Interesting Article on How DPMs are Helping to Rebuild in Haiti

Cool article about how DPMs are helping to rebuild in Haiti, from the blog of Patrick DeHeer DPM written by Fairuz Parvez DPM:

When asked about my experience in Haiti, at first I did not know where to begin. If I were to sum it up in a word, it would be: shocking.

It was eye opening to say the least. I was at a loss for words when I first landed in Haiti. I knew there was some structural destruction but I did not truly understand at what level, the depth of the devastation, and why it was still so. I was as guilty as the next American assuming Haiti was not so bad off. Boy, did I get a crash course in the reality of things there.

The first thing that shook me to my core was just how impoverished the country really was. I have visited developing nations in the past and even there you can find modernized areas with better conditions and buildings that are comparable to those of the west. With Haiti, almost the entire country looks like the ghetto of a developing nation. High rises are almost nonexistent and modern buildings are truly in the minority. Most buildings are primarily plaster or poorly constructed one-floor concrete-ish structures. Then you have the tent cities and makeshift shacks that line the sides of the road.

Yes, I know, I know. You are probably thinking the same thing I was. “Well, what about those innumerable fundraising efforts for millions of dollars by members of Hollywood and various philanthropists? It has been five years since the earthquake. What’s been going on since then?”
The issues with Haiti are more complicated and deeper than just some physical damage to some buildings from the earthquake. If it were that simple, Haiti would have been “fixed” by now. Haiti has been in dire shape since long before the earthquake. If anything, the earthquake was sort of almost a service to the country. It forced the world to pay attention to a country that is so desperately impoverished and functionally broken at the most basic, fundamental levels. The country needs far more than a few well-meaning philanthropists throwing some money at it. That will not solve any problem. The country needs help to establish foundations and basic infrastructure in every field from healthcare to finance to education to agriculture and even to tourism. Without the right kind of help, Haiti will only fall deeper into despair.

As Dr. DeHeer so astutely put, “Haiti is devastatingly endearing.” It truly is. You see people in absolute, abject poverty along the streets in Haiti. Yet there they are, trying to carve out a meager existence, selling their wares. Somehow, they still push forward. Yes, invariably, with international efforts, a culture of dependency has also developed. Nonetheless, this has not completely taken over the psyche of the Haitians. There is great enthusiasm among them when they are afforded an opportunity to learn something new. However, things are still in a fragile state. After my week in Haiti, it us clear that our support is necessary more than ever.

Sure, coming to Haiti and doing a handful or even a large number of surgeries on a mission visit is satisfying, but useless nonetheless. I have always planned to do mission work, knowing it would be part of my practice in the future in some way. But after my visit to Haiti, my entire perspective shifted. Most of my concerns and thoughts seem so insignificant now. I realize I can’t just go to an impoverished country and provide treatment/perform surgeries, and expect to think it made some sort of difference. It is simply not enough.

That old adage “give a man a fish, you feed him for a day. Teach a man to fish and you feed him for a lifetime” rings true here. This is the only thing that will truly make a difference in Haiti. We really need give our Haitian colleagues the proper tools (be it medical equipment or medical training) so they can help themselves. Only then can they truly recover and grow.

Now before I give the impression that my trip to Haiti was a bust, let me clarify. It was a great success. The best part of my trip to Haiti was discovering that the organization, Step by Step Haiti, is doing all that and more. It was truly wonderful working alongside our Haitian colleagues. They took our direction and instructions so enthusiastically. They were exceptionally eager to learn what we had to offer. They asked insightful questions and truly try to apply their newfound knowledge to help their fellow citizens. There are real efforts now happening in the communities to educate and reach the average Haitian citizen. They see there is a chance and it is encouraging. It was quite enriching and exciting seeing our colleagues not only treat patients, but be able to demonstrate that they are actively sowing the seeds for preventative care in limb salvage as well.

There is still a long way to go but progress is surely happening. Once these clinics are fully established around the country with appropriate tools and protocols, we hope to establish a Haitian medical residency as a tradition for coming generations.

I am proud to say I have been consumed by my trip to Haiti. I am just getting started and am anxious to do more. All in all, my first trip to Haiti has been truly satisfying. With all of the wreckage I found, I also saw a silver lining. It is with this silver lining that hope springs eternal in the human breast. Hope for a better future for our Haitian brothers and sisters.

Source: Podiatry Today

No Surprise: High Heels Culprit of Most Women’s Foot Issues

The American Podiatric Medical Association (APMA) today announced the results of its Today’s Podiatrist survey, which measures the public’s attitudes toward foot health. The study, which surveyed 1,000 US adults ages 18 and older, revealed that nearly half of all women (49 percent) wear high heels, even though the majority of heel wearers (71 percent) complain these shoes hurt their feet.

These findings seem to fit the old adage that “beauty is pain.” Even chronic discomfort doesn’t appear to deter women from purchasing the strappy stilettos they love: The average woman who owns high heels has nine pairs! Asked what they do when shoes hurt their feet, 38 percent of women said they’d “wear them anyway if I like them.”

However, in spite of their extensive shoe collections, only two percent of women say they wear high heels every day, and just five percent say they wear high heels five days per week. Almost half say they wear heels rarely or never (46 percent)—which may give them a leg up when it comes to preventing permanent damage to their feet.

“With high heels, moderation is key. It’s best not to wear them every day,” said Matthew G. Garoufalis, DPM, past president of APMA. “Daily heel-wearing can cause the Achilles tendon, the strong tendon at the back of your ankle, to shrink. This increases your risk of an injury while doing activities in flat shoes, including exercise.”

Heel height also plays an important role in preventing foot pain. Almost half of women say they can withstand wearing heels that are three inches or higher, though podiatrists recommend staying more grounded.

“Heel wearers should avoid heels higher than two inches,” said Dr. Garoufalis. “Wearing heels three inches or higher shifts body weight forward, and puts great pressure on the ball of the foot and the toes.”

While high heels were far and away the biggest culprits of foot pain, affecting 71 percent of wearers, women said other types of footwear including barefoot running shoes (27 percent), boots (26 percent), flats (23 percent), and flip flops (23 percent) also caused discomfort.

“Foot pain is never normal, and it’s critical that anyone experiencing chronic pain—from footwear or otherwise—seeks care from an expert,” said Dr. Garoufalis. “We hope these findings encourage Americans to fight foot pain with the help of today’s podiatrist.”

For detailed survey findings and an infographic on high heel pain, visit the APMA website.

The American Podiatric Medical Association (APMA) is the nation’s leading professional organization for today’s podiatrists. Doctors of Podiatric Medicine (DPMs) are qualified by their education, training, and experience to diagnose and treat conditions affecting the foot, ankle, and structures of the leg. APMA has 53 state component locations across the United States and its territories, with a membership of more than 12,000 podiatrists. All practicing APMA members are licensed by the state in which they practice podiatric medicine. For more information, visit www.apma.org.

APHA ‘Get Ready Day’ Helps Americans Prep for Emergencies

The American Public Health Association (APHA) is creating awareness through their Get Ready Day campaign, which will be held on September 16, 2014. The campaign helps Americans prepare themselves, their families and their communities for all disasters and hazards, including the flu, infectious disease, natural disasters and other emergencies.

It’s certainly a good reminder to be aware of potentially dangerous situations and how they are safely handled. Here is a list of how to prepare for pretty much any emergency situation you can think of.

This is also probably the cutest video you’ll ever see about emergency situations…Get Ready Video

REPORT: Office Visits by Patients With Diabetes Rising Rapidly in United States

Office visits in the United States for diabetes rose 20% from 2005 to 2010, with the largest increase in adults in their mid-20s to mid-40s, according to a new data brief from the Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics (NCHS).

Nearly 29 million people in the United States have diabetes, putting them at risk for other chronic conditions, such as heart disease, eye disease, and stroke, Jill J. Ashman, PhD, and colleagues from the NCHS note in the brief.

On an annual basis, the cost of diabetes in the United States approaches $245 billion, and patients with diabetes have medical expenditures 2.3 times those of patients without diabetes.

The researchers analyzed recent trends in office visits by patients with diabetes using the National Ambulatory Medical Care Survey (NAMCS), a nationally representative survey of visits to nonfederal office-based physicians (excluding anesthesiologists, radiologists, and pathologists).

They found that office-based physician visits by patients with diabetes rose from 94.4 million in 2005 to 113.3 million in 2010 (a 20% increase). Visits by patients with diabetes made up about 11% of all office-based physician visits in 2010.

The number of office visits increased during the study period for all age groups except for those younger than 25 years. The largest percentage increase (34%) occurred in people in the 25- to 44-year age range.

However, the volume of visits was higher for older adults; individuals aged 65 and older made 53.7 million visits in 2010 compared with 2.6 million visits made by those younger than 25.

The researchers did not see any marked change in the rate of office visits by patients with diabetes in any age group during the study period. The highest rate in 2010 was among those aged 65 and older (1380 visits per 1000 persons) and lowest in those younger than 25 (20 visits per 1000).

“Diabetes is not the only health concern for the majority of patients who have it, with 87% of visits being made by patients who have additional chronic conditions,” Dr. Ashman and colleagues say.

Regardless of age, they found that patients with diabetes use “extensive health resources,” making frequent trips to the doctor and often receiving multiple prescriptions.

One of the federal Healthy People 2020 goals is to reduce the disease and economic burden of diabetes. “Continuing to examine office-based physician visits by patients with diabetes is especially important given changes in standards of care that may influence such visits,” Dr. Ashman and colleagues say.

Source: Medscape

What is driving a physician shortage and how can it be stopped?

As its name insists, the Affordable Care Act (ACA) is supposed to give more American access to reasonably-price healthcare, but this affordability would prove fruitless if the number of primary care physicians in the United States continues to decrease.

Recent findings from the likes of SERMO, the largest online community of physicians, show that amongst all provider specialties family and internal medicine are two of three unhappiest groups of physicians, 62 percent and 60 percent, respectively. Only obstetricians and gynecologists come in lower at 59 percent. For internists and family physicians, dissatisfaction with lifestyle was a common factor leading many to rethink their choice of specialty, 25 and 23 percent, respectively.

“These are the doctors on the front lines in medicine who are seeing the increase pressure and in particular now with the ACA in play and a higher stream of patients coming in,” SERMO CEO Peter Kirk tells EHRIntelligence.com. “It is still a challenging work environment and they are at the lower end of the pay scale. Those are the ones looking to change whereas those on the higher end of the pay scale — orthopedists, physiatrists, oncologists, etc. — are happiest with their professions.”

Although these physicians admit to dissatisfaction with their choice of specialty, it does not mean that they are leaving it for another. So then why is this problematic? The answer to that question is seen in the choices made by the next waves of physicians, residents, who are opting more lucrative and less stressful professional positions.

“Based on some of the conversations on the site, you can build a sense of how much there is a drive toward specialty right off,” Kirk explains. “Having your own private practice as a primary care physician is not the dream anymore. It doesn’t pay the bills. There’s too much complexity, too much involved in running a business. This is driving residents into searching for the best-paid specialties in order to help pay of their debt and have a nice head start moving forward.”

Here lies the basis on predictions that physician shortages are only a matter of time. The ACA and increase of insured Americans should only serve to exacerbate the stresses associated with primary care.

“There will not be enough real doctors at the front lines of primary care to handle the workload, especially with the ACA adding 30 million additional patients to the system,” maintains SERMO’s CEO. “More pressure and more of the primary care are being assigned to non-physicians. The NPs and PAs are likely to do more of the work. That’s going to play out over the next five to ten years.”

A solution to the problem?

The physician shortage problem is real, but what can be done about it? Both the Association of American Medical Colleges (AAMC) and American Medical Association (AMA) believe the solution to be found in graduate medical education.
Crediting medical schools for increasing enrollments and students for responding with an increasing number of applications, the AAMC is placing the onus on lawmakers:

Now Congress must do its part by lifting the cap on the number of federally supported residency training positions. Lawmakers have responded with proposals in the House and Senate to increase the number of residency positions. But they must act now in order to ensure that there are enough physicians for our growing and aging population.

Meanwhile, the AMA has developed a new policy to encourage state and federal legislators and private payers help fund residents in training with an emphasis on promoting the teaching of team-based and patient-centered care models by accrediting associations.

Through its Accelerating Change in Medical Education initiative, the AMA has convened nearly a dozen medical schools to decrease disparities in medical education. “As more patients continue to receive health care coverage, it is essential that the next generation of physicians is sufficiently trained,” said AMA Board Member Stephen Permut, MD.

Health information technology (IT) has a role to play in easing the burdens on providers if developed, implemented, and used properly. But it is still only a support and no substitute for the skill and expertise of physicians using it.

Source:
Kyle Murphy, PhD
EHR Intelligence

APMA Advocates for Permanent Medicare Payment Reform

WASHINGTON—The American Podiatric Medical Association (APMA) today voiced its concern over the short-term solution known as the “doc fix” legislation passed by voice vote in the House of Representatives. APMA calls on Congress to discontinue use of these temporary fixes, and instead focus efforts on continuing bipartisan negotiations, working toward a permanent SGR replacement package that includes provisions of the APMA-sponsored HELLPP Act.

The one-year “doc fix” keeps Medicare payment levels at their current level and averts the 24-percent payment cut scheduled to take effect April 1. Instead, providers would see a 0.5-percent increase in payments through December 31, 2014. Payments would then revert to their current levels through April 15, 2015. The bill would also delay the ICD-10 transition until October 2015. While the delay does allow for additional time for preparation, it poses a significant financial and resource impact on entities that were heavily invested in the transition.

“APMA continues to work with members of Congress to replace the flawed sustainable growth rate formula as well as any burdensome requirements that adversely affect our members, including our collaborative goal of an orderly ICD-10 transition,” said APMA President Frank Spinosa, DPM. “APMA urges its members and all physician organizations to push for permanent Medicare payment reform.”

Contact APMA’s Legislative Advocacy department at advocacy@apma.org.

New Children’s Foot Health Campaign Kicks Off

April’s foot health awareness month provides APMA the opportunity to educate the general public about the importance of maintaining children’s foot health at all stages of development, and the role today’s podiatrist plays in promoting positive foot health.

This year’s campaign, titled “First Steps: Keeping Kids’ Feet Happy and Healthy”, will provide members with a host of new educational materials, including an online resource page, poster, customizable newsletter, kid-friendly worksheet, and shareable multimedia.

A dedicated media relations strategy targeting “mommy bloggers” will also take place throughout the month, positioning APMA members as experts in the realm of children’s foot health.

The “First Steps” campaign kicks off April 1, and resources will remain on APMA.org for a full year after the campaign’s completion for members’ use. For any questions, or to learn more about how you can get involved, contact the APMA Communications department.

Fashionable Footwear – Good for Style, Bad for Foot Health

More than half of Americans suffer from foot problems, and often those problems are directly related to shoes.

But no matter how cute a shoe looks, Orly Avitzur, medical adviser at Consumer Reports, said that having fashionable footwear isn’t worth the health risks.

“Wearing the wrong shoes can lead to lifelong deformities that require surgery to fix,” she said.

According to a new study from the Institute for Preventive Foot Health, uncomfortable and ill-fitting shoes are a serious problem. Shoes that force feet into narrow or pointy toes can cause bunions or hammertoes, where the toes curl unnaturally downward.

But that doesn’t stop women like Trisha Calvo and Jennifer Frost from wearing name brand heels.

“I feel fabulous in them,” Frost said. “You feel fabulous in your shoes…not physically
fabulous in them.”

Studies show that high heels can shorten your Achilles tendon and can trigger planter fasciitis, an inflammation in the soles of the feet. Avitzur recommends foregoing high heels for something more comfortable.

“Opt for a lower heel to take some of the pressure off the ball of your foot,” she said. “Make sure that there is enough room in the toe, and avoid thin-soled shoes that have little or no support.”

But even flat shoes can hurt feet if they lack proper support and cushioning, especially if they’re the wrong size.

One recent study revealed that up to a third of people wear the wrong shoe size, sometimes by up to one-and-a-half sizes. To combat that problem, Consumer Reports recommends measuring your feet each time you buy, especially for people over 40. After that, feet can grow up to half a shoe size every 10 years.

Source:
WRAL

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