The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

July 26, 2010 #3,914 Publisher-Barry Block, DPM, JD

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Toning Shoes Can Create Foot Problems: NY Podiatrist

Some medical professionals question the value of a sneaker that requires an instruction booklet (Skechers recommends limiting use to 25 to 45 minutes per day for beginners and guides consumers to find their balance by stepping in the middle of the soft foam heel, rolling forward, and pushing off with their toes.)

Dr. David Davidson

“There’s major risks, especially for adults,” said David M. Davidson, former national president of the American Academy of Podiatric Sports Medicine. He has treated patients who developed Achilles tendonitis and stress fractures that he suspects were caused by wearing toning shoes. “Creating instability, on adults especially, is not a good thing,” said Davidson.

Source: Jenn Abelson, Boston Globe [7/23/10]

OCPM Receives Research Funding Through National Institutes of Health

OCPM was awarded a research grant from the National Institutes of Health to study the clinical implications of plantar shear stresses in diabetic ulceration. Dr. Metin Yavuz, Assistant Professor and Research Associate at the Ohio College of Podiatric Medicine (OCPM), will be leading the research project. The project will take three years with an approved budget of $150,000 plus indirect costs.  Over a hundred diabetic patients will be recruited and their 3D plantar loading patterns will be assessed. The project will start this summer.

Dr. Metin Yavuz

According to Dr. Yavuz, “there are still unresolved issues in the pathology of diabetic foot ulcers. Studies in the last decade have shown that foot pressure is not a reliable tool for predicting plantar ulcers. Frictional shear forces under the foot have long been associated with diabetic ulceration. However, such an association has never been studied before. In this study, we will explore whether plantar shear can be used clinically to identify patients who are at risk. The results of the project will help us better understand the etiology of diabetic foot ulcers. It is thought that diabetic patients will be offered better therapeutic footwear and treatment options based on the results.”

Langone Elected President of AAPSM

At the American Academy of Podiatric Sports Medicine Annual Meeting recently held in Seattle, Washington, the AAPSM announced that Karen A. Langone, DPM, a sports medicine podiatrist in private practice in Southhampton, New York, was elected President.  Dr. Langone received her Doctor of Podiatric Medicine degree from the New York College of Podiatric Medicine. In addition to being a Fellow and President of the AAPSM, Dr. Langone is a Fellow of the American College of Foot and Orthopedics and Medicine (ACFAOM) and serves as the Lead Clinical Director for New York State Fit Feet Special Olympics International.

Dr. Karen Langone

Also elected were:  President-Elect - James Yakel, DPM, Brighton, CO; Vice President - Robert Conenello, DPM, Orangeburg, NY; Secretary/Treasurer - Paul R. Langer, DPM, Minneapolis, MN; and newly elected Director - David Jenkins, DPM, Glendale, AZ. David Davidson, DPM, Amherst, NY serves as Immediate Past President. Rita J. Yates, of Walkersville, MD, serves as AAPSM Executive Director.

Docs Slow to Adopt Advanced e-Prescribing

Although electronic prescribing tools are widely available, they are not very widely used. According to the 2009 National Progress Report on E-Prescribing released in March by the electronic prescription exchange service Surescripts, about 68 million prescriptions—or 6.6% of the U.S. total—were transmitted electronically in 2008. This tripled to 191 million, or about 18%, in 2009, the Surescripts report noted.

The Center for Studying Health System Change report acknowledged barriers to the use of these applications. It mentioned other studies' findings that doctors suffer "alert fatigue" from the drug-interaction feature and often stop using it. The report also noted that many physicians are reluctant to rely on health-plan-supplied formulary information because they perceive this data to be incomplete or inaccurate and that patients' pharmacies sometimes lack the capacity to receive electronic prescriptions.

Source: Andis Robeznieks, Modern Healthcare [7/22/10]

Take Your Time - Part 2

If you still feel rushed, you may start speaking too quickly, but that’s one of the biggest mistakes you can make on the phone. Here’s how to slow down:

•  Note the times callers ask you to repeat yourself. If they routinely ask you to restate your name or the name of your organization, that is a sign that you are introducing yourself too quickly.
•  Pause between sentences. On the phone, it’s especially important to heed the periods or commas that would apply to your comments if they appeared in print. Wait one second to speak again after you finish a sentence or between items you’re reading from a list.
•  Listen to your outgoing voice-mail message. Check whether you are slurring words together, mumbling or making it hard for others to hear you.

Note: Telephones transmit lower pitches more accurately than higher tones. So you may need to speak in a slightly lower tone than usual to sound confident when you’re making calls. Remind yourself to maintain a clear, confident tone—even during uncomfortable conversations. When a caller asks you a tough question, concentrate on replying in your natural voice instead of letting the pressure you’re under cause your voice to rise.

Source: Communication Briefings

Query: Parkinson’s Disease 

I have several patients with Parkinsonian tremors and gait abnormalities.The tremors make it difficult to do any procedures, including debriding fungal nails. Does anybody have some solutions? Do distraction techniques help?  Would orthotics/AFO's help with the gait problems by adding support and providing added proprioception feedback?

Steve Bennett, DPM, NYC, NY

Query: Supergroup vs. IPA

I'm looking to join a "supergroup" without walls in Texas, such as the one from Dallas mentioned in PM News. Another group is claiming to be an IPA. I can't understand the difference between the IPA concept and the Dallas group. Can anyone compare and contrast them?

Name Withheld

RE: Passing of  Godfrey Viegas, DPM

On July 23, 2010, we lost A 1990 graduate of SCPM. Dr. Viegas completed the three-year residency at the University of Chicago. A skilled surgeon, he started  practice in Crystal Lake, IL and grew it into a thriving surgical practice. He lectured internationally. He was beloved by patients, staff, and classmates. Godfrey was a professional jazz guitarist, and the class of 1990 was fortunate to have heard him play.  He will be missed. The profession has lost a star and I have lost a dear friend.

Gary Trent, DPM, Chicago, IL

RE: Research on Toning Shoes
From: Kevin A. Kirby, DPM

One of the fastest growing segments of the shoe marketplace is the "toning shoe", including MBT (Masai Barefoot Technology), Skecher Shape-Ups, and Reebok EasyTone, to name a few. These shoes typically have a thick rocker sole, have a relatively soft heel wedge and are considered to be a less stable shoe sole design. These shoes retail from about $110 to $250. The marketing claims from the manufacturers of these shoes push the envelope of "truth in advertising", with advertisements claiming that the shoes will help burn more calories, tone up the legs and buttocks, and improve posture. Even though I have a number of patients who have benefitted with reduced foot pain while wearing these shoes, an equal number of my patients have purchased and tried these shoes and found they didn't help them, or even hurt them.
 
A recent independent scientific study from the American Council on Exercise shows that none of the "fitness shoes" tested helped the subjects burn more calories or exercise muscle groups more intensely than a typical running shoe while walking from 3.0 - 3.5 mph on a treadmill (Porcari J, Greany J, Tepper S, Edmonson B, Foster C, Anders M: Will toning shoes really give you a better body (acefitness.org).  This independent study is, to my knowledge, the first research study on these shoes that was not funded by one of the shoe manufacturers.
 
I hope this research may help the readers of PM News better answer questions from your patients regarding these shoes and the validity of their manufacturer's marketing claims.  (acefitness.org/getfit/studies/toningshoes072010.pdf)
 
Kevin A. Kirby, DPM, Sacramento, CA, kevinakirby@comcast.net

RE: Multiple Fractures vs. Charcot Foot? (Jeffrey Kass, DPM)
From: David L. Nielson, DPM, Brad Makimaa, DPM

Since the patient has neuropathy and diabetes, Charcot is the first diagnosis in the differential as Dr. Kass has stated, and I would treat it as such. However, if you want to find out the difference, a bone scan followed with indium will also differentiate. This would not matter to me since I would treat it as the most crucial pathology: Charcot.

David L. Nielson, DPM, Roanoke, VApampantla@hotmail.com

Unless this patient had excess physical activity or trauma, you have the definition of Charcot and, if not immobilized, the foot will have a significant collapse and debility will develop. You should consult a local podiatrist with more knowledge of Charcot to work through this with you. No offense, but until you underestimate one of these and see it go bad, you will not truly appreciate it.

Brad Makimaa, DPM, Key West, FL, drmak3@comcast.net

RE: Recent HIPAA Regulations
From: Michael L Brody, DPM

Regarding the recent comments on HIPAA regulations: HIPAA does require that all workstations be password-protected, but it does not require that all applications be password-protected. We can all continue to use our word processing software to generate letters to patients, referral letters to other doctors, or even create our chart notes with no concern about being in violation of HIPAA.

HIPAA also specifies rules regarding encryption of data, especially data that is stored on removable media such as thumb drives. So, if you wish to utilize a word processor to store patient data,  when you back up your word processor data, you will need to configure the encryption of your removable media yourself.

There are additional rules regarding security and passwords for software to be certified for the incentive payments. But if you are using a word processor as your EMR, you are not eligible for the incentive; so in this case, these rules are moot.

Michael L Brody, DPM, Commack, NY, mbrody@cmeonline.com

RE: Podiatry Hall of Fame Thank You
From: Lynn Homisak

As I humbly sat on the dais among many of podiatry's “greats” - about to receive what was the most prestigious award in my lifetime – a blanket of forgetfulness covered me. In his "roast", Jason Kraus managed to humorously point out some really important people whom I know. Afterwards, even with a prepared acceptance speech in front of me and a case of individually wrapped bottles of wine ready for distribution, I neglected to shed light on who the important people in my life REALLY are. I would now like to take this opportunity to publicly acknowledge and thank those individuals, there in the room that day, with whom I proudly share this Podiatry Hall of Fame spotlight and all that this Lifetime Achievement Award represents.

I would never have received such an honor were it not for their unselfish guidance and support which has helped influence and shape my career: Jason Kraus of Langer Labs, whose friendship, ethics and loyalty I continue to respect and admire; Denis, my husband who truly is the wind beneath my wings, my children, Jessica, Kristy, Nick, and Ben, Dr. Roy LaBarbera and Mr. Glenn Lombardi (of Officite) who each made “day trips” from the eastern side of the country just to be with me on my special day, Dr. Barry and Hermine Block who continue to make me look good as an author, and to Dr. Howard Schaengold, Dr. Glenn Gastwirth, Dr. Donald and Ann Orminski, Yolanda Christianson, Dr. Hal Ornstein, Dr. John Guiliana, and Dr. Susan Scanlan for their teachings and advice. These are among and always will be to me...the really important people in my life! My warmest congratulations once again to Dr. Allen Jacobs – I was honored to share this Hall of Fame induction with you! 
 
Lynn Homisak, PRT, Renton, WA, lynnprt@msn.com

FULL-TIME ASSOCIATE NEEDED FREDERICK/HAGERSTOWN, MARYLAND

Reconstructive Foot & Ankle Institute, LLC  needs full-time DPM at least PMS 36 to join premier group in Frederick/Hagerstown, MD. ASC, EMR, DR-digital radiography and ultrasound, Vascular/nerve testing, DME, retail store, strong hospital affiliations, salary, bonus and benefits. Respond to drmichaels@rfainstitute.com

PRACTICE AVAILABLE - WESTERN WASHINGTON

General Podiatry practice in Port Townsend, WA. Nice community, 25+ year old practice, busy 3 days a week with growth potential. Owner leaving area, needs someone to take over the practice, lease and equipment. Contact Jessica at ptpod@yahoo.com or 925-519-0624.

ASSOCIATE POSITION - NEW JERSEY - JERSEY SHORE REGION

Part-time associate wanted. Looking for a motivated and ethical practitioner. Competitive salary with incentives. Tuesday AM - Thursday PM - 2 Saturdays/month. Please respond to: NJSHOREFOOTDOC@aol.com

PRACTICE & STATE LICENSED ASC FOR SALE (MARYLAND, DC SUBURB)

38 yr old general podiatry practice grossing over $550K. Fully equipped with digital x-ray, diagnostic ultrasound, 2 orthotic scanners, computer network and well-equipped surgical suite. Retiring owner will stay on as needed. Email - dpmpracticeforsale@yahoo.com

PODIATRY ON CALL - MIAMI-DADE & BROWARD COUNTIES, FLORIDA

Call us for vacations, "unexpected emergencies" and playing hooky. Part-time or Per Diem Basis! Extensive surgical and non-surgical training with Dr. Stanley R. Kalish in Atlanta, Georgia. On call everyday to meet your office needs! Contact: podiatryoncall@gmail.com or 305-342-9797.

ASSOCIATE POSITION - SOUTHEAST GEORGIA

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking associate or new residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

PART-TIME, LICENSED PODIATRIST - WEST BLOOMFIELD, MICHIGAN

Immediate opening for treating patients in a nursing facility setting.  If interested, please email drteetime@aol.com

PART-TIME ASSOCIATE - NY LOWER HUDSON VALLEY (PUTNAM COUNTY)

Wednesday's & Saturdays  compensation dependent on collections. Hospital privileges & wound care center available. Excellent relationship with local Drs. including orthopedists- References required. Great opportunity for recent resident to gather cases for ABPS. Reply to PodAssociate@aol.com

ASSOCIATE POSITION - FREDERICK, MARYLAND

Fredericks premier group practice is located only 45 minutes from both DC and Baltimore. Immediate opening for a minimum PSR 36 Podiatrist for full time position. We have it all: EMR, digital x-ray, ultrasound, ASC, etc. Excellent salary with bonus structure and benefits. Please email resume to docsbnb@aol.com

POSITION AVAILABLE - SOUTHERN CALIFORNIA

Very well established, multiple location group practice has immediate opening for associate doctor. Attractive compensation and benefit package offered. E-mail resume to mrsmcmackin@aol.com

PODIATRISTS NEEDED NATIONWIDE

Podiatry referral company has thousands of diabetic patients nationwide in need of immediate service. We are looking for podiatry practices interested in joining our network to receive referrals. Email coasttocoastpodiatry@yahoo.com

ASSOCIATE POSITION - VIRGINIA IS FOR LOVERS

PRACTICE FOR SALE – MAINE

25 year full scope in medical building, podiatrist friendly hospitals, appreciative and cooperative patients, excellent expansion potential, physician referrals. Wonderful place to raise a family. Retiring seller will stay for transition. mainefootdoc@yahoo.com

PM News Classified Ads Reach over 12,000 DPM's and Students

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