The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

June 27, 2007 #2972 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2007- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

IL Podiatrist Offers Summer Foot Health Tips

"We notice more athlete's foot (fungus) in kids in summer," Dr. Marlene Reid says. "It's not a new risk. Keep feet dry. Rinse them during the day, change socks twice a day. And don't wear the same sweaty old shoes every day." Reid also recommends using an antiperspirant on feet. "It robs fungus of the moisture it likes," she says (and helps with foot and shoe odor).

Dr. Marlene Reid

Another source of contaminated water is nail salons. Some California pedicure salons were found to have drains full of organisms. If you go get a pedicurist, Reid recommends getting one of the first appointments in the morning. Always be sure you are getting sterilized instruments -- even a file used on your own hands should not be used on your feet.

"Pedicurists," Reid adds," are not supposed to use a blade to peel off calluses." Diabetics should not get pedicures -- your doctor will take care of your feet. Never shave your legs before a pedicure, either, Reid says. "If there is bacteria around, you don't want it in small cuts on your legs."

Source: Star Lawrence, WebMD [6/21/07]

Lavery Receives 2007 American Diabetes Association Roger Pecoraro Award

Lawrence A. Lavery, DPM, PhD, Professor of Surgery at Texas A&M College of Medicine at Scott & White Memorial Hospital was awarded the Roger Pecoraro, MD award yesterday by the American Diabetes Association. Considered by many the top honor in the field, it signifies a body of research and clinical work that deserves worldwide attention. "Professor Lavery is, without question, the profession's crown jewel of clinical research", noted David G. Armstrong, DPM, PhD, Professor of Surgery and Chair of Scholl's Center for Lower Extremity Ambulatory Research (CLEAR).

Dr. Lawrence Lavery

Dr. Lavery, in his award lecture, focused on a provocative subject: worldwide screening for risk. He challenged the standing-room-only audience with data that suggested that, as he put it "We may have it wrong" and "screening for vascular disease may turn out to be more important in terms of near and medium-term benefit than screening for neuropathy". Lavery's comments are available in a 15 minute podcast interview available on-line (iTunes keyword CLEARcast or http://diabetic-foot.net).

'Superbug' More Common Than Estimated: Study

The rates of methicillin-resistant Staphylococcus aureus, or MRSA, a drug-resistant bacteria that can be deadly to patients with compromised immune systems, is eight to 11 times higher in hospital settings than previously estimated, according to a report released today by the Association for Professionals in Infection Control and Epidemiology.

Researchers of the report, titled the National MRSA Prevalence Study, collected data on MRSA-identified patients from 21% of acute-care hospitals (or 1,237 facilities), with facilities from all 50 states participating in the study. Researchers found death rates among patients with MRSA were 2.5 times higher than among patients with staph infections that were susceptible to treatment with an antibiotic. The cost for treating MRSA-infected patients was also much higher than treating those with other healthcare-associated infections: $35,367 compared with $13,973.

The superbug now represents 60% of all healthcare-associated infections compared with just 2% in 1972, according to statistics from the Centers for Disease Control and Prevention. Reducing or eliminating MRSA infection, which is passed to patients through contact with unwashed hands or contaminated gloves and medical equipment, could substantially decrease the rates of death due to hospital-acquired infections, the association’s epidemiologists said. The group’s eight-point prevention guidelines for hospitals includes developing an MRSA risk-assessment program using past and current infections-rate data; developing a comprehensive surveillance program; enforcing hand washing hygiene, and the wearing of appropriate barrier clothing among healthcare providers and other workers who come in contact with patients; and isolating MRSA-infected patients.

Source Shawn Rhea, Modern Healthcare [6/25/07]

Query: Addiction to Oxycontin

I am appealing to my colleagues for help. Last year I was injured in a motorcycle accident. My doctor prescribed me Oxycontin, which helped relieve the pain. Unfortunately, it also has become an addiction. I realize that my career could be in jeopardy. What advice do you suggest?

Name Withheld by Editor

Editor’s comment: PM News does not provide legal advice. You’ve taken the difficult first step in admitting you have a problem and seeking assistance. You are to be commended for that. You are not the first (nor will you be the last) podiatrist to find yourself in this situation. Fortunately, others have been in your situation and returned to productive practice.

We suggest you contact the Physician’s Recovery Network Resource for Healing. They provide confidential, anonymous assistance and referral for drug and alcohol problems, depression, marital/family issues, physical impairments, etc., call the Physician’s Recovery Network (PRN) hot-line at 800-488-4767. This is an APMA-sponsored program. The PRN’s mission statement says that it was “developed to identify and assist impaired (whether by substance abuse, physical and/or mental conditions) podiatric physicians and/or members of the podiatric medical family (including, but not limited to, podiatric medical students, family members, and office staff of the podiatric physician) so that they can be restored to a full life and/or effective professional practice.”

RE: Shortened 5th Digits (Anas Khoury, DPM)
From: Multiple Respondents

I have seen many of these types of post-op issues. What works for me: Plantar skin plasty to bring down the toe. Bone graft interposition in the IPJ or an Osteomed silicone implant to maintain position.

David Weiss, DPM, Richmond, VA, podmed3@msn.com

I have seen the osteomed "interflex" digital implant used for just that scenario and the devices will give you some length and keep the toes in a fairly rectus position. Of course, an MPJ release should be done if there is contracture or caspulitis at the MPJ leve.

Mitchell A. Barber, DPM, Laurel, MD, mitchbkid@hotmail.com

I would consider doing a callus distraction procedure with an Orthofix mini rail. An alternative would be bone graft with arthrodesis, but those can sometimes compromise the neurovascular structures.

Sloan Gordon, DPM, Houston, TX, sgordondoc@ sbcglobal.net

RE: High Heels Won’t Cause Permanent Damage (John J. Holtzman, DPM)
From: Mary Schuh, DPM

There are published studies which show the increased heel height increases the forces at the knee. The researcher questioned whether this could be a factor in why women get medial knee OA earlier and more often than men.

Just as pushing on a tire iron close to the wheel produces little rotational force- yet pushing at the end of the tire iron produces much greater force - heel height increases the length of the vector from subtalar axis to the ground, and thus, ground reaction force increases across each joint above.

Pressure load to the forefoot is also increased, as the (supinated) foot in a heel has a decreased area of contact with the ground. Years ago I assisted Dr. Roy Lidtke on research for a high heel manufacturer in the Scholl gait lab using tracking and pressure sensitive testing devices. The 2.5 inch pump style shoe placed an amount of pressure on the forefoot similar to that of what an elephant has on a front foot in normal walking. The particular manufacturer was comparing themselves to another company's shoes ( the competitor's shoe had less shock absorption) - but neither pump compared well to the same subjects pressure levels walking in their own sneakers.

Mary Schuh, DPM, Burbank, CA, emptyshoe@hotmail.com

Editor’s note: This topic is now closed.

PRACTICE FOR SALE – OHIO – SOUTHEASTERN

.

Reputable, thriving, well-rounded practice available with EMR. Grossing over $320K over the last 3 years. Priced to sell at 150K. Owner relocating. Email inquiries and CV to podsx@yahoo.com

.

WANTED: BIOMECHANICS CONSULTANT

.

West Houston Medical and Kingwood Medical Centers are seeking a biomechanics consultant to help develop competency based curriculum/assessment forms, provide workshops, and lecture to their residents. The individual must be Board Certified by the ABPOPPM, be a Fellow of the American College of Foot and Ankle Orthopedics and Medicine, and must be able to come for quarterly visits to Houston, Texas. Interested candidates should fax a C-V and consulting fees to Dr. Samuel Mendicino, Residency Director, West Houston and Kingwood Medical Centers. 281-589-1618.

ASSOCIATE POSITION – SOUTHEAST MICHIGAN

.

Seeking quality-oriented, patient-focused, RPR-trained associate for a fast-paced, established group practice This is a secure, long-term position. Emphasis on diabetic foot and wound care. Gain surgical experience while earning an excellent living. Partnership possibility. If you are highly motivated, ethical, and have good communication and clinical skills, forward CV to: fax (734) 466-8501 or email mbell6@msn.com

EQUIPMENT FOR SALE - WASH. DC

Name your reasonable price and pay shipping- Body chairs, X-Cell X-rays, Konica developer, SmartDop20, viewboxes, lakesidecart, Endoscopic unit with all attachments, topical hyperbaric O2 units, castle autoclave, xerox copier, fax machines, etc. call 202-841-5545 or email to JHALLUX@yahoo.com

ASSOCIATE POSITION - MIAMI BEACH, FL

Seeking well trained PMS 36 / PSR 24+ for Full-Time associate position. Leading to partnership for the person. practice is 50% hospital based. Must have strong Sx skills, including Limb Salvage & Trauma. Competitive Salary & benefits Package. Fax 305-652-6672 or Call 305-785-2559 Email: doctorsole@aol.com

ASSOCIATE POSITION – ORANGE COUNTY, CA

High volume surgical practice seeking well trained surgical associate for full-time position in orange county California immediately. This position can lead to separate private practice or partnership for the associate. Excellent Salary & benefits Package included. Email CV, photo, and questions to: FootSurgeonOC@aol.com

ASSOCIATE POSITION SANTA FE, NEW MEXICO

We are looking for a highly trained, personable, ethical, and caring podiatrist, to work in a two doctor, three office practice, of thirty years. Send CV to sfpodiatry@ aol.com

PRACTICE FOR SALE - RIVERSIDE, CA

.

Practice grossing over 250K/yr three days/wk. room to expand, large physician referral, good mix of sx., wound care, DME's, routine care. no rest homes. Medicare cert. surgery center on site. Will consider associate-to-purchase. may carry paper. Consider all offers. Office and sx. center also for sale. e-mail tentoes001@hotmail.com or call 951 7804782.

.

ASSOCIATE POSITION FLORIDA - NORTHEAST REGION

.

Busy, well established, full scope podiatry practice seeking highly motivated, hard-working, reliable, responsible and especially likeable to the average human, Associate. Surgical training a plus. Prefer PSR 24+. This is an Associate position with lots of potential. Team players only. Email CV to: healthparkmgr@bellsouth.net or fax CV to: 904-826-1586, Attn: Amy

.

POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA

.

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

WEEKLY SPECIAL - One week of ads (5x) for only $85

PM Classified Ads Reach over 9,500 DPM's and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 9,000 DPM's. Write bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 dekagan@aol.com

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.