The Voice of Podiatrists

Serving Over 9,800 Podiatrists Daily

September 25, 2007 #3,049 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2007- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Congratulations to Roger Beck, DPM of Lake City, FL, our weekly survey contest winner, who has won a one-week Windjammer Barefoot Caribbean Cruise (Value $2,200) .

Windjammer Barefoot Cruise

Copper Socks Effective For Athletes Feet: SC Podiatrist

Foot problems aren’t exactly topics we like to talk about, but it’s a problem many people have to deal with at one time or another. But experts now say a specific kind of sock, with copper fibers woven into the material, could be the solution to those awful foot problems.

According to the manufacturer, the socks relieve burning, itching and keep feet dry. The metal itself is a proven antibacterial and antifungal agent, they add. But podiatrist Richard Zatcoff was skeptical it would work in socks, so he launched a small clinical trial with 56 patients, who were all diagnosed with athlete's foot. "Patients were photographed, symptoms recorded and then they were given socks either with copper soles or control socks without copper soles," says Dr. Zatcoff.

Participants were rechecked after about a week, and then again sometime between three weeks and a month and a half. Dr. Zatcoff says he was surprised at the results. "We had almost 100 percent improvement or resolution in symptoms such as redness, scaling, burning and itching," he said. He adds that he also believes the copper cover-ups may help diabetics. The socks are registered with the FDA as a medical device and they have the American Podiatric Medical Association seal of acceptance.

Source: KDKA [9/20/07]

CA Podiatrists are Volunteers for Flying Doctors of Mercy

David Nielson, DPM and Russell Buttars, DPM of Encino, CA are members of Ligan International: Flying Doctors of Mercy. Every month, trips are planned for a weekend in small villages in Mexico to help the underprivileged.

Drs. Russ Buttars (l) and Dave Nielsen (r) with patient and family

The little girl shown in the photo (above) was treated for met adductus. Ligan International doctors treat a variety of things ranging from polydactyly, dog bites to removing wax out of the ear canals.

Obesity Seen as Putting Strain on Emergency Care

Obese patients are placing a strain on emergency-care providers and equipment, according to an article in the October issue of the Annals of Emergency Medicine. “From the emergency room perspective, it (obesity) has increased the number of healthcare problems,” said Theodore Delbridge, chief of emergency medicine at 755-bed Pitt County Memorial Hospital in Greenville, N.C. “It puts strains on the (emergency department). We are seeing an increasing number of patients with diabetes and complications—renal failure or hypertension,” Delbridge added.

Treating obese patients can also result in hospitals having to purchase more expensive equipment, such as bariatric ambulances. While a typical ambulance with equipment and two paramedics might have the capacity for a 400-pound patient, a bariatric ambulance, which has a winch to pull a stretcher up a ramp, could carry a patient up to 1,000 pounds, the article said. “More than a decade ago, we were able to lift people in the ambulance,” Delbridge said. “Now there are hydraulic stretchers. A few decades ago that should have existed anyway, but what makes it more of a priority is the weight of patients.”

Source: Jessica Zigmond, Modern Healthcare [9/22/07]

Query: Brace Recommendation for Polio Patient

I am treating a patient who has been affected by polio, in the posterior quadrant of his lower leg, at an early age. He has been treated by ankle and subtalar fusion. He isn't a surgical candidate and requires bracing. Can someone recommend a spring-loaded or regular brace which would assist in ambulation and compensate for the absent muscle group?

Frank J. DiPalma, DPM, Athens, GA, Fivetoes1946@aol.com

Query: Keeping Medical Records and EOB’s

How long does a physician need to save patient records and EOBs. I have heard 7 years. We also make it a customary practice to pull charts older than 3 years and if a patient returns to our office we make a new chart for the patient. Does the law on saving medical records include the original chart that was created even if it was greater than 3 years from their last visit?

Rory Cohen, DPM, NYC, NY

Editor’s comment: PM News does not provide legal advice. Most practice management consultants recommend that charts be held for seven (7) years. This includes the original chart. The statute of limitations (SOL) for Medicare is five (5) years. Under New York contract law, the SOL is six (6) years. The SOL for holding charts varies in each state.

RE: Sclerosing ETOH injection for Tarsal Tunnel (Alan K. Mauser, DPM)
From: Multiple Respondents

The tibial nerve has several motor branches (unlike a traditional Morton's neuroma). It would be unwise and potentially negligent to perform a chemical neurolysis on a motor nerve.

David T. Taylor, DPM, Flint, MI, dttaylor_19@yahoo.com

I would not recommend any type of destructive process to the tibial nerve unless the patient is non-ambulatory/wheelchair bound. You risk foot weakness or dysfunction as a result because you are dealing with the major motor nerve to the foot. I would consider physical therapy to break up the scar tissue and iontophoresis with a steroid agent. If the pain is chronic and cannot be relieved, I would consider finding a pain management specialist that can place a spinal cord stimulator.

There have been some suggesting cryosurgery for tarsal tunnel. I personally think this is a dangerous practice based on what I said above. The patient can end up with significant disability as a result.

Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

After having a steroid injection and unsuccessful tarsal tunnel release, this is a perfect indication for cryosurgery on the posterior tibial nerve. I have had my best success on patients who have had previous surgery, as they can usually pinpoint their pain very well. I was lucky enough to do about 40 cases of tarsal tunnel cryoablation, and I know some of my fellow cryosurgeons have also done a fair amount. I have a case study that I published in Podiatry Management Magazine and Dr. David Lombarski has published one in Podiatry Today. You may first want to look at those to get a basic understanding of what we have done.

Steven H. Goldstein, DPM, Wayne, NJ, stevefootdr1@cs.com

RE: Aquaspray Nail Drill Repair (Kandy Inskeep)
From: Martin G. Miller, DPM

I have found a company on Long Island that can repair all sorts of podiatric hardware Their name is Medpro their address and phone number are: 2a Firwood Rd., Port Washington, NY 11050, 800-633-7761

Martin G. Miller, DPM, Freeport, NY, mgmiller@optonline.net

RE: Root Vs. Schuster Article (September PM)
From: Lloyd S. Smith, DPM

I took great pleasure in reading the history of Root vs. Schuster written by John McNerney. As a student and friend of Dick Schuster, he was an icon to me. We spent many hours in school and later at sports medicine meetings discussing his thoughts. I still quote many of his theories to my patients and I still use the devices he advocated. The theory and practice of biomechanics and orthotics continues to deserve our brightest minds as we try to help our patients and understand their issues. It was fun to relive some of the history told by John in his September article in Podiatry Management.

Lloyd S. Smith, DPM, Newton, MA , lloydpod@yahoo.com

P/T ASSOCIATE POSITION - QUEENS, NY

10 yr old practice seeks motivated, surgically-trained individual . Fax CV with hours available to (718) 458-0053.

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

PAIN RELIEVING DEVICE FOR SALE

Matrix pain device, upgraded with latest Sanexas software. Great working order, operating manual, and programs to treat nerve and muscle pain, edema, circulation, inflammation, and other health problems. $28,000 new, will sell for $12,000. Covered by Medicare, most all insurances, coding and billing information provided. Photo can be seen at http://www.outcomemedical.com/matrix E-mail don@outcomemedical.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-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com -- www.homephysicians.com

PRACTICE FOR SALE - HARRISBURG, PA

Well established, very profitable, full time surgical and general podiatry practice available. Looking for a highly motivated individual for a turn key operation. Owner willing to stay on and to teach and train the right individual to run a successful practice. Multiple financial and employment options are available. E-mail blkdmddoc@aol.com

This is your once in a lifetime opportunity to join one of the largest, most successful practices in the United States. Start immediately with a six-figure income. If you are motivated, and knowledgeable in practice management, your income is unlimited. Please fax resume to: 513-577-7261

WEEKLY SPECIAL - One week of ads (5x) for only $85

PM Classified Ads Reach over 9,500 DPM's and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 9,000 DPM's. Write bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 dekagan@aol.com

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.