The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

April 05, 2011 #4,126 Publisher-Barry Block, DPM, JD

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CA Podiatrist Discusses Cyclists' Burning Feet 

Painful burning of the ball of the foot (a.k.a. "hot foot," or metatarsalgia) is usually a result of hot weather or poorly fitting shoes—or both—on long, hilly rides. "Pressure can pinch nerves in one or both feet and shut down a ride fast," says Amol Saxena, DPM, a time-trial cyclist and podiatrist in the department of sports medicine at the Palo Alto Medical Hospital in California.

Dr. Amol Saxena

"If hot foot strikes while you're on a ride, there isn't much you can do other than stop, take off your shoes and let your feet cool down." Saxena will take these precautions to keep his feet cool and comfortable when he races in the Duathlon World Championships in September.

Source: Marianne McGinnis, Entrytime & Enteronline [4/4/11]

OH Podiatrist Appointed to AAPPM Board

The American Academy of Podiatric Practice Management (AAPPM) has announced the appointment of Dr. Andy Bhatia to its board of trustees. "Dr. Bhatia has been a strong lecturer at our seminars and brings to the Academy expert knowledge on DME and wound care," said Dr. Hal Ornstein, AAPPM Chairman. "His ability to explain proper utilization of wound care and DME integration into practices will help our members improve patient outcomes into their practices."

Dr. Andy Bhatia

Dr. Bhatia was voted in unanimously by the Board. "We are pleased to have him contribute to our mission of positively affecting the practices of podiatric medicine," said AAPPM president, Dr. Jeff Frederick.

Magazine Recognizes CT Podiatrists as "Top Docs"

In our 2011 survey, we asked New Hampshire doctors whom they would choose to provide for the medical needs of friends and loved ones and their choices are here in your hands. To broaden the reach of our poll, we list our top doctors, along with other leading physicians in each specialty. Plus, we solicited votes from our readers. 

Dr. David Court

The top vote-getter in the podiatrist category was David D. Court, DPM. Other leading practitioners were: David Kosofsky, DPM, Raef Fahmy, DPM, Anna Ruelle, DPM, and Brian Tedesco, DPM.

Source: New Hampshire Magazine [April 1, 2011]

NY Podiatrist Explains How Science Trumps Superstition

Last month, we received an e-mail attachment of a video, where, to our mounting horror, we saw our old friend, podiatrist Dr. Steven Abraham, being positioned on a bed of nails; then two cinder blocks were placed on his chest and a hefty, bearded man smashed those blocks with a sledgehammer. We placed an urgent call to the good foot doctor, and he confirmed the contents of the video, adding that he had been a sensei (master) of the martial arts for some 20 years, and, even more astonishing, that there was a simple, scientific explanation to the whole thing. He emailed us the following note: 

Dr. Steven Abraham's Science Experiment

"Every time I perform the bed of nails demo, the audience gasps in astonishment. Everyone wants to believe in the supernatural. Actions that are out of the ordinary seem to enhance the expectation that there are things out there that we don’t know about. Well, I do this demo for the exact opposite reason. I demonstrate that with knowledge and careful analysis, we can do exceptional things. First, the more nails per square inch, the more my weight gets distributed evenly. My body weight is never concentrated on just a few nails. Second, cinder blocks are designed to shatter laterally. The cinder blocks absorb and dissipate the force of the sledge hammer. So, science vs. superstition? I take science every time."

Source: Grand Street News [April 2011]

House GOP Budget to Include Medicaid Block Grants, Medicare Changes

House Republicans will propose significant changes to the federal government's major health programs—including block grants to Medicaid—in the budget they will unveil this week, the chairman of the House Budget Committee said Sunday.

In a "Fox News Sunday" interview, Rep. Paul Ryan (R-WI) said President Barack Obama's fiscal year 2012 budget “does nothing to address the drivers of our debt,” and his committee's budget for next year will propose statutory caps on discretionary spending, tax reform, and changes to the Medicare and Medicaid programs. Host Chris Wallace said reports have suggested the GOP proposal will cut spending by $2 trillion over the next decade, but Ryan said the plan will cut much more than that amount. He did not specify a figure, saying the numbers are still being fine-tuned

Source: Jessica Zigmod, Modern Healthcare [4/3/11]

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: Can you actually stretch your Achilles tendon?

Dr. Richard Braver

Richard Braver: No, the Achilles tendon does not stretch - but the muscles above it - the gastrocnemius and the soleus, do but not the actual Achilles tendon. You also cannot stretch the plantar fascia, and it will tear if you stretch it, but only a very miniscule amount. You are stretching the muscles above the plantar fascia. 

Dr. John Grady

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). The next segment will feature author, educator, and surgeon Dr. John Grady,. You can register for this event by clicking here

Query: Difficulty Passing National Boards Section

I recently graduated and I have failed the same section of the National Boards Part II three times (section III – orthopedics, biomechanics, and sports medicine). I do not know what I am doing wrong or what else I should do to prepare. Unfortunately, I forfeited two excellent surgical residencies because I have struggled with this particular area. Please advise on what I could be or should be doing better in order to prepare for the exam. Any advice and resources would be greatly appreciated.

Name Withheld

RE: Painful Callus, 5th Metatarsal (Stephen S. Pirotta, DPM)
From: Robert S. Schwartz, CPed

A non-surgical solution is to design a dorsiflexion-assist high top shoe (AFO boot) that extends at least one inch above the lateral malleolus; broaden the inside and outside of the shoe along the lateral side to accommodate the base of the fifth, ankle, and inverted foot deformity. Add lateral wedging to bring the foot to neutral position if ROM is available.

The lateral aspect of the shoe should extend in a vertical line to the lateral prominence of the lateral malleolus. Provide a 30 degree forefoot rocker sole with dispersion under the base of the fifth to accommodate sagittal plane weakness, increase weight-bearing proximal and distal to the callus, and add heel elevation, as necessary.

Robert S. Schwartz, CPed, Eneslow Pedorthic Enterprises, Inc., rss@eneslow.com

RE: Obesity and Podiatry (Robert Bijak, DPM)
From: Howard Dananberg, DPM

Dr. Bijak continues to write cynically about podiatry and its patient interactions. How sad! You do not have to be an endocrinologist in order to discuss the disadvantages of high carb diets or the lack of exercise. There are so many patients who don’t have a clue as to how to eat for a healthy lifestyle. Getting them started on the right foot, so to speak, can be very much part of a podiatry practice. And, if there is an interest in this, appropriate referrals can be made. The goal is helping patients improve their lives.

Several years ago, I sat down with a patient who became dangerously obese after very unsuccessful back surgery and secondary immobility. It was clearly going to kill him. We had a very frank discussion, and he was sent to a nutritionist while I fabricated AFO’s to improve his gait. He completely changed his life around, lost 100 lbs, exercises regularly, and lives a far healthier life. I can assure you that my degree is of little importance to him. Podiatry can be so satisfying to practice if the patient objectives are first and foremost.

Howard Dananberg, DPM, Bedford, NH, howiedbpg@aol.com

RE: Obesity and Podiatry (Robert Creighton, DPM)
From: Cam White

Every year, we launch a program called "Walk It Off Austin". When people come into our store, they are invited to fill out an entry form and weigh-in. From that moment until the end of the calendar year, we award $1.00 in store credit for every pound lost. No purchase is necessary. Participants must weigh-out by the end of the year to redeem their gift certificate. We send them periodic e-newsletters for tips on walking and exercise to help keep them motivated throughout the year.

Most people don't weigh-out, but we always get a few dozen people wo have lost 10, 25, or 40 pounds. And there are always a few people who come in having walked off 60-80 pounds. It's gratifying to play a role in their commitment to lose weight. Could a similar "rewards" program like this work for podiatrists?

Cam White, Total Relief Footwear, Austin, TX, camwhite.shoes@gmail.com

RE: Code for Removal of GPS Ankle Bracelet!

Last week, I had scheduled an Austin/Youngswick procedure for a patient with a symptomatic, moderate bunion with hallux limitus. All objective and subjective symptoms were within normal limits with the exception of an ankle bracelet that I paid no attention to, as patients today have all sorts of tattoos, body jewelry piercings, etc..
 
The morning of surgery, I received a call from the OR saying that my patient had a release from his parole officer giving me permission to cut off (remove) his monitored GPS tracking ankle bracelet, prior to surgery. The OR supervisor called a telephone number given by my patient which was found to be fictitious. Surgery canceled....I went back to sleep.
 
David Wolf, DPM, Houston, TX

ASSOCIATE POSITION - TEXAS

Are you looking for a busy, well-rounded practice experience?" Group practice in DFW area looking for a 3-year surgically-trained associate with a sports medicine background. Needs to be as comfortable making orthotics as fixing a complex flat foot. Email CV to crane@faant.com

ASSOCIATE POSITIONS - NW INDIANA, CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

ASSOCIATE POSITION - CT - (FAIRFIELD AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to Dr.Kassaris@yahoo.com

ASSOCIATE POSITION - MICHIGAN

Entry level DPM needed to join an established, full service, group podiatry practice in Monroe, MI. A generous salary and future partnership opportunity will be offered to the right applicant. Check out our website at www.monpod.com Send CV and cover letter to info@monpod.com

POSITION AVAILABLE – NEW YORK

Well-established, multi-doctor podiatry practice with offices in Putnam and Westchester counties. Compensation based on productivity. Excellent opportunity for recent residency graduate to build skills and learn practice management. Full-time preferred but right part-time candidate will be considered. Email cover letter and CV to: Podiatry2011@gmail.com

ASSOCIATE POSITION - NYC, NY

Part/time, full/time associate for busy, well established multi-doctor, multi-office NYC group. Seeking motivated, ethical, NYC licensed DPM with excellent office management and clinical skills in all phases of Podiatry. Board Qualified/Certified preferred. Salary plus incentives, pension/medical/dental. Partnership potential. E-Mail CV to urbebe78@aol.com

ASSOCIATE POSITION - MANHATTAN

Podiatrist wanted full/part time for busy midtown Manhattan practice. Must participate in the networks Aetna, BlueCross, Oxford, and United Healthcare. Please respond to 44footcare@gmail.com

EQUIPMENT FOR SALE - COOL TOUCH LASER

Cool Breeze Cool Touch CT3 plus laser used for ugly, unsightly, toe nail infections. Less than six months old. Great price won't last long. Considering a laser? We also have the Q- Clear Q- switch laser too. This laser is perfect for you. Also a used Lumix 2 laser, best price today. Dr. Zuckerman is in the Fort Lauderdale area and will demo these lasers on your patients. E-mail footcare@comcast.net

EQUIPMENT FOR SALE- MIDMARK CHAIR

Midmark 647 podiatry procedure chairs, x2, condition new (only 1 yr.) , wired & wireless foot controls, block screen, base rails, light and dark blue upholstery with matching stools, under warranty. Other pod. equip., large modern curved reception desk. Midtown Manhattan, contact NYCfoot@aol.com for further information.

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Great opportunity. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K. dpmpracticeforsale@yahoo.com

PRACTICE FOR SALE - HOUSTON, TEXAS

28 year old busy, progressive practice for sale with an excellent reputation and well established referral base. Well-trained, dedicated, supportive staff. Excellent cash flow $475K income after overhead. EMR, digital x-ray, diagnostic ultrasound. Free standing building also available with large outdoor sign. Also available are two transferable surgical center partnerships(with distributions). Owner retiring and willing to stay part time during transition. Cover letter/CV to softechpodiatrist@gmail.com

OFFICE TO SHARE- NYC GREAT OPPORTUNITY

6 rooms (1000 sq. feet), Gramercy Park area. Newly renovated, painted, fully equipped and wired. Good for all situations. Available for immediate occupancy. Rental terms are competitively priced based on need. Please contact 157629@gmail.com for more information.

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. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

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