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Pivotal Improvements That Have Led To Increased Efficiency And Quality Care

William Fishco DPM FACFAS — Fri, 13 Nov 2009 08:30:46 -0500

I want to share with you some of the greatest improvements I have implemented in my office that have changed the way I practice podiatry.

Understanding The Role Of Advanced Imaging Techniques In Diagnosing Infection

Michelle L. Butterworth DPM FACFAS — Tue, 10 Nov 2009 09:32:33 -0500

Unfortunately, many physicians rely on various imaging modalities to deliver a diagnosis of infection, particularly osteomyelitis. I have seen a multitude of imaging modalities worthlessly ordered and performed with the physician desperately trying to get a definitive diagnosis to no avail.

Keys To Identifying Patients At Risk For Charcot Foot

Molly Judge DPM FACFAS — Wed, 04 Nov 2009 13:15:45 -0500

It is well known that patients who present with the acute or chronic Charcot joint require a tremendous amount of time, energy and effort in both patient education and proactive management in an attempt to reduce the risk of limb loss.

Can Teams Trump Technology When It Comes To Optimal Care For High-Risk Patients?

David G. Armstrong DPM PhD — Tue, 03 Nov 2009 08:29:10 -0500

Can teams trump technology in the new healthcare debate? I ask this question because I continuously see many patients referred to the Southern Arizona Limb Salvage Alliance (SALSA) who have been relegated to amputation. This is not because they have not had access to technology. In fact, most have had extensive work done by well-intentioned clinicians. What frustrates me, and I know my SALSA partners agree as well, is the lack of access to a team.

Why A Website Is Essential For Your Practice

Patrick DeHeer DPM FACFAS — Fri, 30 Oct 2009 09:05:11 -0400

I recently saw a new patient in one of my offices and I asked him how he found out about my practice. His reply was very interesting. He found me on his insurance plan but also noted that I was the only one on the list that had a Website. He picked me from the list solely because of my practice website.

Do you have a website? Do you think it is vital to your practice? How many new patients are you losing a month because you do not have a Website? How much money are you ultimately losing due to this?

Does Training Residents Cost Our Attendings Too Much?

Kathleen Satterfield DPM FACFAOM — Wed, 28 Oct 2009 10:22:12 -0400

Working with residents is a rewarding experience that most of us would not want to trade for anything. The idea of mentoring the next generation of podiatric physicians is fulfilling and generates lifelong friendships.

Gary Jolly, DPM, FACFAS, is still my mentor and friend. I will always carry with me his reassuring words, “Kath, there is nothing that you could break that I cannot fix so go ahead and start the surgery. You have to learn and I am here to teach you.”

Automated Technology And Custom Foot Orthoses: What You Should Know

Doug Richie Jr. DPM — Mon, 26 Oct 2009 15:50:00 -0400

Previously, I discussed the fact that several large podiatric labs commonly provide an orthotic fabricated over a prefabricated mold and sell this device to a doctor under the guise of a “custom foot orthoses.”

Key Tips and Pearls on Bunion Surgery

Lawrence Fallat DPM FACFAS — Wed, 21 Oct 2009 09:22:13 -0400

Although I do a lot of trauma and reconstructive surgery, I still consider bunion surgery to be very challenging and at times, difficult. While we can easily evaluate the X-ray and select an appropriate procedure, we must also consider the function and cosmetic appearance of the foot. Perception of the final result can vary greatly between patients. Of course the patients want the bunion removed, but many want the great toe to be straightened.

Are Ethics Getting Shortchanged In Student And Residency Training?

Allen Jacobs DPM FACFAS — Tue, 20 Oct 2009 09:32:40 -0400

Recently, there was discussion on Podiatry Management online regarding the professional conduct of students and residents. The discussion was centered on what was perceived to have been “unprofessional” conduct, and a discussion of the evaluation of so-called “non-cognitive behaviors” ensued.

Lateral Column Pain: Underscoring The Challenges In Diagnosis And Treatment

William Fishco DPM FACFAS — Mon, 12 Oct 2009 10:02:06 -0400

The majority of patient encounters to the podiatrist are secondary to pain in the foot and/or ankle. If we draw an imaginary line bisecting the lower leg and extending distally to the third toe, pain in the medial aspect of the foot and ankle is typically straightforward.

Expressing Concerns About Health Care Reform

Patrick DeHeer DPM FACFAS — Mon, 05 Oct 2009 11:58:30 -0400

If you are like me, you are concerned about what is going to happen with health care reform but are kind of tired of all the rhetoric you hear each day from both sides of the debate.

Clearly, the system is broken and cannot sustain itself at its current rate of growth. Additionally, the number of uninsured and underinsured is disgraceful for one of the wealthiest countries in the world. I do not consider myself too liberal but I do think health care is an individual right -- not a luxury -- if you can afford it.

Current SALSA Research Efforts To Preserve The Pedal Peninsula

David G. Armstrong DPM PhD — Fri, 02 Oct 2009 11:32:37 -0400

Greetings from the Southern Arizona Limb Salvage Alliance (SALSA). Joseph Mills, MD, and I recently did an interview with one of our professional magazines and we were reflecting on the unique nature of the diabetic foot. The diabetic foot is at the end of what I refer to as an “anatomic peninsula.” For that reason, the diabetic foot is hostage to the supply from the “anatomic mainland.”

A Closer Look At The Modified Hoke Arthrodesis For Flatfoot Deformity

Allen Jacobs DPM FACFAS — Fri, 25 Sep 2009 10:04:09 -0400

For many years, I have employed a modification of the traditional Hoke procedure in the management of flatfoot deformity. Surgeons generally employ medial column stabilization in flatfoot deformity to augment other pronation limiting surgical interventions such as arthroereisis, tendo-Achilles lengthening (TAL), calcaneal osteotomy, etc.

Ankle Sprains In Athletes: Key Tips On Facilitating A Return To Activity

Michelle L. Butterworth DPM FACFAS — Wed, 23 Sep 2009 08:33:13 -0400

Managing ankle sprains in athletes and ensuring an appropriate return to activity can be quite challenging.

In addition to being a podiatric surgeon and my partner in practice, my husband is a high school football and baseball coach. Needless to say, we deal with ankle sprains on a very frequent and regular basis. I am usually in charge of the overall treatment of the athlete since he is involved on a more personal level and is usually very anxious to get his player back out on the field.

Can ‘Beam’ Surgery Have An Impact For The Collapsed Charcot Foot?

Lawrence Fallat DPM FACFAS — Tue, 22 Sep 2009 09:23:49 -0400

I have been performing “beam” surgery for the treatment of the collapsed Charcot foot for about 18 months. If you are not familiar with this procedure, it involves reducing the deformity and percutaneously inserting a large diameter screw inside the bones of the medial column.

Keeping Surgery Simple: Why K-Wires Are Underrated

William Fishco DPM FACFAS — Fri, 04 Sep 2009 12:05:44 -0400

In some of my earlier blogs, I wrote about how I like to keep things simple in daily practice. This concept also applies to surgery.

Let’s face it: we are always looking for better ways of doing things in surgery. That is what separates a surgeon from a technician. Maybe you want to tweak the way you make your bone cut or try different fixation techniques. After all, we are always striving for perfection every time we walk into the operating room.

Are You Really Getting A Custom Foot Orthotic?

Doug Richie Jr. DPM — Thu, 27 Aug 2009 09:02:08 -0400

When you order and pay for a custom prescription foot orthotic from an orthotic laboratory, how sure are you that the device received is truly “custom”? When your patient pays you for a perceived custom foot orthotic, is the patient really getting what he or she paid for?

This will be the first in a series posted on my blog, which will explore a potential crisis facing the podiatric profession and the custom prescription foot orthotics industry.

Getting More Out Of A Conference Than Free Pens

Kathleen Satterfield DPM FACFAOM — Tue, 25 Aug 2009 13:55:33 -0400

Some folks see attending a medical conference as an opportunity to have fun and catch up with old friends. For others, the medical conference represents an opportunity to get ahead, meet possible mentors and address some business issues. That is a whole different ballgame. For the same amount of money you spend to go to a conference, you can have an entirely different experience.

Some people pack their toothbrush to go to a conference. Other people pack extra business cards, legal pads and letters of introduction. Which person are you?

Enduring The Endless Paperwork Shuffle: Why Tort Reform Is Essential

Molly Judge DPM FACFAS — Mon, 24 Aug 2009 15:25:18 -0400

Have you gone to a hospital for a case using local anesthesia lately? It has truly become bizarre. When I began private practice in 1997, you could walk into the hospital, fill out little more than a consent form and you could be in and out as fast as you would at any outpatient surgery center.

Why I Advocate The Medial Incision Approach In Hallux Valgus Correction

Allen Jacobs DPM FACFAS — Thu, 20 Aug 2009 16:27:33 -0400

Many years ago (more than I wish to recall), Guido LaPorta, DPM, turned me on to the medial incision for the correction of hallux valgus deformity. Over the years, I have found that the medial incisional approach to hallux valgus correction has been most effective and is associated with less postoperative problems than I have encountered with the traditional dorsal-medial longitudinal incision for hallux valgus surgery.