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01/29/2021
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
From: Tilden H Sokoloff, MD, DPM
Leonard Levy DPM, MPH, is spot on. In spite of the “California leadership” working with the California Medical Association and California Orthopedic Association in gaining a plenary license, the issue is bigger than one state.
For our graduates and well trained podiatric physicians to achieve this status, we need a collective stewardship. The APMA has to make this a priority and pull out all the plugs. We have educators, who have the vision, have gone through the process, have ECFMG certification, and have passed the USMLE. Bryan Caldwell MD, DPM is Senior Associate Dean of Academic Affairs at KSUCPM. Daniela Capota MD DPM, practices internal medicine and pediatrics in Florida. I name these people because they are in proximity to schools of podiatric medicine. We have others who are licensed MD DPMs who have finished medical residency programs in the USA with a minimum of additional training in clinical areas.
As Leonard said,” if not now, when?” He knows the “how”. He was Dean, President of many podiatric medical institutions, and osteopathic medical schools. He understands process of accreditation, getting students through the entire process. He is well respected in the medical education community. He started an accredited DPM DO Program at Nova Osteopathic Medical School for podiatric residents. Let’s use our resources well and not reinvent this wheel. Medical education is in disarray, USMLE is redefining how to measure competency and, as of yesterday, the USMLE dropped the clinical skills test permanently. Too much talk and no action = 0. Nurse practitioners have gotten full scope practice licenses in 29 States. We can do this.
Tilden H Sokoloff, MD, DPM, Ketchum, ID
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01/21/2021
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
From: Leonard A. Levy, DPM, MPH
I do respect the comments of Allen Jacobs, DPM, but DPMs do need to be careful about what they say. Whether we administer vaccines or any of the many other drugs we may employ (and my understanding is that we are indeed allowed and hopefully capable of safely administering other drugs by mouth and parenterally), we also need to be able to be prepared for adverse reactions that patients may experience. If we are not, then it may be questioned by others as to why we are so permitted to administer such agents.
A large percent of COVID-19 vaccinations are given by pharmacists and many other healthcare workers who are not specialty trained physicians. Furthermore, we are experiencing what is perhaps the most serious public health emergency in the history of the world and almost a quarter of all COVID-19 deaths have occurred in the U.S. The capabilities of the podiatric physician should not be under-estimated.
Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL
01/20/2021
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
From: Elliot Udell DPM
Dr. Levy makes a good point that DPMs are well trained to give IM injections of a vaccine and if there is a manpower shortage, we as a profession could solve the problem. Let’s be honest and take this one step further. A monkey could be taught to give an IM injection. The injections that podiatrists give all day long require knowledge and training. Hence, if the powers that be at the various states get their acts together, we could help solve this very serious problem and really make a difference for our society.
Elliot Udell, DPM, Hicksville, NY
12/24/2020
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
From: Wenjay Sung, DPM, Pete Harvey, DPM
I received my vaccine on Friday and actually was given the opportunity to sign up on the first day for vaccination with the “high risk” medical personnel like ICU, ER, etc. I’m not a “staff” podiatrist at my hospital but I do take ER call and I’m frequently consulted for inpatient services. I don’t believe podiatrists were excluded or I was given preference at my hospital because I’m way too young to be senior in anything.
Wenjay Sung, DPM, Arcadia, CA
If you're on active staff of a hospital, they will inform you of your tier turn after injections have been provided to ER workers and other staff who work closely with COVID patients. Be sure that you are on the hospital email list by checking with the medical staff office. Your hospital’s Covid injection supply will also play a role in the timing. Otherwise, I would check closely with your own family physician.
Pete Harvey, DPM, Wichita Falls, TX
06/22/2020
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
From: Larry Schuster, DPM
My waiting room used to be a major social gathering place as patients would enjoy seeing friends and relatives every few months before or after their visits. I have seen offices where they placed tape over every other chair to allow for some social distancing. Of course, chairs would have to be cleaned before and after each seating as we do in our treatment rooms.
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My simple solution is pictured above, anti-social, simple but effective. We take each patient directly to a treatment room. Fortunately, we have 5. Scheduling is very carefully done and no patient actually comes in contact with another. Everyone is masked and universal precautions have always been followed.
Larry Schuster, DPM, Parsippany, NJ
04/24/2020
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
RE: Employees in the COVID-19 Pandemic (Jill Hagen, DPM)
From: Brian Kiel, DPM, Jeffrey Worman, DPM
Let me get this straight. The doctor wants her office manager to work for free 20 hours a week so the doctor can have an income and then calls the employee lazy for getting $300 more in unemployment than her salary. I can’t imagine how little her salary was but I say - why would she not?
Brian Kiel, DPM, Memphis, TN
It is my understanding that the amounts currently being paid for unemployment are being bolstered to help people during this crisis. It is also my understanding that normal unemployment wages are far less than the standard 40 hour work week pay. More importantly, in my mind, is that Dr. Hagen's logic that any employee would simply do a "mitzvah" for 20 hours a week with the promise of "this being remembered when this whole disaster is over." You can't read possibly read that sentence and think that makes sense. I have VERY loyal employees who are dedicated to me and my practice, and they are compensated for such. To expect them to do it for 20 hours/week for free is completely laughable.
Jeffrey Worman, DPM, Largo, FL
04/21/2020
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
RE: Podiatric Residents and the COVID-19 Pandemic
From: Amira Mantoura, DPM, Mike Piccarelli, DPM
Residents currently serving in hospitals with high volume COVID-19 patients will be some of the best trained ever. There is no substitution for the experience gained by playing in a live game. Thank you for stepping up. We are all proud of you.
Amira Mantoura, DPM, Stamford, CT
I applaud all of the residents, attendings, and nurses who have answered the call for help with the COVID-19 outbreak at their respective hospitals.
As the program director for Richmond University Medical Center Staten Island, NY, I particularly would like to thank my residents (one of whom was infected and has thank-God recovered and is back at work) for stepping up when called on. They are working 12-hour shifts, 6 days per week in the epicenter of the outbreak in NYC. Even with the overwhelming nature of the work, they have shown remarkable resolve in all that they have done.
Mike Piccarelli, DPM, Staten Island, NY
04/16/2020
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
From: Name Withheld by Editor
I just wanted to share a recent case (2 weeks ago) in my practice similar to the article mentioned by Dr. Chris Stewart. This is a 17 year old male who presented with very similar findings; itchy, painful, purplish spots on his toes, otherwise asymptomatic.
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Cutaneous Manifestations of COVID-19 |
04/14/2020
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
From: Barry H. Block, DPM, JD
You can sterilize N-95 masks by putting them in an oven at 158 degrees Fahrenheit for 30 minutes. If you use the respirator type mask, be sure to keep the plastic part up. Because oven temperatures can vary, I suggest trying this technique on a single mask before sterilizing multiple masks.
Barry H. Block, DPM, Forest Hills, NY
04/07/2020
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
From: David Armstrong, DPM
I wholeheartedly agree with Dr. Sokoloff’s comments vis a vis the evolution of our specialty. We are one of the few (if any) specialties that seems to want to “pre-credential” itself. We seem to draw odd anatomic Mason-Dixon lines at obscure joints. We have many different boards for the same anatomy. We really need to stop this. It is, frankly, slightly embarrassing. Podiatric surgery is a surgical specialty in the USA. There may be a spectrum of surgical activity - like in any surgical specialty. However, we need to consolidate in this peri- and post-pandemic era.
We should leave credentialing to the hospitals and base it on our surgical experience and training— like in any other specialty. I see this happening more and more, which is heartening. We should also team up to do our part to a) keep folks out of the hospital during this unprecedented time and b) dive in to help care for inpatients if we so choose. Here’s to Dr. Theodoulou and Dr. Sokoloff and the others who have trained and continue to train the next generation of men and women focused on helping people move through the world a little better.
David Armstrong, DPM, Los Angeles, CA
03/24/2020
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
From: Denis LeBlang, DPM
I practice in Rockland County, New York and so far we have had a small number of coronavirus cases but we are told it is coming and it can be a large percentage of people living here. I have closed my office to everyone except emergency patients and some post-operative patients from a few weeks ago. We have a mindset to treat and help our patients so most of us will stay open for these patients. I spoke with PICA and they told me if you close your office, you could suspend your coverage for as long as you are closed as long as you are not seeing patients.
We also feel that we have to make a living to pay our monthly bills. Our normal patterns have been...
Editor's note: Dr. LeBlang's extended-length letter can be read here
03/23/2020
RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) - PART 1A
From: Lawrence Oloff, DPM
Everybody wants to help during this unprecedented crises. Everybody wants to fulfill their duties to their patients. But it is also important that this duty extends beyond foot care. When I read the posts about the coronavirus, I am getting the sense that many are not appreciating the seriousness of what is going on. Of course, maintaining social distance in the waiting rooms and doing an extra good job of cleaning is important, but the best thing you can do is keep patients out of your waiting rooms and your offices in this critically important time. The economics of what I am suggesting are dire, but the risks are worse.
Coronavirus is an untreatable condition and is spreading rapidly. It is affecting some areas more than others, but it will affect everybody eventually. There is no treatment. Antivirals are in early testing to curb the severity of the disease. Vaccinations are at least a year off. The numbers are going up exponentially. The ICUs...
Editor's note: Dr. Oloff's extended-length letter can be read here
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