The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

March 30, 2009 #3,506 Publisher-Barry Block, DPM, JD

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NY Podiatrist’s Rx for High-Heel Caused Pain: Moderation

Spring is officially here, the snow is finally gone and to celebrate, women around the capital region are packing up their boots, and putting on their heels. But those stylish shoes could be costing you more than just your hard earned cash. Board certified podiatrist, Dr. Mark Lentini, says "Unfortunately it also projects your weight onto the forefoot, which causes a pinching of your metatarsals and your toes which could aggravate or lead to the development of bunions or hammertoes."

Marie Bubonia is all too familiar with these foot problems as well as back pain. Her cute- shoe addiction walked her straight to the doctor's chair. Luckily, she doesn't have to give up her heels. Dr. Lentini says it's all about finding the right fit for your foot.... and wearing them in moderation. Lentini’s prescription? Restricting her high heel wearing to special occasions and sporting more sensible shoes when going about her day to day business. She admits this regimen has greatly improved her health and her back feels much better. But she also admits she'll never give up her love of high heels completely.

Source: Carey Proctor, WRGB CBS-TV [3/24/09] 

Guiliana Keynotes at OCPM AAPPM Practice Management Club

Dr. John Guiliana recently delivered the annual keynote address to scores of members of the OCPM AAPPM Practice Management Club. Hegave them advice and tools to use to create  balanced and successful lives as a podiatric physicians.

(L-R) Nathaniel Hamm, club president Shyla Narasimhan, Dr. John Guiliana, Lauren Kishman, and Kamran Hussain

This presentation was made possible by a grant from Dr. Les Appel and Stable Step, Inc., maker of Powerstep® prefabricated orthotics. AAPPM provides sponsorship support to student practice management clubs at the podiatric medical schools, including annual sponsorship of  AAPPM’s leading speakers. 

Doctors Increasingly Close Doors to Drug Reps

The relationship between doctors and drug reps may never be the same again. Pharmaceutical companies -- battered by a sluggish drug pipeline, the looming loss of blockbuster patented drugs, an economy in recession and scrutiny of their relationships with physicians -- are re-examining the value of sending drug reps into doctors' offices. Detailers are struggling to grab a shrinking slice of physicians' valuable time and attention while adjusting to new drug industry rules banning freebies such as pens and notepads.

While most physicians still have positive views of detailers and drugmakers, those sentiments are cooling. About one in four physicians works in a practice that refuses to see drug reps. Of doctors who do see reps, about 40% will meet with detailers only with scheduled appointments. The by-appointment-only figure jumped 23% during the last six months of 2008, according to a survey of more than 227,000 medical practices representing 640,000 physicians that was released in February.

Source: Kevin B. O'Reilly, AMNews [3/23/09]

Query: Chronic Calluses and Skin Fissures

I have a 35 y/o female, healthy, no medical problems with moderate to severe callus formation and chronic skin fissure lesions under the soles of both feet. She's been tested for allergies and there were none noted. Two fungal cultures were negative. She claims her feet have been this way since she was a teenager. I started with OTC Kerasal and it didn't even touch it. I would appreciate some no-nonsense recommendations for this stubborn problem. 

James M. Petko, DPM, Falls Church, VA

Query: Should I keep my DEA Number Active?

I have been out of podiatry for the past few years in order to take care of my children and it is time to renew my DEA number. My plan is to return to practice podiatry again within the next 1-2 years. Should I pay the $500+ dollars to keep my DEA # active or should I worry about it when it is time to return and apply again? 

Name Withheld - New York

RE: Heel Pad Stabilization (Calvin Britton, DPM)
From: Multiple Respondents

Try heat-molded Plastizote inserts in  shoes with a strong  heel counter. Use 50% urea ointment under occlusion PRN to reduce and remove callus formation. 

Dwight L. Bates, DPM, Dallas, TX, dlbates04@yahoo.com

Try a rocker sole shoe with a heel rocker. A ready-made version is MBT. Look for the styles that have a higher heel. It is designed to carry weight under the midfoot. The goal is no heel contact, and reducing pronatory motion. Fill the arch cavity as needed inside the shoe to support the midfoot. A negative heel shoe is contra-indicated.

Robert S. Schwartz, C.Ped, NY, NY, rss@eneslow.com

Editor's note: An extended-length letter by Mr. Jeff Root can be read at: http://www.podiatrym.com/letters2.cfm?id=25427&start=1

RE: Extra-Depth Scuba/Swim Fins (John P. McLoughlin, DPM)
From: Joseph Weisenfeld, DPM, James Breedlove, DPM

Open-back scuba fins are depth-inlay. They are made to accommodate cold water boots (5mm.). If there is a width or vamp issue, using warm water booties (3mm) should allow for the room. If the issue is with the toes, most fins come with open toes, or the offending area of the toe can be cut out without ruining the integrity of the fin. If you're talking about snorkeling, these fins are not appropriate. I'd also suggest going to a large dive show (like Beneath the Sea, which visits Boston once a year) and all the manufacturers present their products. My personal favorite is Mares (I wear a 12 wide and need a high vamp).
 
Joseph Weisenfeld, DPM, Staten Island, NY, JAtoe2@aol.com

Editor’s note: An extended-length letter by Dr. Breedlove can be read at: http://www.podiatrym.com/letters2.cfm?id=25426&start=1

RE: A Challenge to PICA/Proassurance and the Profession (Ken Malkin DPM)
From:  Michael M. Rosenblatt, DPM,

Dr. Ken Malkin suggested that those who receive checks from the sale of PICA donate a percentage to APMA Educational Fund. As you may know from recent news, the Obama Administration is trying to reduce the tax value of charity donations. But that is unlikely to occur this year.

This is all the more reason to make your donation to the APMA Educational Fund now. During the height of the real estate bubble, I sold a property and made a substantial donation to the APMA fund as part of our Charitable Remainder Trust (after my wife and I are deceased). I am not reporting this for self-aggrandizement, but instead to extol the extraordinary tax advantages from charitable giving. When you give to a 501c registered charity, you win, the charity wins and your estate wins (The only party that loses is government).
 
Had I (been forced to) pay all taxes due at time of the sale, I would have seen this account dwindle to a very small fraction of the sale value of the property during the recent economic collapse. But that is not the reason I did it. APMA was very good to me throughout my practice years. I am proud to offer something back. I salute APMA! 
 
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

Another nice way to donate to The APMA Educational Fund is a memorial donation. I frequently make a check to The Fund “In Memoriam” to family, friends, colleagues, and patients who have passed away. This is an ongoing donation.
 
Pete Harvey, DPM, Wichita Falls, TX, pmh@wffeet.com

RE: PM News Marks Issue #3,500 & 15th Anniversary
From: Keith Gurnick, DPM

I also want to send my congratulations and thank you to Dr. Block for his excellent daily podiatry-oriented on-line service. Each day, I look forward to reading the posts and responding when I might have something to offer our colleagues. I have actually learned many things here and I take notes and write down useful information that has been helpful to my patients and my practice. Each day is like a free mini-seminar without C.E. units. When I scroll down the screen, I am never bored and usually I want to read more. I especially like the heated debates then eventually the notation "Topic Closed", signifying that enough is enough. Keep the written words coming.

Keith Gurnick, DPM, Los Angeles, CA

Editor’s Note. This topic is now closed.

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 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

ASSOCIATE NEEDED - MIAMI DADE FLORIDA

Partnership/buy out opportunity for the right candidate. Well-established modern practice. EMR , digital x-rays, gait scan etc. Excellent hospital privileges. SALARY...two options. $50,000 starting, 40% of everything you generate over $120,000, 50% over $200,000, 55% over 250,000 and 60% of everything you generate over $350,000. Want a fixed salary instead? $80,000 a year. I feed you patients and provide an excellent well-trained staff. Contact doctorinhialeah@aol.com

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

PODIATRIST NEEDED FOR MIAMI-DADE COUNTY

Multi office practice needs doctor of podiatry for full time and/or part time for private office, clinics, and nursing homes. Great opportunity to grow with and unlimited income potential. Offices in Miami, Hialeah, Westchester, and Cutler Ridge. Email to feetdoctor@aol.com

ASSOCIATE POSITION – VICTORIA, CANADA

Beautiful Victoria, B.C. Canada on the ocean, fast growing area. Associate for multi-office full scope practice. Licenser exam to be given in June 2009. Reply to dr.cole@shaw.ca

ASSOCIATE POSITION NEW YORK

Podiatrist needed for private clinic setting in N.Y.C.  All RFC, no stress, $40+/hr. Great opportunity to earn some easy extra money. For more info. And details call (917) 880-6639 or e-mail: hansfeet@aol.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 NEEDED - MIAMI DADE FLORIDA

Partnership/buy out opportunity for the right candidate. Well-established modern practice. EMR , digital x-rays, gait scan etc. Excellent hospital privileges. SALARY...two options. $50,000 starting, 40% of everything you generate over $120,000, 50% over $200,000, 55% over 250,000 and 60% of everything you generate over $350,000. Want a fixed salary instead? $80,000 a year. I feed you patients and provide an excellent well-trained staff. Contact doctorinhialeah@aol.com

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