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01/01/2020    

RESPONSES/COMMENTS (NON-CLINICAL)



From: Dieter J Fellner, DPM


 


I applaud Dr. Ribotsky's well-intentioned solution for sourcing Radiesse. At the same time, I am truly flabbergasted. This company apparently unchallenged can, through their actions, indulge their gross and unfettered bias towards a legitimate professional medical body of healthcare professionals, such as podiatry, so much so, as to affect the company’s profit margins. At the very least, does Merz not have any fiscal responsibility for their investors? Is this company not answerable to anyone? I would strongly advise their investors to consider the extreme folly of this company.


 


I suspect I must be wrong in my assumptions - there HAS to be a rational explanation why a legitimate, state licensed and fully accredited doctor, a specialist no less, should be denied legitimate access to Radiesse. Instead of receiving the customary professional courtesy from a company such as Merz to be 'allowed' the privilege to increase their sales and profit, the doctor needs instead to consider going cap in hand to a colleague to beg for a supply. 


 


Until Merz’s CEO issues an unreserved apology and is fired and/or their abstract, discriminatory and possibly illegal policy is reversed, I will quite simply prefer to drill multiple holes in my own cranium without anesthesia, before I will consider putting a single cent towards this company and its ridiculous and shameful business policy. 



 


Dieter J Fellner, DPM, NY, NY


Other messages in this thread:


02/17/2020    

RESPONSES/COMMENTS (NON-CLINICAL)



From: James S. Scales, DPM, Jay Seidel, DPM


 


We have used Physician Claim Corp, for the better part of the past 15 years. I can't say enough good about them!  I highly recommend them!  I have used other billing services, as well as done it in-house, and found that it was much more cost-effective to use PCC.


 


James S. Scales, DPM, Arvada, CO


 


I have been using OnTimeMedicalBillingSolutions.com for the past 6 months. My collections have jumped and I have received only positive feedback from my patients. David Weiss truly makes each physician client of his feel like they are his ONLY client. His services include: checking co-pays/deductibles before patient visits so you know what to collect before the patients are even seen, submitting claims, following up with denials/corrections/appeals as needed, sending patient statements, and fielding patient billing questions. His fees are also very reasonable. I recommend his services without any reservations.


 


Jay Seidel, DPM, Deerfield Beach, FL

02/12/2020    

RESPONSES/COMMENTS (NON-CLINICAL)



From: Greg Cohen, DPM


 


This product is still available from L’Oreal by contacting Cerave.CustomerService@loreal.com.


 


Greg Cohen, DPM, Brooklyn, NY

02/11/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Safety Net for Podiatrists in Crisis


From: Mark E Weaver, DPM


 


I feel PM News is the most important podiatry blog. There is, however, a vacuum in the area of podiatry camaraderie. There are personal, natural, and man-made disasters in the country every month. California fires, Puerto Rican earthquakes, Floridian hurricanes, Mid-western floods, and major boating and auto accidents. I know that I had local podiatrists who would come to my aid in a personal crisis, But, in a local or statewide crisis as noted above, there is strain on all the local professionals in their own practices. Do we have, or do we need a system to provide assistance for our colleagues that have had unfortunate circumstances?


 


I have recently retired, but I feel I still have reasonable skills and time that is not unlimited but more available for several years to come to help in cases of emergency. And, for example,...


 


Editor's note: Dr. Weaver's extended-length letter can be read here.

02/11/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2



From: Hartley Miltchin, DPM


 


They have discontinued the foot moisturizing cream because of poor sales in the foot category.  The CeraVe SA cream used on other parts of the body is the exact same formula.


 


Hartley Miltchin, DPM, Toronto, Canada

02/07/2020    

RESPONSES/COMMENTS (NON-CLINICAL)


RE: Zimmer enPuls Shockwave (Supna Reilly, DPM)


From: Steven Kravitz, DPM


 


I will not comment on the Zimmer device specifically, but rather on the general use of shockwave therapy relative to wound healing. A leading authority worldwide on the topic is an  orthopedist from Taiwan. Ching-Jen Wang, MD has performed extensive research for over 20 years and has published multiple articles on this topic. He has lectured worldwide, is a frequent speaker, and has received multiple awards from the American Academy of Orthopaedic Surgeons (AAOS). He is retiring and will be presenting his final abstract on the culmination of his research at the Academy of Physicians in Wound Healing (APWH) Annual Conference in October.


 


Past lectures from the speaker has demonstrated significant effects of shockwave therapy on healing otherwise non-healing wounds. The research is impressive. He has also studied other orthopedic-related problems. 


 


Steven Kravitz, DPM, Winston-Salem, NC

02/06/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Zimmer enPuls Shockwave (Supna Reilly, DPM)


From: David Zuckerman, DPM


 


I wrote an article on this technology. The Zimmer EnPuls isn't FDA-approved. It has no approval for shockwave indications. I am not aware of any results reported except for doctors’ observations. The Zimmer enPuls is a class 1 device, not a class 3 device. FDA-approved ESWT devices have undergone evidence-based studies that are double-blind, randomized, placebo-controlled studies with multicenter evaluations. While the Zimmer enPul may work, it isn't a shockwave device per FDA Class 1 classification.


 


I am not saying it can't help your patients. It may be right for your practice, but you should understand and know whether a device is FDA-approved or FDA-cleared and for what indications.  


 


David Zuckerman, DPM, Cherry Hill, NJ

02/06/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2


RE: ABPM Non-Recognition of Residencies (William E. Chagares, DPM)


From: Daniel Chaskin, DPM


 


GME funding is linked to the fewest years needed for the certification process. Why can't such funding co-exist with an additional alternate path of 30 years' or 20 years’ experience in practice? The public is hurt by excluding qualified podiatrists from board certification with the experience and the knowledge to pass a certification exam. This would be a win-win situation for all experienced podiatrists who never got a residency match.


 


Daniel Chaskin, DPM, Ridgewood, NY

02/05/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: William E. Chagares, DPM


 


The eligibility criteria for access to board certification are set by CPME. This includes the length of post-graduate training required. The APMA HOD, CPME, and recognized specialty boards worked together to create more uniform residency programs of greater complexity and length. This is reflective of the training and education required to accommodate the public need for podiatric practitioners.


 


There has consistently been adequate, publicly-advertised time for access to certification by graduates of the archival program types of shorter length. Furthermore, GME funding of training programs is linked to the fewest number of training years eligible to access the certification process. This is critical in keeping podiatric residencies fully funded by GME, and thus maintaining viability for the future of our profession. The profession and key stakeholders who are responsible for maintaining a standard of training commensurate with current practice, have consistently endeavored to move forward while allowing adequate opportunity for those from older training models to access the certification process.


 


The ABPM encourages everyone to reply to CPME's call for public comment during revisions to Document 320 (Residency Training Standards). There was a public comment period for revisions to Document 220 (governance of specialty boards - JCRSB) which was adopted in October 2019. This would have been an appropriate time and place for comments regarding access to board certification.


 


William E. Chagares, DPM, President, American Board of Podiatric Medicine

02/05/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2



From: Supna Reilly, DPM


 


The enPuls unit is extremely effective and has been a wonderful source of revenue for our office. We do 6 treatment sessions spaced 2-3 days apart, and charge $100/session. Literature suggests the efficacy of shockwave to be around 80%, and we have found that to be the case in clinical practice as well. It tends to be an easy sell for patients who don't want to go the surgical route or have plateaued in their progress. The customer service on the unit is also unparalleled. I recommend this unit.


 


Supna Reilly, DPM, Chicago, IL

02/04/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2



From: Kevin A. Kirby, DPM


 


The “Pose Method” and “Chi Running” are styles of running popularized over the past decade where coaches teach runners to try to land more on their forefoot, and not on their heels, during running. These two running “methods” were created by individuals who have sold books, produced videos, and have trained coaches to teach runners on “the proper way to run”. Neither of these running methods, which have likely made their creators lots of money, have been shown to be more “natural”, more metabolically efficient, or less injury-producing than other running styles.


 


Pose and Chi running became popular during the barefoot running fad of 2009 to 2015, where many self-proclaimed “running form experts” on the Internet asserted, without supporting scientific research evidence, that...


 


Editor's note: Dr. Kirby's extended-length letter can be read here.

02/04/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Jeffrey Kass, DPM,


 


I agree with the absurdity referenced in the post by Dr. Gertsik. This is a prime example of the divisiveness within our profession. My solution for Dr. Gertsik is to get boarded by the American Board of Medical Specialties in Podiatry. 


 


Two years of residency would allow you to sit for their board, and 20 years of clinical practice would equate to two years of residency. From your post, it sounds like you would qualify based on your training or years in practice. 


 


Jeffrey Kass, DPM, Forest Hills, NY

02/04/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 3A



From: Alan Sherman, DPM


 


I want to respond to Stephen Kominsky’s message critical of the APMA’s and podiatrists’ efforts to educate the lay public about what we are and what we do. Throughout my 42 years as a podiatrist, I’ve seen so many efforts by the APMA and state associations to educate the public. I don’t believe that it has done no good at all, and I don’t thing Dr. Kominsky is saying that. I’m sure it has helped. But we must acknowledge that what we tell the public about ourselves is not going to have the credibility of what they observe on their own, or are told by trusted sources.


 


In this age of ubiquitous media, we have all developed sophisticated filters and have learned to challenge many sources of information that 100 years ago would have been... 


 


Editor's note: Dr. Sherman's extended-length letter can be read here

02/04/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 3B



From: Estelle Albright, DPM


 


Not only patients, but our colleagues in medicine are unaware of the scope of podiatry, both surgical and conservative. Further, they are unaware of the extent of our training. Point in case: I gave a noon-time medical lecture to staff at our CME series at my hospital. I opened the lecture with my credentials and spoke about the scope of podiatry.


 


After the lecture and Q&A session, a staff cardiologist approached and said he had no idea of our training, thinking that podiatrists simply went to, 'trade school'. I was happy to have imparted the information about our profession, but was made acutely aware that many other medical professionals have no idea of what we do and how we are trained.


 


Estelle Albright, DPM, Indianapolis, IN

02/03/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: ABPM Non-Recognition of Residencies


From: Vladimir Gertsik, DPM


 


Since primary podiatric medicine, podiatric orthopedics, and other names are gone (with their respective residencies), it is time to acknowledge that most non-surgical podiatrists are pretty much the same. Some see more kids than others, some do more orthotics than others, but we are still mostly podiatrists. I appreciate the name change. But what I do not appreciate is the stubborn refusal of the Board to recognize their own residency types (now obsolete but nevertheless CPME-approved at their time). 


 


All podiatrists who have in good faith completed a residency program should have a pathway to board qualification. ABPM does not recognize its own residencies! Why should these pathways ever be closed? This is absurd. If a 2-year residency was acceptable 20 years ago, why is it no longer acceptable? Do 20 years of practice count for anything? Apparently not. What are these boards trying to prove, and to whom? Since there is no logic in all this, I feel that this board is not legitimate.  


 


Vladimir Gertsik, DPM, NY, NY

02/03/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2A



From: Alan Sherman, DPM


 


Dr. Allen Jacobs in a recent letter said, “I was evaluating a post-op Austin-Akin patient today. She told me that she watched the (My Feet Are Killing Me) reality show. Her exact words were; “I’m impressed. I had no idea podiatrists did such complicated things.” This just goes to show you how different a patient’s perspective can be from a physician’s. I’m wondering what she saw on the show that seemed more complicated than the intricate surgery that she had done by Dr. Jacobs. Maybe she meant, “unusual” or “serious” or “rare” or “bizarre”, but complicated? We should all be more aware of how different a patient’s perspective can be from our own.


 


By the way, keep an eye out for media segments that Drs. Ebonie Vincent and Brad Schaeffer did on the Dr. Oz Show, TMZ, DailyQ, Good Day, and recently, they filmed a segment for the Tamron Hall Show which aired on Friday at 1PM. These two podiatric reality superstars have been quite busy talking up podiatry to a huge national audience.


 


Alan Sherman, DPM, Boca Raton, FL

02/03/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2B



From: Stephen Kominsky, DPM


 



The last few words spoken by [Dr. Jacobs'] patient have been my mantra for the 37 years that I have been in practice. Instead of the APMA producing Johnny Sorefoot Balloons and the like, I have always felt, and feel even stronger today, that it is an absolute MUST that the “lay-public” be educated about what a podiatrist can do. For someone in this day and age to ask a podiatrist that question is a "Shonda" (Yiddish expression meaning something terrible).


 


Just like the AMA has done a miserable job on educating the public about the declining reimbursement, we have done a poor job regarding our education and abilities. We MUST be better at telling everyone what a podiatrist can do, and do it better than anyone else, or we will not survive. 


 


Stephen Kominsky, DPM, Washington, DC


01/31/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2A


RE: My Feet Are Killing Me Cable Series


From: Keith L. Gurnick, DPM


 


To all of us who are watching or will watch the new show made for TV, "My Feet Are Killing Me" Cable Series, please understand that this is a made for TV show and is for the purpose of  entertainment to viewers. Don't expect to see on television that every patient is greeted, examined, diagnosed, and treated as if you were their doctor in your practice or office. Patients for these types of shows are cherry-picked for various reasons, and filming is edited down to produce a final product without  doctor involvement. 


 


Do not assume that what you see on TV is the full extent of the treatment. Do not expect many of the patients to exhibit the problems that most of us encounter. These might seem to the TV audience to be extreme and often include unusual back stories for the patient or their families  to make the show more interesting. 


 


Keith L. Gurnick, DPM, Los Angeles, CA

01/31/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1



From: Joe Boylan, DPM


 


I never was an advocate of the “Pose Method” regarding the foot strike; forefoot to forefoot. It does help with upper body posture. In my view, a forefoot to forefoot gait for most runners would predispose one to a host of overuse injuries.


 


An exaggerated heel-toe gait (as we do when walking) is also not recommended. The ideal foot strike is on the plantar heel/mid-foot (almost like a shuffle). 


 


Joe Boylan, DPM, Ridgefield, NJ

01/31/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2B



From: Allen Jacobs, DPM


 


“Although lasers are approved by the FDA for onychomycosis” is not entirely correct. The FDA states that lasers may be used as adjunct therapy to supplement accepted management protocols for the treatment of onychomycosis. In fact, the FDA published policy on the matter advises not to claim that lasers are a cure for onychomycosis, but provide only temporary improvement in the appearance of the toenail. At-risk populations in which the treatment of onychomycosis is considered necessary (e.g.- diabetics, PAD patients, immunosuppressed patients) are denied appropriate treatment when lasers are employed, while subjected to potential risks.


 


The FDA approved the safety of lasers, not the specific employment of this modality for onychomycosis. And yes, while speciation is not required as lasers are not “species specific," some confirmation of fungal infection would seem appropriate prior to treatment.


 


I was evaluating a post-op Austin-Akin patient today. She told me that she watched the show. Her exact words were; “I’m impressed. I had no idea podiatrists did such complicated things.” 


 


Allen Jacobs, DPM, St. Louis, MO

01/29/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1


RE: Investing in the Future of Podiatry


From: Allen Jacobs, DPM


 


Over the last several years, I have observed the commendable efforts of the New York State Podiatric Medical Association in promoting our profession and encouraging recruitment of students to enter the field of podiatry. Each year, the NYSPMA offers a one-day program for college career counselors and premedical advisors introducing them to podiatry. A hotel room, meals, and an excellent program are provided. This includes a tour of the exhibit hall and attendance at a lecture. Students, residents, young and older practitioners, as well as local thought leaders provide a brief synopsis of their experiences and perspective. Additionally, college students are given conference and exhibit hall tours and discussions regarding podiatry as a potential choice for patient care.


 


Might I suggest that each state society and regional conference take responsibility for doing the same. Yes, some effort and money is required. However, from my observation, it would appear that participation of each state society, possibly with the assistance of a college of podiatric medicine, could potentially serve as an excellent means of student recruitment. Organizations holding scientific conferences, for example ACPM, ACFAS, DermFoot, PRESENT, and many others, should consider the same. There is no crime investing in the future of podiatry. 


 


Allen Jacobs, DPM, St. Louis, MO

01/29/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2



From:  Timothy P. Shea, DPM


 


Like other podiatrists, I have been interested in, and pleasantly pleased, by the presentation of podiatric medicine and surgery on this series. These young podiatrists present a very pleasant, personable, and professional image of our profession. This can only help to promote our image in the public arena. I know we can be a little nit-picky about topics and credentials, but recently I was approached by the chief of medical staff at one of my local hospitals about the program. He and his wife (a physician) also watch it and enjoy it very much. The key point he made to me about this series is that it presents interesting cases and good information to the public about foot and ankle care. That was a real compliment. Kudos to the stars of this show.


 


Timothy P. Shea, DPM, Concord, CA

01/28/2020    

RESPONSES/COMMENTS (NON-CLINICAL)



From: David Wolf, DPM


 


In response to Dr. David Krausse’s question:  He posits, “Does it not bother anyone that neither one of these two doctors are not board certified in foot surgery?” Really? Who cares? The only ones who are "bothered” by this are the minority of our colleagues who keep those DPMs who are not board certified off of hospital staffs and insurance plans. Unfortunately, podiatric insecurity that has its genesis in podiatric medical school is still “alive and well.”


 


As a ABFAS board certified podiatrist, I or my staff had NEVER been asked if I was board certified. “Patients don’t care what you know; they want to know that you care.” These two TLC podiatric surgeons will have, through this national exposure, a positive and infinite benefit to our profession.


 


David Wolf, DPM (Retired), Houston, TX

01/27/2020    

RESPONSES/COMMENTS (NON-CLINICAL)



From: Dieter J. Fellner, DPM


 


Dr. Krausse asks: "does it not bother anyone that neither of these doctors are board certified in surgery?"


 


Absolutely not: is Dr. Krauss referring to the "Board Certification" test that requires the examinee to perform a series of abstract MCQs.  Plus, of course, lest we forget, the even more abstract computer patient simulation test. How does this series of non-practical testing, non-field testing guarantee ANY kind of surgical competence? Surgery is a hands-on practical skill. If the profession wants to test the surgeon, then test with a practical exam. That, by the way, should be the crowning achievement of the surgical residency.


 


I have met quite a few 'Board Certified' surgeons with highly dubious practical skills and equally dubious decision-making faculties; and also, of course, those with excellent practical skills and knowledge. The 'Board Certification' provides a guarantee for neither attribute. 


 


Dieter J. Fellner, DPM, NY, NY

01/24/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A



From: David S. Wolf, DPM


 


Kudos to both podiatrists in this reality TV series, who exemplify the finest in our profession. They will educate the public of the scope of our practice and will augment what the APMA has attempted to accomplish. We have all seen the pathology of these TV patients but at least now, it will be seen by millions of viewers. What a positive PR coup for our profession. Wish I would have thought of it.


 


David S. Wolf, DPM, (Retired) Houston, TX 

01/24/2020    

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1B



From: David Krausse, DPM


 



I hope that the new TLC show is helpful in spreading the good work of podiatry around and I hope that the 2 podiatrists featured make good decisions and help their patients. That being said, does it not bother anyone that neither of these doctors are board certified in surgery? 


 


David Krausse, DPM, Flemington, NJ

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