The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

December 24, 2009 #3,735 Publisher-Barry Block, DPM, JD

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MO Podiatrist Advises Preventative Foot Care for Seniors

Older people often develop systemic conditions like diabetes or vascular disease that cause problems in the extremities. Peripheral neuropathy, which can be a symptom of diabetes, causes loss of sensation in the feet and can affect walking and balance, making falls more likely, points out Dr. John Dailey, a podiatrist with The Missouri Foot & Ankle Institute in Washington, Mo. Circulatory problems also can cause injuries to become ulcerated and painful because an inadequate blood supply slows healing.

Dr. John Dailey

“Usually, older patients see me when a problem has occurred, but preventive care would be better,” Dailey says. “Billions of dollars were spent last year on treating conditions of the lower extremities as a result of diabetes. Good preventive care could save money and help people avoid pain and suffering.”

Dailey’s preventive regimen includes regular podiatric check-ups. “I suggest everyone see a podiatrist for a preventive exam, just like you would see your primary-care physician on a regular basis,” he says. “Those who have health conditions should be checked twice a year. We may take x-rays, examine how you walk and make sure you’re wearing appropriate shoes.”

Source: Ladue News

Sengstock Elected President of MPMA

Jodie Sengstock, DPM has been chosen to serve as president of the Michigan Podiatric Medical Association (MPMA) Board of Directors for the next two years. Dr. Sengstock has been practicing podiatric medicine since 1997 and has been an associate at Feet First Podiatry in West Bloomfield, Michigan for eight years. Dr. Sengstock is also a Staff Physician at Garden City Hospital in Garden City, Michigan.

Dr. Jodie Sengstock

Dr. Sengstock is currently chairwoman of the editorial committee for the MPMA. She has been recognized for her dedication and involvement within medicine, receiving the Dr. Arthur J. Wessfield Memorial Award for Excellence in Podopediatrics (1996), Award for Excellence in Physical Diagnosis (1996), Podiatrist of the Year, Southeast Division, MPMA (2004), and Meritorious Service Award, APMA (2008).

Source: Footsteps (OCPM) Vol 34

Buyer Beware of Fitness Shoe Claims: TX Podiatrist

Forget dumbbells and yoga mats. the latest get-fit tool is a pair of funny-looking shoes. Reebok Easytones, MBTs, Skechers Shapeups, FitFlops, and Shape Up Shoes purportedly get you in shape as you walk. Here’s the basic premise: create instability in the sole of a shoe to force lower- body muscles to work harder. The result is killer legs and buns. Is wearing a pair of ugly athletic shoes to the grocery store enough to get you fit?

Dr. Marque Allen

There are no unbiased, published studies backing up the shoe manufacturers’ claims, says Dr. Marque Allen, a spokesman for the Texas Podiatric Medical Association and a physician for the San Antonio Spurs. “I would say buyer beware,” Allen says, especially considering the cost of the shoes, which can run as high as $390. He also recommends people who have foot or ankle problems see a doctor before buying shoes with unusual platforms.

Source: Jessica Belasco, San Antonio Express-News [12/21/09]

Plaintiff Alleged Infection Due to Unsterile Instrument (Kentucky)

FACTS: Sue Blevins, then age 62 and a church janitor, underwent a surgery on her ankle on 8-9-04 to remove a cyst. It was performed by Defendant, and followed a course of conservative care. On a post-operative visit several weeks later, Defendant removed the sutures with an instrument.  Blevins recalled that Defendant continued to use the instrument even after dropping it to the floor. Thereafter, on a subsequent visit, there were signs of an infection. Two days later, she was admitted to a local hospital with a significant infection. She remained hospitalized and underwent a skin graft repair surgery.

Her medicals were $86,520 and lost wages totaled $28,580. Impairment was capped at $100,000, Blevins seeking $300,000 more for pain and suffering. In this lawsuit, she alleged negligence by Defendant in several regards, (1) the surgery was not needed to begin with, her problems being related to tendon dysfunction, not the cyst, (2) a delay by Defendant in sending her to the hospital, and (3) maintaining an unsterile environment by using the dropped instrument.

Defendant defended that the surgery was properly indicated and followed a lengthy course of conservative care. Thereafter, while there was an infection complication, defendant postured that he responded to it properly and ultimately it was controlled. The court's instructions asked if defendant violated the reasonably competent podiatry standard. The answer was no, and Blevins took nothing.

RESULT: Defense verdict on liability.

PLAINTIFF'S EXPERT: Dr. David Widom, Palm Coast, FL.
DEFENDANT’S EXPERT: Dr. Alan Catanzariti, Pittsburgh, PA

Source: 13 K.T.C.R. 1  Kentucky Trial Court Review

CMS’s Summary of HIPAA Security Reviews Implies Employee Background Checks May Be Required

The first batch of government reviews of covered entities (CEs) for compliance with the security rule revealed a host of deficiencies, ranging from failure to conduct even an initial risk assessment to inconsistent employee training, according to a summary of findings and recommended corrective actions recently released by CMS.

The Security rule requires “appropriate access,” which CMS takes to mean “background investigations on personnel,” for both those with on-site and remote access. Background investigations on personnel should be conducted before they are given access to electronic PHI, the report states. The audits found CEs sometimes completed such checks after the employee had already been granted such access.

Source: Report on Patient Privacy

Send Out Introductory Letters

New patient introductory letters are a great way to touch your new patients and make them feel like you really do care about educating them about their foot and ankle problems. This letter should be sent out within 48 hours of their visit. It should be a one-page welcoming letter which explains the patient’s diagnosis. It should educate the patient on the other services offered by the office, and then provide three different contact options (e-mail, nurse line, and an alternative number) for any further questions.

Added to the letter should be a handout about the patient's diagnosis to reinforce what was discussed in the office visit. Lastly, include a copy of your last newsletter or flyer, as well as a magnet with the office contact information. Many patients pass the handouts on to friends who have similar problems. The magnet goes on the refrigerator so that patients never forget which foot doctor they went to, so they can refer their friends and family.

Source: Marybeth Crane, MS, DPM, Grapevine, TX. For information the American Academy of Podiatric Practice Management click here.

RE: Mal Perforans-Like Ulcer (Alan Berman, DPM)
From: Paul Kruper, DPM

Use a cast, antibiotics, and ulcer care until the ulcer heals. Create an incision along the medial aspect, and dissect tissue off the plantar aspect of the distal and proximal phalanges from medial to lateral to expose the plantar boney prominence. Use a bone file which should be easy work on cystic bone. Bone files provide more control of bone removal and more control in a small incision opening.

Paul Kruper, DPM, Kingsburg, CA, prkruper@yahoo.com

RE: Osteomyelitis? (Wm. Barry Turner, BSN, DPM)
From: Art Hatfield, DPM

Dr. Turner's case reminds me of a patient I took care of about 15 years ago. He was a blind 60 y/o diabetic with an ulcer with infected exposed bone sub right 5th MPJ. He related that he had a similar problem in the same area of the left foot. He then stated that he was able to cure the problem with applications of "Neosporin Ointment." He had no insurance and his 80+ y/o mother was helping him financially. I took an x-ray of the left foot free of charge, and guess what? He did have a healed osteo. of the left 5th M-head. Good stuff sometimes happens!

Art Hatfield, DPM, Long Beach, CA, afootjob@juno.com

ASSOCIATE POSITION – CINCINNATI, OHIO

This is your once in a lifetime opportunity to join one of the most successful practices in the United States. We do not have a seniority system. If you are motivated and have completed a PSR 24-36 residency, your income is limited only by your enthusiasm and desire to achieve.  Email resume to khart@cincinnatifootcare.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 - 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 - 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

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

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