The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

May 13, 2009 #3,544 Publisher-Barry Block, DPM, JD

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NC Podiatrist Debunks “Foot Detoxification”

Some claim it eases chronic pain, prevents disease, and promotes a healthy body balance. Others insist it's just a way to drain your wallet.  "Foot detoxification is certainly a way to help rid the body of a lot of unwanted toxins [from] the things we eat and the environment we live in," says Liz Marsh of Kea Lani Foot Detox Hut. She runs a low level electrical charge through a salt water foot bath. Marsh says it stimulates the release of toxins through the pores on the soles.

Dr. Richard Sikora

But foot experts aren't convinced the foot bath works. "Yeah, your feet feel better, but is it really something from detoxifying agent?" asks podiatrist Richard Sikora. "Something is drawing something out? It's pretty unlikely." For him, there's no mystery about what comes out of feet. "Our sweat," he says. "There may be some natural oils that are occurring, but nothing as far as mucus or serum or blood products or anything like that."

But what about those who really feel a foot detox difference? "It has just been proven to work well for myself, on my family members and as well as the feedback that I get from my clients," says Marsh. "That probably is a placebo effect," counters Dr. Sikora. "About 20 percent of people who are given something and told that this is gonna make you feel better, will probably come back and say 'I feel better.'" Marsh acknowledges the treatment is no cure, and it needs time to catch on. But don't expect Dr. Sikora to write prescriptions for it anytime soon.

Source: Julia Bagg, WFMY News 2 [5/6/09]
 

PA Podiatrist Discusses When it’s Prudent to Drop Out of a Race

It's not exactly inspirational to hear this the day before the race, but it's important for a runner to know when it's prudent to drop out. Ron Ferguson, Jr., a Forest Hills podiatrist and avid runner, is a veteran of almost two dozen marathons. He has a PR of 2:45.53 [Boston 1981]. He knows feet. There's a lot he can say about keeping them in great shape but he's also familiar with the myriad of problems that can arise.  "I've dropped out of one marathon, and should have dropped out of another," he said. Here are his thoughts on knowing when it's smart to call it a day.

Dr. Ron Ferguson, Jr.

"The first thought that occurs to me is that many runners have a 'tough-guy' mentality that they must finish a race at all costs, and that it is a disgrace or shameful to drop out.  In my opinion, nothing could be further from the truth.  It can take a lot of courage to drop out of the race when family, friends, and co-workers are looking forward to learning how you finished.  That said, there are many reasons that either an experienced or a novice runner should consider dropping out of a marathon.” 

"As a general rule-of-thumb, if a previously healthy runner develops a sudden, sharp, severe, unrelenting musculoskeletal pain that increases with every step, then the runner is best served by dropping out.”

Source: Maria Sciullo, Pittsburgh Post-Gazette [5/2/09]
 

DMU's First Foot and Ankle Surgery Symposium a Success

More than 160 podiatric physicians and students attended the first-ever Foot and Ankle Surgery Symposium, May 1-2, hosted by Des Moines University's College of Podiatric Medicine and Surgery. Held on the DMU campus, the symposium offered 13.5 hours of continuing medical education.

(L-R) front row - symposium co-chairs Drs. Collin Pehde and Michael Lee, Jill Frerichs, Alan Catanzariti, and Glenn Weinraub, back row: Don Buddecke, Shannon Rush, Jordan Grossman, Eric Barp, Chris Hyer, and R. Tim Yoho.

Topics included the first ray, PTTD revisited, difficult trauma, considerations in Charcot/limb salvage, injuries in the athlete and complex reconstruction.

Query: Diabetic Ulcer Sub-met 3

This is a fragile diabetic patient that has had multiple surgeries on her right 3rd metatarsal. The head was ultimately removed and she did well for several years. She now has a crevice in her foot sub-met 3,  and is starting to break down sub-met 4 as well.

Ulcer Sub Met 3

Any thoughts on how to proceed with this patient would be appreciated. She cannot afford to be out of work for an extended period of time.

Ulcer Sub-Met 3

Rick Burnell, DPM, Camden, SC

Query: Coding a Brace Adjustment

Is there a code for in-office repair/adjustment for orthotics or a brace?

David Sands, DPM, Great Neck, NY

Response: L4205 is repair of orthotic device, labor component, per 15 minutes.

L4210 is repair of othotic device, repair or replace minor parts.

Mark Schilansky, DPM, Catskill, NY

Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm

RE: DVT Risk in Podiatric Surgery? (Lee C. Rogers, DPM)
From: Multiple Respondents

I would wholeheartedly agree with Dr. Rogers' assesment. It is erroneus of the authors to generalize their analysis to "podiatric surgery" when it is clearly only looking at forefoot procedures or injections. For an in depth review, I would refer readers to the April/May 2009 issue of Podiatry Management where I summarized the same topic.

Although routine prophylaxis against VTE in foot and ankle surgery (especially procedures limited to the forefoot) is not indicated based on previous literature - there are certain subsets of patients who require consideration.

Adam Budny, DPM, Altoona, PA,  abudnydpm@gmail.com

I would like to take this opportunity and applaud Dr. Lee C. Rogers for his careful review and  critical evaluation of the article by Felcher, et. al. in Chest. Reading journals is simply not enough.  We must also look at these publications critically. This a perfect example of just that.

Gerald Mauriello, Jr., DPM, MA, Philadelphia, PA, drmauriello@gmail.com

In the hospital OR where I work, we usually only take DVT precautions for general anesthesia cases, especially longer cases and/or where paralytic agents are used as these greatly increase the risk of DVT. Most podiatric cases that we see are indeed forefoot cases done under local, local plus a bit of IV conscious sedation, or MAC (monitored anesthesia care) which does not involve paralytics. We therefore, generally do not take DVT precautions for these cases.

Paul Busman, DPM, RN, Clifton Park, NY, brewerpaul@aol.com

RE: Venous Stasis Hyperpigmentation (Elliot Udell, DPM)
From: Hal Ornstein, DPM

We have had great results for years using Amerigel® Care Lotion with Oakin® which resolves hyperpigmentation. Micronized ingredients found in the Amerigel Care Lotion assist in penetrating through the layers of the skin, addressing the condition subdermally, not just topically. Oakin® & Zinc Oxide accelerate the breakdown of the iron deposits. Trapped iron deposits caused from trauma and vascular insufficiency are broken down, allowing the body to reabsorb the minute iron fragments while exfoliating the remaining fragments trapped in the epidermal layer of the skin. This lotion is free from steroids, dyes, and fragrances. 

Protocol: Apply Amerigel® Care Lotion to the affected area(s) twice daily. For best results, apply immediately after showering or bathing. Changes will be seen after several weeks of application.   

Disclaimer – Amerigel is a corporate sponsor for the American Academy of Podiatric Practice Management for which I serve as Chairman. I am not a paid speaker or consultant for this company.

Hal Ornstein, DPM, Howell, NJ, toetoe@optonline.net

RE: Automated Appointment Reminder (Timothy B. Maclin, DPM)
From: Jason Gross MHA

Prior to using an automated service, we had been calling our patients ourselves, which helped us avoid no-shows, but was both laborious and costly because of the long distance fees when calling patients for our satellite locations. Like Dr. Maclin, we were concerned about how our patients would receive the automated system since they had grown accustomed to our staff making the calls. While there was a slight adjustment period, our patients have ultimately had no problem with the new system. 

ClientTell is the company we use. Since their clients range from not only small practices like ours, but many large teaching hospitals, they offer many robust and useful tools that make the process user-friendly for the patient and functional for the practice. I did a much more in-depth analysis before we began but, to make a long story short, we were able maintain our patient schedule, save money, and contribute to employee retention. For us, it was a good move.

Disclaimer: I have no financial relationship with ClientTell.

Jason Gross, MHA Practice Administrator, Forest City, NC, jgross@footandanklenc.com.

BIOMECHANICS FELLOWSHIP – NEW YORK CITY

Neoteric Biomechanics 3-6 Month Fellowship: At The Foot Typing Center in New York City. Practice, Research, Publish and Credentialize Yourself In This New Paradigm. $1,000 a Week Stipend. New York License Required. Fax Interest to: 212 288 3034 or apply to Dr. Shavelson @ 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

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 – TUCSON, ARIZONA

Full-time position which involves all phases of podiatry. Compensation based on training and experience. Must have current Arizona podiatry license. Send Resume to Transcription697@aol.com

PODIATRISTS NEEDED – DALLAS/ FT WORTH – TEXAS AREA

Texas Home Footcare Associates, a podiatry exclusive company specializing in house calls and visits to facilities for the elderly, is looking to hire podiatrists. We are located in the Dallas area. Full and part-time positions are available. Immediate Openings Available. Must have a Current Texas license. Competitive Compensation Package. If interested fax curriculum vitae to 972 931-4819 or e-mail gjmdpm@tx.rr.com. For further information, call 972-380-8028.

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                            

ASSOCIATE POSITION - HENDERSON, NEVADA

Associate wanted for thriving, well-mixed 3-doctor digital office, leading to partnership. Surgery, diabetic, pediatric, and general podiatry. Great office and location, fun area to live. Need 2+ years surgical residency. Must be energetic, self motivated, great patient skills. Salary plus bonuses. Email CV to gtorgesen@yahoo.com

ASSOCIATE WANTED - FLORIDA

Associate needed for a dynamic multi-doctor practice in the Tampa Bay area. Partnership opportunity for the right candidate. Preference given to a PSR 24+ resident completing their education this spring/summer, and must have a Florida license. Well-established practice, high tech with EMR and digital x-rays, with specialties in sports medicine, surgery and wound care. No nursing homes or HMO's. Excellent hospital privileges available. Choose an area of practice concentration that you are passionate about and enjoy a lifestyle for yourself and your family that is second to none. E-mail: kimvelez@tampabay.rr.com

OFFICE SPACE/ MRI RENTAL – NYC, LI   
 
Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, and Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITION – ILLINOIS 
 
Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings available. If interested, fax curriculum vitae to 312 225-9366 or e-mail feetwork@aol.com

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