The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

December 21, 2006 #2,771 Editor-Barry Block, DPM, JD

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Obesity Leads to Foot Pathology in Children: UK Study

Overweight children are more likely to have deformed feet and be unable to keep their balance when walking. That is the verdict of research carried out at the University of East London. Dr. Stewart Morrison, a lecturer in Podiatric Medicine at UEL's School of Health and Bioscience, announced his findings at a conference in Brighton.

He studied a group of 200 children aged nine to 12. He showed that excessive body mass led to structural foot changes, causing obese children to develop feet slightly longer and wider than those of normal weight.

A further study of nine to 11-year-olds found that excessive body mass led to instability when walking, with obese children walking at a slower pace and spending significantly more time balancing on two feet, rather than one, in comparison with normal weight children.

Source: Newham Reporter (UK) [12/19/06]

Evans Authors Chapter in Public Health Text

At its annual meeting in Boston in November, the American Public Health Association (APHA) announced the publication of a new textbook edited by Arthur Helfand, DPM, titled Public Health and Podiatric Medicine, Principles and Practice, 2nd Edition. Dr. Chet Evans, vice president for medical affairs and dean of the School of Podiatric Medicine, authored a chapter on “Public Health Educational Considerations” discussing the important role that podiatric medical education plays in the public health arena.

Dr. Chet Evans

Dr. Evans discusses the history of podiatric medicine in public health and the educational opportunities that exist for podiatric medical students and graduate DPMs. With twenty plus years experience in medical education, podiatric medicine, and public health, he has served as chair of the podiatric section for the APHA. Dr. Evans developed the Professional Master of Public Health (MPH) for the Barry University’s Division of Medicine. This unique degree, for physicians, nurses, and other professional health providers, is designed to give health practitioners the knowledge to reduce and prevent disease and maintain the well being of all populations.

FDA Proposes More Prominent Warnings For Pain Medications

The FDA on Tuesday proposed new rules that would require more prominent warnings on the labels of nonprescription pain medications about risk for liver problems and gastrointestinal bleeding, the New York Times reports (Saul, New York Times, 12/20).

Under the rules, labels for nonprescription acetaminophen drugs -- such as Tylenol, manufactured by Johnson & Johnson, and many generic medications -- would include warnings about risk for liver damage when taken with moderate amounts of alcohol or with other acetaminophen treatments (Corbett Dooren, Wall Street Journal, 12/20). As many as 450 deaths annually result from acute liver failure caused by overdoses of nonprescription acetaminophen drugs, and, although the majority of those deaths are suicides, as many as 200 are caused by unintentional overdoses, according to FDA.

The rules also would require labels for nonprescription NSAIDs -- such as aspirin, ibuprofen, naproxen and ketoprofen -- to include warnings about risk for gastrointestinal bleeding, with a focus on patients who are older than age 60, have ulcers or prior stomach bleeding, take blood thinners or steroid medications, consume more than three alcoholic drinks daily or take more than one NSAID (New York Times, 12/20). Reports link non-prescription NSAIDs with more than 200,000 hospitalizations and about 16,000 deaths annually in the U.S., FDA said (Bridges, AP/Detroit Free Press, 12/20).

Under the rules, non-prescription acetaminophen drugs and NSAIDs would have to state "acetaminophen" or "NSAID" on the package (Schmit/Appleby, USA Today, 12/20). The rules would take effect one year after publication in the Federal Register on Dec. 26.

Source: American Health Line [12/20/06]

Query: Hallux Limitus

My patient, a 50 year old who likes to wears heels, had a cheilectomy about 18 months ago by another podiatrist. Her x-rays reveal typical grade 1 changes of the 1st MPJ. She has about 45 degrees of DF and 3 degrees of PF. The plantar ROM comes to a hard stop. Her contralateral 1st MPJ is normal. It feels like the sesamoids are preventing plantar motion. There is no evidence of arthritis of the sesamoids. Her pain is mostly plantar. I plan to have her return for manipulation under local anesthesia and if I am able to get the plantar motion back, I would follow it up with rehab. If this fails, are there any other thoughts for treatment short of implant or fusion? She has tried orthotics with a Morton's extension, as well as cortisone injections. There is no evidence of elevatus.

Peter J. Bregman, DPM, Woburn, MA

RE: The Massachusetts Plan (Dale Smith, DPM)
From: Lloyd S. Smith, DPM

I have been unable to define the MA plan in a way that makes me comfortable with enrolling as a provider. There is no fee schedule published as yet. One of my hospitals has asked me to enroll, and suspects fees will be paid at Medicaid rates. If so, I would lose money on each patient seen.

Perhaps someone else has been able to see a fee schedule.

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

RE: Podiatric Staff Salary Survey - Take II
Lynn Homisak, PRT

In case you missed my initial posting in PM's issue dated 12/19/06, you are invited to participate in podiatry's first time Podiatric Staff Salary Survey. I am conducting this survey in an effort to determine a national benchmark for podiatric staff salaries for your/our profession, taking into consideration your location, type of practice and amount of staff training (among the requested criteria.) I know you are all very busy, but the survey should take you no longer than 90 seconds and I would very much value and appreciate your participation. It is completely anonymous. The overall results will be posted in an upcoming issue of Podiatry Management Magazine.

Only one response per office is requested, so if you have already taken the survey...thank you! If not, you can just click on:

http://www.zoomerang.com/survey.zgi?p=WEB225YAWBU3UT to get started. If you are an assistant in charge of payroll, please feel free to participate. If not...please forward this email to your doctor or the individual responsible for recording payroll and request he/she complete it on our behalf. Also, I would appreciate your "passing it forward" it to other friends/colleagues you feel may be interested. The more that participate, the more accurate our numbers can be.

Lynn Homisak, Renton, WA, LynnPRT@msn.com

ASSOCIATE POSITION - CINCINNATI, OHIO

One of the largest podiatry practices in the United States is again in need of a PSR 24-36 Associate. All present doctors are in their thirties with similar training. Everyone is treated equally and there is definitely no limit to your success. Please submit resume or contact Karen Roesch via email or phone. Kroesch4poh@aol.com (513) 729-4455

ASSOCIATE POSITION- MEMPHIS, TN

30 year-old, high volume, multi-office practice in Memphis, looking for 24-36 PSR trained individual. Good opportunity for reconstructive surgery and wound care. No nursing homes or weekends. Potential partnership opportunity. Contact Footdok4@gmail.com

ASSOCIATE POSITION--PHOENIX SUBURB

Attractive opportunity for enthusiastic, proficient, and personable associate. Well-established modern practice with multiple newer spacious offices, technology and equipment. Solid referral base, close to hospitals, knowledgeable certified staff. 22% MCR. Practice and surgical center partnership potential opportunity. Prefer 24-36+ PSR. Send CV: AZpodassociate@aol.com

POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

Multi-office, multi-doctor, well-established practice near the beach cities. Seeking a board eligible/certified PSR-24 or PSR-36 trained foot and ankle surgeon. Well-rounded practice requiring knowledge in biomechanics, pediatrics, sports medicine, diabetic wound care, trauma, and reconstructive foot and ankle surgery. Full-time position available immediately with generous compensation and benefits, including malpractice, and health insurance. Two-year commitment required with partnership opportunity. Send CV to akemfoot@sbcglobal.net or fax to (310) 838-0227.

ASSOCIATE POSITION - CENTRAL CALIFORNIA

Central California multi-location practice looking for PSR-36 associate leading to partnership. PSR-36 trained podiatrist with great opportunity for reconstructive surgical practice. Practice has Medicare-approved surgery center. Must have excellent interpersonal skills. Excellent salary and incentive. Respond to: westsidefoot@yahoo.com

ASSOCIATE POSITION – SOUTHERN WISCONSIN

Thriving Southern Wisconsin practice looking for an ethical, hard-working and highly trained podiatrists for an associate position at a well-established practice. Applicants must have completed a 2-year residency and be trained in all aspects of podiatric medicine. Strong potential for future partnership opportunity. Please fax CV and cover letter to (608)829-1319 or e-mail us at footdr@madisonpodiatrists.com.

ASSOCIATE POSITION - FINGER LAKES REGION UPSTATE NY

Leading regional group practice seeking ABPS residency-trained associate with partnership in mind. Excellent compensation/benefit package. Associate to see the same patient mix as partners, and will be involved in expanding the practice. State-of-the-art wound care center. Surgical privileges in nearby PA. Great opportunity for a well-trained, ethical podiatrist to work in a beautiful area that is great for family. NewYorkAssociate@comcast.net

ASSOCIATE POSITION – NEW YORK CITY

Looking for an enthusiastic well-trained foot and ankle surgeon to join busy Manhattan/Brooklyn practice leading to partnership. Candidate must have completed a minimum two-year surgical residency program, demonstrate qualities of self-motivation and have impeccable skills in forefoot and rearfoot surgery. Package includes malpractice ins. health ins. plus salary. Terms negotiable. Email Manfootcare@aol.com or call 917-756-3686

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