The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

April 11, 2011 #4,131 Publisher-Barry Block, DPM, JD

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HI Podiatrist Discusses Toning and Minimalist Shoes

Podiatrists see plenty of problems walk into their offices. The most common are heel pain and pain in the balls of the feet. These can be treated with proper shoes. So, we asked Straub podiatrist Dr. David Yee which shoes would put us on good footing. Asked about Sketchers brand toning shoe, he said, "It rocks. It allows just a nice, smooth roll off of the shoe," The toning shoes are also called "rocker-soled" shoes because they give the foot a smooth transition from heel to toe. They're all the rage - promising to strengthen core muscles. Dr. Yee says there's some truth to that, but maybe not as much as the hype would have you believe. 

Dr. David Yee

The minimalist movement shoes - along with the five-fingered running shoe, which looks like a glove for the feet - are another huge trend. They're lighter and have less material which means less arch support and heel cushion. "Barefoot running emphasizes running on your toes, running on the balls of your feet, on your toes. It takes a lot of energy to run like that, and you've got to be in pretty good shape," explains Yee. He recommends them for athletes, not the weekend plodder.

Source: Teri Okita, KGMB, KHNL [4/7/11]

U.S. Dept. of Defense Awards Barry University $2 million Grant

The United States Department of Defense has awarded Barry University a $2 million congressionally-directed grant. These funds from the Defense Advanced Research Projects Agency (DARPA) will allow researchers to conduct studies that could lead to the reduction of bacteria in wound infections for soldiers in combat. This innovative research project titled, “Identify Parameters for the Optimal Delivery of Pressurized Nitric Oxide to Reduce Bioburden in Wound Infections,” will specifically study how to deliver nitric oxide to deeper layers of skin in order to reduce the presence of pathogens. Researchers will examine how much pressure is safe to use by testing on human skin models in the laboratory.

Dr. Jeffrey Jensen

The two-year project will be guided by Dr. Gerhild Packert, associate dean and professor in Barry’s College of Health Sciences in conjunction with its School of Podiatric Medicine Dean, Dr. Jeffrey Jensen, and Dr. Evelio Velis, health services administration program director. Dr. Jensen, a surgeon and wound healing expert, will assist in oversight of the project and supervise graduate students.

No Silver Bullet for Every Wound: FL Podiatrist

Dr. Desmond Bell, a wound care specialist and founder of Save a Leg, Save a Life Foundation (SALSAL), recommends going straight to a podiatrist or wound care specialist if a cut, sore, or wound does not heal in a week or two. Those with a history of diabetic foot ulcers should see a specialist immediately. 

Dr. Desmond Bell

Bell said several newer treatments are available to treat these wounds. None are a "silver bullet" for every single wound. SALSAL hopes to educate both physicians and the general public in order to prevent unnecessary amputations.

Source: Sanjay Gupta, CNN Health [4/8/11]

FL Podiatrist Charged With Child Abuse

Physician Evaristo Enrique Rivero, 53, was arrested Friday morning at a Sebring residence on a charge of child abuse without great harm, which is a third-degree felony. According to a Highlands County Sheriff's Office report, Rivero committed an act of battery/domestic violence on the evening of March 10 at his Sebring residence.

Rivero intentionally head-butted an 11-year-old boy, causing a bruise on the left side of the victim's forehead, the report states. The victim told authorities that he was completing some homework at the kitchen table when Rivero became upset, grabbed his head with his hands and head-butted him, causing pain, the report shows.

Source: Marc Valero, Highlands Today [4/9/11]

Bill Would Make Medicare Payments Public

Senators Chuck Grassley (R-IA) and Ron Wyden (D-OR) have introduced legislation that would allow Medicare payments to physicians to be made public. The Medicare Data Access for Transparency and Accountability (DATA) Act would overturn a 1979 court decision that prohibits Medicare from providing public data about its billing information to physicians.

Grassley's prepared remarks also stated that the bill would call for HHS to develop a "searchable Medicare payment database that the public can access at no cost," as Medicare payments to physicians would no longer have a Freedom of Information Act exemption. According to the bill, the database would include the amount paid to each provider or supplier, the items or services that were billed to Medicare and the location of the provider or supplier.

Source: Jaimy Lee, Health IT Strategist [4/8/11]

Query: Orthotic for Golfer With Met Adductus Foot

My golf buddy is suffering from severe enthesiopathy of the peroneus brevis which is exacerbated by his golf swing. As he follows through and rolls up onto his left foot, he is experiencing a lot of pain at the base of the fifth metatarsal. The base of the 5th is prominent as one would expect in a Met adductus foot. His foot type is associated with moderate hypermobility of the medial column. The rest of his biomechanical exam is unremarkable.

He is in a CAM boot, takes NSAIDs, uses ice and rests. I would like some suggestions on an orthotic that will control his foot, but at the same time, not prevent him from supinating his left foot as he follows through.

Vincent Gramuglia, DPM, Bronx, NY

RE: Chronic Stasis Dermatitis Draining Lymph Fluid (Frank J. DiPalma, DPM)
From: Simon Young, DPM

There are lymph edema clinics scattered throughout the country. They usually have an aggressive 30-day regimen prior to discharging to their own care. I recall there are ones in the Boston and NYC areas.

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

RE: Presentation to Nursing Students (Michael Lawrence, DPM)
From: Michael DiGiacomo, DPM, David L. Nielson, DPM

Go through the systems we examine: integumentary neurologic, vascular, and musculoskeletal. Show them what you evaluate in each and some simple pathology for each system. Encourage questions and it will be a remembered and meaningful experience.

Michael DiGiacomo, DPM, Oakland, CA, mddpm2003@yahoo.com

What a great way to introduce foot ailments to the nursing staff. APMA has a great PowerPoint on topics such as podiatric care, heel pain, etc. This is a great way to introduce this information. It also introduces yourself. I often tell nurses that I will do the dressing changes along with the care that will unburden their overworked schedule. They are very appreciative of this and it generates referrals.

David L. Nielson, DPM, Roanoke, VA, DrDavidnielson.com

RE: Celebrex Not Being Detailed to Podiatrists (James Breedlove, DPM)
From: Michael J. Schneider, DPM, Jeffrey Kass, DPM

We are routinely detailed by the Celebrex representative who leaves samples every visit. Call the company.

Michael J. Schneider, DPM, Avon-Frisco, CO, vailfootdoc@aol.com

I find Dr. Breedlove's posting interesting and shows poor business practice on behalf of the makers of Celebrex. Podiatry has a narrow scope of practice, and hence, we are limited to what we prescribe compared to MD's. However, anti-inflammatory medication, antibiotics, and antifungals are probably what we write for 95% of the time. I think those companies that have made a niche market in podiatry realize the millions of dollars that can be made from our profession.

The bottom line is - if you want Celebrex samples and the company won't detail you, don't write for it. Pedinol is, and has been, podiatry-friendly for many years, and distributes Nalfon. Support those who support you. There are many generic anti-inflammatory meds that can be used as well.

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

RE: Advertisements for Laser Treatment of Onychomycosis (George Jacobsen, DPM)
From: Rob Eells, DPM, James R. Holfinger, DPM

I think there has been "overselling" of the expected outcome of laser treatment for onychomycosis in many cases. Remember when the endoscopic plantar fasciotomy procedure first became available? How many podiatrists were advised to tell patients that they would be back at work in three days after surgery in a regular shoe? Didn't quite work out that way, did it? When new treatments arrive on the scene, there is often some hype that needs to be recognized and eventually toned down in all aspects of the profession - not just with lasers.

Rob Eells, DPM, Des Moines, IA, rgeells@gmail.com

I was the first podiatrist to ever purchase a Light Age, Inc. Q-Clear laser, and our practice has treated over 300 patients in the past 14 months. I was so impressed with the early results that I became an independent sales representative for the Light Age, Inc. and have provided training and sales to dozens of podiatrists. Much confusion exists regarding new applications in podiatry. Manufacturers, representatives/distributors, and doctors have at times overstated results. Some companies have unusual sales, leasing, or profit-sharing strategies. Most podiatrists do not understand the unique characteristics of different laser wavelengths and the resulting effect of pulse durations (q-switched vs. long or continuous), protocols, and most of all expectations. It is understandable that many are skeptical. I can only speak from my own experience.

Laser treatment for any condition is not a panacea. Virtually everything we do in practice is not 100% effective. Lamisil does not cure all onychomycosis. Pulse-dye lasers do not cure all warts. Not every bunion surgery result is perfect. I have found the laser to be useful as an option for several podiatric conditions with some excellent results, some modest results, and some failures. Patients and physicians need to have realistic expectations. Valid scientific evidence is very limited at the present time. More research is needed and is being conducted. In time, the results will speak for themselves.

James R. Holfinger, DPM, Middleburg Heights, OH, jholfinger@aol.com

RE: GA Podiatrists Recommends That Clients Bring Their Own Instruments to Nail Salons
From: Carl Solomon, DPM

Are we being a little too harsh on pedicurists and nail salons? I see horror stories from investigative reporters, in the newspapers, on the radio, and even on this forum. It was stated that patients are seen "...on a daily basis who get some type of infection...from nail salons." But when I consider my own practice experience, the numbers just aren't there. The serious infections I see that are related to nail salons are a drop in the bucket, compared to those from self-care in people's own bathrooms. Why is it considered more hazardous to get a pedicure with sanitized instruments than getting a shave (and very possibly a nick in the skin) with a non-sterile razor in a barbershop. There are serious outbreaks of community-acquired MRSA on wrestling mats, atheletic fields, locker rooms, etc. Are we telling kids not to participate in sports?  

I'm not saying that the horror stories are untrue, and don't deny that there are patient populations who are highly at-risk, regardless of exposure. But I would take the position that, as a rule, clinical infections are not caused by a few organisms on an otherwise clean (not necessarily sterile) surface, but by tens of thousands per cubic cm. Provided that the salons take reasonable sanitary measures, I don't have any problem with my non-risk patients going to nail salons. 

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

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

GROWING PRACTICE FOR SALE- PHOENIX ARIZONA

Part of the largest multi-specialty group in Phoenix comprised of approximately 30 referral sources. Selling 50% share in practice grossing 600K. Gross is based on part-time practice but easily expandable to full-time if desired. Active, healthy client population, excellent surgical base, very minimal palliative care. PSR-36 required. Inquire at drlaurel@cox.net

PRACTICE FOR SALE - HOUSTON, TEXAS

28 year old busy, progressive practice for sale with an excellent reputation and well established referral base. Well-trained, dedicated, supportive staff. Excellent cash flow $475K income after overhead. EMR, digital x-ray, diagnostic ultrasound. Free standing building also available with large outdoor sign. Also available are two transferable surgical center partnerships(with distributions). Owner retiring and willing to stay part time during transition. Cover letter/CV to softechpodiatrist@gmail.com

PGY-3 POSITION - NEW YORK CITY

PGY-3 position available starting July 1, 2011 at Beth Israel Medical Center in New York City. Please contact Dr. Richard Frankel at rfrankel@chpnet.org

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

OFFICE TO SHARE- NYC GREAT OPPORTUNITY

6 rooms (1000 sq. feet), Gramercy Park area. Newly renovated, painted, fully equipped and wired. Good for all situations. Available for immediate occupancy. Rental terms are competitively priced based on need. Please contact 157629@gmail.com for more information.

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

ASSOCIATE POSITION - CT - (FAIRFIELD AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to Dr.Kassaris@yahoo.com

ASSOCIATE POSITION - TEXAS

Looking for podiatrist to see patients in nursing facilities in East Texas and two nursing facilities in El Paso. AVAILABLE IMMEDIATELY. Please contact me at doconcall02@aol.com

ASSOCIATE POSITION - NEW YORK CITY & QUEENS

One of the fastest growing podiatry practices in New York City and Queens seeks a podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Preferably a Spanish speaking podiatrist. Contact me at Podocare@aol.com

ASSOCIATE POSITION - MICHIGAN

Entry level DPM needed to join an established, full service, group podiatry practice in Monroe, MI. A generous salary and future partnership opportunity will be offered to the right applicant. Check out our website at www.monpod.com Send CV and cover letter to info@monpod.com

PODIATRY SUPPLIES--CHEAP!

Closing office. Gloves, pads, CAM walkers, casting splints, Powersteps, dressings, Covelets, Elastikon, Zonas, Coban, etc, etc. E-mail for complete list/description. Why pay full price? Huge discount if you take entire inventory. E-mail for complete list/description to goodfeet@hbci.com or call 507-429-7957.

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 these lasers on your patients. E-mail footcare@comcast.net

PM News Classified Ads Reach over 12,500 DPM's and Students

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