The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

May 03, 2011 #4,150 Publisher-Barry Block, DPM, JD

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Australian Medical Association Attacks Medical Training of Podiatrists

The Australian Medical Association is resisting a push to allow non-medically trained podiatric surgeons to operate on feet, challenging their ability to provide quality care and claiming their very titles may mislead patients. AMA vice-president Steve Hambleton claimed patients could be misled into believing a podiatric surgeon was a medically-trained doctor, and podiatrists and podiatric surgeons lacked the wider knowledge that could prove vital for some patients. Many patients could have simultaneous medical conditions that podiatrists would be ill-equipped to handle. 

Andrew Schox

Perth podiatrist Andrew Schox, president of the Australasian Podiatry Council, said that, contrary to the AMA's claims, podiatric surgeons trained for a similar amount of time to orthopedic surgeons before qualifying, by which time they would have done an average of 3,000 foot operations. Mr. Schox rejected the claim that patients with other health problems might suffer, saying operations were done in consultation with a patient's GP or specialist. He rejected the AMA's claim that patients might be misled by the term "podiatric surgeon", saying "doctor" was a courtesy title used by vets and dentists as well as doctors.

Source: Adam Cresswell, The Australian, [5/2/11]

Barefoot Running a Fad at This Point: CA Podiatrist

Dr. William Gilbrech has a podiatry practice in Auburn. He has worked with ultra-runners and professional sports teams like the Seattle Seahawks and the former Seattle Sonics. Gilbrech said that he considers barefoot running to be more of a fad at this point. “Shoes do protect your feet and socks help absorb shock. It helps you to have a platform to reduce foot deformities,” Gilbrech said. 

Dr. William Gilbrech

“(Barefoot running) might be just a small part of your training, but I wouldn’t recommend it for 90 percent of your running,” according to Gilbrech.  Gilbrech also said that there really isn’t enough evidence to formulate any conclusions yet. Until that information becomes available, Gilbrech recommends that patients err on the side of caution.

Source: Sara Seyydin, Auburn Journal [4/28/11]

PA Podiatrist Appointed to Wound Healing Institute

Ohio Valley General Hospital has appointed Dr. Christopher J. Hajnosz, podiatrist at The Wound Healing Institute. Hajnosz graduated from the  Ohio College of Podiatric Medicine and completed his residencies at the Cleveland Clinic Foundation and Community Health Partners. 

Dr. Christopher J. Hajnosz

Dr. Hajnosz is board certified by the American Board of Podiatric Surgery and practices with the Greentree Foot And Ankle group.

Source: Pittsburgh Post Gazette [5/1/2011]

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky:  Why should one consider specializing in peripheral vascular disease? 

Dr. Earl Horowitz

Earl Horowitz: In general, one should look for something that people need no matter what it may be.  I feel very strongly about peripheral vascular disease because it is one of those pandemic things.  Peripheral vascular disease is becoming a forerunner because if you are going to find PVD, you are going to find cardiovascular disease, so you can help prevent an awful lot of patients from getting heart attacks. I think it is a wonderful niche to get involved with.  It does, however, require specialized equipment such as testing with plesthysmorgraphy and Dopplers.

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST).  This week's guest is to be announced . You can register for this event by clicking here

Complex Regional Pain Syndrome In Left Foot (New York)

Facts: On Jan. 4, 2007, plaintiff Susanne Burchell, 42, a retail store's floor manager, underwent a surgical procedure at a medical office in which a bone was removed from her left foot. The surgery was performed by defendant podiatrist. Burchell had first visited the defendant in late 2006, after complaining to her general practitioner of pain in her left foot. X-rays did not reveal any broken bones; an MRI showed tendonitis.

Burchell later claimed that the defendant, having concluded that Burchell's foot did contain an accessory navicular bone, recommended it be surgically removed. Burchell and defendant would later dispute whether x-rays of Burchell's foot revealed an extra bone. During the procedure, defendant removed...

Editor's note: The complete facts can be read here.

Result: Verdict-Plaintiff Award Total: $318,000

Plaintiff's Expert Witness: Myron Boxer, DPM, Woodmere, NY
Defendant's Expert Witness: Thomas DeLauro, DPM, New York, NY

Query: Sgarlato Snap Fixation Pin Substitute
 
For years, I have been using the Sgarlato Snap Fixation Pins, which are threaded K-wires for internal fixation for Austin bunionectomies.  I use the 20 mm length pins, which are buried. Sgarlato Labs has informed me that they are no longer available. I was wondering if anyone knows of a comparable product.

Mark H. Sugar, DPM, Hyattsville, MD

RE: Neuroma Injection Complication? (Ron Werter DPM)
From: Michael Forman, DPM, Arnold B. Wolf, DPM

I have had only one post-injection cellulitis (that I know of) in over forty years of practice. It occurred in a woman whom I was treating for a neuroma with local corticosteroid injections. I believe that Dr. Werter's patient did not develop an infection from the alcohol injection, but rather from a superficial seeding of bacteria from the skin. As a matter of fact, I believe alcohol injections have less of a chance of becoming infected than a corticosteroid injection.

This one episode in my practice changed my routine slightly. After scrubbing the injection site with alcohol, I then use a Betadine-soaked cotton tipped applicator on the site. So far so good.

Michael Forman, DPM, Cleveland, OH, im4man@aol.com

As a general rule, I always approach "bilateral neuroma pain" with an increased level of suspicion. If there is a "bilateral/symmetrical" neuropathy, we should be concerned about proximal etiologies for the nerve pain distribution...unless, of course, we have a confirmatory diagnosis (ultrasound, MRI, etc.) of defacto bilateral neuromas. Secondly, I maintain a concern with a "series approach" to alcohol injections to the intermetatarsal spaces. When we introduce what is essentially a strong base (chemically speaking) into the interspace, we must consider what possible "collateral damage" we may be doing to the surrounding tissues (interossei, lumbricales, joint capsule). If there is an adverse affect from the treatment, we should anticipate that possibility and subsequently be prepared to handle the new problem.

Arnold B. Wolf, DPM, Sterling Heights, MI, omnifootcare@prodigy.net

RE: Distal Hallux Nail Growing Into Distal Nail Edge (David Kahan, DPM)
From: David S. Chung, DPM

What has worked for my patients with the distal hallux nail growing into the distal skin is to have an artificial nail attached under the distal nail edge with super glue or a tape - to help guide the nail grow over the distal tuft. It may need to be replaced periodically. This does take several months, but has worked for my patients who did not want to go through surgery.

David S. Chung, DPM, Aloha, OR, icfeet57@yahoo.com

RE: TrakNet EMR (Laura R Lefkowitz, DPM)
From: Kevin Lam, DPM

As an avid EMR user for the past six years, here is my personal take on this. Background: I built my own network and servers when I started practice, and my other doc is also computer savvy. Surescripts the integrated ERX program takes forever to write an Rx, and cannot do refills for now. It went down on us once in the last five months, which killed our production. At times, it took forever to write an Rx, and the doctor currently has to find the pharmacy and put that information into the patient’s chart vs. the front desk being able to do this for the doctor.

Saving time? You have to do some major customization but it...

Editor's Note: Dr. Lam's extended-length letter can be read here.

RE: Duty to See Patients in Isolation (J M Cortez, DPM)
From: Brian Kashan, DPM

I find it appalling that a physician would think that he may pick and choose which patients' illnesses he will restrict from his practice. So many arguments came into my head when I read this post, I don’t know where to start!

First of all, if you choose to practice in a facility like a hospital, nursing home, or convalescent center,  whom do you think you are going to see? This is where sick patients are! Yes, they have diseases that are communicable. As a physicians, we swore an oath that didn’t have asterisks, parentheses, or exceptions to providing care. Maybe their diploma should read, “Practice Limited to the Healthy”. Did the thought ever come to mind that these people need our services more than anyone else!

If all physicians decided they wouldn’t treat patients with MRSA, HIV, TB, etc, who would treat them? What would have happened to the first patients with polio, rubella, leprosy, etc.? If a physician doesn’t want to treat these patients, my first suggestion is not to be on staff at these facilities. The second is to look in the mirror. And lastly, re-evaluate why you became a physician in the first place. Sorry for the tirade. I apologize if I offended anyone with my frank commentary.

Brian Kashan, DPM, Baltimore, MD, drbkas@att.net

RE: Amazing Charts (Dean Clement, DPM)
From: Michael L. Brody, DPM

Dr. Clement states, "For the simple act of efficient medical recordkeeping and hassle-free daily use (which is why we all want EMR in the first place, isn't it?), it's miles ahead of much more complicated and expensive programs."

I would like to point out that use of EMR is not for the purposes of efficient medical recordkeeping and hassle-free daily use. Obviously, it is something that we all want, but it is far from where we should want to be.

As a profession, we should be striving to have EHR - electronic health records. There is a world of difference between EMR and EHR. EMR is... 

Editor's note: Dr. Brody's extended-length letter can be read here.

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

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

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 - SOUTH/CENTRAL PENNSYLVANIA

PSR-24/36 trained individual for busy practice in family-friendly college town. Seeking personable, ethical, motivated individual to join our well established practice providing all aspects of podiatric care. Competitive salary and benefits package. Reply with letter, CV and photo to Jagerone@aol.com.

ASSOCIATE NEEDED - MIAMI, FL

Full-time. Very Busy practice. Rearfoot/forefoot/wound care. Salary + % gross. Send CV to footdoctorinmiam@aol.com

PART-TIME PODIATRIST NEEDED - LOS ANGELES, CALIFORNIA

Busy podiatrist looking for assistance with treating home-bound patients. Flexible hours, independence, and great compensation. If interested, email CV to homefootcare@hotmail.com

ASSOCIATE POSITION - TEXAS

Need a good paying job in San Antonio or Austin? Just ask the other podiatrists working with us. Good hours and great support staff. Consider us first! Check out www.footmobile.com and reply to footcenter1@sbcglobal.net

ASSOCIATE POSITION AVAILABLE - THE BRONX

Excellent hospital based opportunity. Inpatient & Outpatient Care. Busy clinics. Large diabetic population. Practice all aspects of Podiatric Medicine & Surgery. Requires Surgical Skills. CV to nealblitz@yahoo.com

ASSOCIATE POSITION – NEW JERSEY

Associate wanted full-time, for practice in East Orange NJ PSR 24-36 trained. Must be motivated to grow practice, especially build wound care and surgical services. Buy-in possible after the 1st year. send CV to Drfoot44@gmail.com

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