with a full time position. Please send your CV by fax (631) 293-3462 or e-mail to mets724@gmail.com

ASSOCIATE POSITION – NEW YORK

Busy, well-established for 35 years, multi-site practice in upstate New York looking for licensed podiatrist who is ready for a thriving practice. Must be highly motivated, personable and great with patients. Competitive salary and benefit package. Send CV or letter of interest to associateinfoot@yahoo.com

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION - DAYTON, OHIO

Join a well-established modern practice with an excellent reputation and referral base. Base salary $100,000 and benefits with a bonus structure. EMR, diagnostic ultrasound, all aspects of DME, Padnet vascular studies, and CO2 lasers. We seek a surgeon that is well trained, personable and motivated to join our group of 3 Podiatric Surgeons. Would like this individual to buy in the practice eventually. Please send resume and photo to ohiodoctors@aol.com

IMMEDIATE OPENING - GEORGIA

Multi Office Specialty Group seeking a Qualified, Motivated, Surgically-trained Board Eligible/Certified Podiatrist to join our Practice. Must be licensed in the State of Georgia. Salary and Benefits commensurate with experience, etc. Interested Candidates please forward updated CV to: Executiveinfo1@yahoo.com

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Immediate opening. Well-established multi-office practice with EMR, Digital x-ray, and more. Seeking full-time associate with PM and S-36 training. Independent and highly motivated. Must be BC/BS in rearfoot and ankle with confidence in complex reconstructive cases. Full benefits package, competitive salary. Email CV to: JLH459@aol.com

BOSTON UNIVERSITY LIMB PRESERVATION FELLOWSHIP PROGRAM

Boston University Medical Center has a accredited fellowship position. Become an expert in Limb Preservation, Tissue Repair and Regeneration. Be part of this unique Fellowship at a major teaching facility. During this time, you would be expected to become a knowledgeable expert who will contribute significantly to research, surgical procedures, teaching, and innovation. Requirements: Completion of a two or three year surgical residency; Candidate must possess a commitment to an academic career in Podiatric Medicine and Surgery. Submit a CV and letter of interest to: Erin Springhetti erin.springhetti@bmc.org and  Dr. Vickie Driver Vickie.driver@bmc.org or if questions call 617-414 6821.

PRACTICE FOR SALE - MARYLAND, DC SUBURB

Own your own practice and be your own boss. Great opportunity. Retiring after 38 years in practice at the same location. Practice is fully equipped with digital x-ray, diagnostic ultrasound, computer network, orthotic scanner and state licensed ambulatory surgical center. Owner will stay on as needed for easy transition. dpmpracticeforsale@yahoo.com

PRACTICE FOR SALE - BOSTON, MASSACHUSETTS

40 year old updated practice with outstanding potential. Within 5 miles of Boston hospitals and 5 blocks from train station. Buy the practice, equipment and goodwill for a reasonable price. Excellent opportunity for resident or second location for practicing podiatrist. Multiple referral sources. Email vshdeep@yahoo.com

PRACTICE FOR SALE SPACE TO SHARE - MANHATTAN

Lic. podiatrist with an active practice to share space in a State-Of-The-Art professional medical office in the Midtown area. Newly renovated, modern office with spacious Tx rooms with cherrywood cabinets and granite countertops. X-ray equipment on site. Please call Dr. Robert H. Singer @ 212-921-5775 to view space.

PM News Classified Ads Reach over 12,500 DPM's and Students

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