Volume 15 - Issue 7 - July 2002

Feature »

Vascular Intervention In Difficult Wounds

By Richard M. Stillman, MD, FACS | 13742 reads | 0 comments

About four of 1,000 people will develop a leg ulcer during their lives, but the prevalence of leg ulcers rises dramatically with age, increasing to about 1 percent in people over the age of 60 and 2 percent in people over the age of 80. In the U.S., about 3 million people suffer from leg ulceration, costing an annual $4 billion in treatment costs and losses of over 2 million days from work.
In general, diagnosing the cause of leg and foot wounds requires examining the wound, the extremity and the patient. Let’s start by taking a look at venous problems.
Any disease state that leads to ven



Feature »

When You Have To Fire An Employee

By Robert Smith | 7471 reads | 0 comments

Unfortunately, it doesn’t always work out and the staffer you thought to be perfect for your team winds up bringing down your practice in some significant way. It is when you recognize that you must fire the employee that the real work of managing your office truly begins. Indeed, with the increasingly litigious nature of our era, firing staffers has become a problematic process, fraught with many legal and ethical landmines.
“We all know how to terminate someone,” notes Hal Ornstein, DPM, who has a private practice in Howell, N.J. “It’s not hard to say ‘You’re fired.’ The id



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Treating Stress Failure Injuries In Young Athletes

By Patrick Agnew, DPM | 4882 reads | 0 comments

Is the term “overuse injuries” really appropriate? After all, many so-called “overuse” injuries of the lower extremity are unilateral. In most cases, the right foot is used just as much as the left foot so the term becomes illogical. Perhaps stress failure phenomena would be a more accurate description of these injuries. Some examples of mechanisms leading to stress failure problems include repetitive motion, repetitive loading and repetitive impact.
Your patients might encounter repetitive motion injuries in endurance sports like swimming or sports such as cross-country running or b



Forum »

The Night The Lights Went Out In The O.R.

By John McCord, DPM | 2428 reads | 0 comments

I graduated from podiatry school and went through residency in the mid-‘70s, about the same time power instruments were introduced to podiatric surgeons. We wore grounded booties and used noisy nitrogen-driven drills. When you walked past an O.R. with a foot case going, it sounded like a Black & Decker convention. We loved our power instruments.
The problem with these new tools was young podiatrists became totally dependent upon nitrogen- and later electrically-powered drills, saws and wire drivers. Hand tools like osteotomes and mallets were retired to hospital storage closets. The new bre



News and Trends »

Insurance Costs Pack A Punch For DPMs

By Brian McCurdy, Associate Editor | 3497 reads | 0 comments

Paying malpractice insurance premiums is a necessary evil for doctors. Lately, however, both doctors and insurance companies have been feeling the crunch more than ever before. The entire country faces a “crisis” when it comes to medical malpractice coverage, although some states, like Pennsylvania and Texas, are hit particularly hard, according to PICA President and CEO Jerry Brant, DPM.
“I’m fortunately busy enough that I can afford to do surgery,” says Stephen A. Monaco, DPM, who practices in suburban Philadelphia, an area with high insurance and settlement costs. He acknowledge