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01/11/2017    

RESPONSES/COMMENTS (NEWS STORIES)



From: Dennis Shavelson, DPM


 


When minimalist running, one reduces heel contact running, which for most of us, would be a good thing. Runners must be willing to break in their new stride, speed, and distances slowly to reduce fractures and other overuse injuries such as Achilles tendonitis. These rules apply when breaking any new activity or sport.  


 


The article states, “These days, more of Kirby’s patients are running with thicker-sole shoes than ever before. Every third runner he sees wears Hokas, a sneaker brand with the thickest underfoot cushions in the market today." I must interject that they may be dangerous for many runners. I published a white paper regarding Sketchers Rocker Shoes. I eventually wrote the 41 page brief involved in the successful lawsuit against Sketchers Rocker Shoes involving 300 injuries.


 


Rockers and flexible soled shoes designed to shock absorb and create cushioning using thick and flexible materials when married to the flexible foot types of many runners, will result in injuries to some of those feet, especially if runners transition too quickly. Rockers obviate the need for healthy internal biomechanics and predictably allow feet with high SERM-PERM Intervals to degenerate to the point that they need rockers all the time. Hokas are unproven short- or long-term as to safety and they are being poorly disclaimed. They are not the next Nike Waffle Trainer yet!


 


Dennis Shavelson, DPM, NY, NY

Other messages in this thread:


06/23/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 1



From: Josh White, DPM, CPed


 


DPMs who adopt protocols espoused by the American Diabetes Association's “Standards of Medical Care” and the CDC’s STEADI program for fall prevention, endorsed by the APMA, can easily satisfy 4 of the 9 required 2017 registry MIPS Quality Measures (126, 127, 154, 155).  


 


Such an approach not only helps avoid what’s now a 4% penalty but also offers the opportunity to bill 99213 E&M visits for comprehensive diabetic foot exam and fall risk assessment provided that evaluation determines a qualifying risk factor and that a plan of care is provided.


 


Incorporating a thorough, routine approach to care offers the best way to identify risk factors that often go untreated and makes clear indications when shoes, foot orthotics, and AFOs may be prescribed as preventative care modalities.


 


Josh White, DPM, CPed, Maplewood, NJ

06/23/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 2



From: Elliot Udell, DPM


 


Congratulations Dr. David Armstrong for once again blazing another trail for our profession. His article titled "Diabetic Ulcers and Their Recurrence" was published in the June 15th issue of the New England Journal of MedicineNot only should we be proud of Dr. Armstrong's latest accomplishment for being the lead author in a paper published by one of the world’s leading medical journals but many of his references at the end of the paper were papers also published by podiatrists.


 


Reading this article today brought tears to my eyes for the same reason that many civil rights leaders cried when the first Black president was inaugurated eight and half years ago. Both represented breakthroughs and in the case of Dr. Armstrong's well-written paper, a breakthrough for our entire profession. Thirty five plus years ago when I first graduated, it would have been a pipe dream for a person with a DPM after his name to have a major paper on foot pathology published in any prestigious non-podiatric medical journal. This "glass ceiling" has now been broken and I salute the authors who made this possible.


 


Elliot Udell, DPM, Hicksville, NY

06/21/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 2



From: Ron Werter DPM


 


When Dr. Katzen talks about a "good man with a gun," I assume he's talking a about a good man (or woman) who has undergone months of intensive training in use of his weapon in many situations, has years of experience, and has undergone frequent repeat training and practice sessions, not some average Joe with a 3-hour gun safety course. It would be like comparing Dr. Wenstrup's actions as a skilled medical professional in saving his Congressional colleague's life to an average Joe with a 3-hour first aid course. 


 


Let's not let our agendas get in the way of reality.


 


Ron Werter, DPM, NY, NY

06/21/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 1



From: Ben Pearl, DPM


 


I wish John a speedy recovery. I hope that witnesses of events like this become aware of the all too often case of people who speed off rather than stop to help the persons that they injured  so that they can be held accountable for their actions. I witnessed an upperclassman get hit by a car while we were riding our bikes after classes in Philadelphia at PCPM. I made sure that at the deposition for the accident, the lawyer representing the driver who hit my friend was not able to twist the sequence of events as lawyers sometimes do.


 


Ben Pearl, DPM, Arlington, VA

06/20/2017    

RESPONSES/COMMENTS (NEWS STORIES)



From: Steven Kravitz, DPM


 


Congratulations to Dr. Arthur Helfand for receiving this national allopathic award from the American Geriatrics Society (AGS). The AGS recognized Helfand, the only podiatrist to attain fellowship in the group, when it marked its 75th anniversary in May in San Antonio. 


 


Recognition of this physician as being a leader in education is very well deserved. In the late 60s and 70s, he published numerous articles in allopathic publications. To this day, he continues to author more allopathic literature than any podiatrist I'm aware of; literally hundreds of articles. His involvement set the stage for the recognition of podiatrists in diabetic care as well as geriatrics. As residency director in a leading hospital in Philadelphia, he trained more than 250 podiatric physicians and is a past president of the APMA. The Academy of Physicians in Wound Healing presented him with its national achievement award in 2014. He's also a recipient of the Lifetime Achievement Award from Podiatry Management Magazine.


 


Steven Kravitz, DPM, Winston-Salem, NC 

06/19/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 1A



From: Leonard Levy, DPM, MPH


 


Brad Wenstrup, DPM and Member of Congress was the first person to tend to the serious wounds inflicted by the shooter in the Virginia attack this morning on a ball field where other congressmen were engaged in a baseball competition. He did not identify himself as a podiatric physician, a CNN interviewer referring to him as a medical doctor. This unfortunate shooting incident, while a national tragedy, dramatically points out the potential role of our profession still not properly recognized by the medical community, as well as state and federal agencies. Rep. Scalise was so lucky to have had the benefits of Rep. Wenstrup's skills.


 


Leonard Levy, DPM, MPH, Ft. Lauderdale, FL 

06/19/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 1B



From: Steven Selby Blanken, DPM, Burton J. Katzen, DPM


 


Congrats to a hero who went into DOCTOR mode during a shooting in VA to help a fellow congressman. He was well prepared from all of his training. I pray for the health of all five people wounded in this horrible act that happened. Thank you, Dr. Wenstrup.



 


Steven Selby Blanken, DPM, Silver Spring, MD



 


Kudos to Rep. Dr. Brad Wenstrup for his bravery and quick action in the Virginia tragedy yesterday where Rep. Steve Scalise was seriously wounded by a crazed gunman. Also, as someone who has many law enforcement patients including a number of Capitol policemen, I also congratulate their quick action, which by some accounts, might have saved 15-20 lives, proving once again that the only thing that can stop a bad man with a gun is a good man with a gun. We all wish the congressmen and wounded policemen a speedy and full recovery.



 


Burton J. Katzen, DPM, Temple Hills, MD


06/19/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 2



From: Elliot Udell DPM


 


Kudos to Dr. Shapiro for coming out against walking without shoes and socks. For years, I felt like I was waging a one-man war on this issue.


 


In addition to catching diseases by walking barefoot, a problem that we also see in the warm weather months are patients with foreign bodies in their feet. Removing spicules of glass is always a challenge. The problem could be prevented by wearing a pair of shoes or sneakers.


 


Elliot Udell, DPM, Hicksville, NY

06/14/2017    

RESPONSES/COMMENTS (NEWS STORIES)


RE: NY Podiatrist Gets Probation for Oxycodone Distribution 


From: Name Withheld 


 


As a daily reader of Newsday (among other daily papers frequented), the above news line is unfortunately not surprising. For the last few years, Long Island, in particular, has been an epicenter of an Oxycodone epidemic. There are almost daily stories, many of which illustrate lives of youngsters whose lives have been ruined if not lost not by illegal drugs, but by legal pharmaceuticals, many of which have been prescribed by greedy or addicted medical practitioners. 


 


It unfortunately took a drug store robbery several years ago which resulted in the deaths of several store employees for NYS law authorities to finally take action against medical practitioners who...


 


Editor's note: Name Withheld's extended-length letter can be read here.

06/08/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 1A



From: Elliot Udell, DPM


 


Thank you, Dr. Kravitz and the APWH for fighting on behalf of our profession.


 


When I first entered practice many years ago, orthopedic surgeons and podiatrists related to each other like cats and mice. The hatred and animosity could be measured with a "fever thermometer." At that same time, orthopedists were allowed to testify against our colleagues. In my geographic area, there were several orthopedists who testified against any and every podiatrist they could. Even if there was nothing wrong with a patient, one of those orthopedists would go out of his way to tell his patients (even if he was examining a back or knee) that "the podiatrist messed you up and that is why your knee or back hurts." The same doctor was quick to testify in court. The fear of his testimony resulted in early settlements against us. I hope that Dr. Kravitz's efforts will prevent those dark days from once again returning.


 


Elliot Udell, DPM, Hicksville, NY

06/08/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 1B



From: Howard Bonenberger, DPM


 



While the idea of allowing unqualified "expert" testimony would seem to muddy the waters for the jury at best and lead to bad decisions at worst, in this specific case there may be a silver lining for the defense:


1. Perhaps the plaintiff was unable to find a foot and ankle orthopod willing to testify.


2. It may come out that the spine doctor is a relative of someone on the plaintiff's side just in it for the fee which would look really bad if he/she is unable to add anything of value with their testimony.


3. Apparently, even podiatry's own hired guns weren't interested.


 


Two questions for the lawyers out there:


1. Would the decision by the judge to allow this testimony be made before depositions? If so, then after being shredded by the defense lawyers in deposition, the "expert" may not even be used by the plaintiff.


2. Is this case a red herring?


 


Howard Bonenberger, DPM, Amherst, NH


06/07/2017    

RESPONSES/COMMENTS (NEWS STORIES)



From: Steve Kravitz, DPM


 


The APWH is very concerned about the ruling described in the above referenced article. The judicial system is one that must be fair and balanced and it is for that reason that juries are made of members who are essentially “peers” of the accused. This is important for criminal law but also civil law as well, especially in subject areas that require knowledge that is specific and based on extensive education and experience in a particular field. The ruling that an orthopedic surgeon, seven years out of practice, with no experience in foot and ankle surgery but only in spinal surgery could participate is inappropriate and does not reference a “peer reviewed” process. 


 


Such testimony should be held “inadmissible”; the court’s decision to not uphold the principle is extraordinary. Specifically in this particular case, there is a lack of knowledge which is necessary to make an appropriate judgment but there’s also a complete lack of experience practicing as a podiatrist. Medicine is not only a science but is an “art” which is totally dependent upon years of experience (in this case) as a podiatrist and is why testimony should be field-specific. This and many other factors are apparently ignored by this overturn of the lower court. 


 


This decision should be challenged. The APWH is a wound care-related organization consisting of allopathic as well as podiatric physicians. The Academy will assist podiatric organizations that have interest in challenging this very disturbing decision.  


 


Steve Kravitz, DPM, Executive Director, Academy of Physicians in Wound Healing

06/07/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 1B



From: Michael M. Rosenblatt, DPM


 



Could a ruling by a state supreme court be considered an act of unreasonable support for the malpractice industry? The PA State Supreme Court is composed entirely of lawyers. They recently decided to permit an orthopedist who has not performed surgery in over 8 years...and even before then specialized in spinal surgery...to testify against a podiatrist.


 


It is definitely in the interest of lawyers and the malpractice industry to "widen" the availability of expert testimony. But what if that "widening" is just an opening for feeding the malpractice industry itself? I believe that this ruling is in that category. 


 


Could this defective ruling be itself subject to Sherman Anti-Trust Act regulation? Why should lawyers have complete control over our society? When is it against the law for a group of well-placed lawyers to make a defective ruling that in itself furthers and benefits only lawyers? This ruling stinks of professional self-aggrandizement. If lack of merit forced plaintiffs to not be able to find a qualified expert to testify for them, they should drop their case. Perhaps it should never have been concocted in the first place. 


 


Michael M. Rosenblatt, DPM, Henderson, NV


06/06/2017    

RESPONSES/COMMENTS (NEWS STORIES)



From: Leonard A. Levy, DPM, MPH


 


While I am certainly flattered by Dr. Ivar Roth referring to me as a "gem", I truly believe it is the profession of podiatric medicine that is the "gem", even if it is so very much underestimated by other healthcare professionals. Certainly in a parochial sense, our focus is on the pedal extremity, but the impact that we make every day on the total health of people is immense, essential not only in saving limbs but also life itself.


 


Leonard A. Levy, DPM, MPH

06/01/2017    

RESPONSES/COMMENTS (NEWS STORIES)



From: Tip Sullivan, DPM


 


This article presents some very interesting research that may have applications in podiatry (besides CVA rehab) that come into mind: Application of yoked prisms in gait alteration may alter weight-bearing gait in diabetics, particularly those with Charcot foot. This area of research is just itching for some podiatric input!


 


Tip Sullivan, DPM, Jackson, MS

05/26/2017    

RESPONSES/COMMENTS (NEWS STORIES)



From:Joseph Borreggine, DPM


 


I suggest Foot Function, Foot Pain and Falls in Older Adults: The Framingham Foot StudyFoot pain has long been linked to fall risk among seniors, according to a study published in the journal Gerontology, but the new Framingham Foot Study has examined the contributions of pain severity, foot posture, and foot function. A total of 1,375 participants with an average age of 69 were asked about falls over the last year, with logistic regression used to calculate odds ratios (ORs).


 


According to the results, 21 percent reported foot pain: 40 percent mild pain, 47 percent moderate, and 13 percent severe. Roughly 33 percent reported falls in the last year, with foot pain associated with a 62 percent increased risk of recurrent falls. Those with moderate and severe foot pain showed increased odds of less than two falls versus those with no foot pain. Foot function was not associated with falls, according to researchers.


 


Finally, compared to normal foot posture, those with planus foot posture had a 78 percent higher chance of two or more falls. The results indicate that both foot pain and foot posture may play a part in increasing the risk of falls among seniors.


 


Joseph Borreggine, DPM, Charleston, IL

05/25/2017    

RESPONSES/COMMENTS (NEWS STORIES)



From: Tip Sullivan, DPM


 


I would like to suggest research in the area of neuro-opthalmic rehabilitation (NORA) to Dr. Richie. I look at it as a “brain retrain”.


 


Tip Sullivan, DPM, Jackson, MS

05/24/2017    

RESPONSES/COMMENTS (NEWS STORIES)



From: Doug Richie, DPM


 


I was astounded to learn that Dr. Kimberly Eickmeier has discovered that a brace can prevent catastrophic falls in the elderly! It appears to work by improving dynamic balance by improving feedback to the brain to "re-develop balance" in these elderly patients. As someone who has published research in this area, I am most interested to learn if there are any studies to substantiate such monumental treatment effects?


 


Doug Richie, DPM, Seal Beach, CA

05/18/2017    

RESPONSES/COMMENTS (NEWS STORIES)



From: Jeffrey Kass, DPM 


 


Congratulations to my podiatric colleagues in Arizona on your recent scope advancement with regards to amputations. I was wondering if the new law was for all podiatrists? Only those board certified in surgery? Those who completed residencies? Did you have to complete a two year program? A three year program? What were the restrictions imposed if any?


 


Jeffrey Kass, DPM , Forest Hills, NY

05/17/2017    

RESPONSES/COMMENTS (NEWS STORIES)


RE: AZ Board of Podiatry Examiners Expands Scope of Practice to Include Amputation


From: Lee Rogers, DPM


 


Thanks to the efforts of AzPMA President Dr. Alan Discont, member Dr. Melissa Galli, and numerous others who lobbied and contributed to the PAC, the scope of practice in AZ is now in line with the actual practice of podiatry.


 


Lee C. Rogers, DPM, Los Angeles, CA

05/11/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 1C



From: Jeff Kittay, DPM


 



I would politely remind Dr. Katzen that retired does not mean dead or out of touch. There was mention in his post of politicians being out of their minds to support legislation that would harm their constituents. I posit that precisely that is happening, politicians so drunk with their own power, so dedicated to erasing any trace of a president they despised, that they are indeed willing to pass legislation truly detrimental to the health of their constituents and not interested in the sequellae.  


 


Dr. Lang’s post was completely accurate in its assessment. The ACA is certainly in need of dramatic modification, or even replacement, but only with a single payer system/Medicare for all, with the total elimination of self-serving health insurance companies. Any tweaking around the edges that leaves these do-nothing money takers is doomed to failure, as the rest of the world realized decades ago.


 


Jeff Kittay, DPM (retired), San Rafael Norte, Costa Rica


05/11/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 1B


RE: OH Podiatrist Comments on AHCA 


From: David Gurvis, DPM


 



To all who are commenting on the “Repeal and Replacement” of the ACA (ObamaCare) and the new (call it what is is) TrumpCare, AKA the American Health Care Bill :Both sides are lying. The Office of the Budget is probably the most accurate. It is disingenuous to dismiss it because it may agree or disagree with your pre-conceived notions,


 


The media is not fake news. Even Paul Ryan, by the way, agreed that many will lose medical coverage but he considers that a “good thing” as it shows they had a “choice” (NPR radio interview). We need to decide in this country if healthcare is a “right” or not. Your view is as valid as mine if it is well thought out and defended


 


And finally: When Republicans and Democrats (meaning you and I) stop hating each other’s views so much that all they can think of is their blind hatred of the other sides, then, and only then, will we get any good ideas coming out of Congress on healthcare.


 


David Gurvis, DPM, Avon, IN


05/11/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 1A


RE: OH Podiatrist Comments on AHCA 


From: David P. Luongo, DPM


 


This is not a Democrat or Republican issue. It is an insurance company issue. They don't want change so they are making the "affordable plans" unaffordable for a reason. To lower costs, the first step was to insure EVERYONE as we did with auto insurance. That, by default, will lower costs for all. Unfortunately, the insurance companies want to profit from all angles since they continue to be unchecked.  


 


Until a non-profit insurance company is formed that only needs to break even, not pay CEO billions and satisfy stockholders, then we are in a bad nosedive. Unfortunately, the powerful insurance companies will not allow this and will cheat, steal, bribe, etc. to prevent anyone taking the golden goose. It's quite a simple problem. Money is the root of all evil and right now it has our country at each other's throats.


 


David P. Luongo, DPM, NY, NY

05/10/2017    

RESPONSES/COMMENTS (NEWS STORIES)



From: Burton J. Katzen, DPM


 


With all due respect to my esteemed and certainly well respected colleague Dr. Lang, I believe the (retired) after your name might have made you  slightly out of touch with the realities of the present day and the future practice of medicine if Obamacare was to remain the law of the land in its present form. 


 


First of all, even the most rational Democrats now realize it is unsustainable financially with the worst yet to come. Also, the amount of insurance companies and physicians leaving the program, along with the outrageous deductibles we are now seeing in our practices are resulting in we are now seeing in our practices are resulting in diminished quality of medical care. 


 


As far as Rep. Wenstrup "drinking the Kool Aid", I applaud him for his vote to improve healthcare for all Americans and will continue to support him in this endeavor in any way I can. I believe...


 


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

05/09/2017    

RESPONSES/COMMENTS (NEWS STORIES) - PART 2



From: Leonard A. Levy, DPM, MPH


 


On June 30, 2017, Lawrence Harkless, DPM, one of the giants in podiatric medical education, is retiring from the deanship of the podiatric medical school of Western University of the Health Sciences. It seems like just yesterday, when as dean of the then California College of Podiatric Medicine in 1970, I interviewed him for admission. I knew even then that he was destined to become a podiatric physician and a leader and mentor in the profession and indeed he did. It is hard to describe how it makes me feel when someone who was my former student achieved at the level he did.


 


I saw in a relatively few years after he acquired a DPM, his becoming an outstanding clinician and then at the University of Texas Health Science Center, Chair and Program Director of its podiatric surgical residency, becoming one of the role models for other residencies in the profession, producing some of the leaders in both the clinical and educational arena. This led him to be selected as founding dean of Western’s College of Podiatric Medicine. The profession is so fortunate to have someone like Dr. Harkless in its midst.


 


Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL
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