The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

April 06, 2009 #3,512 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2009- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

New Earth Shoe Less of a Problem for Men: OH Podiatrist

The Earth Shoe has stepped back onto the fashion footwear scene. This isn't your father's Earth shoe, first made popular in the U.S. during the 1970s. Today's Earth Shoe is lightweight and breathable, with insole boards made of recycled cardboard and quarter linings of post-consumer recycled bottles.

Dr. Deena Chapman

"I know the shoe well," said Oakwood podiatrist Dr. Deanna Chapman. Some people like them and some don't, she said. "In women, the negative heel puts too much strain on the Achilles tendon, because we are used to wearing shoes (high heels) that take the Achilles tendon off stretch, so it's slightly shortened," she said. "A negative heel causes the tendon to stretch out maximally. Some women say they just can't wear the shoes without pain."

"Am I against the Earth Shoe? No, I'm not," Chapman said. "They have a large popularity because of the wide toe box and good arch support." Men don't flip-flop back and forth between high heels and flat shoes like women, so they usually have less problems wearing negative heeled shoes, she said. "The flip-flop back and forth, that's the problem," she said.

Source: Katherine Ullmer, Dayton Daily News [4/4/09]

OCPM Names Hall of Fame Society Inductees

The OCPM Hall of Fame Society is the highest honor given to an OCPM alumnus. The OCPM Hall of Fame Society is designed to recognize OCPM alumni who have demonstrated the highest moral and ethical values associated with podiatry, at least 20 years of dedicated service in the field of podiatry, and a strong appreciation of and loyalty to their alma mater, among other criteria.
 
The Ohio College of Podiatric Medicine has announced the 2009 OCPM Hall of Fame Society Inductees:

Dr. James A. Conforti (1921-1989)

James A. Conforti, DPM, Class of 1944     

Dr. H. Darrell Darby       (1928-2003)

H. Darrell Darby, DPM, Class of 1956                       
 

Dr. Jeffrey M. Robbins

Jeffrey M. Robbins, DPM, Class of 1976 
 
Source: Footsteps [March 2009]

APMA Introduces New Director of Health Policy and Practice

On March 18, 2009, the American Podiatric Medical Association (APMA) introduced Scott L. Haag, JD, MSPH as its new director of Health Policy and Practice. Scott previously worked for Hewitt Associates as a legal consultant where he tracked federal and state healthcare legislation and consulted with employers on strategy and design issues related to employer-provided benefits. Scott will look to draw from his years of experience with large employers, private insurers, Medicare, and ERISA in dealing with the issues currently facing the APMA and its members.

Scott Haig

Scott attended the Johns Hopkins University as an undergrad, received his MSPH from the University of South Florida College of Public Health, and his JD from the University of Connecticut School of Law. Scott is licensed to practice law in Massachusetts and the District of Columbia, and he currently resides with his wife and two children in McLean, VA.  Scott rounds out the HPP Department which also includes Alicia Blakey, assistant, and  Harry Goldsmith, DPM, consultant.

Weil, Jr. Elected President of ISMST

Lowell Weil, Jr., DPM, MBA was elected President of the International Society for Medical Shockwave Treatment (ISMST) at their annual meeting in Sorrento, Italy, this past week. He is the first podiatric physician to be elected to an executive position of this organization. His term of office will run through June of 2010 when he will host the 13th Annual ISMST2010 Meeting in Chicago, IL. This multidisciplinary meeting will not only involve ESWT for musculoskeletal disorders, but also the application of this modality in the treatment of wounds, arterial disorders, cellulite, and other cosmetic conditions.

Dr. Lowell Weil, Jr.

Dr. Weil, Jr has pioneered the use of extracorporeal shockwave treatment ( ESWT) for plantar fasciitis in the United States and has been involved in three FDA studies and written several papers, as well as co-authored a book on the subject of musculoskeletal ESWT. Dr. Weil, Jr. is the Fellowship Director of the Weil Foot & Ankle Institute, Des Plaines, IL and is a team podiatrist for the Chicago White Sox.

Query: Purchasing Absolute Alcohol

I have been trying to find, vials of absolute alcohol for neurolysis procedures. Does anyone know where I could purchase some?
 
Art Korbel, DPM, MD, Coral Springs, FL

RE: Pain Post-op Arthrex Tightrope (Ivar E. Roth, DPM, MPH)
From: Simon Young, DPM

This describes a metatarsalgia as a result of elevatus. Was there pre-op elevatus? Is there post-op elevatus? Check the Seiberg index. Consider NSAID's. There could be bone marrow edema from the stresses on the 2nd met. or new weight-bearing stresses. Orthotics with metatarsal pads and possibly rocker shoes can help. Additionally, you might need to release the Tightrope.

Simon Young, DPM, NYC, NY, simonyoung@juno.com

RE: Scanners for Orthotic Fabrication (David E. Gurvis, DPM)
From: Multiple Respondents

I started using a scanner about 10 years ago and have never regretted the decision. My sense is that the imaging of the scanner vs. the cast is a toss-up. The advantages of the scanner include the mess issue, the cost of casting materials, assistant time, and mailing vs. a 1-step process and an Internet connection. I have generally found the accuracy of the scanner to surpass or be equal to the issues of casting errors, crushed or deformed casts. I think the key is your personal orthotic evaluation and prescription. I never post to cast.  I always do a complete biomechanical exam and write a complete Rx. I am more than happy with my scanner and would never go back to casting. 
 
Lloyd S. Smith, DPM, Newton, MA,  lloydpod@yahoo.com

There will continue to be controversy about scanners until all the devices on the market do two things. First, permit manipulation and positioning of the foot - in space, not against a glass plate- such that neutral position and forefoot deformities can be revealed. Second, when the entire plantar contour can be optically scanned, as opposed to being evaluated by pressure sensors. Pressure sensing devices cannot, by definition, capture plantar contour that remains off the sensing surface - devices made in this way remain approximations only, of true foot contour and position. And, as this image is a weight-bearing image, it is representative of a compensated foot, inclusive of any and all pathological motions that can and do occur in weight-bearing. In my view, these failings make the devices they produce less than truly custom and/or truly corrective. There are systems on the market that do permit the practitioner to practice in a "classical" way; one just has to seek them out.

We should not mistake slick imaging and superior customer service for accuracy and excellence in construction of biomechanical devices, or for a guarantee of their effectiveness. "Best practices" in podiatric biomechanics will always be based on proper visualization and thorough examination of the lower extremity, and casting (or imaging) that captures what we have been trained to find in such examinations.

This is the difference between the DPM and a technician in a shoe store. Whether one uses plaster/STS or not, and I still do, (though NYCPM is acquiring a scanner to sit alongside the classic methods), none of these systems can on their own assess, diagnose and prescribe, and we should not be so quick to permit them to try.

Robert Eckles, DPM, NYC, NY, reckles@nycpm.edu

Here are a few comments regarding foot scanners from the engineering point of view: The scanners that measure foot pressure can provide only information regarding the pressure distribution under the foot, but not any data regarding the 3-D shape of the foot. Therefore, they cannot be used as a reliable tool for capturing the structure of the foot for building true custom made orthotics, even though many of these systems are used, primarily in the retail market, to help sell orthotics and a variety of insoles to consumers.

I tested some of these systems, and scanned my normal foot along with my prosthetic foot, which is totally flat, (and doesn't resemble at all a human foot). The result was not surprising: I received a pair of identical orthotics with a high arch for my normal and prosthetic foot. The best way to get the true shape of the foot is by using scanners, which are based on optical measurements, such as lasers or digital cameras.

The drawback of the optical systems is, that it is impossible to properly load the forefoot for attaining a locked neutral position of the foot without interfering with the scanning process. Therefore, those optical systems are not capable of providing the correct data for building a biomechanical orthotic device, and as Dr. Robert Scott Steinberg mentioned in his response, have a major problem in picking up forefoot varus or valgus.

Ron Bar, PhD, Orthofeet, Inc. ronibar@aol.com

RE: Hyperuricemia Management (Bryan C. Markinson, DPM)
From: Jay Wenig, DPM, Eugene A. Batelli, DPM

Since I boldly said treat gout with allopurinol, maybe I should clarify myself. Recurrent gouty attacks with appropriate blood and urine tests should be treated appropriately. Too many medical doctors do not place much emphasis on gout and still keep their patients on diuretics, despite their attacks. So do I stop them? You're damn right I do, and send them right next door to the cardiologist for better management. Maybe, where Dr. Markinson practices, the medical doctors are wonderful and extremely thorough, but in the real world, they are not like that.
 
With all due respect, Dr. Markinson, lighten up. I have a very busy practice, perform all the latest and greatest surgeries, and bottom line: I do right by my patients. 
 
Eugene A. Batelli, DPM, Clifton, NJ, ebatelli2001@yahoo.com

Editor’s Note: Dr. Wenig’s extended-length note can be read at: http://www.podiatrym.com/letters2.cfm?id=25580&start=1

Editor’s Note:  This topic is now closed.

RE: E-Prescribing (Howard Gale, DPM)
From: Helene T. Nguyen, DPM, Elliot Udell, DPM

There are several free e-prescribing software programs available. They are user-friendly. They are stand-alone software. You can also import your patient information to the software . The best part of it is that there is NO charge in any part of the process (sign-up, set-up fee, annual cost…).  Here are the website links: nationalerx.com, iscribe.com

Also certain billing companies provide e-prescribing as part of the billing service.  No charge, of course.  If you are using one of the billing services, you can ask them about that option. Enjoy e-prescribing!
 
Helene T. Nguyen, DPM, htnguyen@feetnbeyond.com

There are many companies offering e- prescribing programs. Their incentive is to jump on the bandwagon and cash in on physicians wanting to get a bonus from Medicare for e-prescribing. Almost all of the software companies are offering their programs. Quest diagnostic lab is offering a program, and there are some free programs as well.
 
The one problem I see with all of these programs is that you have to type in lots of information on each patient such as insurance info, name, address, etc .This takes up time. This is why I have put using such a program on hold.
 
I too would like feedback from doctors who are using any of the programs. If there is one out there that does not require a lot of work to write a prescription, I would gladly consider investing in it 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

ASSOCIATE POSITION - CHANDLER/GILBERT/PHOENIX, ARIZONA

Seeking a well-trained, ethical and hard working graduate of a PSR 24+/36 Residency to join our growing multi-location practice. This is a practice with a nice mix of 35% surgery/trauma, 20% diabetic/wounds, 25% biomechanics, 20% pediatric. ER Call. Opportunity for partnership at 2 surgery centers. Very modern offices with EMR, U/S, Digital X-Ray, ESWT, Vascular Testing Machine. Excellent referral base, and a well-trained staff. Board eligible/certified a plus. Competitive salary, bonus structure, benefits. Please e-mail CV and references to  FootAnkleAZ@aol.com

OFFICE SPACE/ MRI RENTAL – NYC, LI

Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, and Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

PRACTICE FOR SALE - CENTRAL FL

Practice and medical building for sale, in beautiful, high quality of life, growing area, Central Fl.; 2000 sf bldg. fully equipped/ designed for podiatry; excellent location, features & exposure; near hospital, wound and HBO center. Great opportunity for expansion & investment; good insurance climate. 352-223-2713 / E-mail: windnwave@earthlink.net

ASSOCIATE WANTED - FLORIDA

Associate needed for a dynamic multi-doctor practice in the Tampa Bay area. Partnership opportunity for the right candidate. Preference given to a PSR 24+ resident completing their education this spring/summer, and must have a Florida license. Well-established practice, high tech with EMR and digital x-rays, with specialties in sports medicine, surgery and wound care. No nursing homes or HMO's. Excellent hospital privileges available. Choose an area of practice concentration that you are passionate about and enjoy a lifestyle for yourself and your family that is second to none. E-mail: kimvelez@tampabay.rr.com

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

PART-TIME NON-SURGICAL PRACTICE FOR SALE - NORTH JERSEY    
 
23 yo practice recently relocated to a spectacular newly-constructed and equipped storefront next to a busy supermarket with ample parking and senior citizens in vibrant downtown. Accepting Medicare and Blues only with great potential. Perfect for expanding to full-time, a second office or new practitioner with means and office experience.  Priced to sell. Financing possible. E-mail interest with contact to Mikedup1215@yahoo.com

PODIATRIST NEEDED FOR MIAMI-DADE COUNTY

Multi office practice needs doctor of podiatry for full time and/or part time for private office, clinics, and nursing homes. Great opportunity to grow with and unlimited income potential. Offices in Miami, Hialeah, Westchester, and Cutler Ridge. Email to feetdoctor@aol.com

 PM Classified Ads Reach over 11,500 DPM's and Students

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 11,500 DPM's. Write to  bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 Ext 110.

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.