The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

June 22, 2010 #3,890 Publisher-Barry Block, DPM, JD

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1) Want to win an Apple iPad? In this issue, one of  the ads features a survey. If you are one of the first 200 podiatrists to respond, you can win this new and popular device.

2) PM News will NOT be sent out the week of July 18-25th while we are on a practice management cruise to Alaska.  

Vibram "Barefoot" Shoes Lack Needed Stability: NY Podiatrist

Most of us have left our barefoot days in childhood. Vibrams give a new lease on barefoot adventuring, as they can be worn mountain climbing, in rocky creeks, on muddy trails, and on boats. But, for some, five-toed shoes may not be suitable. Dr. Robert A. Kornfeld, podiatrist from Manhasset, NY, said, “The forefoot (ball of the foot) needs to be stable to propel the body forward. Otherwise compensatory problems occur in the knees, hips, or lower back.”

Dr. Robert Kornfeld

People with unstable forefeet tend to have foot problems such as flat feet, hammertoes, or bunions. If you have some foot problem, consult your podiatrist, who will hopefully give exercises to correct the problem at its origin and prescribe transition footwear.

Source: The Epoch Times [6/19/10]

Summer Footwear Not Always The Best Choice For Feet: APMA President

So long, snow boots, warm weather is here at last after one of the snowiest winters on record. But while you're skipping through summer in your saucy sandals or padding through the sand in your favorite flip-flops, what toll will your seasonal footwear take on your hardworking feet?

Dr. Kathleen Stone

Nearly eight of every 10 Americans have experienced foot problems caused by wearing uncomfortable or ill-fitting shoes, according to the American Podiatric Medical Association. "Many of us increase our activity levels in the summer, and that could mean an increased risk of foot and ankle discomfort or even injury," says APMA President and podiatrist Dr. Kathleen Stone. "Plus, many of the shoes we enjoy wearing during warm weather, like flip-flops and sandals, may not always be the best choice in terms of foot health."

Source: Ft. Leavenworth Lamp [6/19/10]

Make an Impact from the Lectern

What is the best way for a speaker to command attention from the audience and leave a positive impression? Here are three suggestions:

•  Look and sound like you belong there. Eliminate bad habits, like fidgeting, that distract the audience.
•  Know what you are talking about. While you do not want to sound overly rehearsed, you do need to know your material well—even if you do not know everything about your topic— and to organize your thoughts so that listeners can easily follow along.
•  Admit what you do not know. You can be a trusted expert without knowing everything. If you do not know an answer, convey your mastery of the topic by letting listeners know that you know where to find the information.

Source: Adapted from “Impressing the Audience,” Barbara Rocha, Speaking Tips Newsletter, Barbara Rocha and Associates via Communication Briefings

RE: Evidence-Based Medicine Nomenclature
From: Dwight L. Bates, DPM

Most of the letters published on PM News do not use the proper nomenclature regarding EBM, so no wonder there is so much heat and so little light generated. I was intimidated by EBM until I realized the initial edition of the most useful book on EBM written by David Sackett was dedicated to Kilgore Trout.

Evidence-Based Medicine by David Sackett

Read the book! All you have to lose is your ignorance.       

Dwight L. Bates, DPM, Dallas, TX, dlbates04@yahoo.com

RE: Integrative Podiatric Medicine (Robert Kornfeld, DPM)
From: Jengyu Lai, DPM

I have been reading the discussions on the alternative podiatric medicine with great interest. I have received both Western and Chinese medicine while growing up in Asia. Both my grandfather and great-grandfather practiced Chinese medicine, which has been around for four or five thousand years.

Evidence-based medicine has not been strong in any alternative medicine due to the lack of attention in alternative medicine. I think, for Asians, Western medicine offers a quick fix. Pills with highly concentrated ingredients immediately take care of the symptoms. However, they do not necessarily...

Editor's Note: Dr Lai's extended-length letter can be read here.

RE: Integrative Podiatric Medicine (Arnold B. Wolf, DPM)
From: Dennis Shavelson, DPM

50,000-100,000 people die from prescription drugs annually. In practice, every surgical bloodline does its version of the Austin, anecdotally. Every podiatrist does his/her version of subtalar joint neutral, anecdotally. Newton's Laws, when researched in double-blind studies, produce very valid evidence, however, when these same laws are researched using living subjects, they rarely produce valid Level I or Level II evidence.

Evidence-based medicine, according to Sackett, takes the practitioner's experience, the patient’s needs and concerns, and the existing medical evidence weighed as to its level, value, applicability and bias, and incorporates them into caring for a specific patient at the practice level. It is certainly not based on double-blind studies as Dr. Wolf anecdotally proclaims in his post. The great practitioners and consultants in medicine are both artists and scientists, who through evidence-based practice, develop teachable protocols for care that when delivered to professors, then translated to students and practitioners, become anecdotally filtered, diluted, and changed, often making their original teachings moot. Do any of us perform a Rootian examination or dispense an STJ neutral orthotic as Root taught?

Dr. Wolf is encouraging the scary world being fostered by the insurance companies and pharmaceutical companies, forcing us to prescribe their drugs at the same time that they don’t have to pay for us to deliver products or services not successfully double-blinded. Eventually, in that world, diagnosis and treatment will be robotic, and we will not need a physician to render care, just an iPhone in India.

Dennis Shavelson, DPM, NYC, drsha@lifestylepodiatry.com

RE: Cold War in Podiatry
From: Justin C. Jex, DPM

Some time ago, I wrote into PM News and stated my experience in the military at the end of the Cold War. The Russians had a policy of quantity over quality, while the USA had one of quality. We all know who won the Cold War. Now we have a similar situation. The podiatry schools continually amass as many students as possible to feed their tuition-driven addictions, and expect the podiatry community at large to support this habit. Where is there a shortage of podiatrists? Not in Houston, Texas. Why is it that? The podiatry schools continue to max out the podiatry student population and then send them headlong into a training quagmire.

In Texas, we are fighting for our scope of practice. "Were dying here" to quote one famous democratic talking head. We need the schools to back off their insane recruiting binge and focus on a select few of highly qualified students, because there are a ton of orthopods and a lot of podiatrists out here ready to eat them up. Take it from me because I have the bite marks to prove it. We need more quality, and less quantity. Sorry, future graduating classes, you are unfortunately on your own because I have my own problems. PS, I paid my tuition, and paid my dues with training residents for the past five years, so spare me the rebuttals about being ungrateful, etc.

Justin C. Jex, DPM, Houston TX, jex.justin@yahoo.com

RE: Patient Newsletters (Richard T. Koenigsberg, DPM)
From: Chad Schwarz

A great company to work with is Newsletters Ink Plus (newslettersink.com/). Our practice has worked with them on several different projects and have had a great experience. In addition to having professionals advise you on important aspects of developing a newsletter-like layout and color, one powerful thing they offer is podiatry-related content that you can use for your newsletter. This allows you to make a partially customized newsletter, internal or external, while using some of their content to fill the pages with podiatric-related information. 

Chad Schwarz, Howell, NJ, chads@footdoctorsnj.com

RE: Problems With Eclypsis (Elliot Udell, DPM )
From: Michael L. Brody, DPM

With the acquisition of Eclipsys by Allscripts, there has been a lot of discussion and concern regarding the stability of the EMR vendors servicing our profession. Whereas I share the concern about my software provider being bought out or going out of business, I do not support the concept of the government getting involved. It is unreasonable and unrealistic to expect the government to step in and protect the consumer each time a company goes out of business.

As a consumer, you need to protect yourself. Companies, including software vendors, either are purchased or go out of business every day, both in EMR and in other industries. Computer Associates had a reputation of acquiring competitors, sun-downing the competitor’s software, and forcing the users to migrate to the CA software. This is part of free-market enterprise.

When purchasing a software product, you need to look at the contract very closely. You need to negotiate clauses into the contract that protect you should the software vendor stop supporting the product, clauses such as, 'should the company go out of business, you have a right to the source code, so that you can continue to hire programmers to support the code.'  Then, you need to join users groups for the product, and work collectively as advocates for yourselves when communicating with the company.

We need to take responsibility for our decisions, and be our own best advocates, not only when dealing with EMR products but when dealing with all aspects of our practice.

Michael L. Brody, DPM, Commack, NY, mbrody@tldsystems.com

RE: Dragon Questions (Burton Katzen, DPM)
From: Mark K. Johnson, DPM

I have used Dragon 10.0 Medical for about one year; previously, I utilized various Professional Dragon versions from 5.0 on. The best accuracy with Dragon can be obtained with: adequate processor speed, RAM of 3 gig or greater, a GOOD microphone either headset, hand-held, or boom mounted; clear speech and enunciation; and use of reasonable macros that allow for completeness and uniqueness of information. If all of those "ducks" are lined up, recognition is around 97-98%, with some proofreading needed. I also defer to our speech recognition experts in podiatry, especially Dr. Larry Kosova.

Mark K. Johnson, DPM, West Plains, MO, ddr004@centurytel.net

PRACTICE FOR SALE - MINNESOTA

Practice Grossing over $500K yearly. Good mix of surgery, orthotics, DME, diabetic care, general podiatry. Commute < 5 miles to work. Friendly Midwest lakes area with arts, good schools, affordable living, restaurants, shopping. Option to purchase building. Will consider associate to buy-in/ buy-out. Midwestpractice@gmail.com

CANADIAN PODIATRISTS COME BACK HOME!

An Edmonton, Alberta group of DPM’s requires an additional Podiatrist. Interest in biomechanics essential. Given Canadian visa restrictions, this position is open only to Canadian Citizens or permanent residents. Very attractive compensation package. Fax C.V. or letter of interest to: (780) 483-5796.

ASSOCIATE POSITION - FREDERICK, MARYLAND 
 
Fredericks premier group practice is located only 45 minutes from both DC and Baltimore. Immediate opening for a minimum PSR 36 Podiatrist for full time position. We have it all: EMR, digital x-ray, ultrasound, ASC, etc. Excellent salary with bonus structure and benefits. Please email resume to docsbnb@aol.com

ASSOCIATE POSITION  -  PALM BEACH COUNTY FLORIDA

Well-rounded growing practice seeks 3-year surgically trained podiatrist for an associate position. Must be hard-working, personable, and eager to work in a variety of settings. Some exposure to trauma/major reconstruction is preferred. Email CV to tburnam80@gmail.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Full-time 3-DPM group in South Bay of LA County. Minutes from best living in LA County. Practice is an excellent mix of surgery, general podiatry, diabetic care, and DME. Beautiful office with EMR, Digital X-ray and Orthoses, etc. Please e-mail cover letter, and resume to footcareone@verizon.net

PODIATRISTS NEEDED NATIONWIDE

Seeking a part-time or full-time podiatrists to provide podiatry house call and diabetic shoe fitting services to patients nationwide. We are a podiatry management company and have contracts with clients that have 1,000’s of established patients and all we need are hard-working good doctors to service them. We offer an excellent compensation package with benefits and the opportunity to build a fairly large practice very quickly. coasttocoastpodiatry@yahoo.com

EQUIPMENT WANTED – CR SCANNER

Reina 812 Manual CR Scanner in good condition. Contact: pmh@wffeet.com

TN PRACTICE FOR SALE (SOUTH OF NASHVILLE)

Active, established practice with new equipment (digital x-ray, ultrasound, computer network, etc.). Great referral network with an excellent scope of practice. Turn-key operation with seamless transition. Grossed over $350K last year. Call 931-446-5724 or e-mail mchad500@gmail.com for more information.

ASSOCIATE POSITION - SOUTHEAST GEORGIA

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking associate or new residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

LIMB PRESERVATION RESEARCH AND SURGICAL FELLOWSHIP

Boston University Medical Center offers a unique fellowship position. Be part of this unique opportunity at a major internationally-known teaching medical center. During this time, he/she will become a knowledge expert who will contribute significantly to research, surgical procedures, teaching, and innovations in limb preservation and tissue repair. Requirements: Completion of a two or three year surgical residency; Annual Salary: Year 1 $61,000, Year 2 $66,000 plus excellent benefits. Submit a CV and letter of interest to: Erin Springhetti @ erin.springhetti@bmc.org and Dr Vickie Driver @ vickie.driver@bmc.org

ASSOCIATE POSITIONS – TEXAS

Full-time podiatrist(s) needed in Austin or San Antonio. Current Texas license required. Unique mobile podiatry practice. Better pay, fine working conditions with excellent support staff. Check out our website www.footmobile.com. Reply to footcenter1@sbcglobal.net

EQUIPMENT FOR SALE – PODIATRY CHAIRS

2 podiatry chairs - used Midmark 117 and a Ritter 317. Great condition. $950 each Greenwich, NY Call:518-466-3287. Pick up only.

PM News Classified Ads Reach over 12,000 DPM's and Students

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