The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

June 05, 2007 #2,953 Editor-Barry Block, DPM, JD

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VA Podiatrist Provides Advice on Preventing Plantar Fasciitis

Because plantar fasciitis treatment can be diverse and time-consuming, preventing it is the best option. Weight loss is a vital step. "Every step you take in normal walking puts two times your weight on each foot," said Dr. Ilene Terrell, a local podiatrist. "So the 100-pound person comes down with 200 pounds on each foot."

Dr. Ilene Terrell

Terrell recommends wearing good shoes at all times, not just for activities. Other advice: Avoid going barefoot or wearing flat shoes like flip-flops. Orthotics, or at least the over-the-counter supports, can prevent problems. Stretching helps. A standing push-up--where a person stands away from the wall, then leans in toward it while keeping the feet flat--is one helpful stretch.

Source: Laura L. Hutchison, The Free Lance-Star [6/3/07]

ID Podiatrist Voices Concerns Over Proposed Nuclear Plant

Alternate Energy Holdings (AEH) the Virginia-based company proposing to build a nuclear/biofuels complex near Bruneau, held a public information/question-answer meeting at Rimrock Jr.-Sr. High School Thursday evening, May 31. Don Gillespie, President of Alternate Energy Holdings, made a presentation to Owyhee County residents on a proposed nuclear plant.

Dr. Peter Rickards

Gillespie told the audience of about 100 people that there would be opportunities for non-county residents to speak throughout the permitting process. However, the Owyhee County residents-only rule did not sit well with Dr. Peter Rickards, a podiatrist from Twin Falls and self-proclaimed anti-nuclear advocate. When he took the podium to ask his question and announced that he was from Twin Falls, he was reminded that the meeting was for Owyhee County residents, only.

However, a moderate uproar from some audience members shouting 'let him talk' afforded the doctor a turn at the podium. Immediately, he inferred that the public was not being told the truth about nuclear energy. Spewing facts , all disputed by Gillespie , he proceeded to dispute industry claims that nuclear generation plants are safe from terrorism and that they do not release radiation into the air. He noted that there are alternative clean energy sources other than nuclear power.

Source: Melanie Brown, Mountain Home News (ID) [6/1/07]

OH Attorney Sanctioned For Pursuing Frivolous Liability Case

After being dragged through three years of unnecessary litigation and emotional turmoil, as well as taking a hit on his medical liability insurance, Ohio orthopedic surgeon Michael A. Banks, MD, fought back. When the underlying medical liability case against him was dismissed a second time, Dr. Banks sued the plaintiff's attorney for frivolous conduct.

An open lawsuit on his record -- his first -- made him ineligible for insurance discounts, he said. But it was the years of checking "yes" on forms for insurance and hospital privileges that asked if he was ever sued and why, that finally got to him. "I just wanted to be able to say a judge said it was frivolous and it was thrown out," Dr. Banks said.

Now he can, thanks to a May Ohio appeals court ruling that sanctioned Cleveland-based plaintiff attorney John E. Duda for two meritless cases he pursued against Dr. Banks. Ohio State Medical Assn. officials said the case was among the most flagrant they have seen.

Source: Amy Lynn Sorrel, AMNews [6/4/07]

Query: Billing Insurance Companies for Free Examinations

I’m an associate in a large multi-doctor practice. The practice offers “free foot examination” and is successful in attracting many new patients. If the new patient has insurance, we generally bill the insurance company for this initial examination? Is this ethical?

Name Withheld

Editor’s comment: PM News does not supply legal advice. Under the APMA Code of Ethics (2005), this conduct would be deemed unethical.

BE1.31 The podiatrist, as an inducement to provide additional services for a fee, may advertise and offer free examinations or free podiatric medical services. The podiatrist shall not, however, charge a fee to any patient or any third-party payor for any podiatric medical service provided at the time that such free examination or free podiatric medical services are provided.

This could also be a violation of state law since the word “free” is being misrepresented.

RE: Podiatric-Specific Billing Software (Diane Phalen, DPM)
From: Robert Gaynor, DPM

Our practice looked into many of the different software companies for podiatry. We chose Sammy Software and still utilize the software because of their commitment to podiatry and they keep abreast of the changes in podiatry and DME as well. Their reports take seconds to produce and the software is accessible from remote locations as well. The software has all the bells and whistles to make your practice run smoother.

Robert Gaynor, DPM, Lake Worth, FL, nailcutter@aol.com

RE: No Evidence of Flip-Flop Danger (Joel Lang, DPM)
From: Multiple Respondents

I am not convinced either way by this discussion. If the following two questions could be answered, it would be very helpful in my understanding.
1. How do shoes that are not flip-flops prevent pronation?
2. What is missing in the flip flops that regular shoes have that
prevent the pronation?

Stanley Beekman, DPM, Cleveland, OH, sbeekman@internationalbandage.com

In my practice of over 46 years, I can say that even though there may not be specific statistics on it, my empiric findings over the years has been that there actually is a detrimental effect of flip-flops and similar non-supportive shoes. Especially with patients presenting heel spur syndrome/plantar fasciitis, ankle instability, Posterior tibial dysfunctions, etc, etc, my experience is that they all do better once they agree to wear more supportive shoes and orthoses, along with the usual treatment plans. And in any case, any PR we get from letting the public know of podiatrist's advice on these subjects I think is good for the profession.

Arthur Gudeon, DPM, Rego Park, NY,

The question of whether flip-flops are dangerous is an interesting one since it tends to point out how our society’s perception of reality is influenced by the news media. Newspapers and television news shows stay in business by selling ads to companies. Therefore, the more people that read their paper or watch their television show, the better for both the news source and the advertiser.

Since negative news always sells better than positive news, we are therefore bombarded by negative news stories of disaster, danger and pain (i.e. you never hear about the thousands of aircraft that take-off and land safely every day, only the ones that crash). So, in today’s society, in order to keep their newspaper or news show “on top,” news sources have created what I call “false danger.”

“False danger” is that phenomenon that occurs when a news source takes everyday, ordinary occurrences, that we have lived with for years without any problems, and have made them “dangerous” in order to attract more attention from the public and reap more advertising dollars. As one example, here in California in the spring, if the rain has been less than average, the TV news crews will stand in front of a dry field and say that the lack of rainfall has created “fire danger.” However, the next spring, if the rain has been greater than average, the news crews will stand in front of a field of tall green grass and proclaim that the increased rainfall will later create “fire danger” due to the abundance of fuel.

Therefore, it is my opinion that the only danger in flip-flops is the “false danger” that the news media is promoting in their quest for increased advertising revenue, all at the expense of the public’s perception of reality.

Kevin A. Kirby, DPM, Sacramento, CA, kevinakirby@comcast.net

Editor’s note: Dr’s Lang’s response, which exceeded PM News length guidelines can be read at: http://www.podiatrym.com/letters2.cfm?id=14309&start=1

RE: Women's 12 ½ Narrow Shoes (Bonnie Tatar, DPM)
From: Hugh Solaas, C.Ped

Dr. Tatar did not mention the exact width, but a “narrow” shoe is usually a “AA” width. If that is her width, there are plenty of shoes available manufactured by Brooks, Birkenstock, New Balance, Trotters, and others. Many of the brands stop at size W-12, however. If this is the case, a pedorthist can often increase the size of a shoe by ½ size by lowering the footbed and/or stretching the shoe lengthwise. Some of these brands also offer a size W-13, which might be adjusted to fit.

If the foot is a bit narrower than “AA” the pedorthist may also fit the shoe by adding material, bilaterally, at the ball of the foot. If the patient has a “AAAA” foot, there are a couple of companies that make that size. I’d recommend a Google search for that.

Hugh Solaas, C.Ped, Silverdale, WA, solaas@earthlink.net

Editor’s note: This topic is now closed

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