The Voice of Podiatrists

Serving Over 10,900 Podiatrists Daily

June 03, 2008 #3,262 Editor-Barry Block, DPM, JD

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High Heels and Flip-Flops Affect Women Differently: NV Podiatrist

Las Vegas podiatrist Jodi Politz, says the acute pain caused by extreme heels can radiate all the way up the body. However, she says high heels do not affect everyone the same way. "If it feels good, wear it. If it doesn't feel good, it's not good for you. Just because your best friend says it feels good for her, it might not be good for you. Feet are different. Everybody's different. Everybody changes differently. Everybody walks differently," said Dr. Politz.

Dr. Jodi Politz

Politz says some people with aches and pains are unaware that flip flops may be the underlying cause. "There's no support to them. The lack shock absorption. A lot of people start to develop foot pain, heel pain, ankle pain, knee pain, which can continue up the body, causing some lower back pain, shoulder pain -- once again, relating to the mechanics of the foot," said Dr. Politz.

On the flip side, as with high heels, everyone's different. "If you're not experiencing any discomfort, any problems, just continue on," said Dr. Politz. Dr. Politz says regardless of the type of shoe you're wearing, if they're causing discomfort, switch to something else, at least for a few days to see if it makes a difference.

Source: KLAS-TV CBS 8 (NV) [5/30/08]

Wenstrup Receives Scholl Alumnus of the Year Award

Dr. Brad R. Wenstrup has received the Dr. William M. Scholl College Alumnus of the Year Award of Rosalind Franklin University of Medicine and Science at the recent 2008 Midwest Podiatry Conference in Chicago. The Alumnus of the Year Award, the highest recognition award given by the Scholl College, is bestowed by the Scholl College Alumni Board upon an individual who has demonstrated outstanding professional leadership as a role model to students, service to the community and dedication to the College.

Dr. Brad R. Wenstrup in Iraq

Wenstrup is a 1985 graduate of the Scholl College. "Dr. Wenstrup has distinguished himself as a remarkable leader in podiatric medicine and the Scholl College as well as in his military career and community service," said Kert Howard, of Pocatello, ID, chairperson of the Scholl College Alumni Board of Directors. "He represents a model of excellence for all Scholl College alumni."

Wenstrup has served on the Alumni Association Board of William M. Scholl College of Podiatric Medicine from 1989-2003, beginning as a member-at-large and rising to treasurer, president-elect, president and immediate past president. He also served on the Board of Directors at Dr. William M. Scholl College of Podiatric Medicine as a member-at large for 2001-2004. In February 1998, Wenstrup accepted a commission with the U.S. Army Reserve. In 2005, he was deployed in Iraq with Task Force 344th Combat Support Hospital as the chief of surgery as well as the Director of the Wound Care Clinic. Wenstrup was the first podiatrist to serve as Chief of Surgery in the U.S. Army and the first to receive the Bronze Star as a podiatrist.

Source: Community Press & Recorder, KY – [5/23/08]

Judge Rules PA Podiatrist Did Not Violate Non-Compete Clause

A podiatrist with three Schuylkill County offices can keep all of them open, a county judge ruled Friday. Dr. Peter Johnson did not violate a non-competition clause in his contract with Advanced Centers for Podiatry & Wound Care, Inc., Judge John E. Domalakes ruled in a seven-page opinion and order. Domalakes thereby denied the request by the Lehighton corporation for an injunction that might have forced Johnson to shut his Tamaqua office. “Plaintiff ... has not met its burden to show that an injunction is needed,” Domalakes wrote.

Advanced Centers, for which Johnson once worked, sued to enforce a contract clause prohibiting Johnson from working or opening an office within 20 miles of one to which he was assigned. However, Domalakes ruled that Johnson was assigned to the corporation’s Brodheadsville and Kingston offices, and that none of his three offices — Ashland, Mahanoy City and Tamaqua — are within 20 miles of either.

Furthermore, there was no evidence Johnson was hurting Advanced Centers’ business and that the public interest in competition and the interest of Johnson’s patients would be hurt by granting an injunction, Domalakes ruled.

Source: Peter E. Bortner, The Republican Herald [5/31/08]

Make Employees Solve Problems

You’ll make you staff more independent if you tell them that before they bring a problem to you, they must”

• Put the problem in writing.
• List three ways to solve it.
• Pick the best solution of the three.

Payoff: Your staff will often realize that they don’t need your help or that they simply need a simple okay.

Source: Adapted from The Energetic Manager by Fred Pryor.

Query: Laser for Keloids?

Has anyone had personal experience or knowledge of any type of laser therapy for a hypertrophic/keloid scar? I have been using intra-lesion steroid injections with mild success.

Stephen Levin, DPM, Tampa, FL

RE: Prescribing Systemic Drugs (Mike Boxer, DPM)
From: James J DiResta, DPM, MPH, Richard Gosnay, DPM

I would also echo Dr. Gordon's concerns about comments limiting our scope of practice with use of systemic drugs. The prescribing of allopurinol in the overall treatment of the local manifestation of gout IS appropriate and refraining from doing so to me would present a larger problem for the provider of care here. Let's not turn the tide back.

I would also add, we need to be careful in telling others what we cannot do but rather focus on what we can and should be doing. When we feel uncomfortable in prescribing medication or in not doing a certain procedure, we can fall back and not provide the care because we lack the confidence or appropriate training and refer to a provider who can BUT we cannot hide behind the "it's not in my scope of practice" or "but I'm only a podiatrist" excuses.

James J DiResta, DPM, MPH, Newburyport, MA, James.J.DiResta.DMS04@Alum.Dartmouth.ORG

Editor’s Note: Dr. Gosnay’s extended-length letter appears at: http://www.podiatrym.com/letters2.cfm?id=19920&start=1

RE: Post-op Hypergranulation (Chris Seuferling, DPM)
From: Craig Breslauer, DPM

Dr Seufling’s patient will likely respond well to a STSG with immediate placement of a KCI VAC at 150 mmhg. continuous. I use Acticoat 7 and Adaptic under the foam. You can separate the layers of Acticoat and just use the bright silver layer. I would also send her for lymphatic drainage/therapy immediate post-skin graft.

Craig Breslauer, DPM, Palm City, FL, cbdpm@bellsouth.net

RE: Gouty Ulcer (Frank Graham, DPM)
From: Multiple Respondents

I have actually encountered this on more occasions than one would suspect. My regimen has been to identify the tophus as being gouty by sending it to the lab and asking for definitive diagnosis under a birefringent microscope. From a podiatric perspective, I debride the tophi (tophus) to minimal exsanguination (hopefully) and treat it as an ulcer. If it is on a weight-bearing surface, it must be off-weighted or accommodated. Additionally, the picture looks as though there is some cellulitis. I would take a culture and sensitivity and begin empiric therapy with what would be the most appropriate antibiotic for the patient and the clinical presentation of the wound.

Generally, allopurinol takes a little time to work. Acute therapy with indomethacin and/or colchicine is very helpful. Obviously, patients with intolerance to NSAID's or renal issues would require other alternatives. This is especially noteworthy with diabetics. X-rays are essential to look for destructive lesions either near the tophi or at other sites on the foot and ankle. Long-term open tophi can become infected and osteomyelitic, as well.

The key, locally, is to treat this as an open wound/ulcer and systemically to control the creation of more tophi by properly and definitively treating the patient's gout. I routinely hand out a low-purine diet and call the patient's PCP. Additionally, a 24-hour urine can be ordered to look for urate crystals. Persistent tophaceous gout should be co-managed with an internist or rheumatologist.

Steven R. Rudman, DPM, Exeter, NH, ruddoc@aol.com

Editor’s Note: Dr. Gosnay’s extended-length letter appears at: http://www.podiatrym.com/letters2.cfm?id=19919&start=1

RE: Dealing With a Claim of Racism (Name Withheld)
From: Peter Smith, DPM

I believe that you should always contact a colleague if a patient is bad-mouthing them, or worse claiming mistreatment. We all know how patients can hear and believe what they want, regardless of what we tell them. We need to watch each others' backs, and hope that they would do the same for us!

Peter Smith, DPM, Stony Brook, NY, ps84@bc.edu

RE: SAM January 2008 Debate on the Dual DPM-MD-Degree -An Historical Basis
From: Leonard A. Levy, DPM, MPH

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Editor's note: This extended-length letter can be read at: http://www.podiatrym.com/letters2.cfm?id=19925&start=1

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To view this debate click here

BIOMECHANICS FELLOWSHIP – NEW YORK

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PRACTICE FOR SALE - VENTURA, CALIFORNIA

Selling satellite office, fully furnished and equipped. Existing patients and room for more growth. Inquire at tkhk@sbcglobal.net

ASSOCIATE POSITION – CHATTANOOGA, TN

Associate needed for established practice. ABPS qualified or certified candidate preferred. Patient mix, hospital privileges readily available, excellent benefits and salary with production-based bonus. Please e-mail cover letter and CV to asocfoot@bellsouth.net or fax to (423) 855-1558.

PRACTICE FOR SALE – BROOKLYN, NY

Busy multi-faceted 20 year old practice for sale. Large office with 3-4 fully-equipped treatment rooms, modern and updated. Located in Walgreens shopping center, subway on corner. Free parking lot. Turnkey operation. Make money first day. Call Jon @917-364-8057 or email: jonnytee@aol.com for more details.

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. 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

ASSOCIATE POSITION - SAN ANTONIO, TEXAS

Seeking three-year trained resident for associateship, hopefully leading to partnership. Competent in all phases of podiatry particularly reconstructive rearfoot surgery. Outstanding opportunity for the right individual. Reply to Richard Pollak at 210-692-0279, or fax resume to 210-692-0028 or e-mail drpllk@hotmail.com

IMMEDIATE OPENING - MINNEAPOLIS, MN

Associate leading to partner in well-established practice. Seeking personable, skillful, and attentive podiatrist. No nursing homes, evenings or weekends. Competitive compensation package including health insurance, malpractice, short term disability, 401(k), generous vacation, paid holidays, and excellent salary plus bonus! E-mail cover letter and CV to jbremer@associatedpodiatrists.com or fax to (612) 866-5875 attn: Jennifer Bremer

INTERNET FOOT THEMED CANDY BUSINESS FOR SALE

Well-known foot-themed chocolate and candy company with over 6,000 customers. Unique products with trademarked names for seasonal (Mistle Toes, Valentoes, etc.) as well as everyday (A Foot of Feet, Twinkle Toes, etc.). Excellent opportunity to generate income from home with an established business. Serious inquiries to Mwolpa@ToeFood.com

PRACTICE FOR SALE - FLORIDA

Well-known practice in Coral Gables,FL for over 20 years. Excellent location on Coral Way with 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. For additional information contact QVAN@aol.com or 305-975-5516.

ASSOCIATE POSITION – LEHIGH VALLEY, PA

Large medical/surgical practice centered in Lehigh Valley, PA looking for exceptionally trained podiatrist. Excellent opportunity for income as well as potential partnership. E-mail resume to jkaufman@lvfoot.com

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