The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

March 24, 2011 #4,116 Publisher-Barry Block, DPM, JD

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Pros of Wearing Toning Shoes Outweigh the Cons: FL Podiatrist

Experts say the latest fitness shoes can be an incentive to get people moving more by walking, but caution that they aren't without cause for some concern over issues such as balance and other foot ailments. "They're not for everyone," said board certified podiatrist and surgeon Dr. Scott Jason of Jacksonville Foot Clinic and the Foot Clinic of Palatka. "Even though these shape-up shoes require wearers to use more of the gastrocnemius muscle, or the calf muscle located in the back of the leg that can help firm and create more muscle tone, they can increase the workload of the Achilles tendon causing Achilles tendonitis." That's a painful condition often difficult to alleviate, added Jason. 

Dr. Scott Jason

However, Jason thinks the pros of wearing toning shoes outweigh the cons. "They [toning shoes] can be a hit or miss with some people," he said. "For some, the rocker bottoms actually take some stress off the plantar fascia, but for others they can cause Achilles tendonitis or ankle sprains."

Source: Joy Batteh-Freiha, The Florida-Times Union [3/23/11]

OCPM Names Three to Hall of Fame

The Ohio College of Podiatric Medicine (OCPM) has announced its newest inductuees in to the OCPM Hall of Fame: Terence Albright, DPM '75, William Munsey, DPM '54, and Hal Ornstein, DPM '87.

(L-R) Drs. Terence Albright, William Munsey, and Hal Ornstein

Dr. Albright is the former dean at the Scholl College of Podiatric Medicine and a past president of the American podiatric Medical Association (APMA). Dr. Munsey is a past speaker of the House for the APMA. Dr. Ornstein is the Chairman of the American Academy of Podiatric Practice Management. The official Hall of Fame induction ceremony will be held at the Glass Slipper Fete on Saturday, May 21, 2011 at the Embassy Suites Cleveland-Rockside Hotel in Independence, Ohio.

Source: OCPM Footsteps 

IOM Offers Standards for Clinical Practice, Comparative Effectiveness

The Institute of Medicine has issued eight recommended standards to develop trustworthy clinical practice guidelines and 21 recommended standards for systematic review of the comparative effectiveness of medical or surgical interventions. The IOM also said it encourages HHS' Agency for Healthcare Research and Quality to pilot-test the standards and assess their reliability and validity.

“If guideline users had a mechanism to immediately identify high quality, trustworthy clinical practice guidelines, their health-related decision-making would be improved—potentially improving both healthcare quality and health outcomes,” the IOM wrote in a description of its report "Clinical Practice Guidelines We Can Trust," which outlines eight standards that address issues including transparency, conflict of interest, and external reviews.

Source: Jessica Zigmond, Modern Healthcare [3/23/11]

Top 2 Strategies for Beating Stress

Don’t let stress gain the upper hand. Use these two tactics to stay on top of the pressure to do it all:

• 1. Forget perfection. If you expect to do everything perfectly, you are likely to be disappointed. Why add that stress to your load? Aim for reasonable targets, not perfection.
• 2. Ask for help. Pushing yourself to meet your commitments and to do a little more is reasonable. Struggling to do everything on your own is not. Working together is both more effective and more fun.

Source: Adapted from “Three Ways to a Stressless Holiday,” The Confidence Center via Communication Briefings

Query: Dizziness from Urea Cream?

My patient is a 66 y/o female who had been to the ER recently with vertigo/dizziness. An MRI/CT scan of the head was within normal limits. Cardiac work-up was normal. Blood work was normal. The only thing the lady states was different was that she had been using 40% urea cream daily to the feet and nails that I prescribed to her a few weeks earlier. She has stable hypertension and hypothyroidism. At her follow-up visit, she brought to me a data sheet on urea 40% cream, and indeed dizziness is one of the side-effects. Has anybody else ever see this? What would be the mechanism of action for dizziness?

David Weiss, DPM, Richmond, VA

RE: Test for Raynaud's (Jeffrey Kass, DPM, Joan Schiller, DPM))
From: Bryan C. Markinson, DPM

In response to Dr. Kass’ query on a test for Raynaud’s, Dr. Schiller responds, “A positive cryoglogulin.” Don’t hold your breath waiting for this in the vast majority of your Raynaud’s patients. A positive cryoglobulin test will be so in patients with a specific type of Raynaud’s due to cryoprecipitants in the blood precipitating out in the influence of cold temperature and causing decrease in blood flow. I have had maybe 3-4 cases of this in 28 years, and I have about ten to fifteen patients annually in the winter months that I treat with agents such as nifedipine or Cardizem. None have a positive cryoglobulin test. In fact, the vast majority of the Raynaud’s I treat is not associated with any underlying diseases, and hence referred to as Raynaud’s disease.

When there is an underlying issue, usually involving systemic inflammatory diseases such as RA, Lupus, etc., the condition is referred to as Raynaud’s phenomena. With a positive cryoglobulin test, the patient is said to have cryglobulinemia.

In all cases, detailed rheumatologic history taking and joint examination is undertaken. Many times, I will work with rheumatologists as some of these patients have “incomplete” syndromes and rheumatologists are more comfortable and experienced in committing treatment to these patients.

Bryan C. Markinson, DPM, NY, NY, Bryan.Markinson@mountsinai.org

RE: Pain in Hallux Interphalangeal Joint (Jordan Sheff, DPM)
From: Jay D. Helman, DPM

The reason for the pain is that the patient is trying to break down the IPJ to allow for dorsiflexsion of the hallux so he can push off during the gait cycle. It's no different from a hallux rigidus. Once the IPJ can dorsiflex, his pain will resolve. If you wish to resolve the problem quicker, by placing the patient in a rocker-soled shoe (e.g., MBT), you will eliminate the patient's need to push off, thereby eliminating his pain. 

Jay D. Helman, DPM, Suffern, NY, footdr80@hotmail.com

RE: Oil for Ritter Surgical Table (Robert K Hall, DPM)
From: Carl Solomon, DPM

If low oil level is truly the cause of your Ritter 75C's problem , use mineral oil. It's the cheap stuff you can buy at any drug store.

Carl Solomon, DPM, Dallas, TX, cdsol@swbell.net

RE: Replacement Product for Panafil (Theresa L. Schinke DPM)
From: Wm. Barry Turner, BSN, DPM

I am unsure how many of my peers and other wound care professionals contacted the FDA about the removal of Panafil/Accuzyme products. I have. I actually have called the FDA and have written the FDA more than once regarding papain producs. I have been told various reasons why papain products have been pulled - they cause cancer. Someone put it their eye and went blind. I still do not understand why Panafil was pulled.

I do know that there is currently no other enzymatic debrider that works as well. Santyl is not for the same type of debridement. At most, it may be the "little brother" to papain, but it is no where as effective, even when used under occlusion. I want papain products available, maybe with a warning. I feel the removal of this product from our wound care arsenal is insensitive to the blight of our chronic wound care patients. I feel confident that papain products helped many more than they hurt.

Wm. Barry Turner, BSN, DPM, Royston, GA, claret32853@gmail.com

RE: Pissed Off About Healthcare (Gino Scartozzi, DPM)
From: Bob Kuvent, RPh, DPM

I agree with Dr. Scartozzi that we need to organize. I was somewhat overwhelmed with the response to my last post on this issue. I will be setting up a conference call for all those who responded, with more information about the Supergroup we are forming in AZ. If you would like to be involved, let me know.

Bob Kuvent, RPh, DPM, Chandler, AZ, FtFixr@gmail.com

RE: Homeopathy is a Safe Way to Complement Treatment Choices: IL Podiatrist
From: Dan Waldman, DPM

In 2010, I attended Dr. Kornfeld's first seminar on integrative podiatry and found it enlightening. Over the past few months, I have slowly incorporated some of the protocols he taught and found they work well for many of my patients. I explain the pro's and con's of the traditional alliopathic and integrative/holistic treatments to my patients and give them a choice. Many stick with the traditional methods of treatment (steroids, NSAID's, etc). Most of those patients who do go the integrative route do better than I had expected. It has been a wonderful addition to my practice.

Too often, I hear and read comments from nay sayers about new concepts. Be skeptical, but open-minded, and see for yourself. I'm reminded of the story about a fisherman with a bucketful of crabs.  Occasionally, one of the crabs would try to crawl out and escape, but the other crabs would grab its legs and pull him back down into captivity. There are too many crabby podiatrists out there.
 
Dan Waldman, DPM, Asheville, NC, DPMcareer@aol.com

ASSOCIATE POSITION - TEXAS

Are you looking for a busy, well-rounded practice experience?" Group practice in DFW area looking for a 3-year surgically-trained associate with a sports medicine background. Needs to be as comfortable making orthotics as fixing a complex flat foot. Email CV to crane@faant.com

ASSOCIATE POSITION - NYC, NY

ASSOCIATE POSITIONS – MARYLAND

Are you motivated, personable and enjoy working with the elderly? We are offering full or part-time positions in Maryland. Our group, Podiatry Management Services, provides care to the elderly in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your c.v. to drhprosen@verizon.net or fax to 410-486-2049 or call Dr. Herbert Rosen at 410-580-0255.

ASSOCIATE POSITIONS - TEXAS

Podiatrists needed in San Antonio or Austin. Great paying positions for full or part-time physicians. Established, unique mobile podiatry practice servicing senior living facilities. Office locations in both cities with excellent support staff for your assistance and scheduling. Check us out before looking elsewhere. See us at www.footmobile.com.  Reply with cover letter and CV to doctor.cohen@yahoo.com with a cc: to lisa.schulze@yahoo.com or call us at 210-495-6477 or 210-545-3338.

POSITION AVAILABLE – PHOENIX, ARIZONA

Full-time or part-time position available for an associate to join a modern, well established practice. Needed is a motivated, hard-working, well-rounded, surgically-trained podiatrist to complement our office. Excellent income potential with possible partnership opportunity available. Arizona license required. Email CV to Foot.doctor@hushmail.com.
 

ASSOCIATE OPPORTUNITY - FREDERICKSBURG, VA

Progressive, busy practice seeks personable, ethical, confident associate interested in future partnership. Lucrative opportunity for self-starter with strong work ethic. State-of-the-art office in rapidly growing community with two new hospitals and new surgery center. Practice has excellent reputation with well established referral base. Cover letter/CV to: fredfeet@verizon.net

ASSOCIATE POSITIONS - NW INDIANA, CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

EQUIPMENT FOR SALE -  SONOACE ULTRASOUND

2007 Sonoace, Pico color ultrasound image, Medison, MY202C MAI, 7.5 mhz small head, hl59edn, 40 mm, 4 modes - 2d, Doppler, 3-D, and multi-image. $9,800 or best offer. Just finished servicing by Universal, includes Sony black and white printer. Charles W. Kelley III, DPM cwkell2aol.com

EQUIPMENT FOR SALE - COOL TOUCH LASER
 
Cool Breeze Cool Touch CT3 plus laser used for ugly, unsightly, toe nail infections. Less than six months old. Great price won't last long. Considering a laser? We also have the Q- Clear Q- switch laser too. This laser is perfect for you. Also a used Lumix 2 laser, best price today   Dr. Zuckerman is in the Fort Lauderdale area and will demo this lasers on your patients. E-mail footcare@comcast.net

PRACTICE FOR SALE - WASHINGTON STATE - SUBURBAN SEATTLE

16 year established part time practice. Includes Midmark 417 (4 position keypad), Excel X-ray, processor, Ritter M9, instruments, bandaids, etc. 1 Day/week $50K gross. Professional Business appraisal at $48K. Asking $35K. Shared office with 2 FP's. Easily expandable. Reply: practiceforsale18@yahoo.com

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Great opportunity. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K. dpmpracticeforsale@yahoo.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. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

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