The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

December 30, 2010 #4,050 Publisher-Barry Block, DPM, JD

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John Carson

PM News is saddened to announce the passing of John Carson, former Director of Governmental Affairs for the American Podiatric Medical Association.

John Carson

For over three decades, John was APMA’s voice on Capitol Hill. His integrity, intelligence, passion, and perservence won the respect on both sides of the aisle, enabling vital podiatric legislation to be enacted.  He was also the catalyst for the podiatric section of the American Public Health Association. Carson was elected to the PM Podiatric Hall of Fame in 2009.

Over Half of Populuation Suffers Heel Pain at Some Point: CA Podiatrist

Over 50% of Americans will suffer from heel pain at some point in their lifetime. It is difficult to find exact statistics on heel pain since most of the people who suffer from plantar fasciitis do not come in for treatment. In fact, according to Dr. Jack A. Reingold, podiatrist in Solana Beach, CA, "about 20% of the patients I treat suffer from some type of heel pain."

Dr. Jack A. Reingold

Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome. However, heel pain may also be due to other causes, such as a stress fracture, arthritis, tendonitis, nerve irritation, or, rarely, a cyst.

Source: PMW.com [12/27/10]

TX Podiatrist Voted Top Doc by H Texas Magazine

Dr. Gabriel Maislos has been voted as one of the Top Doctors of 2010 in Houston from H Texas Magazine by his peers. This award was based on his continuous commitment to providing the best in quality podiatric care for his patients.

Dr. Gabriel Maislos

Dr. Maislos specializes in a wide array of specialty foot and ankle care including hammertoes, diabetic foot care, heel pain, and bunions. He holds several specific foot and ankle related certifications. He has maintained a solo practice for the past eight years. Maislos also speaks Spanish, which enables him to communicate with all patients.

End The Year on a High Note - Part 2

To aid employees in listing their accomplishments, start with these:

• Training. Which staffers increased their skills by participating in professional development training? Ask them to tell the group one way they benefited from what they learned, to remind employees of the valuable opportunities available to them. Similarly, invite staffers who attended off-site events like seminars and trade shows to reflect on their experiences and what they and the practice gained from the experiences.
• Successes. Many employees have the tendency to focus on the goals they failed to meet and the myriad opportunities that failed to develop. Turn that negative focus around by inviting your team members to reflect on the projects and assignments that went right during the past year.
  

  Source: Communications Briefings [December 2010]

RE: The Passing of John Carson

I just learned of the death of John Carson, who for many years was the APMA Director for Governmental Affairs. John was an unsung hero in the podiatric medical community. With the exception of the APMA leadership and perhaps a few others, relatively few now in podiatric medical practice know about his extraordinary accomplishments on behalf of the profession. These included the establishment of key contacts with governmental leaders who were highly instrumental in the passage of major legislation leading to the recognition and advancement of podiatric medicine, facilitating its ability to serve the health of the nation on a level comensurate with its education and training. He will be very much missed. May he rest in peace.

Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL

RE: Undiagnosed Diffuse Skin Lesions (Elliot Udell, DPM)
From: Bryan C. Markinson, DPM

Dr. Udell outlines the differential diagnoses offered by multiple posters, and is somewhat distressed at the voluminousness of the list, asking if taking multiple biopsies would enable a dermatopathologist to make a "definitive diagnosis which everyone would agree on." This is definitely not the job of the pathologist. It is the job of the clinician and the pathologist, in concert. 

While most of us clinicians are postured in a position of total reliance on the pathologic diagnosis, we do a disservice to our patient if we don't try to come up with a differential. All the differentials brought up in the postings were good ones, and possible. Indeed, there may be more than one process going on in Dr. Agostinelli's patient. Not all skin under the miscroscope represents skin lesions, but reactive patterns, and changes associated with systemic illness that sometimes cannot be pinpointed directly on slide examination. For example, "vasculitis" as a histologic diagnosis may represent changes accociated with a multitude of diseases or insults.

This is why history and photos are enormously helpful to the pathologist. We must remember that the pathologist is another clinician caring for the patient, and more to Dr. Udell's point, is powerless without a biopsy. In conclusion, biopsy is extremely revealing, but clinician cooperation is vital.

Bryan C. Markinson, DPM, NY, NY, bryan.markinson@mountsinai.org

RE: Ethical Dilemma About Miscoding Routine Foot Care (Name Withheld)
From: Michael M. Rosenblatt, DPM

Ever since Medicare started paying for podiatric services, in particular trimming of nails and calluses under "certain" circumstances, this coding has been an unmitigated nightmare for the profession. We struggled for government recognition and coverage of our services. But that very accomplishment is a double-edged sword. Witness just the latest "conviction" for Medicare/Medicaid fraud, written up on this blog. The problem is at once simple and complex:
There are a large number of elderly people who require some form of RFC. The complex part is that they do NOT want to pay for it, and expect government to. A reasonable fee of some kind should be a requirement for those who do not satisfy Medicare requirements for coverage.

Ultimately, no matter how good or how willing patients are to pay that fee, a practice over-weighted in RFC will fail. Your college loans and malpractice insurance rates will cause this. All new practitioners and those "addicted" to over-providing this service must face the facts.

There are a myriad of services provided by podiatrists, both surgical and conservative. If you do not open the door to providing those services, you will eventually hate yourself and the profession for it. At best, you won't make a living. At worse, you run the risk of losing everything, as we so sadly see on these conviction reports.

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

RE: X-Ray Comparison (Michael Forman, DPM)
From: Larry Kosova, DPM, Alan Silverstein, DPM

Adding digital x-rays is something I wish I did many years ago, not just 3 years ago. Time is money, as they say. For a new practitioner, this is the only way to go with linking to EMR technology, etc. Not having to pay for processor cleanings, fluids, parts is great but digital x-rays won't make you money; they will be one part of making your office more efficient. A more efficient office tends to make you more money. 
 
Larry Kosova, DPM, Chicago, IL, lkosova@yahoo.com 

Concerning digital x-rays, one letter writer states that the average set-up costs ~$20K, vs. average wet chemistry costs yearly of at least ~$1200. According to this scenario, it would take about 15-16 years to average the costs out. The next writer states that the costs are recouped after only 1.5 years. This is quite a disparity. Perhaps, it all really comes down to the non-financial aspects, i.e., the superiority of the digital system vs. the wet chemistry system.

Alan Silverstein, DPM, NY, NY, alel@optonline.net

RE: He Can Outshoot You With His Feet

I got this video from my cousin. I was fascinated with the subject’s ability to load as well as shoot with his feet. He has no arms. Click here to view the video. 

Man with arms shoots pistol with feet

Note the hallux valgus of the left foot!

Neil H Hecht, DPM, Sherman Oaks, CA

ASSOCIATE POSITION - KENTUCKY
 
Very well established Podiatry practice in Louisville, KY seeks a motivated, ethical practitioner trained in all phases of podiatry including routine care, surgery and wound care to join 2 other podiatrists. By joining our practice you will receive a competitive salary with a bonus structure and benefits. Our practice is equipped with DME, PadNet, Gait Scanner and on site retail store. There is a huge potential to grow your practice with our ideally located facility that has strong affiliation with leading area hospitals as well as 2 local residency programs. For immediate consideration, please forward CV to Samuel10530@yahoo.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.

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

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

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 - 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

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Be an owner not a worker. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K.
dpmpracticeforsale@yahoo.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

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