July 12, 2006 #2,628 Editor-Barry Block, DPM, JD

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PA Podiatrist Recovering From Recent Flood

More than a week after the flood, Exeter, PA residents are still cleaning up near Hicks Creek — even in areas not normally impacted by rising waters. Drywall, carpet and couches stacked 3 feet high in some spots still lined the street Thursday in Mayflower Village. Overflowing dumpsters sat alongside suburban homes with perfectly landscaped lawns on Donnas Way.

Dr. Michael Baloga built his home here 15 years ago, eventually turning his basement into a carpeted office and family room. Local flooding in 1996 and 2004 did not bring water into his home. On June 28, two pumps couldn’t keep the water out of Baloga’s basement. Another pump, in the basement’s bathroom, barely contained water from an overflowing toilet.

Baloga, a podiatrist, said he was pleased the borough is working to fix the problems. He hopes to bring a group of residents to Tuesday’s 7 p.m. borough council meeting. The residents are not going to point fingers, Baloga said. They just want to help the borough find a solution. “We want to work together to solve this problem,” he said. “We all live here together.”

Source: Nichole Dobo, Citizen Voice, [7/10/06]

Canadian Podiatrist Fights Back Against Osteoarthritis

Not yet 50, Mike Forgrave was devastated to learn that he had to hang up his running shoes. A former elite runner and member of the 1978 Commonwealth Games, he had known his share of aches and pains. Five years before, however, he had been diagnosed with osteoarthritis or OA and advised to stop participating in any sports. "I was told not to do anything and to just wait for a partial knee replacement," says the Kitchener podiatrist.

Forgrave describes the pain as like a "constant, gnawing toothache in my knee." He found even walking a challenge. OA primarily affects the knees and hips where the body's weight is supported. In addition to wearing orthotics in his shoes, Forgrave takes glucosamine, takes regular physiotherapy and has had several rounds of viscosupplementation. The injections can cost up to $350 and are good for between six months and one year.

Currently training for a triathlon, he says he now has his active life back. A few weeks ago, he was mountain walking in Greece and last year he hiked in northern Norway, where he had no difficulty with the uneven terrain. He acknowledges that eventually he'll have to have a partial knee replacement. "The surgeon said, 'Let's wait until you're 50.' I say, 'Let's wait until I'm 70.' I want a full and active life."

Source: Marilyn Linton, The London Free Press, 7/10/06]

Sen. Clinton to Introduce Legislation to Create 'Privacy Czar'

Sen. Hillary Clinton (D-N.Y.) announced plans to introduce the Privacy Rights and Oversight for Electronic and Commercial Transactions (PROTECT) Act of 2006, which would create a "privacy czar." The position would have "oversight into the workings of every government department and the power to make sure the law is being followed and best practices are implemented," according to a prepared statement.

The bill would establish a Privacy Bill of Rights, which includes the right to clear protections of consumers' private information, the right to sue and seek damages, the right to protect phone records, the right to freeze personal credit and the right to medical privacy. Also included is the right to know (1) when identity theft happens, (2) when personal data leave the country and (3) your own credit report.

Source: Report on Patient Privacy [July 2006]

Query: MD/DO Degree Change Poll

Why doesn’t this forum take up a vote and let the higher ups see the result of what the grassroots really want, i.e,. a degree change.

Laurence C. Rogers, DPM, Rochester, IN

Editor’s comment: Actually podiatrists will get the chance to answer this question for the 24th consecutive time in August when we ask it in our annual survey (both in the August issue of PM as well as on the Internet). When we first asked this question over decades ago, podiatrists were against this idea by a two to one margin. Over the years, this ratio has reversed.

We are optimistic that the leaders of our profession will respond to these results or conduct their own referendum on this major paradigm change.

RE: Orthoses Research “Study”
From: Eric Teeman, DPM

While it’s amusing that an Internal Medicine journal feels frisky enough to “study” pathology outside of their expertise, it’s sad that they would publish such ridiculous conclusions. Forgiving the rather small sample size of the study, there seems to be no account for many other factors: use of concurrent anti-inflammatory measures (ice, NSAID’s), stretching, activity modification, orthotic compliance, method of orthotic casting/fabrication, etc. Failure to use and/or control such variables clearly precludes an accurate finding.

Personally, I haven’t performed a similar scientific study, so maybe I shouldn’t comment. Nevertheless, most of us have been successfully employing orthoses to help resolve pain and to improve function in plantar fasciitis patients, both short- and long-term, for decades. In my experience, custom devices have been far more effective, especially in the long-term.

If we’re not going to seal the gaps by publishing accurate studies on the staples of our profession, maybe we should waste our time publishing inaccurate studies on poorly understood internal medicine treatments.

Eric Teeman, DPM, Tampa, FL, eteeman@tampabay.rr.com

RE: Off-Loading Healed 5th MPJ Ulcerations (Thomasin Hammer, DPM)
From: Itamar Rosenbaum, C.Ped.,

I would check to see that there is no inversion influence on the forefoot either by rearfoot varus, or by forefoot varus or supinatus. If there is no such influence, then I would check for an equinus that is possibly causing undue stress on the forefoot.

What is critically important is the position of the apex of the rocker sole on the shoe. In this case, it needs to be proximal to the 5th met head and on an oblique axis so that it forces the forefoot to toe off on the medial side of the foot rather than on the lateral. Additionally, there needs to be a spring steel sole bar embedded in the sole of the shoe which gives the rocker more integrity and better function.

I would also try a high top shoe which tends to reduce plantar pressure levels significantly.
What also needs to be added to this internally is a metatarsal bar proximal to the met heads.

Itamar Rosenbaum, C.Ped., New York Pedorthic Associates, Inc.

nycped@verizon.net

HOUSE CALL PRACTICE OPPORTUNITY- CHICAGO/NORTHWEST INDIANA

Chicago-Home Physicians specializes in house calls to the elderly homebound. Full and part-time positions available in Chicago/Northwest IN. Competitive Compensation, including malpractice. Contact Scott Schneider. Phone-773-292-4800. Fax-773-486-3548. E-mail sschneider@homephysicians.com www.homephysicians.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.

ASSOCIATE POSITION – TEXAS

Full time associate position for a PSR-24 podiatrist to join established dynamic medical and surgical practice in Central Texas. Looking for a personable, motivated, ethical, hardworking individual to join our board certified group. Please send resumes or CV to centexfootdoc1@aol.com

EQUIPMENT FOR SALE – SONOCUR ESWT

I have a Siemens Sonocur shockwave FDA-approved machine for sale $70,000. Call 416-545-1166 or email: dracula65@hotmail.com

ASSOCIATE POSITION- LAUREL, MARYLAND (SUBURBS WASHINGTON DC)

Great opportunity for a hard working, ethical podiatrist to join a vibrant, successful podiatric medical and surgical practice. ASC on-site . Practice has dedicated, supportive staff with marketing knowledge. Board eligible/certified referred. Surgical residency. Competitive salary with bonus. Fax CV to 240 465 0332

PRACTICE FOR SALE--BUFFALO, NY

Part time practice with full time possibilities. Mix of conservative, biomechanics and diabetic foot care. Good surgical potential. Gross 180K. Willing to stay through transition. Call 716-836-8123.

HOUSE CALL PRACTICE FOR SALE – SOUTHERN CALIFORNIA

House Call practice for sale which includes approx. 400 patients and continued referrals. erfect for solo practitioner. Extremely easy and profitable practice to run. Yearly gross of over $200K. Current DPM is retiring. Financials will also be provided. Please contact
ccipinc@ccipinc.net

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

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