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Serving Over 11,000 Podiatrists Daily

April 21, 2009 #3,525 Publisher-Barry Block, DPM, JD

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Flip-Flops Can Cause Tendinitis: NY Podiatrist

The switch to summer footwear can result in "flip-flop tendinitis" and other foot problems, a U.S. podiatrist warns. Adapting to flip flops or sandals from closed shoes creates stress on the shin muscles as they try to balance the shoe on the foot, says Dr. Tzvi Bar-David of New York-Presbyterian Hospital in New York. He advises transitioning gradually and giving muscles a chance to adapt to avoid painful shins or tendinitis.

Dr. Tzvi Bar-David

After a long winter, there may also be a lot of enthusiasm for returning to the outdoors to exercise, but Bar-David advises taking time to get proper footwear and to stretch muscles. Sneakers should have a rigid heel counter and flexible ball of the foot. All shoes should have a comfortable toe box, be well padded, and have a cushioned sole. "Heel and arch pain can occur when starting to exercise without proper stretching," Bar-David says in a statement.

Bar-David encourages stretching calf muscles for several minutes every day as well as before exercising. "Stand two to three feet behind a counter or wall, placing your hands there," Bar-David says. "Keep your heels planted on the ground firmly and bring your body forward thus stretching the back of the calf. Hold for one minute and repeat several times."

Source: UPI [4/13/09]
 

Scholl Student Wins APMWA Student Writing Competition

Janson Holm, a fourth-year student at Des Moines University, College of Podiatric Medicine and Surgery has been named the winner of the 23nd Annual American Podiatric Medical Writers Association Student Writing Competition. His paper was entitled, "Thoughts on Performance and Improvement in Podiatric Education.”

Student Dr. Janson Holm

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

The award for Honorable Mention went to Tyler V. Jolley, a first-year podiatric student at Des Moines University for his paper “Do Not Cut Yourself Short."
 

Basic Structural Biomechanics Not Altered By Shoes: DC Podiatrist

Some researchers suggest that running shoes actually cause the very injuries they're supposed to prevent. That idea has been out there for more than a decade, but it's gaining force, thanks to the work of Daniel Lieberman, a professor of anthropology at Harvard University who has been studying the biomechanics of the foot and the evolution of human running. Before the invention of the modern running shoe, runners couldn't land on their heels -- it was simply too painful. Doing so in today's shoes leads to excessive foot rolling, known as overpronation.

Dr. Stephen Pribut

Shoe companies and podiatrists will explain the need for specially designed shoes by going on and on about the constant pounding on the foot and the benefits of support and cushion. "We're not all built the same way, so for certain feet, a guidance system can be very beneficial," says Washington, D.C.-based Dr. Stephen Pribut, a former president of the American Academy of Podiatric Sports Medicine and a member of the board of advisers for Runner's World magazine. "Basic structural biomechanics will not be altered by shoes."

Source: Christopher McDougall, Boston Globe [4/19/09]
 

Physician Pay Could Drop 6.8% Under National Public Health Plan: Report

Physicians and hospitals would see their overall income reduced if a public health plan such as the one proposed by President Obama were expanded to all employers and paid at Medicare levels, even after adjusting for new patients and reduced uncompensated care, according to a new report.

Obama's proposal for a national public health plan to compete with private plans has not been laid out in detail by the president or lawmakers. But the report by the Lewin Group -- a healthcare consultant -- estimates that physician net annual income would drop by $33 billion, or 6.8%. Losses would shrink or disappear if enrollment were restricted to small employers, individuals and the self-employed -- as Obama has proposed.

Source: AMNews [4/13/09]

Query: Podiatric Billing Classes

I'm trying to find any future dates for podiatry billing classes offered alone or during conferences. Any information would be appreciated.

Sandra Trevino

RE: Inexpensive Wood’s Light
From: Larry Aronberg, DPM

For those who have wanted a Wood's light, but postponed getting it because of its expense or size, Photon Light sells an ultraviolet microflashlight which seems to work perfectly for the task. The wavelength is off about 5 nm from most Wood's lights, but I've got excellent fluorescence from inspected digits.

Photon-1 UV Light

Shipped, it cost less than $20. I purchased the Photon 1 model (photonlight.com/UV-Ultraviolet-LED-Lights-Specialty-LED-Lights-p/uv-ultraviolet-led-blacklight.htm).

Disclaimer: I have no connection of any sort with the company.
 
Larry Aronberg, DPM, Lake Worth, FL, lwp01@bellsouth.net

RE: Chronic Achilles Tendinitis (Alan Mauser, DPM)
From: Multiple Respondents

I have had significant success with this chronic condition utilizing trigger point radial ESWT with the EMS Swiss Dolorclast unit. This technique requires three to five treatments one week apart with no anesthesia. I combine this with a spray (ethyl chloride) and stretch the tendon immediately after each treatment, along with using Kinesio taping. Since this technology is non-invasive, there is no disability or post-treatment pain.

Howard A. Penn, DPM, Buffalo, NY, footdoc87@msn.com

I have excellent results with a combination of prolotherapy and MicroVas therapy. I would certainly try this before surgical intervention.
 
Bob Kornfeld, DPM, Lake Success, NY, Holfoot153@aol.com

I have been successfully using TOPAZ for >4 years and have accrued 45-50 or so Achilles cases. I have been in practice 18 years and was trained old school. I haven't had to fall back on any alternative procedures (FDL transfer, debulking, GraftJacket, allograft, etc.) during this time. I have applied Topaz coblation to the most severely diseased Achilles tendons and have been extremely happy with the results so far. I have treated insertional Achilles tendinopathy in maybe 10 cases and had only one non-responder over the last 10 months. Almost all cases are done percutaneously. 
 
S. Jeffrey Siegel, DPM, Philadelphia, PA, heeldoc@verizon.net
 

RE: Recalcitrant Shear Tyloma (Pat Evoy, DPM)
From: Elliot Udell, DPM

One orthotic product that I have gotten consistent results with in the treatment of tylomata beneath the met heads is called the Balanced Inlay. It is only made by Bergmann Orthotic Labs in Northfield, Illinois. It is completely hand-made and the areas of excessive pressure are balanced out in the cast. The doctor receives the actual plaster moulds back along with the orthotics.

I have found this particular orthotic to be the only one that is really effective in eliminating IPK's and tylomata caused by excessive pressure and shearing located beneath the met heads. The only caveat to this is that you have to take a plaster cast with the patient lying in the supine position and prior to casting, you have to use a special marker provided by the lab in order to outline the lesion. This mark transfers onto the plaster. The lab can then balance the final plaster mould and create an actual balanced orthotic for the patient. Since these orthotics are totally hand-made and highly customized, no two will appear the same. 

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.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 

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

ASSOCIATE POSITION AVAILABLE-MIDTOWN MANHATTAN

Looking for Full-time associate to work in well established practices in midtown Manhattan and Forest Hills. Immediate opening for PSR 24-36 surgically trained Podiatrist. Great opportunity with competitive salary along with malpractice benefits. Please send CV to slurie@papapc.net

NEED EXTRA INCOME? IMMEDIATE OPENING FOR A PER-DIEM DPM

Our practice continues to grow and we’re in need of a well-trained DPM who is great with patients. Our multi-office practice is located in the scenic Hudson Valley region of upstate NY. This is a great opportunity to grow with our practice and provides unlimited income potential. Reply to: Hudson Valley Foot Associates, PO Box 3300, Kingston, NY 12402-3300; or email CV and cover letter to: jobs@hvfa.com

ASSOCIATE POSITION - CENTRAL VIRGINIA

Join a solo surgeon in a two office private practice, modern facilities with EMR and digital x-ray, reconstructive and trauma surgery.  Excellent starting salary and benefits. Position leads to partnership. Submit letter of introduction and CV to jdisabato@vfasa.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 - ILLINOIS
 
Podiatrist needed to provide care for elderly population in Long-Term Care and Assisted Living Facilities. Must be ethical, hard-working, interested in geriatric care and willing to travel. e-mail resume to poddoc2328@hotmail.com

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

 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 

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