The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

December 17, 2010 #4,039 Publisher-Barry Block, DPM, JD

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NY Podiatrist Says Ugh to UGGs Shoes

UGGs can be ugly to your feet and ankles, causing pain and throwing your walk out of whack so problems extend to the knees, hips and back. The plush lining also can create an ideal breeding ground for foot fungus. "UGGs have little to no arch support," explained Krista Archer, a podiatrist and foot and ankle surgeon in Manhattan.

Dr. Krista Archer

Archer is especially  worried about the boot's roominess in the ankles and heels now that the boots are popular with both tweens and toddlers. "Kids seem to shuffle around in them," she pointed out. They make that irritating foot-dragging sound called the "UGG shuffle" by the Urban Dictionary. Skin infections like athlete’s foot and dermatitis also can be a problem with UGGs, Archer adds, since bare feet can really sweat in the fur. She urges devotees to wear socks and spray the liner with an anti-fungal spray once a month.

Source: Cari Nierenberg, The Body Odd @MSNBC.com [12/13/10]

TUSPM Martial Arts Club Incorporates Biomechanics Into Training

The TUSPM Martial Arts Club (TMA) was founded to merge studying anatomy while getting the workout that students claim they don’t have time for.  The Martial Arts Club, or “Fight Club” as it has been nicknamed, is led by Rikhil Patel, and fellow second year student, Joseph DiStefano. Being black belts in their respective disciplines, they are able to teach various techniques of different martial arts to their classmates, providing a non-contact martial arts workout and social outlet for anyone interested to have fun.

TUSPM Martial Arts Club

The club has grown from 5 people training in an apartment to 30 members strong with club dues, elected officers, and a wide variety of striking pads. The use of anatomical terms in their commands keeps their surgical minds fresh while promoting martial arts appreciation.  For example, “Plantarflex your toes and extend your knee as you hit the sternum with the dorsum of your foot.” A typical session starts with cardio and stretching, then goes through basic punches, kicks, or blocks, and finally challenges that test physical fitness. Disciplines include Karate, Taekwondo, Muay Thai, Capoiera, Boxing, and Savate.

NJ Podiatrist Hopes to Collect 500 Pairs of Socks By Christmas

Dr. Paul Scollo has been collecting new Socks for distribution to the homeless through his Fairfield and Hasbrouck Heights, New Jersey offfices. With the help of family, staff, friends, patients, fellow podiatrists and even strangers, he hopes to reach a goal of 500 pairs of new, warm socks by Christmas.

Dr. Paul Scollo and his wife Mary Ann (R), his daughter Jeanne-Marie, and his son, Paul, Jr.

"We started the program last year at the suggestion of my wife, Mary Ann, and everyone thinks it's a great idea. We are networking with the Felician College youth group who collect all sorts of items for those less fortunate men, women, and children."

Obama Signs Doc-Pay Legislation

President Barack Obama has signed the Medicare and Medicaid Extenders Act of 2010 (PDF) that delays for one year a 25% reduction in Medicare payments to physicians. The cut would have gone into effect Jan. 1, 2011.

The cost of delaying the payment cut and extending the current rates for 12 months is estimated at $14.9 billion. This expense will be paid for over a 10-year period by raising caps on how much individuals and families must return if they receive overpayments from healthcare affordability tax credits.

Source: Andis Robeznieks, Modern Healthcare [12/15/10]

CMS Wants Input on EHR User Registry

The CMS is taking public comments on a proposal to set up a registry of meaningful users of electronic health-record systems under the American Recovery and Reinvestment Act.

To be formally called the Medicare and Medicaid Electronic Health Record Incentive Program National Level Repository, the listing will include the names of participating physicians, other eligible providers, hospitals, critical-access facilities and Medicare Advantage organizations, as well as their National Provider Identifiers, business addresses, phone numbers, taxpayer identification numbers, CMS certification numbers and other information as specified by the CMS, according to a notice published in the Federal Register. 

Source: Joseph Conn, Health IT Strategist [12/15/10]

Change Your Attitude About Complaints

Patient complaints are a good thing, so why are they so hard to accept? Statistics make clear what you already know: Only 4% of upset  patients complain—the other 96% just walk away. And because it costs six to ten times more to obtain a new patient than to retain a current one, you need to cherish each patient complaint as the money-saving, business-building opportunity that it is.

Tip: Don’t tell yourself, “The patient is always right.” That implies that you are wrong. Instead, remember that the patient is always the patient. Because you value each patient, you need to do what it takes to resolve every complaint.

Source:  Adapted from “Tips to Create the Right Mindset About Complaints” via Communication Briefings

Query: State Regulation for Off-Label Use of Products

I received a letter from my NH State Board of Podiatry telling me that "a podiatrist may only promote the use of a laser to treat toenail fungus that has been specifically cleared by the FDA for such use."  They then go on to state that the PinPointe FootLaser is the only such laser and that no other laser may lawfully be promoted for this specific claim.

My question is simply this: If you are promoting laser treatment of toenail fungus, be it cold laser, hot laser, or Vbeam laser, etc., how can a state come after you for using something off-label as long as you do not say it is FDA-approved for such treatment? As long as you are not misrepresenting what you are doing, where is the legal issue?
 
Peter J. Bregman, DPM, Tewksbury, MA

RE: Austin Complication (Multiple Respondents)
From: Gino Scartozzi, DPM

I believe that surgeons should perform what their comfort levels dictate. If you want to draw the osteotomy with a marking pen, use a guide wire, or use a osteotomy guide, that should be dictated by what works "best" for that surgeon. I would like to rebut and clarify certain positions put forth by Drs. Morelli, Kass, and Young in their posts for the sake of academic debate.

1. Dr. Morelli states that...

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

RE: Aging Practitioner Name Withheld (NM)
From: David E. Gurvis, DPM

This is a sad situation and one that may face many of us in due time. We all hope we have the sense left to know when we are a danger and should stop treating patients, but some of us may not.

If you have already taken reasonable steps including talking with the doctor himself, involving family members, and so on to no avail, I would see nothing left to do but to report him to the podiatric licensing board and let them take the appropriate steps to counsel him or, if necessary, revoke his license. This can, or will be a devastating blow to this podiatrist but it is necessary in this case.

Hopefully, since even without a license, he may still legally own the practice, your position will be safe, and any payouts due can be handled with his family.

David E. Gurvis, DPM, Avon IN, deg1@comcast.net

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

Name Withheld had an unusual request from a defense attorney for a DUI episode in which the police officer used a "walk the narrow line" method to determine intoxication. The defendant was wearing old (5 years) tattered orthotics, which allegedly affected the gait at the test. Defense attorney hopes to use that argument to vacate the DUI charges.
 
The podiatrist who originally prescribed them is now being called upon to provide some kind of testimony or verification that this occurred. The defense attorney is only doing his/her job. He is required by law to do everything (legally) possible to get his client off. But by any metric you choose, the argument is a "stretch."  It is far more likely that very high heels would obstruct gate more than warn orthotics. The podiatrist can be forced to testify by subpoena, but chances are this would not occur without prior knowledge of how you would testify. (Which side) If there were a death involved, this could occur.
 
You should tell the family your opinion. Don't expect them to be pleased by it. But I wouldn't mention anything about your daughter's friend's tragedy. It's not really relevant. You should remain in your best professional demeanor in discussing it with them, and stay as technical as possible, suggesting that there are "no studies" that support their argument, etc. It would be vital to have some literature verification, because no matter how you testified, you would be challenged. 
 
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

You might want to point out that orthoses are intended to IMPROVE gait, not impair it.

Paul Busman DPM, RN, Clifton Park, NY, paul@busmanwhistles.com

I completely understand your response. I have been a member of my local fire department for over 25 years and have been in the middle of these tragic scenes too many times. The attorney is just doing the job he is hired to do. However, because of our knowledge with biomechanics and the use of orthotics, most of us (I hope) would recognize that the attorney doesn't have a case. An unfortunate fact in our country is that people don't want to take responsibility for their actions. 
 
Sam Pearlstein, DPM, Fayetteville, NY, sbpdpm@hotmail.com

RE: Bad Review by Patient on the Internet (Name Withheld)
From: Gary Ignotofsky
 
Although it may not be possible to "remove" a damaging and untrue review posting on the Internet, there are several ways to combat it.

1) Ask some of your patients to post favorable reviews on the same review site. Their reviews should mention your name and your practice name. Review sites typically list postings chronologically. With some luck, the negative posting will get "buried" out of plain sight.
 
2) Ask different patients to post reviews on other review sites. Be sure to ask them to use your full name and the name of your practice in their reviews which will help create additional search engine results for you.
 
3) Post a press release through one of the many free press release sites which states your practice name, your name, along with a short write-up about your practice. Perhaps you could mention a new technology or treatment modalities that you have recently introduced into your practice.
 
4) Produce a series of web videos about your practice and have them syndicated (uploaded) across 15-20 search engines which will dramatically increase your web presence and search engine listings. Be sure to include your name and your practice name in the uploaded video titles, descriptions, and tag words. These videos will also enhance the performance of your website when strategically placed on the appropriate pages.
 
Gary Ignotofsky, Web Power Video, videop@hotmail.com

RE: House Vote Sends Doc-Pay Bill to Obama (Nicholas Sol, DPM)
From: Marc Katz, DPM

This is made out to be some big victory for us. Granted the APMA does many wonderful things for us, but this is a joke on us! How numb can we be? Can you imagine if you worked each year and your employer told you that there was good news. You're not going to get a 23% cut this year, WOW! There would be walkouts every day. We should be up in arms about this. I'm tired of getting legislative urgent emails to contact my senator to avoid a cut. Who is in control here? Not us, as we should be.

I would like to see the APMA build a campaign to help podiatrists feel empowered enough to know that they deserve more for what they do. Do we have such low self-esteem to think we don't deserve more? We need to demand more and stop lowering the value of our services.  Podiatrists need to take control of their own destiny. Find a niche area and start converting some of your patient services to cash. People want your services regardless of insurance. They know that they will rarely meet their deductible, so they will pay for valuable services. Do you provide high value services? It's all what you believe about yourself and what you provide! 

Marc Katz, DPM, Tampa, FL, dr_mkatz@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

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  -  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

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

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 - 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 - 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 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.

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