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12/01/2009
RESPONSES / COMMENTS (NEW STORIES)
RE: TX Podiatrist Donates $100K to New Medical School (David G Armstrong, DPM)
From: Michael M. Rosenblatt, DPM Marque Allen, DPM recently made an extraordinary generous donation to the new medical school at Rowan University (an allopathic program). Every person has one's own reasons to select certain charities over others, and it is a "private" choice. However, as a DPM graduate from an institution that accepted Dr. Allen as a prospective student, I'm sure Temple University's College of Podiatric Medicine would find ample and effective use of that funding. Allopathic medical schools have a much higher rate of donation response, governmental assistance, and recognition than (most) colleges of podiatric medicine. Dr. Stephen (and Sandra) Wittenberg, a fellow alumnus, recently made a very generous donation to OCPM during 40th reunion celebrations. My own charity choice is an endowment to APMA's Educational Foundation. It was, after all, podiatric medicine and surgery which placed me where I am today. I don't begrudge personal charity choices, but I hope that podiatrists remember where they came from and who helped put them there. Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net
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11/26/2010
RESPONSES / COMMENTS (NEW STORIES)
RE: Pain-killers Darvon, Darvocet Withdrawn at FDA Request (Robert Kornfeld, DPM)
From: Elliot Udell, DPM
I am certain that Dr. Kornfeld is savvy enough to know when to not use "alternative therapies" and resort back to what he was taught in medical school. This is not true for many alternative practitioners who rely totally on unproven therapies when classical therapies are indicated. This past year, a dear friend of mine was diagnosed with bladder cancer. The urology/oncology team said that based on the type of tumor and the extent of its invasion, with immediate aggressive surgery he would survive. Instead, he opted to follow the therapies of an herbalist and took all sorts of herbal and homeopathic potions in lieu of having surgery and chemotherapy. On his death bed, he admitted that had he known, what he then knew, he would not have followed the advice of a charlatan but would have heeded the voices of doctors at Sloan Kettering.
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com
11/09/2010
RESPONSES / COMMENTS (NEW STORIES)
RE: No Scientific Research That Barefoot Running Reduces Injuries: APMA
From: Ray McClanahan, DPM I believe the APMA is wise in their counsel to be wary when considering barefoot running. This is the same counsel that is offered by barefoot running experts. The APMA’s released statement on barefoot running was slightly more neutral than this story in PM News, as they stated, “inconclusive scientific research”, as opposed to “no scientific research, that barefoot running reduces injuries.” There is peer-reviewed research currently available, that examines... Editor's Note: Dr. McClanahan's extended-length letter can be read here.
11/04/2010
RESPONSES / COMMENTS (NEW STORIES) - Part 2
RE: PA Podiatrist is Among Doctors Paid By Pharmaceutical Companies on Posted Database
From: Al Musella, DPM I do not think that a drug company should ever give money directly to a speaker to talk about their product. Even if it doesn't influence the speaker, there is always the appearance of bias. A simple alternative is to use an intermediary so that the speakers' income (as well as future speaking engagements) is not tied to what he says about the drug.
I run a brain tumor foundation, and we put on a lot of conferences, and drug companies and device manufacturers are usually the largest sponsors. I set it up so that these companies pay my organization as an unrestricted educational grant, and they have no say at all on what topics are covered or which speakers talk about their product. I pick the speakers, and tell them which topics to cover - and to not worry about who is paying for it - they are free to say what they feel about the products. A perfect example was one of our recent conferences, right after a new drug was approved for brain tumors. I intentionally picked one speaker whom I knew loved the drug and one that I know hated the drug, so we would get a balanced view of it. The head of the drug development team from the drug company was sitting next to me as one of the biggest neurosurgeons in the world said terrible things about their drug. I thought we might have lost them as a sponsor, but for the next conference, I asked for the same amount of money, and they immediately gave it to us. Even if we lost them as a sponsor, it would have been worth it as it gave our conference more credibility since we presented both sides.
Al Musella, DPM, Hewlett, NY, musella@aol.com
10/25/2010
RESPONSES / COMMENTS (NEW STORIES) - PART 1b
RE: FDA Laser Clearance for Treatment of Onychomycosis (Keith Gurnick, DPM)
From: Marc Katz, DPM Here is the bottom line with these treatments and approvals. I spoke with a source at the FDA. There will be several other companies FDA-approved very shortly. There are three levels of FDA approval for this type of treatment. Pinpointe currently has obtained the lowest level. When 510Ks are submitted, many companies will obtain the same approval because the level of evidence is minimal, and stronger studies are not needed. Some may or may not get higher levels of FDA approval. To obtain the other higher levels, there will need to be very solid studies. However, in real life, it's the actual patient results that count. We all know that there is no cure for onychomycosis. There is a real chance of recurrence. We also know that more than one treatment is necessary as evidenced by the statement, 68-81% of patients experienced "increased clear nails at 6 and 12 months. Increased clear nails? Is that 95% increased clear nails or 5% increased clear nails? I can obtain some clearing of nails at 12 months with a cream. I believe Penlac has an "8% cure rate." We must be up-front with our patients when providing these treatments. I hope that all DPM's want their patients to have amazing results that require several treatments, not some clearing and then cash in the pocket. That's a no-win situation. Another thing that we all know is that these FDA approvals are to be taken with a grain of salt when it comes to evaluating effectiveness of treatment. They are basically just making sure that the laser is safe. So let's be real with ourselves and our colleagues, honest with our patients, and realistic about what these FDA approvals really mean. Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com
10/23/2010
RESPONSES / COMMENTS (NEW STORIES) - PART 1a
RE: PinPointe FootLaser Receives FDA Clearance for the Treatment of Onychomycosis
From: Keith Gurnick, DPM I have tried to keep informed about all the latest advances and claims in laser technology to treat toenail onychomycosis, including reading articles in podiatry magazines and any research I can locate on the Internet. I found it interesting that the preliminary published papers on the earlier studies from PinPointe showed a 79% "improvement" in appearance, yet almost every podiatrist's website I have viewed and many newspaper and radio advertisements claim an 87% "success rate" or "cure rate." When I have phoned to ask where that number came from, I was repeatedly told it was from the laser manufacturer's study (three months on small group of patients). I also find it to be a stretch for the public to be able to understand and differentiate between the statement that the "machine is FDA-cleared" vs. the "procedure is FDA-approved." I have not seen this latest study published yet (if someone has it, please forward it to me or send me to the source), but if this newer intermediate-term study shows "68-81% of patients experienced "increased clear nails at 6 and 12 months", this is a far and away decreased claim as compared to an 87% success rate. I will watch to see if podiatrists around the country will revise their written and spoken claims to their patients, as further evidence may continue to show this procedure to be less effective than originally stated, and may require multiple treatments to enhance its efficacy. Keith Gurnick, DPM, Los Angeles, CA, keithgrnk@aol.com
10/22/2010
RESPONSES / COMMENTS (NEW STORIES)
RE: Orthopedists are Obstacle to Improving Scope of Law: NY Podiatrist
From: Alan G. Shier, DPM Sadly, the truth is that the orthopedic surgeons "know" that we have the right training, and they are afraid our expertise will impact on their bottom line. Alan G. Shier, DPM, Little Falls, NJ, dragshier@aol.com
09/21/2010
RESPONSES / COMMENTS (NEW STORIES) - PART 1a
RE: Foot Surgery by CA Podiatrist Saves HS Baseball Career (Charles Reilly, DPM)
From: Kevin Lam, DPM I agree with the editor of PM News on this one. "We can all promote the profession by being featured in the media." What about the foot and ankle orthopedist who gets in the news about minimally invasive ankle arthritis care/relief, aka ankle arthroscopy with synovectomy to the rest of us in the know. The media wants a story, a headline that people want to read. Why are we so critical of our own profession when the media chooses to do a story about one of our colleagues containing more than talk about nails or shoes? Kudos for the story about the os tibiales externum. Most GPs and the public do not know that DPM's do these procedures at all. The media source chooses the title of the story to grab attention, not the subject person. Stop beating up on ourselves. We should get our profession out there on the news. I remember not too long ago there was a thread about podiatrists not being the "go to" profession for surgeries of the foot and ankle, but when a story like this comes up, we are up in arms. If we can’t promote our own profession, the foot and ankle MD's will do it for us. Perhaps, it is a jealously thing. To promote the profession is to educate the public, not blind them by "we all do the same thing," mentality. Many times, I have heard that my triple arthrodesis patients have to go to a foot and ankle orthopod for that procedure for that is an orthopedic procedure. Should we be doing self-promotion - I think so.
Kevin Lam, DPM, Naples, FL, klamdpm@hotmail.com
02/23/2010
RESPONSES / COMMENTS (NEW STORIES)
RE: CA Podiatrist Sees 35% Rise in Insurance Premium
From: Elliot Udell, DPM There has been a great deal of national news about the sudden increases in health insurance premiums. Insurance premiums are going up as much as 20%, and they are too high already. I received a letter from my carrier saying that my insurance co-pays will go up from ten dollars to fifty dollars, and they refuse to tell me what the premium will be when I renew my policy. Congress is set to do investigations into what is happening, especially since there are reports that certain healthcare insurance companies made over 250% additional profits last year on the backs of consumers who are already suffering from the severe recession.
It all boils down to healthcare reform. Whether you like the plan advocated by Democrats or the ones being suggested by Republicans, our way of life will not continue to exist unless insurance premiums are brought under control, and I have a gut feeling that some compromise between both parties will come out of Congress. They say all politics is local politics, and if John Q Public has to pay double for his family's health insurance by this November, his representative in Congress will get walking papers, irrespective of what political philosophy that congressperson espouses.
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com
10/09/2009
RESPONSES / COMMENTS (NEW STORIES)
RE: Obama’s Healthcare Plan (Jonathan Purdy, DPM)
From: Scott Whitman, DPM Dr. Purdy has an amazingly creative definition of socialism, a selective memory when it comes to history and economics, and a horribly bad case of confirmation bias. But he does write authoritatively with lots of passion. What he is saying is to eliminate Medicare and Medicaid, and deregulate insurers. Then tell people that they need to be responsible citizens and buy insurance if they value their lives. And, I'm sure we need a tax break in there somewhere. And if they don't.... they are screwed. Scott Whitman, DPM, Brewster, NY, sewhitman@gmail.com
09/30/2009
RESPONSES / COMMENTS (NEW STORIES) - PART 2
RE: Obama’s Healthcare Plan (Arden Smith, DPM)
From: Elliot Udell, DPM, John Scheland, DPM Dr Smith explained it well. What physicians need to do is what I did last month, participate in town meetings run by our congressional representatives and express what Dr. Smith said in his message in public and in front of people who can do something to correct it. Right now the media focuses on how the US. healthcare system is perceived by patients. Some are happy with their insurance and others who have not needed medical care, have not seen their insurance plans perform in their darkest moments. What the cameras are not focusing on is what doctors know is going on behind the scenes. If health care is left to the status quo, the 24,000 dollars that Dr. Smith and others are paying a year for personal health insurance will seem small and it will also lead an even larger number of people who will not be able to afford it and will have no choice but to go bare. Bottom line: Doctors need to speak up.
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com Dr. Smith is falling for the sales pitch for Obamacare. The president’s sales pitch uses the flaws of the best healthcare system in the world as an excuse to dismantle all that is good about it. Here are some suggestions for your concerns:
1. About escalating insurance costs: Presently you are spending too much for your health insurance. Get a high-deductible insurance about $300/mo. and fund the deductible about $5,000. This will total $8,600 per year for the family, not $24,000/ year. Additionally, the $5,000 each year, if not used, can be rolled into an IRA each year. This is one suggestion, not socialized medicine.
2. Insurances are not subject to market forces (one of the flaws). The problem is cultural; patients know more about their TV or car that they purchased than their health insurance. The "investigational" or "uncovered" services would shrink if the public gave better scrutiny to their insurance products. For now, "investigational" services exist; under socialized medicine, they will disappear. Is this how we deal with problems of access - by destroying the options themselves?
3. Long-Term care is a challenge. In the U.S., we have a much greater reverence for human life than in Europe. Modeling a system after those who simply quit delivering care to those who are too inconvenient to give it to, is unacceptable to me. But instead of leaving it to bureaucrats, I prefer families make such decisions. 4. Regarding the economic status of complaining physicians, a government-run system removes the ability for physicians to have a business by which there are multiple avenues to create an income. This increases patient load and decreases reimbursement. The effect? Increased burdens on already stressed practices. Office staff will be let go to offset the reimbursement problem and quality will suffer. Don't turn to government; turn towards yourself and become a smarter doctor/business person.
John Scheland, DPM, Clarks Summit, PA, limblengthener@yahoo.com
09/24/2009
RESPONSES / COMMENTS (NEW STORIES)
RE: Obama’s Healthcare Plan (Stephen Bennett, DPM)
From: Marc Garfield, DPM I am extremely disappointed to hear that Dr. Bennett and others fail to grasp the differences between Government run and private health insurance. Private insurers are required (by the government they must compete against) to keep reserves of money available to cover claims. So,… Marc Garfield, DPM, Williamsburg, VA, mgarfield1@cox.net Editor's note: Dr. Garfield's Extended-length note can be read at: http://www.podiatrym.com/letters2.cfm?id=29068&start=1
08/31/2009
RESPONSES / COMMENTS (NEW STORIES)
RE: Buy Children's Shoes for Fit, Not Size: IN Podiatrist
From: Paul Busman DPM, RN Good advice, but I'd expand that to include adults too! How many times have we told patients that their shoes are too tight, only to have them indignantly reply, "But I've ALWAYS worn that size!"? Feet change, and shoe sizes vary from brand to brand and style to style. I always told my patients to regard the size on the box as a rough guide to how those shoes might fit; more for the convenience of the store clerk selecting sizes than as an actual guarantee of a good fit. Paul Busman DPM, RN, Clifton Park, NY, brewerpaul@aol.com
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