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08/23/2013
RESPONSES / COMMENTS - (NON-CLINICAL) - PART 1A
RE: Wart Treatments (Theresa M. Hughes, DPM)
From: Michael J. "Dusty" McCourt, DPM
In regard to cantharone, I obtain mine from a compounding pharmacy in Roseburg, OR and have even heard that the local compounding pharmacy here in Eugene does it as well. I, too, have had great results and happy patients with using it.. Here are the websites:
NW compounding pharmacy: nwcmpd-rx.com/Homepage.html
Broadway: broadwayapothecary.com/
Michael J. "Dusty" McCourt, DPM, Eugene, OR, dustydock@gmail.com
Other messages in this thread:
08/20/2013
RESPONSES / COMMENTS - (NON-CLINICAL) - PART 1A
RE: Diagnostic Ultrasound (Bryan Markinson, DPM)
From: Robert Kornfeld, DPM
Bryan Markinson states a case of ultrasound abuse which has nothing at all to do with efficacy of guided injections. This simply sounds like an unethical doc. Guided injections have their place in our armamentarium. There is no shortage of journal articles supporting its use. I have found it to be extremely helpful in injection placement and efficacy (although I do not inject cortisone into ligaments, tendons, or joints). Realize that if your injection is not in the right place or the right plane, no amount of "diffusion" is going to get it there. My fellow podiatrists should also know that guided injections are becoming the gold standard in radiology, rheumatology, orthopedics, etc. It should be in podiatry as well. Why rely on hit or miss when you can clearly see where you need to be?
In the same vein, why should we do minimally invasive fluoroscopic or endoscopic procedures? Let's just put the knife in and slash around. We're bound to be right half of the time.
Robert Kornfeld, DPM, Manhasset, NY, holfoot153@aol.com
08/16/2013
RESPONSES / COMMENTS - (NON-CLINICAL) - PART 1A
RE: Diagnostic Ultrasound (Bryan Markinson, DPM)
From: Martin E. Wendelken, DPM, Bill Greco, DPM
The use of diagnostic ultrasound in the identification of tumors on any location of the foot should not be understated. I have identified 4 malignant soft tissue masses that appeared to be “ganglions”, some of which were injected by others thinking they were ganglions. Therefore, all soft tissue masses are examined using diagnostic ultrasound before we inject or aspirate them.
One oncologist unfortunately stated to one of the referrals that injections into tumors can complicate treatment and may cause spreading of the cells/mass (causing legal issues for one of the podiatrists). This technology can improve patient care, however, it is clearly operator-dependent. As far as guided injections, sonography can allow for exact placement of injectable medications in the area where the pathology is located as determined by the US exam. We have found, in fact, that this reduces the number of injections to achieve a satisfactory result.
Martin E. Wendelken, DPM, RN, NY, NY, drmew@optonline.net
Is the example of ten ultrasound-guided steroid injections an example of the fallibility of ultrasound or the incompetence of care, bordering on malpractice, of one individual?
Ultrasound as a practice adjunct will provide the practitioner valuable information. Is the mass cellular or fluid? Is it lobulated or a single chamber? Are there extensions of the mass beyond...
Editor's Note: Dr. Greco's extended-length letter can be read here.
08/08/2013
RESPONSES / COMMENTS - (NON-CLINICAL) - PART 1A
RE: Diagnostic Ultrasound (Michael Forman, DPM)
From: Marc Katz, DPM
There is no overuse of ultrasound. There is not enough use of ultrasound. I completely agree that ultrasound is invaluable for all of the applications that you mentioned and serves as a great diagnostic tool.
However, there are issues to be discussed. Many doctors that use ultrasound have no clue what they are viewing, but they use this tool to add dollars to...
Editor's note: Dr. Katz's extended-length letter can be read here.
07/11/2013
RESPONSES / COMMENTS - (NON-CLINICAL) - PART 1A
RE: Reliable Medical Billing Company
From: Joseph Smith, DPM, Michael Forman, DPM
My billing company rules - 1st Choice Medical Billing Terry Raynor-Fritz (757 560-0202) . She has been doing podiatry for over a decade and has been teaching medical billing at Tidewater Community College for over 20 years. She handles all types of practices and handles many out-of-town clients.
Joseph Smith, DPM, VA Beach, VA, jsmith531@cox.net
I am using Doctors Central Billing in Ohio. They are easily the best billing service I have had. At this time, they are also in Indiana, Kentucky, and Florida. Write to PaulF@drsbillinginc.com
Michael Forman, DPM, Cleveland, OH, im4man@aol.com
06/27/2013
RESPONSES / COMMENTS - (NON-CLINICAL) - PART 1A
RE: TRAKnet Charges (Marge Portela, DPM)
From: Irma Godoy, DPM
The new owners need to charge for services, but I am still paying a lease. My contract says “lease to buy, services included for 5 years, buy-off $1.” I was supposed to be the owner of the software in 5 years; now I own nothing and have to pay extra (almost the same amount that I’m paying for the lease), and I am being threatened that if I don’t pay, I will incur fees, and my software might have problems working. I love the software; I finally learned how to work it, but being a small business, it’s too expensive for me. What are TRAKnet's owners doing about it?
Irma Godoy, DPM, Wayne, NJ, igrt53@yahoo.com
06/25/2013
RESPONSES / COMMENTS - (NON-CLINICAL) - PART 1A
RE: Will Podiatric Residencies Accept MDs? (Ivar Roth, DPM, MPH)
From: David Gottlieb, DPM
While it’s a nice thought for the times when there are more programs than applicants, MDs cannot be podiatry residents. One of the required prerequisites to be accepted into a CPME-approved residency program is that the applicant has graduated from a CPME-approved podiatry school/college.
A better option would be for your son to graduate medical school, then go to podiatry school for 2 years. At that time, he would be an MD/DPM and could decide which residency track and specialty he wanted [MD or DPM].
H. David Gottlieb, DPM, Baltimore, MD, hdavidgottliebdpm@gmail.com
06/19/2013
RESPONSES / COMMENTS - (NON-CLINICAL) - PART 1A
RE: Time for EBM Study on Custom Orthotics (Carl Solomon, DPM)
From: Roy Lidtke, DPM
This is a big problem but it is also a big project. There have been several projects funded by APMA, PFOLA and even physical therapy, but obviously we have not seen any great change in our research portfolio on the "pro" side of the argument. It is expensive to do any substantial research. Research projects like this will not get done until someone pays for it.
As funds are limited by the government, and industry isn't stepping up, I suggest we set up a crowd source funding website and invite the "experts" to submit proposals with all of us voting on the best. Maybe then something will get done.
Roy Lidtke, DPM, Marion, IA, Roy.Lidtke@dmu.edu
06/18/2013
RESPONSES / COMMENTS - (NON-CLINICAL) - PART 1A
RE: Time for EBM Study on Custom Orthotics (Carl Solomon, DPM)
From: Kevin Kirby, DPM
Over the last seven years, I have written one paper and two book chapters which describe, in detail, the multitude of research studies which show that foot orthoses not only effectively alter the kinetics and kinematics of gait, but also show that foot orthoses are very effective at treating a number of foot and lower extremity biomechanical pathologies. Most of these research studies are published in non-podiatric scientific journals. I highly recommend Paul Scherer's recently published book which focuses on the research evidence for foot orthoses (Scherer PR (ed), Recent Advances in Orthotic Therapy: Improving Clinical Outcomes with a Pathology Specific Approach, Lower Extremity Review, USA, 2011).
Kirby KA: Foot orthoses: therapeutic efficacy, theory and research evidence for their biomechanical effect. Foot Ankle Quarterly, 18(2):49-57, 2006.
Kirby KA: "Evolution of Foot Orthoses in Sports", in Werd MB and Knight EL (eds), Athletic Footwear and Orthoses in Sports Medicine. Springer, New York, 2010.
Kirby KA: Introduction to Recent Advances in Orthotic Therapy. In Scherer PR (ed), Recent Advances in Orthotic Therapy: Improving Clinical Outcomes with a Pathology Specific Approach, Lower Extremity Review, USA, 2011.
Kevin A. Kirby, DPM, Sacramento, CA, kevinakirby@comcast.net
05/29/2013
RESPONSES / COMMENTS - (NON-CLINICAL) - PART 1A
RE: Square.com (Andy Dale, DPM)
From: Shannon Roesch, DPM
I started using the Square device in my office about 3 months ago. It's a great way to enforce timely payments without the high fees of other credit card processors. It comes in handy, especially with those flex benefit cards. The device is free, and it's really easy to use. The funds are posted to your account the next day.
I hesitated for a long time to get a credit card device. But now, I'm really glad I did it. Now, there's never an excuse for patients not to pay their outstanding balances.
Shannon Roesch, DPM, Floral Park, NY, shannon.roesch@gmail.com
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