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Serving Over 12,500 Podiatrists Daily

December 21, 2010 #4,042 Publisher-Barry Block, DPM, JD

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Improper Footwear Can Contribute to Winter Falls: MO Podiatrist

There are ways to prevent slipping on ice. And if you do fall, you may not necessarily need treatment. Dr. Martin Docherty, an emergency department physician at Barnes-Jewish Hospital in St. Louis, and Dr. Timothy Oldani, a podiatrist at DePaul Health Center, offer tips on surviving icy weather intact. Seek treatment If 1) you have severe pain. 2) If you're taking blood thinners, such as Coumadin and Plavix. 3) If you hit your head on the ground. 4) If you're unable to put weight on your foot or ankle.

Dr. Timothy Oldani

Improper footwear can contribute to slipping, and Oldani said one popular brand, Ugg, and their copycats are among the worst in slippery conditions. "They have no arch support whatsoever so they don't give you any stability," he said. "There's also no traction or grooves in the outer sole. That's not true of all of them, but there are hundreds of knockoffs which are of lesser qualities, and they have shallow ridges."

Source: Cynthia Billhartz Gregorian, St. Louis Post-Dispatch [12/17/10]

TUSPM Researchers Study Whether Weight Loss Can Improve Foot Function

With rising rates of obesity among baby boomers, seniors are likely to face a range of health issues caused by increased body weight, including declining function in the legs and feet. To combat that issue, researchers in the Gait Study Center at Temple’s School of Podiatric Medicine are studying whether weight loss can improve foot structure and the function of the lower extremities in people aged 50-75.

Dr. Jinsup Song

“Increased body weight has been suggested to be a cause for things like knee osteoarthritis and heel pain syndrome among this group, but there has yet to be a controlled scientific investigation on the improvement of foot function related to weight loss, and its effects on quality of life measures,” said center director Jinsup Song, DPM, PhD.

Don't Limit Yourself to One Profession: Retired CA Podiatrist

Dr. Mark Valinsky, podiatrist, actor, producer, photographer, author, black belt, and more, was interviewed on the HealthyLife.Net Radio Network show “The Millionaire Mindset” by creator Jim DeCicco. The topic, “Entrepreneurship – Focusing and Branding Your Creativity.”

Dr. Mark Valinsky

While many believe a secret to success is to do one thing well, Mark Valinsky feels you can also be successful by doing the many things you are passionate about, and doing them well. The statement “A jack of all trades, a master of none.” really doesn’t always apply, nor should it.  He uses a few examples and states: “Can you imagine what would have happened if someone convinced Leonardo di Vinci, “Leonardo, maybe you should just paint and forgot about all these other crazy ideas that pop into your head?”

Source: Sherill Whisenand, bignews.biz [12/17/10]

New PHOs Are Being Structured as Stepping Stones to ACOs

A growing number of hospitals are turning to physician-hospital organizations (PHOs), a model from the 1990s that these hospitals say will prepare them for certification as accountable care organizations (ACOs). Among the structural and operational elements that differentiate these PHOs from their predecessors are full transparency, strong physician leadership, and organizational structures that enable them to operate as independent legal entities in which risks — and rewards — are shared equitably.

Many of the new pre-ACO PHOs operate as limited liability companies (LLCs) with operating agreements that ensure that the investment risk is equally divided between physicians and hospitals, and that all contracting and payment mechanisms are fully transparent to members. “These PHOs typically are controlled equally by the physicians and the hospital,” says John Harris of DGA Partners, a healthcare management consulting firm, although in some cases physicians hold majority voting power.

Source: Michael E. Carbine, ACO Business News [12/17/10]

Most Missed or Delayed Diagnoses are Due to Systems-Related Problems

Nearly two-thirds of missed or delayed diagnoses involve systems-related problems that can make it harder for physicians to reach the correct diagnosis. Here are areas of failure and the problems they represent:

• Policies and procedures: Lack of protocols exist to ensure appropriate follow-up.
• Inefficient processes: There are unnecessary delays in scheduling visits or procedures.
• Teamwork: Needed information or skills go unshared.
• Management: Studies are not read in time; x-rays are lost or misplaced.
• Care coordination: Consult requests are lost or not acted upon promptly.
• Equipment: Test instruments are faulty, miscalibrated or unavailable.
• Supervision: There is a failure to oversee trainees properly.
• Expertise: Required specialists are not available in a timely fashion.

   Source: "Diagnostic Error in Internal Medicine," Archives of Internal Medicine via AMNews

Query: Radiesse or Other Injectable Implants

Is anyone using Radiesse or other injectable implants in the feet? If so, how much is typically injected for metatarsal fat pad atrophy? Do you first  do posterior tibial blocks? I would appreciate any information regarding anesthesia, amounts injected, placement, frequency, best products, etc.

Peter Schaffer, DPM, Birmingham, MI

Query: eRx Unbundling Fee

Our office utilizes eRx. However, our software company now wants to unbundle the service and charge a $60/month fee. I am curious if anyone on this forum has run into this same problem?

Pete Harvey, DPM, Wichita Falls, TX

RE: Medicare Reimbursement Vs. Inflation (Stephen Doms, DPM)
From: Marc Garfield, DPM, Philip Larkins, DPM

I recommend that Dr. Doms continue his analysis based on starting a practice in 1990, 1997 (Inception of the SGF), 2000, and 2005. Could he also include CPT codes 28296, 11750, and 73630? Then factor in the average malpractice policy, student loans, office rent, MA salary, and healthcare benefits or overall average overhead per doctor in absolute dollars. Then assess if you can see the same number of patients to pay your overhead and pay yourself a salary that offers the same ability to support your family and fund a retirement as in 1981. 

I offer a podiatry elective for a family practice residency. In discussions with these residents, many are carrying $250-$300,000 in student loans. I do not know what the average DPM tuition runs today, but I would be surprised if it only goes up 2-3% per year. There are several factors that affect us that are not reflected when looking at national inflation. 

Marc Garfield, DPM, Williamsburg, VA, mgarfield1@cox.net

This form of simple logic regarding physician reimbursements is ludicrous at best. It is important to remember that we do not live in a vacuum. I would recommend you pull out an electric bill from as far back as you can, and see what the monthly charge was. Try the same with a phone bill. How about a DSL or high-speed modem bill? You probably can't find one of those from 1981. The bottom line is that healthcare reimbursements have not kept up with cost of living (COLA), CPI, AND cost of doing business. The latter is the real devil in the details. 

My profit margin is probably 10-15% after all is said and done. If the proposed Medicare cuts went through of approximately 23% (according to the flawed sustainable growth formula), I would slowly bleed cash and die a death of a thousand cuts. Healthcare costs and ancillary costs have spiraled out of control. We should be getting an INCREASE each year from Medicare of AT LEAST the CPI, and probably more!
 
Philip E. Larkins, DPM, Escondido, CA, larko33139@yahoo.com

RE: Plan Exit Strategy When Forming Company (David Helfman, DPM)
From: Michael M. Rosenblatt, DPM 

I was gratified to read Dr. David Helfman's letter advising of the necessity to plan and run a business as a podiatrist. He mentioned (with some accuracy) that this is not taught in podiatry colleges. That is not entirely correct, for the Ohio College is preparing an entire curriculum on practice management, along with other vital subject matter. It is highly popular with the students.

It is beyond belief, but very few podiatrists have anything close to a "business plan" when they struggle to either start a practice or an associateship. Even those fortunate enough to obtain a position in a large multi-specialty practice are not immune from that necessity.

Even more important than just a business plan is also a "life plan" that encompasses your business plan like an umbrella. This may include practice purchase, a time-project to get your boards, paying off student loans, rental real estate purchase, retirement investing, skinflint living (it's hard to bring spouses into that) and preparation for the day when you are laid off of your associateship.

Associateships fail. Practices fail. Your long-time group practice contract may not be renewed. What are YOU doing to prepare for these exigencies? Do you have a plan? Is it the fault of the profession that you do not?

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

RE: Shoes Good Enough to Eat

Crisp waferlike textures bejeweled with beads of fruit combine to create beautiful layers of puff pastry in the form of two mille-feuilles. But these Mille feuille are not the kind you eat: You wear them on your feet. Yes, this is just one of the many pairs of shoes among the works on display at a fun exhibition of Chiho Akama's podiatric creations.

Chiho Akama's Edible Shoe Creations

Shoes? Shoes...Still, Shoes! is a showcase of her sometimes scrumptious footwear, themed on everything from sushi to insects. The event lends a fun, pleasant atmosphere to Pola Museum Annex in Ginza, Tokyo, where a selection of her works are currently on show. Each of the shoes uses original fabrics and other materials to re-create a variety of objects, ranging from grasshoppers and beetles to ikura, Christmas cakes, and roasted chicken.

Source: Kumi Matsumaru, Daily Yomiuri  via AP [12/17/10]

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Douglas Richie, DPM is seeking a well-trained, motivated podiatric physician to join his two office practice located in North Orange County, California. Applicants must have completed a 3-year residency program and must have exceptional skills in reconstructive foot and ankle surgery, sports medicine and podiatric biomechanics. This is a salaried position with a goal of long-term buy-in for equity ownership. Send letter of interest and CV to drichiejr@aol.com

ASSOCIATE POSITION - CHICAGO 

Weil Foot & Ankle Institute, Des Plaines, IL (www.weil4feet.com) is seeking associate position in summer  2011. This 15 member podiatric medical and surgical group is internationally acclaimed. Twelve locations throughout Chicagoland, with a 3 operating room surgery center, MRI’s, computerized footprint analysis, orthotic and brace laboratory, radiofrequency coblation technology, extracorporeal shockwave devices, PRP and  clinical research program. Successful candidate will have completed a 3-year residency, experience in wound care, trauma, and sports medicine. Competitive salary, bonuses commensurate with experience and training. E-mail letter of interest and CV to Harriet Kass, HR, hkass@weil4feet.com 847-390-7666

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 - 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

ASSOCIATE POSITION - BOSTON

CPME Board certified podiatrist wanted to join Orthopedic & Arthritis Center at Brigham & Women’s Hospital, Boston, MA. The position is per diem, 2 days/ week. Interested candidates should send their CV to: Brenda Surowiec, Orthopedic & Arthritis Center, 75 Francis Street, Boston, MA 02115. Or email to bsurowiec@partners.org

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) 293-5984  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

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

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.

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

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