The Voice of Podiatrists

Serving Over 10,900 Podiatrists Daily

June 27, 2008 #3,283 Editor-Barry Block, DPM, JD

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CA Podiatrist Pioneers Non-Metal, Biological Ankle Replacement

Patients suffering from severe arthritis now have an option for total-ankle replacement that offers increased mobility and pain relief without permanent metal implants. Pioneered by Daniel K. Lee, DPM at University of California, San Diego Medical Center, this technique is the first in the United States to offer arthritis sufferers a non-metal, biological ankle replacement.

Dr. Daniel K. Lee

"Up until now, patients have had two options for replacing their ankle joints: metal implants or fusion of the joints," said Lee, director of foot and ankle surgery at UCSD Medical Center. "Now there is an option that actually restores the ankle with an FDA-approved biologic material that is similar to the collagen found in cartilage."

During a 2-hour, minimally invasive surgical procedure, Lee, a podiatric foot-and-ankle surgeon, removes the damaged cartilage around the ankle joint through a 4-centimeter incision. The collagen material is then molded into the joint where it adapts to the contour of the patient's ankle. "Unlike a metal device, the advantage to this material is that the implant can be customized in size and contour for every patient's individual need," said Lee. "No matter how the patient's ankle is shaped, the collagen is a perfect fit."

Source: Physical Therapy Products (CA) [6/25/08]

CSPM at Samuel Merritt Names Venson as New Dean

Samuel Merritt College has named John Venson, DPM, as the new dean of its California School of Podiatric Medicine, effective Monday. Venson succeeds Albert Burns, DPM, who said this spring that he would return to a full-time faculty position after working as dean at the Oakland college since 2001.

Dr. John Venson

In his role as dean, Venson is the podiatric school's chief administrative and academic officer, in charge of its administration and curriculum. Major goals include enhancing Samuel Merritt's alliances with hospitals to create additional clinical clerkship and residency opportunities, promoting clinical research and strengthening ties between the college and the podiatric community, the college said.

Since receiving his Doctor of Podiatric Medicine in 1976, Venson has had a variety of jobs in podiatric medical education, accreditation, credentialing and management, most recently as associate director of credentials at the American Board of Podiatric Surgery in San Francisco.

Reid Seeks To Speed Action On Medicare Bill

Senate Majority Leader Harry Reid (D-NV) has taken action to move a Medicare reform bill directly to the Senate floor. The bill, approved by the House by a veto-proof margin of 355-59, would avert a Medicare pay cut to physicians and make other adjustments to the program. Reid invoked a rule that would allow the bill to bypass the Senate Finance Committee and get on the calendar for Senate consideration. The bill could be considered as soon as Thursday.

The House legislation is based on a Medicare reform bill from Senate Finance Committee Chairman Max Baucus (D-MT). According to a Baucus aide, Baucus and Sen. Chuck Grassley (R-IA), ranking member of the Finance Committee, had met to re-evaluate their options on a Medicare compromise in light of the House vote.

Finance Committee member Sen. John Rockefeller (D-WV) told reporters he hoped the Senate would consider the House bill. “It’s time to stop playing games” and get legislation approved, he said.

Source: Jennifer Lubell, Modern Healthcare [6/25/08]

Show That You're Ready and Willing

Signal your willingness to collaborate with a simple non-verbal gesture. Hold your palms upright, open and pointing to the ceiling. This gesture lets others know that you are open and willing to hear them out.

Note: Avoid this posture when you want to come across as powerful and dominant.

Source: Adapted from The Power of Body Language: How to Succeed in Every Business and Social Encounter by Tonya Reiman.

Query: Drysol as an Anticoagulant

I understand from a recent seminar lecture that Drysol can be used as an anticoagulant at small skin biopsy sites. Can anyone tell me: 1. How Drysol is mixed? 2. How it is stored in the office? 3. What's the shelf life? Any other insight is appreciated.

Bruce G Blank, DPM, Martins Ferry, OH

Query: Ordering 10% NAOH

As a practical matter, where would one order NAOH 10% for toenail ablation? The current literature seems to favor NAOH vs phenol.

Bruce Lebowitz, DPM, Baltimore, MD

RE: DVT Prophylaxis for Patent Taking Birth Control Pills (Richard Brandel, DPM)
From: Paul Busman DPM, RN, Gerald Mauriello Jr., DPM, MA

For a procedure this short, DVT shouldn't be a major issue. If you're really worried, let the OR put on some sequential compression stockings. In the hospital OR where I currently work, barring risk factors we usually only take special DVT precautions when a patient is under general anesthesia, especially with paralytic agents used.

Paul Busman DPM, RN, Cohoes, NY, BREWERPAUL@aol.com

In my opinion, there is no indication for DVT prophylaxis. The literature does not support it.

Gerald Mauriello Jr., DPM, MA, Toms River, NJ, mauriellodpm@gmail.com

RE: DVD on Procedures (Stephen Hartman, B.Sc.)
From: Multiple Respondents

"Surgery of the Foot and Ankle" edited by Coughlin has a very good accompanying DVD of surgical procedures. This book has many references to DPMs.

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

'The Art of Surgery' videos are well done and good reference material which I used as a resident. Visit OAMercado.com for a listing of available DVD's.

Christopher Formanek, DPM, Baton Rouge, LA, cformaneaux@bellsouth.net

The ACFAS has a Surgical Procedure Series that individual procedures which can be purchased at acfasdistancelearning.com/SurgicalProcedureSeries_2007/

Philip Wrotslavsky, La Jolla, CA, drphilipw@msn.com

RE: Value of Belonging to APMA
From: Jeffrey Kass, DPM

I read with great excitement today's PM NEWS.
1) Medicare Bill clears house with Veto Proof margin...
2) Accreditation Exemption status moves to Senate....

Both of these accomplishments are important reasons why EVERY podiatrist should consider joining APMA. We are a small profession - and it is important to stay united.

Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

RE: Pedorthists Vs. Podiatrists (Paul Kesselman, DPM)
From: Multiple Respondents

I find it interesting that a CPed would criticize the podiatric profession in a very public forum. I can only assume that this CPed gets his referrals from elsewhere. Podiatric referrals are a large part of my company's pedorthic business and I would like it to stay that way.

The road gets bumpy from time to time, Doctors get frustrated with me and I get frustrated with them. Simple communication is usually the answer. I value the referrals they provide. They give my stores' foot traffic that is hard to come by these days, they enhance the stores reputation, and I appreciate the trust that is placed in my crew.

The doctors value the services and goods we provide, but beyond that, we look out for our referring Doc's best interest. If the patient has an issue with the doctor, we smooth it out and give the doctor a quick heads up/voice mail. The first thing out of our mouths after deciphering the signature on the script is "Oh, you saw Dr. Smith, she is a good doctor." By building the patient's trust in the doctor, it helps us gain the patient's compliance.

In a nutshell, I guess what I am trying to say is that the patients come out winners when the podiatrist/pedorthist relationship is healthy. If you have a problem with some members of the other profession or they have one with you, repair it for the patient's sake, but leave it off of the newsletters.

John Luck, CPed, Akron, OH, jluck@neo.rr.com

While Dr. Kesselman demonstrates amazing restraint in his letter, I am not so inclined. There is a reason C.Peds could get CME since at least the early 90's by attending AOAFAS meetings. It wasn't for their attention during lectures on complex foot and and ankle surgical techniques. It was to curry favor. Now jump forward to today, and my experiences with a few C.Peds (shoe fitters in retail stores). I sent a patient into a well-known shoe store for a specific model of shoe. All the patient needed was to be fitted for the correct size, and return to my office when I received her orthotic, and not wear the shoes until then. The C.Ped said they couldn't sell her the New Balance shoes without first examining the orthotic. Further, they told her husband that they could make him an orthotic for a lot less than I was charging the insurance company.

I am now very well prepared when patients come to me with complaints of foot or ankle pain made worse, or at least not made better by the expensive shoes and outrageously priced devices given to them by people in shoe stores. They get a letter from me stating the condition was made worse, in my expert opinion, and then list the reason why. I ask the patient to attach a letter to mine, and mail it to the State Attorney General's office. I even supply the addressed, stamped envelope. I then tell the patient to go back to the retail store, show them the letter, and then demand a refund.

This is not to cast a bad light on the whole of pedorthists, just maybe the ones who are in retail to make money at any cost.

Robert Scott Steinberg, DPM, Schaumburg, IL, Doc@FootSportsDoc.com

Editor’s Note: Brett Richey’s extended-length letter can be read at: http://www.podiatrym.com/letters2.cfm?id=20403&start=1

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