The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

February 20, 2007 #2,814 Editor-Barry Block, DPM, JD

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WA DPM Provides Tips on Preventing Winter Foot Ailments

Winter chill can be tough on your toes. Not only do you run the risk of developing frostbite, but you could also be prone to trench foot and athlete's foot, experts say. According to the U.S. Centers for Disease Control and Prevention, wet feet lose heat 25 times faster than dry feet. To compensate, the body shuts down peripheral circulation. Less blood circulating to the feet means less oxygen and nutrients, and skin tissue begins to die, a condition, which can lead to trench foot.

Dr. Donald Hovancsek

Choose shoes that are waterproof and insulated, and be sure to check insulated shoes for leaks before use, advises Dr. Donald Hovancsek of the American Podiatric Medical Association.

Source: PakTribune [2/10/07]

Baby Boomers Undertake Marathons For the Challenge: MD Podiatrist

A few months ago, podiatrist John Senatore stood near Mile 22 of the Baltimore Marathon, cheering loudly for the runners - quite a few of whom were his patients at Union Memorial Hospital's Sports Medicine Center. He was in New York to encourage his wife, who is running her first marathon at the age of 45.

Dr. John Senatore

"People in this age group are looking for a new challenge," says Senatore, 50, himself a former marathoner. "A marathon is a big undertaking. People do marathons for the same reasons they climb mountains and jump out of planes. It challenges them physically, emotionally and intellectually."

Source: Linell Smith, Baltimore Sun, [11/5/06]

Bush Budget Cutting Medicare Physician Payments Opposed by Democrats

President Bush presented an austere fiscal year 2008 budget to Congress earlier this month, pledging no new money for Medicare physician reimbursements and proposing to slash the rate of public health program growth in other areas.

The administration's decision not to call for any funding to help reverse Medicare physician pay cuts prompted strong criticism from physician organizations, including the AMA and the American College of Physicians. If no changes are made, doctors could see an across-the-board cut of 10% or more next calendar year.

Bush's $2.8 trillion budget proposal is not binding on Congress. Democratic leaders, who will largely control the agenda this year, immediately announced that some of the proposed health program reductions were essentially dead on arrival.

Source: David Glendinning and Doug Trapp, AMNews [2/26/07]

Query: Power Naps

Everyone it seems, is sleep-deprived these days - - taking its toll on productivity and one's sense of well-being. Does anyone engage in Power Naps (20-minute rest periods) during the day and/or allow staff members to do so? The benefits are many and (as just reported) reduce the chance of heart attacks by one-third.

Bob Levoy, Great Neck, NY

Query: Dox Podiatry EMR

I'd like some feedback about Dox Podiatry EMR from anyone who currently utilizes this service. Aside from basic monthly payments for EMR software, what are the additional monthly costs (in dollar amounts) that those using EMR are experiencing?

Lori Weisenfeld, DPM, New York, NY

RE: APMA State Leader as an Expert Witness (Name Withheld)
From: Multiple Respondents

Even though a malpractice case is "minor" in terms of egregiousness, involving little or no alleged patient disability or damages, it is still a "big deal" to the podiatrist going through it. Whenever you have a case against you that requires notification of your liability carrier and starting a process of defense, this goes permanently against your underwriting record. Under some circumstances it could result in the suspension of surcharges, suspension of coverage or worse.

As the editor stated, it is important that you notify your state president and board that the present board member is testifying for the patient against you. It is also appropriate in my opinion to notify the State Podiatric Medical Practice Board that you regard this as an official "conflict of interest."

Your recommendations should be as follows: Either the involved podiatrist resigns his/her status as a State Board Member, or withdraws from serving as the plaintiff’s expert. The two positions are incompatible. You have every right and obligation to present this to your State Practice Board, and request they enforce this issue.

In order to take additional legal actions, you will have to hire your own private attorney. This constitutes one of the primary reasons why it is sometimes essential to hire another attorney on your own, who will be "overseeing" your case and protecting your interests. This also sends a message to your insurance companies' attorney that their actions will be closely monitored.

Michael M. Rosenblatt, DPM, San Jose, CA, ROSEY1@prodigy.net

In Maryland, the State Board had agreed that no member, while serving, may be a witness in a malpractice case, nor offer any advice as an expert on a case that involves a Maryland-licensed podiatrist. I am not sure if they have changed that policy since I left the Board two years ago, but I do not think they have.

Brian Kashan, DPM, Baltimore, MD, drbkas@worldnet.att.net

I am a past state president. I serve as an expert witness, but only for the defense. I do that for my personal comfort level. If the defendant violated community standards/standard practice, I do not hold back, but rather identify the failure to the defendant's attorney, so that they can deal with it. Do you really want to eliminate former president's and board members from serving in this capacity?

Jay Goldstein, DPM, Portland, OR, jcgdome@hotmail.com

In the editor's note to answer the query by "name witheld" regarding the fairness of an APMA State leader serving as a plaintiff's expert witness, Dr. Block states that such individuals carry into court the imprimateur (countenance) of the association. This he comments is "unfair." Does the Academic Dean of a Podiatry School bring anything into court that can be judged "unfair" just because of his or her position? What about the Chief of Podiatry at Yale University Medical Center?

Who then can we call who has no unfairness attached to him or her? I know, how about 1-800-NoChargeFootSurgery? That person might not bring into court any unfairness. This conversation hinges on two facts....all plaintiffs experts are perceived as scum, and if the APMA leader that "name withheld" refers to were on the defense side of the table, his post would never have been written. Everyone, including the jurors, judge, and counselors walk into court with conflicts, prejudices, and a mountain full of "unfairness." The credibility of the profession is harmed by everyone with a meaningful credential who limits their "service" to either the plaintiff or the defense. If New York State Podiatric Medical Association adopts the resolution that all board members past and present cannot do any expert testimony, an already slimy system will ooze ever thicker green.

Bryan C. Markinson, DPM, New York, NY, Bryan.Markinson@msnyuhealth.org

Editor’s comment: Dr. Markinson can relax. Even excluding state association leaders, there are thousands of very qualified podiatrists who are capable as serving as expert witnesses for both the plaintiff and defense. In fact, a podiatrist who serves as the chief of surgery at a hospital is an excellent choice for an expert (unless the case involves a member of his/her staff).

Ethically, such as expert is far different from a podiatrist holding an elected position of a state association or employed by a college of podiatric medicine. First of all, from a technical standpoint, being president of an association does not imply medical or surgical expertise. The conflict of interest arises when the officer testifies in a case involving a dues-paying member of APMA.

As to faculty members, we were pleased to learn from Dean Yoho that (after the uproar created by the recent testimony of DMU’s Dean of Clinical Affairs) the Des Moines college has prohibited their faculty members from testifying in malpractice cases.Again the conflict of interest arises when a college faculty member testifies against an alumni.

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required. Fax resume to 248-478-1370
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SOUTH CENTRAL PENNSYLVANIA- PM&S 36 ASSOCIATE WANTED
      
Large, busy podiatry group looking for associate interested in future partnership. Practice 
facilities and technologies include: Surgical Center, Physical Therapy Department, six 
appointment locations, EMR, MRI and Digital X-ray. Full compensation and benefit 
package offered. Mail CV to Martin Foot and Ankle, 1203 S. Queen St. York, PA 17403 or
 email business administrator,  johnreitzel@comcast.net

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