The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

April 10, 2009 #3,516 Publisher-Barry Block, DPM, JD

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NY Podiatrist Discusses How to Avoid Blisters from Sandals

While it seems like a no-brainer, buy sandals that fit. Wearing even a half size too big or small will cause blistering. Feet constantly change size, due to weight shifts and aging, so get measured every Spring,” says Hillary Brenner, a podiatric surgeon in New York City.

Dr. Hillary Brenner

When choosing shoes, look for flexible materials, such as soft leather and microfiber. Avoid stiff straps that fall across blister-prone ankles and toes. Once you get your sandals home, moisturize your feet (well-conditioned skin is less likely to blister) and wear the shoes for an hour one day and two the next. “It’ll help soften the shoe and mold it to your foot more comfortably,” says Dr. Brenner.

Source: Kelley Heyworth, Fitness Magazine [April 09]
 

CSPM Women’s Basketball Team Takes Second in Tourney 

On the weekend of March 27-28, the California School of Podiatric Medicine (CSPM) Women’s Basketball team once again finished up with a successful playoff in the Annual Podiatric Student Basketball Tournament. The championship match ended when the girls had a tough loss in a close game to Temple University, who eventually went on to win the tournament. 

CSPM team (L-R) Ninveh Hiskail, Brooke Goodman, Sky Shanks, Cindy Peng, Kristy King, Judianne Walker, Lisa Khan, and Annie Nguyentat.

This is the first time Samuel Merritt University (SMU) hosted the tournament since it began in 1985 as an annual event organized by the American Podiatric Medical Students Association (APMSA) Corporate Advisory Board. About 40 SMU students in the Doctor of Podiatric Medicine (DPM) program at SMU competed against basketball players from the other seven podiatry schools around the country.

According to Ninveh Hiskail, second-year podiatry student, the tournament was an opportunity to promote athletic competition, recognition to CSPM, and build student camaraderie. “Regardless of how fierce we were on the court, after the games were over, all the teams started talking as if there was no competition,” said Hiskail. “As cliché as it sounds, we already felt like winners when we found out we made it to the last game. I love playing on the team and representing our school.”

Dr. Comfort Shoes & Inserts Awarded APMA Seal of Acceptance

Dr. Comfort has been awarded the American Podiatric Medical Association (APMA) Seal of Acceptance for their line of men’s and women’s diabetic footwear, athletic shoes, elite inserts (heat-moldable) and Gel Plus inserts.

APMA Seal of Approval

The APMA Seal of Acceptance is widely known as the preeminent recognition of excellence for footwear, materials, inserts and other materials used in the practice of podiatric medicine. Dr. Comfort’s diabetic footwear, including men’s and women’s dress, casual and athletic shoes, has been evaluated by the APMA’s Committee on Podiatric Seals and awarded the Seal based on the safety, quality and effectiveness of the products.

 “We’re thrilled to be granted the Seal of Acceptance for Dr. Comfort’s diabetic footwear and inserts,” said Rick Kanter, founder and President of Dr. Comfort. “This recognition comes after years of designing the highest quality footwear and witnessing tens of thousands of successful fitting experiences for diabetic patients.”

Query: Re-injury of Ruptured Tendons

I have an obese female who about 2 years ago suffered Right LE double peroneal rupture. She was in a CAM boot for 10 months and finally was seen for a second opinion which suggested a repair. The primary repair failed; therefore, a FDL transfer was done to the base of the 5th metatarsal. Things were fine for 1.5 years until recently, when she suffered an inversion sprain. Now the foot is in a flexible cavus position.  The calcaneal resting position is +1, and the mortise view shows lateral gutter widening.  I'm afraid she ruptured that FDL that was transferred. Now she has to have total knee replacement, but her orthopod would not do such until I get her foot stabilized. Any ideas? 
 
Kevin Lam, DPM, Naples, FL
 

Query: Diabetic Shoes from a Drug Store
 
I gave an Rx for DM shoes and inserts to an "at-risk" diabetic patient and referred her to an orthopedic shoe store with trained and certified personnel. She returned to the office wearing shoes that were too small which she obtained from the local mom & pop drug store through the Medicare Therapeutic Shoe Program. She showed me their flyer advertising "free" shoes for diabetics. I telephoned and spoke with the clerk who stated he was trained by a major podiatric supplier on how to fit people for shoes and inserts. Although I did arrange for her to return the shoes, get reimbursed, and go to the proper facility, I am concerned how this program, which was put in the hands of qualified personal to prevent DM foot complications, is allowed to be administered by a drug store clerk. Has anyone encountered a similar situation?  Any thoughts, pro or con?
 
James Korponay, DPM, New York, NY

RE: Current Protocol for Patients on Plavix (Mark Hiskes, DPM)
From: Bill Trabulsi, DPM

The cardiology department at our hospital has sent out a memo with supporting documentation asking all surgeons NOT to stop Plavix for patients with drug-eluting stents. If you'd like, I can send you the documentation.
 
Bill Trabulsi, DPM, Lutz, FL, trab3@msn.com
 

RE: Ehlers-Danlos Syndrome (Todd Lamster, DPM)
From: Adam Cirlincione, DPM

I agree with much of what Dr. Lamster states regarding the potential skew foot present and ensuring that your patient is fully educated prior to surgery and even the need to address the hindfoot . However, I have to disagree with the notion that metatarsal cuneiform joint arthrodesis is the only viable option for the bunion deformity. If the patient truly has a skew foot with a metatarsus adductus as mentioned, then I fail to see how the arthrodesis at this level would correct the hallux valgus. Although laxity at this level (metatarso-cuneiform) would be addressed, it would fail to address the position of the toe. Although this is a young patient, it may be in the best interest to perform multiple metatarsal osteotomies or a fusion at the level of the metatarsophalangel joint as a definitive procedure. This, of course, could be coupled with midfoot or hindfoot procedures as deemed necessary.

Adam Cirlincione, DPM, Glen Cove, NY, pittpod@aol.com

RE: Denial of GraftJacket (Greg Caringi, DPM)
From: Chris Lotufo, DPM, Tip Sullivan, DPM

I received the exact same denial letter from BCBS of GA about 6 months ago. The hospital asked that I write a short statement regarding the indications and use of the product along with their appeal. We were denied a second time. BCBS then asked for peer-reviewed articles supporting the use of GraftJacket for DFU's. I simply went to the Wright Medical website and used the articles they referenced for their product. Within 2 weeks of sending in the second appeal, the hospital and I received our reimbursement. I've been using the product for the last 7-8 years on DFU's and have never been denied before. I can see it being denied as experimental to augment a lateral ankle stab or to resurface an arthritic joint, but for a DM foot ulcer? It seems to me the insurance companies are continually searching for ways to deny the practice of good medicine. 
 
Chris Lotufo, DPM, Newnan, GA, chris_lotufo@hotmail.com

There is a part of this response that I feel obligated to point out. It does not have anything to do with "graft Jacket" or specific reimbursement. It is in Dr. Caringi's last paragraph when he says, "As surgeons, it is part of our responsibility to see that all services-and apparently specialized materials too- are precerted and covered by the individual insurance policies before the surgery is performed". I think this attitude is what got us in the sad situation that we are in today where insurance companies are literally dictating how we treat our patients. My patients' insurance should not be any of my business. It should be the patients' responsibility to make sure that their insurance covers their service. My patient /Dr. contract should be just that - an agreement between myself and a patient. By allowing insurance carriers and "the government" to place themselves in the middle of that agreement, we give them the power to dictate the terms of the agreement, which in essence is practicing medicine without a license. I guess that I am really getting old, but this issue really gets back to some basic rights and wrongs. 
 
Tip Sullivan, DPM, Jackson, MS, tsdefeet@msfootcenter.net

RE: Health Net Denials in CT, NJ, and NY for Diagnostic Ultrasound (D Mullens, DPM, JD)
From: Michael M. Rosenblatt, DPM

David Mullens, DPM, JD is considering instituting a class action lawsuit regarding refusals for podiatric diagnostic ultrasound re-imbursement in Connecticut, New Jersey and New York. These denials come from Health Net, and have been in force for the last three years.
 
We often complain about denials, and yet few of us do anything to fight them. Dr. Mullens does. Podiatrist in those target states need to examine their denials. Denials are like a virus. They "trans-mutate" from carrier to carrier, and if left alone, become epidemic.  We have no right to complain unless we do something about it. Now is that time. Please help Dr. Mullens. You are helping yourself. His e-mail is: dmullens@mullenslawoffice.com
 
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

LOOKING FOR FINANCIAL SECURITY?

Our practice continues to grow and we are in search of a motivated, well-trained DPM who is great with patients. Our multi-office practice is located in the scenic Hudson Valley region of New York State. This is a great career opportunity for the right person(s), with an excellent compensation package available. Please reply to Hudson Valley Foot Associates, PO Box 3300, Kingston, NY 12402-3300; or email CV and cover letter to: jobs@hvfa.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

PART-TIME NON-SURGICAL PRACTICE FOR SALE - NORTH JERSEY    
 
23 yo practice recently relocated to a spectacular newly-constructed and equipped storefront next to a busy supermarket with ample parking and senior citizens in vibrant downtown. Accepting Medicare and Blues only with great potential. Perfect for expanding to full-time, a second office or new practitioner with means and office experience.  Priced to sell. Financing possible. E-mail interest with contact to Mikedup1215@yahoo.com 

PRACTICE FOR SALE - CENTRAL FLPractice 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 WANTED - FLORIDA

Associate needed for a dynamic multi-doctor practice in the Tampa Bay area. Partnership opportunity for the right candidate. Preference given to a PSR 24+ resident completing their education this spring/summer, and must have a Florida license. Well-established practice, high tech with EMR and digital x-rays, with specialties in sports medicine, surgery and wound care. No nursing homes or HMO's. Excellent hospital privileges available. Choose an area of practice concentration that you are passionate about and enjoy a lifestyle for yourself and your family that is second to none. E-mail: kimvelez@tampabay.rr.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

TWO YEAR FELLOWSHIP IN RECONSTRUCTIVE FOOT SURGERY AND RESEARCH

2-year fellowship at Beth Israel Deaconess Medical Center, a primary teaching hospital for Harvard Medical School. Fellows have clinic, perform complex reconstructive procedures (external fixation, flaps, Charcot reconstruction), and conduct clinical research (20%). Fellows train residents and receive appointment at Harvard Medical School faculty. Excellent salary/benefits. Program begins SEPTEMBER, 2009. Must have completed PSR-36 or similar. Submit applications to: Adam Landsman, DPM, PhD alandsma@bidmc.harvard.edu Include CV, letter describing goals and any research interests. Deadline: May 1, 2009.  Beth Israel Deaconess Medical Center and Harvard Medical School are Equal Opportunity Employers. Women and minorities are particularly encouraged to apply.

ASSOCIATE POSITION - HENDERSON, NEVADA

Associate wanted for thriving, well-mixed 3-doctor digital office, leading to partnership. Surgery, diabetic, pediatric, and general podiatry. Great office and location, fun area to live. Need 2+ years surgical residency. Must be energetic, self motivated, great patient skills. Salary plus bonuses. Email CV to gtorgesen@yahoo.com

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

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.

PM Classified Ads Reach over 11,500 DPM's and Students

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