The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

October 19, 2011 #4,283 Publisher-Barry Block, DPM, JD

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Merritt Podiatric Students Participate in Community Health Fair

Allen Temple Baptist Church held its annual health fair in Oakland. City leaders consider the event one of the largest free screenings in the City. Various vendors, sponsors, organizations, and schools like Samuel Merritt University (SMU) were present and assisted participants with various medical and health-related questions.

(L-R) CSPM Screeners: Nhu Do, Diksha Dutt, Grace Chuang, (middle two students unidentified) , Laksha Dutt, Melinda Bowlby, and Lan Li

Several podiatric students were on hand as volunteers, along with their supervising faculty advisors Alison Cook, DPM, MS and Trinh Pham, DPM, both alums from the California School of Podiatric Medicine. The focus was on preventative foot care, a campaign started by Allen Temple Church member and podiatrist Sharon Burleigh, DPM. Buleigh assisted in publicizing the free foot screenings throughout the ministry and Oakland community and in gathering the supplies needed.

NY Podiatrist Receives Black Achievers in Industry Award

Dr. Breeann N. Wilson was honored at the annual Black Achievers in Industry Awards dinner, held recently in Adam’s Mark Hotel. It was the 39th year for the event, which provides an opportunity for business, civic, and religious organizations to recognize individuals who have made significant contributions in career and community endeavors. 

Dr. Breeann N. Wilson

Dr. Wilson is a podiatrist with Northtown Podiatry. A Lewiston native and graduate of City Honors School, Dr. Wilson is the only African-American female podiatrist in Western New York. She also has a master’s degree in public health.

Source: Denise Jewell Gee, Buffalo News [10/17/11]

GA Podiatrist Exhibits at Albany Museum of Art

The Albany Museum of Art will be revealing a new exhibit Wednesday in partnership with Phoebe Putney Memorial Hospital. The Art of Health and Healing exhibit showcases art honoring the healthcare industry.The exhibit even includes craftwork by local podiatrist Dr. Chris Stanich who says he really doesn't consider himself an artist, but loves working with his hands. 

Dr. Chris Stanich

“The two larger pieces are actually urns for people's ashes, and as I made progress through the cross project, it kind of evolved into more of a rugged cross and wrapped around the cross, the crown of thorns, the suffering and all of that,” says Stanich.

Source: Ashley Knight, WFXL Fox News [10/12/11]

When to Speak

You know that you must speak up when you discover a problem with legal implications. But how much must you reveal in other situations? When the answer isn’t clear, put the matter to this test: What would you say if someone later revealed that you knew about the situation and did nothing?

If you wouldn’t be able to justify not taking action in that case, you can’t justify it now. So plan what you want to say, to whom and how.

Important: If you can say the information is not any of the other person’s business, you can remain quiet with a clear conscience.

Source: Adapted from “How You Can Avoid Becoming the Next Rupert Murdoch,” Robert Jones, thoughtLEADERS, LLC via Communication Briefings

Query: Mitek Bone Anchor

When performing a Kidner procedure, what size of Mitek bone anchor is typically used to secure the posterior tibialis tendon?
 
Mark K. Williams, DPM, Olympia, WA

Query: Damaged Records

What is the protocol when there is a flood in the basement where charts are stored?  We recently had a flood in our office building basement, and all charts were damaged from six years ago and more. What agency do you contact if charts are requested and had to be thrown out or are not salvageable?

Jason M. Grossman, DPM, Old Bridge, NJ

Editor's comment: PM News does not provide legal advice. This experience underscores the importance of electronic records, which can be backed-up and stored off-site. Fortunately, the chance of six-year-old records being requested is low. Documentation of the flood, including a report to your insurance company, as well as photo documentation, should be maintained. Floods and fires are extraordinary events, and agencies are generally understanding in these matters.

Query: Richie Brace Replacement

I have a patient who needs a new Richie Brace (L1970). She had one made two years ago. What is the time regulation as to how often NHIC Medicare Specialties will pay for fabrication of this custom-hinged AFO?

Allan Hetelson, DPM, Bensalem, PA

Response: Medicare's guidelines for the usual lifetime expectancy for orthotics (we're talking AFOs here) is five years. If the brace your patient is currently wearing is in a state of disrepair due to normal wear and tear without any other mitigating circumstances with respect to the patient, then have the device repaired. Medicare will not pay for a new device due to normal wear and tear for five years.

If the device was lost, stolen, or damaged beyond repair by a one-time event (e.g., car ran over it, child placed it in the compactor, etc.), then Medicare would pay for the full cost of replacement. An "RA" modifier ("replacement of a DME, orthotic or prosthetic item") would need to be placed to indicate that the orthotic is being replaced due to a one time event. A police or insurance report should be obtained by the patient. One should make a copy of this report and place it in the patient's medical record.

If the patient's clinical diagnosis or something specific about the patient has changed (gained or lost a significant amount of weight, Q angle change due to knee replacement, etc.), which renders the current device harmful, no longer usable, or not beneficial, then Medicare will pay for replacement.

In any of the above scenarios, one should careful document the circumstances mandating the new device.

Paul Kesselman, DPM, Woodside, NY

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RE: Chronic Ankle Ulcers (Jay Goldstein, DPM)
From: Mike Boxer, DPM

From the history and pictures, six-year-old ankle ulcers are most probably due to incompetent perforating veins at the ankle level. The treatment is simple. The ulcers will heal with the application of an Unna boot and venous hearts applied directly over the ulcers. It does not matter what you put on the ulcers. Use any anti-bacterial topically and an Unna boot from the toes to the below-knee area.

Incorporate venous hearts (quarter inch thick pieces of foam rubber cut to the size of the ulcers placed directly over the ulcers) into the Unna boot and apply a Coban wrap over the Unna boot from the toes to the below-knee area. Compression is the cure. It would also be prudent to rule out other possible rare causes of chronic ulcers such as TB, syphilis, hypertension, deep mycoses, and malignant changes prior to starting treatment.

Mike Boxer, DPM,  Woodmere, NY, MCBDPM@aol.com

RE: TightRope for Hallux Valgus (Michael B. DeBrule, DPM)
From: Joseph Menn, DPM

Dr. DeBrule asks how he can minimize complications with this procedure. Yeah. Don't do it. Seriously, do you really think that we can overcome the structurally abnormal forces of an HAV deformity by WIRING the metatarsals together? Do you really think that it has any chance at all of withstanding the force of a 205 pound patient in full stride of a run....held together by a little tiny wire?

Where oh where do these crazy ideas come from? Oh yeah, someone lectured about how freakin' great it was. And the masses believed. Procedures like these remind me of...

Editor's Note: Dr. Menn's extended-length letter can be read here.

RE: Plantar Fibroma (Mark H. Sugar, DPM)
From: Simon Young, DPM

I disagree to some extent with Dr. Sugar. I too am old school. I do not believe that any surgical procedure is a "no-brainer." Local excision of a fibroma has a high recurrence rate. A generous excision is indicated. Other treatments, including conservative treatment (not permanent), are available like steroid injections and Verapamil patch therapy. Pathology often shows neuroma. Surgically, if fibromas are very painful, they usually do impinge on digital nerves from the medial plantar nerve.

Simon Young, DPM, NY, NY, Simonyoung@juno.com

RE: Money-Back Guarantee for Orthotics (Charles Perry, DPM)
From: Paul Langer, DPM

Our policy at Footbon Orthotic Lab is to work with our clients to ensure that every orthotic fits properly and functions optimally. To that end, we will perform all adjustments free of charge for the first six months of wear. The plastic or graphite shells of the devices are guaranteed for life against breakage.

Paul Langer, DPM, President, Footbon Orthotic Laboratory, mail@paullanger.com

RE: You Can't Suture That (Elliot Udell, DPM)
From: Timothy James Henne, DPM

Look at what was sutured on this toe from the ER.  Yes, the foil from the suture.

Foil sutured Toenail

Timothy James Henne, DPM, Clermont, FL

SEEKING ASSOCIATE POSITION - SUBURBAN DETROIT

ABPS certified podiatrist with several years experience seeking part-time position in suburban Detroit. On staff at area hospitals. Excellent clinical, surgical, and practice management skills. Please respond to michpod@hotmail.com

PODIATRY OFFICE TO SHARE - SEATTLE, WASHINGTON 

Fully equipped podiatry office in North Gate area of Seattle. Office located in medical professional building near I-5. Office has 3 treatment rooms, 3 physical therapy rooms, direct digital x-ray, PAD- net, NCV testing equipment, physical therapy equipment. Please contact us: www.206footdoctor.com Tel. 425-643-8901 isbinc2006@gmail.com

SPACE AVAILABLE - NYC & LI

2 lightly used Microvas units (2010) for sale at $7,000 each plus shipping. Paid $16,000 for each machine. Great way to add therapy modality to your practice. Contact: klamdpm@hotmail.com

EQUIPMENT FOR SALE - ULTRASOUND, CRYO-PAC, FLOUROSCAN

Ultrasound w/printer, Cryo-Pac w/two probes, Flouroscan w/printer. There may be other surgical equipment as well. Please contact Jolene as young_jolene@yahoo.com

PRACTICE FOR SALE - SOUTHERN OH

Busy, well-established, full-time home visit practice. 100% referral-based. Wound care, pain management, routine care & DME’s. Excellent income, low overhead. Great opportunity for husband/wife business team. DPM relocating out-of-state for family. Contact: nanetter@zoomtown.com

PRACTICE FOR SALE – NANAIMO, BRITISH COLUMBIA, CANADA

Have you ever dreamed of owning a practice where...you can see 0-50 patients daily * average 100 new patients monthly * have zero accounts receivable * gross $480 M per year * live in a beautiful community with skiing, hiking, fishing, and boating on your doorstep. This could be yours! If interested contact pistone@telus.net or call 250-754-4192.

PRACTICE FOR SALE - ARKANSAS

Busy, well established practice of 13 years grosses 160K/year for the past 5 years, while working 3.5 days/week. Nursing homes available. 50% Medicare, average of 15 new patients/week. Doctor retiring. Please call 800-983-4194 for more details, or e-mail contactus@podiatrypracticeconsultants.com

PRACTICE FOR SALE/LEASE - NORTHERN, NJ

Part-time practice for sale or lease. Flexible terms, will consider lease with option for sale. Structured for a fast sale, first option on real estate. Great opportunity for a start-up or satellite with immediate income. Call 201-573-0555 or 551-574-0776 billfeet@aol.com

ASSOCIATE POSITION - FLORIDA/N.W. FLORIDA- TALLAHASSEE AREA

Home of Florida State University. Great university town! Well established full scope solo physician with busy practice. Looking for a full time associate leading to partnership in a short time. Great general practice with 2 locations. Staff privileges with 2 local hospitals and 2 surgery centers. Offering competitive salary, health insurance. Will need forefoot and rearfoot surgical competency. Friendly office with fun staff that’s easy to work with. Call/Text – 850-510-4371.

ASSOCIATE POSITION – IOWA CITY AREA

Well-established, rapidly growing practice. Motivated, ethical and personable with well-trained PSR-24/36. Modern office with complete EMR, digital radiography, diagnostic ultrasound, and laser. Competitive salary/benefits package. If interested please email your CV, letter of intent and references to: NHFootDoc@yahoo.com

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Immediate position for associate to potential partnership available for a surgeon that is BQ/BC by ABPS. Must be a PSR 24 or PM&S 36 graduate. Salary with bonus. Email CV and samples recent cases done recently to: susmitad86@yahoo.com

SOUTHEAST GEORGIA & SOUTH CAROLINA

Seeking associate physician to join practice to cover nursing home facilities. Comprehensive package including Salary, Travel and Bonus benefits. Email cover letter and CV to melissafoot@pol.net.

ASSOCIATE POSITION - SOUTH WEST FLORIDA

Full-time associate positions for an established group practice in Southwest Florida. Willing to train the right new graduates. Job will involved all aspects of podiatric care. You must be ambitious, hard-working and should have good people skills. Please e-mail your resume/CV tocontactus@ankleandfoot.net

ASSOCIATE POSITION - SOUTH CAROLINA
 
Upstate practice seeking PSR-24/36 trained associate. Full-time position with partnership opportunity. Must be ethical, highly-motivated with strong surgical and medical skills. Please send CV to palpodiatry@att.net

ASSOCIATE POSITION - DAYTON, OH

Join a Well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and current photo to Ohiodoctors@aol.com

ASSOCIATE POSITION - NASSAU COUNTY, NY

Podiatrist needed in Nassau county to start immediately. Flexible hours 2 days a week. Please email pittpod@gmail.com with inquiries.

ASSOCIATE POSITION - EAST TENNESSEE

30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. Extremely competitive base salary with bonus incentives and benefits. Knoxville is consistently ranked in top 5 places in U.S. Post-residency experience a plus. Please send resume to ddavidphawk@yahoo.com

ASSOCIATE POSITION - TEXAS (HOUSTON AREA)

Become a “SUCCESS”! Multi-professional podiatric practice seeks personable, talented, enthusiastic physicians with expertise in any of these areas: 1. Biomechanics 2. Geriatrics 3. Pediatrics 4. Trauma. Send CV and letter of intent to: sierrajip@gmail.com

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