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Sounding Off On Ultrasound
The utilization of diagnostic ultrasound by podiatric physicians has increased substantially over recent years. Diagnostic ultrasound offers musculoskeletal diagnostic opportunities, particularly for soft tissue pathology, is superior to standard radiographs and, in some instances, is equal to or superior to magnetic resonance imaging (MRI). In addition, ultrasound guided interventions such as injections offer the potential of increased efficacy by virtue of increased accuracy of site directed therapies to sites of pathology.
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Dead Men Do Tell Tales: When Neglecting Family History Leads To A PE-Related Fatality And Malpractice Lawsuit
Anyone who has visited the Disney Pirates of the Caribbean ride has heard the entertaining recital of the phrase “Dead men tell no tales.” Unfortunately, in the real world, dead men can leave behind quite a tale, often in the mode of a malpractice suit.
The following case settles this month and illustrates a problem that I had discussed in an earlier blog (http://www.podiatrytoday.com/blogged/why-a-post-op-fatality-is-a-wake-up... ). Different case, same problem.
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Dumb And Dumber: Questioning Risky Treatment In A Case Of Posterior Heel Pain
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.
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Does Informed Consent Trump Standard Of Care?
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.
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Is Conservative Care Mandatory Prior To Bunion Surgery?
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.
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Raising Questions About The Technologic Imperative At Podiatry Conferences
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.
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Can We Achieve The ‘Equality’ In Surgery That We Have Achieved In Wound Care And Diabetic Limb Salvage?
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.
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Was This Bunion Case Malpractice? You Be The Judge
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.
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Thanks For Playing Orthopedics
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.
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A TENS Unit For Heel Pain? Questioning The Ethics Behind Some ‘Practice Management’ Lectures
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.
