The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

January 20, 2012 #4,363 Publisher-Barry Block, DPM, JD

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AZ Podiatrist Injects Amniotic Membrane to Heal Diabetic Foot Ulcers

A Scottsdale podiatrist has developed a treatment for diabetic foot ulcers that could prevent amputation and other health problems. The treatment is the brainchild of Dr. Bruce Werber of InMotion Foot & Ankle Specialists, who has practiced podiatry for 32 years. Werber gets the open, infected wounds to close by injecting them with amniotic fluid. In the last year, he said, most people whose ulcers were not responding to treatment saw their wounds heal completely using this new treatment," says Werber.

Dr. Bruce Werber

"We now have amniotic membrane and fluid that is cryopreserved. So it can be used on anybody at any time and anywhere and morselized so it can be injected. We don't have to have a live birth to collect it, and it can be harvested in very clean, sterile conditions. We inject it in and around the wound, and it enhances the healing.

Source: Lisa Kennell, The Arizona Republic [1/18/12]

CA Podiatrist Speaks at Barry

The cost of diabetes in the United States is predicted to increase 270 percent by 2030. Amputations and ulcers make up more than 30 billion dollars a year, spurring Dr. Lee Rogers, the co-director of the Amputation Prevention Center at Valley Presbyterian Hospital in Los Angeles, CA, to launch a congressional campaign and bring his experience to Congress. This week, during a campaign visit to Florida, Rogers spoke to more than 50 podiatric medical students at the Barry University’s School of Podiatric Medicine.

(L-R) Dr. Jeffrey Jensen, Barry’s School of Podiatric Medicine dean poses with Dr. Lee Rogers, congressional candidate in California, and Class of 2013 president, Hani Badahdah.

Rogers discussed his views on medicine in the future, on preparing for graduate podiatric medical education, and how podiatric physicians can play a leading role in chronic illness prevention, including diabetes, hypertension, and obesity. He is vying for a seat in California’s 25th Congressional District. “With the exploding rate of diabetes and the aging of the baby boomers, podiatric physicians are the primary providers of diabetic amputation prevention care now and in the future,” said Rogers. There are currently more than 200 attorneys holding office in the U.S. House of Representatives and 18 seats are held by physicians.

MA Podiatrist Adds Wellness Coaching to Her Repertoire

Dr. Michelle McCrumb's approach to health and fitness is gentle and gradual. A longtime podiatrist who has added wellness coaching to her offerings, she advocates starting small, doing what's comfortable, and adding to the challenge slowly but surely. She insists that even starting the tiniest exercise plan can lead to a productive fitness routine in time.

Dr. Michelle McCrumb

This new pursuit began about two years ago when she noticed so many foot-care patients complained they could not exercise. "People come in and their feet hurt, so they're not exercising as much, so they gain weight because they're not exercising, then their feet hurt more," said Dr. McCrumb. "I found myself saying the same things over and over." Realizing that people in many situations had pain or discomfort that discouraged them from trying exercise, Dr. McCrumb wanted to intervene. "I developed a plan to help people reverse that cycle," she said. "It's really important that they keep moving."

Source: Pat Waring, The Martha Vineyard Times [1/17/12]

FL Podiatrist Joins Lee Memorial Health Systems

Officials at the Lee Memorial Health System have announced that podiatric physician, Dr. Arin J. Sheingold, has joined the medical staff. Sheingold obtained his degree from Barry University School of Podiatric Medicine. 

Dr. Arin J. Sheingold

Dr. Sheingold completed a Podiatric Surgery Internship and Residency at Chestnut Hill Hospital and is Board Qualified in Foot Surgery by the American Board of Podiatric Surgery and is Board Qualified in Reconstructive Rearfoot/Ankle Surgery by the American Board of Podiatric Surgery. He has joined Foot & Ankle Center.

Source: Lehigh Acres Citizen [1/18/12]

SGR Repeal Dilemma Could Make Passage Harder

Repealing Medicare's sustainable growth rate (SGR) formula for physician pay — a goal that always seems just out of reach — poses a dilemma for lawmakers that could make the measure even harder to pass. The dilemma is described in a study issued last month by the Congressional Research Service (CRS), an arm of the Library of Congress. It states that passage of an ambitious "doc fix" to the Medicare reimbursement crisis would force lawmakers to choose whether Medicare beneficiaries or taxpayers in general would suffer financially from one of the measure's overlooked consequences.

The SGR formula had called for a 27.4% cut in Medicare rates on January 1, but Congress voted in late December to extend the deadline to March 1. Exasperated by continual short-term postponements of scheduled cuts since 2003, organized medicine has lobbied Congress to replace the SGR formula with one more equitable for physicians. The Congressional Budget Office (CBO) has estimated that junking the SGR and freezing Medicare rates for 10 years would cost roughly $300 billion over that time frame.

Source: Robert Lowes, Medscape News [1/11/12]

Query: Keeping Toes Warm During Antarctica Marathon

A friend of mine will be running in the Antarctica Marathon in March. I am concerned that her toes are going to get uncomfortably cold or frostbitten due to the length of exposure to very cold temperatures during the marathon. My concerns are two-fold: the uppers of many running and trail shoes have a looser mesh weave which allow cold air in. Second, the running surface is going to be cold; therefore by conduction, the interior of the shoes will get cold. I was wondering if anyone has any tips on keeping her feet warm during the race?

Ayne Furman, DPM, Alexandria, VA

RE: Fast, Reliable Scanner (Mark Ray, DPM)
From: Alan Sherman, DPM, Pete Harvey, DPM

Fujitsu has made the best and most reliable scanners for many years. At Amazon, they list models from $400 - $1500. Whenever I've been in a bank or a law office where a lot of mission-critical scanning is done, it's invariably a Fujitsu.
 
Alan Sherman, DPM, CEO, PRESENT e-Learning Systems, asherman@presentelearning.com

There are many good scanners. We use a Lexmark 544 and, on some days, scan and import up to two reams of records per day. I have not used a hand-held scanner, but I don’t see how it could scan as fast as a stationary one. You might consult your local IT.
 
Pete Harvey, DPM, Wichita Falls, TX, pmh@wffeet.com

RE: Our Challenges: Innovate, Grow, or Wither Away? (Howard Dinowitz, DPM)
From: Bryan C. Markinson, DPM

Dr. Dinowitz posts a well-thought-out detailed appraisal of the myriad of encumbrances that exist upon medical practice today. He is also correct in saying that these are not limited to podiatrists. However, one thing that is glaringly missing from most postings of this nature, especially when the comment is made that all of medicine is similarly affected, is simply that any MD, in any state, in any city, on any given day of the week, at his or her will, can get employment for $160,000 dollars a year.

It may not be the best of venues, or the most desirable location, etc., but it is there always and always will be. The shortage of primary care physicians is enormous, guaranteeing these employment opportunities well into the future, in any healthcare system. Podiatric medicine could find ourselves in similarly good stead, if we as a profession decided to produce podiatric medical and diabetic specialists, as triple the amount of diabetics in the next two decades are staring us right in the face. Yet we have chosen to be/emulate foot and ankle orthopedic surgeons.

Dr. Dinowitz challenges us to grow or wither away. We need to first seize upon what podiatric medicine patients will be serving up for us to treat. We will be ready for the osseous ankle, that seemingly holy grail of podiatric surgery, but how much of that will there be to go around?
 
Bryan C. Markinson, DPM, NY, NY, Bryan.Markinson@mountsinai.org

RE: Wood Laminate Flooring in the Office (Arthur Lukoff, DPM)
From: Ellen Wenzel, DPM

The point of my post about our use of laminate was not that we have a 'sterile' office. No one can surely claim to achieve this impossibility. The point was that it allows us to keep a 'clean' environment and has been withstanding the demands of our practice because it makes it easy to do. Any solid surface flooring material will always outperform carpeted types in ability to disinfect and prevent from contamination after spills and messes, seams or no seams.

And, while the flooring of any office, institution, or surgery suite is considered a potential source of contamination (as are your counters, computers, chairs, and other inanimate objects), even the CDC regards flooring as a 'non-critical surface' and recommends only low to mid levels of disinfection, even in the hospital setting.

The link to a great infection plan that offices can read and adapt to their specific settings is: (cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf).

Ellen Wenzel, DPM, Vancouver, WA, wenzeldpm@gmail.com

RE: ADA and Deaf Patients (Jon Purdy, DPM)
From: Tip Sullivan, DPM

I was talking to another doctor about this issue and he related the following story to me. He had a deaf patient who came in to see him with a family member as an interpreter. He concluded the visit and the family member, who was acting as an interpreter, presented him with a bill and told him that if he did not pay it, he would be violating the ADA. SOME PEOPLE!
 
Tip Sullivan, DPM, Jackson, MS, tsdefeet@MSfootcenter.net

RE: Podiatry Management Celebrates 30th Anniversary
From: Gerald Peterson, DPM, Fay and Ted Mushlin, DPM

Congratulations to PM and to Barry Block for 30 years of outstanding leadership in providing a valuable communication tool for our profession. The somewhat instant interaction the readership is given in this forum is extremely valuable to the practitioner in the field. It is always helpful, and at the tip of your fingers at all times. The interactivity is what makes it such a great avenue for discussion and dissemination of information. Keep it up for another 30 years.
 
Gerald Peterson, DPM, West Linn, OR, DRP@ifixft.com

Ted and I want to congratulate Dr. Barry Block on the 30th year of Podiatry Management and PM News. Barry, you are what keeps the profession connected. Thank you for all your hard work and the time you spend getting the publication and listserv out to everyone. Kudos on your accomplishment.
 
Fay and Ted Mushlin, DPM, Newton Square, PA, teegee46@gmail.com

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