The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

December 21, 2009 #3,732 Publisher-Barry Block, DPM, JD

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Kevin P. Kortsch, DPM

Dr. Kevin P. Kortsch passed away on December 17, 2009, at age 77 years.  Kevin was devoted to strengthening the practice of podiatry in Wisconsin; serving as President of the Wisconsin Society of Podiatric Medicine from 1963 - 1967, and as the Executive Director from 1967 - 2005.

Dr. Kevin P. Kortsch

Dr. Kortsch was a longtime delegate and alternate to the American Podiatric Medical Association’s House of Delegates. His loss is felt not only by the Wisconsin Podiatric Medical Association, but by the entire profession.

PM News policy is to recommend that donations be made to the Kevin P. Kortsch Student Scholarship Endowment of the APMA Educational Foundation.

Cincinnati Mayor Appoints OH Podiatrist to Board of Health

He knocked off Republican Brad Wenstrup last month in the mayor's race. Now Mark Mallory is starting his second term by appointing Wenstrup -- a 51-year-old physician and Iraq War vet -- to an important city board. OhioDaily has the scoop from City Council submissions being readied this week:

"APPOINTMENT, submitted by Mayor Mark Mallory, pursuant to the authority granted by Article V, Section II of the Cincinnati Municipal Code and subject to the consent of Council, I hereby recommend the appointment of Mr. Brad Wenstrup to the Board of Health. Mr. Wenstrup, a Cincinnati resident is a Podiatrist with Wellington Orthopedic and Sports Medicine. Mr. Wenstrup will serve a three year term set to expire on December 31, 2012."

Dr. Brad Wenstrup (Photo Malinda Hartong)

Wenstrup was a political novice who lost his first race for public office. He and Mallory did not get into any bruising battles on the campaign trail. And it appears that the mayor came to respect his rival.

Source: Bill Sloat, Ohio Daily [12/17/09]  

NJ Podiatrist Collects Socks for the Homeless

Dr. Paul Scollo of Fairfield and Hasbrouck Heights has been collecting new, sealed packages of socks for homeless men, women and children since Thanksgiving week. His family, staff, patients, and even strangers have donated about 150 pairs of socks and still counting with just days until Christmas.

Dr. Scollo with his daughter, Jeanne-Marie and son, Paul.

"My wife, Mary Ann, came up with the idea. We usually collect shoes for the homeless at Christmastime, but her reasoning was to do something different this year that would still help people - that's how our "Socks for the Homeless" program started. We hung up signs in our offices and distributed flyers to local businesses. We even got our referring providers' offices involved and received packs of socks from their patients," said Dr. Scollo.

"I think it might be a great idea to start the sock drive earlier next year and encourage other podiatric offices to do the same thing. Warm socks should help with the cold winter upon us. Maybe it will be a Merry Christmas and a better New Year for those less fortunate people among us," he said.

Source: The Caldwell Progress [12/18/09]

Query: Post-Operative Tremor S/P Metatarsal-Cuneiform Exostectomy
 
I performed a met-cuneiform exostectomy on this patient one week ago. There were no complications from IV sedation/local anesthesia and no risk factors. She is a non-smoker, does not use oral contraceptives, and there is no history of brain or spinal tumors in the family, and no neurological problems in the family.
 
She presented one week post-operative. The foot is fine ... just about healed, but she has a tremor of her foot. Here is the video of it.  I sent her to a neurologist, but short of an UMN/LMN lesion, I'm stumped. any suggestions?

Sloan Gordon, DPM, Houston, TX

RE: Congenitally Deformed Fifth Toe (Paul Kruper DPM)
From: Ray Botte, DPM, Narmo L. Ortiz, Jr., DPM

Dr. Kruper presents an interesting dilemma. I agree that the distal lateral phalanx should be removed and I would also suggest a lateral condylectomy of the proximal phalanx head along with debulking of the toe laterally, i.e., excision of a wedge of skin and subcutaneous tissue laterally. Leave the remaining middle and distal phalanges alone.  A reasonably good cosmetic appearance with the intact toenail should be acceptable.
 
Ray Botte, DPM, Scottsdale, AZ, acupodaz@hotmail.com

Providing more views would have helped more in suggesting a proper procedure, but being that the 5th toe will be subjected to potential shoe pressure trauma, I would excise all bone fragments distal to the proximal phalanx and "remodel" the remaining stump. 

On the other hand, if you chose fusion of the remaining fragments to maintain length, this is better achieved with permanent fixation rather than temporary. Again, potential shoe pressure may cause ongoing pain or callus.

Narmo L. Ortiz, Jr., DPM, Cape Coral, FL, nlortizdpm@embarqmail.com

RE: Osteomyelitis? (Wm. Barry Turner, BSN, DPM)
From: Multiple Respondents

Dr. Turner presents an interesting case that raises many issues when it comes to the diagnosis and treatment of osteomyelitis. Many of these topics I have written about in the 3rd Edition of the Handbook of Lower Extremity Infections and blogged about at www.leinfections.com. Some previous responders have already offered excellent commentary with which I agree.

1. I question whether this is even an osteomyelitis. It is rare that a patient develops a local osteo like this without...

Editor's note: Dr. Warren Joseph's extended-length letter appear at:
http://www.podiatrym.com/letters2.cfm?id=31339&start=1

Quinolones seem to have a higher incidence of tendon ruptures. I come across articles specific to Achilles tendon ruptures. Eight weeks time on a quinolone would obviously increase the risk versus a 10-14 day course. It is also not unusual to find equinus deformity in neuropathic patients, which might make them more susceptible to a rupture. In this specific case, if indeed it is a fracture as opposed to an infectious process, an equinus as etiological factor is definitely in the differential. End result: she did okay. That is all that matters. Thank you for posting the case.
 
Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@ao.com

The reason this case was so interesting is that she was treated successfully with a poor choice of antibiotics and virtually no intervention.  The biopsy report was "overall pattern consistent with chronic osteomylitis." I agree that you never treat the wallet, but I am in rural North Georgia. No infectious disease specialist is nearby. Patients have to put up a cash deposit for non-emergency care at the hospital. The biopsy pretty much took all the patient's money. Send her to a clinic? The closest clinic is at least 45 miles away. Up to about 10 years ago, we didn't even have an orthopedist. Also, I knew the patient could only afford so much, so I selected the test I thought would give me the best chance of an accurate diagnosis.

I ordered a WBC-tagged bone scan, not a regular bone scan, not an MRI, so I would have a fairly good chance of being correct with my diagnosis. Then when I followed with the bone biopsy, I both confirmed the diagnosis and that the current treatment was working - Cipro. Cipro is a very low cost antibiotic in my area and it was working.  She was afebrile, and showed no local signs of infection after initial prescription of antibiotics. Why do a CBC, Sed Rate? Yes they would be helpful and if she continued showing signs and symptoms of infection, I might have ordered the lab work; but I did not, and the case evolved to what we see in the after x-ray. Don't get me wrong, I like supportive imaging and lab work, but sometimes you have to pick priorities of  what you really need and what you can skip. Is this good medicine, no. But, sometimes it is reality. 
 
Wm. Barry Turner, BSN, DPM, Royston, GA, claret32853@gmail.com

RE: Strengthening the Feet Will Not Correct Biomechanical Problems (Bruce Williams, DPM)
From: Multiple Respondents

I have enjoyed the discussion between Drs. Pribut, Williams and McClanahan regarding barefoot running. I recently was asked to be involved in a debate on barefoot running in a... 

Editor's note: Dr. Kevin Kirby's note in this closed topic, as well as those from Dr. and Mrs. McClanahan can be read at: http://www.podiatrym.com/letters2.cfm?id=31341&start=1

RE: The Prescribing of Uric Acid Lowering Drugs (Richard Gosnay, DPM)
From: Multiple Respondents

Dr. Gosnay's post yesterday compelled me to write a bit about this closed topic so I will refrain from discussing who should be treating with uricosurics, but offer some general observations on gout. Like Dr. Gosnay, my foundation knowledge of gout came about during...

Editor's note: To read the rest of Dr. Bryan Markinson's letter, or the letters of Drs. Barry Mullen and David Gurvis see:
http://www.podiatrym.com/letters2.cfm?id=31348&start=1

No further letters will be accepted on this topic.

RE: Kevin P. Kortsch, DPM
From: Michael Thompson, DPM and Steven Frydman, DPM

It is with much sadness that we must report the passing of Kevin P. Kortsch DPM. Kevin P. Kortsch, DPM, entered the Illinois (now Scholl) College of Podiatric Medicine in September, 1953, following military service during the Korean War. He graduated in June, 1957, and returned to his native city of Milwaukee to enter practice. His love affair with his profession was evident from...

Editor's note: This extended-length letter appears at: http://www.podiatrym.com/letters2.cfm?id=31346&start=1
 

RE: Handling Office Emergencies (Bryan C. Satterwhite, DPM)
From: Al Musella, DPM

I have an AED in my home office. I think we all should have one and have everyone who works there take the class on how to use it. The most likely beneficiary of it is YOU and the staff, not the patients. They are only in your office for a few minutes a year. You are always there. Having an AED handy can mean the difference between life and death. I wouldn't work at a place that didn't have one handy (except now I have one implanted in my chest, so it is always handy).
 
Al Musella, DPM, Hewlett, NY, musella@aol.com

Dr. Satterwhite brings up an excellent question particularly after the dialogue on here regarding who should treat gout, etc. I have the emergency kit. Thank G-d I never have had to use it, and to be honest, would probably not be comfortable using it. In my office, I keep a phone. 911 is where I'd go.

I am okay with performing CPR, etc., but as to the meds in my emergency kit, I am not comfortable with them. Maybe, I need to be. It's not a bad idea for a review course on emergency meds.
 
Jeffrey Kass, DPM, Forest Hills, NY, Jeffckass@aol.com

DREAM PRACTICE OPPORTUNITY - OKLAHOMA

Use forefoot, rearfoot, wound skills in ideal small city with nearby lake. No buy-in costs. No limit on income. EMR. Act fast. OK State License deadline is 1-30-10 and test is comprehensive. Personality preferred over ego. Email julietburk@gmail.com or call 918-931-1425 for details.

ASSOCIATE POSITION - FREDERICK, MD

Well-established and growing 2 office state-of-the-art practice located in medical/professional buildings. EMR, Digital X-ray, Ultrasound, DME provider, etc. Competitive Base Salary plus bonus, malpractice, health insurance, etc. PSR 24 minimum/Board Qualified or Certified with ability and desire to take ER call. If interested, forward CV to DOCSBNB@aol.com

ASSOCIATE POSITION - SOUTHEAST GEORGIA & SOUTH CAROLINA

Seeking recent residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facility. Fax cover letter & CV to (843) 208-3348 or E-mail to melissafoot@pol.net

PODIATRISTS CHICAGO/NW IND/BALTIMORE/WASHINGTON, DC

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Jake Shimansky, Director of Physician Recruitment. Phone-773-342-5221 FAX 773-486-3548-E-Mail jshimansky@homephysicians.com www.homephysicians.com

ASSOCIATE POSITION - NORTHERN VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes. Top hospitals. Fax CV with references to 703-491-9994

EQUIPMENT FOR SALE - DIAGNOSTIC ULTRASOUND

MINDRAY DP-6600 Diagnostic Ultrasound for sale. 7.5 Mhz linear transducer. Like new condition, less than 2 years old. Comes with mobile stand. Contact robdaughertyddd@yahoo.com or 573-979-1809 for further information.

PRACTICE FOR SALE – NE OHIO

Long established general practice. Grossing $300,000 annually with very little surgery. Modern, well equipped office in desirable location. Large diabetic patient base with DME. Excellent referrals with over 500 new patients per year. Great growth opportunity for surgically trained podiatrist. Owner will stay to introduce. Email: docjoc227@hotmail.com

ASSOCIATE POSITION - HUDSON VALLEY, NY

Excellent opportunity for a three-year surgically trained foot and ankle physician. We are a high-volume, diversified, multi-office practice utilizing state-of-the-art modalities. Ample growth opportunities for a personable and highly-motivated DPM with ability, and a desire to teach and take ER call. If interested, please forward CV to: healthyfeet4ever@yahoo.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

EQUIPMENT FOR SALE

X-Cel MB-700 X-ray unit, All-Pro Processor, and Anodyne unit.
731-446-7285/E-mail nraines@charter.net

PRACTICE FOR SALE - TENNESSEE

Well established practice for sale. Full scope medical and surgical practice including DME. Exceptional practice with a high volume of new patients. Excellent hospital and surgical center privileges with investment opportunity. Great area for a family and the outdoorsman. 731-446-7285/E-mail nraines@charter.net

PRACTICE FOR SALE - CENTRAL FL

Practice and medical building for sale, in beautiful, high quality of life, growing area, Central Fl.; 2000 sf bldg. fully equipped/ designed for podiatry; excellent location, features & exposure; near hospital, wound and HBO center. Great opportunity for expansion & investment; good insurance climate. 352-223-2713 / E-mail: windnwave@earthlink.net

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

PM News Classified Ads Reach over 12,000 DPM's and Students

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