The Voice of Podiatrists

Serving Over 10,000 Podiatrists Daily

December 22, 2007 #3,124 Editor-Barry Block, DPM, JD

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Recent Advances in Bunion Surgery Have Led to High Success Rate: NJ Podiatrist

Recent advances in surgical techniques have led to a very high success rate in treating bunions. “A variety of surgical procedures are performed to treat bunions,” says Dr. William A. Freundlich, a surgeon podiatrist and director of The Wound Center at St. Mary's Hospital in Passaic. The procedures are designed to remove the "bump" of bone, correct the changes in the bony structure of the foot, as well as correct any soft tissue changes that may also have occurred. The goal of these corrections is the elimination of pain.

Dr. William Freundlich

“In selecting the procedure or combination of procedures for your particular case, the surgeon will take into consideration the extent of the bunion deformity based on the x-ray findings, your age, your activity level and other factors,” says Freundlich. The length of the recovery period will vary depending on the procedure or procedures performed.

Source: Betsy Querna, NorthJersey.com [12/18/07]

IA Podiatrist is 'Biggest Loser'

The past 12 weeks of Dr. Greg Lantz's life can be summed up in two words: then and now. Body weight then, 255 pounds. Now, 205 pounds. Waist size then, 46 inches. Now, 37 inches. Percentage of body fat then: 32.3. Now, 20.9. Lantz beat out 11 other contestants to win the title of Cedar Valley's Biggest Loser. Twelve weeks of grueling workouts and healthy eating led him to victory in the YMCA contest.

Dr. Greg Lantz (Photo Brandon Pollock)

"I'm pretty excited," Lantz said. "It's been quite a journey. It's been a mental process, also. I've had to get in the right frame of mind. The bottom line is they wanted every single person to lose weight and change their lifestyle habits to improve their health."

Lantz, a podiatrist with Family Foot Health Care, had to explore different ways of working out because of a hip replacement and arthritis in the other hip. There were some parts of some cardio classes he couldn't do, but instructors were quick to modify exercises for him. "If he couldn't participate in a class, he was in here every day on a stair stepper," Lombardi-Hutchens said.

Source: Meta Hemenway-Forbes, Courier Life, [12/20/07]

NC Podiatrist Indicted for Alleged 500K Diabetic Shoe Fraud

A federal grand jury has indicted David Tsui, 37, a Chapel Hill podiatrist and president of Dr. 2 Shoes, for allegedly submitting false claims for more than $500,000 for diabetic shoes provided to Medicare beneficiaries.

Dr. David Tsui

The 43-count indictment states that Tsui and Dr. 2 Shoes, Inc., filed false claims, made false entries, committed wire fraud, health care fraud and aggravated identity theft related to his unauthorized use of physician Medicare provider numbers.

If convicted, Tsui faces maximum penalties of up to 20 years in prison for the wire fraud charges and an additional two years for each aggravated identity theft count.

Source: The Durham Herald-Sun [12/20/07]

Query: Bone Densitometry

Is anyone using a bone densitiomter, the kind that images the calcaneus? Does anyone have any experience with it? I believe there is one from Hologic and one from Apollo.

Sloan Gordon, DPM, Houston, TX

Query: Abscess I&D - Simple or Complicated?

A patient presents with a localized painful, red, swollen, warm nail groove with a localized superficial abscess and an onychocryptosis (ingrowing nail). The patient is otherwise not having any problems or complications.

The patient is injected with local anesthesia. The offending nail border is avulsed. The abscess is I&D'ed. A wound culture may or may not have been taken. The patient is placed on antibiotics. Is this treatment simple or complicated?

Arden Smith, DPM, Great Neck, NY

Response: Pretty damn simple, and you have two ways you can bill it: 10060 or 11730.

Harry Goldsmith, DPM, Cerritos, CA

Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm

RE: Liquid Nitrogen for Warts (John Moglia, DPM)
From: Multiple Respondents

I use a device called Cryoprobe which is quite effective in eliminating plantar warts as well as other lesions. The device delivers a very thin stream of cold liquid nitrogen and you can aim it carefully at the margins. It is not painful and is well-tolerated by patients. The only downside is that you have to use a new canister of fluid for each patient, which costs roughly three dollars. The actual unit costs approximately 1,500 dollars.

Although we are quite happy with this mode of therapy, we have had resistant cases of verrucae that have not responded to any single therapy, including cryotherapy and I have had to resort to other methods of treatment. I guess if someone ever developed a single treatment that safely and painlessly treated all verrucae, that person would be up for a Nobel Prize. Until that happens, Cryoprobe is one of the modalities that is high on our list of therapeutic options.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

I have found that liquid nitrogen works well for warts almost anywhere on the body EXCEPT the feet. A better modality for any wart treatment is liquid nitrous oxide. You will need to purchase a "CryoProbe" device. These are for sale at a number of the larger podiatry conferences by the company, Cryosurgical Concepts (1-866-736-6577). The liquid nitrous oxide cartridges are supplied in boxes of 10 and have an unlimited shelf-life. The discomfort level with this treatment is minimal. I have used it successfully in children and adults. It's clean, fast and always ready to use. Call Cryosurgical for more information or visit them in the exhibitor area of your next major conference. They now have a "training" video to help out new users.

David F. Hettinger, DPM, Wheaton, IL, davidhett@msn.com

I have utilized cryotherapy of various type in my practice for a number of years, and have found that liquid nitrogen is difficult to maintain in your office on a long-term basis because of its leakage into the atmosphere. If you don't have a very active practice in skin care, then it becomes expensive to utilize this modality. Liquid nitrogen does not have pinpoint accuracy and can cause blood blistering for lesions treated on the sole of the foot.

I have been utilizing the CryoProbe, manufactured in Belgium, which utilizes nitrous oxide cartridges instead of an open liquid nitrogen thermos type device. It is very cost-effective at only three dollars per cartridge. It is precise in its application and is effective for treatment of plantar warts, porokeratosis, seborrheic keratosis, and stucco lesions commonly found in the foot. The cartridges have a long shelf-life and come 10 cartridges to a box.

John Hahn, DPM, ND, Portland, OR, jmhahn2@verizon.net

RE: ACFAS Drops APMA Membership As Renewal Requirement
From: Multiple Respondents

Here we go again. The non-joiners, non-members, non-donators & non-volunteers are again screeching. Unfortunately the squeaky wheel gets the oil or the few outliers ruin it for everyone else. Let’s NOT allow this travesty to happen! We still are a minority profession that has to battle every day to maintain all the successes that we have achieved as a unified group. Under one umbrella we have and will continue to succeed. The nay-sayers will always bitch and moan. They will never be satisfied even if we pay their dues and donations.

The ACFAS continues to promote a civil war. The Bylaws mandate membership in the APMA as a prerequisite for membership in the ACFAS. An organization divided cannot stand. We must all join arm and arm and demand that ACFAS once and for all stop this monetary ploy and follow membership bylaws for the good of our profession. Pooling our resources will continue to advance our podiatric medical profession.

Donald Popper, DPM, Wellington, FL, dpopper5@aol.com

We have not held a meeting of the St. Louis Podiatry Association for at least 15 years. There is in fact no functioning organization. In order to maintain my APMA membership I am compelled to also pay dues to this non-functional organization.

I agree with Doc Dockery that active membership in both APMA and ACFAS is critical. However, APMA must wake up and remove the condition of mandatory membership to state and local societies as a condition for APMA membership.

Allen Mark Jacobs, DPM, St. Louis, MO, allenthepod@sbcglobal.net

I support the ACFAS policy change and appreciated the way they listened to the membership and came up with a very fair arrangement moving forward. In Illinois the IPMA has become to union-focused and one-sided politically.

Michael A. DeVito, DPM, Oak Lawn, IL, devitodr2@sbcglobal.net

As president of the American Society of Podiatric Medicine, another APMA clinical interest organization, the temptation has always been there to accept members who are not also part of the APMA and increase our roster of membership. We would not do this, not just because our bylaws forbid it but there is a much more important reason. It’s maintaining the integrity of the main organization that represents the vital interests of our profession. By splintering off from the APMA or giving a blessing to those who seek to avoid belonging to the APMA, the ACFAS may be undermining the only organization that is strong enough to defend the rights of all podiatrists.

Let us not be naive. We still practice medicine in a country where there are plenty of other medical, and surgical associations that are big enough, strong enough and have the financial and political ability to push for legislation on the national and state levels to severely limit our ability to practice podiatric medicine and surgery. The political arms of these organizations are constantly at work to try to limit our scope of practice as well as private and governmental insurance reimbursements. The APMA, in addition to everything else it does for the profession, is a strong and constant defender of our right to exist.. Any sign of weakness or disunity on the part of our profession would immediately lead to actions by these other organizations to limit our ability to practice. Groups like ACFAS or any of the other smaller associations, including my own, would not have the means to do what a strong and united APMA does every day to defend and enhance our profession. I hope that ACFAS will reconsider the path of action they are considering.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

Editor’s Note: An extended-length note by Dr. Hultman appears at:
http://www.podiatrym.com/letters2.cfm?id=17144&start=1

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com -- www.homephysicians.com

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

PRACTICE FOR SALE - MINNESOTA

Minnesota practice for sale in upscale suburban location with turnkey absentee-ownership opportunity. This owner let's this practice run on auto-pilot while collecting $700's and associates treat all patients. This is a very well established practice and staff is willing to stay. Financing is available OAC. Contact American Doctor Sales 614-918-3000 or email us at sell_my_practice@yahoo.com

EQUIPMENT WANTED – USED PORTABLE ORTHOPOSER

I will arrange for delivery or pickup upon purchase confirmation. Please call or email with asking price. 718-896-3080 / afootdoc@ix.netcom.com

ASSOCIATE POSITION – VIRGINIA

Must have Virginia license. Requires 24 to 36 month Residency. Permanent position with potential buy in. Includes all phases of Practice excluding nursing homes. Competitive Salary and Benefit package. Please send Resume including salary requirements and availability date to needpodjob@yahoo.com

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City . Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

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