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07/03/2020
RESPONSES/COMMENTS (PM NEWS QUICK POLLS) - PART 1B
From: Estelle Albright, DPM
Thank you Dr. Markinson for your advice: I will further refine my methods of nail care with improved type face masking, and face and head cover, similar to operating in the OR. Currently, I mask and glove, wear glasses, and use sharp, sterile-bagged double action bone cutters for hard nails and use Miltex 40-226A nail nippers for non-dystrophic nails. I do not grind nails.
I treat fungal or dystrophic nails medically with oral antifungals and/or nail softeners, or surgically with matrixectomy or nail avulsion. My aim is cure, not maintenance. Granted, this is not an option for some patients, but for most, be the physician that you are: Treat with your best knowledge and skills.
I use a 12 month treatment plan for non-surgical nail fungus patients. This includes ketoconazole shampoo for foot washing, topical antifungals, environmental clean- up/disinfection instructions, patient education/brochures, and UV light shoe disinfection with SteriShoe/similar device. I have a very good cure rate. Many of these patients had severe, chronic nail and skin infection (often since military service, or with poor circulation or diabetes). Patients are happy and grateful to be cleared of the infection. I follow patients at 4, 8 and 12 months. I think that ultimately podiatry will endorse protection like I see at my dentist's office; this is surely the path of the future.
Estelle Albright, DPM, Indianapolis, IN
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12/23/2020
RESPONSES/COMMENTS (PM NEWS QUICK POLLS) - PART 1B
From: Elliot Udell, DPM
Dr. Tritto questions the use of posterior tibial nerve blocks in light of the fact that there are no published studies supporting their efficacy. The point he is making is well taken. Even though the late Dr. Marvin Steinberg, who was regarded as the father of modern podiatric medicine, showed that by blocking the posterior tibial nerve, a patient could be rendered almost asymptomatic within minutes, there are no studies published in any peer-reviewed journals supporting it. Why?
Studies cost megabucks and no pharmaceutical company will invest millions of dollars into showing that PT blocks are helpful, when there is no way they will make money off of the procedure. What makes it worse is that most insurance companies will not pay for PT blocks because there is no research. Could there be research and publications on PT blocks? Sure! Our professional associations along with our colleges of podiatric medicine would have to fund the research without corporate sponsorship. If enough of us want it to happen, maybe it will.
Elliot Udell, DPM, Hicksville, NY
07/02/2020
RESPONSES/COMMENTS (PM NEWS QUICK POLLS) - PART 1B
From: Bryan C Markinson, DPM
A simple search of the global microbiological, occupational science, radiological, and infectious disease literature dating back 2-3 decades will reveal a plethora of citations in the potential dangers and actual incidence of respiratory illness from inhaled nail dust and the microbes that tag along with it. A British NHS study reveals 4x the incidence of asthmatic-type illness among podiatrists.
If Dr. Moglia won’t be convinced until he sees dramatic numbers of lung cancer cases, which he won’t, then he should stop wearing seat belts and bicycle helmets. And another word to the wise, should any podiatrist be immunocompromised by any number of medical issues and or
treatments, the risk is...
Editor's note: Dr. Markinson's extended-length letter can be read here
02/21/2020
RESPONSES/COMMENTS (PM NEWS QUICK POLLS) - PART 1B
From: Joe Agostinelli, DPM
I respectfully disagree with Dr. Peacock’s comments on doing away with waste of time rotations and only teaching surgery to our podiatric residents. I come to this because of my background as a DPM in the USAF for 23 years in orthopedic clinics, then 13 years in private practice with a large orthopedic surgical group as their DPM.
During my first assignment at a USAF hospital that trained 25 orthopedic surgeons, I quickly realized the need to become a “good doctor first“, then a surgeon after that. The four years of podiatry school gave us the background in biomechanics, surgery, palliative care, etc. and the mostly...
Editor's note: Dr. Agostinelli's extended-length letter can be read here.
01/24/2020
RESPONSES/COMMENTS (PM NEWS QUICK POLLS) - PART 1B
From: Bob Hochron, DPM
The survey question is an interesting one, because it really refers to only one side of the important equation. Having retired almost five years ago, I have been asked this question by many friends and colleagues. The quickest way to answer this is to pose the rest of the question: How much do you need to live on?
My suggestion is to start with a clear and comprehensive idea of what it actually costs you to live for 3 years. I recommend every dollar spent be tracked with a simple program like Quicken, which...
Editor's note: Dr. Hochron's extended-length letter can be read here.
01/23/2020
RESPONSES/COMMENTS (PM NEWS QUICK POLLS) - PART 1B
From: Steven Finer, DPM
A carefully managed portfolio spread out among stocks, bonds, and tax-free bonds will do well. I prefer using at least two separate managers. Good rental properties can do very well beating the markets; however, they can be nightmares. I and some of my friends have both good and horrible stories to tell.
Finally, the determining factor will be your health. Unfortunately, [if you have health problems] the money will almost become meaningless. We have all witnessed these situations.
Steven Finer, DPM, Philadelphia, PA
10/12/2019
RESPONSES/COMMENTS (PM NEWS QUICK POLLS) - PART 1B
From: Judd Davis, DPM
The government has a special fund called the National Vaccine Injury Compensation Program to compensate individuals who have been permanently injured by vaccines of various kinds including seasonal flu vaccines. According to their website, to date, it has paid out $4.2B in injury settlements. This does not include amounts paid out via traditional lawsuits, so who knows what the real damages are. The site says the injury compensation rate is about one person per million vaccines administered. However, I have had a fair number of patients over the years that suffered Guillain-Barré syndrome after various vaccines, so I have to wonder how accurate their data really is?
I imagine most of the general public is not even aware of this fund or the potential risks of getting vaccines as I have not seen it discussed by the mainstream media, and therefore individuals may not seek damages when injured. It’s something to think about and might help your patients get compensation if they have major side-effects. The website is an eye-opener.
Judd Davis, DPM, Colorado Springs, CO
10/10/2019
RESPONSES/COMMENTS (PM NEWS QUICK POLLS) - PART 1B
From: David Secord, DPM
Question: Does the evidence support the call for universal influenza vaccination?
Response from Eric A. Biondi, MD, MS, Assistant Professor of Pediatrics, Pediatric Hospitalist, University of Rochester Medical Center, Rochester, New York
Response from C. Andrew Aligne, MD, MPH, Assistant Professor of Pediatrics, Director of The Hoekelman Center, University of Rochester School of Medicine & Dentistry, Rochester, New York
Influenza vaccination is a yearly ritual. The Advisory Committee on Immunization Practices (ACIP)[1] and the American Academy of Pediatrics (AAP)[2] recommend annual influenza vaccination for...
Editor's note: Dr. Secord's extended-length letter can be read here.
01/13/2016
RESPONSES/COMMENTS (PM NEWS QUICK POLLS) - PART 1B
From: Jeffrey Kass, DPM
I congratulate Dr. Weil on bringing this suit. I notice in Dr. Forman's response though he changes the verbiage of his own statement. He first uses the words custom-fit orthotics and then asks how many podiatrists make custom orthotics in this manner. It appears to me the question revolves around the definition of custom fit vs. custom orthotics. Can a pre-fabricated device, if there are a few versions, qualify as a custom fit? I think this is the heart of the question that a jury will have to decide.
Other good points to bring up are whether the devices if custom can be dispensed without the patient/client being see by a doctor? Does Dr. Scholls enter into a doctor/patient relationship when the patient or consumer step onto the scan? What if the patient/customer picks out the wrong device and it causes harm? There is no question that I side with Dr. Weil and wish him the utmost luck in this endeavor. While, I am told associations cannot back him in the suit, I am wondering if individual podiatrists can?
Jeffrey Kass, DPM, Forest Hills, NY
06/03/2015
RESPONSES/COMMENTS (PM NEWS QUICK POLLS) - PART 1B
RE: Do You Consider Yourself a Workaholic (Marc A. Platt, DPM)
From: Gregory K. Eirich, DPM
All doctors are workaholics to some degree, but nobody stands outside the OR at 11:00 pm on Friday night and tells you how noble you were for doing that surgery. We all care for our patients, but was it necessary to do the case on a Friday night at the expense of your family? Your patients love and appreciate you, but your family has your back. No one has ever laid on their death bed and said, "I wish I would have worked more."
Gregory K. Eirich, DPM, Tustin, CA
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