The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

November 30, 2009 #3,714 Publisher-Barry Block, DPM, JD

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Back, Knee, and Hip Pain Can Often Be Traced to Feet: MO Podiatrist

Women, rejoice! If you’re tired of being told that your foot problems are caused by your Laboutins, meet Dr. John Dailey. “Shoes, no matter how high the heel or pointy the toe, don’t cause foot problems,” says Dailey, medical director of The Missouri Foot & Ankle Institute in Washington, Mo. “Shoes can make a problem worse, but the problem itself is caused by hereditary tendencies that lead to structural deformities.”

Dr. John Dailey

Dailey says that knee, hip and back pain can often be traced to the feet, even when the patient has no foot pain. “Structural problems in the lower extremities can cause pain all over your body,” he explains. “I’ve got nothing against chiropractic, but if you see a chiropractor for back pain and he or she manipulates your back, you’ll be okay for a day or so, but the pain will return if it’s caused by structural problems in the foot."

Source: Ladue News [11/12/09]

CA Podiatrist Shows That Real Healthcare Starts in Your House

Dr. Bill J. Releford, his staff and over 230 volunteers demonstrated that real healthcare reform begins at home with the recent success of the Los Angeles Initiative of the Black Barbershop Health Outreach Program. Targeting over 100 barbershops throughout Los Angeles County, Riverside County and the High Desert communities, the event took place earlier this month. Compared to the general public, more African-American men die prematurely from preventable diseases such as diabetes and high blood pressure. As a result, they have the lowest life expectancy of any group in the nation.

Dr. Bill Releford

The effort went into Black-owned barbershops and offered free screenings to customers. Since its inception in December 2007, the program has screened over 10,000 men in over 23 cities and 230 barbershops. Ultimately, the goal is to screen over 500,000 by the year 2012. “We have to begin to be more responsible for our own health,” Releford said. “Relying solely on policy-makers to keep us healthy may not be a wise move. Real health reform begins in your house and not the White House.” Releford, a podiatric surgeon with more than 20 years experience in preventing diabetes-related amputations in high-risk populations around the world, is the founder of The Diabetic Amputation Prevention Foundation.

Source: Compton Bulletin (CA) [11/26/09]
 

Acknowledge Politics

Ease workplace anxiety and improve relationships by openly addressing the issue of office politics when appropriate. Tell people that you are not interested in “scoring points” but in working well together and delivering excellent results.

Source: Adapted from “10 Ways to Survive Office Politics,” by Calvin Sun, via Communication Briefings

RE: Congenital Hypertrophy of Intrinsic Muscles (S. Jeffrey Siegel, DPM)
From: Paul Busman, DPM, RN

If all the patient complains of is a "full feeling", have him get roomier shoes for the time being. Once the feet reach full bone growth, the geometry of those muscles may change and not be so much of a problem after all. The surgical option is always there, better later than sooner. 

Paul Busman, DPM, RN, Clifton Park, NY, brewerpaul@aol.com

RE: Osteomyelitis (Richard Frost, DPM)
From: Multiple Respondents

A year or so ago, I had a free-standing diagnostic center send over their radiologist to explain to me that he could diagnosis a bone infection from an MRI. I listened very politely, but to this day I do not believe him. Many of my local hospitals have stopped providing WBC tagged bone scans as not cost-effective and reportedly not necessary due to MRI capability.

When I have a patient whom I suspect has osteomylitis, I want a WBC Bone Scan. I have seen multiple doubtful positive responses from MRI scans. I have had very few false reports with WBC Bone scans. I may use an MRI as a screening tool and I have recently had some private insurance companies require the MRI prior to approving a WBC Bone scan. I have to admit, I do not know the difference in cost, profit, or the true reason MRI's are being forced on me. I do know I still want a WBC tagged bone scan when I am going to treat osteomylitis. And if I am treating your mother, or son, you want me to have a WBC tagged bone scan. If I am wrong, I would like to hear it from my peers.

Wm. Barry Turner, BSN, DPM, Royston, GA, claret32853@gmail.com

I appreciate all the responses. Some clarification for this 64 yo diabetic neuropathic patient. His cultures are positive for Staph aureus (methicillin-sensitive), open wound plantar right foot (3rd/4th met head). He has been non-weight-bearing, right foot x6 weeks. He has also received consultations with infectious disease, medicine, endocrinology, and other podiatrists. It has been explained to him on several occasions that "no guarantees" can be given. ID has recommended IV antibiotics as well as surgical debridement. He will be receiving IV antibiotics.

He is at the surgical stage of treatment. He has had very thorough, exhaustive conservative treatment and is looking at a "definitive" surgical option.
 

Richard Frost, DPM, rfrost@rockwoodclinic.com
 

RE: Adolescent Verucca Treatment (Chris Seuferling, DPM)
From: Sidney E. Sharp, DPM, Heather Kaufman, DPM
 
In treating this type of widespread mosaic verruca, I have found success in some patients with the use of Lazerformalyde Roll-on Solution daily along with mechanical grinding at least twice weekly. I have seen resolution in as little as a few weeks to upwards of several months. Naturally, application of Lazerformalyde should be discontinued if irritation, redness, or swelling occurs.

Sidney E. Sharp, DPM, Cherry Hill, NJ, ssharpdpm@pol.net

I have found that when the wart lesions are that numerous and in such large clusters, either hyfurcation or laser ablation is the most effective first line treatment. Following this treatment, I manage the patient with in-office and at-home wound care until there is at least 50% healing of the lesions. At that point, I have the patient start applying the Aldara cream. I realize the instructions are to apply every other evening under occlusion. However, I have my patients apply it nightly with the instructions to remove it in the morning with soap and water. If recurrence is seen following these steps, I may apply Canthrone to small recurrent lesions followed by Aldara cream. I will have patients continue the Aldara up to two weeks after resolution of the lesions.

I also advise the patient on proper hygiene, even going so far as to recommend throwing away shoes that cannot be washed, and washing shoes that can be washed with hot water and bleach. I also instruct them on appropriate cleaning of their tubs, tiles, and other surfaces which may harbor the viral element to prevent re-infection or infection of family members.

Make sure that your patient understands that the lesions may return despite all of your efforts simply because it is a virus living in the body.
 
Heather Kaufman, DPM, Grand Junction, CO, kaufmandoc@yahoo.com
 

RE: Metanx and Epidermal Nerve Fiber Density Testing (Michael Turlik, DPM)
From: Allen Mark Jacobs, DPM

I would appreciate a simple YES or NO answer to the following question: Does Dr. Turlik restrict all of his therapeutic interventions to only those supported by level-1 evidence? If the answer is yes, please forward me his office address, as I would like to open an office across the street. There is very little that we do on a daily basis supported by level-1 evidence. EBM is much more than the "ideal" of level-1 EBM.

Allen Mark Jacobs, DPM, St. Louis, MO, allenthepod@sbcglobal.net

RE: Save Money On Shipping Shoes
From: Philbert Kuo, DPM

Orthofeet told me to fax all orders at one time (such as at the end of the day) and they will be shipped together. If faxed separately, the orders will ship separately because different people will process the order.

I called Dr. Comfort and they recommended choosing one a day week that the orders ship. UPS shipping is over $10 per box and that adds up.

Philbert Kuo, DPM, Chesapeake, VA, philbear@pol.net
 

RE: TX Podiatrist Donates $100K to New Medical School
From: David G Armstrong, DPM

Many thanks for posting the heartwarming story of the donation made by Dr. and Mrs. Allen. I can only hope that the leadership that this shows is able to translate into more similar giving by the rest of the profession. This gift reflects so very well on all of us and for that, we should thank him-- on this weekend above all others.
 
David G Armstrong, DPM, Phoenix, AZ, armstrong@usa.net
 

ASSOCIATE POSITION - FREDERICK, MD

Well-established and growing 2 office state-of-the-art practice located in medical/professional buildings. EMR, Digital X-ray, Ultrasound, DME provider, etc. Competitive Base Salary plus bonus, malpractice, health insurance, etc. PSR 24 minimum/Board Qualified or Certified with ability and desire to take ER call. If interested, forward CV to DOCSBNB@aol.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

PRACTICE FOR SALE - CENTRAL SOUTH CAROLINA

Practice grossing $400,000 annually based on one full-time doctor with two offices. Surgery is currently about 10-15% but can easily be increased. Medicare makes up 52% of revenues. May be able to take over practice with no money down. Interested parties email to footdocsc@gmail.com

ASSOCIATE POSITION - MINEOLA, NEW YORK

Full-time associate position with future partnership potential available with busy multi-office practices on Long Island. Must be proficient in all phases of podiatry with emphasis on surgery, biomechanics and RFC. Minimum standards include either a three-year PSR, or board qualified/certified status with ABPS. Existing hospital privileges with a NY based facility helpful. Interested doctors are encouraged to e-mail their CV to mets724@gmail.com

ASSOCIATE POSITION FULL-TIME - SUBURBS OF CHICAGO

PSR 36 - month-trained podiatrist needed for busy suburban Chicago practice. Office and diagnostic equipment state-of-the-art. Full benefit package included. If interested, please fax your curriculum vitae to 847.352.0270 or email to foot1st@yahoo.com

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

ASSOCIATE POSITION - PHOENIX, ARIZONA

Part Time/Full Time, ethical and hard working graduate of a PSR 24+/36 Residency to join our growing multi-location practice. Good mix of Surgery/Pediatric/Trauma. Very modern offices with EMR, U/S, Digital X-Ray, ESWT, ABI Testing. Excellent referral base, and a well-trained staff. Base salary, bonus structure, benefits. Current AZ License a Must. Please e-mail CV and references to azpodiatrists@hotmail.com

ASSOCIATE POSITIONS - INDIANA/OHIO

PrimeSource Healthcare is a leading provider of mobile, on-site healthcare services at long-term and skilled nursing facilities. Our exceptional growth has created an immediate need for traveling, independent contractors of podiatry services in Indiana/Ohio. Earn between $175k and $225k per year. E-mail CV to kwright@pshcs.com. Visit us at pshcs.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 a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to fmassuda@footexperts.com

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