Volume 15 - Issue 4 - April 2002
The winds of change have blown through the medical community with a vengeance in the last 25 years. Managed care has turned medicine upside down. Dramatically lower fees and higher overhead expenses have made us work doubly hard just to maintain some level of consistency in our practice. Just as we have seen in the hospital community, economic necessity has made some strange bedfellows.
Digital contractures are among the most common deformities we see in podiatric practice. McGlamry described three etiologies for hammertoes: flexor stabilization, flexor substitution and extensor substitution.1 While each entity may exist independently, it is more likely you will see co-existing etiologies, particularly when you’re dealing with more complex deformities.
Most hammertoes in early stages primarily involve sagittal contractures. However, as the deformity progresses, transverse plane components may be unmasked. You may recognize transverse plane deformities early on as a subtle
Diabetes Watch »
Over 16 million people in the United States have diabetes and this number is growing by the hour. Diabetes is now the fifth leading cause of death in this country.1 By understanding the pathophysiology of diabetes and the environmental factors which contribute to this disease, we can have a better focus on the scope and nature of the threat to our patient population with diabetes.
With this in mind, it’s important to have a thorough knowledge of the potential impact of insulin resistance syndrome, a condition in which the tissues of the body become desensitized to insulin. It is a chronic s
The lifeblood of a quality podiatry practice is a steady and diverse physician referral base. No podiatrist would argue that point. However, there is a flipside to the axiom that all referrals are a good thing. I’m thinking about the “referral traps” I have experienced over the past 27 years as a small town podiatrist.
Managed Care Insider »
Which managed care contracts should you sign? Which are truly beneficial for our individual practices? Many of us sign up for every managed care contract out of a sense of fear. There is this notion that if you don’t sign up, someone else will and you will lose access to a group of patients. Then when we submit claims or request authorizations, we find out that working with certain plans is cumbersome and frustrating. By that time, it is too late.
There have been many articles written about reviewing contracts from a legal perspective, but what about the practical aspects? There are sever
Orthotics Q&A »
Muscle strength testing is not always part of a standard podiatric biomechanical evaluation. Unfortunately, muscular weakness can often influence function and, if undetected, can lead to chronic pain in the joints which the weakened muscles support. There are several reasons for muscular weakness, but the most common cause is chronic inhibition signaling from the CNS. Since motor signals to muscles normally cycle between facilitation (excitation) and inhibition, an alteration in this signaling can often cause chronic inhibition and subsequent pain.
With this in mind, our expert panelists offe
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