The Voice of Podiatrists

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May 03, 2008 #3,236 Editor-Barry Block, DPM, JD

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NC Podiatrist Provides Tips For New Runners

Dr. Doug Milch, an Asheville, NC podiatrist, said many new runners suffer from shin splints, an inflammation that occurs at the connection between the muscles and the shins, along with heel or arch pain, knee pain and stress fractures. Runners tend to have more injuries than walkers or swimmers or bikers, he said. “There’s more jarring with it.”

Dr. Doug Milch

Milch said people should not increase the intensity of their workouts more than 10 percent each week. This allows the body to adapt to the stress of running, he said. “The body is great,” he said. “We can really increase things if we sneak up on it gradually.” Milch also recommends running on a track, which usually is composed of a surface that gives more than pavement.

Milch said new runners should get properly fitted for running shoes at a specialty running store. Although these shoes may cost more, Milch said not wearing the right shoes can lead to shin splints, knee problems and stress fractures. Companies even make sneakers with more control designed specifically for heavier runners, Milch said.“Just starting, that’s an investment that people may not want to make, but it’s crucial,” he said.

Source: Nanci Bompey, Asheville Citizen Times, [4/29/08]

IN Podiatrist Helps Solve Crimes Via Shoes and Footprints

DNA, fibers, and fingerprints are some of the ways police catch criminals. Often overlooked is evidence you could literally be standing on – footprints. “A footprint can have ridge details, just like a fingerprint, but you can tell so much more, such as a person’s height or if he has a limp” says Crowne Point, IN podiatrist Dr. Michael Nirenberg.

Dr. Michael Nirenberg in his forensics lab

Dr. Nirenberg is one of only 10 forensic podiatrists in the United States. “You can identify a person by his shoes or his footprints.” One Dr. Nirenberg’s most famous cases was solving a double homicide in Idaho by studying the shoes of a suspect and matching them to th footprints left at the crime scene.

Source: Margaret Shortridge, Fox News [4/29/08]

Insurance Premiums Rose 10 Times Faster Than Income

Employer-sponsored health insurance premiums for family coverage increased more than 10 times faster than U.S. employees' median incomes from 2001 to 2005, according to a report released Tuesday by the Robert Wood Johnson Foundation, the Washington Post reports.

According to the report, monthly premiums for family coverage increased 34.6% from $1,921 in 2001 to $2,585 in 2005, while median family income rose 3.1% from $40,818 to $42,068 during the same period (Washington Post, 4/29). The report also found that the percentage of health insurance premiums covered by employees increased to 24.1% in 2005 from 23.2% in 2001 (Park, Arkansas Democrat-Gazette, 4/29).

In addition, the number of people with private coverage dropped by about 6% from 2001 to 2005, while the number of private-sector employers that offered health insurance declined by 0.8%, the report found (St. Paul Pioneer Press, 4/28). Premium increases contributed to 2.4 million fewer U.S. residents with private health coverage in 2005 than in 2001, according to the report.

Source: American Health Line (4/29/08]

Query: Synvisc

I have a 22 years old patient with mild subtalar joint arthritis that I would like to inject with Synvisc. What is the experience of others, and how many cc’s would be used?

Ivar E. Roth DPM, MPH, Newport Beach, CA

Query: Z-Coil Shoes

What do you know about the Z-Coil shoes?

I've had some patients say they love them initially and then not do so well with extended wear.

Michel Lawrence, Chattanooga, TN

Query: Locum Tenens

Where can I go to get information on coding locum tenens? I am also interested in the Medicare locum tenens rules (including billing).

Robin Hopkins, Watsonville, CA

Response: Your timing couldn't be any better! CMS has just updated these rules, as of April 4, 2008 (and effective May 5, 2008): Click here

This should get you going with what you're looking for!

Leslie Johnson, CPC , Fort Wayne, IN

RE: ACFAS Members Vote to Reject APMA Membership Requirement
From: Multiple Respondents

After reading the ongoing issues between ACFAS and its members, I’m with Dr. Boudreau. Let’s start a new “college” under APMA and support the organization that supports all of us as a profession. There are too few of us to create resentment amongst ourselves when we have much bigger battles to fight such as scope of practice issues, equal reimbursement from insurance companies and standardization in our schooling and training.

Until we get our act together as a profession from these standpoints, we will always be vulnerable and open to attacks from groups such as orthopods who are well organized and can eventually make all of this infighting irrelevant when we are left cutting toenails for cash!

Marco A. Vargas, DPM, Sugar Land, TX, drvargas@drvargas.com

Editor’s Note: An extended-length letter by Ken Malkin, DPM appears at: http://www.podiatrym.com/letters2.cfm?id=19289&start=1

RE: Scope of Practice Mixup
From: Michael Fine, DPM

A fifty year old male patient recently came into my office for his scheduled foot care. I asked him if anything was new since his last visit. He said that he just had his tonsils and adenoids removed. I inquired as to why this needed to be done. He informed me that he was suffering from sleep apnea and that his doctor wanted to make more room for his vulva that hangs down in the back of his throat! I didn’t ask him who his OB/GYN was.

Michael N. Fine, DPM, Kansas City, MO

ASSOCIATE WANTED- SOUTH JERSEY

Full scope group practice. Digital Xray, EMR, Diag U/S. PSR 24-36. Team player. Prefer individual with several years previous experience willing and able to provide quality palliative and surgical care. Competitive financial package. Email resume to skimom3015@aol.com

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