The Voice of Podiatrists

Serving Over 10,700 Podiatrists Daily

March 12, 2008 #3,191 Editor-Barry Block, DPM, JD

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Pulsed Dye Laser Ideal for Difficult-to-Treat Warts: WI Podiatrist

People of all ages can suffer from painful warts on the bottoms of their feet. While many warts can be removed at home with over-the-counter treatments, some can be difficult to remove because they are a live virus, with their own blood supply. If a home treatment isn't working, you might need more advanced treatment with a pulsed dye laser.

Dr. Kerry Dernbach

According to podiatrist Dr. Kerry Dernbach, “The pulsed dye laser is ideal for those with warts that are numerous or difficult to treat. The laser beam causes little or no pain because it doesn't burn the wart or the skin but goes right through the skin and cuts off circulation to the wart.”

“Most people need just one treatment; about 20 percent require a second treatment.” Says Dernbach. “While some of my younger patients have resumed running and playing sports the day after treatment, many people prefer to stay off their feet for a day or so.“ Although most health insurance plans will pay for the pulsed dye laser procedure for people whose warts have proven difficult to remove, or who have extensive warts, it is not considered a first-line treatment.

Source: Wausau Daily Record [3/10/08]

Barefoot Running Not for Most Runners: TX Podiatrist

"If you have perfect (running) biomechanics - and I've yet to meet many people who do - then absolutely you can run barefoot and be fine," says Dr. Mary Beth Crane, a Dallas podiatrist, veteran marathoner and spokeswoman for the American College of Foot and Ankle surgeons.. "But the reality is that most people do not have perfect biomechanics. It takes a lot of strengthening and cross-training to get the strength in the areas that you'd need to run more biomechanically sound barefoot.

Dr. Marybeth Crane

"More likely than not, you'll wind up with puncture wounds, stress fractures, shin splints and tendinitis due to the fact your biomechanics are more faulty because you don't have cushioning of shoes." Crane says a regimen that involves some barefoot running on a synthetic track can be beneficial for high school- and college-age runners. "But once you're fully developed and running on concrete surfaces, there's more risk associated with barefoot running than benefits," she says.

Crane and other physicians say most runners land on their heels first and roll the foot because it's less jarring. She points to a higher incidence of muscular injuries for runners landing on the balls of the feet. "Are there anomalies? Absolutely," she says. "But I'd bet they've been running barefoot a long, long time and have a relatively normal foot type.

Source: Sam McManis, Sacramento Bee [3/11/08]

One Dead in Double Shooting at TX Podiatrist’s Office

At about 2:30pm, police responded to a robbery/double shooting call at the Greater Houston Foot Center near Harwin in southwest Houston. One person, apparently a female nurse, is dead. Another person, a man, had to be taken to an area hospital. He is reportedly in critical condition. The door says it's the office of Dr. Abeer Foteh, a podiatrist. The information also says he specializes in diabetic foot wound care.

Murder scene at Houston Podiatry Office

Police say the suspect also stole the victim's vehicle. A search for the suspect and the vehicle is underway. Authorities will be checking video from surveillance cameras at the doctor's office and other nearby businesses.

Source: KTRK-TV (ABC) [3/10/08]

Query: Diagnostic Ultrasound Units

Our practice is considering the purchase of a diagnostic ultrasound unit. Can anyone give me advice on which unit to select?

Brian Kiel, DPM, Memphis, TN

RE: Amerigel S/P NaOH Matrixectomies (Greg Caringi, DPM)
From: Multiple Respondents

I have patients who see me, then go directly to our retail and purchase what they need. I also have people walk in just for the retail because who knows feet better than podiatrists. Not only are they getting quality products, but they are tailored to their specific needs and they work. If you suggest it and believe in it, they will purchase it. Amerigel is not a major money maker, but it will augment your bottom-line. You make about $10 per sale. You do the math.

Thomas C. Hewitt, DPM, St. Louis, MO, feetfirst33@hotmail.com

RE: ABPS Qualifying Examination
From: Multiple Respondents

I've used Present Board Review and am quite happy with it. It allows you to view lectures at your own pace in your own time. Also, for each lecture you receive CME credits. They have a demo on their website. Here is the link: http://www.podiatriceducation.com/boards/

Carla Porter, DPM, Middletown, NY, buddha17@aol.com

I Recommend Functional Reconstruction of the Foot and Ankle (Hardcover) by Sigvard T Hansen, MD. It’s a great book. It helped me study for the ABPS Reconstructive Rearfoot/Ankle boards.

Damien M. Dauphinee, DPM, Denton, TX, Dauphinee@completefootandanklecare.com

I used the following study guide for the null examination: Hershey Board Certification Review Outline Study Guide published by the Goldfarbl Foundation at 800-841-3668. I felt it was a comprehensive review and found it to be very useful.

Timothy B. Maclin, DPM, Tulsa, OK, wire58@aol.com

RE: Tighter Standards For DME Suppliers (Paul Kesselman, DPM)
From: Jeffrey Kass, DPM

It would be another of a long list of tragedies if the medical community does not stand up and have physicians (podiatrists included) excluded from this DME accreditation process. I would love to hear if we are being represented by the APMA on a national level, and all our various state societies on state level. Furthermore, it is my own personal opinion that the schools that graduate us need to step up to the plate.

This stricter set of standards appears to be needed because of non-physician businesses, if this is accurate, physicians in no way should be penalized or grouped together with this other business entities. This proposed accreditation process is an expensive proposition and one that is being placed unfairly on us.

Let us not wait for this to happen. Please be proactive and heed Dr. Kesselman's advice. If anyone is dispensing DME from their office - this affects you. Do you want to pay 3-5 thousand dollars to have to be accredited? Read the links Dr. Kesselman provided. Call and get your associations involved If you are not members - at least call your congressman.

Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

RE: Podiatric Assistants Performing Routine Foot Care (Allen Jacobs, DPM)
From: Multiple Respondents

I am 100% in favor of establishing a new profession which will include a "podiatric hygienist", so to speak. With the improvement and standardization of residency training, an increasing aging and diabetic patient population, the podiatric physician should look to do what dentists did decades ago. We all could benefit in the future by having a Medicare-recognized podiatric hygienist, assistant, or nurse, or whatever we decide to name this medical assistant. Financially, we could gain by working side by side with an assistant who has completed a training program, educating him or her to perform a minor assessment, then debride corns, calluses, and nails; analogous to the care we all receive when going to our local dentist.

How does having an assistant perform such tasks diminish a podiatric physician's " importance"? It does not. These are our patients who come to our office and receive care under our direction, so that we can perform the care we are trained to do. The days of clipping and chipping should be numbered. Let's elevate the profession and take value in our education, training, physical examination, and surgical skills.

Georgeanne Botek, DPM, Cleveland , OH, botekg@ccf.org

I have read all of the posts regarding podiatric assistants performing "at risk foot care. Responses have been about 50% for 50% against. All of the responses have been well-crafted and I respect those opinions.

I also do not want our profession to lose this important and much needed service. My fear is that if the APMA study regarding our future manpower needs is even half-accurate, and the training of our residents continues to improve with greater sophistication; many DPM's will be less inclined to do this work. I want to keep this area of care where it should be, in the podiatrist's office. I have always felt that rather than follow the allopathic or osteopathic models we would do better to look at dentistry.

Thank you for your comments. I promise I will check back and keep you all informed with my progress.

Michael Forman, DPM, Cleveland, OH, im4man@aol.com

Editor’s note: An extended-length note from Dr. Markinson appears at: http://www.podiatrym.com/letters2.cfm?id=18393&start=1

ASSOCIATE POSITION - FT. MYERS/CAPE CORAL FL

Great opportunity for BE/BC established DPM or podiatric surgical resident with strong surgical skills. Well-established podiatric practice offering high surgical volume, advanced wound care, PT, vascular diagnostics and large diabetic population. Exceptional pay with incentives for high performers. Generous benefit package. Relaxed lifestyle, golfing, boating, fishing, close to beautiful SW FL beaches. Please send CV with references to janekelly331@msn.com

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City . Currently four (4)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

ASSOCIATE POSITION - UPSTATE NEW YORK

Multi physician, multi office busy diverse practice looking for associate with definitive plan leading to partnership. Excellent Compensation and Benefit package. Send CV to wnyfoot@rochester.rr.com

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

ASSOCIATE POSITION - NEW YORK CITY

Excellent opportunity for foot/ankle surgeon, Manhattan and Brooklyn Associate position leading to possible partnership. Requirements: Two years enrollment in a surgical residency program Qualities of self-motivation and impeccable skills in forefoot and rear-foot surgery. Package Includes: Malpractice insurance, Health Insurance plus salary, Incentives. Terms negotiable Email CV to Manfootcare@aol.com 212-349-7676

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901.

COLORADO PRACTICE OPPORTUNITY

inquiry@axint.net This is an auto response. Thank you.

FULL-TIME ASSOCIATE WANTED - CHATTANOOGA,TN

Well established, well-respected surgical/medical practice seeking full time associate. Send CV/ inquiries to: chattfootdoc@yahoo.com

TEXAS - SEEKING ASSOCIATE TO FULL PARTNER

Busy multi-physician podiatric group with 2 locations seeking BQ/BC surgically trained doctor. Applicant should be well-trained in all aspects of surgical and conservative care. Seeking ethical, hard working and outgoing physician to join our 4-physician group. Excellent quality of life in suburban Houston, near NASA and the Gulf of Mexico. Email CV and cover letter to Dr. M. Rockett at Mrockettman@comcast.net

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