The Voice of Podiatrists

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June 05, 2008 #3,264 Editor-Barry Block, DPM, JD

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IL Podiatrist Uses New Joint Implant For Arthritic Joints

Hallux rigidus affects the large joint at the base of the big toe. While some joint wear and tear commonly occurs after age 30, doctors increasingly are seeing this type of arthritis in younger, more active patients, according to Dr. Howard Stone, a podiatrist with the North Shore Podiatry Group in Glenview, Lake Forest and Gurnee. Injury to the big toe joint also can cause arthritis. A recently introduced procedure offers new hope.

Dr. Howard Stone

The new Arthrosurface HemiCAP system was approved by the FDA in 2006 for treatment of moderate and advanced arthritis of the big toe. The system replaces damaged cartilage with contoured implants precisely matched to the patient's anatomy using three-dimensional mapping technology. Matching the curvature of the cartilage allows for proper function of the big toe joint.

"This is the new wave of what's happening in orthopedics," said Dr.Stone. "The implant is set into the same level of the remaining cartilage and acts as brand-new cartilage. You're not destroying the joint, but resurfacing the joint." Stone cautions, however, that it's important to choose the patient properly. "This is for people with a moderate amount of arthritis," he said. "If the joint is really destroyed, you can't do this." The implant should last around 20 years, about as long as an artificial joint, he said.

Source: Terri Yablonsky Stat, Chicago Tribune [6/3/08]

$3.5 Million Verdict in VA CRPS Malpractice Case

A Roanoke jury has awarded a $3.5 million verdict to a Clifton Forge woman who sued her podiatrist over a 2003 surgery that she says caused incurable chronic pain and led to the amputation of the front of her right foot. The sizable verdict is remarkable in that it's a larger sum than the $3 million Donita Franklin originally sought when she sued Dr. Jennifer Feeny in 2005.

Feeny, of Shenandoah Valley Podiatry in Troutville, maintains that she did nothing wrong when she performed surgery on Franklin's foot to remove a bunion. Feeny said in a statement released Monday that she empathizes with what Franklin has gone through but that the condition afflicting Franklin, known as complex regional pain syndrome, has no known cause. Paul Kuhnel, one of Feeny's lawyers, said there was compelling evidence that Franklin's problems resulted from "a very rare complication from surgery that could not have been prevented."

The excruciating pain Franklin suffered became a permanent condition that didn't go away even after she had the front of her right foot amputated, Fennell said. Franklin, who used to be a factory worker, now lives on disability and uses a wheelchair or crutches to get around. "She used to be very active before this" and liked to ride horses, the lawyer said. "Now she can't do anything." Steven Feeny, Jennifer Feeny's husband and office manager, said Monday that he and his wife could have settled the suit but felt that "she did nothing wrong and she just had to have her day in court."

Source: Mike Alle, Roanoke Times (VA) [6/3/08]

Most Medical Schools Do Not Adequately Limit Rx Industry Gifts

Most U.S. medical schools do not adequately limit gifts and payments from pharmaceutical companies to physicians and students, according to a report released on Tuesday by the American Medical Student Association, the New York Times reports. For the report, which AMSA began to compile in November 2007, two evaluators issued letter grades on the conflict-of-interest policies of 150 medical schools.

According to the report, only seven schools -- including Mount Sinai School of Medicine, University of Pittsburgh Medical Center and three University of California medical schools -- received grades of A. The report also said that 14 medical schools received grades of B and that 15 schools received grades of F. The 16 medical schools that declined to submit their conflict-of-interest policies and the 29 schools that did not respond to four requests for their policies also received grades of F, according to the report. The report also said that 28 medical schools currently are employing efforts to revise their conflict-of-interest policies.

Source: Gardiner Harris, The New York Times Via American Health Line [6/3/08]

Ramp Up Your Praise Techniques

Offering well-deserved praise is an effective—and inexpensive—way to build a loyal and productive staff. Use these tips:

• Look harder for extraordinary accomplishments. Ignore routine tasks that meet basic or average performance standards. Focus on menial or less pleasant tasks done to standards of excellence.

• Distinguish individual contributions from team efforts. Devote time with staff to discussing both overall project success and individual superior performance.

• Avoid a hit-and-run approach. Effective praise is both specific and sincere. Offer praise the time it requires by talking at length with deserving employees to learn exactly what motivates them to deliver outstanding results.

Source: Adapted from “Giving Praise As a Noncash Employee Motivator,” by Reylito Elbo

Query: MagneVu In-Office Extremity MRI

Does anyone know what happened to this company? I know they were based out of Carlsbad, CA and they had some potential bankruptcy issues. Did another company take them over or is anyone else marketing their device?

Jonathan Rosenblum, DPM, Jerusalem, Israel

RE: Tennis Serve Metatarsalgia (David Arkin, DPM)
From: Robert S. Schwartz, C. Ped., Jeff Root

Try MBT shoes for tennis. They will prevent excessive MTP joint motion and allow the player to propel forward at the end of the serve. And don’t forget about a larger size shoe. Short shoes exacerbate the problem.

Robert S. Schwartz, C. Ped., New York, NY 10016, rss@eneslow.com

Editor's Note: Jeff Root's Extended-length note appears at: http://www.podiatrym.com/letters2.cfm?id=19977&start=1

RE: Prescribing Systemic Drugs (Mike Boxer, DPM)
From: Stanley Beekman, DPM

Dr. Boxer first says “The proper medication to treat a tophus is a uricosuric agent such as probenecid and not allopurinol.” And then he says, “Additionally, the patient needs to be evaluated with a twenty-four hour urine to see if allopurinol is needed or probenecid is needed.”

The key to treatment is to lower the uric acid levels, and the tophi will eventually resorb.

Regarding the treatment of the manifestations of systemic conditions with systemic drugs, Dr. Boxer taught us to treat “burning of the feet” with AllBee + C because of the B12 that was in it. As a student, I had a patient with burning feet, and vitiligo. My work-up found that the patient had an undiagnosed pernicious anemia as a result of a partial stomach resection a few years earlier. I started B12 injections that helped his condition. On an appeal of my clinical evaluation, I mentioned this case to which Dr. Boxer told me that I was out of scope. If I had followed Dr. Boxer’s advice, I would have missed the diagnosis and I would have rendered an ineffective treatment.

Stanley Beekman, DPM, Cleveland , OH, sbkmn1@gmail.com

RE: CA Podiatrist Found Not Guilty on Sexual Battery Charges
From: Tip Sullivan, DPM

I am very happy to see one of our colleagues cleared of the charges against him in court by a jury of our peers. I think that it would be very interesting and helpful for all of us to find out how in the world Dr. Sciarons’ situation developed. (i.e.,-not having a nurse in the room during an exam?) I am sure that this was a “life-changing” and very difficult time for him. I cannot imagine the damage that could be done professionally and personally by false accusations such as the ones levied against him. I wish Dr. Sciaroni well and just pray that something like that does not happen to myself or any of us.

Tip Sullivan, DPM, Jackson, MS, tsdefeet@msfootcenter.net

RE: MD Logic EMR
From: Ira J. Gottlieb, DPM

Editor’s note: This extended-length letter appears at: http://www.podiatrym.com/letters2.cfm?id=19980&start=1

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 full-time podiatrist in a multi practice location in the Chicago land and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

INTERNET FOOT THEMED CANDY BUSINESS FOR SALE

Well-known foot-themed chocolate and candy company with over 6,000 customers. Unique products with trademarked names for seasonal (Mistle Toes, Valentoes, etc.) as well as everyday (A Foot of Feet, Twinkle Toes, etc.). Excellent opportunity to generate income from home with an established business. Serious inquiries to Mwolpa@ToeFood.com

IMMEDIATE OPENING - MINNEAPOLIS, MN

Associate leading to partner in well-established practice. Seeking personable, skillful, and attentive podiatrist. No nursing homes, evenings or weekends. Competitive compensation package including health insurance, malpractice, short term disability, 401(k), generous vacation, paid holidays, and excellent salary plus bonus! E-mail cover letter and CV to jbremer@associatedpodiatrists.com or fax to (612) 866-5875 attn: Jennifer Bremer

PRACTICE FOR SALE – NEW JERSEY

Well-established practice in Teaneck, NJ (10 minutes from GW Bridge). Excellent location (in Medical building) heavy traffic, great visibility and large parking lot. Fully equipped, full-time office with established patients. Grossing over 220K with tremendous growth potential. Office is currently open and busy ready to takeover with seamless transition. For additional information please e-mail doctors@gramercyparkpodiatry.com

SEEKING RESIDENT FOR PSR-24 POSITION: BALTIMORE, MD 10X

Mercy Medical Center Position for a highly motivated individual who desires a surgical residency or an individual wishing additional surgical training in a well-established Podiatric Residency Program. Busy metropolitan hospital with high surgical numbers and inpatient care. Resident is integral member of multidisciplinary team. Begins mid June 2008. Includes competitive salary/benefits. Send inquiries to rsher18@yahoo.com

BIOMECHANICS FELLOWSHIP – NEW YORK

Neoteric Biomechanics (patent pending) Nine-Month Fellowship: At The Foot Typing Center® in New York City. Practice, Research, Publish and Credentialize Yourself In This New Paradigm. $36,000 Stipend. New York License Required.Fax Interest to: 212 288 3034 or apply to Dr. Shavelson @ drsha@lifestylepodiatry.com.

PRACTICE FOR SALE - VENTURA, CALIFORNIA

Selling satellite office, fully furnished and equipped. Existing patients and room for more growth. Inquire at tkhk@sbcglobal.net

ASSOCIATE POSITION – CHATTANOOGA, TN

Associate needed for established practice. ABPS qualified or certified candidate preferred. Patient mix, hospital privileges readily available, excellent benefits and salary with production-based bonus. Please e-mail cover letter and CV to asocfoot@bellsouth.net or fax to (423) 855-1558.

PRACTICE FOR SALE – BROOKLYN, NY

Busy multi-faceted 20 year old practice for sale. Large office with 3-4 fully-equipped treatment rooms, modern and updated. Located in Walgreens shopping center, subway on corner. Free parking lot. Turnkey operation. Make money first day. Call Jon @917-364-8057 or email: jonnytee@aol.com for more details.

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