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05/25/2022
RESPONSES/COMMENTS (NON-CLINICAL) PART 1
RE: Who is Better Trained to Treat Foot Conditions?
From: Daniel Chaskin, DPM
Which students are better educated to diagnose and treat causes of foot conditions, medical students, or podiatric medical students? Does the answer to this question relate to the cause behind the pathologic foot condition, be it trauma vs. systemic?
1. In diagnosing a systemic cause of foot edema due to impaired liver function, is a podiatric medical student better prepared than a medical student to diagnose any hypoalbuminemia causing a decrease in plasma oncotic pressure causing fluids to exit blood vessels?
2. In treating foot edema due to a tear of the anterior talar fibular ligament, how many medical students are familiar with foot anatomy and the biomechanical mechanism causing such a tear or injury compared to podiatric medical students?
My opinion is that podiatric medical students should learn from medical students and vice versa.
Daniel Chaskin, DPM, Flushing, NY
Other messages in this thread:
02/13/2024
RESPONSES/COMMENTS (NON-CLINICAL) PART 1 C
From: Allen Jacobs, DPM
The Good Feet Store discussion is not about competition for the orthotic business. Realistically, our exhibit halls have long been populated by those selling “pre-fabs", as it were. Many podiatrists dispense such non-custom pre-fabricated inserts in their offices. Thus, the concept of using such inserts is not unique to the Good Feet Store chain.
My concerns are the following:
1. A patient going to the GFS for “orthotics“ more likely than not is suffering from some foot or ankle, or lower extremity pathology, for which they are seeking relief. They are essentially diagnosed and treated by other than a podiatrist. It would be implicit that some of these patients have pathology that requires treatment beyond a simple, pre-fabricated...
Editor's note: Dr. Jacobs' extended-length letter can be read here.
02/24/2023
RESPONSES/COMMENTS (NON-CLINICAL) PART 1B
From: Mark Block, DPM
It is my opinion that my strategic role associated with this issue allows me to clarify any confusion. In fact, a licensed podiatric physician in the State of Florida can obtain their 40 credits by attending an approved in-person live meeting, virtual live meeting, or a maximum of 8 credits through an approved home study course as delineated/stated in the Florida Podiatric Practice Act. Apparently, the confusion re: 40 credits for home study was a one-time exception that existed during the past licensing cycle/COVID and reverted back to maximum of 8 credits after that cycle expired.
Disclaimer: Details and clarification on this and similar licensing issues should be referenced with the Florida Board of Podiatric Medicine rules and guidelines.
Mark Block, DPM, Boca Raton, FL
07/01/2022
RESPONSES/COMMENTS (NON-CLINICAL) PART 1
RE: Shoes are Getting a Bad Rap
From: Dennis Shavelson, DPM
In a society with paved streets, clustered homes, and physical activities that use special surfaces, equipment, and extreme movements, shoes maintain quality of life, prevent injury and disease, help with healing those with chronic foot conditions, and offer support for inadequate biomechanics or excess rearfoot pronation, while enabling us to perform in hazardous conditions.
Unhealthy foot biomechanics are the root cause of most of our standing and moving issues. Harmful and unnecessary impact and stress on parts of our feet, ankles, knees, hips, pelvises, and low backs that eventually lead to pain, deformity, degeneration, injury, and poor performance over time. These are caused by Earth’s gravity and civilized hard ground surfaces. Shoes are the #1 device discouraging all that from happening.
Shoes protect against sharp objects. Shoes cushion feet and postures. Shoes offer protection from impact stress. Shoes help feet heal from infections, injury, and disease. Shoes keep us active. Shoes do things that support and stabilize our feet and postures. Shoes can incorporate mass produced or custom modifications that promote better alignment in your feet, ankles, knees, hips, and lower back. Shoes allow us to live a longer healthier life. And yes, until the foundational biomechanics and bio-architecture is corrected with or without surgery, shoes promote bunions and hammered digits to form. Isn’t that a better price to pay than a knee or hip replacement, a spinal fusion, generalized weakness, and a collapsed posture or a fall?
Dennis Shavelson, DPM (Retired), CPed, Tampa, FL
06/29/2022
RESPONSES/COMMENTS (NON-CLINICAL) PART 1A
From: Elliot Udell, DPM
There is no doubt that there are some orthopedic surgeons, especially older practitioners who did not train with podiatrists, who might cast aspersions on DPMs doing ankle or rearfoot surgery. By and large, the younger orthopedists who trained together with podiatrists would be less likely to say such disparaging things about our colleagues. That is unless they felt that they were losing money to the DPM "down the block."
Money has always and will always be the source of enmity between the two professions. There are other examples from other medical specialties where enmity and bad mouthing is present. Some colon surgeons will bad mouth gastroenterologists because both professions do colonoscopies and get paid well for those procedures. Neurologists are often at odds with physiatrists because they both bill for neurological testing. The list goes on and on.
Elliot Udell, DPM, Hicksville, NY
02/10/2022
RESPONSES/COMMENTS (NON-CLINICAL) PART 1A
From: Richard J Manolian, DPM, Steven J. Kaniadakis, DPM
When I got rid of my x-ray units, the Massachusetts Department of Public Health (DPH) informed me that I had to use a certified disposal company to pick up the devices along with cutting the power cord and any other connection, rendering it inoperable. There was also an associated fee, and I acquired a form/receipt showing proper disposal.
Richard J Manolian, DPM, Cambridge, MA
This is a very good question. I think that you should check with your state's department of health or professional regulations for the best answer.
Steven J. Kaniadakis, DPM, St. Petersburg, FL
11/10/2021
RESPONSES/COMMENTS (NON-CLINICAL) PART 1B
From: Robert Kornfeld, DPM
I’ve used Traumeel and many other homeopathic injections since 1987. I’ve never had one bad reaction. Not one. I’m sure I’ve administered nearly 200,000 injections of this type with generally excellent results. So why is it off the market? Big Pharma? Hello? You there? That said, you can safely use prolotherapy or PRP on tendons with confidence.
My only caveat is to consider your patient. If they have a burdened immune system, your results will be less than stellar. Also, these techniques do not work well with patients on NSAIDs, steroids, or immunosuppressants. Sarapin will not foster healing. It is used for pain relief (works great) but that medicine will probably soon disappear as well.
Robert Kornfeld, DPM, NY, NY
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