From: Ron Freireich, DPM, Burton Katzen, DPM
We had this exact problem here in Ohio and we checked with our patients to see if they initiated the refills. They too did not request the refills. We filed a complaint with the State of Ohio Pharmacy Board. The faxes quickly stopped.
Ron Freireich, DPM, Cleveland, OH
Unfortunately, with the single sheet faxes of today, even when you mark unsubscribe, they still keep coming and it is hard to stop. Many years ago, I was getting 3-4 faxes a day from one company advertising office furniture. At the time, we had a fax that used a paper roll, and I attached 3 pages together (top of the 1st one to the bottom of the last one) that said UNSUBSCRIBE, called the number and left for the night. Surprise!! No more faxes from them. I always had a vision of them not being able to get in the office the next morning because of the mass of paper blocking the door.
Burton Katzen, DPM, Temple Hills, MD
From: Allen Jacobs, DPM
It is not appropriate to willfully misrepresent facts to a patient. Tell the patient the truth. You are paid less for multiple procedures performed concurrently. You are not willing to accept the reduced payments. The patient should be made to understand that you utilize the same degree of care, time, cost, and expertise for each procedure.
If you are found negligent in the performance of a second or third procedure, I do not believe the jury award or settlement by the carrier is reduced 25 or 50 or 75 percent. Just tell the patient the truth. Misrepresentation is always unethical regardless of any well-intentioned reasons for doing so.
Allen Jacobs, DPM, St. Louis, MO
From: Doug Richie, DPM
Dr. Udell appropriately applauds the recently published study published by Wrobel, et al., supported by a grant from the APMA. However, the "positive difference" which Dr. Udell cites which were provided by custom foot orthoses, compared to pre-fabricated and sham orthoses, must be put into proper context. When examining the results of this study:
There was no significant benefit of any type of orthosis, including sham devices over traditional stretching and icing in terms of reducing morning pain. The custom and pre-fabricated orthoses did reduce evening pain compared to the sham device, but there was no superiority of custom devices. There was no benefit of custom or pre-fab foot orthoses compared to sham devices in terms of overall foot function. The custom foot orthoses did produce a significant improvement in spontaneous physical activity, duration of standing, and duration of walking compared to the other devices.
The message here is: If improving activity is your primary goal when treating plantar heel pain, then custom devices appear to be superior to pre-fab based upon this study. If relief of pain is your primary treatment goal, custom devices continue to show no advantage over pre-fab devices.
Doug Richie, DPM, Seal Beach, CA
From: David L. Kahan, DPM
VOIP is definitely the way to go. Check out Costco services for business phone. Great phone options, GREAT pricing. However, you will still need to have a good Internet provider. VOIP is always less expensive than the traditional phone system, more reliable, and feature-rich. There really is no comparison.
David L. Kahan, DPM, Sacramento, CA
From: Michael L. Brody, DPM
I understand and appreciate your comments, but let me pose a few questions regarding how camera phones would be used and how low-cost digital cameras would be used.
1) If you have a low-cost digital camera that does not leave your office, what is the risk of...
Editor's note: Dr. Brody's extended-length letter can be read here.
