The Voice of Podiatrists

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September 28, 2007 #3,052 Editor-Barry Block, DPM, JD

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Flimsy Footwear Results in Overuse Injuries: CA Podiatrist

If you've been wearing flip-flops since the beginning of summer, your feet may already be in trouble. The flimsy footwear could be doing permanent damage.

Dr. Robert Lee

Podiatrist Dr. Robert Lee of UCLA University Podiatry Group, blames flip flops for tendonitis, shin splints, knee & back pain, even hammertoes. He said it's all due to the lack of support. "You're pretty much using all the muscles in the foot and the leg with every step you take. It's that these muscles have to work harder for each step. And that overuse is what causes these problems," said Dr. Lee.

Source: WCPO- TV [9/26/07]

Armstrong Becomes First-Ever Tenured Podiatric Physician at Rosalind Franklin

David G. Armstrong, DPM, PhD, Professor of Surgery and Chair of Scholl's Center for Lower Extremity Ambulatory Research (CLEAR), today became the first podiatrist to receive tenure at Rosalind Franklin University of Medicine and Science.

Dr. David G. Armstrong

"I think that this is more of a nod to podiatric medicine than it is to any single podiatrist", noted Armstrong. “I think what it says more than anything else is that podiatric medicine has reached a level where it is recognized for its clinicanship, research, community service and scholarship. It really is a terrific time to be in this profession and it is a privilege to be at a place where a difference can be made every day."

Terence Albright, Dean of Scholl College and Past President of the American Podiatric Medical Association was equally enthusiastic, "Tenure for faculty in podiatric medicine at a large teaching institution is a tribute to the profession's advances in academia and mentoring. It's another signal that we've arrived."

From Air Traffic Controller to Army Podiatrist

It’s a true life rags to riches story. Ten years ago Anetra Williams was a private in the Army, serving as an air traffic controller. When opportunity knocked in the form of an Army “Green to Gold Scholarship”, Williams elected to enroll at Des Moines University College of Podiatric Medicine.

Dr. Anetra Williams

Today, she proudly wears captain’s bars as a podiatric surgeon. She has just finished her first year of residency at Ft. Gordon in Augusta, GA and will complete her next two years at Ft. Bragg in North Carolina. “I love what I do, exclaims Williams.

Query: Answering a Subpoena

About the end of 2003, I prescribed a common lotion to a patient for dry skin. I never saw him again. Last year I was informed that a lawyer was suing the company that made the lotion in a product liability law suit. The patient developed some sort of reaction to the medication which required him to hospitalized, and afterwards, according to the plaintiff’s attorney, his health deteriorated and he passed away last year. I was never made aware of any adverse reaction nor was I informed that the patient was ever hospitalized. I sent a copy of my records to both parties as requested.

Now I am being subpoenaed to be deposed by the attorneys from the product company. The plaintiff's attorney has offered to represent me at no charge. I have two questions; first, do I need an attorney to represent me( I am totally uncomfortable being represented by an interested party)? Secondly should I inform my malpractice carrier of this situation? I would think I would have been sued by now if the plaintiff attorney thought there was a case to be had against me.

David Gutierrez, DPM, Bronx , NY

Editor’s comment: PM News does not provide legal advice. As a general principle, any podiatrist who is involved in a lawsuit should retain independent counsel. Without adequate representation, you are unprotected, and run the risk of becoming a named party.

Additionally, one should contact his/her malpractice carrier whenever a legal matter develops involving potential liability. This is why one purchases such coverage. If one fails to timely notify the carrier, it opens the door to potentially allow the carrier to escape its obligation to cover you. Please read the fine print of your policy.

RE: Treatment For Verrucae (Kevin Lam, DPM)
From: Barry Mullen, DPM, David Secord, DPM

Over the years, I've encountered several cases of plantar verruca which manifested as xerotic fissured skin of the posterio-plantar heel, exactly as depicted in this slide. All too often, we tend to pass this fissuring off as purely mechanical with an endemic autonomic nervous system xerosis component. However, infectious causes do exist, with verruca and tinea being the two most common. I'd guestimate the #1 leading systemic cause is hypothyroidism which frequently manifests in various degrees of "thyroid acropachy" which affects the finger nails , toenails, plantar and palmar skin surfaces to mimic “elephant hyde changes".

At any rate, you have a bonified pathology report, which assuming an adequate biopsy was performed, should be utilized in planning a treatment course. I'd certainly begin by using a strong keratolytic under occlusion at bedtime along with an emollient bid during the daytime and see how things progress. A rubber heel cup and suggestion of closed heel shoe wear should help reduce the friction and shearing forces to reduce the discomfort associated with open heel wear.

Barry Mullen, DPM, Hackettstown, NJ

I was wondering if anyone was going to question the appearance of the lesion and the pathologic conclusion of mosaic verrucae. The lab the hospital uses when I submit stuff from the O.R. seems to love the diagnosis of verrucae. A number of soft tissue specimens I've submitted--which seemed clearly not HPV in origin to me--came back verrucae. I once had the ominous diagnosis of "verrucae of bone" after resecting an aneurismal bone cyst from a calcaneus. Now, that's a guy who likes verrucae.

If indeed this is a mosaic verrucae, I have always used the Panacos graft in patients without immune compromise. I've only done 24 of these, but all 24 resolved completely with the one treatment. I've also performed Dr. Dockery's treatment of curettage and steroid application with good results.

David Secord, DPM, Corpus Christi, TX, David5603@pol.net

RE: Backwards Heel Shoe
From: Paul Kesselman, DPM, David Secord, DPM

I have two questions regarding the backward heel shoe:

Is there a V Code for the secondary diagnosis relating to the injuries caused by this shoe? Which lab will be the first to develop an orthotic device for this shoe and will the insurance industry cover it?

Paul Kesselman, DPM, Woodside, NY, pkesseleman@pol.net

If you do ankle fractures or PB tendon tear repairs, this could be a bonanza!

David Secord, DPM, Corpus Christi, TX, David5603@pol.net

ASSOCIATE POSITION – CENTRAL FLORIDA, ORLANDO AREA

Exceptional opportunity for qualified candidates. Associate position available in a rapid growing, well established multi-office practice. Applicant must be bilingual in English and Spanish, well trained (PSR-24 or more). Compensation includes excellent salary plus incentives and benefits. Please e-Mail CV, letters of reference to CF_resume@hotmail.com

PODIATRIST WANTED – RIVERHEAD, NY

Podiatrist needed in Riverhead, NY for an Article 28 Diagnostic and Treatment Facility with unlimited growth potential. Multidisciplinary site with much cross referral. Great opportunity. Call 631-981-1333. lakechiropllc@optonline.net

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

ASSOCIATE POSITIONS – MARYLAND

Are you motivated, personable and enjoy working with the elderly? We are offering full or part-time positions in Maryland. Our group, Podiatry Management Services, provides care to the elderly in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your c.v. to drhprosen@comcast.net or fax to 410-486-2049 or call Dr. Herbert Rosen at 410-580-0255

ASSOCIATE POSITION – MANHATTAN / QUEENS

Associate wanted for busy and growing Manhattan/Queens office. Full-time, PSR-24 minimum, straight 30% income with possibility of partnership in 1-3 offices. Call 917 880-6639 or e-mail hansfeet@aol.com

ASSOCIATE POSITION – CINCINNATI, OH

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

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

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