PROFILES PODIATRIC
PODIATRIC SURGEONS USE STAGED RECONSTRUCTION TO RESTORE FOOT & ANKLE FUNCTION
Dr. Zeeshan Husain and Dr. Kyle Lawton
TARGETED THERAPY STARTS WITH IDENTIFYING THE GENUS & SPECIES
BAKODX'S
Helping Podiatric Physicians keep America on its feet!
Michigan Podiatric Medical Association
Derek E. Dalling Executive Director derek@kdafirm.com
Jason Wadaga Deputy Executive Director jason@kdafirm.com
Geri Root Director of Events geri@kdafirm.com
Trina Miller Membership Director trina@kdafirm.com
Lauren Concannon Continuing Education Coordinator lauren@kdafirm.com
Miranda Strunk Financial Administrator miranda@kdafirm.com
Melissa Travis Advertising Coordinator melissa@kdafirm.com
Lauren Gass Legislative Assistant lgass@kdafirm.com
Podiatric
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Dr. Andrew Mastay
MPMA BOARD OF DIRECTORS
PRESIDENT
Andrew Mastay, DPM
PRESIDENT ELECT
Joshua Faley, DPM
TREASURER
Bruce Jacob, DPM
SECRETARY
Michele Bertelle, DPM
IMMEDIATE PAST PRESIDENT
Zeeshan Husain, DPM
MPMA DIVISION REPRESENTATIVES
UPPER PENINSULA
Jake Eisenschink, DPM
MACOMB/OAKLAND
Marc Weiner, DPM
NORTHEAST
Joyce Patouhas, DPM
WESTERN
Vacant
SOUTHEAST
Crystal Holmes, DPM
Randy Kaplan, DPM
SOUTHERN
Mark Hosking, DPM
MPMA President Dr. Andrew Mastay
As we welcome the new year, I am reminded of the vital role each of us plays in advancing podiatric medicine and improving the lives of our patients. The Michigan Podiatric Medical Association (MPMA) remains dedicated to supporting your success, whether it’s through legislative advocacy, professional development, or practice resources.
This February, I encourage you to join us at the 2025 MPMA Great Lakes Conference. With a mix of virtual and in-person sessions, this event offers 40 hours of top-tier continuing education. From cutting-edge techniques in wound care to the latest in surgical advancements, the conference is an unparalleled opportunity to learn, network, and grow professionally. I look forward to connecting with many of you during our membership meeting and other events.
Beyond education, advocacy is a cornerstone of MPMA’s mission. This year, our focus includes supporting initiatives that enhance patient care, reduce regulatory burdens, and ensure fair reimbursement for our services. Your involvement is crucial, and I encourage you to contribute to the Michigan Podiatric Action Society (MPAS) and the APMA PAC to help us continue these efforts.
Finally, I want to recognize the hard work and accomplishments of our members. From groundbreaking research presented at national conferences to innovative approaches in patient care, your contributions elevate our profession and improve lives. Together, we are shaping the future of podiatric medicine in Michigan.
Thank you for your dedication and support. Here’s to another year of growth, collaboration, and excellence in podiatry.
Warm regards, Andrew Mastay, DPM President, Michigan Podiatric Medical Association
MICHIGAN PODIATRIC ACTION SOCIETY
2025 PAC DONATION
The 2025 MPMA Great Lakes Conference will be held February 5-9. This year’s conference, offering 40 hours of continuing medical education, will be held virtually on Wednesday, Thursday and Friday and in-person at The Henry Dearborn on Saturday and Sunday, with a welcome reception on Friday evening. Don’t miss Michigan’s largest podiatry event of the year!
GREAT LAKES CONFERENCE
CONFERENCE FORMAT AND REGISTRATION
Lectures will be delivered virtually on Wednesday, Thursday and Friday and in-person on Saturday and Sunday with a welcome reception on Friday evening. You must attend the live lectures on each day to receive credit. There isn’t an option to attend virtually on the weekend. The lectures are ending earlier on Friday to allow for travel to The Henry.
REGISTRATION FEES
MPMA Member .........................................................................$475
MPMA/APMA Senior Member ..............................................$250
MPMA/APMA Life Member .................................Complimentary
Resident Member .................................................Complimentary
Students ...................................................................Complimentary
APMA Member (Other State) ................................................$550
Non-Member ..........................................................................$1,000
Early registration ends January 29. An additional $50 will be added beginning January 30. Registration is available at mpma.org.
VIRTUAL CONFERENCE INFORMATION
The conference will be held live virtually on Wednesday, Thursday, and Friday. Approximately 3 days prior to the conference, you will receive an email with login information. Your login is unique to your and will be used to determine the number of continuing education contact hours to be awarded.
Time will be scheduled on Wednesday morning so that you can test your log in, become familiar with the virtual platform and CME sign-in. Prior to the convention, MPMA will send instructions on how to achieve continuing education credits, along with the convention program.
LOCATION AND ACCOMMODATIONS
The Henry Fairlane Plaza, 300 Town Center Drive Dearborn, MI 48126 888-709-8081
The conference will be held in person at The Henry on Saturday and Sunday. The Henry is offering a special rate of $156 for the conference. To make reservations, call 888-709-8081 by January 9 and be sure to mention MPMA Conference to receive this rate.
PARKING
Complimentary self-parking is available. Valet parking is also available for a fee.
GREAT LAKES CONFERENCE
FEBRUARY 5-9, 2025
VIRTUAL | THE HENRY
CONFERENCE INFORMATION
INTENDED AUDIENCE
The convention will be of interest to podiatric physicians and surgeons. Other healthcare professionals with special interest in the diagnosis and treatment of lower extremity disorders will also benefit from this conference.
LECTURES
The topics and speakers may have changed since this brochure was published. Visit mpma.org for the most upto-date schedule and for lecture descriptions and learning objectives.
CONTINUING EDUCATION CREDIT
This activity has been planned and implemented in accordance with the standards and requirements for approval of providers of continuing education in podiatric medicine through a joint provider agreement between the American Academy of Podiatric Practice Management and the Michigan Podiatric Medical Association. The American Academy of Podiatric Practice Management has approved this activity for a maximum of 40 continuing education contact hours.
Continuing education certificates will be available beginning February 24, 2025. If your license renews before this date, please contact the MPMA office.
CONFERENCE PURPOSE AND OBJECTIVES
This conference will provide information on the most up-todate diagnostic and treatment methods for lower extremity disorders. Conference objectives include:
• To provide the podiatric physician with a broad range of programs offered in an intensive five-day conference.
• To establish an understanding of developing concepts in the diagnosis, evaluation and treatment of lower extremity disorders and foot conditions.
ABOUT MPMA
The objective of the Michigan Podiatric Medical Association shall be to promote the art and science of podiatric medicine and surgery within the state of Michigan, promote the improvement of the practice of podiatric medicine and surgery, and promote the betterment and protection of the public’s podiatric health. This will be accomplished through affiliation with the American Podiatric Medical Association, to cooperate in carrying out the purposes of the Association.
PRIVACY AND CONFIDENTIALITY POLICY
Michigan Podiatric Medical Association’s (MPMA) Policy on Privacy and Confidentiality dictates the Association’s handling of a learner’s personal information. This policy is enforced in all areas of the Association’s business, including online communications, offline communications, direct marketing, and event registration.
MPMA maintains a comprehensive database of information on its learners in accordance with the general needs and expectations of the organization and its learners. This information is intended exclusively for purposes related to official Association business and to facilitate interaction between the Association and its learners. Directory information in the database may include home or work addresses, telephone numbers, fax numbers, e-mail addresses, and activity registrations/online purchases.
MPMA will use personal information to fulfill registrations for events, orders for materials and services made online, and other requested services. For educational meetings (CME activities), MPMA may share a list of registered attendees with the registered sponsors for that event.
SCHEDULE
WEDNESDAY, FEBRUARY 5
Lectures offered virtually | 10 CECH
9:00 a.m.-10:00 a.m.
Cutaneous Manifestations of Underlying Systemic Diseases | 1 CECH
Leland Jaffe, DPM
10:00 a.m.-11:00 a.m.
Medical and Surgical Management of Complex Wounds using Intact Fish Skin Graft | 1 CECH
JennaLouise Hollnagel-Kauffman, DPM
11:00 a.m.-12:00 p.m.
Revolutionizing Lymphedema Care: Harnessing the NEW Lymphedema Treatment Act in Clinical Practice | 1 CECH
Jonathan Moore, DPM
12:00 p.m.-12:45 p.m.
Break
12:45 p.m.-1:45 p.m.
Understanding Value-Based Care in Podiatric Surgery | 1 CECH
Charles Day, MD, MBA
1:45 p.m.-2:45 p.m.
Human Trafficking in Today’s World | 1 CECH
Danielle Bastien, DNP
This lecture qualifies for 1 continuing education contact hours of human trafficking education.
Visit mpma.org for the most current lecture information.
VIRTUAL
2:45 p.m.-4:45 p.m.
Opioid Prescribing and Management | 2 CECH
Andrew Mastay, DPM
This lecture qualifies for 2 continuing education contact hours of controlled substance education.
4:45 p.m.-5:30 p.m.
Break
5:30 p.m.-6:30 p.m.
Spinal Cord Stimulation (SCS) | 1 CECH
Bryan Toma, MD
6:30 p.m.-8:00 p.m.
Implicit Bias and How It Can Impact
Our Care | 1.5 CECH
Rebecca Sundling, DPM
This lecture qualifies for 1.5 continuing education contact hours of implicit bias education.
8:00 p.m.-8:30 p.m.
How Fellowship Training Impacts
Podiatric Surgery | 0.5 CECH
Kayna Patel, DPM and Akram Aljumail, DPM
THURSDAY, FEBRUARY 6
Lectures offered virtually | 11.5 CECH
7:00 a.m.-7:30 a.m.
Review of Important Coding | 0.5 CECH
Alan Bass, DPM
7:30 a.m.-8:00 a.m.
E&M and Incident-to Billing | 0.5 CECH
Alan Bass, DPM
8:00 a.m.-8:30 a.m.
Proper Documentation: What you Should Think About When Charting | 0.5 CECH
Alan Bass, DPM
8:30 a.m.-9:00 a.m.
How Would You Code This? | 0.5 CECH
Alan Bass, DPM
9:00 a.m.-9:30 a.m.
Perioperative Management of the Podiatric Patient | 0.5 CECH
Matthew Salter, DO
9:30 a.m.-10:00 a.m.
The Role of Hyperbaric Oxygen Therapy | 0.5 CECH
Randy Semma, DPM
10:15 a.m.-10:45 a.m.
Update on Diabetic Management | 0.5 CECH
Berhane Seyoum, MD
10:45 a.m.-11:45 a.m.
Trends in the Management of Lower Extremity PAD and CLI | 1 CECH
John Evans, DPM
11:45 a.m.-12:15 p.m.
PAD: Procedures and Cardiac
Concerns for Diabetics | 0.5 CECH
Jay Mohan, DO
SCHEDULE
12:15 p.m.-12:45 p.m.
Challenging Cases: PAD and Diabetic Management | 0.5 CECH
John Evans, DPM; Jay Mohan, DO; Andrew Mastay, DPM (Moderator)
12:45 p.m.-1:30 p.m.
Break
1:30 p.m.-2:00 p.m.
Wound Care Principles | 0.5 CECH
Rene Juridico, DPM
2:00 p.m.-3:00 p.m.
Venous Wounds and Intervention | 1 CECH
Jeffrey Miller, MD
3:00 p.m.-3:30 p.m.
Regenerative Wound Solutions | 0.5 CECH
Alton Johnson, DPM
3:30 p.m.-4:00 p.m.
Wound Care Considerations in a Multicultural Society | 0.5 CECH
Alton Johnson, DPM
4:00 p.m.-4:30 p.m.
The Role of a Pedorthist in Preventative Diabetic Care | 0.5 CECH
Lisa Pedilla
4:30 p.m.-5:00 p.m.
Surgical Treatment of Lower Leg Nerve Entrapments | 0.5 CECH
Josh Rhodenizer, DPM
5:00 p.m.-5:30 p.m.
Prophylactic Surgery in the Diabetic Patient | 0.5 CECH
Jason Weslosky, DPM
GREAT LAKES CONFERENCE
FEBRUARY 5-9, 2025
VIRTUAL | THE HENRY
Register at mpma.org.
VIRTUAL
5:30 p.m.-6:30 p.m.
Break
6:30 p.m.-7:00 p.m.
Management of Midfoot Charcot Neuroarthropathy | 0.5 CECH
Oliver Ryan, DPM
7:00 p.m.-7:30 p.m.
Use of WOLF Frames as an Offloading Option | 0.5 CECH
Raquel Sugino, DPM
7:30 p.m.-8:00 p.m.
Reconstruction and Flap Options in Complicated Diabetic Patients | 0.5 CECH
Raquel Sugino, DPM
8:00 p.m.-8:30 p.m.
Panel Discussion: Charcot and Its Challenges | 0.5 CECH
Karl Dunn, DPM; Oliver Ryan, DPM; Raquel Sugino, DPM; Zeeshan Husain, DPM (Moderator)
FRIDAY, FEBRUARY 7
Lectures offered virtually | 5.5 CECH
7:00 a.m.-7:30 a.m.
CAC Update | 0.5 CECH
Jodie Sengstock, DPM
7:30 a.m.-8:00 a.m.
Management of Lisfranc Injuries | 0.5 CECH
Randy Semma, DPM
8:00 a.m.-8:30 a.m.
Metatarsal Fractures: Fix or Boot? | 0.5 CECH
Karl Dunn, DPM
8:30 a.m.-9:00 a.m.
Understanding Current Trends in Ankle Fracture Treatment | 0.5 CECH
Jake Eisenschink, DPM
9:00 a.m.-9:30 a.m.
Ankle Sprains: Do We Fix Too Often? | 0.5 CECH
Karl Dunn, DPM
9:30 a.m.-10:00 a.m.
Management of Non-Unions | 0.5 CECH
Zeeshan Husain, DPM
10:15 a.m.-10:45 a.m.
Treatment Options for Midfoot Arthritis | 0.5 CECH
Vince Lefler, DPM
10:45 a.m.-11:45 a.m.
Pediatric Deformity
Correction | 1 CECH
Mitzi Williams, DPM
11:45 a.m.-12:45 p.m.
Podiatric Dermatology Protocols for Better Patient Outcomes:
Diagnostic Tools and Treatment
Options | 1 CECH
Bela Pandit, DPM
SCHEDULE
FRIDAY, FEBRUARY 7
CONTINUED
6:00 p.m.-7:30 p.m.
Conference Registration and Welcome Reception at The Henry
SATURDAY, FEBRUARY 8
Lectures offered in-person at The Henry | 9 CECH
6:30 a.m.-6:00 p.m.
Conference Registration
7:00 a.m.-6:00 p.m.
Exhibit Hall Open
7:00 a.m.-7:30 a.m.
Current Guidelines for the Management of Hallux Limitus | 0.5 CECH
Andrew Mastay, DPM
Visit mpma.org for the most current lecture information.
IN-PERSON
7:30 a.m.-8:00 a.m.
Management of Gout | 0.5 CECH
Andrew Sulich, MD
8:00 a.m.-8:30 a.m.
Systemic Arthridities in the Podiatric Patient | 0.5 CECH
Andrew Sulich, MD
8:30 a.m.-9:00 a.m.
Arthroscopic Approach for OCL of Talus | 0.5 CECH
Joshua Faley, DPM
9:00 a.m.-9:30 a.m.
Current Concepts in Flatfoot Treatment | 0.5 CECH
Jake Eisenschink, DPM
9:00 a.m.-11:00 a.m.
Podiatric School Student Outreach
9:30 a.m.-10:00 a.m.
Break and Visit Vendors
10:00 a.m.-10:30 a.m.
The Podiatric Triple-Double | 0.5 CECH
Jason Weslosky, DPM
10:30 a.m.-11:30 a.m.
The Tall and Short of It: Bunions, Why They Occur and Why They Come Back | 1 CECH
Anthony Giordano, DPM and Andrew Mastay, DPM
11:30 a.m.-12:00 p.m.
Point-Courterpoint: Open vs. MIS
Lapidus Bunionectomy | 0.5 CECH
Joshua Faley, DPM and Jason Weslosky, DPM, Zeeshan Husain, DPM (Moderator)
12:00 p.m.-1:15 p.m.
Randy K. Kaplan Legislative Luncheon
1:30 p.m.-3:00 p.m.
MPMA Annual Membership Meeting
3:00 p.m.-3:30 p.m.
Break and Visit Vendors
3:30 p.m.-4:30 p.m.
Abstract Competition Part 1 | 1 CECH
Zeeshan Husain, DPM (Moderator)
4:30 p.m.-5:30 p.m.
Abstract Competition Part 2 | 1 CECH
Zeeshan Husain, DPM (Moderator)
5:30 p.m.-6:00 p.m.
Break and Visit Vendors
GREAT LAKES CONFERENCE
FEBRUARY 5-9, 2025
VIRTUAL | THE HENRY
SCHEDULE
6:00 p.m.-7:30 p.m.
Abstract Competition Part 3 | 1.5 CECH
Zeeshan Husain, DPM (Moderator)
7:30 p.m.-8:30 p.m.
Abstract Competition Part 4 | 1 CECH
Zeeshan Husain, DPM (Moderator)
SUNDAY, FEBRUARY 9
Lectures offered in-person at The Henry | 4 CECH
7:00 a.m.-11:00 a.m.
Conference Registration
IN-PERSON
7:00 a.m.-11:00 a.m.
Exhibit Hall Open
7:30 a.m.-8:30 a.m.
Panel Discussion: What Should I Be Coding? | 1 CECH
Alan Bass, DPM; John Evans, DPM; Louis Geller, DPM; Andrew Mastay, DPM (Moderator)
8:30 a.m.-9:15 a.m.
Breakfast and Visit Vendors
9:15 a.m.-11:00 a.m.
Kaplan-Kanat Memorial Keynote Presentation: Hallux Varus and Forefoot Derangement | 1.5 CECH
Michael Cornelison, DPM
FACULTY
Akram Aljumail, DPM
Alan Bass, DPM
Danielle Bastien, DNP
Charles Day, MD
Tom Davis, MD
Karl Dunn, DPM
Jake Eisenschink, DPM
John Evans, DPM
Joshua Faley, DPM
Louis Geller, DPM
Anthony Giordano, DPM
JennaLouise Hollnagel-Kauffman, DPM
Zeeshan Husain, DPM
Leland Jaffe, DPM
Alton Johnson, DPM
Rene Juridico, DPM
Vince Lefler, DPM
Andrew Mastay, DPM
Jeffrey Miller, MD
Jay Mohan, DO
Jonathan Moore, DPM
Bela Pandit, DPM
Kayna Patel, DPM
Lisa Pedilla
Register at mpma.org.
11:00 a.m.-11:30 a.m.
Chronic Limb Threatening Ischemia (CLTI) | .5 CECH
Tom Davis, MD
11:30 a.m.-12:00 p.m.
Management of Plantar Plate Injuries | 0.5 CECH
Randy Semma, DPM
12:00 p.m.-12:30 p.m.
The Stainsby Procedure | 0.5 CECH
Anthony Giordano, DPM
Joshua Rhodenizer, DPM
Oliver Ryan, DPM
Matthew Salter, DO
Randy Semma, DPM
Jodie Sengstock, DPM
Berhane Seyoum, MD
Raquel Sugino, DPM
Andrew Sulich, MD
Rebecca Sundling, DPM
Brian Toma, MD
Jason Weslosky, DPM
Mitzi Williams, DPM
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Dr. Zeeshan Husain and Dr. Kyle Lawton
Podiatric Surgeons Use Staged Reconstruction To Restore Foot & Ankle Function
The patient, LM, was treated for a left ankle fracture in early 2021 by another surgeon. Over the next six months, he developed a progressively worsening ankle tilting such that he was walking on the outer side of the foot, creating a very painful wound (FIGURE 1). Prior to his injury, he was a very active 78-year-old who could enjoy walks with his wife independently all day. He now had to wear a tall walking boot to help keep his ankle partially straight that limited his walking due to pain. He could not walk without the boot and was seeking a return to his previous active lifestyle without limitations.
In evaluating LM’s condition, it was important not only to appreciate his structural alignment radiographically (FIGURE 2), but also understand the balanced functioning of the tendons around the left ankle that are responsible for maintaining a functional limb. Clinically, the left hindfoot was severely inverted that was revealed radiographically with the dislocated joint below the ankle due to the overpowering of the tendons on the inner side of the foot with complete loss of the tendon function on the outer side of the ankle. Nerve conduction testing demonstrated loss of muscle innervation to the peroneal tendons, but that the muscle was still functional. This complex imbalance created an almost clubfoot type deformity, cavovarus contracture, that was only going to progressively worsen.
In discussions with LM, we discussed various treatment options including fusing his ankle in a straight position that would not allow his ankle to bend. Alternatively, we offered a two-staged approach to address his hindfoot for realignment with mixed bony and tendon balancing. The second stage would address any residual forefoot deformities once he had sufficiently healed the procedures from the first stage. Because he wanted to maintain ankle motion and protect his knees and hips, he opted for the staged approach despite this approach requiring a longer recovery. The patient was motivated to return to his original active lifestyle and was willing to do whatever it would take to return to his pre-injury level.
The first stage surgery involved realigning the hindfoot. We began by releasing all the soft tissue contractures on the inner side of the left ankle including the Achilles tendon. The posterior tibial tendon was driving the inner twisting of the foot and was transferred through the back of the leg to the front of the ankle and foot. The long tendon to the great toe coming from the leg was rerouted from the inner side of the ankle and passed behind the ankle and attached to the peroneal tendons by the
FIGURE 1A
FIGURE 1B
ankle (FIGURE 3). This would allow restoration of the tendon balancing on the outer side of the left ankle as well as stabilize the ankle joint from possible sprains. Lastly, the dislocated hindfoot joint was fused with screws. The hindfoot was now straight and balanced. Patient had to be non-weightbearing for the next six weeks with a knee scooter. Patient worked with a physical therapist to improve his strength and balance. Although his heel was now under his leg and he could wear a shoe, the forefoot was still tilted causing callus on the outer side of the foot similar to what he had before just with less severity (FIGURE 4). He was able to rotate the ankle whereas it was stuck in an inverted position pre-operatively. He was able to walk without any gait assistance, but was looking forward to having the forefoot corrected.
The second staged procedure was performed eight months after his first surgery to address his forefoot deformity. The midfoot was realigned to derotate the forefoot to create a foot that could be flat on the ground. This would eliminate his painful callus. Patient was allowed to transition into a short walking boot post-operatively. Subsequently, he returned to physical therapy where he was able to improve his overall muscle grade to
Continues on pg. 16
FIGURE 2A
FIGURE 2B
FIGURE 3
4/5 around the left ankle with a preserved ankle joint without having to wear a brace or boot (FIGURES 5 and 6).
One of the most rewarding experiences for me is getting to know patients on a personal level as we help them with their foot problems. Over three years, LM was able to share with me his love of Michigan and Detroit Lions football and his favorite show, Yellowstone. I will miss our recaps of the games and show. As a podiatrist, I am proud of how far our profession has progressed and that I have been able to serve my community here in Michigan.
FIGURE 1:
The entire foot was turning inward near the ankle joint creating almost a clubfoot-like deformity. The tendons on the outer side of the foot were not functioning following a previous ankle fracture surgery such that all the tendons on the inner side of the foot were creating a progressively worsening contracture. He was walking on the outer side of the foot resulting in a painful ulcer formation.
FIGURE 2:
Radiographs of the foot show the foot perpendicular to the leg. Plates and screws in the ankle are from previous ankle fracture repair. The hindfoot deformity came from dislocation of the subtalar joint under the ankle joint due to the tendon imbalance.
FIGURE 3:
Two tendons were redirected so that the foot would no longer twist inward. The pos-
terior tibial tendon (on the left) was rerouted to the front of the ankle and foot to improve upward movement to the ankle. The flexor hallucis longus tendon (on the right, closer to the foot) was rerouted behind the ankle and to the opposite side of the foot to restore stabilization of the ankle and counter the intact tendons on the inner side of the ankle.
FIGURE 4:
Hindfoot shows almost straight alignment with significant foot realignment. However, the forefoot tilting was affecting his walking as the great toe was not touching the ground when walking. The radiograph shows much better positioning, but the forefoot is still tilted as noted by the stacking of the metatarsals.
FIGURE 5:
Radiographs after second stage surgery to address the forefoot. This allowed the forefoot to be flat on the ground.
FIGURE 6:
Final walking pictures show straight alignment with him taking a step with all of his weight on the left foot without any assistance. Final radiograph shows realigned forefoot.
Dr. Husain is the residency program director at McLaren Oakland Hospital in Pontiac, MI.
Dr. Lawton is currently in his second year of residency training at McLaren Oakland Hospital in Pontiac, MI.
FIGURE 4A
FIGURE 4B
FIGURE 5A
FIGURE 6A
FIGURE 6B
FIGURE 5B
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INDUSTRY NEWS
MICHIGAN PODIATRISTS EARN TOP HONORS FOR IMPACTFUL RESEARCH
Congratulations to MPMA podiatric physicians who submitted standout abstracts at this year’s Symposium on Advanced Wound Care (SAWC) Fall event.
It attracted nearly 3,000 participants, representing over 26 countries. The Symposium’s education program included over 65 high-impact sessions led by over 75 presenters, each an expert in wound care.
Nearly 400 abstracts were submitted, and over 200 will be published online in the industry-leading Wounds journal. Dr. Oscar Alvarez is the Abstract Chair, SAWC Fall and SAWC Spring.
Wounds, the official publication for SAWC and indexed in MEDLINE/PubMed, is the most widely read, peer-reviewed journal focusing on wound care and wound research. Whether dealing with a traumatic wound, a surgical or non-skin wound, a burn injury, or a diabetic foot ulcer, wound care professionals turn to Wounds for the latest research and practice in this growing field of medicine.
Several standout contributions emerged, earning top honors for their impactful research and insights. The groundbreaking research cements SAWC Fall’s position as the world’s leading meeting for wound care professionals.
Of the 391 submissions, 312 were selected for poster or presentation at SAWC Fall. These award-winning abstracts include:
Oral Abstracts
• First Place:
Christopher Girgis, DPM, “Does Cognitive Dysfunction Impact Diabetic Foot Ulcer Outcomes?”
Top Scoring Abstracts by Category
• Top Scoring Clinical Research:
Christopher Girgis, DPM, “Does Cognitive Dysfunction Impact Diabetic Foot Ulcer Outcomes?”
The Symposium showcases the innovation and dedication of wound care professionals. SAWC Spring will be held April 30May 4, 2025 in Grapevine, Texas. Registration is now open. Research is now being accepted and closes on January 3.
Resource: https://hmpglobal.com/story/sawc-fall-2024-celebrating-excellence-wound-care-research
UM Podiatry Fellowship Program Congratulates Top Podiatric Doctors
The University of Michigan Podiatry Fellowship program congratulates Christopher Girgis, DPM, Stephanie B., DPM, Crystal Holmes, DPM, Brennen O’Dell, DPM, DABPM, AACFAS, Sari Priesand DPM, DABPM, D.ABFAS, Brian Schmidt, DPM, and Beth Tronstein, DPM, MPH, DABPM, AACFAS on winning the 2024 Rapid Fire as well as Marie Brown Etris, 1st place Oral Abstract Award AND the 1st Place 2024 Highest Scoring Abstract--Clinical Research Award for the abstract poster, “Does Cognitive Dysfunction Impact Diabetic Foot Ulceration Outcomes?” at the Symposium on Advanced Wound Care (SAWC) Fall conference.
Michigan podiatric physician, Christopher Girgis, DPM, earns first place Oral Abstract and Top Scoring Clinical Research at the 2024 Symposium on Advanced Wound Care (SAWC) Fall event.
PODIATRIC MEDICAL ASSISTANTS REQUIRE X-RAY TRAINING
In March, the director of the Michigan Department of Labor and Economic Opportunity (LEO) announced new rules regarding adding medical provider staff to the list of medical assistants who must undergo x-ray training and maintain continuing education.
The new rules are regulated under MIOSHA within LEO with the full rule set here.
To confirm, the new training applies only to podiatric staff and not DPMs. Michigan-licensed podiatrists take X-ray images within their scope of practice law.
MPMA recommends the following to meet the new rules:
1. Prepare a “Written Statement of Assurance” for every CA / unlicensed individual currently taking x-rays in your office IMMEDIATELY.
2. Once a “Written Statement of Assurance” for every unlicensed staff taking x-rays in your office, they will have until March 13, 2027 (approx. three years), to complete a required 40-hour training program.
NEW REMOTE MONITORING CODES
By Michael L. Brody, DPM
The AMA has approved significant changes to the 2026 CPT book for Remote Monitoring Codes. If you are providing Remote Therapeutic or Remote Physiologic Monitoring, you need to be aware of these code changes. With these changes the burden associated with Remote Monitoring is reduced and you may want to look at incorporating Remote Monitoring into your practice.
The following NEW codes will be added which cover the first 2 – 15 days of monitoring:
• 99XX4 - remote physiologic monitoring device supply code
• 99XX5 - remote physiologic monitoring treatment management services code
• 98XX4 – respiratory remote patient monitoring code
• 98XX5 - musculoskeletal remote patient monitoring code
• 98XX6 - cognitive behavioral therapy remote patient monitoring code
• 98XX7 - remote therapeutic monitoring treatment management services
The following codes will be revised for 2026:
• 99454 Will cover 16 – 30 days of remote monitoring
• 99457 - Will include only 11-20 minutes. Previously you had to interact with a patient for 20 minutes or more to bill this code, now when you hit the 11-minute threshold the code is billable.
• 99458 - (an add on code) Will cover each additional 10 minutes of interactive communication. The code is currently for each additional 20 minutes, the time is more granular enabling you to capture more of your billable time and be reimbursed for that time.
MPMA members are beginning to receive radiation inspection visits from MIOSHA. The MPMA encourages members to prepare a “Written Statement of Assurance” now. Click here for a sample statement of assurance to modify for use in your practice.
MPMA leadership is discussing offering CE credit for x-ray training at the Great Lakes Conference in February 2025. This includes the creation of a training program moving forward.
Please look for future updates on this topic and contact MPMA with any questions
• 98975 - Will be updated to include digital therapeutic intervention
Continues on pg. 20
• 98976 - Will be revised to include device supply for data access or data transmissions to support respiratory Remote Therapeutic Monitoring of patients.
• 98977 - Will be revised to include device supply for data access or data transmissions to support musculoskeletal Remote Therapeutic Monitoring of patients.
• 98978 – Will be revised to include device supply for data access or data transmissions to support cognitive behavior Remote Therapeutic Monitoring of patients.
• 98980 - Will be revised to include only 11-20 minutes. Currently you have to interact with a patient for 20 minutes or more to bill this code, In 2026 when you hit the 11 minute threshold the code is billable.
• 98981 (an add on code) will cover each additional 10 minutes of interactive communication. The code is currently for each additional 20 minutes, the time is more granular enabling you to capture more of your billable time and be reimbursed for that time.
The changes will be effective in January of 2026 so don’t jump the gun, as more details and guidelines for these remote monitoring codes come out, we will inform you. But it is nice to see that remote monitoring is becoming more granular making it less burdensome for clinicians to monitor patients and recognizing that daily monitoring is not necessary for many conditions.
Michael L. Brody, DPM is the CEO of Registry Clearinghouse. He can be reached at info@registryclearinghouse.com.
Continues on pg. 22
Dr. Michael Brody, DPM is a board-certified Podiatrist, serving his community for over 30 years at his practice, Long Island Podiatry.
Dr. Brody went to MIT for his Undergraduate Education and received his DPM from New York College of Podiatric Medicine. He created and was the Residency Director at DVAMC Northport and worked at the VA Hospital from 1989 until 2016.
Dr. Brody provides personalized care and takes the time to make sure he knows each patient and provides each patient with the quality service they deserve.
His office in Southold and is equipped with the latest in technology including Electronic Health Records, Computerized Vascular Analysis, and Digital X-Ray.
MPAS CONTRIBUTORS FROM 2024
The MPMA extends a big THANK YOU to all of the following individuals who made a contribution to MPAS. Thanks to the people below, MPAS raised nearly 70% of its 2024 goal.
This year, with your help, the MPAS can meet its goal of $20,000 to assist in the MPMA political strategies. Last year, MPAS contributed significantly to elections across the state, and MPAS needs to rebuild its war chest in 2025.
To make your 2025 contribution simply visit: https://www.mpma.org/political-action
Anthony Alessi, DPM
Corwyn Bergsma, DPM
Michele Bertelle-Semma, DPM
Marc Borovoy, DPM
Norman Brant, DPM
Matthew Brown, DPM
Gene Caicco, DPM
Edith Clark, DPM
Timothy Dailey, DPM
Derek Dalling (Executive Director)
Marie Delewsky, DPM
Durene Elem-Vaughn, DPM
Lawrence Fallat, DPM
Ahmad Farah, DPM
Jeffrey Frederick, DPM
Anthony Giordano, DPM
Lee Gold, DPM
Patricia Guisinger, DPM
Rachel Height-Kaplan, DPM
Neil Hertzberg, DPM
Edith Hogan, DPM
Michael Holland, DPM
Crystal Holmes, DPM
Scott Hughes, DPM
Zeeshan Husain, DPM
Laura Jamrog, DPM
Charles Johnson, DPM
Randy Kaplan, DPM
Kristi Ledbetter, DPM
Stuart Leff, DPM
David Levitsky, DPM
Jeffrey Levitt, DPM
Donald Lutz, DPM
David Mansky, DPM
Andrew Mastay, DPM
APMA PAC CONTRIBUTORS FROM 2024
Bruce Meyers, DPM
John Miller, DPM
Heidi Monaghan, DPM
David Moss, DPM
Joyce Patouhas, DPM
Craig Pilichowski, DPM
Nicholas Post-Vasold, DPM
Kristin Raleigh, DPM
Shawn Reiser, DPM
Mark Saffer, DPM
Ali Safiedine, DPM
Jodie Sengstock, DPM
Steve Sheridan, DPM
Andrea Simons, DPM
Casey Smith (Vendor – Advanced Pathology Solutions)
Marshall Solomon, DPM
Jeffrey Solway, DPM
Harold Sterling, DPM
Sarah Stewart, DPM
Rebecca Sundling, DPM
David Taylor, DPM
Elizabeth Tronstein, DPM
Christine Tumele-Vogt, DPM
David Ungar, DPM
Brent Van Til, DPM
Gregory Vogt, DPM
Jason Wadaga (Deputy Executive Director)
Gary Wasiak, DPM
Marc Weitzman, DPM
Charles Young, DPM
Laal Zada, DPM
The following MPMA members have contributed to the APMAPAC in 2024. Additionally, the MPMA continues to support the APMA PAC as well. Every year, the MPMA is among the leading state associations supporting the advocacy efforts of the profession. This year, the MPMA provided $7500 to the APMA PAC.
Together the MPMA and the MPMA members below collectively contributed almost $23,000 to the APMA PAC in 2024. THANK YOU!
Platinum Level Supporters
($1,000–$2,499)
Dr. Marc Borovoy
Executive Director Derek Dalling
Dr. Scott Hughes
Dr. Randy K. Kaplan
Dr. Rebecca Sundling
Dr. Daniel Thomas
Bronze Level Supporters
($150–$299)
Dr. William Bennett
Dr. Marie Delewsky
Dr. John Evans
Dr. Ahmad Farah
Dr. Lanny Foster
Dr. Jeffrey Frederick
Dr. James Gallagher
Dr. Crystal Holmes
Dr. Donald Lutz
Dr. David Moss
Dr. Neal Mozen
Dr. Hemant Patel
Gold Level Supporters
($500–$999)
Dr. Zeeshan S. Husain
Dr. Bruce Jacob
Dr. Andrew Mastay
Dr. Ali Safiedine
Dr. Jodie N. Sengstock
Dr. Joyce Patouhas
Dr. Andrea Simons
Dr. Ann Spriet
Dr. Christine Tumele-Vogt
Dr. Gregory Vogt
Deputy Executive Director Jason Wadaga
Silver Level Supporters
($300–$499)
Dr. David Moss
Dr. Mark Saffer
Dr. Harold Sterling
Patriot Level Supporters (Less than $150)
Dr. Norman Brant
Dr. Bruce Kaczander
Dr. Kristi Ledbetter
Dr. Angela Robin
Dr. Gary Rothenberg
Dr. Marshall Solomon
Dr. Marc Weiner
Dr. Marc Weitzman
The future of our great profession and your future depends upon your support of APMAPAC. If your name is not on this list or if you want to move your name to a higher level, it is easy to contribute.
To make your 2025 contribution to APMA PAC, simply go online and visit: www.apma.org/Donate or scan the QR below!
Be safe and healthy.
PODIATRY TODAY FEATURES MICHIGAN
PODIATRIC DOCTOR RESEARCHER
Christopher Girgis, DPM
Below are excerpts from the research completed by Dr. Christopher Girgis. He’s a clinical assistant professor and podiatrist at the University of Michigan. The research was shared on Podiatry Today and the Symposium on Advanced Wound Care (SAWC) Fall.
Does Cognitive Dysfunction Impact Diabetic Foot Ulcer Outcomes?
The prevalence of cognitive dysfunction in patients with diabetes can complicate their adherence to self-care behaviors, but there is little understanding about how cognitive dysfunction may impact outcomes. Our recent abstract presented at the Symposium on Advanced Wound Care (SAWC) Fall evaluated the effect of cognitive dysfunction on outcomes in individuals with diabetic foot ulcers.1
Our 6-year retrospective study focused on 56 patients with ulcer and cognitive dysfunction (mean age 71.9 years and 75% male) and 68 patients with ulcer without cognitive dysfunction (mean age 56 years and 76% male).1 At 6 months, 32% (18) of patients with ulcers and cognitive dysfunction were healed compared to 72% (49) of patients with ulcers without cognitive dysfunction. The study also found 17.8% (10) of patients with ulcers and cognitive dysfunction versus 5.9% (4) patients with ulcers without cognitive dysfunction underwent higher level amputations, and 57.1% (32) of patients with ulcers and cognitive dysfunction versus 33.8% (23) of patients with ulcers without cognitive dysfunction required at least one foot-related admission.
Our study concluded that individuals with a diabetic foot ulcer and cognitive dysfunction are at elevated risk of major amputation, hospitalization, and suffer from non-healing more often than those without cognitive dysfunction at 6 months after diagnosis.1
Cognitive function is crucial for diabetes self-management but in the diabetic foot literature, there’s limited evidence to support this, although when you think about it, I can’t think of a larger and more difficult self-care behavior than managing a foot ulceration. However, there have not been many studies to evaluate that.
I have seen this phenomenon in my own practice, and that is a major reason why I am very committed to this work. In my experience with patients who have diabetic foot ulcerations, it’s relatively common to encounter individuals who show signs of cognitive impairment, which may affect their ability to follow through on what I’m recommending for them to do. However, a lot of these patients go without a formal diagnosis, so it’s challenging to then address this effectively.
This raises important questions. If these patients do perform poorly with their wound care and have poor outcomes, how can we best screen cognitive impairment? What additional support can we offer to these patients to help them improve their outcomes?
DPMs can do a number of things to help decrease the risk of complications in this patient population. If we have any concern about a patient’s cognitive status, we should not just brush it away. At the very least, we should begin with a conversation with
the primary care provider to determine if additional evaluations or referrals like a referral to neurology, if you’re noticing significant changes over a specific period of time, would be necessary. DPMs can also involve a caregiver or consulting social work to see if there’s additional support we can offer these patients such as case management or home health services. Finally, tailor your educational modalities and patient follow-ups to keep a closer eye on patients and a closer follow-up so you can more specifically help and offer these patients increased support.
I think there’s a lot of opportunities for future prospective work in this area as it relates to how we can best screen this patient population in the podiatry clinic and what evidence-based algorithms can we apply and deploy for these patients to ultimately improve outcomes.
Click here for a related video - https://www.hmpgloballearningnetwork.com/site/podiatry/does-cognitive-dysfunction-impact-diabetic-foot-ulcer-outcomes
Dr. Girgis is a Clinical Assistant Professor and podiatrist at the University of Michigan.
Reference
1. Girgis C, Behme S, Holmes C, O’Dell B, et al. Does cognitive dysfunction impact diabetic foot ulcer outcomes? Presented at Symposium on Advanced Wound Care (SAWC) Fall, Las Vegas, NV, 2024.
A Q&A About Dr. Girgis’ Research: Does Cognitive Dysfunction Impact Diabetic Foot Ulcer Outcomes?
What did your research find on the subject of DFUs and cognitive function?
So, to provide some context, our study aimed to evaluate how cognitive dysfunction affects outcomes in patients with diabetic foot ulcerations. We thought that this was an underlooked-at topic, and so we wanted to evaluate this. And so the way we did that was we conducted a 6-year retrospective study using an electronic medical record in ICD-9 and ICD-10 codes using a cohort discovery tool called DataDirect and basically it was able to pull electronic medical records from that 6-year time period and we were able to follow these patients for 2 years.
And so basically in order for the patient to be included, they needed to have diabetic foot ulceration and they were excluded if they did not have a diabetic foot ulcer or were not followed by a podiatrist, and if they screened positive for cognitive impairment within 5 years, then they were excluded from the group without cognitive impairment. And in order for them to be included to the group with cognitive impairment, they had to have some ICD-9, ICD-10 code that signified that they had some level of cognitive impairment.
And so what we found was we looked at them over the course of 2 years, they had to have a diabetic foot ulceration, and we looked at the outcomes of time to heal rate of amputations and then foot-related admissions during this period of time. And what we found was that patients with diabetic foot ulcerations and cognitive impairment had an increased risk of major amputations secondary to more severe ulcerations. They had an increased risk of foot-related admissions and more frequent nonhealing at 3 months and 6 months compared to those patients without cognitive impairment. So this suggests that cognitive impairment worsens the challenges and outcomes of diabetic foot ulcerations.
Why does cognitive dysfunction predispose patients to DFU complications?
Cognitive function has been shown to be crucial for diabetes
self-management elsewhere in the literature, not only the diabetic foot. And so there have been multiple studies that have shown somebody’s cognitive function and how that impacts their ability to conduct self-care behaviors.
For instance, there were multiple studies in 2012 that showed one’s ability to follow through with diabetes self-care behaviors, like checking their blood sugar, for instance, was directly related to their cognitive function. And so if they had a diminished cognitive function, then their ability to follow through on these tasks was very, very poor.
And unfortunately, in the diabetic foot literature, there’s limited evidence to support this, although when you think about it, I can’t think of a larger and more difficult self-care behavior than managing a foot ulceration. So intuitively, you would think that that would apply. It’s just that evidence isn’t there just because there hasn’t been many studies to evaluate that. And so that’s what we sought to evaluate, was to see if somebody did have cognitive impairment. How would that impact diabetic foot ulceration outcomes? And with our retrospective data, it did show that they did perform poorly.
How the author’s own practice reflects this phenomenon
I have seen this phenomenon in my own practice. And that is a major reason for why I am very committed to this work. In my experience with patients who have diabetic foot ulcerations, it’s relatively common to encounter individuals who show signs of cognitive impairment, which may affect their ability to follow through on what I’m recommending for them to do. However, a lot of these patients go without a formal diagnosis. So it’s challenging to then address this effectively.
And so this raises an important question of if these patients do perform poorly with their wound care and have poor outcomes, how can we best (one), screen for them, screen for cognitive impairment and (two), what is the additional support that we can offer to these patients to help them improve their outcomes.
How can DPMs help prevent complications in patients with cognitive issues? DPMs at this time, I believe can do a number of things to help decrease the risk of complications in this patient population.
Continues on pg. 24
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Now, a lot of my work and my time with this research is dedicated to formulating algorithms and treatment plans for which we can provide evidence to support these items. But I think at the very least, a DPM, if they have any concern about a patient’s cognitive status, I think what we should not do is just to brush it away. I think at the very least, we should begin with a conversation with the primary care provider to determine if additional evaluations or referrals like a referral to neurology, if you’re noticing significant changes over a specific period of time, would be necessary. So first and foremost, reaching out to the primary care provider to discuss these concerns with them.
The second would be involvement of a caregiver or consulting social work to see if there’s additional support that we can offer these patients such as case management or home health services. So I think reaching out for caregiver help as well as you know social work to see if we could offer them more support would also be ideal.
The last piece of this would just be tailoring your educational modalities and patient follow-ups to maybe keep them on a closer eye and a closer follow-up so that you can more specifically help and offer these patients increased support. Those would be the 3 areas that I think that DPMs can offer support for this high-risk population.
I think that this is a very interesting topic. I think there’s a lot of opportunities for future prospective work in this area as it relates to how we can best screen this patient population in the podiatry clinic and what evidence-based algorithms can we apply and deploy for these patients to ultimately improve outcomes.
MPMA DUES RENEWAL
Third quarter and the second semi-annual dues notices were mailed out this week. Maintaining membership is crucial to the success of the podiatric profession in Michigan. MPMA serves as your voice in Michigan and we are truly stronger together.
Please feel free to call our office to make payment over the phone at 800-968-6762, pay online, or email membership questions to trina@kdafirm.com. We are here to serve you and help you keep your membership current.
THE BIG TOE HAS A BIG JOB
The foot’s big toe is instrumental in movement (locomotion) and overall health and fitness. Although often covered with shoes, good big toe function is needed for body stability.
”Diabetes can affect toes where they’re not fully functioning. Other things can cause it, too, including age, foot anatomy, wearing tight shoes, and sometimes over-exerting one motion,” says Kyle Lawton, DPM. One can suffer from a stiff big toe joint, called hallux limitus, or painful rigidity, called hallux regidus. Both are extremely painful.”
PODIATRISTS PLAY A PIVOTAL ROLE IN DIAGNOSING AND TREATING
CONDITIONS
AFFECTING THE BIG TOE, THEREBY ENHANCING PATIENTS’ MOBILITY AND QUALITY OF LIFE.
“An ill-functioning big toe can affect the legs, hips, and back as a person tries to compensate to walk. Naturally, a person will try to reduce the pain by not walking on their foot, but they turn themselves into pretzels to prevent it.”
KEEP BIG TOES MOBILE
The big toe acts as the lever for the foot to function by allowing the body to move forward to help maintain an even stride or gait, transferring the body’s weight when walking and running. The big toe also helps maintain balance without assistance from a cane, walking stick, or walker. Overall, it helps prevent falls.
A flexible big toe helps people push off to take the stairs, reach up, and kneel.
When a person has a minimal range of motion with their big toe, the pain can be so excruciating that it causes immobility. To compensate for the pain, an individual may, for instance, lift their leg or foot differently, using more of the leg or hip rather than the foot. This puts more tension on other parts of the body.
And over time, it begins to interfere with overall health and livelihood.
BIG TOE JOINT
Michigan podiatrists can access the function of the big toe by looking at both passive and active ranges of motion.
Podiatrists check the toe’s range of motion by moving the toe up toward the shin and down toward the heel. When the big toe is bent back with the hand, the po-
WHEN THE BIG TOE JOINT
BECOMES ARTHRITIC AND THE JOINT IS TOO DAMAGED TO
RESTORE FUNCTION, FUSING THE JOINT HAS SHOWN TO RESTORE FUNCTION DESPITE LOSING MOTION TO THE JOINT. A PODIATRIC SURGEON WILL BE ABLE TO ASSESS A PATIENT’S SPECIFIC PARAMETERS AND NEEDS TO DETERMINE THE BEST PROCEDURE.
diatrist is looking for a 65-degree or greater angle and around 30-45 degrees in the opposite direction. The goal is to move the big toe.
Podiatrists may also use weight-bearing tests to continue their analysis. This may include standing on both feet and lifting one heel off the ground while keeping the big toe planted on the floor. This exercise checks for stability, mobility, and balance.
HOW TO IMPROVE YOUR BIG TOE MOBILITY
The good news is regular walking can be a great mobility exercise for your big toes, with a wide enough toe box in supportive shoes. The toes need room to move within the shoe, which should allow for natural flexibility of the foot and toes. Foot stretches and mobility exercises help keep foot joints “fluid” with a good range of motion.
If an individual experiences pain when doing foot stretches and exercises, it’s essential to have it checked out by a podiatrist. The podiatrist will identify a rigid big toe and its causation, including bunions, nerve issues, and improper footwear. They can use non-invasive tests, including X-rays, to see what’s happening inside.
For patients with loss of mobility, podiatric surgeons can offer different surgical options to restore pain-free flexibility. Podiatric surgeons are trained to perform a cheilectory, removal of bone spurs around the big toe joint to relieve pain and restore motion, a particiularly effective procedure during early stages of hallux regidus. An osteotomy is a procedure to realign the big toe by cutting and repositioning bones, commonly used to correct bunions. And anthrodesis, which is the fusion of the big toe joint to alleviate pain in severe arthritis cases, but can limit joint motion. It’s best to discuss options with the doctor.
Podiatrists play a crucial role in managing big toe conditions through both conservative and surgical approaches, aiming to restore function and reduce discomfort. Early consultation with a podiatrist is essential for effective treatment and prevention of further complications.
Sources: Chochane.org thehealthsciencejournal.com
AUBURN HILLS
PRACTICE FOR SALE
Well-established, fully equipped, 31-year practice for sale. All facets of podiatry with emphasis on conservative care. Wide referral base in desirable location. Sale includes over 27,000 patient base, office equipment, building, and care for multiple assisted living facilities. Email: icfeet.tf@charter.net
PRACTICE FOR SALE
House call practice. Senior buildings and group homes only. No individual houses or nursing Homes. Tri-county and Genesee County area. Gross $200,000 Email: fotmon@aol.com
TRAVERSE CITY, MI PRACTICE FOR SALE
Well-established practice with option to purchase/lease physician-owned (updated) building/apartment. The practice is busy, highly visible, and conveniently located on the east side of town near the TART Trail, and two blocks from East Grand Traverse Bay public beach. Email: tcfootdoc1@gmail.com
PRACTICE FOR SALE
Established podiatry practice located in southeastern metro Detroit. 1,200 sq. ft. Office includes 2 treatment rooms, 1 surgical suite and x-ray room. Immediate availability. Seller will help facilitate transition. Contact: nffs52282@gmail.com with inquiries.
MOBILE PODIATRIST WANTED
Full-time or part-time position. Services are for routine foot care. Areas include: UP, West Michigan and Greater Detroit area. Capitation work primarily. Negotiable daily rate. Please contact Mobile Medical Support at: Jashteneau@mobilemedicalsupport.com
PRACTICE AVAILABLE
Mid-Michigan - Established full-scope modern podiatry practice with ancillary services grossing $600,000 yr with a part-time schedule. Full hospital privileges with no call, low monthly overhead, perfect for a DPM looking for a betterbalanced work-life schedule. Seller available for transition. Email: forsalepodiatryclinic@gmail.com
PRACTICE AND BUILDING FOR SALE
Well-established 34-year practice for sale in beautiful Petoskey. Two locations with a steady inflow of new patients. Turnkey practice with three well-equipped treatment rooms, digital X-rays, certified EHR, and on-site furnished apartment. Office buildings available--purchase or lease. Serious inquiries only please. Contact: Upnorthfoot@gmail.com
PRACTICE AVAILABLE
Residency/fellowship graduates - looking to open a practice in the Ann Arbor area? The previous Dexter Foot & Ankle location is available for immediate occupancy. Six months rent-free, to help get your practice running. Contact: 734-812-3194 for details.
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