The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

December 23, 2010 #4,044 Publisher-Barry Block, DPM, JD

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Diabetic Foot Ulcers are Frequent Cause of Stress: NY Podiatrist

Chronic diabetic foot wounds are a daily part of a podiatrist’s life. Diabetes as a national issue is a growing health concern. The worst cases of diabetes often have numerous factors that increase the likelihood of an early demise. The weight of these multiple health issues complicates the life of a diabetic, causing stress and often depression.

Dr. Dan T. Smith

"In my arena, diabetic foot ulcers are a frequent source of stress due to lack of proper healing. For example, a diabetic patient may be overweight and may have poor blood circulation and numbness in both feet, which in turn causes ulceration, infection and often amputation," says Dr. Dan T. Smith of Skaneateles, NY.

Source: Auburnpub.com [12/21/10]

Sand and Snow are Worst Surfaces to Run On: PA Podiatrist

Running on sand and snow have been shown to increase the incidence of Achilles tendonitis by ten times, says podiatrist Dr. Brian Crispell, of Ardmore, PA. Crispell is an accomplished marathoner and cyclist. "The extreme softness of the surface causes you to over-push during the toe-off part of the gait cycle. This engages the Achilles tendon to a high degree, and causes overuse of the tendon," says Crispell.

Dr. Brian Crispell

"If you're aware of this, you can mentally compensate by slowing your pace, staying off your toes, and by running flatfooted. Avoid running on steeply sloped beaches. When possible, run on the beach at low tide, and stay on the hard, wet sand closest to the water," advises Crispell.  

Source: Liberty Sports Magazine [December 2010]

OH Podiatrist Named Director of Hospital Wound Care Center

Ara Kallibjian, director of Parma Community General Hospital’s Division of Podiatry, has been named medical director of the hospital’s Wound Center. The wound center was opened in 2009. It treats non-healing wounds and ulcers.

Dr. Ara Kallibjian

Dr. Kallibjian, a podiatrist and graduate of the Ohio College of Podiatric Medicine, is board-certified in foot and ankle surgery by the American Board of Podiatric Surgery. He specializes in wound treatment.

Source: Bob Sandrick, Sun News [12/21/10

NJ Podiatry Group Collects Over 1,000 Gifts for Holiday Giveaway

Each year a group of dedicated volunteers in Howell organize  the “Howell Holiday Giveaway” program (howellholidaygiveaway.com) sanctioned by township officials to collect gifts for hundreds of less fortunate children. The program aims to collect new, unwrapped gifts for over 450 children ages infant to 17 years old and involves many neighborhoods, residents, non-profit groups, and local businesses. One of many local businesses heavily involved in the “Howell Holiday Giveaway” is Affiliated Foot & Ankle Center, LLP in Howell, NJ.

(L-R) Drs. Alison DeWaters, Jasen Langley, and Hal Ornstein

This local podiatry practice of Drs. Hal Ornstein, Jasen Langley, and  Alison DeWaters  has implemented many programs to support the “Howell Holiday Giveaway” program, and this year achieved their highest collection ever, totaling 1,000 gifts. Utilizing their medical practice in Howell, they’ve been communicating with their patients about the program through email communication, mailing letters to the homes of every new patient for the months leading up to the holidays, hanging a “giving tree” in their waiting room, and distributing information about the program in their office.

Use of Fully Functional EHRs Rises: NCHS

Finally, a very thin majority of office-based physicians have some form of electronic health-record system in use, according to preliminary data from a federal health agency. The annual survey, which the National Center for Health Statistics (NCHS) conducted between April and July 2010, questioned more than 10,000 office-based physicians (excluding anesthesiologists, pathologists, and radiologists) — its largest sample size to date.

One question NCHS surveyors asked was: "Does this practice use electronic medical records or electronic health records (not including billing records)?"  According to the agency, an arm of the Centers for Disease Control and Prevention, 50.7% responded "yes."

Source: Joseph Conn, Modern Healthcare [12/21/10]

                                         Obama Signs Red-Flags Bill Exempting Physicians
 
President Barack Obama, on Saturday, signed "red flags" legislation that makes doctors exempt from the anti-identity theft requirements and safeguards that banks and other creditors must follow.  The two-page piece of legislation, which amends the Fair Credit Reporting Act, is mostly a definition of the term "creditor." The measure, titled the Red Flag Program Clarification Act of 2010, was introduced in the Senate on Nov. 30 and read three times that day before being passed without amendment by unanimous consent, according to the Thomas congressional bill-tracking website.

Confusion over the definition of "creditor" resulted in a Federal Trade Commission position that physician practices and other small professional service businesses would need to comply with the same regulation that calls for banks and creditors to have written procedures in place to prevent, identify, and mitigate identity theft and to train staff to follow those plans.

Source: Andis Robeznieks, Modern Healthcare [12/21/10]

Query: HIPAA-Compliant Website for Back-ups

I just bought an EMR software for my practice. I am looking for a HIPAA-compliant off-site website to back up my database. Does anyone have any recommendations?

Dang Vu, DPM, Baltimore, MD

RE: Resorbed Sesamoid (Chuck Ross, DPM)
From: Barry Mullen, DPM, Gino Scartozzi, DPM

Answer- Avascular necrosis (AVN)- sesamoid vascular supply is very poor to begin with. Now throw in a comminuted fracture and AVN becomes a very feasible scenario.

Barry Mullen, DPM, Hackettstown, NJ, yazy630@aol.com

I have never seen such a phenomenon as described. I suppose that the vasodilatory effects post-trauma may account for the resorption of the "fractured" sesamoid bone. In regard to a potential differential diagnosis that should be contemplated (not to be a fly in the ointment), an osteomyelitic process should be evaluated and ruled out, especially with such a significant trauma present.
 
Gino Scartozzi, DPM, New Hyde Park, NY, Gsdpm@aol.com

RE: Radiesse or Other Injectable Implants (Ron Worley, DPM)
From: Leonard A. Levy, DPM, John Moglia, DPM

Ron Worley, DPM indicated that he believed that Susan Levine, DPM, was the first podiatrist to be using injectable fillers in feet. In fact in the 1980s, an injectable collagen product (Keragan) which was not used off-label, and did have FDA approval for use in the feet was introduced for interdigital and plantar injections. I had considerable experience with it and was among about 20 or 25 podiatric physicians around the U.S. to use the material during the initial clinical trials. No sedation was ever suggested nor was it thought to be necessary.

While it was as effective as reported by both Dr. Worley and Bret Ribotsky, DPM, at that time it never quite caught on among DPMs (perhaps because of the cost) and this specially prepared collagen designed for the feet was discontinued in just a year or two.

Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL, levyleon@nova.edu

Any news about Podosil (medical-grade injectible silicone gel)? It was tested on diabetics with chronic ulcers and fared well with no systemic side-effects. Podosil would be a more long-lasting alternative to collagen injection into a weight-bearing area. My patients ask when it will be available. They would prefer periodic injections over an osteotomy procedure. I believe it is available in England.
 
John Moglia, DPM, Berkeley Hts., NJ, drjohnmoglia@aol.com

RE: Austin Complication (Simon Young, DPM)
From: Michael Forman, DPM

I have really enjoyed the discussions about the Austin bunionectomy. I would like to discuss the 60 degree cut. If the cut is not acute enough, i.e. 80 degrees, the osteotomy is less stable. If the cut is too acute, i.e. 40 degrees, the end of the proximal metatarsal can easily fracture. As I recall, the original question was related to inability to shift the capital fragment laterally. I think that this has been adequately discussed by several writers to PM News.

My point is that it is not the angle of the cut that makes it difficult to move the capital portion, but the other rather...

Editor's Note: Dr. Forman's extended-length letter can be read here.

RE: X-Ray Comparison (R. Alex Dellinger, DPM)
From: Simon Young, DPM

I am aware of the benefits of digital x-rays, which ideally should be incorporated into our practices, but certain economic issues must be addressed. As with any expensive item ($30,000-$40,000), how many years will it take to recoup your cost (I would assume a 5-year return on investment)? Are there additional costs with licensing the software on other computers? Is there an issue with technology obsolescence?

For me, the return on investment is a minimum of 10 years. I decided against purchasing. I will continue to review my decision on a yearly basis.
 
Simon Young, DPM, NY,NY, simonyoung@juno.com

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

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 - 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

PODIATRIST NEEDED -  NYC/ QUEENS 
 
SPANISH SPEAKING Podiatrist. PSR-24 +. Experience in Current office billing,  interpersonal skills,  business and staff operational skills, knowledge of Ins. policies, ability to sell non-ins. covered products/treatments, well-trained and confident from basic RFC to Surgery, respectful & honest to  patients and staff all a must. Position includes non-paid training as well as paid office sessions. P/T with real potential for growth, full-time position/partnership. Multi-Office practice looking for help towards  growth and expansion. Please call 631-270-4724 and fax cover letter and C.V.

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 - 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

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

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

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 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. 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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