The Voice of Podiatrists

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October 09, 2008 #3,369 Editor-Barry Block, DPM, JD

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We’ve just posted an October CME titled:

By Robert G. Smith, DPM, MSc, RPh

You can Earn 30 CPME-Approved CME Contact Hours Online

MS Podiatrist Uses Non-Invasive Test to Detect Peripheral Arterial Disease

Leg pain and cramping are often common side-effects experienced after excessive exercise or physical exertion. However, chronic leg pain experienced after moderate amounts of exercise or while at rest can be warning signs for peripheral artery disease. Early diagnosis of PAD improves the chances of saving limbs and improving the quality of life. Fortunately, a simple 30 minute, non-invasive PADnet test can provide early detection of PAD.

Hattiesburg Clinic Podiatric Medicine physician Suyon Rhee, DPM, in conjunction with Hattiesburg Clinic Vascular Specialists, currently offers the PADnet test at the Clinic's Courtenay Circle location. PADnet uses special blood pressure cuffs and a computer to record segmental blood pressure in your arms and legs, called the Ankle-Brachial Index. It also measures blood volume in the legs and blood pressures in the toe.

The findings are immediately transferred to a web interface for interpretation by vascular specialists J. Keith Thompson, D.O., and Lewis Hatten, M.D. The test is painless and patients can expect to receive their results in about a week.

Source: Lisa Bynum, Hattiesburg American [10/7/08]

Playoffs are Reminder of Proper Foot Care: NJ Podiatrist

In baseball, as with other sports, proper foot care is critical to both agility and concentration - and to being able to stay in the game. New Jersey podiatrist Dr. Bruce Bitcover says the playoffs can serve as a reminder to casual athletes - especially runners and walkers over 40 - that they need to pay attention to the basics of proper foot care. That includes regularly checking athletic shoes for wear and tear.

Dr. Bruce Bitcover

Dr. Bitcover says, "Players from Little Leaguers to senior citizens need to be cautious about injuries that can result from improper preparation and technique and poorly fitted shoes. Because baseball involves quick starts and stops, even children need to do some stretching and warm-up before getting into the game."

He adds, "Those older than 40, who are diabetic, smoke or have any type of physical disability should see a physician before picking up the sport again. People who already know they have foot problems should see a podiatrist, who can assess the risks involved."

Source: PR Web [10/7/08]

Improve Copy on Websites

Improve copy on websites by sharing this rule: The writing on your site must pass the same tests that apply to writing on paper. Writers must know their purpose, audience, and key reason for writing. Follow that rule and your Web copy will not only inform, but also prompt action.

Source: Adapted from E-Writing: 21st Century Tools for Effective Communications by Dianna Booher

Query: Weil Osteotomy w Cheilectomy

Has anyone considered or performed a Weil osteotomy along with cheilectomy on the first metatarsal for decompression of the joint with stage 1 or mild stage 2 hallux limitus with a long first metatarsal? Please opine.

Stuart W. Kushel, DPM, Plainsboro, NJ

Query: Inexpensive Vascular Testing System

Can anyone suggest an inexpensive vascular testing system which I can use to perform ABI and basic arterial Doppler reports with a printout.

William Alexander, DPM, Atlanta, GA

RE: Nail Dust Inhalation (Steve Bennett DPM)
From: Multiple Respondents

Thank you, Dr. Bennett for bringing up this very important subject. As an allergy sufferer, I can attest that vacuum devices do not extract all of the particles of nail dust from the air. When patients ask why I don't grind their thick toe nails, I explain that not only will it make me wheeze, but they will be breathing in their own fungal nail debris plus the nail dust from every other patient who was treated in that room for the past several hours. No patient after understanding this risk, has been disappointed. They appreciate me for it.

Dr. Bennett documented this potential hazard well. We must face these facts and realize that grinding potentially infected nails in our offices poses a potential health hazard to not only us, but to our patients and staff.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

I agree with Dr. Bennett's assertion that grinding nails inevitably leaves residual particles in the air. That is why I have stopped grinding them. Besides inhalation, the dust accumulates on all surfaces with God-knows-what spores and pathogens. I do excisions and biopsies in those rooms! I debride nails with a standard-sized podiatry nail nipper, which is large enough to skive down nails. It does not leave a nice smooth finish like a power burr does. But it does achieve the medical goal, which is to debulk the nail to relieve pressure. Very sharp residual edges can be dressed with an emery board, but I don't necessarily want to compete with nail salons. In my practice, grinding nails has gone the way of whirlpool baths.

Richard Gosnay, DPM, Danbury, CT, glabroushead@gmail.com

My practice consists of a great deal of palliative care in which debridement of hypertrophic nails are done using a Dremel drill. Being a frustrated garage inventor, I have developed and have been using a homemade vacuum system hooked up to a Dremel drill. My staff of two assistants do most of the burring. After several years of development and refinements, I have put together an inexpensive system that attaches to any hand-held Dremel.

The kit contains the Dremel attachment, hose with vacuum adaptor and on/off foot control pedal. Just provide your Dremel and Hoover canister vacuum, (model # S1361) found at Circuit City, Best Buy or directly from Hoover for around $60. A FIVE PERCENT DONATION will be made to APMAPAC for every unit that is sold. The total price of the unit along with the Dremel and vacuum will be in the $220-230 dollar range complete. I have tested several units and found mine to have better suction and be very quiet. If I can get the castings in time, I plan on having them to demo at the SAM convention in Orlando.

J. Ressler, DPM Lauderhill, FL, redwingcrzy@aol.com

RE: Non-Payment By Palmetto Medicare
From: David Mullens, DPM, Esq

I have had a flood of calls regarding the complete cessation of payments from Medicare in California. If you have a provider enrollment problem with Palmetto, call Lydia at CMS in San Francisco at 415-744-3658. She will help you if you have not received payments for more than several months. Otherwise, go to the Palmetto website (palmettogba.com) and click on “Contact Us” at the top. A page will come up with phone numbers and an email address. Apparently, according to Lydia, very few doctors use the email address, but response from Palmetto by email is very quick.

David Mullens, DPM, Esq., Palo Alto, CA, dmullens@mullenslawoffice.com

RE: Ultrasound Machines (J. Velazquez, DPM)
From: Hal Ornstein, DPM

In our office, we choose to buy our machines from Biosound Esaote (podiatryultrasound.com). They are the manufacturers, and therefore I can upgrade to any of the many models they make, including the MyLab series which far exceed the Pico for value, portability and available features. It makes us feel much safer buying from the manufacturer as the other sellers are dealers or distributors and therefore may not be carrying the same equipment next week. In addition to high quality ultrasound machines, their customer service, as well as follow-up is outstanding and they are big supporters of our profession.

Hal Ornstein, DPM, Howell, NJ, toetoe@optonline.net

RE: Louis M. Newman, DPM
From: Sam Bell, DPM, Tilden H. Sokoloff, DPM

I was very saddened to learn of Dr. Newman's passing. I was a student at PCPM in the late 60's. He was truly a pioneer in our profession. He was always eager to teach and help and he was a real gentleman.

Sam Bell, DPM, Schenectady, NY

I knew Lou for over 40 years. He was a larger-than-life figure for a young podiatric medical student in 1963. He was a very proud professor of podiatric surgery, who encouraged me to become active in podiatric surgery and helped me to become a resident at Highland Hospital in Oakland, CA.

Lou was unique in a time of transition. PCPM was becoming a school of podiatry out of the ashes of chiropody. He fostered hospital privileges throughout Philadelphia and enabled students to get a great hospital experience at a time that they were far and few between. Our profession lost a leader, educator, mentor and friend to a lot of his students. I will miss him.

Tilden H. Sokoloff, DPM, Alamo, CA

PODIATRISTS NEEDED - CHICAGO -- NORTHWEST INDIANA

EQUIPMENT WANTED – AUTOCLAVE/CHAIRS

Wanted to buy – Used New Style (not pressure cooker) desktop digital autoclave (e.g. Midmark Ritter) and 2 waiting room chairs. Call 212-724-4457 or e-mail frottenberg@juno.com

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for full-time podiatrist in a multi practice location in the Chicagoland and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

PODIATRISTS NEEDED – DALLAS/ FT WORTH – TEXAS AREA

Texas Home Footcare Associates, a podiatry exclusive company specializing in house calls and visits to facilities for the elderly, is looking to hire podiatrists. We are located in the Dallas area. Full and part-time positions are available. Immediate Openings Available. Must have a Current Texas license. Competitive Compensation Package. If interested fax curriculum vitae to 972 931-4819 or e-mail gjmdpm@tx.rr.com. For further information, call 972-380-8028.

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, fax to 410-486-2049, call r. Herbert Rosen 410-580-0255

ASSOCIATE POSITION - NORTHERN VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes.Top hospitals. Fax CV with references to 703-491-9994

SSOCIATE POSITION - NORTHWEST IOWA

Great opportunity for hard-working, ethical podiatrist to join Midwest multi-physician, podiatric group with multiple locations. A well-established, successful, growing practice with strong hospital affiliations seeking FT and PT surgically trained physician. Applicant should be well-trained in all aspects of surgical care, completed a 24-36 month residency, & at least board eligible. Diverse practice offering high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume to: 712-258-9977

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