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10/04/2022
RESPONSES/COMMENTS (PM ARTICLES)
From: Paul Kesselman, DPM
For the past decade or so, I have been fortunate enough to be invited by the American Orthotics and Prosthetics Association (AOPA) to attend their annual meeting. It is a treasure trove of both scientific and trade information. A few of the same vendors you see at podiatry meetings are here. Unfortunately, there are only a few, as many who are here tell me the attention they get at podiatry meetings is appalling. This is because of a lack of interest, due to the very reasons Dr. Phillips mentions in his article and what many others have seen happen with the younger generation of DPMs. That is a loss in interest in biomechanics.
What stands out with AOPA meetings over the last decade, however, is the variety of innumerable in-depth research-based lectures and posters on biomechanics. These are rare at podiatric meetings and...
Editor's note: Dr. Kesselman's extended-length letter can be read here.
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12/01/2022
RESPONSES/COMMENTS (PM ARTICLES) - PART1B
From: Paul Kesselman, DPM
I have to mostly agree with Dr. Markinson's sentiments and publicly want to acknowledge that many years ago, Dr. Markinson often referred his patients to my practice for proper evaluation of shoes/inserts through the Therapeutic Shoe program, because his practice could not deal with the bureaucracy of the program. He and I am sure most continue to believe the program is theoretically needed, but from a practical office-based practice perspective is untenable.
Most podiatrists (and others), as opposed to pedorthists, do not offer custom molded inserts (A5513) simply because they don’t want to deal with the increased costs of the custom molded devices, while still receiving the exact same reimbursement as for custom milled (A5514) devices. Most pedorthists and some orthotists produce their own custom molded inserts in-house. But they too...
Editor's note: Dr. Kesselman's extended-length letter can be read here.
12/01/2022
RESPONSES/COMMENTS (PM ARTICLES) - PART 1A
From: Elliot Udell, DPM
There is an elephant in the room that we are not addressing when it comes to diabetic shoes and inserts. It’s called "entitlement." The patients feel they are entitled to them and will do anything to get them once a year, even if they do not use them. We had one patient who was "Johnny on the spot" every January 1st for his shoes. He never seemed to be wearing the old ones. When confronted, he would say that he just left them at home by mistake. Was he really using them or selling them on the street corner or on E-bay? We'll never know.
Elliot Udell, DPM, Hicksville, NY
09/22/2022
RESPONSES/COMMENTS (PM ARTICLES)
From: Kevin A. Kirby, DPM
I have been reading the comments on custom foot orthoses and different theories of biomechanics here on PM News for the last week and feel I need to offer some additional thoughts on the subject. I am well aware of all the different podiatric biomechanics theories and know very well the individuals who promote their own orthosis lab’s method of making foot orthoses as being the “best orthoses” for all individuals. With that in mind, I recommend that any time a new theory or foot orthosis technique is being promoted, the podiatrist needs to be very skeptical of these new ideas and techniques before they “jump in with both feet” believing that they have now found the newest and best “foot orthosis guru.”
One of the most disturbing comments I saw in this thread was the comment: “I believe in the MASS theory so much that I have told my son...
Editor's note: Dr. Kirby's extended-length letter can be read here.
09/21/2022
RESPONSES/COMMENTS (PM ARTICLES) - PART 1B
From: William Beaton, DPM
Be careful what you ask for in payment for orthotics from insurance companies. Many of us remember when we were appropriately reimbursed for bunion/hallux valgus surgery $2,000. +/- as compared to the current reimbursement rate with the 90-day follow-up. That is what happens when insurance companies control free enterprise with participation contracts and make us providers for their insureds. This past week, I counted 19 advertisements on Facebook for all different kinds of orthotics to cure from plantar fasciitis to low back pain from $39.00 to $250.00. This is a sad state of affairs, creating confusion for the general public.
William Beaton, DPM, Saint Petersburg, FL
09/21/2022
RESPONSES/COMMENTS (PM ARTICLES) - PART 1A
From: Jeff Root
I’m glad to hear that Dr. Roth has had success with the MASS theory of foot orthotic therapy. I have spoken to other podiatrists who claim to have had success with it and others who did not experience adequate success and abandoned the MASS approach as a result. I have also spoken to podiatrists who have had tremendous success with Root’s approach and others who have had less than satisfactory results. How can one explain these contrasting experiences and outcomes? Part of the answer to that question is the fact that there is variability between and how clinicians examine a patient, cast or scan the foot, and in the devices that they order for their patients. In addition there is variability between custom foot orthotics made by different manufacturers who, in many cases, claim to subscribe to the same manufacturing theories and protocols.
Fortunately, my father Merton Root did not have a vested interest in the commercial manufacture of...
Editor's note: Jeff Root's extended-length letter can be read here.
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