The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

March 23, 2009 #3,500 Publisher-Barry Block, DPM, JD

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PM News Marks Issue #3,500 & 15th Anniversary

This issue commemorates two significant milestones for PM News.  This publication, which started out in 1992 as notes exchanged between a few dozen podiatrists on the Prodigy service, began formally publishing as PM News in Spring 1994. In the interim, PM News has grown from 150 initial subscribers to over 11,000 podiatrists and students, becoming podiatry’s daily newspaper.

We’d like to thank all those responsible for PM News’ success, especially our advertisers, without whom which we could not supply this free service. Special acknowledgment goes to our Webmaster Al Musella, DPM who developed and maintains the software that runs both PM News and our website. Additional praise is due to Hermine Block for her superb copy editing and Harry Goldsmith, DPM for providing Codingline. Last, but not least, we thank you, the readers who constantly post queries and comments. Your input provides the unique interaction that makes PM News unrivaled by any other medical specialty.

MO Podiatrists Provide Spring Foot Health Advice

With the advent of sandal weather, Thomas Hewitt, DPM, a podiatrist with Foot Healers, says he sees patients who have a variety of cosmetic concerns, including fungal toenails, calluses, athlete’s foot and hammertoes.

Dr. Thomas Hewitt

“Almost everything can be surgically avoidable for a period of time,” Hewitt says. “But eventually, surgical correction may be needed to correct the deformity.” Orthotic shoe inserts and prescription medications are among the first treatments for patients who present with early-stage foot conditions or deformities.

Dr. Constantine Kyramarios

One of Hewitt’s clinical partners, Constantine Kyramarios, DPM, adds that ill-fitting shoes can contribute to cosmetic issues. For instance, “fungal infections of the toenails, especially in the big or little toe, can be caused by wearing shoes that are too tight,” he says. “The shoes can cause micro-trauma to the nails, lifting the nail plate and allowing fungus to get underneath.” He notes that any sign of nail fungus is best assessed by a podiatrist because the condition can be difficult to eradicate with over-the-counter medications and, if left untreated, can lead to chronic athlete’s foot, which is caused by the same pathogen.

Source: Ladue News [3/5/09]   
 

Nomir Hopes for Fall FDA Clearance of Laser For Oncyhomycosis

Nomir Medical Technologies in Waltham, MA is developing a laser called Noveon for diseases like antibiotic-resistant staph infections, as well as nail afflictions. Noveon is a type of laser already commonly used by doctors for treatments like cataract surgery, dental work and even hair removal. Noveon beams two different wavelengths of near-infrared light at toenails to selectively take aim at and kill fungi.

After four treatments with Noveon, about half of the 39 toenails tested no longer had active nail infections, according to the results of a clinical trial that the company presented this month at a national dermatology meeting. Six months after the initial treatment, about 76 percent of the volunteers had clear nail growth, the study reported. “We will be able to reach people who have heretofore stayed away from treatment because of the toxicity or the costs or other reasons,” said Richard F. Burtt, Nomir’s chief executive.

Mr. Burtt said the company was preparing to submit the data to the Food and Drug Administration, hoping to receive clearance to market Noveon by this fall. The agency has already cleared Noveon for use on the skin and in nasal passages. But the company is not taking orders for or distributing the laser for nails until it receives specific permission to do so, Mr. Burtt said.   For full story click here.

Source: Natasha Singer, New York Times  [3/19/09]

Blumenthal Pick for IT Chief is Greeted With Praise

Physician, researcher, and healthcare policy wonk David Blumenthal was named as President Barack Obama’s choice to become the national coordinator for health information technology at HHS, an announcement that met with approval from industry groups.

Blumenthal, an internist who founded the Institute for Health Policy at 907-bed Massachusetts General Hospital, Boston, in 1998, intimately knows the size and contours of the gaps in EHR adoption rates at U.S. hospitals and doctors’ offices.

In 2007, Blumenthal became senior health adviser for Obama’s presidential campaign and previously served on the White House Health Professional Advisory Group during the Clinton administration. Before that, he was a staff member for Sen. Edward Kennedy's health and scientific-research subcommittee. Blumenthal, who replaces physician Robert Kolodner as ONC chief, was named to Modern Healthcare’s list of the 100 Most Powerful People in Healthcare in 2003, 2004, and 2006.

Source: Joseph Conn, Modern Healthcare [3/20/09]

Query: Botox for Hyperhydrosis

I need information on Botox injectables. I had a patient come in with sweaty feet who has tried almost everything. I also told her this procedure could be very painful. I might consider doing this outpatient with some sedation. Where can I obtain the product? Any info would be helpful.

Stephen Kinard, Rocky Mount, NC

Editor's note: An excellent article on the topic, Application of Botox® for Pedal Hyperhydrosis by Mostafa Niknafs, DPM & Mohsen Khoshneviszadeh, DPM , which appeared in Podiatry Management can be read at: http://www.podiatrym.com/pmarticle.cfm?id=104

RE: Associate  Compensation (David Zuckerman, DPM)
From: Multiple Respondents

I have personal experience with a situation like this and feel Dr. Zuckerman is paying his associate VERY well. Regardless where the patients come from, a successful venture like this requires trust.  Obviously, the original doctor in the group is going to give patients to the new associate and also pay the associate at the same rate. My advice to the new associate, shut your mouth, play your cards right, and you will do better as a group than a solo practitioner.

Eugene A. Batelli, DPM, Clifton, NJ, ebatelli2001@yahoo.com

It sounds like Dr. Zuckerman is giving his associate a great deal . I practice in a solo practice that sometimes doesn't net me 40%. The associate may have a misconception about overhead expenses.  
 
Karen Malley Banks, DPM, Thomasville, GA, kmbwwjd@rose.net

Figure out your overhead. If it is in the 50 - 55% range, paying him anything over 40 - 45% may cost YOU money!
 
Neil B. Levin, DPM, Sycamore, IL, DRFEET1@aol.com

RE: Central Vacuum Attachment for Handpiece (Jeffrey Horowitz, DPM)
From: Scott Evans, DPM

There is a physics principle which states that only so much air can go through a certain diameter tube. If you take a small vacuum tube which is attached to a drill and connect it to a wider diameter tube going to a central vac, your central vac will not work as well. You will end up sucking up less air (and nail dust) through the smaller tube on your drill than if you just attached the larger central vac tube straight to your other hand. I used to make a little sling to hold my central vac tube on top of my left hand (while debriding with my right). The last few years, I got lazy and just held the tube in my left hand. It worked fine.

Scott Evans, DPM, Tucson, AZ, sevans@tucsonortho.com

RE: Mitch Pokrassa, DPM

Last week was indeed a sad one for the world of podiatric medicine as we lost a great mentor and teacher, Dr. Mitch Pokrassa. For those of you who did not have the pleasure of personally knowing him, his work is left behind in McGlamry’s textbook (Chapter 29, clubfoot deformity). Mitch was an excellent, caring doctor, person, and friend. We all will miss him.

Mak Yousefpour, DPM, Los Angeles, CA

CASE CONSULTING

PRACTICE FOR SALE - CENTRAL FL

Practice sale, in beautiful, high quality of life, growing area; 2000 sf bldg. fully equipped/ designed for podiatry; excellent location, features & exposure; near hospital, wound and HBO center. Great opportunity for expansion; good insurance climate. 352-357-7499 / E-mail: windnwave@earthlink.net

PRACTICE FOR SALE-SOUTHEAST MICHIGAN-BRIGHTON

Great opportunity. Established 11 years. Excellent location. Large illuminated sign on busy main road. Mid to high income growth area.  Supplies, furniture, and equipment included: X-Cell X-Ray w Hope Autoprocessor, Pelton-Crane Autoclave, Parks Lab, Bircher, Burton Floor Light, OR with Lighting, bone instruments and power equipment, Midmark Chairs. Quality 1,350 sf build-out. convenient parking. Must sacrifice. Call (248) 565-5266. Docpod@aol.com

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

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 Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

PRACTICE FOR SALE – FLORIDA 

Who wants to continue making good money in a down economy, and would like to live in Florida on the coast? I have been working for 45 years and have had enough. My business grosses over $900,000 a year and nets over S250,000. I see approx. 40 patients a day and am sitting on a little gem. Office space is approx. 2,000 Sq. Ft. Hospital surgical center very close. If you are seriously interested, I help you get  qualified for a loan. Large scope of practice in Florida. $525,000. Contact me at Hagen5644@yahoo.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.

ASSOCIATE POSITION - CHANDLER/GILBERT/PHOENIX, ARIZONA

Seeking a well-trained, ethical and hard working graduate of a PSR 24+/36 Residency to join our growing multi-location practice. This is a practice with a nice mix of 35% surgery/trauma, 20% diabetic/wounds, 25% biomechanics, 20% pediatric. ER Call. Opportunity for partnership at 2 surgery centers. Very modern offices with EMR, U/S, Digital X-Ray, ESWT, Vascular Testing Machine. Excellent referral base, and a well-trained staff. Board eligible/certified a plus. Competitive salary, bonus structure, benefits. Please e-mail CV and references to FootAnkleAZ@aol.com

OFFICE SPACE/ MRI RENTAL – NYC, LI   
 
Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, and Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITIONS – CALIFORNIA

Three podiatrists needed for busy North Hollywood office. Full-time Monday-Friday 8am-2:30pm.  No weekends and no call. Pay negotiable. New podiatrists are encouraged to apply. Please email resume and salary request to Coasttocoastpodiatry@yahoo.com

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

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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 11,500 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 Ext 110.

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