The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

December 16, 2011 #4,333 Publisher-Barry Block, DPM, JD

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High Fashion Shoes a No-No for Toddlers: NY Podiatrist

Podiatric surgeon Dr. Suzanne Levine of Lenox Hill Hospital says choosing the wrong shoes might make kids' feet suffer. "We are seeing a lot of 15-month, 16-month-olds, even in some celebrities who have these designer-type shoes on their little kids, with even little heels, which are clearly inappropriate," says Levine.

Dr. Suzanne Levine

"Maybe if it's just for photo-ops, I can see it, but you don't want your child in these fashionable shoes," says Levine. "When they can place both feet on the ground, they are somewhat stable. You want a shoe with a straight last. You want something that is not too heavy, not too light. The traditional tie shoes are probably best."

Source: Kafi Drexel, Your News Now [12/14/11]

Kent State and Podiatry College Could Merge by July

Trustees at Kent State agreed Tuesday to enter into exclusive talks with the podiatry school about the idea of folding the college into Kent State's operations. Officials with both parties have been in talks for months about a potential merger. Jacqueline Woods, chair of the trustee board at Kent State, said the agreement approved yesterday means Kent State will "enter into an exclusive arrangement with (OCPM) to continue due diligence that might ultimately lead to merger acquisition within six months of the first of the year." 

Dr. David Nicolanti

Dr. David R. Nicolanti, executive vice president of OCPM, told Kent Patch previously that the podiatry college had been considering partnerships with Ohio universities for several years to improve the clinical experience of its students. "A 40,000-student university offers some advantages a 400-student college does not," Nicolanti said.

Source: Matt Fredmonsky, Kent Patch [12/14/11]

OPMA Elects Officers for 2012

During the 96th Annual Ohio Podiatric Medical Association’s House of Delegates held in Columbus, OPMA elected new officers to lead the state organization in 2012.

Dr. David Hintz

President – David Hintz, DPM, MPH, CPH
First Vice President – Marc Greenberg, DPM
Second Vice President – Karen Kellogg, DPM
Secretary-Treasurer - Angelo Petrolla, DPM
Immediate Past President -  Alan J. Block, DPM, MS

Alan Block, DPM, MS received the Thomas J. Meyer Award. Bruce R. Saferin, DPM, who is retiring from the OPMA Board of Trustees, was recognized for 21 years of volunteer service on the OPMA Board.

NJ Podiatrist Conducts Holiday Toy Drive

Family Foot & Ankle Specialists, a podiatry office in Piscataway and Hillsborough, NJ is collecting toys for children in need. Each year, the office collects new toys for children whose families may not be able to afford a lot or anything at all during the holidays. An unwrapped new game, puzzle, book, or toy of any kind is appreciated.

Dr. Peter Wishnie

"Each year, we try to exceed our last year's collection," says Dr. Peter Wishnie. "Many families are struggling to pay their rent or mortgage and keep food on the table, so toys are a low priority."

Source: Jessica Gleason, mycentraljersey.com [12/14/11]

Query: Concierge Medical Care on Demand

A very interesting twist into the concierge side of medicine came to my attention this week. An orthopedic spine specialist I know started charging patients $300 for "same day, next day" appointments. He started concierge medicine on demand. This doctor normally has a 4 week wait for an office visit, and has for years scheduled his last patient at 4:20 p.m.  He bills 99050-GA and has the patient sign an Advanced Benefit Notification as to the cost of this service. He is earning an extra $5-8,000 dollars a week. Is this something to look at if your market can support it? What do others think?

Bret M. Ribotsky, DPM, Boca Raton, FL

RE: Increased Frequency of C Diff.
From: Paul Kesselman, DPM

I recently received this link from Beth Israel Hospital. It speaks of the significance of C Difficile, whether you treat patients in the hospital or are simply an office-based provider prescribing antibiotics. It is extremely important to review this posting and take the necessary actions as advised during this short presentation.

Paul Kesselman, DPM, Woodside, NY,  pkesselman@pol.net

RE: 8 y/o with Abnormal Gait and Calcaneal Apophysis (Mark Aldrich, DPM)
From: Stephen Musser, DPM, Barry Mullen, DPM

From what Dr. Aldrich describes, it sounds like Sever's disease. I would treat it as such i.e., NSAIDs, gait plate, ice, rest, and supportive footgear. Could Dr. Aldrich describe the patient's gait in more detail?

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

Dr. Aldrich raises interesting concerns over his 8 year old patient with bilateral heel pain. He indicates a subjective history from the mother that her child has always: 1) "walked funny" and 2) is currently in OT for upper extremity coordination issues. The questions that need answers are WHY and what's the presumptive diagnosis for this objective sign?

Dr. Aldrich notes a "slow gait" which could be related to the pain the child experiences in both heels, or perhaps, a more global, underlying systemic process that affects muscle coordination in the lower extremity, as observed in the upper. No other objective LE findings are listed, but what are the results of your LE neuro exam and muscle testing?

Frankly, there isn't enough clinical information to fully assess the heel pain complaint and whether it relates to other more obvious ongoing "whole body" issues or not. From my perspective, the larger issue is...

Editor's Note: Dr. Mullen's extended-length letter can be read here.

RE: Starting A Practice (Robert Bijak, DPM)
From: Michael M. Rosenblatt, DPM

I’m not sure I completely agree with Dr. Bijak’s opinion that practice management seminars are mainly “glitz and over-commercialization.” Often, new procedures, devices, and coding are discussed. When a practitioner segregates him/herself, this tends to result in repetitive care that is not sensitive to new standards. The last place you want to hear about your possible deviation from standard of care is in a court room, when you would have heard about it instead at a seminar years ago. And you should also go to mixed specialty seminars offered for MDs and DOs, where standard of care reaches a wider group of concerns.

An interesting example is absolute alcohol injection for neuroma. When I was in practice, cortisone injection, padding, and surgery were the standard of care. That has been replaced now with absolute alcohol injection in various dilutions. There are myriad other examples in wound care and grafting. So too is the issue of coding regulations, which change yearly. Old outdated codes can not only result in less income and returned claims, but could also put you into conflict with the law, especially if you use them repetitively.

Finally, there is the issue of “re-inventing” and refreshing yourself. This can successfully fight burn-out and exhaustion. Yes, it’s about money too. I always found significant increases in financial returns from my practice after I returned from various seminars, including practice management events. And I enjoyed them.

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

RE: This Country is Going Broke
From: Robert Bijak, DPM

I disagree with the those who blame the "rich CEOs." I'm happy to live in a country that gives us all the opportunity to make what others are willing to pay us without a ceiling. The real culprits are the unions.  Costs will continue to go up as long as the unions pay outrageous wages and benefits to minimally-skilled employees. The "Teamster" truck driver who delivers supplies to the hospital is making nearly a hundred grand; so are the UPS workers, police, teachers, etc. Is it because they're so skilled or because of union extortion and threats? The unions raise healthcare costs, not the CEOs.  

Robert Bijak, DPM, Clarence Center,NY, rbijak@aol.com

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

I am curious what the sources are for Dr. Secord's statistics. Both the Census Bureau and the Center for Disease Control put the 2009 uninsured at about 49 million and the 2010 number at 49.9 million. While these numbers are difficult to pin down with exactitude, the 2 - 6 million range seems very far off the mark. Dr. Secord goes on the say, "in every instance where competition is eliminated, prices rise, production falls, quality suffers, and inefficiency reigns." This would suggest that when competition is unregulated, prices would be stable or fall, and the systems would be efficient. Well that certainly has not been the case in healthcare for the past 20 years.

Proper solutions to complex problems are rarely achieved by making black and white ideological judgments. The deregulated financial system of the past decade should serve as a potent reminder that good public policy and free market goals are not always aligned. We can identify as many examples of regulatory actions that have resulted in vital improvements to our well being as a society as we can where regulations have had deleterious effects. Painting them all with the same brush is short-sighted and counter-productive.

Jason Kraus, Deer Park, NY, jason.kraus@langerbiomechanics.com

RE: A New Question for Your Employment Application?

After interviewing about 15 people for a back room assistant's job, we hired a nice young lady who started on Monday morning at 8 A.M. She went out to lunch at 12:30 and called the office at 1 P.M. saying that she quit. She explained that she loved our office and staff, but never realized that the sight of feet made her sick to her stomach; and as much as she would like to try it, she didn't think she could handle it and was getting nauseated thinking about coming back for the afternoon.

In the future, we will ask all potential employees, "Can you stand the sight of feet?" and require at least 4 hours of employment before their pay kicks in.
 
Burton Katzen, DPM, Temple Hills, MD

Codingline & PM News
In conjunction with AAPPM Present
The Greenbrier Coding & Practice Management Workshop
(Following the 2012 APMA Annual Meeting in Washington, DC)  August 20-22, 2012

The Greenbrier

Click Here for information  or  to Register

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 - 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 - 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

ASSOCIATE POSITION - NEW MEXICO

Exciting opportunity for an associate in sunny Albuquerque, New Mexico. Please visit our website at FamilyFootTeam.com for all the details and how to apply.

ASSOCIATE POSITION - TEXAS

Practice in Houston is looking for PSR 24/36, BE/BC trained doctor. We are situated in an affluent area with a large medical community with EMR, diagnostic ultrasound, digital x-ray, multi use laser and our own surgery center. We seek a highly skilled surgeon, well-trained in trauma, wound care and rear foot reconstructive procedures willing to learn and incorporate into our “system.” Must be outgoing, goal-oriented, motivated and positive.  Partnership available after successfully attaining the first year’s goals.  Compensation includes excellent salary, health benefits, paid vacation and CMEs.  Please send CV, references and letter of interest to faajobs@gmail.com  

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 - 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 - 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 - 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

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