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From: Robert Creighton, DPM


I believe the story regarding balance in the elderly could have been better stated to more positively reflect on the profession. While we certainly should unashamedly profess our academic and practical knowledge along with our technical skill in treating our patients in the context of their footwear, if we want to elevate the profession and be considered physicians, we need to refrain from reflexively talking about shoes as soon as we speak.  


There is so much more that could be said regarding the lower extremity and balance that is consistent with a physician's level of expertise. When responding to questions, we need to think about moving footwear down the list. Physicians would speak first about the lower extremity in the context of the patient as a whole. Then, when applicable, consider the lower extremity in the context of footwear. In this case, we are less apt to sound like glorified shoe technicians. It is time to slay the shoe dragon and better represent our knowledge, the physician status we aspire to, and the three years of post-graduate training we now demand.


Robert Creighton, DPM, St. Petersburg, FL, 

Other messages in this thread:



From: David E. Samuel, DPM


Way to go Dr. Kirby. A solid knowledgeable opinion on a very high-end performance shoe. We all need to be very cognizant about how we recommend or opine on products out there without having all the facts/and or actually treating those high-end athletes on a very regular basis and not just seeing a runner or basketball player now and again. This is especially true when these statements are put out in a public forum or widely published article. I bet Nike would not be too pleased either. These athletes are VERY different and this is why these new designs are being engineered from running shoes to hockey skates.


David E. Samuel, DPM, Springfield, PA



From: Kevin A. Kirby, DPM


The big story about the Nike Vaporfly 4% running shoes are not its upper material. Rather, it is the revolutionary combination of a compliant, resilient, and lightweight midsole foam along with a carbon-fiber plate embedded within that midsole foam that makes the Nike Vaporfly shoe so special.


The name “Vaporfly 4%” came about since Nike’s own research by Hoogkamer, et al., published in 2018, showed their shoe reduced the energetic cost of running in all 18 subjects tested, with the Vaporfly 4% shoe being about 4% more energy efficient compared to two other popular marathon racing shoes, the....


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



From: Keith L. Gurnick, DPM


Before I enter a treatment room and greet and meet a new patient on the initial visit, I am already somewhat aware of their chief complaint or main concern(s). On some patients, the concerns are diagnosed quickly and the remedies can be simple, yet they are entitled to and get a proper and thorough examination. Often, however, the patient concerns are more complex, or involve multiple issues, and thus require not only more time, examination, and testing, but also a high level of expertise and experience to diagnose accurately, and develop treatment plans that will yield good outcomes. Experienced and well-trained podiatrists should have this high level of expertise that other healthcare providers just do not have. Replacing doctors with nurses is done for one purpose only, to reduce expenses and make more profits.


Substituting nurses for doctors is another example of The Peter Principle. I would not want to relegate the quality of care that I provide to the entirety of my patient population to any nurse. The Peter Principle is an observation that the tendency in most organizational hierarchies is for employees to rise in the hierarchy through promotion until they reach a level of respective incompetence.  


Keith L. Gurnick, DPM, Los Angeles, CA



From: Joshua Kaye, DPM


During a recent hiking trip in Patagonia, Chile, we were in a bus full of hikers. There were several large signs written in both English and Spanish requesting that the hikers do not remove their shoes due to the foot odor. Our seasoned guide told us that most people don’t understand the importance of choosing the best sock fibers for outdoor activities. Cotton is clearly the worst as it retains perspiration, creating a damp uncomfortable foot. Almost as bad as cotton are the plastic fiber socks containing blends of polyester, nylon, or similar synthetic fibers that supposedly “wick”. Such socks are sold under trade names such as Coolmax or Drymax. Those plastic fibers generate foul foot odor after a short period of use.  


Without doubt, as my professional hiking guide said, the best socks contain a high percentage of merino wool. Not only are they the most comfortable, made of a natural fiber, provide true wicking, but can be worn for several days without laundering without producing any odor. I was very surprised at his knowledge about sock fibers. He suggested that when I return to America, I should do a comparison study for myself. Skeptically, I did his experiment. He was 100% correct. Since then, I tell my patients that once you go to a high percentage wool blend sock, you will never go back to smelly plastic socks. Similar thin dress socks are also available for more formal use when you can “air out” your feet without embarrassment.


Joshua Kaye, DPM, Los Angeles, CA



From:  Robert Kornfeld, DPM


I’m sorry and disappointed to see this kind of biased reporting on this site. CBD has been legalized in all 50 states for use in adult humans and pets (not children other than for seizures). There is far from a paucity of literature about its safety and efficacy. It has been well studied for years and there are still ongoing studies. Yes, there are unscrupulous companies out there. Selling to pregnant women is unethical since there are no teratogenicity studies. Putting it in food is a direct violation of FDA guidelines. It doesn’t belong in food no more than ibuprofen belongs in food.


Claims for its effects in advertising and on labels will always be an issue with the FDA since they don’t allow claims to be made for any natural substance. Putting in chemical additives is another issue. I’m all for removing companies like this from the market. However, this FDA release smacks of BIG PHARMA. There are NO studies to show it can do harm when...


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



From: Tip Sullivan, DPM


I just don't get it? This type of promotion by companies is done in almost every business. I don't see anything morally or ethically wrong with it! I think companies should pay doctors like they do professional athletes to promote them to other doctors and the public. Give me a bunch of money and I’ll wear a scrub hat with your name on it or a set of O.R. scrubs with your company's name plastered all over it. 


Tip Sullivan, DPM, Jackson, MS



From: Dan Chaskin, DPM


Thank you PM News, for bringing Richard Willner's accomplishments to our attention. Even more importantly, thanks for mentioning there is someone available to defend podiatrists and physicians against a sham peer review.


Dan Chaskin, DPM, Ridgewood, NY



From: Elliot Udell, DPM


The American Society of Podiatric Medicine congratulates our executive board member, Dr. Arthur Helfand, on having a chapter published in a text on gerontology. Because of Dr. Helfand's teachings, The American Society of Podiatric Medicine has now dedicated itself to advancing the cause of geriatrics within our profession. To this end, all future lectures and conferences sponsored or co-sponsored by the ASPM will contain lectures on podo-geriatrics. 


Elliot Udell, DPM, Hicksville, NY



From: Harry A. Yankuner, DPM


The article states that the BSA Silver Beaver Award is the highest awarded for adults. I would like to clarify that statement. The BSA Silver Beaver award is the highest award at the BSA COUNCIL level.


In the BSA, the three highest levels of recognition for meritorious service are:

        The Silver Beaver awarded for outstanding service at the COUNCIL level.

        The Silver Antelope awarded for outstanding service at the REGIONAL level.

        The Silver Buffalo awarded for outstanding service at the NATIONAL level.


This year, 13 individuals were honored with the Silver Buffalo. In 2011, William M. Finerty, DPM, a podiatrist in Ohio was honored with a Silver Buffalo award for his service and contributions to BSA.


Harry A. Yankuner, DPM, Dallas, TX



From: Paul Liswood, DPM


Falls in the elderly is a significant public health issue. The New York State Podiatric Medical Association (NYSPMA) recently had high level meetings with the New York State Department of Health section on aging (DOH) to discuss podiatry’s role in fall prevention. Through our Public and Population Health Task Force, NYSPMA developed an evidence-based fall prevention program, and we are working on a payment model in connection with this issue. The clinical protocol was reviewed with DOH.


In working with DOH, NYSPMA has developed a webinar course for CME credit on fall prevention prepared by Allen Jacobs, DPM. This members’- only benefit will educate our members on fall risk assessments, interventions, and coordination of care among other providers as part of the team approach to care. We will provide our members' names that completed the course to DOH and managed care organizations, and we are looking to expand podiatry’s role in fall prevention within the NYS prevention agenda. 


NYSPMA has also began working with hospital systems on demonstration projects around podiatry-led fall prevention teams, and we are engaging CMS in discussions on fair payment models for podiatry-led fall prevention collaborative care models. We believe these approaches will not only improve public health, but strengthen and raise the profile of our profession. For those at risk for falls, help is on the way as podiatry is stepping up in NY!


Paul Liswood, DPM, Brooklyn, NY, Past President, NYSPMA



From: Janet McCormick, MS


Thank you, Dr. Woodly, for your comments on pedicures and for your suggestions for how consumers can make sure that the place they are going to is good; such as their use of a new and unopened package of instruments, and that the techs are licensed and are staying within their scope of practice. These are great suggestions. I would like to add some. 


First, that the new, unopened package of instruments should be from an autoclave; second, that the place where the pedicure is offered must be immaculate; and third, that the technician has a certification as an advanced nail technician (ANT) or, if in a podiatry office, a certificate as a medical nail technician (MNT). These technicians are trained to only perform aesthetic pedicures and they are additionally trained to "Recognize and Refer" to a podiatrist if they...


Editor's note: Ms. McCormick's extended-length letter can be read here.



From: Ellen Lubell, Hal Ornstein, DPM


Congratulations on your 25th anniversary! I learn something every day from PM News.


Ellen Lubell, Communications Manager, NYCPM


What a great blessing Barry and his team have been for 25 years of supplying PM News. This has become a pillar of our podiatric community with roots that help so many. It’s the resource that keeps giving and the dedication of those who make this possible does not go unnoticed. So thank you and please revel in the fact of how many lives you touch and affect.


Hal Ornstein, DPM, Howell, NJ



From: Donald R Blum, DPM, JD


Congratulations to Tye Liu. Well deserved! 


Dr. Liu has been dedicated to serving Podiatric Medicine/Surgery at Southwestern Medical school (the premier medical school in Texas and recognized nationally), the State of Texas and nationally as a speaker and member of the Board of Directors for the ACFAS.


Donald R Blum, DPM, JD, Dallas TX



From: Don Steinfeld, DPM


Thank you to doctors Bass and Udell. All of us see patients on a daily basis who are enamored with treatments or products that we may have little or no confidence in. It is important not to dispel their faith in what may result in a beneficial placebo effect. That is why when patients show me their magnetic insoles, I tell them that those insoles may make them more attractive. Everyone is happy.


Don Steinfeld, DPM, Farmingdale, NJ



From: Janet McCormick, MS


Dr. Anderone's statement, "when cosmetologists aren't following regulations, they could be putting your body at risk" is certainly true. Many short cut salons don't perform proper infection control practices and do put their clientele at risk. However, it is not true that all nail technicians are to be painted with the same broad brush - which many of you do. Many technicians are taking advanced courses to expand their awareness on safety practices and then only perform safe practices. 


Rather than warning patients "do not go to nail salons," it is more positive and productive to...


Editor's note: Ms. McCormick's extended-length letter can be read here



From: Keith Gurnick, DPM


Mechanically-induced back pain can be reduced/improved or alleviated with better postural mechanics and improved lower extremity function in standing activities and during gait with the help of custom prescription foot orthotics. This usually requires a combination of treatment modalities including stretching, core muscle strengthening, activity modification, and foot orthotics.


An excellent test to see if custom orthotics might be successful is to first try a properly applied low-Dye tape strapping(s) and when indicated also concurrently the use of a unilateral measured heel lift inside the shoe for limb-length discrepancy. Podiatrists who dispense orthotics should be checking for LLD on exams. If the temporary taping and a heel lift helps, I have found that this is a good predictor that custom prescription orthotics will help as well. This two-step approach is quite understandable to our patients who are looking for relief of their back pain. These patients will often try anything but unfortunately they become disappointed when poor outcomes and results don't meet the hype and their expectations.


Keith Gurnick, DPM, Los Angeles, CA



From: James Yakel, DPM, David Kaufmann, DPM


Dr. Dananberg has been instrumental in exploring sagittal plane biomechanics and how it affects gait. If Dr. Kaye was current with biomechanics and orthotics, I’m sure he would be aware of Dr. Dananberg’s contributions to podiatric biomechanics. I applaud Dr. Dananberg’s professional response.


James Yakel, DPM, Longmont, CO


Dr. Dananberg has devoted a lifetime to the science of biomechanics, both clinically and within the research settings. As one familiar with his training and experience, he is at the apex of his specialty. Dr. Dananberg poses interesting questions and theories with solid evidence behind his thoughts. I find it perplexing that someone would question his academic reputation in such a disrespectful way. In Dr. Dananberg’s case, the legal phrase applies: res ipso loquitor (the thing speaks for itself).


David Kaufmann, DPM, Nashua, NH 



From: Aakruti Bhalja, DPM


I must disagree with a statement made regarding the contribution of yoga to the development or exacerbation of plantar fasciitis. Though there are advanced levels of yoga that may be far too demanding for those who are unstable or disabled, most poses can be easily modified or designed to be suitable for almost anyone. In addition to proper arch support during ambulation, improving flexibility in the gastrocnemius complex and regaining strength in the posterior tibial tendon are critical to the treatment of plantar fasciitis. Evidence-based research is highly supportive of the ability of yoga to not only improve physical function and muscle-specific lower extremity strength, but also to decrease depression, anxiety, and fatigue. 


Aakruti Bhalja, DPM, Hamilton, NJ



From: Ronnie Lepow, DPM


Teacher, mentor, consummate physician, colleague, and visionary. It is rare to find someone who fits this description but that is how I would describe my old friend Lowell Weil. When I was a student, Lowell was one of my most respected instructors, and his work had a profound effect on my professional career both as a practitioner and as a politician in our profession.


Over the years and especially during the 1990s as we both led our respective podiatric medical organizations, my interactions with Lowell were always cordial, professional, and productive. I look back at those years with fond memories. To our younger generation of doctors, I highly recommend that you review the history, academic work, and accomplishments of this great pillar of our podiatric profession.


Retirement? How can that be? If you must, my most hardy congrats, warm wishes, and best of luck in your future endeavors. You certainly spent your life paying it forward for all of us, and so Dr. Weil, you deserve the best retirement ever.


Ronnie Lepow, DPM, Houston, TX



From: Joseph W. Cavuoto, DPM


Lowell, best wishes on your retirement. Thanks for your direction during my Northlake residency; it made the transition to podiatric practice easy. My family and I will always be grateful. We certainly enjoyed your family's hospitality during the year, especially at Thanksgiving for the out-of-town residents and families. Your twenty-four hour arthroplasty was a real gift that patients loved, including Jane my wife.    


Joseph W. Cavuoto, DPM (Retired), Dix Hills, NY



From: Allen Jacobs, DPM


The suggestion that patients utilize a hair dryer for moisture control of the foot and “fungus infection prevention“ is a poor one. The literature is replete with case reports of burns secondary to hair dryers. Anyone with neuropathy or PAD would be at particular risk. Hair dryers have been recalled due to uncontrolled temperature regulation. There are no standards regarding the actual temperature at which such dryers operate. One minute to dry? One minute to burn!


I would admonish any patient, let alone a diabetic patient, if they followed Dr. Roth’s extraordinarily poor advice.


Allen Jacobs, DPM, St. Louis, MO



From: Steven Kravitz, DPM


Marc Benard, DPM has been the most dedicated leader of the ABPM. He has been its heart, soul, and inspiration taking it from a fledgling organization, facing difficult times, to a thriving and respected certifying board that has helped shape and mold our profession to its current status today. We wish Marc the best in moving on to his next phase of future accomplishments and whether that be professional, family, social and/or, I suspect, his interests and wonderful talent in music and the arts.


That said, there is no individual better suited to take the reins and assume the leadership and guidance as the executive director of ABPM than James Stavosky, DPM. He is a respected podiatric physician and surgeon, educator, speaker, and author in addition to assisting other organizations in leadership roles. Congratulations, Dr. Stavosky and to ABPM for making a superb selection. 


Steven Kravitz, DPM, Winston-Salem, NC



From: Joseph Borreggine, DPM


The “new” bunion procedure that is called the lapiplasty which was brought to fruition by Dr. Paul Dayton, et al. and his team certainly has “changed” the way we look at the biomechanics  of a bunion deformity, let alone, how to correct it. But, the question I pose to the PM News readers and to my podiatric colleagues: is this bunion procedure the pinnacle of podiatric surgical success because of its continual outcome of “reproducible” results along with reduction in bunion deformity re-occurrence? 


Or is this procedure driven like most of our profession’s innovations by the vendor dollars created by performing said procedure? Or is this procedure’s ability to stay in the limelight of surgical success fueled by the...


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



From: Brian W. Fullem, DPM


In reading Dr. Zuckerman's comment on Shockwave Therapy, I disagree with his statement: "Comparing high-energy FDA-approved ESWT with the EPAT is false and misleading. They are entirely different modalities with different uses and outcomes." 


EPAT produces a sound wave; it is commonly known as Radial Extracorporeal Shockwave Therapy. The old terminology would be low energy, whereas the machine is similar to the Dornier EPOS. The new terminology is Radial ESWT and Focused ESWT. They both produce sound waves. There is also no difference in the literature as to which technology works best, both produce similar results which are in general better than any other technology for soft tissue injuries. 


I highly recommend that people read this medical article. The article is a... 


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



From: Howard Friedman, DPM


I am responding to the letter from Bill Beaton DPM which appeared on April 26, 2018 saying I recommended Crocs for medical professionals in a recent article in In fact, I recommended Dansko clogs which have an APMA seal of approval. I did not mention Crocs in that interview. The article specifically says "Clogs are also a good choice, says Howard Friedman, DPM, a Suffern, New York-based podiatrist. They tend to have a wide toe box, which helps accommodate feet as they naturally expand throughout the day."


Howard Friedman, DPM, Suffern, NY

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