Dumb And Dumber: Questioning Risky Treatment In A Case Of Posterior Heel Pain

Allen Jacobs DPM FACFAS
6/15/11 | 3705 reads | 3 comments
In reviewing medical records, I often wonder why some doctors will place themselves into an arena that invites malpractice actions. Let me present an example, a recent case that I reviewed for a plaintiff. Although I did not feel that there was malpractice in this case, I did find the treatment of the patient interesting. A relatively healthy middle-aged female consulted a podiatrist for posterior heel pain. She had no prior treatment. Her medical history was significant for controlled hypertension and low thyroid function. Read More.

Does Informed Consent Trump Standard Of Care?

Allen Jacobs DPM FACFAS
5/17/11 | 3101 reads | 3 comments
I would like to raise the following question: Can something be legal but not ethical? Informed consent is a powerful tool serving to protect clinicians from patients who claim they were not informed about their treatment. My question is whether true informed consent allows patient and clinician to bypass recognized standards of care for the patient. Read More.

Is Conservative Care Mandatory Prior To Bunion Surgery?

Allen Jacobs DPM FACFAS
4/21/11 | 6906 reads | 13 comments
A recent Cochrane Review concluded there is no evidence that non-operative management of bunion deformity, including the use of orthotics, is in any way superior to no treatment at all.1 In fact, the studies reviewed by the Cochrane database suggested that one year following initial evaluation for a bunion deformity, more people are pleased with the results of surgery than with orthotic or other non-operative management. Read More.

Raising Questions About The Technologic Imperative At Podiatry Conferences

Allen Jacobs DPM FACFAS
3/15/11 | 2997 reads | 3 comments
A recent meta-analysis has suggested that the evidence for the utilization of orthobiologic materials in place of autogenous bone grafting is low level evidence at best.1 There is hardly a podiatric scientific meeting wherein at least one, if not more than one, lecture was devoted to the need for the incorporation of orthobiologics in surgery, even routine surgeries such as osteotomy or arthrodesis in the non-compromised patient. Read More.

Can We Achieve The ‘Equality’ In Surgery That We Have Achieved In Wound Care And Diabetic Limb Salvage?

Allen Jacobs DPM FACFAS
10/21/10 | 3526 reads | 3 comments
In the last several months, I have had the opportunity to attend four major wound care conferences. Standing in the back of the room at the Diabetic Limb Salvage conference, world famous researchers and academicians Peter Sheehan, MD, and Andrew Boulton, MD, commented to me how wonderful this meeting and others such as the American Professional Wound Care Association (APWCA) meeting had become in educating medical professionals on limb salvage. Read More.

Was This Bunion Case Malpractice? You Be The Judge

Allen Jacobs DPM FACFAS
9/24/10 | 4398 reads | 5 comments
The radiograph at the top of this page is the postoperative X-ray of a patient who underwent a Lapidus procedure for the correction of a bunion. The patient went on to develop a symptomatic nonunion, which required eventual bone grafting and revision. Although the procedure was radiographically and clinically successful, the patient continued to have some persistent symptomatology and sued the podiatric physician who initially treated him. Read More.

Thanks For Playing Orthopedics

Allen Jacobs DPM FACFAS
7/28/10 | 4599 reads | 4 comments
Increasingly, podiatric physicians are being employed by orthopedic surgery groups to provide varying levels of care for foot and ankle surgery. The degree of acceptance for podiatric physician care by such groups is somewhat variable. However, it would seem that overall the competency of podiatrists as physicians and surgeons has been increasingly accepted. Read More.

A TENS Unit For Heel Pain? Questioning The Ethics Behind Some ‘Practice Management’ Lectures

Allen Jacobs DPM FACFAS
6/1/10 | 7792 reads | 5 comments
I have had the opportunity to listen to so-called "practice management" presentations at a number of state and APMA component society meetings. To be quite frank about it, the content presented is nothing less than offensive as it advocates profit motive over patient care. What is even more shocking in my opinion is the seeming growing relationship of the APMA with these programs. Read More.

Do Advances In Plantar Fasciitis Treatment Hold Up To Scientific Scrutiny?

Allen Jacobs DPM FACFAS
4/27/10 | 7228 reads | 7 comments
I am constantly amazed at the variety of treatment modalities that are effective for plantar fasciitis. In fact, I am amazed when a modality exists that is not effective for plantar fasciitis. Just think about all that you learn at conferences, see in exhibit halls and read in non-peer reviewed journals. You would have to be an idiot not to be able to cure plantar fasciitis. Read More.