The Voice of Podiatrists

Serving Over 10,000 Podiatrists Daily

December 21, 2007 #3,123 Editor-Barry Block, DPM, JD

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CA Podiatrist Discusses Diabetic Peripheral Neuropathy

"Diabetic peripheral neuropathy starts out at the tips of the toes, developing a burning sensation," said Dean Vayser, a podiatrist doing diabetes research at the Whittier Institute for Diabetes at Scripps Health in La Jolla, CA. "Like a glove pattern, it goes up to the arches, heels, ankles and leg."

Dr. Dean Vayser

Doctors now suspect that the body's sugar invades and eventually damages the nerve in the foot, setting off a "cascade of events," said Vayser. In men, the first sign is often erectile dysfunction, but then it characteristically moves to the feet. In the early stages, diabetics most often feel a "burning or tingling, like ants crawling," according to Vayser.

Eventually, the foot goes numb, and diabetics are in danger of stepping on glass or a tack and not feeling the wound. That "pivotal event" sets off an infection. Because there is no sensation in the foot, many patients are not aware of the wound until they smell the infection or see puss or blood on the sock, he said.

Source: Susan Donaldson James, ABC News [12/19/07]

FL Podiatrist Gets to Photograph His Childhood Dolphin Legends

Dr. Bret Ribotsky is best known as a podiatric lecturer, but his other passion is being a professional sports photographer. While on the field of the Miami Dolphin's game last Sunday, he had a dream come true. "The Dolphins are my favorite team" said Bret Ribotsky, who grew up in Miami Beach.

Jim Langer, Bob Griese, Bret Ribotsky, and Paul Warfield

"The Perfect Season" (1972) has always been a period of pride for Miami, and on December 16 the surviving members of the '72 Dolphins were honored at Dolphins' Stadium. For Ribotsky, meeting Bob Griese, Paul Warfield, Jim Langer, and Larry Czonka was a childhood dream come true.

“These Hall of Fame members have demonstrated what dedicated, committed people can do", said Ribotsky. "Find people getting the results you want, and copy what they are doing." Their inspiration must have worked as the 0-13 Miami Dolphins won their first game of the season.

Medicare Bill Expected to be Signed By Bush Shortly

The Senate unanimously passed a legislative package that reverses a scheduled Medicare physician pay cut of about 10% and extends funding for the State Children’s Health Insurance Program through the early part of 2009. The bill now goes to the House for a final vote—perhaps as soon as today—where passage is expected. President Bush is expected to sign the bill, which was crafted with input from the White House.

Included in the legislation are a host of provisions to extend several Medicare and Medicaid programs that were set to expire, including a physician quality-reporting initiative and a system of bonus payments to doctors who practice in shortage areas. Though the measure replaces what would have been a steep cut to doctors with a short-term 0.5% pay increase through June 30, 2008, several physicians groups still registered complaints.

Source: Matthew DoBias, Modern Health Care [12/19/07]

RE: Liquid Nitrogen for Warts

I would like to offer my patients liquid nitrogen for the treatment of warts. This is a commonly used modality by pediatricians and dermatologists. Any advice regarding cost, maintenance/ storage, sources for purchase, patient tolerance, as well as technique would be appreciated.

John Moglia, DPM, Berkeley Hts., NJ

Query: Communication System of Lights

I would like to install a communication system of lights outside of each treatment room. I have spoken to a company called Varitronics, Inc. What suggestions or methods do PM News subscribers have for a multidoctor practice?

John Clarke DPM, Fremont OH

RE: ACFAS Drops APMA Membership as Renewal Requirement
From: Multiple Respondents

Time is long overdue for our organizations to commit to work together for the good of the profession.

The recent move by ACFAS to drop the requirement for APMA membership to maintain membership in ACFAS seems to me to be divisive and not in the best interests of the profession. Since I graduated from CCPM in 1981, in that quarter century, podiatry has made tremendous strides in our relations with other medical specialties, and the public. Much of that progress has been due to the fine work that both the APMA and ACFAS have done in reaching out to hundreds of medical associations and educating them as to our level of training and worthiness to be the nation's foot care providers of choice.

Two factors that have slowed us down are the less than optimum percentage of podiatrists who support the APMA by paying dues, and the confusion caused by having multiple competing specialty boards and academic colleges. I would encourage ACFAS to mend fences, resolve this issues with the APMA and re-instate the requirement that all ACFAS Associates and Fellows be dues paying members of APMA. Now if we could just get ABPS and ABPOPPM to merge and eliminate that confusion.

Alan Sherman, DPM, CEO, PRESENT e-Learning Systems, asherman@presentelearning.com

I have been a loyal member of the APMA for over 30 years and I have been a loyal member of ACFAS for 27 years. During all of these years there have been times when I wished I didn't have to pay dues to one or the other. I also wished I didn't have to pay for life insurance, health insurance, disability insurance, home mortgage, auto expenses and many others. However, I believe that it was always in the best interest of the organizations and myself to remain a party to each of them. I, for one, will continue to maintain membership in both the APMA and the ACFAS and I would encourage all others to do the same.

G. Dock Dockery, DPM, Seattle, WA, gdockdockery@aol.com

The real issue here is not that members can’t afford to belong to APMA or their state component; it is that you have to belong to the state component in order to belong to the APMA. APMA membership is inarguably a great value. For years, however, members have wanted to drop out of the Michigan Podiatric Medical Association but didn’t want to lose their APMA membership, nor, more importantly, their ACFAS membership. They were all linked, and it started with the state association. ACFAS is the beacon of integrity for our profession, and as the Immediate Past-President of the MPMA, I spent most of my time trying to raise the bar of integrity in our state, especially with respect to continuing education. How could we achieve parity with our allopathic colleagues if we didn’t raise our own standards? We should be leaders by example.

Unfortunately, not everyone agreed with this strategy, and we were left with a mess in Michigan. Since this is not the first time this has happened, many members finally said that enough is enough. If you don’t believe in what is happening in your state, and you get involved and you still can’t fix it, why continue to support it? You shouldn’t have to sacrifice membership in an organization that you are proud to be a part of because you leave an organization that you are ashamed of. We only wanted to maintain our ACFAS membership, and that is what we requested. We would likely maintain APMA membership if we didn’t have to join the MPMA, but that is up to APMA. ACFAS had the courage to listen to its membership and do what they have always done: the right thing.

Michael T. Ambroziak, DPM, Bay City, MI, ambroziakm@aol.com

PRACTICE FOR SALE - MINNESOTA

Minnesota practice for sale in upscale suburban location with turnkey absentee-ownership opportunity. This owner let's this practice run on auto-pilot while collecting $700's and associates treat all patients. This is a very well established practice and staff is willing to stay. Financing is available OAC. Contact American Doctor Sales 614-918-3000 or email us at sell_my_practice@yahoo.com

EQUIPMENT WANTED – USED PORTABLE ORTHOPOSER

I will arrange for delivery or pickup upon purchase confirmation. Please call or email with asking price. 718-896-3080 / afootdoc@ix.netcom.com

ASSOCIATE POSITION- KANSAS CITY, MO

ASSOCIATE POSITION – VIRGINIA

Must have Virginia license. Requires 24 to 36 month Residency. Permanent position with potential buy in. Includes all phases of Practice excluding nursing homes. Competitive Salary and Benefit package. Please send Resume including salary requirements and availability date to needpodjob@yahoo.com

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

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

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