The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

May 11, 2010 #3,854 Publisher-Barry Block, DPM, JD

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Barefoot Running - Not For Most People: WA Podiatrist

Larry Maurer, a Kirkland, WA, podiatrist and running specialist who has done research for the running-shoe company Brooks, has mixed feelings about barefooting. "If you can run without shoes, I think you should," he says. "I just don't think there are very many people who are in that category."

Dr. Larry Maurer

Most people simply aren't born to run. "You've got the people who are resilient and super durable, and nothing's going to stop them," he says. But "some people aren't durable. Some people aren't conditioned. Some people have mechanical issues." There's overpronation, flat feet, you name it.

Source: Maureen O'Hagan, Seattle Times [5/9/10]

PA Podiatrist Appointed to State Board

Dr. Richard DiBacco was recently appointed to the Pennsylvania State Board of Podiatric Medicine by Pennsylvania Governor, Edward Rendell. Governor Rendell recognized Dr. DiBacco's vast experience and expertise in Podiatric Medicine and Surgery to assist in adjudicating and implementing policies governing the practice of Podiatric Medicine in Pennsylvania. DiBacco serves on the boarf of the Ohio College of Podiatric Medicine.

Dr. Richard DiBacco

Pennsylvania Senator Jane Earll supported his appointment stating that, "Dr. DiBacco has been involved in every hospital in Northwest Pennsylvania, either teaching or performing surgery. He has brought the latest techniques to the patients of the area, and has served as a resource for other practitioners."

Source: Footsteps (OCPM) [Mar/Apr 2010]

VA Podiatrist Publishes Book on Healthy Living

Dr. Myles Schneider has written a new book titled To Be Or Not To Be Healthy. His book discusses the choices that individuals can make to lead ourselves into a healthy lifestyle. Schneider, who practices in Annandale, VA is a 1969 graduate of the Ohio College of Podiatric Medicine.

Dr. Myles Schneider

Schneider writes, "One of the biggest things that changed was my understanding of what true health really means. Despite a lifetime immersion in the medical field (my father was a family doctor, my mother was a dietician, and I have been a podiatrist for nearly four decades), it turned out that I was quite ignorant about the real definitions of health and wellness. I did not realize just how much power and control each of us has over our physical health - both our current and future health."

Source: Footsteps (OCPM) [Mar/Apr 2010]

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

Bret Ribotsky: Do podiatrists want a degree change, and is this goal achievable?

Dr. Tilden Sokoloff

Tilden Sokoloff: I think the reality is that if you took the temperature of the average podiatric physician in this country, they feel the need and really want a degree change. There is zero leadership within our profession other than the consistency of Barry Block who keeps that issue on the front burner. I keep writing articles and producing vehicles that will allow this to occur with credibility. Yes, there are some hoops to be jumped through. Is it a solution? Absolutely. Am I passionate about it and is it something that is achievable?  Absolutely. I think that every podiatrist down deep wants to understand how we can accomplish that.

Dr. Jeffrey Robbins

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's show features Jeffrey M. Robbins, DPM, the Director of Podiatry Services for the Veterans Health Administration . You can register for this event by clicking here

Add Assertiveness to Your Game Plan

Exert more influence by speaking with polite forcefulness. Here are some ways to deliver your message powerfully:

•  Speak your piece. Don’t allow interrupters to derail you. Say, “Kindly let me finish” or “Please hold that thought.”
•  Own your opinions. When you offer feedback, saying, “I think” or “I feel” is a good strategy for minimizing defensiveness. Yet, when you preface every opinion with, “I think” or “I feel,” you can sound weak and easy to dismiss. To sound sure of yourself, replace, “I  think that is a good idea,” with a firm statement like, “That is a good idea.”
•  Watch your language. If you speak in an active voice rather than a passive voice, your listeners will know exactly what you mean. Gain their trust by saying, “I will finish that by noon” rather than, “That will be done by noon.”

Caution: Speak in an even voice tone. If you end with an upward intonation, you will seem hesitant or unsure.

Source: Adapted from “Family Balance,” Working Mother via Communication Breifings

Query:  A2D2 DR Digital X-Ray Unit

Does anyone have experience with the A2D2 DR digital x-ray unit? How does it interface well with Traknet?
 
Mario Dickens, DPM, Chattanooga, TN

RE: Post-Traumatic Pain in the Interspaces (Gregory Teles, DPM)
From: Multiple Respondents

I would send your patient for a pain management or neurology consult. It sounds like she has CRPS (RSD).

Ken Meisler, DPM, NY, NY,  kenmeisler@aol.com

This situation could be the result of compartment syndrome after a crush injury. It is too late to decompress the foot and you now must deal with the sequelae. You need to rule out CRPS by checking for allodynia or vasomotor changes. An MRI with contrast might help to evaluate if there is muscle atrophy secondary to increase compartment pressure damage or neuromata secondary to the injury. The symptoms sound neurogenic, therefore test the interspaces for hypoesthesia. If you diagnose nerve injury and there is no CRPS, you might consider alcohol neurolysis or radiofrequency ablation of the involved nerves. This case requires more thinking and not surgery.
 
Martin M. Pressman, DPM, New Haven, CT, mpress4@optonline.net

The symptoms  which include burning, tingling, shooting pains, occasional twitching of the foot and sensitivity to pressure and cold, calls for the inclusion of complex regional pain syndrome in the differential diagnosis. The presence of twitching is cause for alarm. It might mean that the condition is already affecting the motor nerves and there might be muscle deterioration. Has the patient been tested for loss of muscle strength in the office? This can be done by comparing the strength of the pedal dorsi and plantar flexors as well as the abductors and adductors. Another symptom to be aware of is clinical depression. The nerves affected, synapse in the part of the brain also governs emotions. Dr. Hooshmand, who wrote the definitive text on CRPS, has often written that clinical depression is a hallmark of this condition.

The fact that the patient does not respond to NSAIDs or steroids is also suggestive of CRPS since it is a neuropathy. You might try gabapentin or Lyrica. Gabapentin allows you to gradually raise the dosage levels to higher levels than you can with Lyrica. Antidepressants are also effective and trazadone might really help. Irrespective if the patient wants surgical intervention or not, if you are dealing with CRPS, it's best to be as least invasive as possible. Physical medicine such as interferential therapy, H-wave, the Dynatronics STS, and several other modalities, in addition to the above-mentioned pharmaceuticals, might help this patient.

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

RE: Drop Foot  (Chuck Ross, DPM)
From: Josh White, DPM

Patients with flaccid drop foot and no frontal plane instability often do well with a Peromax carbon graphite ankle foot orthosis. This L1951 AFO is only 3 mm thick, fits easily into shoes, and is extremely light-weight. When frontal plane instability is present, the dynamic device by Ossur is better. It features a shin piece that assists in side-to-side stability. It may be billed as L1932. When there is also the need to control arch morphology, AZ or Richie-type custom devices can be considered.

DPMs would be wise to look for drop foot in patients with a history of knee replacement, as it is my understanding that some measure of common peroneal injury occurs in approximately 20% of patients having the procedure. Frequently, these patients (and their doctors) are missing an opportunity to improve mobility, reduce the likelihood of falls, and improve quality of life.

Josh White, DPM, CPed, Maplewood, NJ, joshwhite@safestep.net

RE: NY Podiatrist Provides Pedicure Safety Tips (Jay D. Helman, DPM)
From: Robert Spalding, DPM

I noticed two pedicure statements by two podiatrists in the last two issues of PM News regarding "cuticles." Dr. Youner says, "not to cut cuticles" and Dr. Helman was wise to add a comment, "not to push back cuticles." Both pods are technically correct.
 
I have been looking critically at the salon industry for 12 years and have...

Editor's note: Dr. Spalding's Extended-length letter can be read here.

RE: More Bad News About Flip-Flops
From: Steve Gershman, DPM

Flip-flops cause not just foot pain but can cause whiplash and auto damage! On the way in to work last week, an assistant in our office was involved in an auto accident. She is okay other than the rear-end damage to her car and a sore neck (whiplash).

She was stopped at a light when a car behind hers rammed her. The woman driving the auto that hit her claimed that her flip-flops caught the gas pedal when she tried to hit the brake. So, the moral is-flip-flops cause our auto insurance rates to go up and can injure necks and rear-ends.    

Steve Gershman, DPM, Auburn ME

SEEKING EMPLOYMENT - SOUTH FLORIDA

Board Certified Foot Surgeon. Had own practice in Texas for twenty years. E-mail:  ehe2852341@yahoo.com

ASSOCIATE POSITION - MINEOLA, NEW YORK 
 
Full-time or Part-time associate position with future partnership potential available with busy multi-office practices on Long Island. Must be proficient in all phases of podiatry with emphasis on surgery, biomechanics and RFC. Minimum standards include either a three-year PSR, or board qualified/certified status with ABPS. Existing hospital privileges with a NY-based facility helpful. Interested doctors are encouraged to e-mail their CV to mets724@gmail.com

ASSOCIATE POSITION - MARYLAND

Podiatrist needed for Maryland practice. Fax resume to 410-749-6807.

ASSOCIATE POSITION – GREATER MILWAUKEE, WI

Great opportunity: our busy multi-physician, podiatric group practice, with multiple locations, strong hospital based affiliations and clinical appointments, with teaching faculty positions at PM&S-36 residency programs, is seeking a full-time RRA BQ/BC, PM&S-36 surgically trained doctor. Position will be available for July/August, 2010. Applicant should be well trained in all aspects of conservative care and surgical forefoot, rearfoot, reconstructive surgery, trauma, wound care and limb salvage. Candidate should be ethical, hard working, outgoing and a self-starter. Commensurate pay, income guarantee, with incentives and full benefit package. Definitive plans will be discussed leading to partnership tract. Contact: Daniel Hellman, M.D. @ 414.831.0512 or by e.mail @ hellmandr@gmail.com

LOOKING TO PURCHASE PRACTICE IN FLORIDA

Experienced, surgically trained, very successful FL licensed podiatrist currently practicing out of state looking to purchase successful full time practice in Florida to relocate for family reasons. I have been in practice for over 10 years and am fluent in English/Spanish. Serious inquiries only. Please send email to faajobs@gmail.com.

ASSOCIATE POSITION -  NAPLES, FLORIDA  
Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office, multi-doctor practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. We rotate for ER call at all 4 hospitals. Candidate needs to be ethical and motivated. Established practitioner or new practitioner OK. Salary and percentage based on skills and experience, benefits including 401K. Current Florida license a plus. This a wonderful world class community. Fax CV to (239)566-8778 or Email CV to Drgordon@gulfcoastfootcare.com

CANADIAN PODIATRISTS COME BACK HOME!

An Edmonton, Alberta group of DPM’s requires an additional Podiatrist. Interest in biomechanics essential. Given Canadian visa restrictions, this position is open only to Canadian Citizens or permanent residents. Very attractive compensation package. Fax C.V. or letter of interest to: (780) 483-5796.

ASSOCIATE POSITION – NEW YORK 
 
Great Opportunity  NY podiatric practice – multiple locations – seeks well-trained, ethical DPM per diem and full-time positions available. Competitive salary. Send resume and CV to: info@advancedfootcare.org

ASSOCIATE POSITION - LAS VEGAS, DALLAS, HOUSTON, AND SAN ANTONIO AREAS

Seeking well trained ABPS board rearfoot/ankle certified/qualified foot surgeons for surgical practice with national foot/hand/orthopedic surgery group. Excellent salary/benefits. Email CV and cover letter to: slb99@pdq.net

TRAUMA FELLOWSHIP - FOOT & ANKLE

Broadlawns Medical Center in Des Moines, IA is currently accepting applications for its 12 month trauma surgery fellowship beginning August 1, 2010. Fellowship to include advanced techniques in all foot and ankle surgery with an emphasis on lower extremity trauma, reconstruction & total joint replacement. Residency training required. Competitive salary and benefits. Please submit a letter of interest, CV, and 3 letters of recommendation to: Ben Olsen, DPM, Director: Foot and Ankle Trauma Fellowship, Broadlawns Medical Center, 1801 Hickman Road Des Moines, IA 50314, 515-282-7927, bolsen@broadlawns.org

POSITION WANTED - SOUTH FLORIDA  (BROWARD OR PALM BEACH COUNTY)

Board Certified, Experienced Podiatrist available for per diem work, nursing home, house calls, locum tenens. Reference available. Please reply to soflpod@aol.com

PRACTICE & BUILDING FOR SALE - MIDDLE TENNESSEE

Two locations each with 3 exam rooms, x-ray room, large waiting room, and ample parking. Excellent locations and growth potential. All equipment and furniture included. Website and marketing material included. Seller happy to assist with transition. Grossed 350K last year, priced to sell with financing available 200k. Call 931-446-5724.

ASSOCIATE POSITION NORTH CAROLINA - ASHEVILLE/MOUNTAINS

Well established, multi-doctor, multi-office diverse practice has immediate need for associate doctor leading to partnership. Associate doctor will be very busy from day one. Attractive compensation and benefits. Buy-in potential after one year. Contact at smfc2@charterinternet.com or 828-734-1535

PM News Classified Ads Reach over 12,000 DPM's and Students

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