The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

August 05, 2011 #4,225 Publisher-Barry Block, DPM, JD

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Annual Foot Exam is Essential for Diabetics: TX Podiatrist

"Mexican Americans, the largest Hispanic subgroup in Texas, are almost two times as likely to have diabetes as non-Hispanic whites," says podiatrist Dr. Jose Rivera. The prevalence of diabetes is also at least two to four times higher among Hispanic American women than among non-Hispanic white women.

Dr. Jose Rivera

"A simple foot exam is essential for all diabetics. An annual foot exam can reveal the first signs and symptoms of diabetes and identify more serious factors that could potentially lead to further complications. Beyond the annual professional foot exams, diabetics should inspect their own feet daily, and visit their doctor at the first sign of any cuts, swelling, bruising, ingrown nails, loss of sensitivity, or pain. Diabetes can be managed and controlled, but it takes equal parts of patient and physician care to ensure the best interest of the patient," says Rivera.

Source: San Antonio Express-News [08/03/11]

85% of Patients Get Injured While Transitioning to Minimalist Shoes:TX Podiatrist

Inspired by Christopher McDougall's best-selling book, Born to Run, which chronicles how a tribe of Tarahumara Indians in Mexico run distances exceeding 161km wearing thin sandals, many runners are experimenting with running barefoot or with so-called barefoot shoes, like FiveFingers, by Vibram, which have articulated toes and thin, pliable soles.

Dr. Marybeth Crane

Podiatrist Dr. Marybeth Crane in Grapevine, TX, who also is a marathon runner and specializes in sports medicine, told Men's Health recently that "85 per cent of my patients get injured trying to transition to the new shoes." For its part, New Balance is cautioning runners by adding stickers on the boxes of NB Minimus shoes. The stickers say the product "increases the strain on the foot, calf, and Achilles tendon" and "should be introduced slowly into a running exercise routine," starting with only "10 per cent of overall running workouts and very gradually increasing time and distance."

Source: Todayonline [8/2/11]

Two Key AACPM Employees to Retire

The American Association of Colleges of Podiatric Medicine has announced the retirement of two long-standing, invaluable employees. Without any pre-planning to "go out together", each will retire as of Wednesday, August 31, 2011.

Carol Jensen officially joined AACPM 22 years ago. "There is no way that the residency selection process within podiatric medicine would be what it is without the commitment and loving attention to detail that Carol has brought to both the CASPR and CRIP programs. Her support of the projects and issues concerning the Council of Teaching Hospitals is without equal," said Mori North, AACPM Executive Director.

(L-R) Mori North, AACPM Executive Director, Carol Jensen, Sally Rush, and Michael Trepal, DPM, AACPM Chair

Sally Rush officially joined AACPM more than 19 years ago. She has served as Office Manager, Supplies Manager, Meeting Planner, and Assistant to the Executive Director. "Her guardianship of both the Faculty Curriculum Project and faculty participation in the NBPME test development committee meetings has ensured the success of both projects," said North.

NY Podiatrist Relocates to MN

Otter Tail Podiatry will come under new ownership on September 1. Drs. Greg and Karen Rouw are passing the torch to Dr. Marc Butcher. Dr. Butcher has been an associate of the practice since September, 2010. This year he will take over ownership.

Dr. Marc Butcher (center) with Drs. Greg and Karen Rouw.

Dr. Butcher earned his degree from Ohio College of Podiatric Medicine in Cleveland. He completed a three-year surgical residency at the Veterans Administration Hospital in Dayton, Ohio where he served as chief resident. He went on to join a practice in Binghamton, NY. “My wife and I are both small town people,” Butcher said. “After three years in Binghamton, we realized we were tired of living in cities. When we came to Fergus for my interview, we knew right away that this is where we want to be.”

Source: Fergus Falls Journal [8/2/11]

Expert Witnesses on Trial

Lawmakers, physician organizations, and courts are taking steps to combat unethical testimony by so-called hired guns. In recent years, several states have enacted tighter restrictions on expert witness testimony in medical negligence cases. At the same time, more medical associations and state medical boards have created standards for proper expert witness testimony and acted against experts who violate those rules.

Florida is the latest state to pass restrictions on the use of expert witnesses in medical liability cases. Under a law signed July 1 by the governor, out-of-state physicians offering expert testimony must apply for a certificate to testify. The state medical board can discipline them if they provide deceptive testimony. At least 30 states have similar expert witness laws. Some statutes, such as Arizona's, require witnesses to practice in the same specialty as the physician defendant. Others, like Maryland's, mandate that doctors spend a certain amount of time actively practicing medicine.

Source: Alicia Gallegos, AMNews [8/1/11]

Allegedly Improperly Performed Surgery Which Led to Woman's Numbness, Pain (NY)

Facts: On Feb. 19, 2002, plaintiff Nina Johnson, 46, underwent open surgery that addressed the dorsal aspect of her left foot, which had been chronically numb and painful. The procedure was performed by a podiatrist.

Johnson claimed that her pain and numbness worsened. A doctor ultimately determined that Johnson's symptoms were a result of damage of nerves of her left foot, and Johnson contended that the damage occurred during the surgery that...

Result: Verdict-Defendant Award Total $0

Plaintiff's Expert Witness: Frank Lattarulo, DPM; Yonkers, NY
Defendant's Expert Witness: Thomas DeLauro, DPM, Staten Island, NY

Source: NY Jury Reporter

Editor's Note: The complete text of the Jury Verdict Reporter can be read here.

RE: Medial Malleolus Screw Removal (Gary Bjarnason, DPM)
From: Allen Jacobs, DPM, Gerald Mauriello, Jr., DPM, MA

Advance the screw slightly prior to backing the screw out. If the screw breaks in the bone, no big deal. Check for infection and biocorrosion. Keep it simple.

Allen Jacobs, DPM, St. Louis, MO, allenthe pod@sbcglobal.net

Based on review of the x-ray provided, this screw looks as if it could actually be tenting the skin.  Via stab incision over the prominence or via the original incision, I would locate the screw head and remove it utilizing the driver from a small fragment set. The screw is likely a 4.0. We have a universal screw removal set with all types of drivers and a system to remove stripped screws as well. Worst case, it looks as if you can grab the screw with a needle-nose pliers and back it out counter-clockwise carefully. I would exercise care as not to break the screw off at run-out.     

Gerald Mauriello, Jr., DPM, MA, Freehold, NJ, drmauriello@gmail.com

RE: Surgical Considerations for Chronic Smoker (Michael DeBrule, DPM)
From:  Jeffrey Kass, DPM

I am a bit confused by Dr. DeBrule's posting. "Also, a toe amputation should have better healing potential than the arthroplasty." Is the implication - an amputation should be the primary procedure? Certainly, if you go back to the surgical textbooks, amputations, at one time, were common for digital deformities. In fact, when elderly patients have a severe HAV deformity and a second digit crossover toe, I do recommend an amputation as a primary procedure. In my mind, in a case of PIPJ pain, where a simple arthroplasty could fix the trick, I think an amputation, while possibly simpler, is "not the right thing to do".

This is strictly my opinion and technically an amputation is one of the myriad procedures that could in fact be done.
 
Jeffrey Kass, DPM, Forest Hills, NY jeffckass@aol.com

RE: Bone Stimulators and Hammertoe Deformities  (Tip Sullivan, DPM)
From: Jeffrey Kass, DPM

I agree with Dr. Sullivan. However, keep in mind this is America and we are not allowed to summarily drum anyone out of the profession. There have been some pretty outrageous claims on the "Jury reporter" regarding podiatric testimony in the past.

If Dr. Sullivan finds a way to weed out those "hired guns" willing to sell out others who in actuality followed the standard of care, then I hereby nominate him or any other podiatrist to the Podiatric Hall of Fame.
 
Jeffrey Kass, DPM, Forest Hills, NY Jeffckass@aol.com

RE: Leasing Digital X-Ray Systems (Claudine DuPont, DPM)
From: Jeffrey Kass, DPM

Normally, when leasing medical equipment, the company you are purchasing the equipment from has a leasing company in place where you can make your lease through. This is convenient. However, keep in mind that you are paying money to lease, and sometimes you can get a "better rate" = lower interest elsewhere.

I will share an incident that happened to me - so that others may avoid the same situation. I placed my monthly lease payments on a piece of equipment on "automatic monthly payments" from my bank. Apparently, the sales tax amount changed, and the leasing company started sending me "late fees" as I was sending less than the amount due. I admit I was not opening up the invoices, as I thought I had set up the payments and was fine until the end of the lease. After much arguing back and forth - they dropped the fees. Maybe, have something like that amended to your lease or simply open all mail.
 
Jeffrey Kass, DPM, Forest Hills, NY Jeffckass@aol.com

RE: Barefoot Exercises Improve Balance: NY Podiatrist
From: Lloyd Nesbitt, DPM

It was refreshing to read Dr. Splichal’s views on barefoot exercise.  What’s even more interesting is that she appeared on Oprah, giving instructions to women on walking in stilettos (oprah.com/style/Dr-Emily-Splichals-Stiletto-School-Video)!

This is great P.R. for our profession!  Most DPM’s would be speaking out against stiletto’s even though we know women will wear them despite our warnings. This was aired a while ago, but is interesting nonetheless.

Lloyd Nesbitt, DPM, Toronto. Canada, lloydn@rogers.com

RESIDENCY OPPORTUNITY - MASSACHUSETTS

SUB LEASING TIME on MRI (NYC)

.31 tesla extremity MRI in state-of-the-art midtown Manhattan office location. Lease time on magnet in compliance with the Stark laws. This magnet is the only one that will be accepted by Medicare and all other insurance as of 2012. Why not bill out for your own MRI's???  Email today dri@myfcny.com.

EQUIPMENT FOR SALE - CLASS FOUR LASER

EQUIPMENT FOR SALE - COOL TOUCH LASER

Cool Touch Varia 1064 yag laser for treatment of onychomycosis. One year old, two-year warranty remains. Excellent condition, also treats warts, hair removal, spider veins and more . Email contact information to: jobke@aol.com

ASSOCIATE POSITION -CENTRAL VALLEY/SOUTHERN CA

Seeking associate with partnership availability. Must be highly motivated and have good patient skills and personality. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Compassionate and well-trained for immediate position. Surgery Center and hospital based with no HMOs/no rest homes. Bilingual in English and Spanish preferred. Offering a permanent position/partnership in a multi-million dollar hi-tech practice with Partnership also in Surgery center. Please e-mail CV and short bio to: Tonya@wetreatyourfeet.com

PODIATRIST(S) WANTED -  NORTHERN CALIFORNIA

For practice in skilled nursing facilities in Northern California especially the S.F. Bay area, Sacramento and Stockton.  Send C.V. with contact information to ZbubblesZ@aol.com

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