January 20, 2012 #4,363 Publisher-Barry Block, DPM, JD
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PODIATRISTS IN THE NEWS
AZ Podiatrist Injects Amniotic Membrane to Heal Diabetic Foot Ulcers
A Scottsdale podiatrist has developed a treatment for diabetic foot ulcers that could prevent amputation and other health problems. The treatment is the brainchild of Dr. Bruce Werber of InMotion Foot & Ankle Specialists, who has practiced podiatry for 32 years. Werber gets the open, infected wounds to close by injecting them with amniotic fluid. In the last year, he said, most people whose ulcers were not responding to treatment saw their wounds heal completely using this new treatment," says Werber.
Dr. Bruce Werber
"We now have amniotic membrane and fluid that is cryopreserved. So it can be used on anybody at any time and anywhere and morselized so it can be injected. We don't have to have a live birth to collect it, and it can be harvested in very clean, sterile conditions. We inject it in and around the wound, and it enhances the healing.
Source: Lisa Kennell, The Arizona Republic [1/18/12]
AT THE COLLEGES
CA Podiatrist Speaks at Barry
The cost of diabetes in the United States is predicted to increase 270 percent by 2030. Amputations and ulcers make up more than 30 billion dollars a year, spurring Dr. Lee Rogers, the co-director of the Amputation Prevention Center at Valley Presbyterian Hospital in Los Angeles, CA, to launch a congressional campaign and bring his experience to Congress. This week, during a campaign visit to Florida, Rogers spoke to more than 50 podiatric medical students at the Barry University’s School of Podiatric Medicine.
(L-R) Dr. Jeffrey Jensen, Barry’s School of Podiatric Medicine dean poses with Dr. Lee Rogers, congressional candidate in California, and Class of 2013 president, Hani Badahdah.
Rogers discussed his views on medicine in the future, on preparing for graduate podiatric medical education, and how podiatric physicians can play a leading role in chronic illness prevention, including diabetes, hypertension, and obesity. He is vying for a seat in California’s 25th Congressional District. “With the exploding rate of diabetes and the aging of the baby boomers, podiatric physicians are the primary providers of diabetic amputation prevention care now and in the future,” said Rogers. There are currently more than 200 attorneys holding office in the U.S. House of Representatives and 18 seats are held by physicians.
PODIATRISTS IN THE COMMUNITY
MA Podiatrist Adds Wellness Coaching to Her Repertoire
Dr. Michelle McCrumb's approach to health and fitness is gentle and gradual. A longtime podiatrist who has added wellness coaching to her offerings, she advocates starting small, doing what's comfortable, and adding to the challenge slowly but surely. She insists that even starting the tiniest exercise plan can lead to a productive fitness routine in time.
Dr. Michelle McCrumb
This new pursuit began about two years ago when she noticed so many foot-care patients complained they could not exercise. "People come in and their feet hurt, so they're not exercising as much, so they gain weight because they're not exercising, then their feet hurt more," said Dr. McCrumb. "I found myself saying the same things over and over." Realizing that people in many situations had pain or discomfort that discouraged them from trying exercise, Dr. McCrumb wanted to intervene. "I developed a plan to help people reverse that cycle," she said. "It's really important that they keep moving."
Source: Pat Waring, The Martha Vineyard Times [1/17/12]
HOSPITAL PODIATRISTS IN THE NEWS
FL Podiatrist Joins Lee Memorial Health Systems
Officials at the Lee Memorial Health System have announced that podiatric physician, Dr. Arin J. Sheingold, has joined the medical staff. Sheingold obtained his degree from Barry University School of Podiatric Medicine.
Dr. Arin J. Sheingold
Dr. Sheingold completed a Podiatric Surgery Internship and Residency at Chestnut Hill Hospital and is Board Qualified in Foot Surgery by the American Board of Podiatric Surgery and is Board Qualified in Reconstructive Rearfoot/Ankle Surgery by the American Board of Podiatric Surgery. He has joined Foot & Ankle Center.
Source: Lehigh Acres Citizen [1/18/12]
SGR Repeal Dilemma Could Make Passage Harder
Repealing Medicare's sustainable growth rate (SGR) formula for physician pay — a goal that always seems just out of reach — poses a dilemma for lawmakers that could make the measure even harder to pass. The dilemma is described in a study issued last month by the Congressional Research Service (CRS), an arm of the Library of Congress. It states that passage of an ambitious "doc fix" to the Medicare reimbursement crisis would force lawmakers to choose whether Medicare beneficiaries or taxpayers in general would suffer financially from one of the measure's overlooked consequences.
The SGR formula had called for a 27.4% cut in Medicare rates on January 1, but Congress voted in late December to extend the deadline to March 1. Exasperated by continual short-term postponements of scheduled cuts since 2003, organized medicine has lobbied Congress to replace the SGR formula with one more equitable for physicians. The Congressional Budget Office (CBO) has estimated that junking the SGR and freezing Medicare rates for 10 years would cost roughly $300 billion over that time frame.
Source: Robert Lowes, Medscape News [1/11/12]
QUERIES (SPORTS MEDICINE)
Query: Keeping Toes Warm During Antarctica Marathon
A friend of mine will be running in the Antarctica Marathon in March. I am concerned that her toes are going to get uncomfortably cold or frostbitten due to the length of exposure to very cold temperatures during the marathon. My concerns are two-fold: the uppers of many running and trail shoes have a looser mesh weave which allow cold air in. Second, the running surface is going to be cold; therefore by conduction, the interior of the shoes will get cold. I was wondering if anyone has any tips on keeping her feet warm during the race?
Fujitsu has made the best and most reliable scanners for many years. At Amazon, they list models from $400 - $1500. Whenever I've been in a bank or a law office where a lot of mission-critical scanning is done, it's invariably a Fujitsu.
There are many good scanners. We use a Lexmark 544 and, on some days, scan and import up to two reams of records per day. I have not used a hand-held scanner, but I don’t see how it could scan as fast as a stationary one. You might consult your local IT.
Dr. Dinowitz posts a well-thought-out detailed appraisal of the myriad of encumbrances that exist upon medical practice today. He is also correct in saying that these are not limited to podiatrists. However, one thing that is glaringly missing from most postings of this nature, especially when the comment is made that all of medicine is similarly affected, is simply that any MD, in any state, in any city, on any given day of the week, at his or her will, can get employment for $160,000 dollars a year.
It may not be the best of venues, or the most desirable location, etc., but it is there always and always will be. The shortage of primary care physicians is enormous, guaranteeing these employment opportunities well into the future, in any healthcare system. Podiatric medicine could find ourselves in similarly good stead, if we as a profession decided to produce podiatric medical and diabetic specialists, as triple the amount of diabetics in the next two decades are staring us right in the face. Yet we have chosen to be/emulate foot and ankle orthopedic surgeons.
Dr. Dinowitz challenges us to grow or wither away. We need to first seize upon what podiatric medicine patients will be serving up for us to treat. We will be ready for the osseous ankle, that seemingly holy grail of podiatric surgery, but how much of that will there be to go around?
The point of my post about our use of laminate was not that we have a 'sterile' office. No one can surely claim to achieve this impossibility. The point was that it allows us to keep a 'clean' environment and has been withstanding the demands of our practice because it makes it easy to do. Any solid surface flooring material will always outperform carpeted types in ability to disinfect and prevent from contamination after spills and messes, seams or no seams.
And, while the flooring of any office, institution, or surgery suite is considered a potential source of contamination (as are your counters, computers, chairs, and other inanimate objects), even the CDC regards flooring as a 'non-critical surface' and recommends only low to mid levels of disinfection, even in the hospital setting.
The link to a great infection plan that offices can read and adapt to their specific settings is: (cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf).
I was talking to another doctor about this issue and he related the following story to me. He had a deaf patient who came in to see him with a family member as an interpreter. He concluded the visit and the family member, who was acting as an interpreter, presented him with a bill and told him that if he did not pay it, he would be violating the ADA. SOME PEOPLE!
Congratulations to PM and to Barry Block for 30 years of outstanding leadership in providing a valuable communication tool for our profession. The somewhat instant interaction the readership is given in this forum is extremely valuable to the practitioner in the field. It is always helpful, and at the tip of your fingers at all times. The interactivity is what makes it such a great avenue for discussion and dissemination of information. Keep it up for another 30 years.
Ted and I want to congratulate Dr. Barry Block on the 30th year of Podiatry Management and PM News. Barry, you are what keeps the profession connected. Thank you for all your hard work and the time you spend getting the publication and listserv out to everyone. Kudos on your accomplishment.
Podiatry office in Los Angeles county looking for part-time biller experienced in podiatry Workman's Comp. Please fax or e-mail resume to 661-265-1877 or firstname.lastname@example.org
EQUIPMENT FOR SALE– LASER SYSTEM
Laserscope Model Lyra i YAG Laser system with 3 hand pieces, eyewear sets, calibration unit, complete manual foot control and video information, for fungus nails, vein therapy and hair removal. The unit has the attached cooling system and all accessories $8,email@example.com
ASSOCIATE POSITION- MARYLAND
Looking for 3rd associate. Must be personable, well trained and highly motivated. Great locations in Southern Maryland, including an Ambulatory Surgical Center. We currently have EHR, digital radiography, dispensing center and PADNet. Looking for immediate hire! Please send CV to:firstname.lastname@example.org
ASSOCIATE POSITION- LONG ISLAND, NY
Full time associate position available with well rounded multi-office group on Long Island. Ideal position for July 2012 graduating third year resident who wants to practice and live on Long Island. Candidates must be board qualified or board certified, and well trained in all phases of podiatry including surgery, biomechanics, wound care and palliative care. Compensation includes salary,malpractice insurance, paid vacations and surgical incentives, with a future partnership opportunity available for the right candidate. Interested doctors are encouraged to submit their CV's in response to:email@example.com.
ASSOCIATE POSITION - NEW JERSEY
Well established, well rounded podiatry practice, looking for well trained podiatrist. Large number of new patients monthly, digital x-rays and EMR. Doctor is Chair of Podiatry Department and involved in hospital wound healing center. Offices 75 miles west of New York City in the Lehigh Valley. Looking to hire a personable, highly motivated individual with strong ethics. Seeking an associate leading to potential partnership. Please send resume to:firstname.lastname@example.org
ASSOCIATE POSITION- PHILADELPHIA, SOUTHERN NEW JERSEY
Seeking motivated, independent foot & ankle surgeon to join large practice. Our multi office practice covers all aspects of foot and ankle pathology, including heavy limb salvage/ hospital volume. Offering competitive salary and benefit package. Send CV and two references to:email@example.com
ASSOCIATE POSITION-SOUTHWEST FLORIDA
Immediate position for associate to partnership for a surgeon that is BQ/BC by ABPS. Must be PSR-24 or PM&S-36 trained. Excellent salary w bonus. Must be ethical, self-starter, hard worker. Willingness to learn/work as part of a team. Surgery Block time. Must be proficient in rearfoot/ankle surgery. Email CV, photo, LOI to:firstname.lastname@example.org
PART-TIME PODIATRIST NEEDED- LOS ANGELES, CALIFORNIA
Busy podiatrist looking for assistance with patients located in facilities, homes, office, etc. Flexible hours, independence, and great compensation. If interested email CV to email@example.com or call Terri at 323-353-8103.
ASSOCIATE POSITION-LAS VEGAS/HENDERSON, NV
Well-established 22 year practice in Las Vegas/Henderson, Nevada seeking full-time associate. General podiatric care with moderate amount of surgery to be done in local hospital or surgery center. Competitive salary and benefits. Modern office in new area. Please respond by email to:firstname.lastname@example.org
Lead to partnership &/or buy practice. Well-established, reputable & successful (700K collection annual) 25+ year practice. Newer 2k sq.ft office condo & w/5 tx rooms, Aver.80 new patients monthly, full hospital privileges, DME, Padnet, digital x-rays. Inquires to email:email@example.com
ASSOCIATE POSITION- EAST TENNESSEE
30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. $160,000 base salary with bonus incentives and benefits. Post-residency experience a plus. Please send resume firstname.lastname@example.org
ASSOCIATE POSITION- NEW YORK
Well established, well rounded, hospital based podiatry practice, looking for well trained podiatrist. Large number of new patients monthly, digital x-rays, EMR, and vascular and nerve testing. One partner is Chair of Pod Dept, other is involved in wound center. Two offices 75 miles north of New York City, in the beautiful Hudson Valley. More affordable cost of living than Westchester County; it’s a great place to live. Looking to hire a personable individual with strong ethics and high motivation. Seeking an associate leading to potential partnership. Must have PM & S- 36 training. Please call (845) 471-2243 or email@example.com.
ASSOCIATE POSITION-NAPLES, FLORIDA
Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. Candidate should have the skills and desire to perform rearfoot/ankle surgery. Florida has a great scope of practice law and we rotate for ER call. Candidate needs to be ethical and motivated. Established practitioner or new practitioner. In a cover letter tell me why you should be selected for the team. Email cover letter and CV with subject line "I am your new team member." to:Drgordon@gulfcoastfootcare.com
PRACTICE FOR SALE- SOUTHERN CALIFORNIA (ORANGE COUNTY)
Strong & diverse local economy, in a beautiful beach community. Well rounded, established since 1983, fully equipped. Consistently grossing over $600K. Many types of insurance, reimbursement and revenue sources. Local hospitals allow full scope of podiatric care. Terms available. Contact firstname.lastname@example.org
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 516 476-1815PODO2345@AOL.COM
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