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PM News

The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily


October 28, 2008 #3,385 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2008- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

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PODIATRISTS IN THE NEWS

NY Podiatrist Discusses Bunions

Bunions, if you have one you know because you have to pass up those fancy shoes that offer no comfort, yet only style. “A bunion is a deformity of the foot where the bones are misaligned so what ends up happening is you have these two bones that should be parallel and one of them starts to shift in and causes the big toe to come inward," said podiatrist Dr. Jennifer Hutton. The force of the bones pulls on muscles and tendons that insert into the big toe and causes it to pull, and a bump forms on the side of the foot. It affects children, women and men.

Dr. Jennifer Hutton

“We do find that of most of the men who come in have larger bunions because men have a lot easier time finding a shoe to fit them in. So usually, when the men get really severe or really bad, they are coming in with a lot of pain. The shoes that women wear are narrow and pointy, so they can have very small bunions and have pain,” Hutton said.

Conservatively, depending on the pain, we use ice and anti-inflammatories. If it is just that the bump is hurting in a certain shoe sometimes we will pad it. Besides that, if it comes in and somebody has terrible pain, we give cortisone injection just to get it to flare down, but it’s no getting rid of it,” said Hutton. In mild cases, the side bump can be surgically removed. Moderate cases involve more surgery of the bone.

Source: Marcie Fraser, TWEAN News Channel of Albany (NY) [10/26/08]

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MEETING NEWS

Heartland Podiatry Conference Uses Interactive Video

The Heartland Podiatry Conference is proving to be a leading course in podiatric medicine and surgery. This year’s annual conference was hosted by the Iowa Podiatric Medical Association and included 370 participants from multiple states in the region. The keynote address was given by Warren Joseph, DPM who highlighted current and future therapies for skin and nail infections. Dr. Joseph noted the field may be much different in the near future as research is concentrating on devices for onychomycosis, such as microwave therapy and single dose laser treatments.

Dr. Armstrong presents a case live from the University of Arizona.

The conference also featured David G. Armstrong, DPM, PhD. who lectured from his office at the University of Arizona using Apple’s iChat technology. Dr. Armstrong presented a case live from the University’s hospital which included photos, and a question and answer session.

FREE SAMPLE--POWERSTEP PROTECH CLASSIC PLUS*

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ProTech Classic Plus joins the family of other highly successful Powerstep ProTech products—the ProTech Full Length and the ProTech 3/4--that are sold only to members of the medical profession. Powerstep is offering a free sample of this exciting new product to allow you to try it for yourself.
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MEDICAL EDUCATION NEWS

Pressure of Medical School Has Many Contemplating Suicide

More than 2,200 medical students from seven medical schools participated in a recent study on whether they had suicidal thoughts.

Source: "Burnout and Suicidal Ideation among U.S. Medical Students," abstract, Sept. 2, Annals of Internal Medicine

The FootHelpers Lab Podiatry Program
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PRACTICE MANAGEMENT TIP OF THE DAY

Gift Etiquette

A professional associate - a patient - a physician you refer to - has given you a gift. Should you open in front of the person who gave it to you?

Business etiquette expert Ann Marie Sabath says that you should not. "Avoid opening the gift unless the person encourages you to do so." In fact, Sabath says, while most Americans are comfortable with opening gifts immediately, doing so is considered rude in many cultures. Reason: If you exchange gifts and your gift is of higher value, the other person could be embarrassed.

Source: Adapted from One Minute Manners: Quick Solutions to the Most Awkward Situations You'll Ever Face at Work by Ann Marie Sabath

SureFit®…Seeing is Fundamental!

Ever notice how some patients say a shoe looks “heavy” from a photo? For most, having a lightweight shoe that they can pick up and feel first hand is all the convincing they need. SureFit’s Ultralites are so light your patients will be amazed! SureFit’s Shoe Display includes our UltraLite line as well as the very popular New Balance, Hushpuppies and Rockport styles in a space saving, slim 18” diameter design which can be easily wheeled from room to room. Let you patients experience how fashionable and lightweight a therapeutic shoe can be!

Call 800.298.6050 to order your SureFit Shoe Display today for only $99!


QUERIES (CLINICAL)

Query: Ketamine/Ketoprofen/Gabapentin Topical for Treatment of Neuropathy

A patient presented with a topical gel from a local compounding pharmacy consisting of ketamine 10%/ ketoprofen 10% /gabapentin 6%. I have never written for this compound, but this patient was very pleased with the relief it has given her, stating that her neuropathic pain was much improved within the first 24 hours of use. Has anyone here written for this compound regularly? What has been your experience with it?

Nat Chotechuang, DPM, Bend, OR

MEETING NOTICES

INCREASE REVENUES & IMPROVE OUTCOMES WITH AFO THERAPY
An interactive workshop with Doug Richie, DPM.

11/9/08 7:30am-12:30pm, Four Points Sheraton, Plainview, NY

Topics include-Evaluation and use of AFO’s for Adult Acquired Flatfoot, lateral ankle instability, DJD of the ankle & Charcot foot deformity. Evaluation of Neuro-muscular conditions including drop foot, multiple sclerosis & Charcot Marie Tooth. Also, casting techniques, trouble shooting, coding & more.

CME Sponsor: NY College of Podiatric Medicine. The NYCPM is an approved sponsor of CME by the Council on Podiatric Medical Education, 4 CME’s approved. Affiliated Sponsor, STJ Orthotic Services, Inc. To register call STJ at 1-800-321-4785. Registration fee is $49, no charge for all APMA members.


QUERIES (NON-CLINICAL)

Query: Hospital Credentialing

I have been asked by one of my hospitals to gather credentialing information specifically regarding non ABPS boarded applicants. I would like to hear from other DPMs who are familiar with the credentials process who have encountered applicants who are certified by an alternative board to ABPS. What do you do in a circumstance where an applicant is "world renowned" as a foot and ankle surgeon, but not ABPS certified or qualified? Have your hospitals granted practice credentials to non-ABPS or non-APMA recognized board certification / qualification?

Paul Bishop, DPM, Yorkville, IL

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'For a list of all meetings go to: www.podiatrym.com/meetings.pdf


RESPONSES / COMMENTS (CLINICAL) - PART 1

RE: Plate System for Osteotomy (Jason Serpe, DPM)
From: Ira Weiner, DPM, Kevin Lam, DPM

I have used the Wright medical BOW plate on several occasions and it has become my plate of choice. There are some caveats with it though. First and foremost, it is not all that easy to make the cut. It has to be done slowly and carefully, so as not to fracture the lateral cortex. Fracturing the cortex can literally become a disaster, but when done correctly, the results are completely reproducible. Second, you should also use some type of bone filler with it to fill the void created by the plate. I have used Wright Medical Allomatrix for this and it works extremely well. Finally, Wright Medical indicates you can have the patient bear partial weight after the procedure. Frankly, I am not that brave, and prefer to cast the patient.

Ira Weiner, DPM, Las Vegas, NV, vegasfootdoc2005@yahoo.com

I have used both the Arthrex and Wright medical plate. I'm more of a fan of the Wright medical plate for one main reason: 1) the screws are locking, thus have better stability, thus earlier WB. I do the like the Arthrex instrumentation, but I have found the screws to be weak, especially the long stabilization screw. It is a wonderful plate, but I am worried about early WB with this plate since it is not locking.

The one problem that Wright Medical is working on currently is to get a better distractor in preparation for the plate. Correction is 2 degrees for every mm. of wedge. I usually pack the space with Allomatrix. It works wonders. The learning curve is in the use of a locking plate itself. But once you've done one, it's a 30 - 45 min procedure, and very powerful.

Common pitfalls and pearls:
1) not locking the "bullets / guide" all the way tight prior to drilling.
2) Use the Olive wires in the Wright set to temp stabilize the plate prior to drilling.
3) Do not over-tighten the locking screws because the plate is titanium, and you can sink the screw and ruin the locking mechanism.
4) I like to stabilize the proximal two screws, since that is most stable. Then carefully fixate distally. Once you drill, you can't take it back at all.

To be fair, Arthrex does have a great product, but I'm just a sucker for the stabilization, low profile that locking plates offer.

Kevin Lam, DPM, Naples, FL, klamdpm@hotmail.com

CODINGLINE CORNER

CURRENT TOPICS BEING DISCUSSED ON CODINGLINE'S LISTSERV INCLUDE:

o Destroying Warts with Implantation
o DME Accreditation
o Rejections for Routine Foot Care
o EDL Tendon Plasty Code
o Billing CPT 97605 in a PO Period

Codingline subscription information can be found here


RESPONSES / COMMENTS (CLINICAL) ACTIVE - PART 2

RE: Corticosporin Otic Suspension Discontinued (Richard Rettig, DPM)
From: Hal Ornstein, DPM

All the podiatrists in our practice stopped using Corticosporin otic solution when performing a matrixectomy several years ago due to the excellent results we got with use of AmeriGel wound dressing. It is much more convenient for the patient, with no soaking and once-a-day application. Outcomes are significantly improved with less redness, infections, pain and drainage. The Oakin in AmeriGel Wound Dressing provides the antimicrobial properties to fight off and kill the most common infections, and helps to remove debris. Amerx has packaged the AmeriGel nicely in a small box that includes gauze, Band-aids and wound wash. It is nice that we can add to the bottom line since Amerigel is not a prescription product and patients love that they save a trip to the pharmacy.

Hal Ornstein, DPM, Howell, NJ, toetoe@optonline.net

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CLASSIFIED ADS

PRACTICE FOR SALE – DALLAS TEXAS

10 year old practice for sale. All phases of podiatry: routine care, diabetic foot care, surgery, etc. Grossing $185,000 on three days per week. Could easily be full-time. Located in busy shopping center. Great Potential. Start making money from day one!! Owner will stay for transition. All serious offers considered. MUST SELL!! please respond to: footdoc8390@yahoo.com

SUBLET SPACE WANTED - NORTHERN NEW JERSEY

I am looking to sublet space in the Tenafly, Teaneck, Fair Lawn or general area. I need the office two 1/2 days per week or 2 full days, whichever is available. I can supply equipment, if needed, but prefer a turn-key operation. 516 476-1815 podo2345@aol.com

PODIATRISTS NEEDED - CHICAGO -- NORTHWEST INDIANA & BALTIMORE

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 or SHARED SPACE FOR RENT - CORAL GABLES FLORIDA

Well-known practice for over 20 years. Excellent location on Coral Way: heavy traffic, great visibility and plenty of parking. Busy, fully-equipped, full- time office with established patients. Grossing over 300K with tremendous growth potential. Office is currently open and ready to take over immediately. Contact QVAN@aol.com
or 305-975-5516.

EQUIPMENT FOR SALE – NEW ERGO HANDPIECES

New Storz-Ergo Sagittal Saw and Reciprocating Saw. 25% of price donated to Musella Brain Tumor Foundation. Bid on E-Bay by clicking on links above.

ASSOCIATE WANTED – NORTH CENTRAL PENNSYLVANIA

Excellent associate practice opportunity leading to a partnership for PSR 24-36 trained foot and ankle, surgically trained podiatrist. A well-established, ethical and academic, successful, solo, half-time and multi-faceted podiatric practice wishes to expand surgical services. No competition with foot fellows. Need diabetic limb salvage, plastic surgery techniques, strong surgical rear foot and ankle reconstruction, ABPS qualified certification required. Practice has state-of-the-art orthopedic surgical environment and plenty of future expansion capabilities for a bright, eager, reliable associate. Excellent salary and benefits; no nursing homes. Present doctor is podiatric chief of three hospitals. Mail CV with current references to fgsddpm@verizon.net

POSITION - NORTHERN VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes.Top hospitals. Fax CV with references to 703-491-9994

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.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 full-time podiatrist in a multi practice location in the Chicagoland and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com


WEEKLY SPECIAL - One week of ads (5x) for $89 One month of ads (20x) for $340 .


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

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 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.

Disclaimers
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management Magazine and Podiatry Management Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify me and you are hereby instructed to delete all electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be either timely or free of viruses.
Guidelines
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  • Notes should be original and may not be submitted to other publications or listservs without our express written permission.
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  • Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.

Barry H. Block, DPM, JD
 
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