July 01, 2006 #2, 620 Editor-Barry Block, DPM, JD

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One in Five Worldwide Have Tinea Pedis- TX DPM

Doctors have not been able to figure out why some people are more susceptible to developing an infection than others. "Twenty percent of the population worldwide are likely to be infected by tinea pedis," said Dr. J.R. Vazquez, a podiatrist and president of Foot Healthcare Center of El Paso.

Vazquez recommended alternating shoes and changing your socks twice a day if you sweat a lot to help prevent the likelihood of contracting athlete's foot.

"Treatments usually include using a topical antifungal cream twice a day for two to four weeks," Vazquez said.

Source: Leonard Martinez, El Paso Times [6/29/06]

NYCPM Volunteers Fit Boots For Over 1,320 Incoming Cadets

On June 27th and 28th, four faculty members from the New York College of Podiatric Medicine (NYCPM), assisted by nineteen third- and fourth-year students, worked feverishly to fit the more than 1,320 new cadet candidates of the U.S. Military Academy at West Point with properly-fitting boots. The NYCPM volunteers identified cadet candidates with a variety of pre-existing problems, ranging from blisters to bunions, hammertoes and other conditions, and referred them to their company medic. Cadets found to need special boot accommodations were referred to the Academy’s orthotist.

NYCPM third-year students Josephine Kleyner and Evan Adler follow up with two West Point new cadets during the Boot Fit.

This year’s participation in the Boot Fit by NYCPM marked the fifth year in a row that the College provided faculty and students to West Point to help out. Leading the effort were Lt. Col. Timothy Duffy, D.P.M., Chief of the Podiatry Service at Keller Army Community Hospital; Terry L. Spilken, D.P.M., Dean for Student Services, and President of the NYCPM Alumni Association, which picked up all NYCPM costs. NYCPM faculty members taking part were Michael J. Trepal, D.P.M., Vice President for Academic Affairs and Dean; Russell G. Volpe, D.P.M., Professor and Chair, Department of Pediatrics; and Anthony Iorio, D.P.M., Associate Professor and Chair, Department of Primary Podiatric Medical Sciences. NYCPM Alumni Association Trustee Charles Kaplan, D.P.M., and his wife, Robyn; Barry Sussner, D.P.M.; Barbara Spilken; and Kathleen and Daniel Trepal also participated in the Boot Fit.

“We deeply appreciate the New York College of Podiatric Medicine’s involvement in helping to prepare our incoming cadets,” said Lt. Col. Duffy. “Since NYCPM started this volunteer program of foot care for our new cadets, injuries such as stress fractures and infections have been reduced by seventy percent. And boot returns and blistered or injured feet are no longer a major problem for us.”

Insurers to Develop Personal Health Record for CMS

A joint venture involving two health insurers will develop a pilot personal health record for Medicare for free under a contract with the CMS. The CMS announced its intent to develop a pilot record in January. The contract was awarded to Capstone Government Solutions, Nashville, a joint venture of Blue Cross and Blue Shield of Tennessee and Cigna Government Services, an arm of Cigna Corp.

CMS is expected to award at least one other contract to develop a pilot personal health record. The Capstone contract will involve no money and run six months, said Gloria Barone, Cigna's director of public relations. "We want to be a good partner to the government," Barone said. "Obviously, we'll learn a lot, as well as the government." The CMS sought contractors with a working personal health record.

Source: Joseph Conn, Modern Healthcare [6/29/06]

Query: CRPS

I recently performed an instep fasciotomy on a patient. The surgery is doing very well, however after his posterior tibial nerve block, he was numb for several days and then began to get severe burning pain along the course of the PT nerve. His pain has become so severe that you can barely touch his tarsal tunnel area. He is 5 weeks post op and I have him currently working with a PT and an appointment with a pain management MD. I believe he is developing CRPS. He is deathly afraid of a PT injection. Has anyone ever had a similar experience? Any thoughts on anything else I can try?

Peter Riznyk, DPM, Orchard Park, NY, opfootdoc@adelphia.net

RE: Flip-Flop Fear
From: Nat Chotechuang, DPM

It appears to be the party line lately to sound the code orange alert to the general public about the catastrophic dangers of flip-flops, but since it's de rigeur fashion I doubt too many people will listen to a few podiatrists harping on them to simply stop wearing the easy-breezy summer shoe. What are you going to do? Wear your SAS shoes to the beach?

Instead, I've been pointing people towards the flip-flops I've found (and yes, personally wear daily) that have something of an arch support: Montrail Molokai/Molokini, and Chacos. They're not as supportive as a custom orthotic of course, but they're better than the $4 models from Wal-Mart. Do you all know of any other brands of supportive flip-flops, or are these the only two manufacturers for now?

Nat Chotechuang, DPM, Bend, OR, natchot@hotmail.com

RE: MD/DO Degree
From: John Scheland, DPM, Jeffrey Trantalis, DPM

I have seen this issue come and go from podiatric discussions for several years. I agree that something has to be done, but I am not completely sure of all the issues we would need to address. We need to know more about the legal, educational, and training issues as well as solve the NBME, licensure and logistical issues to make all this a serious discussion.

I suggest that instead to complaining about it, why don't we get our leadership involved into looking at the problem, including logistics on degree change, and have them develop steps toward our ultimate goal, parity.

My suggestion is to employ all our resources toward this goal and not only look to the APMA, but the ACFAS, ABPS and the CPME to address all aspect of what seems to be a daunting task ( don't we contract with the AFL/CIO? why not use their lawyers/lobbyists?). If this is a degree change, then so be it. However, it will require all our resources and talent to climb the fences that we ourselves helped to build.

I have yet to see our leadership even so much as comment on this issue. They may fear that succeeding on a project like this would make the reason for their existence obsolete. This would also be wrong thinking, we would grow the profession better and increase our need for them even more.

John Scheland, DPM, Winchester, VA, limblengthener@yahoo.com

There is a very small, but powerful group of orthopedic doctors that are members of American Orthopaedic Foot and Ankle Society. They have a website http://www.aofas.org/i4a/pages/index.cfm?pageid=1 and I recommend viewing it. Their name is not important. What they represent is very important. Their goal and motto are to put us podiatrists out of business. They are slowly succeeding because of their huge resources for research and within the MD community.

Years ago S. Hansen, MD (foot and ankle internationally recognized specialist) started a foot and ankle fellowship program with the help of the local podiatrist. It was kind of ironic that podiatrists were teaching these orthopedic fellows. This organization is getting their information out to the media and thus the public. The media will seek these doctors out instead of podiatrist, for their opinions. If you do not have one of these orthopedists in your community presently, I can guarantee you will in the near future. Then see where your referrals go. So it behooves us not to debate this issue any further. We need to be pro-active immediately for our future and our existence.

Jeffrey Trantalis, DPM, Deerfield Beach, FL

trantalis@bellsouth.net

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-
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PRACTICE FOR SALE - NEW JERSEY

Well established practice with modern equipment for sale. Two main offices and two satellite offices included. One podiatrist has been able to make very comfortable living, but also great for two docs looking to start up. Willing to transition over 1 year. This is a great opportunity! contact DOCCAPO@YAHOO.COM

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- 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.

PRACTICE FOR SALE - CENTRAL FLORIDA

Well established surgical podiatry practice for sale. Located in a state-of-the art out patient surgical center.Grossed $1,038,000 in 2005. Low down payment. Price negotiable. Contact Camille Todd/Transworld 321 217-3625 or camille@tworld.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 - BEST OFFER CONSIDERED NOW!!!!

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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