Volume 16 - Issue 12 - December 2003

Practice Builders »

What You Can Do About Malpractice Insurance

By David E. Marcinko, MBA, CFP | 12538 reads | 0 comments

Professional malpractice liability insurance protection is a major fixed operational expense in any at-risk medical practice. In most practices, liability insurance costs often represent one of the largest single line item expenses, often falling second only to staff payroll expenses.
To contain these liability overhead expense costs, the physician-executive should understand the dynamics of the insurance industry selling process, which is generally sold through one of three agency avenues:
• direct insurance agents serving as employees of a single insurance company;
• captive insuranc



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Are Your Patients Taking Herbal Meds?

By Donald Green, DPM, and Kathleen Halat, DPM | 5556 reads | 0 comments

Alternative medicine has achieved widespread popularity in the United States in recent years. One survey of trends in alternative medicine use found that people in the U.S. visit alternative medicine practitioners more frequently than primary care physicians.1 Another recent survey of alternative medicine use in 3,106 pre-surgical patients found that 22 percent of patients were taking herbal remedies and 51 percent were taking vitamins.2 The greatest use of these therapies occurred among women between the ages of 40 and 60. The most common herbs used were echinacea, gingk



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How-To Insights For Expanding Your Practice

By John Guiliana, DPM, MS, Lynn Homisak, PRT, Richard S. Levin, DPM, Hal Ornstein, DPM, and Charles R. Young, DPM | 5129 reads | 0 comments

When looking to expand your practice, there are an array of tactics you can use to help bolster your patient base. You could take a closer look at advances in technology that could either provide a new service for patients or enhance efficiency. Enhancing your Web presence is another avenue you can take. Embracing continuous quality measures is another approach. However, the consensus among practice management experts is that physician referrals are the golden nuggets of a successful practice.



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How To Master Posterior Heel Disorders

By Babak Baravarian, DPM | 26588 reads | 0 comments

Disorders of the posterior heel may present at any age. The multitude of posterior heel problems include retrocalcaneal and pretendinous bursitis, Achilles tendonitis, retrocalcaneal exostosis and Haglund’s deformity. It is essential to consider each of these disorders as a separate entity and, although they often occur in combination, each entity requires a separate course of therapy.



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Reviving An Ancient Therapy To Manage Chronic Pain

By Nicholas A. Grumbine, DPM | 9776 reads | 0 comments

Controlling pain has become a sophisticated, albeit inexact science. Artful pain assessment, integrated care, the titration of medications and the effective use of therapies and modalities are tailored for each patient. Indeed, meticulous clinicians must avoid tunnel vision and take the proper steps in diagnosing and treating chronic pain.



Continuing Education »

How To Select The Right Procedure For Hallux Limitus

By Harold Schoenhaus, DPM | 18537 reads | 0 comments

When it comes to hallux limitus, there are several circumstances in which one may see this decreased range of motion of the first metatarsophalangeal joint. You may note a limited range in the direction of dorsiflexion, plantarflexion or both. Depending upon the etiology, you may see the restriction during nonweightbearing, static stance or during the propulsive phase of gait.
The etiology may be secondary to direct macrotrauma to the great toe joint, metabolic conditions such as gouty arthritis or, most commonly, first ray hypermobility associated with abnormal pronation. Hypermobility of



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