The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

December 18, 2012 #4,641 Publisher-Barry Block, DPM, JD

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Stilettos Dangerous for Pregnant Women: Aussie Podiatrist

Experts say glamorous celebrities like Jessica Simpson are setting a bad example for pregnant moms. Australian Podiatry Association delegate Brenden Brown said pregnant women need to be aware of the dangers of wearing stilettos, despite what celebrities do. "Wearing high heels at any time is an injury risk but this is significantly increased when pregnant, particularly in the later stages as you gain weight and body mass, which affects balance and puts stress on the feet and ankles.

Brenden Brown

"Such hormonal, physical changes also put strain on the lower back making this combination hard on the feet. Adding a pair of high heels to this mix is therefore an absolute no-no and should be avoided."
 
Source: Kieran Banks, Daily Mercury [12/14/12]

CA Podiatrist Volunteers at Women’s Free Homeless Clinic

On any given Wednesday night, rain or shine, Pershing Park transforms from a simple park into a bustling congregation of doctors, nurses, other volunteers, and folks in need of food and medical attention. A similar transformation happens most Fridays on East Ortega Street, when the Women’s Free Homeless Clinic opens its doors to women in need of everything from food and supplies to medical attention and counseling.

Dr. Joseph Pineda

Occasionally, men can be found at the Women’s Free Homeless Clinic, including Dr. Joseph Pineda, who goes by “Dr. P.” to the patients. A UCSB graduate and a podiatrist, Dr. P. volunteers his services free of charge. “I just show up and take care of everything that I can. Do what you can do, you know?” The women at the clinic all speak highly of Dr. P., as well as of the entirety of the volunteer staff.

Source: Catherine LaFunte, Santa Barbara Independent [12/15/12]

FL Podiatrist's Orlando Restaurant Tops Zagat Rankings

In a David-and-Goliath-like showdown, Cress restaurant in downtown DeLand received the top spot in Zagat Survey's 2013 Orlando City Guide, which includes rankings of restaurants in the greater Orlando area. Cress nosed out the posh Victoria & Albert's in Disney's Grand Floridian Resort & Spa for top honors in the area, although the latter took top honors for service.

Executive Chef Hari Pulapaka and Dr. Jenneffer Pulapaka

"We're elated about the ranking," said Executive Chef Hari Pulapaka a tenured math professor at Stetson University who co-owns the eatery with his wife, Dr. Jenneffer Pulapaka, a podiatrist with a practice in DeLand. "It's gratifying that enough people think we're worth trying. I'm proud of our team, and it's always a good thing to bring attention to our community." His wife echoed the sentiment. "It's excitement for a job well done," she said. "We're humbled when looking at the group we're in."

Source: Joe Crews, Fort Pierce Hometown News [12/14/12]

Editor's Note: PM News is to present excerpts from Meet the Masters

Bret Ribotsky: How often do you see a diabetic patient with an ulceration?

Dr. Marc Brenner

Marc Brenner: I start with seeing the patients twice a week. The idea of once a week seems to be common from how most podiatrists were taught in our podiatric schools. This is not based on what’s best for the patient. I see patients with ulcers twice a week because I am focused on saving their legs. This helps with compliance and it is very important on the road to recovery.

(clockwise) Drs. David Armstrong, Lowell Weil, Sr., and Glenn Gastwirth

Meet the Masters is broadcast each Tuesday night at 9 PM (EST). This week's show will feature a  year-end wrap-up with Drs. David Armstrong, Glenn Gastwirth, and Lowell Weil, Sr. You can register for future events by clicking here

Physician Burnout Decreases With Shorter Trainee Rotations

Shorter, 2-week clinical rotations appear to be similar to 4-week rotations with respect to patient revisits within 30 days (a measure of patient care). They may decrease burnout and stress among attending physicians on the internal medicine wards, who are training house staff and medical students, according to a new trial.

Brian P. Lucas, MD, from the Department of Medicine, Cook County Health and Hospitals System and Rush Medical College, Chicago, Illinois, and colleagues report their findings in an article published in the December 5 issue of JAMA. According to the researchers, although some variation exists among hospitals, there is a current trend for attending physicians to be assigned to ward teams for the purposes of training for only 2 continuous weeks, which is approximately half the previous standard duration.

Source: Emma Hitt, PHD, Medscape News

Query: Foot Powder for In-office Dispensing

Is there a company that sells moisture-absorbing foot powder which can be dispensed out of the office?

Jason M. Grossman, DPM, Old Bridge, NJ

RE: Year-End Use of HSA Accounts
From: Keith L. Gurnick, DPM

Remind your office staff (and maybe post a small sign at the checkout station) that if your patients have an HSA card, with remaining money that expires if unused, the card can be used to purchase necessary medical supplies that may not be covered through insurance, but are
prescribed by the doctor. For such supply items to be covered, even when they are OTC, they must be prescribed by the doctor and purchased by the patient for use by that patient for a medically necessary condition, which can include skin conditions of the feet.

I have patients who use their HSA to purchase 2 or 3 sets of orthotics at the end of the year. It is important to "run" the card right away for the amount you are charging, to ensure that the    money is actually in the account. Patients usually know how much is remaining, but sometimes they can be mistaken. Just yesterday, one of my patients bought a dozen footbuffers with an HSA card ($90).

Keith L. Gurnick, DPM, Los Angeles, CA,  keithgrnk@aol.com

RE: Efficacy of "Pain" Creams (Tip Sullivan, DPM)
From: Gerald I. Falke, DPM

Through the years, I have had similar skepticism of topical 'pain' medications, finding that their efficacy, if any, was short-lived. Recently, however, my wife had a reaction to a fluoroquinolone dispensed for a URI, developing a rapid-onset, crippling, bilateral acute Achilles tendonitis. Those of you who have had experience with this malady recognize that there is no predictable nor particularly effective treatment. The lucky ones get better, many do not.
 
In desperation, in an online search for DMSO, I found an interesting product - Soothanol X2 - a topically-applied liquid using DMSO as its vehicle base with some 11-12 other ingredients, including emu oil, limonene oil, olive oil, cayenne, menthol, St. John's wort, MSM, and arnica. Application of only 2 drops rubbed into the Achilles tendons produced dramatic, almost instant relief of her tendon pain. It is marketed by NorthStar Nutritionals primarily for arthropathy and neuropathy. A small bottle costs around $50 and can only be purchased online (Google Soothanol X2 for more info).
 
I wish I would have known of this product while I was still in practice. Many of my patients may have benefited. For my wife, it was a game-changer. I recognize that this is a purely anecdotal experience, but I would be interested to hear of others' experiences with similar DMSO products. 

Disclaimer: I have no financial interest in the company.
 
Gerald I. Falke, DPM, retired, Hagerstown, MD, falkeg@hotmail.com

RE: Efficacy of "Pain" Creams (Tip Sullivan, DPM)
From: Joseph Crisafulli, DPM

I've been using compounded medicine for many years now. I find that my patient's appreciate the safety profile, namely the lack of drug-drug interactions, and side-effects commonly seen with oral administration. Having said that, inherently patient compliance seems to be quite high. I personally found compounding to be an excellent adjunctive treatment in many commonly-seen podiatric conditions, e.g., shin splints, neuritic conditions, inflammatory mediated conditions, and in PVD, to name a few.

As for the cost profile, like many other drugs today, compounded drugs are covered by some carriers (fully or partially), and non-covered by other carriers. However, many compounding pharmacies do have a "need" program. My practice is similar to that of many of my colleagues. Today, I seem to find myself writing fewer prescriptions for narcotics. As a result, I find myself writing for more compounds.

As to compounding and its efficacy, I refer you to the literature found in many of our colleagues' journals, where you will find all the details you truly need. Or discuss it with your local rheumatologist, pain management specialist, physiatrist, or dermatologist.

Disclaimer: I am a consultant for Bellevue compounding pharmacy.

Joseph Crisafulli, DPM, Albany, NY jacpod@nycap.rr.com

RE: The Doppler an Integral Part of a Podiatric Practice
From: Ed Cohen, DPM

The office Doppler can be an invaluable aid to diagnosing PAD. The ABIs, PPG waves, and hallux pressures provide significantly more information about the vascular status of a patient than can be determined by just feeling the patient's pulses. Some patients will not have any ulcers and have a lot of foot pain which is not from an ingrown big toenail, neuroma, or other podiatry problem, but is from PAD.

It is important to determine the vascular status, which can be a real challenge, especially in the geriatric and diabetic population. The podiatric history can be very helpful, however, sometimes on rare occasions a patient could...

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

RE: Rental Real Estate Market
From: Michael M. Rosenblatt, DPM

Timing is everything, “they” say. Here in the Bay Area, housing prices are seeing a 36% gain and higher in many facets, even condominiums, since last year. Of even greater consideration is that every sector of the RE market is affected. 30-40 offers on some homes are not unusual (mostly from investors) at mercurynews.com/real-estate.

By most reckoning, podiatrists have not suffered at all through the recession of 2008. Some of you are interested in diversifying your investments to include rental real estate. We don’t expect your own local markets to share the extraordinary upsurge occurring in the Bay Area, but you can use that fact to be prepared.

Start looking now. Hire a good real estate broker to help your search. Learn about real estate. There are many excellent books on the subject. I have written articles in Podiatry Management on that subject. If there is a political “cliff” settlement coming, you may not have time to catch up on the bargains that will occur in your area, unless you start now. Buy low and sell high has never been more meaningful.

Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.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 PODO2345@AOL.COM 516-476-1815.

EQUIPMENT FOR SALE - USED Q-CLEAR LASER

Still under warranty. New laser head just added. First Best Offer. Marketing and training included. Dr. Zuckerman will train you. e-mail with questions to mook863@comcast.net

ASSOCIATE POSITION - KANSAS CITY

Kansas City may be the perfect move for you and your family. I am looking for an entrepreneurial minded associate who wants to grow and then own part of an already successful practice. If you are the right candidate for this associate position, you will enjoy a competitive compensation package and you will be working with a doctor who is as committed to your success as he is to his own. Go to: www.YourFutureInPodiatry.com for full details.

ASSOCIATE POSITION - PORTLAND, OREGON

Busy office with good steady referral sources looking to expand. Areas of expertise wanted: wound care, surgery of all aspects, knowledge of running an office. Please come with good personality and hard work ethic. New main and satellite offices. Email: office.pfac@gmail.com

ASSOCIATE POSITION - NYC & QUEENS

P/T position available for PSR-3 MIN. Must have winning personality, highly skilled , ambitious and EXCELLENT work ethic. Hourly salary with % of net revenues generated. Possible F/T and partnership opportunity. Email cover letter & resume to hansfeet@aol.com

ASSOCIATE POSITION – NORTHERN CALIFORNIA/SF BAY AREA

We’re looking for someone entrepreneurial to join our growing practice. Must have great people skills, clinical/surgical skills, and positive demeanor. California license required. No nursing home visits. Send your CV and cover letter to: cvpodiatrist@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

PODIATRISTS WANTED - NORTHERN AND SOUTHERN CALIFORNIA

Excellent opportunity for independent, professionally managed practice in skilled nursing facilities. E-mail interest and CV to ZBUBBLESZ@aol.com.

ASSOCIATE POSITION - NASSAU COUNTY, NEW YORK

Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to: Podiatryoffice@doctor.com

ASSOCIATE POSITION - NC PIEDMONT

Excellent opportunity for highly motivated, ethical, and personable PSR 24/36. This well established, 3-physician practice has excellent rapport with physician community, multiple office locations, and hospital privileges. Intent is an associate leading to partnership for the right individual. Competitive salary & benefits. Email CV to dpmassociatenc@gmail.com.

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Busy multi office practice with latest in technology EMR, digital X-rays. Looking for BQ/BC by ABPS. Must be able to handle rearfoot / ankle trauma and reconstructive cases. Paid vacation, health insurance and partnership available. New or experience practitioners welcomed. Email resume to: mny1029@gmail.com

ASSOCIATE POSITION - NORTHERN VA / DC METROPOLITAN AREA

Busy 20 years established practice with concentration in advanced surgical techniques. Opening new offices! Salary plus commission and benefits with excellent opportunity for growth and advancement in high demand market. PSR36/PM&S36 required. Send CV and certifications to practice manager joyce.kingsbury@patientaccountservices.com

ASSOCIATE POSITION - FLORIDA

Associate wanted for well-established practice in central Florida. Experienced support staff, six figure salary, malpractice coverage and health insurance provided. Excellent opportunity for a promising future, this position will provide for the possibility of partnership in the future. To apply please go to www.yourcareerinpodiatry.com

ASSOCIATE POSITION - GRAPEVINE, TEXAS

Do you want to practice in a fast paced office environment? Do you like all aspects of podiatric medicine? Very busy 2 office practice looking for associate to add to our group of 5. If you are a forward thinking, surgically trained podiatrist send your CV to giacalone@faant.com

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Welcome to paradise! Immediate opening in a busy, multi-location practice. Six figure income potential possible for the motivated individual in the first year. Surgical training a plus. Hospital privileges available, depending o training. Must be Florida licensed. Great benefit package. Send CV and cover letter to 1foot.ankle@gmail.com.

ASSOCIATE POSITION - ORANGE COUNTY, NY

Full-Time or part-time. Looking for a highly motivated, surgical trained podiatrist in Orange County, NY (West Point). Hospital, wound center and surgical center affiliated. A busy practice that covers hospital in-patients, wound center, and ER calls. Must be trained in all foot surgery and be able to handle advanced diabetic wound care. 1 hour car ride from NYC and close to hiking, fishing, skiing and state parks. Email CV and contact info to: clsp4@yahoo.com

ASSOCIATE POSITION - NEW YORK

Established and modern podiatry practice seeking well trained podiatrist for our two offices located in the Hudson Valley. Individuals must be highly motivated, ethical, and have PM & S-36 training. Partnership potential! Please see our recruitment video (845) 471-2243, esims@simspodiatry.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 to Dr.Kassaris@yahoo.com

ASSOCIATE POSITION - MICHIGAN

Multi-doctor practice looking to add associate for two offices in Flint, MI. Partnership opportunity for right person. Needs to be proficient in forefoot surgery. Two docs already proficient in rearfoot/ankle surgery. Competitive salary, paid vacation and seminars. Patient schedule available “now” from retiring associate. Email resume flintfootdocneeded@gmail.com

ASSOCIATE POSITION - NEW YORK CITY / BROOKLYN

Full time office locations. Excellent opportunity for a motivated, ethical and enthusiastic associate to join a successful, well established hospital affiliated practice. Must be residency trained PSR 24/36.Board eligible/certified by ABPS preferred. Must be competent in forefoot and rearfoot surgery. Competitive salary with incentives. Email CV to DRSTEVEMENNA@GMAIL.COM

POSITIONS AVAILABLE- NEW YORK, NEW JERSEY, BUFFALO, CONNECTICUT, BOSTON

Looking for podiatrists to see residents in nursing homes. Great opportunity for supplemental or full time income. Positions in Buffalo to be filled immediately with other locations made available for the right candidate. Email inquiries to phasetwopodiatry@gmail.com.

PM News Classified Ads Reach over 14,000 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 14,000 DPMs. Write to:bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 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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