The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

December 22, 2012 #4,645 Publisher-Barry Block, DPM, JD

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Correction

The headline of yesterday's "Podiatrists and Sports Medicine" section should have read "FL Podiatrist Performs Foot Surgery on Tennis Star." Serena Williams had foot surgery performed, but it was not bunion surgery. 

WI Podiatrist Receives “Friends of Franklin Public Schools” Award

Dr. Bill Weis of Oak Creek, WI recently received the “Friends of Franklin Public Schools” Award for his volunteer efforts. Each quarter, the Franklin, Wisconsin Board of Education recognizes individuals who have donated significant time to the Franklin Public Schools.  These individuals are nominated by staff each quarter.

(L-R) Aimee Schlueter, Allison Umhoefer, and Dr. Bill Weis

Weis has volunteered many hours to help the FHS Music Program. His  experience performing with his rock band “Bushwood” gave him the familiarity to assist with the marching band program, the Jazz Cabaret, and other band and orchestra events. He was nominated by Allison Umhoefer, FHS Band Director.

IN Podiatrist Arrested for Voyeurism

A Richmond podiatrist has turned himself in after accusations that he planted a video camera in an office restroom launched an investigation. According to Wayne County Sheriff Jeff Cappa, Dr. Brian Altman turned himself in to the sheriff's office Wednesday. Altman is charged with voyeurism after an employee spotted a video camera hidden in the employee restroom pointed at the toilet, according to reports.

Source: Holly Samuels, WDTN [12/12/12]

Podiatric Growth Restrained By Patients' Tendencies to See PCPs First

The podiatric profession has benefited from an aging population and increasing rates of diabetes and other chronic illnesses that require foot care. In addition, the industry is making efforts to boost awareness among consumers and the healthcare community regarding the importance of podiatry in achieving overall well being. Along with favorable demographic trends, these efforts are expected to contribute to average annual revenue growth of 1.7% during the five years to 2012. In 2012, revenue is expected to reach $4.7 billion, representing growth of 1.5% from 2011.

“Despite efforts to raise foot-care awareness, podiatrists still compete with general practitioners for patients,” says IBISWorld industry analyst Nikolas Hulewsky. “Studies indicate that people often visit their primary care provider for foot ailments rather than going to a podiatrist.” This has restrained industry growth to some degree and has led to heightened efforts to level the playing field in the years ahead.

Source: beaumontenterprise.com [12/19/12]

Query: Use of Terbinafine With History of Chronic Hepatitis C
 
I have a patient with a history of hepatitis C, with positive Hep C RNA Quant viral load PCR. He has an AST of 20 and an ALT of 23. I’m looking for some opinions about using terbinafine or other oral antifungals for this patient with these findings. The patient is homeless, has no insurance or other resources, so other forms of treatment are not available.   
 
Edmond F. Mertzenich, DPM Rockford, IL

Query: AOS Incompatibility Problem with Windows 8

I have been using AOS practice management software for many years. My computer broke and I bought a new one loaded with Windows 8. My problem is that we cannot input numerals because of an incompatibility issue with Windows 8. I called AOS and their tech person said that it's a Windows 8 problem and they have no plans to fix it because most of their clients still use earlier versions of Windows. Any suggestions on how to handle this problem without having to ditch AOS? I went back to the vendor where I bought the computer and they told me that they all come pre-installed with Windows 8.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

Query: CAM Walker Payment

Is L4386 (walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, includes fitting and adjustment) billable to Medicare for the treatment of plantar fasciitis? If not, how would you code it?

Barry Rosen, DPM, Bayside, NY

Response: Under the AFO LCD, the only limitations for treatment of plantar fasciitis are listed under the non-weighbearing devices, specifically L4396. There are no specific restrictions for the use of a non-pneumatic walking boot (L4386) or pneumatic walking boot (L4360). As with all other services and or DMEPOS provided, if there are no specific diagnostic restrictions within an LCD, the coverage would be subject to medical necessity and standards of care.

Be careful about using CAM boots as an initial or primary treatment for plantar fasciitis. This is likely not the standard of care and could potentially subject you to a DME audit if you are considered an outlier. Certainly, I would not refrain from using a CAM boot if the patient has documented failure of more conservative treatments or medical contra-indications to those therapies.

Paul Kesselman, DPM, Woodside, NY

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RE: Displaced MBA Implant
From: Zeeshan Husain, DPM

The arthroereisis implant allows the soft tissue to remodel and sustain the correction after removal beyond 6 months. When I was a resident, we were investigating the corrections achieved by the use of the MBA implant and also tracked a few patients after they had them removed. The removals included patients who had the implants in for at least three years. Once the implants were removed, radiographic angles were unchanged, and correction was maintained.

There is enough scar tissue that forms that seems to allow the subtalar joint to stay in place. I suggest a wait and see approach to what happens to the foot after removal. Otherwise, it is not possible to predict what will be needed to maintain the correction.

Disclosure: I have no financial relationships with any implant company.

Zeeshan Husain, DPM, Rochester, MI, zee@alum.mit.edu

RE: Displaced MBA Implant
From: Dwight L. Bates, DPM, Louis W. Nordeen, DPM

If the "displacement" only occurs while NWB, possibly a brace could be fabricated to prevent the  precipitating motion. Since it would only be used while NWB, a crude device might not injure the skin. Trial devices might be made of PVC and Velcro.  

Dwight L. Bates, DPM, Athens, TX, dlbates04@yahoo.com

I have taken out 13 STJ arthroereisis implants with the post-operative period ranging from 2 to 8 years. They all have done very, very well without re-implantation. If the implant still irritates the sinus tarsi area after 1-2 years post-op, and you actually see migration of the implant, it may be wise to remove it. This patient is 18 now and developed, so I would remove it, and "scope out" the STJ. Arthroscopic cleaning out of the STJ upon removal of the implant helps significantly! This limits that feeling of "sprained ankle" that remains after removal. A 4.0mm 30 or 70 degree scope works great. These patients do very well.
 
Louis W. Nordeen, DPM, Mechanicsville, VA, onefoot7@gmail.com

RE: Policy for Handguns in a Podiatric Office
From: Frank Lattarulo, DPM, Bob Hatcher, DPM

With respect to the  responses of Drs. Ganio, Shier, and McKinney, first off make no mistake, I never mentioned fear in my post. I don't fear too many people. Secondly, don't question my interpretation of the Second Amendment nor my respect for anyone or anything. Nowhere  did I mention the word BLAME or stated I had a problem with anything. It kind of sounds like the pro-NRA people are a little sensitive right about now. And lastly, please re-read my post. I was simply requesting office policy (I didn't ever mention I was going to post it). A far simpler answer would have been appreciated much more by the gun toting population.

Frank Lattarulo. DPM, NY, NY, doclatt@aol.com

Regarding office safety, especially if you are not trained in handgun use, afraid of guns, or philosophically opposed to their use - why not consider bear spray? It works from 30-32 feet away, disables immediately, is cheap, and causes no permanent damage to innocent bystanders. In certain areas of the country maybe a can or two in your office might come in handy.

Bob Hatcher, DPM, Raleigh, NC bob@blhatcher.com

RE: Efficacy of "Pain" Creams
From: Kathleen Neuhoff, DPM, Matthew Roberts, DPM

I have used compounded topicals with DMSO, tetracaine, and betamethasone for many years and have found them very helpful for localized problems such as neuritis. I do not use them for long-term because the steroid can thin the skin and the DMSO can become irritating, but they have been very helpful to provide immediate relief while the underlying problem is addressed and resolved.

Kathleen Neuhoff, DPM, South Bend, IN, vetpod@aol.com

Other than counter irritants or capsaicin, what is the mechanism of action of these products? As I recall, narcotic analgesics work on opiate receptors in the midbrain. Are there any such receptors in the PNS that these narcotic compounds work on? If not ,what is the efficacy of applying these compounds locally?
 
Matthew Roberts, DPM, Miami, OK, matrob87@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

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. 6 figures salary guarantee. New or experience practitioners welcomed. Email: mny1029@gmail.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 - 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 - LEADING TO FULL OWNERSHIP 20 MINUTES NORTH OF BOSTON MA

Well-established practice & beautiful modern office and equipment great location. X-ray, EMR, ultrasound. Great work ethic needed. Fast track to ownership. Competitive starting salary. Well-rounded practice was grossing over 600K. Strong emphasis on surgery & sports medicine. Send CV to footguru@cox.net

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

ASSOCIATE POSITION - MARYLAND

If you are a graduating resident, in July, or an established practitioner (available now) and you are enthusiastic, personable, motivated and well-trained, we would be delighted to discuss an associate position in our group with you. We are a 17-doctor group, with 12 locations. Significant patient flow already in place to keep you busy from the start! All the bells and whistles-EMR, digital x-rays, ultrasound, computerized scheduling, certified ambulatory surgical centers, hospital and physician referral base. Please send cover letter and resume to newdpm@footandankle-usa.com. We look forward to hearing from you.

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

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.

ASTORIA PODIATRY OFFICE FOR RENT/SHARE

BEST ASTORIA location. 30TH AVE./32nd ST. Turn-key operation with 4 fully equipped, built-out exam rooms, private Drs.' Office/Consult room, X-ray, cryo-therapy, beautiful waiting area, large staff area, Shockwave, Multiple Lasers etc. Perfect for NEW PODIATRIST or SATELLITE location. ALL you need is a PHONE and COMPUTER! RENT includes all other standard expenses (utilities, cleaning, waste disposal etc.) P/T, $2500. F/T., $3500. Please send inquiries to hansfeet2@gmail.com.

NYC PODIATRY OFFICE FOR RENT/SHARE

BEST NYC location. FIFTH AVE/42ND ST. Turnkey operation with two fully equipped, built out exam rooms, third exam room if needed , X-ray, Shockwave, lasers etc. Perfect for NEW PODIATRIST or SATELLITE location. ALL you need is a PHONE ,and COMPUTER! Even has in-office Physical Therapist for you to work with! RENT includes all other standard expenses (utilities, cleaning, waste disposal etc.) P/T, $2250. F/T., $3000 Please send inquiries to hansfeet2@gmail.com.

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

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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