The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

February 20, 2012 #4,389 Publisher-Barry Block, DPM, JD

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Pregnant Women Need Supportive Shoes: CA Podiatrist

Many women complain of swollen and achy feet late in pregnancy, but now there is a line of footwear designed to address the needs of those mothers-to-be. New Life Shoes are designed specifically to accommodate the changes experienced by late-term mothers. Dr. Eugene Spector, Chief of Podiatry at California Pacific Medical Center, told CBS 5 the biggest foot problems he sees are swelling and a condition known as “over-pronation.” 

Dr. Eugene Spector

“It comes mainly from a change in the center of gravity of the patient,” Spector explained. “The other issue is the relaxing hormones from being pregnant will cause the ligaments to stretch out, and the foot pronates more than it should.” In an overly pronated foot, the heel bone angles in and the arch can flatten. Spector noted that the condition can lead to arch pain, heel pain, and pain in the ball of the foot. He recommends pregnant women wear supportive shoes, shoes that breathe well and shoes that expand well.

Source: CBS San Francisco [2/9/12]

Road Hazards are Biggest Risk to Barefoot Runners: IL Podiatrist

Dr. Beth Jarrett, podiatrist and professor at Rosalind Franklin University of Medicine and Science, says that unknown roadways for barefoot runners present the real risk. “Probably the bigger issue in terms of injuries with barefoot running is the fact that you’re barefoot, and more likely to step on stones or glass,” she said. 

Dr. Beth Jarrett

Dr. Jarrett says she would not generally recommend barefoot running, unless someone had access to a safe running environment to minimize the risks of injuries from unknown surfaces. As Dr. Jarrett says, if people are not already runners, they shouldn’t try barefoot running out of the blue. “It’s important to remember that just as not everyone is meant to be a runner, not everyone is meant to be a barefoot runner,” she said.

Source: Yasmin Rammohan, WTTW [2/16/12]

Car Crashes in MD Podiatrist's Office

A woman on her way to the senior center drove her car into the side of a Berlin doctor's office after getting lost. Constance Heppding, 73, told police she thought her car was in reverse when she stepped on the gas pedal of her 2010 Ford Fusion. The car, which was parked facing the office of podiatrist Dr. William Olischar, was in a forward gear, however, and went through the wall of the building Wednesday. 

Worker repairs damage to Dr. William Olischar's office (Photo: Thomas Melville)

Olischar was sitting at his desk, which was against the wall that Heppding hit, at the time of the accident, according to Berlin Police Chief Arnold Downing. He said the podiatrist was taken to Peninsula Regional Medical Center but that he suffered no major injuries.

Source: Charlene Sharpe, Delmarva Daily Times 2/17/12]

AZ Podiatrist Delivers Virtual Keynote to Colombo, Sri Lanka

Dr. David G. Armstrong, Professor of Surgery and Director of the Southern Arizona Limb Salvage Alliance (SALSA) at the University of Arizona delivered a "virtual" keynote speech to a packed house of physicians and surgeons in Colombo Sri Lanka. "In 2009, for the first time in the history of human kind, more people died of non-infectious diseases like diabetes, heart disease, and cancer than from infectious disease," noted Armstrong. 

Dr. Armstrong lecturing from University of Arizona Medical Center Studios to Sri Lanka

After noting that more than 80% of non-communicable disease deaths are occurring in the developing world, he delivered some good news about the state of play in care of diabetes and in limb salvage. "We now see that teams reduce amputations. When we come together around this problem in South Asia, East Africa, or North America, good things happen."

Congress OKs Measure Averting Doc-Pay Cut

The House and Senate approved a payroll tax package that includes a provision to stave off a 27.4% cut in Medicare physician payment rates scheduled for March 1 and freezes rates at their current level until Dec. 31, 2012.

House members voted 293 to 132 to approve the legislation, which received support from 146 Republicans and 147 Democrats. Meanwhile, 91 Republicans and 41 Democrats voted against it. Reps. Phil Gingrey (R-GA) and Michael Burgess (R-TX), both physicians, did not vote in favor of the bill. The bill then moved to the upper chamber, where the Senate approved the legislation in a 60-36 vote.

Source: Jessica Zigmond, Modern Healthcare [2/17/12]

Query: Unknown Lesions on Legs

My patient is a 57 yo male, with a cavus foot type. These B/L lesions start off as small pimples which grow larger and eventually erupt into open superficial ulcers with a mild amount of non-purulent drainage. The lesion dries and becomes a scab, eventually leaving a mark on the skin. PMH - Polio at a young age, carotid surgery for blockage, smoker (1pk/day x 30yrs.).

Unknown Lesions on Legs

Three biposies havd been inconclusive. Blood tests are normal. He has been placed on different types of antibiotics, and Dapsone. None of the treatments have made a significant difference. Any suggestions on how to proceed?
 
Razi Ahmed, DPM, Bakersfield, CA

RE: Calcaneal Pain (Michael Ryan, DPM)
From: Roodabeh Samimi, DPM, Terrance J. Mueller, DPM

Have you tried a negative heel shoe or rocker shoe (assuming the patient is not obese and has no balance issues). You might even try the shoes with springs under the heels, which could reduce impact on the heel. Caution with stairs and bending are advised.

Roodabeh Samimi, DPM, Flushing, NY, roody.samimi@gmail.com 

I've seen such cases associated with forefoot valgus, either semi-flexible or rigid, and often a limb-length discrepancy (a shorter symptomatic side). We need more of the lateral x-ray to show the medial column. A comparison view might help to establish this (besides limb measurement). This adds up to poor shock absorption at heel contact, which might explain why an orthotic with a horseshoe pad was helpful for the patient. 

Additional details about the polio (e.g., where were the symptoms originally, any residual/developing muscular weakness, any scoliosis- especially if progressive, etc.) would be helpful. PPS (post-polio syndrome) has to be considered. Additionally, I'm a bit curious as to what was injected (fascia, bursa, fat pad) and which medications were injected.
 
There is no law which precludes more than one thing going on (i.e., more than one of the above). However, if PPS can be ruled out, and it's simply a biomechanical problem, I'd advise the use of a shock-absorbing, semi-flexible orthotic (to sulcus) with a heel lift, should there be a short side.
 
Terrance J. Mueller, DPM, St. Louis, MO, DrTerryMueller@aol.com

Editor's note: Click on the underlined subject heading of this and other notes to see original note and/or photo.

RE: Complete Tear of Peroneus Longus (David Taylor, DPM)
From: Dennis Shavelson, DPM

This fascinating case deserves long-term monitoring and reporting by Dr. Taylor. That is because it serves as the “gold standard” of flexible forefoot FFT. In this foot type, “peroneal inhibition” (described by Dananberg) and/or Shavelson’s “peroneal exhaustion” progressively takes place. With time, this leads to FHL, met primus elevatus, hallux extensus, and dystrophic hallux toenails. At the time of the peroneal tear, the patient's forefoot type morphed to flexible. For that reason, it would be interesting if we knew the functional foot type of the opposing limb.
 
My operative choice would be a Lapidus fixated at the level of the opposing limb. In addition, if the patient has a concomitant flexible rearfoot FFT, I would consider subtalar stenting. My interventional choice would be a Foot Centring cast in optimal functional position with a high 2-5 forefoot varus posting and an aggressive 1st ray cut-out. This patient would benefit from aggressive compensatory threshold training and balancing of the muscle's engines, especially the triceps, FHL, EHL, PT, and adductor hallucis. I suspect that higher heeled shoes may be of help in preventing an equinus from developing.

Dennis Shavelson, DPM, NYC drsha@lifestylepodiatry.com

RE: Gouty Tophi, 3rd Digit (Charles Baik, DPM)
From: Joel Berman, DPM, Pete Harvey, DPM

One of my patients had a toe very similar to the one in the photo. I put her on allopurinol, and after approximately one year, the
tophi receded and the digit assumed an anatomic shape.

Joel Berman, DPM, Marysville, CA, biggsboy@aol.com.

This patient should be referred to an endocrinologist or nephrologist very soon. I would be concerned about kidney damage.
 
Pete Harvey, DPM, Wichita Falls, TX, pmh@wffeet.com

RE: Podiatry Plus Malpractice Insurance (Brett Roeder, DPM)
From: John Murray

Our podiatry group has used Ace/Podiatry Plus Malpractice Insurance for 10 years and have been completely satisfied. It's consistently 20% or more less than what others charge. The key driver to this is that they have various liability pools based on the amount of surgery our podiatrists actually do versus putting all in the same risk pool. Additionally, our agent has proven to be the single most professional resource I have found. He is a true business partner and great resource beyond just getting our policies done at the most competitive rates.
 
John Murray, St. Louis, MO, jmurray@foothealers.com

RE: Podiatric Physicians Practice Podiatric Medicine: RIP Podiatry (Alan Sherman, DPM)
From: Eric J. Roberts, DPM

In response to those who think we should remain “podiatry” and “podiatrists,” I pose the following analogy: Would you, who call yourselves podiatrists, be happy if you were called a chiropodist? Would you be happy to hang a sign outside of your office that said “Chiropody Office”? You have to realize we eventually progressed from chiropody to podiatry. 

TODAY, we are moving from podiatry/podiatrist to foot and ankle specialists, foot and ankle surgeons, and podiatric clinicians/physicians. I can understand those of you who are proud to call yourselves podiatrists. Let me remind you, in case you forgot, what our degree stands for - DPM: Doctor of PODIATRIC MEDICINE, not Doctor of Podiatry. Our residency programs receive the designations: PM&S or new PMSR: Podiatric Medicine and Surgery, or Podiatric Medicine and Surgical Residency. 

As a new generation of DPMs graduate and infiltrate the work force, you will find that many of us (myself included) are seeing the differences in how people respond to the word “podiatrist.” Many of the public see podiatrists as people who cut nails and trim calluses, but most are surprised when they find out their foot and ankle surgeon is one of those people. As a wise man once told me, “Perception is 9/10ths of reality.” How do we want to be perceived as we move ahead?
 
Eric J. Roberts, DPM, Forest Hills, NY, lordertz@gmail.com

RE: New MD Shoe Company Tells People to "Ditch Your Orthotics" (Juliet Burk, DPM)
From: Lloyd Nesbitt DPM

While Dr. Burk may have found the OESH shoes to be “great” and wants to wave their flag, the shoe company is shooting itself in the foot with their negative comments that reflect upon each and every podiatrist. Their opinion on orthotics, as stated clearly on their website, goes against what has been taught in the colleges of podiatric medicine and has been proven clinically with hundreds of thousands of podiatry patients in the past forty years. Their website is an insult to the podiatry profession. To say that orthotics will cause increased stresses and essentially do more harm than good is bordering on slanderous.

This is one company that I personally won’t be in a hurry to promote. Fifteen thousand podiatrists can influence the shoe-buying decisions of a great deal of Americans and our profession should think twice about supporting their rhetoric.

Lloyd Nesbitt DPM, Toronto, Ont, foothealth@lloydnesbitt.com

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

ASSOCIATE POSITION - EAST CENTRAL NEW JERSEY

Well established practice needs a career-minded podiatrist for associate position leading to Fast Track Partnership. Competitive salary/benefits. Busy practice. Great location. Board Certification a plus. Part-time or full-time. Immediate availability, but will wait for best candidate. GardenStateDPM@aol.com

ASSOCIATE POSITION - KANSAS CITY, MISSOURI

I'm not just looking for an associate. I am looking for a doctor who wants to build a highly successful career with a doctor who is as committed to their success as he is to his own. Go to www.YourFutureInPodiatry.com to find out about this opportunity.

ASSOCIATE POSITION - SOUTHERN KENTUCKY

Available in beautiful southern Kentucky in progressive, multi-office practice with 6 providers. Excellent base salary, malpractice, full benefit package with 2-year track to partnership. Looking for someone that wants to grow with our practice, work hard and develop relationships with local hospitals and surrounding communities. Strong communication skills, bedside manner and willingness to learn a must. Narrow window for interviews: email CV and letter of interest before March 1: footdocky@gmail.com

ASSOCIATE POSITION - CENTRAL NJ

Looking for a three-year surgically-trained associate who has entrepreneurial spirit. Partnership guaranteed within three years for the right person. Must be very outgoing and personable. Great opportunity for a person who is confident and a go getter. drwfoot@verizon.net

ASSOCIATE POSITION - NORTHEAST GA

Well-established 18 year practice in Northeast Georgia seeking full-time associate leading to partnership. General podiatric care with moderate amount of surgery to be done in local hospital or surgery center. Competitive salary and benefits.  Please respond by email to: Fivetoes1946@aol.com

ASSOCIATE POSITIONS - MULTIPLE STATES

Podiatrist Needed in Missouri, Nebraska, Iowa, Minnesota, North Dakota, South Dakota, Ohio, Texas, Colorado, Oregon, Washington, Arizona, Massachusetts, Rhode Island, Wisconsin, Indiana, Oklahoma, Connecticut and Vermont. Expanding multi-state medical practice seeking podiatrists to service long-term care community residing in nursing homes and assisted living facilities. We offer an established patient base, scheduling, equipment allowance and cover travel expenses. Provide generous compensation, bonus opportunities, disability, health insurance benefits, malpractice coverage and flexible scheduling. Looking for a Podiatrist with excellent skills, able to provide expert and compassionate care to patients. Email CV to: careers@aggeus.org or call 773-770-0140 x300/x305.  www.aggeus.org

ASSOCIATE POSITION - MARYLAND

Looking for 3rd associate. Must be personable, well trained and highly motivated. Great locations in Southern Maryland, including an Ambulatory Surgical Center. We currently have EHR, digital radiography, dispensing center and PADNet. Looking for immediate hire! Please send CV to:myfeetfeet@aol.com

PART-TIME PODIATRIST NEEDED - LOS ANGELES, CALIFORNIA

Busy podiatrist looking for assistance with patients located in facilities, homes, office, etc. Flexible hours, independence, and great compensation. If interested email CV to or call Terri at 323-353-8103.homefootcare@hotmail.com

ASSOCIATE POSITION – FLORIDA

Emerald Coast on the North Shore of the Gulf of Mexico, a well-established group practice with multi-offices, seeking an associate with opportunity for partnership for a PSR-24/36 Doctor well-trained in foot/ankle/diabetic problems/wound care/surgical and medical podiatric care, covering 3 area hospitals, NO nursing homes. e-mail letter of interest, CV, and references to basewedge@yahoo.com

ASSOCIATE POSITION – F/T MARYLAND

Looking for a bright, hard-working, personality plus, extremely well trained podiatrist with both top notch surgical and non-surgical skills. Remarkable opportunity with our busy practice. Excellent salary and benefits. Email CV and salary requirements to Marylandpodiatrist@live.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Full-Time Associate needed for busy multi-office locations in LA, Orange, San Bernardino and Riverside counties. SIX FIGURE SALARY PLUS BENEFITS!! Knowledge of Spanish is helpful. Good mix of office patients, house calls, some surgery, etc. NO NURSING HOMES!! Needed in July, 2012 or sooner. If interested, please send contact information and CV to scpodgroup@yahoo.com

ASSOCIATE POSITION - MIAMI, FLORIDA

well established modern practice all phases of podiatric medicine/surgery needs associate. Respond with CV and cover letter. podiatristinsouthflorida@aol.com

ASSOCIATE WANTED - MANHATTAN

Park Avenue office seeks personable, capable and experienced podiatrist, part-time. Office needs coverage March 21 until May 2, possibly longer, with one day a week position available after May 2 .Growth potential. Please fax CV to 212-889-6150 or email info@healthyfeetny.net

ASSOCIATE POSITION - UPSTATE NEW YORK

Outstanding Opportunity. Our medical surgical group is recruiting a well-trained licensed podiatric physician. Located in Beautiful upstate NY. Full hospital privileges, as well as working with two residency programs. Must be highly motivated and great with patients. Opportunity for growth. Competitive salary and benefit package. Please send CV to associateinfoot@yahoo.com

SOUTHEAST GEORGIA- SAVANNAH & SURROUNDING AREAS

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking podiatrist looking to build a career & long-term relationship. Either established practicing physician or new residency graduate. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

EQUIPMENT FOR SALE

Koven Doppler, Synthes Titanium Mini Frag screw set, Zimmer & Hall Micro 100 set (all 5 heads including wire driver), Two full major surgical instrument sets, miscellaneous surgical tools including osteotome set (curved & straight). All German stainless steel. Best offer. Retired due to illness. Call 586-675-4311 or 440-285-2827. Dr. Gary Docks.

EQUIPMENT FOR SALE

Cosman Radiofrequency Generator for Sale! Model RFG-1B Like New Condition. Comes with Manual, 17 Dispersive Electrodes, 2 CSK-R 10 Kits, 2 CSK-R 5 Kits, 11 CC RF Cannula 10cm/10mm/22G, 4 CC RF Cannula 10cm/5mm/22G, 1 - 5cm RF Cannula/22G (4mm Sharp Curved Tip), & 2 Replacement Fuses. Asking $10,500 OBO Please Contact: nffpbosk@gmail.com

EQUIPMENT FOR SALE

Koven Smartdop 45 hand-held Doppler w/training CD, operator's manual and reference guide. PC compatible (used less than 20 hours). Cryostar cryosurgery- tabletop unit with (2) Hand-PC (4) probes (2 dull, 2 sharp) for Morton's neuroma, plantar fasciitis, and fibromas. Comes with rolling carrying case, training CD & instruction manual. Also CryoPen, CryoProbe case, several N2O cartridges (for warts, etc.). Diabetic inserts, all different sizes. Please email me at young_jolene@yahoo.com

EQUIPMENT FOR SALE - COOL BREEZE COOT TOUCH VARIA

Cool Breeze Coot Touch Varia. Very low use. You won't find a laser at this price. $39,500. Has about 19 hours of use of it. E-mail for photos, and ask any questions. Will go fast. David Zuckerman DPM 856-229-2939 footcare@comcast.net

EQUIPMENT FOR SALE - ARE YOU CONSIDERING A PADNET UNIT?

If so, save thousands of dollars on a lightly used unit with venous option and laptop. Why pay full price for our unit which is in perfect working order. We also have a SIUI CTS 200 ultrasound with 7 mHz probe and SONY printer. Let's Make a Deal!! Call 516-220-8258 today. 

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Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 13,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 for a 50-word ad. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451. 

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