The Voice of Podiatrists

Serving Over 9,800 Podiatrists Daily

September 06, 2007 #3.033 Editor-Barry Block, DPM, JD

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Pre-Fab Orthotics Recommended for Dancers, Children: NY Podiatrist

Dr. Robert Conenello, a podiatrist in Orangeburg, NY, who specializes in sports medicine, agrees that good shoes are essential and that orthotics for athletes should not be too rigid. But he said the proper orthotics provide far more arch support than sneaker insoles.

Dr. Robert Conenello (photo: Angela Gaul)

Conenello, the global coordinator for the Special Olympics Fit Feet program, has a lab make orthotics from a combination of materials, including carbon graphite, resin compounds, rigid or soft foam, leather and polypropylene in varying degrees of thickness. He customizes them depending on the patient's size, weight, physical activities and shoe structure.

He said most athletes who come to him have exhausted their options with shoes and store inserts. Even so, he said, about half do fine with pre-fabricated orthotics, which he sells for $30 to $60. They come with different arch heights. Conenello said he often recommends them for dancers and for children who need orthotics. but must replace them frequently as their feet grow

Source: Alison Bert, The Journal News [9/2/07]

NYCPM Professor Elected as Fellow of Infectious Diseases Society of America

Mark A. Kosinski, DPM, FIDSA, Professor of Primary Podiatric Medical Sciences at the New York College of Podiatric Medicine (NYCPM), has been elected as a Fellow of the Infectious Diseases Society of America. In addition, Dr. Kosinski has been appointed as a full member of the Infection Control Committee at Metropolitan Hospital in New York City, an affiliated teaching hospital for NYCPM.

Dr. Mark A. Kosinski

The Infectious Diseases Society of America (IDSA) is the nation’s leading professional society in infectious diseases. Fellowship in IDSA honors individuals who have achieved professional excellence and provided significant service to the profession. “Fellows are recognized by their peers as leaders in the field of infectious diseases, either nationally or locally, in their communities and in their hospitals,” said IDSA President Henry Masur, MD, FIDSA. “It is an honored rank that the Society reserves for its most notable colleagues.”

Edwards Backs Mandatory Preventive Care

Democratic presidential hopeful John Edwards said his universal healthcare proposal would require that Americans go to the doctor for preventive care. “It requires that everybody be covered. It requires that everybody get preventive care,” he told a crowd sitting in lawn chairs in front of the Cedar County (Iowa) Courthouse. “If you are going to be in the system, you can’t choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK.”

Edwards said his mandatory healthcare plan would cover preventive, chronic and long-term healthcare. The plan would include mental healthcare as well as dental and vision coverage for all Americans. “The whole idea is a continuum of care, basically from birth to death,” he said.

The former North Carolina senator said his plan would cost up to $120 billion a year, a cost he proposes covering by ending President Bush’s tax cuts to people who make more than $200,000 per year.

Source: Associated Press Via Modern Healthcare [9/4/07]

Query: Saving EOB’s in Electronic Format

What is the legality on keeping electronic formats of EOB's that are sent as paper. Is it legal to scan these and keep them in an electronic format for seven years or must you keep the originals?

Jeffrey B Gewirtz, DPM, New York, NY

Editor’s comment: PM News does not provide legal advice. The 21st century will undoubtedly be known as the electronic age, and there is every indication that in the near future, almost all records will be stored electronically. We are not aware of any rule which requires EOB’s or any other chart item to be stored as paper. The only caveat to electronic storage is that you should have your documents backed-up, preferably at a remote and secure location.

RE: Digital X-Ray Equipment (Tip Sullivan, DPM)
From: Neil A Burrell, DPM, Nat Chotechuang, DPM

We purchased a Reina system 2 years ago and wonder how I've practiced without it. It will measure the angles for you. The x-rays can be magnified, darkened, or lightened. We are a twp doctor practice and we both love it. We calculated that the system, cost $48,000, paid for itself in a little less than 2 years. Patients are amazed and feel that we are cutting edge therefore we must be great podiatrists. Copies are easy to make. I'm also old fashioned, but I love the digital x-rays.

Neil A Burrell, DPM, Beaumont, TX, nburrell@gt.rr.com

Our practice has a Reina digital x-ray system. There is an icon on a
toolbar that allows us to measure angles and distances. One could also
print out the image on paper then measure it with a tractograph and
draw lines with a pen the "old-fashioned way" if one so desired. I think we paid approximately $30,000 for our setup, but Reina could give you a more accurate quote based on the options you want.

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

RE: Uncontrolled Gout (Barry Mullen, DPM)
From: Multiple Respondents

Try having the patient go to www.goutcure.com
It seems to prevent the uric acid from crystalizing and the changes in deposition nodules are most impressive. Multiple Respondents

Howard J. Dananberg, DPM, Bedford, NH, howiedbpg@aol.com

As a follow up to my initial query. The patient in question is also allergic to probenecid and allopurinol. Upon aspiration of the crystals, they have come back from the lab as positive for gout. She is also on a low purine diet. Again, any suggestions as to how dissolve the crystals?

Randy Lisch, DPM, Austin, TX, Drumpire@aol.com

Barry Mullen stated: "Lastly, the injection of intra-articular crystalline steroids is contra-indicated for gout. "

I object to him making that statement like it is a fact It is an opinion. Even in school, we were taught that there were those that held that opinion, even though evidence showed otherwise. I understand the argument about introducing additional crystals into a joint already inflamed by crystals. That doesn't make it scientific fact any more than the assumption that a stomach irritated to the point of ulceration requires a 'bland diet' as treatment. Statements in medicine should be based on facts, not on logical assumptions that aren't necessarily all that logical. I have seen inflamed gouty joints calmed by cortisone injections (Kenalog) which I use on occasion when NSAID's are contraindicated. I have never seen one made worse. That is just my own anecdotal observation. But it is enough for me to disagree with the way he phrased his wording. It is opinions that are loosely thrown around as fact that make it more difficult to defend malpractice suits. Dr. Mullen is entitled to his opinion, just state it as so! .

Rich Rettig, DPM, Philadelphia, PA, rich.rettig@verizon.net

RE: Conflict of Interest for Experts (Richard Boone, Esq.)
From: Brian Kashan, DPM

One point I haven't seen addressed regarding the conflict of interest of board, society members , etc. being experts is that it may influence the reasons for people taking these positions. Currently, many board and society positions are voluntary. If people in these positions were to become "experts," their positions would be used by attorneys as to elevate their testimony coming from a "state board member," or "national society position." There would be a significant rush to get these people to testify, due to their "lofty" positions.

The intent of the position, its volunteerism, and its "pureness", would be compromised as there would be significant remuneration coming with the position as a springboard to being an "expert." When you assume one of these positions, you wear a hat that limits other hats you may be offered. It is not limiting free speech, just ensuring that the position is not being taken for the wrong reasons.

Brian Kashan, DPM, Baltimore, MD, drbkas@worldnet.att.net

Editor’s note: This topic is now closed.

PODIATRY ASSOCIATE WANTED – YONKERS, NY - ASAP

P/T-3 days per week for busy Yonkers and White Plains location-
Surgical training a plus, but not mandatory. Please fax resume to 9149939031 or call 914 325-9198 for more details.

ASSOCIATE POSITION SANTA FE, NEW MEXICO

Immediate opening for PSR 24/36 individual in three office practice. We are looking for an ethical, hard working, well trained Podiatrist. Partnership available. Please Fax CV to sfpodiatry@aol.com

Privileges at Certified Surgical Facility With MRI- NY & LI

Certified operating rooms which qualify under the new NY Patient Protection Law (which will require accreditation for in-office procedures) are available in Manhattan East 60th Street and Plainview, LI. Rent or Lease Extremity MRI. Turn-key operation no investment needed. Call 516 433-4447 for information or e-mail podo2345@aol.com

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-292-4800. Fax 773-342-4201 -E-Mail sschneider@homephysicians.com -- www.homephysicians.com

ASSOCIATE POSITION – LOUISVILLE, KY

Immediate opening for multi-office podiatric practice specializing in general podiatry, high volume orthotics, surgery, and advanced wound care. Looking for a motivated, surgically trained podiatrist. Partnership opportunity. Competitive starting salary, benefits, and pension. Please submit: CV, letter of intent and references to: jbroyles23@yahoo.com

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City. Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

CRYOPROBE SALE: ADDITIONAL PRICE REDUCTION!*

A cryoprobe system (less than one year old and rarely used) from CryoTech is available for only $9750.00 or *best offer*. This lists for $14,900.00 new. The CryoPac system comes complete with two fully sterilizable Probes. This system has been used less than 15 times and can be used to treat plantar fascitis, neuromas, and other foot pathology. Please email inquires or your offer to: drsammendicino@gtef.org

SATELLITE PODIATRY OFFICE FOR RENT - TUCSON, ARIZONA

Modern x-ray with automatic processor. Professional atmosphere. office is shared space in a chiropractic office with separate front desk. Excellent start-up opportunity for a new doctor Front desk staff, copy machine, fax are also available. Contact Dr. Parks at 520-544-2445 or parksovc@aol.com

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