The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 07, 2011 #4,200 Publisher-Barry Block, DPM, JD

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Combination of Heels & Flats is Bad for Your Feet: CA Podiatrist

When wearing super high heels, many women will carry along a pair of flip-flops or slippers to change in and out of. While this might seem like a good idea, podiatrists say it's bad for your feet. "When you're wearing a high heeled shoe, your Achilles tendon and hamstrings are getting shortened so you don't want to go really to a very low shoe," said Dr. Franklin Kase. 

Dr. Franklin Kase

The Burbank podiatrist says going from high shoes to flats with absolutely no support daily is more damaging to your Achilles tendon than just wearing the heels all day. So instead of flip flops, what should you be wearing? Dr. Kase says look for something with a wide toe box, something that's flexible at the ball of the feet, and something with firm heel and arch support. "You want to have good support and stability, that supports the arch of the foot, that supports the heel of the foot," said Dr. Kase.

Source: Denise Dador, KABC-TV. [7/5/11]

OCPM Students Have First-Ever Orthotics Rotation

OCPM and Earthwalk Orthotics have created the first-ever rotation for third year students. Under the direction of Bryan D Caldwell, DPM, MS, Dean of Clinical Education and Operations, OCPM students are spending a day at Earthwalk. They are working side-by-side with Earthwalk’s management staff, learning how contemporary orthotic manufacturing is done, through the process of cast correction, machining, production, and finishing of custom orthoses.  

OCPM Students: Brian McManus, Jason Kelty, Rodney Scott, and Rene Hymel with Susan Bartos, President of Earthwalk Orthotics

Students attend in small groups in an effort to gain hands-on experience with plaster, fiberglass, impression foam, and electronic scans. Each student fabricates his or her own pair, from start to finish, as well as working with “real” orders received at the lab. The student’s reaction to the new rotation has been very favorable. “It is very nice to see the information we learn in books actually put in to use," wrote one student on an evaluation form.

NUI Galway Signs Memorandum of Understanding With NYCPM

The Discipline of Podiatry at NUI Galway in the Republic of Ireland has formally signed a Memorandum of Understanding with New York College of Podiatric Medicine (NYCPM), one of the leading institutes in podiatric medical education in the USA. 

(L-R) NYCPM Dean Dr. Michael J. Trepal; Fiona Lowry, Podiatry Administrator, NUI; Dr. Caroline McIntosh, Head of Podiatry, NUI; and Louis L. Levine, President & CEO, NYCPM

Speaking at the signing, Dr. Caroline McIntosh, Head of Discipline of Podiatry at NUI Galway, said: “This agreement facilitates the establishment of student and staff exchanges, research collaborations, and the co-development of innovative developments in podiatric education which may have academic, clinical, and commercial implications.”

WA Podiatrist Receives Gerard Vincent Yu, DPM Table Instructor of the Year Award

Dr. Mary E. Crawford was awarded the AO North America Gerard Vincent Yu, DPM Table Instructor of the Year Award, in recognition of her dedication and outstanding contribution to the individual instruction of course participants in the science and skills of internal fixation in foot and ankle surgery. 

Dr. Mary Crawford with Gerald Vincent Yu, DPM Award

Crawford is Chair of the Board of Medical Advisors of the International Foot and Ankle Foundation. The award was presented at the Podiatric Basic AO Course, Charlotte, North Carolina.

Query: Austin Complication

A few months ago, I removed a tumor from the right first interspace that I thought, by the history and positive Mulder's sign, was a neuroma; it was not. The tumor was described by the pathologist as non-descript inflammatory tissue. The patient was asymptomatic for a few weeks after recovery (last December). 

Austin Bunionectomy , Post-op

I had already tried injections, orthotics, and ultrasound - all to no avail. According to the patient, the pain is just like prior to surgery. She now tells me that the pain has existed since a bunionectomy six years ago. Revisiting the x-rays, it appears that the alignment is excellent and that the surgery was an Austin. I am thinking of excising the lateral sesamoid; but maybe I should consider saucerizing the most lateral aspect of the sesamoid. Any advice would be appreciated.

Query: Source for Dehydrated Alcohol

My vendors state dehydrated alcohol 1 ml ampules are on backorder indefinitely. Does anyone know where I can purchase ampules?
 
Olga Luespchen, DPM, Sebring, FL

RE: DVT Prophylaxis Protocol Clarification (Yelana Barsky, DPM)
From: Randall Brower, DPM

I have received a few responses suggesting that I was rude and insensitive. I was blunt and short. I didn't intend to offend. However, I am sick of defending podiatrists to my orthopedic and medicine colleagues. You must look at this from our medical colleague's perspective. A surgeon not knowing the basics of peri-operative management is the same as a family practice doctor prescribing HTN meds without knowing what a normal systolic BP is.  The question wasn't about what variation of DVT protocols should be used; the question was whether or not all NWB patients need DVT prophylaxis, etc. 

While I never intended to be rude, I may have been insensitive. I'm sorry. However, podiatrists who don't know that they don't know their limits ruin admitting and surgical privileges for the rest of us.  Also, of our concern for a patient, podiatrists should know basic DVT protocols in school and any legitimate residency. If they don't, they shouldn't be doing surgery. It is harmful to patients and our profession. That was my intent in responding. I apologize for the way I said it.

Randall Brower, DPM, Avondale, AZ, footdoctor33@yahoo.com

RE: Sublesional 4% Alcohol Injections (Austin Reeves, DPM)
From: G Dock Dockery, DPM

Painful punctate keratotic lesions on the plantar feet may be injected with a 4% alcohol solution. I recommend injecting a small amount (1/4 cc) sublesionally, not intralesionally, once a week for three visits. There are published articles on the mixing and techniques for lesion injections. I do not recommend mixing the 4% alcohol with cortisone. Here are two references with more information.
 
http://www.podiatrym.com/cme/Jan04CME.pdf
podiatrytoday.com/article/468
 
G Dock Dockery, DPM,  Seattle, WA, Gdockdockery@aol.com

RE: Organized Medicine and Office Visit Costs
From: Deborah S. Wehman, DPM

I recently read three books at the suggestion of a family practice MD who teaches at the University of MN in the family practice division. They give a different view of current medical practice and give plenty of food for thought. Podiatry is not mentioned specifically. Reading them was informative for my own personal healthcare decisions and makes me less leery of cost and care in the future. It puts some power back in the hands of the patient.

They are: Overdiagnosed: Making People Sick in the Pursuit of Health by H. Gilbert Welch, MD, Worried Sick: A Prescription for Health in an Overtreated America by Nortin Hadler, MD, and Disease, Diagnosis, and Dollars: Facing the Ever Expanding Market for Medical Care by Robert Kaplan. It would be an interesting vein for discussion.

Deborah S. Wehman, DPM, Richmond, IN, DSWehman@comcast.net

RE: How Would Your Life be Different if You Had an MD Degree (Art Korbel, DPM, MD)
From: B.T. Sullivan, MS, DPM

I am a strong advocate for a degree change - mostly for those reasons stated by Dr. Korbel.

The fact that he has developed acceptance in his medical community by "degree" is a good reason to change our degree. For those of us who have developed acceptance in our medical communities, it has taken many years of proving ourselves on a daily basis and years of interaction for the other physicians in our areas to feel comfortable with us and our abilities. The doctors graduating our residency programs should not have to go through that. Our programs should have uniformity and standardization. Our leaders should push us hard in that direction!

The real question that I have for Dr. Korbel is:...

Editor's note: Dr. Sullivan's extended-length letter can be read here.

RE: Runners Who Wear Minimalist Shoes Should Wear Orthotics: IL
From: Dennis Shavelson, DPM

Dr. Duane Brown is certainly entitled to his opinion and the value he puts on his orthotics; however, does he really believe or have any evidence that orthotics provide “total alignment” or that they “make the body more efficient” as he represents our profession in print? Do his devices give cyclists “so much more power” and offer “complete control”? Maybe this is why those touting minimalistic shoes and the NY Times are so against orthotics, podiatry, and the fees and services we provide when it comes to biomechanics, and call us charlatans unfairly.

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

ASSOCIATE POSITIONS - NW INDIANA & CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

ASSOCIATE POSITION/PART TIME - ORANGE COUNTY CALIFORNIA

Experienced podiatrist - 2-3 days/week, two office locations in beautiful south Orange County California. Exceptional opportunity for seasoned semi-retired practitioner. Fax or e-mail Resume and LOI to 949-488-0868/ Info@feetfixer.com.

ASSOCIATE POSITION – IOWA CITY AREA

Modern practice seeking a well-trained (PSR 24/36) associate. Excellent opportunity for an energetic, hardworking individual with strong surgical and medical skills. Solid referral network and 13 years of growth. Come live in the Iowa City area and enjoy the quality of life and stability of a Big Ten University community. Competitive salary and benefit package available. If interested, fax CV to 319-354-1014 or e-mail to dave@341foot.com

ASSOCIATE POSITION - CENTRAL NEW JERSEY

Seeking associate for busy, growing practice located in Toms River, Ocean County. Looking for PSR 24/36, board eligible doctor. Basic podiatry a must. Practice has a up-to-date EMR and practice management program. Digital x-rays, ultrasound, laser, vascular studies. Excellent opportunity for highly motivated and ethical DPM. Send CV to toesec@aol.com

ASSOCIATE POSITION - NORTHWEST FLORIDA BEACHES

Excellent opportunity for an energetic, compassionate, hardworking individual with superior surgical and medical proficiency. Recent graduate or experienced practitioner. Excellent salary, benefits and partner-buy in offered, full admit privileges and surgical scope. Fax CV to Ecpodiatry@aol.com

ASSOCIATE POSITION - SAN DIEGO

Well-established practice is seeking an associate with the opportunity for a future partnership position. Great location and medical environment. Must have a California license and an interest in the full range of podiatric services. Please email resume and cover letter to ethuen@hotmail.com

SPACE AVAILABLE- NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

TURN-KEY PODIATRIC OFFICE - CALIFORNIA

Fully equipped modern suite with built-ins at Mission Regional Medical Center, Mission Viejo CA. Four treatment rooms, New Midmark chairs, x-ray/processor, phone system & much more. $45,000/assume lease. Call Jackie, 949-493-8020.

PRACTICE FOR SALE - NANAIMO, BRITISH COLUMBIA, CANADA

Have you ever dreamed of owning a practice where... you can see 0-50 patients daily .. .average 100 new patients monthly have zero accounts receivable ... gross $480 M per year .... live in a beautiful community with skiing, hiking, fishing and boating on your doorstep. This could be yours! If interested contact pistone@telus.net or 250-754-4192.

PRACTICE FOR SALE - MISSOURI

Well established, but still growing. Grossed over $300,000 last year. Located in a thriving medical community. Good payer mix. All aspects of podiatry needed in the area. Do not let this opportunity to own your own practice pass you by. Contact footdoc2002@yahoo.com for more information.

PRACTICE FOR SALE - MISSION VIEJO, CA

Relocating to Tulsa. Great opportunity. Located at Mission Regional Hospital. Sale price $205,000 including supplies. Gross income 2010 was $340,000. Gross income 2011 estimate $420,000. Approximately 1200 sq ft with 3 treatment rooms, digital x-ray and fully computerized. A/R available at 50% discount. 949-702-1052. David Stoller, DPM (Family Footcare)david@missionviejofootcare.com

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