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05/09/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS)


RE: Dr. Lidtke's Remarks

From: Bret Ribotsky, DPM



I love to read the comments each day on PM News, and I would also like to be fair to the guest masters and to Dr. Block. The Q&As that are published each week are taken out of a conversation that is fluid.  For this, I would request that anyone wishing to make a comment at least listen to the show to see if my follow-up questions answer your concerns.



Each Tuesday night, the microphones are open to anyone listening live on a topic that should be of interest to you. I believe that we collectively can move our knowledge forward. Roy's comments were taken out of a long discussion about how research has demonstrated how podiatric biomechanics was taught and is evolving, and that there is so much we all need to learn. Last Tuesday, we were exposed to a theory that stability can be bad (sorry, Dr. Root) to forces and to orthotic therapy when dealing with arthritis and joint wear. What I learned is that each patient needs to be individualized, and even then, sometimes it's a flip of a coin as to which way to go. Listen to Roy's talk. He is very knowledgeable and makes his points very well.



Bret Ribotsky, DPM, Boca Raton, FL, ribotsky@gmail.com


Other messages in this thread:


07/27/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS)


RE: Charles Lombardi, DPM's Discussion on "Meet the Masters"

From: Charles M Lombardi, DPM



I never said that the three-year model caused the shortage of positions, and quite the contrary, said it played no role in the shortage. The MAVs used for the new PMSR program are the same as the old PM&S-24 program, and in fact, very few programs did not convert.



Charles M Lombardi, DPM, Bayside, NY, LOMBARDI@nyfootsurgeons.com


07/26/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS)


RE: Charles Lombardi, DPM's Discussion on "Meet the Masters"

From: Thomas Ortenzio, DPM



I agree with Dr. Lombardi on the genesis of the residency crisis.  This problem was brought on by the decisions made years ago at the APMA HOD. The delegates were encouraged by the leadership to expand our residency programs to 3 years so that we could reach a level of parity with allopathic medicine. The problem was that the delegates were led to believe that our current residency programs would be able to absorb the third year without creating the crisis we have now. I truly believe that anything that has been done, can be undone. I believe that the best solution to this problem would be to go back to a mandatory 2-year residency for all graduates. Make the third year an optional fellowship year for those who want to do complicated rearfoot and ankle surgery. 



I am not sure that this would totally solve the problem, but it should certainly make more slots available. Maybe someone with knowledge of the slots available could do the math and let us all know if this is a viable solution. If it is viable, let's take such steps as are available under the Bylaws of APMA to conduct an immediate open discussion to seek a solution to this important problem. 



We can all sit around and talk about this problem, or we can do something about it. Let's get moving! If anyone else has a better idea that can be implemented now, let's look at that too. We can no longer kick our new unmatched graduates down the road.



Thomas Ortenzio, DPM, York, PA, footfan@comcast.net


07/20/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS) - PART 1B


RE: Charles Lombardi, DPM's Discussion on "Meet the Masters" (Michael Rosenblatt, DPM)

From: David Gitlin, DPM



The readers of PM News are lucky to have Dr. Rosenblatt's interpretation of Dr. Lombardi’s “Meet the Masters” interview. Unfortunately, his interpretation is somewhat off-base. The interview presented the history of the present residency shortage situation from someone involved in every aspect of podiatry education. He was not there to “defend himself impassionedly” - nor does he need to defend himself for any reason whatsoever.



As for “coldness” toward the recent graduates, he simply said it was a difficult situation with no easy solutions. With all due respect - I think Dr. Rosenblatt may need to listen to the broadcast again.

 

David Gitlin, DPM, NY, NY, uwdave@hotmail.com


07/19/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS)


RE: Charles Lombardi, DPMs Discussion on "Meet the Masters"

From: Michael M. Rosenblatt, DPM



I had the opportunity to hear Dr. Charles Lombardi, DPM defend himself, CPME, and APMA on Dr. Bret Ribotsky’s forum “Meet the Masters.” There are a number of areas in which Dr. Lombardi and I share complete agreement: Among them is that “residencies must start from the bottom up, rather than vice versa.” The second is that (unfortunately) we have a society composed of fewer people who are willing to sacrifice their time and talents to “pay forward” to the future of their profession. This I believe is characteristic of our nation in general, and is to be supremely regretted.



But his “coldness” to the inability of at least 80 recent graduates' ability to obtain a license was a very grave disappointment. He seemed recalcitrant to consider other options for residency programs, which in the past, he himself supported and pushed for. The most logical one would be a general DPM training program that did not necessarily promote a surgical option. Dr. Lombardi made the point that he himself supported this in the past, but it was negated by an under-handed political move at APMA.



None of this takes away his extraordinary contribution to the profession, and his absolute love and willingness to pay it forward. But I also feel that APMA/CPME takes for granted the contribution that HE and other experienced podiatrists willing and able to start new programs have made. This centers utterly in CPME’s own arrogance. APMA seems to share that same attitude.



I don’t think that Dr. Lombardi sees his own attitude as arrogant. But if you are a recent DPM graduate (without a program) looking to a legal option for reclaiming your life, it is an inescapable conclusion. Sadly and with great regret, I do not look upon their plight with any more encouragement than I did before I listened to his impassioned self-defense, which to an uninitiated person outside of podiatry, would sound like a diatribe.

 

Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net


06/12/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS)


RE: How Can American DPMs get Involved Teaching Podiatry Skills Throughout the World? (Bret Ribotsky, DPM)

From: Joseph Quattrone, DPM



I am practicing in Abu Dhabi, UAE and doing plenty of educating and lecturing.  We have the 4th International Diabetic Foot Conference coming up in Dubai in November. I am just getting some traction with my practice now, but let me know if anyone is truly interested, and I may be able to help at least in the Middle East. 



Joseph Quattrone, DPM, Abu Dhabi, UAE, docq1001@yahoo.com


05/13/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS) - PART 1B


RE: Dr. Lidtke's Remarks (Roy H. Lidtke, DPM)

From: George Trachtenberg MS, DPM



I do not recall your making the website ncbi.nlm.nih.gov/pubmed available in your posting in PM News for the readership to refer to. I recall you only made a statement that would amount to an abstract of your conclusion. Also, I never expressed any issue that the shoe in question in your study reduced loads on the knee up to 20%. I simply pointed out that practitioners should be aware that the load in a closed kinetic chain can have an effect on another body region if not dissipated external to the body.



I have not gone to the website above to see if you demonstrate what happens to that load when you...



Editor's note: Dr. Trachtenberg's extended-length letter can be read here.


05/13/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS) - PART 1A


RE: Dr. Lidtke's Remarks (Bret Ribotsky, DPM)

From: Mr. Jeffrey Root



Dr. Ribotsky wrote, “Last Tuesday, we were exposed to a theory that stability can be bad (sorry, Dr. Root) to forces and to orthotic therapy when dealing with arthritis and joint wear.” Although I didn’t listen to last Tuesday’s Meet the Masters discussion, I can tell you that Dr. Root believed that functional orthoses could be used to do far more than reduce or eliminate excessive motion.



While it is true that functional orthoses can be used to enhance stability, they can also be used to...



Editor's note: Mr. Root's extended-length letter can be read here.


05/11/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS)


RE: Dr. Lidtke's Remarks (George C. Trachtenberg, MS, DPM)

From: Roy H. Lidtke, DPM



I am not sure what Dr. Trachtenberg means by "all the research." All the research is available at ncbi.nlm.nih.gov/pubmed



I am a clinician and a researcher. As a researcher, I use the scientific method to establish a finding at the 95% confidence level that the finding is true. At Rush University, we do an NIH-sponsored level of research and publish in journals that have a high impact factor, where the editors and reviewers make sure our methodology and conclusions are correct.



So, as a researcher, I can tell you that wearing the Flex OA shoe does decrease the loads on the...



Editor's note: Dr. Lidtke's extended-length letter can be read here.


05/10/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS)


RE: Dr. Lidtke's Remarks (Bret Ribotsky, DPM)

From: George C. Trachtenberg, MS, DPM



I have no concerns about my comments. They are generic comments based on physics, and it is then left up to the reader to decide what they think. There is, in fact, nothing fluid in “what is". It is what it is! Just putting abstract comments in a publication like PM News can be very misleading to those who don’t evaluate patients with in-shoe mapping systems and/or video analysis. They are just looked upon as expert comments, and that is where the potential danger to the patient ultimately lies.

 

Also, terms such as “The Masters” or the “experts” are often just that…terms!



George C. Trachtenberg, MS, DPM, Vestal, NY, doctor@georgetrachtenberg.com


05/08/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS) - PART 1A


RE: Dr. Lidtke's Remarks

From: George C. Trachtenberg, DPM



Roy Lidtke said, "What our research has shown is that a very flexible shoe will allow more motion to occur and thus decrease forces at the knee. Research that I have been involved with at Rush University has lead to the OA shoe. This specifically-designed flexible shoe has shown to decrease knee forces up to 20%."



Before we accept a statement as broad as this, let's see all of the research. Reducing force on the knee by using a specifically-designed shoe that creates "more motion" does not mean that the force reduced in the knee is not transferred to another area of the body, creating damaging repetitive motion injury in that new location. I do not think statements such as these should be made without seeing the supporting research and the consequences of the outcome, whether positive or negative that occur elsewhere in the closed kinetic chain as a result of its use.



We must remember that energy is neither created nor destroyed but only redistributed. If this force on the knee is not inappropriately transferred to another area, then bravo!  But if foot function is still not normal (in spite of the specifically-designed shoe), this force will stay in the body and move to a new location for the creation of future damage in that location. I fear this could be the case.



George C. Trachtenberg, DPM, Vestral, NY, doctor@georgetrachtenberg.com


05/01/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS)


RE: Success Tips From The Masters (John Mattiacci, DPM)

From: Leonard A. Levy, DPM, MPH



A DPM is a physician: A rose is a rose by any other name. In the April 30, 2013 Success Tips From The Masters, John Mattiacci, DPM, says that “parity is the wrong word” regarding DPMs and MDs. Furthermore, he indicates that Temple Medical School MCAT scores are 10 points higher than for podiatry students. MCAT scores are not relevant when talking about the issue of parity. Many U.S. students are Foreign Medical Graduates (FMGs) not accepted to a U.S. school. The vast majority become licensed to practice medicine as do students graduating from Temple.



Also, many FMGs had MCATs equivalent to (or less than) students applying to U.S. podiatric medical schools. The analogy of “printers vs. plumbers” is not appropriate. A better analogy is comparing  podiatric physicians to ophthalmologists, both of whom virtually have the same responsibilities in their specialty.

 

Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL, levyleon@nova.edu


01/10/2013    

RESPONSES / COMMENTS - (SUCCESS TIPS FROM THE MASTERS) - PART 1B


RE: Residency Shortage (Paul Kruper, DPM)

From: Robert Scott Steinberg. DPM



Paul, Did you have a residency? Who paid your salary? It was Medicare's payments to your hospital. Tell me what law could require a hospital to be forced to host a residency? Colleges of podiatric medicine sure do not have the power to force residencies on hospitals. No, the problem seems to be too many graduates for the number of available slots, not enough doctors willing to be residency directors, and not enough hospitals willing to host programs. And then there is the issue of maybe wanting to limit competition!



Are you a residency director? If not, then you have a huge opportunity to serve podiatry. It's long hours for little extra pay, but gratifying.



Robert Scott Steinberg, DPM, Schaumburg, IL, Doc@FootSportsDoc.com