The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

January 19, 2012 #4,362 Publisher-Barry Block, DPM, JD

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High Heels Can Cause Migraines: NC Podiatrist

They are a biological wonder, carrying your entire body weight for up to 10,000 steps a day without complaint. They contain a quarter of the bones in your body and are vital for balance and mobility — so why do we treat our feet so badly? Uncomfortable footwear can lead to a range of problems from back pain to osteoporosis and even migraines — yet just 19 per cent of us actually seek treatment.

Dr. Jane Andersen

Dr. Jane Andersen, spokesperson of the American Podiatric Medical Association has warned: "The muscular tension that heels put on your back can also lead to migraines." She says heels higher than 2 inches may throw the body out of alignment, putting strain on the back and causing neck and head pain.

Source: Chloe Lambert, Daily Mail [1/17/12]

UK Podiatrist Discusses Wearing Proper Footwear

Podiatrist and spokesman for the Society of Chiropodists and Podiatrists, Matthew Fitzpatrick, noted that high heels heighten the pressure on feet and this is "abnormal to the way the foot should be." Although this footwear is good for women who wish to appear smart, they should not be worn for long periods of time, the healthcare professional stated.

Matthew Fitzpatrick

He claimed people who do a great deal of walking should wear shoes that are sturdy and supportive. Footwear must allow feet to expand, as this body part can "swell naturally" throughout the day, Mr. Fitzpatrick remarked. The expert suggested that men and women get their feet measured, and buy shoes during the afternoon rather than in the morning for this reason.

Source: Expatriate Healthcare [1/17/12]

Maggots Heal Difficult Wounds Faster Than Debridement: Study

Maggots may trump scalpels when it comes to cleaning large wounds that won't heal easily, such as those seen in diabetics, according to French researchers. To allow such wounds to heal, doctors usually remove infected or dead tissue with scalpels or enzymes, a process they call debridement. But that method is time-consuming and doesn't always work. Studies have suggested maggots might be helpful, potentially offering antibacterial and healing benefits in addition to keeping the wound clean -- although not all researchers are convinced insects are the way to go.

The new study was carried out in patients with so-called venous ulcers on their legs. During a two-week hospital stay, they were randomly assigned to either maggot therapy or traditional wound cleaning with a scalpel, with just over 50 patients in each group. Both groups of patients were blindfolded so they wouldn't know which treatment they received.

Source: Frederik Joelving, Medline Plus via Wound Care Insider [January 2012}

Query: Fast, Reliable Scanner

Can anyone recommend a fast, reliable scanner for converting medical records to digital? Are the hand-held scanners as good as the stationary scanners?
 
Mark Ray, DPM, Latrobe, PA

RE: Following up on Attestation (Lori Weisenfeld, DPM)
From: Marc Katz, DPM

To check on your attestation status, click here (and wait for the page to load).

Login with your NPPESS login (which is based on your individual NPI number). At the bottom of the page is a status button that will give all of the information regarding processing of the EHR incentive.
 
Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

RE: ADA and Deaf Patients (Jon Purdy, DPM)
From: Richard A. Simmons, DPM

There should not be an ‘us versus them’ mentality when it comes to the hearing impaired or others with disabilities when they come to our offices. The law requires a “reasonable accommodation.” Most deaf people can type as that is how they communicate from their homes to the outside world. You can hire a signing translator, but you should also be able to simply move the keyboard back and forth to communicate.

The problem with a signing translator is that you (as the physician) probably do not know that your spoken word is being properly translated. The advantage of typing back and forth is that at the end of the session you have a copy for your records and the patient has a copy to take home. This reduces errors in communication. Have your local component contact your local Deaf Association. If you cannot find a listing in your area, contact the National Association for the Deaf at (nad.org). Open up dialogue between the medical and disabled communities so that you are not caught off-guard and spending more time and money than necessary.

Richard A. Simmons, DPM  Rockledge, FL  RASDPM32955@gmail.com

RE: Our Challenges: Innovate, Grow, or Wither Away?
From: Howard Dinowitz, DPM

Generally speaking, podiatrists, like most doctors, care very much about the welfare of their patients, and will do what it takes to follow the Hippocratic Oath in every way; even if it means working too many hours, accepting less remuneration, etc.

The biggest challenge is navigating the ever-increasing amount of change in every aspect of daily practice. The regulatory agencies that govern our scope of practice, coupled with the massive changes in the health insurance agency industry, including cutbacks to doctors and payment hikes to patients, makes it literally impossible to sustain the same income level as...

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

RE: Transition from In-House to Billing Agency (Cedrick Cooper, DPM)
From: Donna Bieze

The transition can be seamless. In our experience, there is no interruption in cash flow. It usually takes a few weeks to get all of the EDI ERA agreements in place. It is a fairly easy process that a billing service can handle completely for you.
 
One good reason to choose a billing company is that they devote 100% of their time to billing. They can't be pulled to work the front desk or to take patients to the treatment rooms. Follow-up on denied claims is very important. This is one area that seems to get neglected when billing is done in-house because it is so time-consuming.
 
It is best to go with a company that knows the ins and outs of podiatry billing. 

Donna Bieze, Revenue Solutions, dbieze@comcast.net

RE: Study Showing Efficacy of Therapeutic Diabetic Shoes (Charles Perry, DPM)
From: Paul Kesselman, DPM

What you do really depends on your relationship with the physician, and the relationship you have with the patient. If this MD/DO never refers patients to you or other DPMs in your area, your handling of them should be quite different from that of an MD/DO who refers patients to you or other DPMs. I have found that lending a sympathetic ear to the paperwork demands of all the DME prescriptions and other paperwork requirements of the PCP is a good idea. Unless you stand in their shoes or the shadows of the physicians (I share an office with one), you have no idea. Their paperwork is far worse than ours (and ours is pretty bad).

Additionally, The "co-signature" requirements of the Therapeutic Shoe Program are an embarrassment to every independent prescribing physician, regardless of their degree designation of MD/DO or DPM. These requirements are not biased against DPMs; they are biased against...

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

RE: Study Finds Remote Dermatology Consults Help Treatment, Outcomes
From: Elliot Udell, DPM
 
The concept of taking a picture of a patient's skin and e-mailing it to a dermatologist sounds very 21st century and could be highly beneficial to our patients. Are there any dermatologists who do this, and how would they be paid for their services?
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Podiatry Management Celebrates 30th Anniversary
From: Robert McKinlay

Congrats on 30 years of Podiatry Management. Not a lot of people understand what Dr. Block has given to the profession by publishing the magazine and PM News. It has been a great achievement, and Dr. Block is to be thanked for all his efforts.

Robert McKinlay, Assistant Dean, Barry University School of Podiatric Medicine, rmckinlay@mail.barry.edu

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