The Voice of Podiatrists

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October 23, 2008 #3,381 Editor-Barry Block, DPM, JD

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Podiatrists Disagree on Effectiveness of High Dose Vit B for Neuropathy

Peripheral neuropathy, or damage to nerves in hands and feet, can cause tingling, pain and numbness. A high-dose vitamin B supplement to treat neuropathy can alleviate pain and improve sensation, says a company that sells it. A few scientific studies show improvement in symptoms, but many physicians remain skeptical.

Dr. Allen Jacobs

A 97-patient study by St. Louis podiatrist Mark Allen Jacobs, presented last month at a scientific conference, found a reduction in neuropathic pain of 35% in patients who took Metanx for 20 weeks, compared with 12% for those taking acetaminophen, the active ingredient in Tylenol. That study wasn't fully "blinded" in that the patients knew which pills they were taking.

Dr. Barry Rosenblum

Barry Rosenblum, a podiatrist and assistant clinical professor of surgery at Harvard Medical School, says he tried Metanx in a few patients and saw no improvement. He says he won't recommend it unless further research is done. Pamlab,, the manufacturer of Mentax, says a large double-blinded multicenter trial is under way.

Source: Laura Johannes, Wall Street Journal [10/21/08]

NYCPM Holds Third Annual Residency Fair

On a recent Friday, the New York College of Podiatric Medicine (NYCPM) held its third annual Residency Fair, at which representatives from forty-four hospitals, from sixteen states, talked with students about their hospitals’ externships and residency programs. Virtually all second- and third-year students attended, as did many first- and fourth-year students.

At NYCPM’s recent Residency Fair, representatives from forty-four hospitals, from sixteen states, talked with students about their hospitals’ externships and residency programs. Dr. Lawrence Santi (Far right)

The Residency Fair was organized by Douglas Doxey and Bradley Hart, both of the Class of 2010. The NYCPM Alumni Association provided lunch during the four-hour Fair. According to both students and the hospitals’ representatives, the Residency Fair was an extremely successful and informative event.

MI Podiatrist, 94 Is Oldest Student in University’s History

Ninety-four-year-old Edward Pintzuk is enrolled in a history class this fall, making him the oldest student ever to attend classes at Oakland University. While fellow classmates are taking classes to earn enough credits to graduate, Pintzuk is in class for one reason: to expand his knowledge. “I also wanted to see if I could hack it,” he added. “I’m enjoying the class and I’m learning what I was looking for.”

Dr. Edward Pintzuk

A lifelong learner, Pintzuk earned a doctorate in podiatric medicine in 1950, and practiced medicine in the Detroit area for 30 years before retiring. He became the oldest person to earn a doctorate from Wayne State University (WSU) when he earned a Ph.D. in history in 1993 at the age of 79. Pintzuk taught as an adjunct instructor for a special program in WSU’s Labor Studies Center, until funding ended four years ago.

Pintzuk was born in Philadelphia and moved to Michigan in 1950. He currently lives in a retirement community in West Bloomfield. His wife of 68 years, Reba, was “one of the best sculptors in the region,” said Pintzuk. After her death in April, he started playing his clarinet again and recently began taking refresher lessons.

Source: Dawn Pauli, Oakland University News [10/21/08]

First-Time Med School Applicants Down

Enrollment figures may be up, but the number of first-time applicants to U.S. medical schools declined slightly this year, according to new data released by the Association of American Medical Colleges. First-year enrollment at the nation’s medical schools in 2008 increased nearly 2% over 2007 to more than 18,000 students, the highest enrollment in history, the AAMC reported. Various ethnic groups helped boost this figure, with the number of Latino and Native American first-year enrollees increasing by more than 10% and 5%, respectively.

The AAMC reports that more than 42,200 applied to medical schools in 2008. While the overall applicant pool is one of the largest in more than a decade, “the number of first-time applicants decreased by 3%,” the association reported. On average, there were more than two applicants for every available opening at a medical school. “In a time of great economic uncertainty, interest in the healing profession of medicine remains stable,” said AAMC President and Chief Executive Officer Darrell Kirch, summarizing the results in a written statement.

According to the AAMC, applicants to medical school this year were among the most academically qualified in history. There was also an increase in the number of applicants who had community service experience and medical research experience on their premedical resumes.

Source: Jennifer Lubell, Modern Healthcare [10/21/08]

Move Past Excuses to Action

Tired of hearing excuses when you ask staffers to pitch in? Solution: Reduce employees' opportunitis to offer them. Prepare for these common excuses:

• "You didn't tell me I had to do that." The real problem: You did not make clear your expectations and the possible consequences. If you tell a staffer, "I need you to work on Project X" you are not being specific enough. To you, "working on" may mean finishing it, but to the staffer a cursory effort might just seem like enough.
• "Somebody else would do it faster or better than I can." The real problem: Staffers need training or retraining. Put in some time now, and soon your staffers will be able to do the task with little or no supervision. Although it seems like more work upfront, teaching others to be more responsible is a wise investment.

Source: Adapted from Kids' Excuses to Get Out of Chores by Sarah Aguirre

Query: Surgery on Patient with Dermatomyositis

I have a 43 y/o male with dermatomyositis currently on Methotrexate and Prednisone. His rheumatologist referred him for a painful 2nd metatarsal joint with advanced x-ray findings of DJD. In my opinion, he needs a metatarsal head resection or excision of the base of the proximal phalanx. Toe amputation would be the least traumatic. His M.D. wants him off Methotrexate for 2 weeks prior to surgery and throughout the wound healing period. This patient is really sick and nearly succumbed to this disease this last year. His skin integrity is not normal. Does anyone have experience with such a case, and what is the downside in trying to help this man?

James W. Clark, DPM, Salinas, CA

Query: Digital Scanning System

We are considering a digital scanning system for accurate foot measurements and/or orthotics. Can anyone with experience with 3DO, Pedalign, X-tremity Scan (PAL), or I-step (Aetrex) provide any recommendations on which to choose?

Mark K. Johnson, DPM, West Plains, MO

RE: Mid-Arch and Met Pain (Kel Sherkin, DPM)
From: Simon Young, DPM

Lower the arch of the orthotic. His foot needs to compensate at the oblique mid-tarsal jointt axis to allow for ambulation with an equinus deformity. An orthotic with too high an arch restricts this ability and causes pain in the arch.

You need to also make sure there is no plantar fibroma in the arch, which can be aggravated by the orthotics.

Simon Young, DPM, NY, NY, simonyoung@juno.com

RE: Mistake by Employee (Name Withheld)
From: Lynn Homisak, PRT,

It is always best to be upfront and clear with your patients about your billing procedures prior to surgery (or any procedure/service provided) as Dr. Block has pointed out. It is not clear from your post if your employee actually DID check the insurance benefits prior to surgery (and was given misinformation) or just lied and told the patient she did; however, it has been my experience that erroneous information is often received from the insurance company and passed on to the patients by staff. That is why, I always recommend to staff (to avoid the "you told me this was covered" blame) that they involve their patients in this process.

Advise patients that you are happy to check their coverage and obtain necessary authorization; but also re-educate them about the "games" that insurance companies play and their personal responsibility as a subscriber. Then hand them a paper with anticipated diagnosis and procedure codes and STRONGLY RECOMMEND that it is in THEIR BEST INTEREST (key words) to also call their insurance and check on this info. Two verifications are better than one. When you put some of the responsibility back in their lap...they usually are willing to participate. This avoids problems (like you mention) down the road. And yes...YOU are always responsible for your staff's actions and behaviors!

Lynn Homisak, PRT, SOS Healthcare Management Solutions
lynnprt@comcast.net

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

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

SUBLET SPACE WANTED - NORTHERN NEW JERSEY

I am looking to sublet space in the Tenafly, Teaneck, Fair Lawn or general area. I need the office two 1/2 days per week or 2 full days, whichever is available. I can supply equipment, if needed, but prefer a turn-key operation. 516 476-1815 podo2345@aol.com

PODIATRISTS NEEDED - CHICAGO -- NORTHWEST INDIANA & BALTIMORE

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. 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 Visit our website

ASSOCIATE 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

HOSPITALIST POSITION - QUEENS, NY

Busy multi-specialty podiatry group looking to hire a motivated individual to work part-time, including weekends as a podiatric hospitalist. Immediate opening available. NYS license a must. Applicant should be well-trained in all aspects of surgical and wound care and have completed a 24-36 month residency. If interested please send CV to docbunion@yahoo.com

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.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

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