How Do We Explain ‘Incidental’ MRI Findings To Patients?

Doug Richie Jr. DPM FACFAS
8/13/14 | 561 reads | 0 comments
When I first entered clinical practice over 30 years ago, diagnostic imaging studies were limited to plain radiographs, arthrography and nuclear medicine bone scans. With the emergence and improvement of magnetic resonance imaging (MRI), we have better ability and accuracy to investigate and confirm the presence of pathologies in the foot and ankle. Unfortunately, this often opens up a can of worms as almost every MRI study reveals the presence of findings that are not related to the symptoms of the patient, i.e. so-called “incidental” findings. Read More.

Should Podiatric Physicians Surrender AFO Therapy To Pedorthists?

Doug Richie Jr. DPM FACFAS
6/23/14 | 1015 reads | 4 comments
I often give workshops at scientific symposia covering topics relevant to ankle-foot orthotic (AFO) therapy. Often, people ask me questions about Medicare regulations for coding and billing for these devices. Recently, someone asked me about a new program in which a commercial AFO company offers to have a certified pedorthist (CPed) evaluate and treat patients in podiatric medical practices. Read More.

Why Are Our DME Claims Being Audited By Medicare?

Doug Richie Jr. DPM FACFAS
5/27/14 | 1127 reads | 1 comments
Many of us who practice in Jurisdiction D have been audited by Noridian Healthcare Solutions for claims submitted for all types of DME devices including walking boots and custom ankle-foot orthoses. Last week, Noridian Healthcare Solutions released the results of its audit for Jurisdiction D (which covers 17 states including California, Arizona and Washington) for the first quarter of 2014 and the results are alarming.1 Read More.

Monitoring The Truth In Medical Advertising

Doug Richie Jr. DPM FACFAS
4/21/14 | 866 reads | 1 comments
During my career, I have had the opportunity to work as a consultant to several footwear companies that market and advertise products directly to the consumer. Currently, I own a company that markets ankle-foot orthoses (AFOs) to healthcare professionals. This experience has taught me that until recently, there has been a clear difference in the standards maintained by companies that market to the consumer and those that market to medical professionals. Read More.

Why Biomechanics Education Is Essential If We Want To Be The Sports Medicine Experts

Doug Richie Jr. DPM FACFAS
3/18/14 | 8301 reads | 0 comments
I just finished reading a tribute to the legendary orthopedic surgeon, Frank Jobe, MD, written by Bill Shaikin, which appeared in the Los Angeles Times on Saturday, March 8.1 Dr. Jobe had passed away two days earlier at age 88. For those who don’t know, Dr. Jobe pioneered the elbow procedure known as “Tommy John surgery,” which has saved the careers of countless major league baseball players. Read More.

How Do Walking Boots Affect Balance?

Doug Richie Jr. DPM FACFAS
1/24/14 | 3100 reads | 0 comments
We commonly prescribe walking boots, sometimes referred to as controlled ankle motion (CAM) walkers, for the treatment of diabetic foot ulcerations, fractures and tendon injuries of the lower extremity. Clinicians continue to be baffled and frustrated by the fact that, in spite of the significance of these pathologies, patients have very poor adherence in wearing these devices that are a vital part of the treatment plan. Read More.

Kudos To JAPMA On Tackling Fall Prevention

Doug Richie Jr. DPM FACFAS
12/30/13 | 1569 reads | 0 comments
This month, the Journal of the American Podiatric Medical Association (JAPMA) published an entire issue devoted to the subject of the prevention of falls in older people (volume 103, issue 6). This publication represents a landmark contribution from the podiatric profession to this vital public health initiative. After reading all of the articles presented in November/December 2013 issue of JAPMA, I was struck by the following observations. Read More.

Obtaining A Rewarding Surgical Outcome With Plantar Plate Repair

Doug Richie Jr. DPM FACFAS
11/22/13 | 4053 reads | 0 comments
In a podiatric practice, a single rewarding interaction with a patient can easily override any of the negative encounters of the day. I recently had this type of positive experience with a patient who followed up six months after undergoing surgical repair of a tear of the plantar plate of the second metatarsophalangeal joint (MPJ). Read More.

Are Gauntlets A Universal Solution For AFO Intervention?

Doug Richie Jr. DPM FACFAS
10/25/13 | 2155 reads | 2 comments
I often lecture on the topic of clinical indications for ankle-foot orthotic (AFO) therapy. Through interactions with many colleagues around the country, I am amazed at the number of practitioners who favor the use of gauntlet-style AFO devices for bracing the lower extremity. My suspicion is that the handsome reimbursement for these devices may supersede better judgment about patient adherence and improved clinical outcomes. Read More.