The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

June 01, 2007 #2,950 Editor-Barry Block, DPM, JD

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IL Podiatrist Discusses Causes and Prevention of Foot Odor

Products such as Odor-Eaters contain activated charcoal to help absorb perspiration. But Dr. Godfrey Viegas, a podiatrist at the Crystal Lake Foot and Ankle Center, said any type of spray deodorant will do.

Dr. Godfrey Viegas

“It’s the presence of the break down products caused by bacteria that produces foot odor,” said Viegas, a member of the Illinois Podiatric Medical Association. “You cannot get rid of these bacteria. The best thing is to use antiperspirants. You reduce the quantity of the sweat significantly.”

Viegas said a person should also be on the lookout for athlete’s feet, another source of foot odor. A good indicator of athlete’s feet is a dry, scaly appearance accompanied by a foul smell. And there’s always the option of committing the ultimate fashion faux pas – socks with sandals. Hey, at least your feet will be dry. But Viegas said it’s tough to resist temptation this time of year to let our feet breath the open air.

Source: Geneva White, Kane County Chronicle [5/28/07]

Accused CA Podiatrist Allowed to See Patients With Chaperone

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A Fresno judge is now allowing a local podiatrist to once again see female patients. Doctor Matthew Sciaroni was in court on Tuesday. The foot doctor is accused of molesting several female patients while examining them in his Fresno office.

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Dr. Matthew Sciaroni

The judge appointed a registered nurse to chaperone the doctor during female exams. Sciaroni will be back in court in July for his trial.

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Source: ABC TV-30 [5/29/07]

Major Physician Group Posts Fees Online

California's largest private physician practice has become one of the first doctor groups in the nation, and almost certainly the largest, to make prices for its medical procedures widely available to consumers. http://www.healthcarepartners.com/patients/basicservicefee.asp

The move by Torrance-based HealthCare Partners Medical Group, which serves more than 500,000 patients, puts a significant crack in the ages-old reluctance by doctors and other medical providers to let consumers comparison shop for services such as chest X-rays, baby vaccinations and Pap smears.

HealthCare Partners quietly posted on its website last week prices for 58 common procedures. Patients can go on the group's website and find that a chest X-ray runs $61 and that a physical examination for a middle-aged patient ranges from $140 to $160. Flu vaccinations are listed at $15, although HealthCare Partners notes that it adds a $31 administrative fee for the first vaccination and $18 for each additional shot on the same visit.

Source: Lisa Girion, Los Angeles Times [5/28/07] ]

Query: Women's 12 ½ Narrow Shoes

I have a female patient who wears size 12 1/2 narrow shoes. She has a difficult time finding any shoes that fit, both dress and athletic. Are there companies that make this size? And where do we find them?

Bonnie Tatar, DPM, Pittsburgh, PA

RE: Archiving Records (Marybeth Crane, DPM)
From: Multiple Respondents

I switched to an EHR 12 months ago and realized that scanning seven years of patient records is a lot of time and $$ for questionable gain. As the records got older I found myself pulling less and less charts. I did have the previous 12 months on my Microsoft word that I placed into a "template folder" on my desktop and could retrieve easily which made things go a bit more smoothly, but I still would not have scanned those old records. In hindsight, scanning old records is tough enough and then retrieving them in the system is also tedious and frankly I think you'll be disappointed after all that effort.

I would suggest leaving the charts in place and when an "old" patient presents pull the chart and you can then scan what you want from the old record into the EHR. Once they are in the EHR you'll go with what you have. As each year goes by you can get rid of more and more of the old charts that are more than 7 years old until you no longer have any remaining and you'll be "paperless."

James J DiResta, DPM, MPH, Newburyport, MA, James.J.DiResta.DMS04@Alum.Dartmouth.ORG

I am in Australia so it’s a bit different for us but we recently started scanning in 10,000 patient files and found the task to be extremely time consuming. We came up with “scan on demand” system, whereby as each patient is booked in for a visit we scan that particular file into our management software. This reduces the risk of wasting time scanning redundant files, e.g., patient deceased, moved, away etc. You will find your regular patients will all end up scanned in quickly thus allowing you to simply store and dispose of your redundant files as determined by your local authorities without wasting the time scanning them.

Stuart Blyth, Practice manager, Holloway Podiatry, hollowaypodiatry@ozemail.com.au

I actually know of a company that does this (Jeff Berry at AMBIT Solutions 205-419-8876). They come out and scan EVERYTHING you have, then put it on DVD for you (2 copies) for back-up. It costs a bit but no longer having to pay storage fees and having everything easily searchable and readable for research is quite handy. I did it and it was great. All of our stuff now is on DVD back-up and hard drives. We use the Fujitsu high speed scanner (about a thousand bucks) and it does front and back, color whatever.

Charles R. Oehrlein, DPM, Hoover, AL, droehrlein@yahoo.com

RE: No Evidence of Flip-Flop Danger
From: Joel Lang, DPM

I am so tired of reading commentaries of the "dangers" of wearing flip flops, sandals, etc. The sequelae supposedly vary from plantar fasciitis, stress and ankle fractures, sprains, etc. It seems, as a profession, we would like to 'think' we are saving everyone from these ills and injuries, but - Are we really?

I have never seen a definitive study to prove scientifically or statistically that these shoes are dangerous. It may 'logically' seem that these injuries may be more likely, but fractures, sprains, stress fractures, plantar fasciitis and hosts of other conditions occur frequently in patients who wear all kinds of other shoes, some of which might be 'acceptable'. Sprains occur in hundreds of ways in all shoes and many kinds of activities. . . and no one really knows the real cause of plantar fasciitis - there are undoubtedly many.

In over 30 years of practice I have seen very few injuries that were directly attributable to flip flops or sandals, most were very minor and hardly worth all the warnings of the sky falling.

Our continuous concentration on sandals and flip flops makes our profession irrelevant. We concentrate on unimportant speculations and misinformation - on what we 'think' - instead of what we 'know' and the value we bring to the public as healing professionals.

Let's stop demeaning ourselves and spending so much time warning the public of dangers that are possible, but not proven. People wear what they want and should be allowed to do so. Stop preaching and keep healing.

Joel Lang, DPM, Cheverly, MD, langfinancial@verizon.net

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