The Voice of Podiatrists

Serving Over 10,800 Podiatrists Daily

April 18, 2008 #3,223 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2008- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

OH Podiatrist Stresses Importance of Proper Shoes For Diabetics

The shoe a diabetic patient slips his foot into literally could make the difference between saving a leg and losing it. The importance of avoiding any irritation in diabetic feet, said Dr. Steven Gross, is crucial to the patient’s continued health.

Dr. Steven Gross

“Here’s why,” said Gross, a podiatrist and partner in the Stark County Foot and Ankle Clinic “You get nerve damage in the foot from high blood sugar. It changes the structure of the nerve and those changes are irreversible. Changes happen to the tendon structures which begin to buckle and contract, causing deformation which results in hammertoes, bunions, and dislocations.

“The average person takes thousands of steps a day. When you take those (foot) defects in the face of neuropathy, you’re going to have pressure, which will cause an ulcer. The kicker is, because of the neuropathy, these patients can’t feel it.” The foot neuropathy, or nerve damage, leaves the diabetic oblivious to pain there. Over the years, Gross has removed children’s plastic Lego blocks and needles from diabetic feet.

Source: Diana Rossetti, Ashland Tab [posted 4/16/08]

Des Moines Student Wins APMWA Student Writing Competition

Mindy J. Engel a first-year student at Des Moines University, College of Podiatric Medicine and Surgery has been named the winner of the 22nd Annual American Podiatric Medical Writers Association Student Writing Competition. Her paper was entitled, "The Immeasurable Value of Early Patient Contact: Through the Eyes of a Medical Student.”

Student Dr. Mindy J. Engel

Engel will receive a one thousand dollar honorarium from a special endowment by Dr. and Mrs. Steven Berlin to the APMA Educational Foundation.

The Awards for Honorable Mention went to Tanya Singleton, a fourth-year podiatric student at Midwestern University, College of Health Sciences for her paper “Patient Adherence: The Need For Shared Responsibility” and to Camille Ryans, a second-year student at Temple University School of Podiatric Medicine for her paper "The Renaissance Student: Promoting Research Opportunities for Podiatric Medical Students."

State Medical Boards Taking Less Disciplinary Actions

The number of disciplinary actions taken against healthcare professionals by state medical boards fell for the second straight year, according to the Federation of State Medical Boards’ Annual Summary of Board Actions report released today. The 5,319 actions taken—including revocation or suspension of physicians’ licenses—in 2007 represent a 4.6% decline from the 5,574 taken in 2006 and a 14.4% drop from the 2005 total of 6,213. The FSMB reported 6,265 disciplinary actions in 2004 and 5,230 in 2003.

Measures such as revocation, suspension or mandatory retirement of a license are referred to as “prejudicial actions,” while more administrative measures are considered “nonprejudicial.” The Dallas-based federation of 70 medical boards—some states have separate bodies to oversee medical doctors, doctors of osteopathy and other healthcare professionals—always notes that the purpose of its report is to track discipline trends in individual states and not to compare one state with another.

Source: Andis Robeznieks, Modern Healthcare [4/17/08]

Query: Von Recklinghausen’s Disease

I have a patient with painful lesions on the plantar surface of the foot secondary to Von Recklinghausen’s disease. She has been treated with Lyrica, which greatly reduced the pain, as well as soft Plastizote liners for her shoes. However, she has a few lesions which are very painful, and large, primarily on the soles of her feet, in the arch area. Does anyone have any suggestions for treatment for these? I am considering alcohol sclerosing injections.

Adam Landsman, DPM, PhD, Boston, MA

RE: Adverse Effects From Lamisil (John Cozzarelli, DPM)
From: Robert Chelin, DPM, Paul Kesselman, DPM

Oral Lamisil came out in Canada several years before it hit the US market. I have had good overall success with this drug but I have noted and reported several side-effects to Novartis. I have had several patients have a loss of taste sensation, a few who had hallucinations, several that developed cryptotic nails post treatment and one who had a toxic reaction to the drug. However, most of my patients who have been placed on this particular drug have done just fine.

Robert Chelin, DPM, Toronto, Canada, ft-biz@rogers.com

I have seen both Lamisil and Sporanox produce the CNS symptoms you describe, GI and GU adverse reactions and trigger multiple gouty attacks. One must be careful with either of these medications if the patient has underlying cardiac disease or suffers from anxiety or depressive symptoms (whether being professionally treated or not). As with any systemic medication, it is extremely important for patients to understand your rationale for taking a thorough history.

I recently saw a patient who denied any neurological symptoms and he later became very manic after taking only 2 doses of Lamisil. I later found out the patient was on Lithium and the Lamisil was discontinued.

Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net

RE: Instrument Sharpening Service (Bryant Tarr, DPM)
From: Hal Ornstein, DPM

We have used Bianco Brother Instruments for years to sharpen our instruments. They do a great job and are reasonable. The idea is to have a quality job done so you are not constantly sending the nippers in for sharpening. They can be reached at 718-680-4492 and 800-217-0817.

Hal Ornstein, DPM, Howell, NJ, toetoe@optonline.com

RE: Limb-Length Discrepancy in Biker (Steve Wolfington, DPM)
From: Doug Mason, DPM, Jennifer Barlow, DPM

When discussing limb-length problems, the first question that you need to answer is where is the length issue? Are the bones physically different lengths or is it a functional problem within the hips/lower back. If she has a true bone inequality, lifting the short leg could help. But if there is a tilting of the hip, that may be a lot harder to correct. There is a lot of stress that is put onto the lower back while riding. With that information, you really need to get an accurate discrepancy to add to the short side. I will usually "cheat" a little with regards to getting measurement.

Have the patient get a standing AP pelvis without shoes on. Use the top of the film as a reference point and measure the head of the femur as well as the iliac crest and compare each side. This method won't tell you if there is an actual bone length problem. If you want the true length, x-rays need to be taken of the entire limb and measured.

Doug Mason, DPM, Freeport, IL, dugdoc@excite.com

Dr. Wolfington’s patient doesn't have to have a women's specific frame, as long as her bike fits her. Another thought would be to put a mismatched crank set on the bike rather than a "custom" crankset.

Jennifer Barlow, DPM, Castro Valley, CA, jenbarlow36@yahoo.com

RE: Podiatrists Vs. Orthopods (Barry Mullen, DPM)
From: Michael M. Rosenblatt, DPM, Jon Purdy, DPM

While I certainly agree with Dr. Mullen, who insists that we cannot "control" what others say about us, we are also in a shared "battle" for the remaining patients who need and want foot and ankle care services. It requires more than "doing our very best" as physicians to accomplish our goals as patient care providers and advocates in our specialty.

There is an economic competition going on. Regretfully, a number of orthopedic competitors see us as an enemy, and are doing what they can to denigrate us politically and in every other way possible. These opposition campaigns are well financed and thought out. It takes a legislative and competitive presence to deal with this. "Good works" is not enough.

We are in a position where we must fight back, and this costs money and effort. It also requires unprecedented support of your APMA's legislative and political programs.

Michael M. Rosenblatt, DPM, San Jose, CA, ROSEY1@prodigy.net

Editor’s note: Dr. Purdy’s extended-length response can be read at: http://www.podiatrym.com/letters2.cfm?id=19043&start=1

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 – PART-TIME MARYLAND

Baltimore County, Maryland Practice seeking motivated and very personable individual with 2 years min. surgical training. Busy practice in great area with hospital grade ASC. Please fax your CV and contact information to: Dr. Maurice W. Aiken 410-602-9781.

PRACTICE FOR SALE- CORAL GABLES, MIAMI AREA (FLORIDA)

Beautiful location in the heart of Miracle Mile. Excellent opportunity for a starting practitioner. Most insurances accepted. Good mixture of surgical and general podiatry. Fully equipped with low overhead. Located in a professional building, with referrals from other doctors in the same building. Contact zoesar@aol.com or call 786-877-5149.

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. 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 -- www.homephysicians.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, Please fax a letter of interest, CV, and references to 850-862-5470, e-mail ecpodiatry@aol.com

ASSOCIATE POSITION – GREATER MILWAUKEE, WI

Great opportunity: our busy multi-physician, podiatric group practice, with multiple locations, strong hospital affiliations and faculty positions with PM&S-36 residency program, is seeking a full-time RRA BQ/BC, PM&S-36 surgically trained doctor. Applicant should be well trained in all aspects of surgical and conservative care. Candidate should be ethical, hard working and outgoing physician to join our practice. Commensurate pay with incentives and benefit package. Definitive plan leading to partnership tract. Contact: Daniel Hellman, M.D. @ 414.831.0512 or by e.mail @ hellmandr@gmail.com

ASSOCIATE POSITION – NW INDIANA (1 HR FROM CHICAGO)

Caring, hardworking podiatrist needed to join our busy practice. We offer great pay and benefits. Must be highly motivated, have a great bedside manner and superb surgical skills (forefoot and rearfoot surgical training a must). E-mail resume to friendlyfootcare@comcast.net or fax resume to (219)662-7290. Learn about here

PRACTICE FOR SALE – WESTERN WASHINGTON

Magnificent natural scenery in unique area of Washington state. Seller owns condo with ASC built for podiatry practice. The layout was designed to provide maximum efficiency for patient, doctor, and staff. Located within sight of hospital and medical community. Over 25 years established podiatric medical practice with potential to grow beyond $400K gross. 386 597-5766

ASSOCIATE POSITION- LOS ANGELES AREA

Dynamic well established practice in brand new office building with surgery center, adjacent to hospital, seeks energetic rearfoot and ankle trained associate with partnership aspirations. E-mail CV to dr4feet@sbcglobal.net.

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

SEEKING RESIDENT FOR PSR-24 - BALTIMORE, MD (MERCY MC)

Position for a highly motivated individual with completed non-surgical residency or one desiring additional surgical training in well-established Podiatric Residency Program. Busy metropolitan hospital with high surgical numbers and inpatient care. Resident is integral member of multidisciplinary team. Begins mid June 2008. Includes competitive salary/benefits. Send inquiries to rsher18@yahoo.com

---

WEEKLY SPECIAL - One week of ads (5x) for only $85

PM Classified Ads Reach over 10,800 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 10,800 DPM's. Write 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.