Gardeners Need Appropriate Shoes: IL Podiatrist

Many gardeners will experience foot pain this season as a result of overlooking the needs of their feet. But a few minutes of preparation and good common sense can keep gardeners comfortable all season. "Gardening is an exertive weight-bearing activity and should be considered a sport rather than a passive hobby," said Dr. Paul R. Kasdan, a board-certified podiatrist and medical director for OurHealthNetwork.com. "As with any sport, one should make sure to wear appropriate foot gear, and to properly stretch before engaging in the activity."

Dr. Paul R. Kasdan

During weight-bearing activities or sports, the feet play an important role in supporting weight, balancing stance to reduce falls, and movement. They also act as shock absorbers. Foot problems commonly associated with weight-bearing activities like gardening are usually due to wearing inappropriate footgear, or the lack of proper warm-up exercises.

"To always be pain-free, the feet must be encased in the proper shoes and socks. If the shoes do not provide proper support and cushioning, then the feet lose efficiency and problems eventually occur," Dr. Kasdan said.

PA Podiatrist Retires With "a Good Taste in His Mouth"

Dr. Gregory Spain retired on Wednesday after 23 years of practice in Somerset, PA. Spain grew up in Iowa and is a graduate of the University of Iowa and the Illinois College of Podiatric Medicine in Chicago. He did his surgical training at the Podiatry Hospital of Pittsburgh. Spain and his wife, Deborah, live in Unity Township. They have a daughter, Megan, 23, who works for the U.S. Department of Agriculture, and a son, Matthew, 18.

Dr. Gregory Spain

The Spains are moving to Naples, FL. He has a business partner franchise, which does promotional items. He does a lot of political campaign materials. “I’m leaving with a good taste in my mouth,” he said. “This is a nice profession; you help a lot of people. Students who want to go into medicine shouldn’t be deterred by the business aspect; you are doing good. I thank all the citizens of Somerset for all the good years you’ve given me. I’ll think of a lot of my patients when I leave.”

Source: Vicki Rock, Daily American [5/2/08]

Shortage of Doctors to Treat Aging Population: Report

Few physicians are pursuing a career in geriatrics, and as the number of older adults nearly doubles between 2000 and 2030, access to geriatricians is expected to be strained. A February report from the Government Accountability Office said there were 264,086 primary care physicians in 2005, or about one for every 1,111 Americans. Here are the IOM's numbers and projections for geriatricians:

..............................................................................2007.................................... 2030

Geriatricians ........................................................7,128................................... 7,750
Geriatricians per older adult .......................1 for every 2,546......... ........ 1 for every 4,254
Geriatric psychiatrists......................... ................ 1,596 ....................................1,659
Geriatric psychiatrists per older adult......... 1 for every 11,372 .................1 for every 20,195

Source: "Retooling for an Aging America: Building the Health Care Workforce," Institute of Medicine, April, 2008

Query: Rotary Bone Burrs

What are others using for removing small bone spurs on the toes and feet with a rotary hand piece? How do you prevent overheating of tissues? What other options are available other than a Shannon burr?

Marc Katz, DPM, Tampa, FL

Query: IPS / ME Everywhere

Has anyone had any experience with IPS Medical billing and integrated EMR software or MD Everywhere, Inc. We are considering a switch from our existing system and would like some feedback on these 2 companies.

Jeffrey Gewirtz, DPM, NY, NY

RE: Synvisc (Ivar E. Roth DPM, MPH)
From: Robert Colligan, DPM

Dr. George Vito, et al., wrote a short article in Podiatry Today concerning the use of Synvisc in an arthritic ankle, but also used in combination with arthrodiastasis (external fixation distraction). This was a limited study that had good results, but obviously needs more research. This served as a good "framework" upon which to open the invitation for further study. But I think this article would serve as a good resource to your question.

Robert Colligan, DPM, Norfolk, NE, rcolligan@MidwestHealthPartners.com

RE: Z-Coil Shoes (Michael Lawrence, DPM)
From: Robert Colligan, DPM

I have had several concerns regarding Z-coil shoes as well and I don't find much in regard to literature to praise or attack these shoes. My concern is that several people with heel pain have tried it and they have found varying amounts of success at least initially. But in the long run, this would lead to a contracted gastrocnemius/soleus, which would lead to a dependency upon wearing nothing but Z-coil shoes.

I see this similarly in farmers that spend their entire careers in cowboy boots with a moderate heel, and then they retire to live in the city and their wives make them wear tennis shoes and get rid of the boots. This is when they come in with plantar fasciitis and Achilles tendonitis, etc.

In my opinion, for certain pathologies such as a partial Achilles tendon strain for instance, it may be appropriate to wear a Z-coil shoe in some instances, but need to consider that wearing this long-term would defeat the purpose. I also tell patients that come in wearing these that I look at Z-coil shoes as something that they have to decide to either wear exclusively or to consider not wearing them at all.

Robert Colligan, DPM, Norfolk, NE, rcolligan@MidwestHealthPartners.com

RE: ACFAS Members Vote to Reject APMA Membership Requirement
From: Patrick J. Nunan, DPM

For many years, we as a profession have been seeking to define who we are and what we do. While we have some super surgeons who do nothing else but surgery, most of our members provide a full slate of podiatric medicine, orthopedics and surgery. Our goal is to have equal training for all podiatrists. With many of the projects we are getting closer to that goal and vision.

Why do we need to re-invent the wheel with a new "surgery" organization? We have another specialty college, the American College of Foot and Ankle Orthopedics and Medicine. Is it possible that they can add surgery to their title and mission? Can we not use them as the vehicle to unify the profession and finally realize that we provide the best comprehensive care of the foot and ankle?

Patrick J. Nunan, DPM, West Chester, OH, PJNDPMRUN@aol.com

ASSOCIATE WANTED - KNOXVILLE, TN AREA

Busy multi-doctor, multi office practice heavily weighted in surgery. PSR-24 + experience preferred. Part-time also available. Area consistently ranked in top five areas of country to live, work or retire. Ranked third in country 2008 Boaters magazine for boating destination. First year guarantee $150,000 plus bonuses and benefits. Send cover letter an c.v. to davidphawk@adelphia.net

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