Volume 15 - Issue 6 - June 2002
Feature »
How To Diagnose And Treat Pressure Ulcers
Currently, over 34 million Americans are age 65 and over. This figure is expected to double to over 68 million by the year 2030. As a result, there has been a tremendous growth in nursing homes and the related federal regulations that oversee these facilities. Pressure ulcers are particularly problematic in this patient population. According to the Agency for Health Care Policy and Research (AHCPR) guidelines, the incidence of pressure ulcers (often referred to as bedsores) in long-term care facilities was estimated to be as high as 23 percent in 1989.
Pressure ulcers (also called decubitus
Feature »
When Injection Therapy Can Help Relieve Painful Lesions
There are a number of keratotic and painful lesions that form on the weightbearing and pressure areas of the foot. You’ll often find that many of these conditions won’t respond to simple debridement and padding, and ultimately prove to be difficult to treat. In general, hyperkeratosis indicates an increased keratinocyte activity resulting from stimulation of the epidermis by intermittent or increased pressure.
Abnormalities in keratinization may represent thickenings, which are commonly referred to as corns, calluses, helomas, hyperkeratoses or tylomas. However, be aware that several unre
Feature »
Assessing Orthotic Quality
Numerous patients use orthotics and have improved foot function as a result of wearing them. Not only do they experience relief from previous pain and symptoms, but wearing orthotics also helps to prevent recurrence of foot, leg and other skeletal pains and conditions. Unfortunately, there are also numbers of patients who are either unable to tolerate their orthotics or are not getting symptomatic relief. We are often asked to evaluate many of these patients and assist them in getting better results from their orthotics.
People may hear about orthotics in different ways, whether it’s throug
Diabetes Watch »
When Should You Be Wary Of Hypertrophic Bone Formation?
Post-surgical hypertrophic bone formation can be a frustrating problem. It has been identified at fracture, osteotomy and amputation sites. The majority of patients with hypertrophic bone formation are largely asymptomatic and practitioners often identify the condition via radiographs they get for other pathologies. However, those who are symptomatic often have a problematic non-healing wound at the site and can complain of pain, swelling or even decreased range of motion if a joint is involved.
Most of the literature addresses hypertrophic bone formation as a complication associated with ac
Forum »
Staying Claim-Free During The Malpractice 'Crisis'
I received a letter last week about another crisis approaching podiatry. The letter was from my insurance company and it warned that premiums were going up because of the malpractice crisis. In my mind, malpractice isn’t a crisis until I become a defendant. In 27 years, I have not had that pleasure. Yet.
I review closed claims for my state podiatry licensing board. I have not noticed an increase in the number of claims but the settlements and jury awards are climbing like a homesick angel. Twenty years ago, a $75,000 settlement was shocking. The last case I saw had a $1.3 million jury verd
Managed Care Insider »
How To Fight Discrimination In Managed Care
Nothing makes us more angry and frustrated than discrimination based on participation and reimbursement levels. One of the classic examples is when we perform a bunionectomy and get reimbursed at a lower rate than an MD or DO for doing the same procedure. Indeed, the cost-cutting measures and restrictive practices of insurers make discrimination an everyday reality in our practices. Often, insurers will take advantage of our ignorance of the law to improve their own profit margins.
Are there any steps we can take to help ensure fair and equal payment for the services we provide to our patien
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