June 17, 2006 #2,608 Editor-Barry Block, DPM, JD

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Shoes Shouldn't Bend in The Middle of the Arch: Jarrett

Here’s some advice on buying shoes from Dr. Beth Jarrett, director of the Scholl Pedorthics Program at Dr. Wm. M. Scholl College of Podiatric Medicine in North Chicago.

"The most common mistakes women make are to buy shoes that are too short. The widest part of the foot, at the ball, needs to fit into the widest part of the shoe," Jarrett says. "Most people's feet are not pointy, so their shoes should not be pointy, either."

She dropped a couple of name brands, including Dansko (a favorite among nurses and chefs) and Birkenstock. What about those new glove-thin, super flexible, mesh gym shoes with the Velcro zigzag across the instep? Not so good: "You can roll them into a ball," Jarrett pooh-poohs. "Your feet don't bend like that."

Shoes shouldn't bend in the middle of the arch. They should have a good heel for absorbing shock, have some arch support, and the inside of the shoe should be shaped like the bottom of your foot.

Source: Leslie Baldacci, Chicago Sun Times [6/14/06]

Failure to Disclose Prior History Results in Additional Sanctions For HI DPM

Podiatrist Andrew Carver has gotten off to a rather rocky start in Hawaii, including a one-year license probation, beginning December 2005, by Hawaii's Board of Medical Examiners for not disclosing within 30 days disciplinary actions taken in another state. The former San Francisco podiatrist voluntarily surrendered his California medical license in April 2004 after allegations of dishonesty, unprofessional conduct, deceptive advertising, and a spousal battery criminal conviction were brought against him by the California attorney general's office. Because Carver entered into a settlement agreement and surrendered his license, the first three allegations were unproven.

In addition to a one-year license probation, Carver's December 2005 settlement agreement with Hawaii also stipulates he pay a $1,000 administrative fine and provide written verification of his completed criminal probation, said Daria Loy-Goto, RICO's supervising attorney.

As a former San Francisco podiatrist, Carver's business practices were brought into question several times, the most recent being the state attorney general's accusation, which was filed Dec. 24, 2003. His recent advertisement in West Hawaii Today prompted several phone calls from the community in regard to Carver's professional history.

"I surrendered my license on the domestic violence charge," Carver said, which was the only allegation he admitted to, denying the other three. Carver plead guilty to one count of spousal battery in January 2002. The general unprofessional conduct allegation stemmed from a separate marital incident, which Carver denied. "Everything has been settled. I paid the price," he said. "I made mistakes. I wasn't perfect, but as a rule I consider myself a very dedicated and caring doctor."

Source: Kim Eaton, West Hawaii Today [6/14/06]

Query: Severe Cramping of Feet & Legs

I have a patient that has severe cramping in his feet and legs. He cannot take quinine sulfate, has been on Lyrica, Requip, magnesium & tonic water, but nothing has helped to this point. The patient is a diabetic and cannot take any sulfur-based medicine. I would like some feedback on what other podiatrists are prescribing in this situation.

Jean Bainbridge, DPM, Delray Beach, FL, bunions1@sbcglobal.net

Query: MPJ Implant to Reverse Fusion

I have a 49 year old healthy female patient who had undergone a 1st MTP joint fusion performed by a local orthopedist 2 years ago, with which she is quite unhappy. The hallux is fused in only some 5 degrees of dorsi-flexion, and is causing painful gait changes. She would like to have the fusion reversed to get motion back in her joint; the tissues surrounding the joint are quite supple, and sesamoids on X-Ray show minimal arthritic changes. Various orthotic modifications have helped, but not to her satisfaction.

Would you consider implanting a total 1st MTP joint replacement? I suggested to her the best option may be to re-do the fusion into a greater dorsi-flexion of the hallux toe, but she is stuck on the idea of getting motion back in the joint. I would appreciate any input!

Gregory Stilwell, DPM, Durango, CO, joegreg@hotmail.com

RE: DMAC Transition

NHIC, the new government contractor for DMAC Region A, announced today that the senior ombudsmen from Health Now, the current DMAC contractor, will be moving over to NHIC as of July 1, 2006. That is excellent news for all suppliers, and should make the transition for NHIC much smoother.

Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net

RE: Adductovarus Hammertoe (Scott Werter, DPM)
From: Thomas A. Graziano, DPM

If the deformity was strictly due to skin contracture, then a skin wedge might work. In the absence of any previous surgical intervention or trauma this would be rare. Its more likely that the deformity is due to either a flexor tendon contracture or interphalangeal joint derangement in which case you must address these areas for adequate correction. Oh by the way, it doesn't really matter what the patient asks for, its up to you to tell him/her what they need.

Thomas A. Graziano, DPM, Clifton, NJ, TGrazi6236@aol.com

ASSOCIATE POSITION - NAPLES- FLORIDA

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills. Hospital privileges available at 548 bed hospital system and multiple surgical centers. Candidate should want to perform rearfoot surgery including Charcot reconstruction. Candidate needs to be ethical and motivated and have a current Florida license. Established practitioner or new practitioner OK. Base, percentage, benefits including insurance and 401K. Fax CV to (239) 566-8778.

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901.

ASSOCIATE POSITION – MIAMI DADE COUNTY FLORIDA

Part time work available. Clinic sessions-nice environment / assistants supplied 8am-12pm / 1pm-5pm. Miami Dade County. Hourly Salary. E-mail response to: podoffice@aol.com

PRACTICE FOR SALE - NORTHWESTERN US

Selling 3 well developed satellite offices with substantial potential of continued growth. All offices in areas of abundant outdoor recreational activities including skiing, fishing, hiking, etc. These offices are priced to sell quickly! Please only serious inquires only and contact via e-mail: offmgr4464@hotmail.com

RESIDENCY POSITION – VIRGINIA

One Year Foot and Ankle/Rearfoot Surgical Fellowship with excellent salary/benefits available July 1, 2006. If you are finishing a PSR-24 and don't have a job yet, this is an excellent way to learn additional surgical and business skills. Please fax resume to 703-
491-9994.

ASSOCIATE POSITION - PITTSBURGH, PA AREA

Excellent opportunity for a hard working, surgically trained podiatrist to join a well-established, high volume, multi/location practice in the suburbs of Pittsburgh. Must be willing to perform all aspects of podiatry. Incentive-based salary, compensation package, with potential for partnership. Must presently have Pennsylvania license. Would like to fill position asap. Fax resume to 412-831-2115.

ASSOCIATE POSITION - MINNESOTA – MINNEAPOLIS SUBURB

Busy, well-established, full-scope podiatry practice, seeking highly motivated podiatrist for a full-time position with buy-in opportunity. Looking for PSR 24/36 trained individual, to help increase surgical volume. Excellent opportunity for long-term growth with unlimited income potential. E-mail CV to employment@associatedpodiatrists.com or fax to (612) 866-5875 Attn. Jennifer.

RESIDENCY POSITION - HOUSTON, TX

RPR, PSR-24, Houston Podiatric Foundation, Starting ASAP. Must have successfully completed PARTS 1 & 2 of National Boards. Contact: Dr. Randal M. Lepow, Director (281-348-3338) (713-725-8988)

PRACTICE FOR SALE - COLUMBUS, OHIO AREA

Fully furnished practice, open ONLY 14 hours a week with an average yearly gross of 235K. 75% primary care, 20% surgical, 5% Nails. Plenty of opportunity for growth and surgery. Changing locations. Financials available upon request. Kyle_DPM@Yahoo.com

ASSOCIATE POSITION- NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

EQUIPMENT FOR SALE - ESWT

If you are using or thinking of using ESWT, I have a new machine that has only been used twice. There is no Orbasone in the country priced like this one. Will provide training and installation. Take a look at http://www.orbasone.com Call 1-856-229-2939.

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