10 reasons why you should choose We Treat Feet

The We Treat Feet Podiatry group takes great pride in putting our patients’ feet and needs first. We pride ourselves on our expert clinicians and top-notch customer service.

Here are 10 reasons why you should choose We Treat Feet Podiatry for all your podiatric needs.

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Diabetes and podiatry; what’s the connection?

Foot complications in diabetes are common yet the link between the two is not very well-known. Here to tell us more about it ahead of World Diabetes Day on 14 November is specialist and author for Journal of Foot and Ankle Research Trevor Prior, with colleague Debbie Coleman.

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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

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

8 Great Suggestions for Diabetic Foot Care

1.) Maintain a blood sugar level of 70 to 130 mg/dL before your meals and less than 180 mg/dL two hours after you’ve started your meal, with a haemoglobin A1C level that is less than 7 percent. This can be achieved through regular exercise, monitoring how often and what you are eating, keeping up with medications prescribed by your doctor, and monitoring your blood sugar as often as is necessary for optimal control.

2.) Never walk barefooted. Seashells, glass, or other ocean debris can cut your skin and cause serious infections without you realizing it. Walking barefoot on a hot pavement or hot sand can also lead to severe burns or infections. Avoid wearing sandals, as sand and other foreign bodies can still get into the sandal. Podiatrist, Cyaandi Dove, advises all her diabetic patients to choose closed shoes over flip-flops and sandals to give their feet maximum protect. She says: “Insects can still have access to your feet and cause problems with bites and other infections. Rather than saying that you should never wear sandals, I would say that you should be very vigilant when you do wear them.”

3.) Be shoe wise. Wearing shoes that are too big or too small can cause blisters or calluses. Measure your feet each time you buy new shoes. It’s is normal for adult feet to change sizes four or five times during your lifetime. Weight fluctuations, changes in the weather, and poor circulation can all alter the shape and size of your foot.

4.) Be sock wise. Choose socks that have no seams. Seams will rub against your skin and cause blisters.

5.) Wash and inspect your feet and shoes daily. Give your feet a daily wash. Inspect your feet before putting on your shoes and once more when you take them off. If you are not flexible enough to see the base of your foot, use a magnifying hand mirror. Shake out your shoes before you put them on and make sure there is no debris that will rub against your feet. Although a tiny grain of sand might not be felt, it could lead to serious infection if it is not treated properly.

6.) Trim toenails. Don’t let your nails get long and overgrown. Trim them straight across, and, if necessary, file down the edges.

7.) Use skin lotion for your feet. As a preventative, Flexitol Heel Balm can reduce the risk of infections and foot ulceration in diabetic patients keeping the skin optimally hydrated. Rub a thin coat of Flexitol Heel Balm on the top and bottom of your feet, but not between the toes. Excess moisture can also lead to fungal infections, so let the balm soak into your skin for a few minutes before putting on socks on covering up your feet.

8.) Visit a podiatrist before and after your vacation. Fungal infections tend to happen a lot more when the weather is heated and increased in moisture. Your feet might also increase in calluses because you have switched to summer footwear. Do not try to remove corns, calluses, or warts on your own. Even over-the-counter products for removing corns and warts may cause burns or damage to your skin that cannot be repaired. Your podiatrist will help you manage minor infections and ensure that they do not lead to serious complications.

Sources: http://www.digitaljournal.com/pr/1282575#ixzz2sMMwFuEF, http://www.diabetes.org.uk/Documents/Reports/State-of-the-Nation-2012.pdf

What’s at stake if Congress repeals the Medical Device Tax?

During the battle to reopen the government, a pot
With that in mind, here are some frequently asked questions about the tax.

Q: What is the medical device tax?

A: Since the beginning of this year, medical device manufacturers and importers have paid a 2.3 percent tax on the sale of any taxable medical device. The tax applies to devices like artificial hips or pacemakers, not to devices sold over-the-the counter, like eyeglasses or contact lenses.

Q: Why did Congress put the tax into the health law?

A: The law created a package of new taxes and fees to finance the cost of the health law’s subsidies to help purchase coverage on the online marketplaces, or exchanges, and the law’s Medicaid expansion. In addition to the tax on medical devices, an annual fee for health insurers is expected to raise more than $100 billion over 10 years, while a fee for brand name drugs will bring in another $34 billion. In 2018, the law also will impose a 40 percent excise tax on the portion of most employer-sponsored health coverage (excluding dental and vision) that exceeds $10,200 a year and $27,500 for families. That has been dubbed a “Cadillac” tax because it hits the most generous plans.

Q: Why do proponents of the repeal suggest the medical device manufacturers should get a break over those other industries?

A: Medical device makers say the tax will cost 43,000 jobs over the next decade and will increase healthcare costs. In a September letter to lawmakers, device manufacturers said if the tax were not repealed, “it will continue to force affected companies to cut manufacturing operations, research and development, and employment levels to recoup the lost earnings due to the tax.”

The device makers also assert that, unlike other health industry groups that are being taxed through the health law, they will not see increased sales because of the millions of people who will be getting insurance through the overhaul. “Unlike other industries that may benefit from expanded coverage, the majority of device-intensive medical procedures are performed on patients that are older and already have private insurance or Medicare coverage. Where states have dramatically extended health coverage, such as in Massachusetts where they added 400,000 new covered lives, there is no evidence of a device ‘windfall,'” the group’s letter to Congress stated.

The left-leaning Center for Budget and Policy Priorities has challenged industry assertions that the tax will lead medical device manufacturers to shift operations overseas and that it will reduce industry innovation. Since the tax applies to imported and as well as domestically produced devices, sales of medical devices in the U.S. will be subject to the tax whether they are produced here or abroad, the center’s analysis notes. Innovation in the medical device industry has slowed for reasons unrelated to the tax, the center said, noting that the health law may spur medical-device innovation by promoting more cost-effective ways to deliver care.

Q: Who else is pushing for a repeal?

A: Republicans and Democrats in both chambers – in particular those who hail from states with many device manufactures, such as Minnesota, Massachusetts and New York — have sought to repeal the medical device tax. Most recently, Sen. Susan Collins, R-Maine, has pushed for a repeal as part of larger legislation to lift the debt ceiling and reopen the government.

The Republican-controlled House has twice passed legislation to scrap the tax, including a recent measure that would have also delayed implementation of the health law by a year. In the Senate, 33 Democrats and Maine Independent Angus King voted earlier this year to repeal the tax, although the vote was a symbolic one, taken as part of a non-binding budget resolution.

Q. Who opposes the repeal?

The White House in the past has said the president would not support such a measure, although it has not commented about the issue in the current negotiations. In a statement issued last year about a congressional effort to get rid of the tax, the White House said, “The medical device industry, like others, will benefit from an additional 30 million potential consumers who will gain health coverage under the Affordable Care Act starting in 2014. This excise tax is one of several designed so that industries that gain from the coverage expansion will help offset the cost of that expansion.”

Senate Majority Leader Harry Reid, D-Nev., has said that the Senate will reject any attempts by Republicans to delay implementation of the law or to repeal the medical device tax as part of reopening the government or lifting the federal debt ceiling. But it is unclear if he would still oppose the effort if it was part of a major bipartisan compromise on the health law and budget issues.

Meanwhile, other health care providers are watching closely. In a recent blog post, Chip Kahn, president and chief executive officer of the Federation of American Hospitals, an association of for-profit institutions, wrote that if Congress reopens the heath law “to reconsider the contributions of any one health care sector that benefits from ACA’s coverage expansion, it should simultaneously address the changed circumstances of hospitals and provide similar relief.”

Source: Mary Agnes Carey, Kaiser Health News/Healthcare Finance News

“We Shouldn’t Be Doing It”: Lecturer Calls Out Serious Podiatric Myths

During his lecture entitled “Righting the Wrong: Exploding Myths in Podiatric Medicine” last month, Bradley W. Bakotic, DPM, DO, Bako Pathology Services in Alpharetta, GA called out some myths which have inexplicably become part of the modus operandi of the modern podiatrist.

“Podiatry is a little bit incestuous,” Dr. Bakotic said. “If you go to MD school, you’re taught dermatology by a dermatologist. In podiatry, you’re often taught dermatology by a podiatrist who has an interest in dermatology. It’s incestuous in the sense that we don’t get out into other disciplines like we should. We pass on ideas, and sometimes they’re frankly wrong.”

The first myth Bakotic tackled was “Soft tissue mass? Just cut it out!” school of thought.

“That’s a big one” he continued, “It’s profession-wide and can actually end up in frank negligence. I think this came from the fact that 70 percent of pedal soft tissue masses are ganglia, which are pseudo cysts. The problem is other neoplasms happen.”

“If you just cut it out blindly, you almost never have appropriate margins, so you’re going to have a higher recurrence rate,” he said. “It almost doubles. Distant metastasis also almost doubles.”

Bakotic went on to state the potential litigative repercussions of this; “When you go in and cut out soft tissue mass with positive margins, you cannot do limb-sparing surgery in the aftermath,” he said. “It has big repercussions.”

His conclusion on the myth was strong; “Cutting out soft tissue mass is something that should be left behind in this profession, we shouldn’t be doing it. We hurt people.”

Dr. Bakotic continued to dispel another myth – that acral dermatitis should be seen as tinea pedis until proven otherwise.

“When I was practicing podiatry, I wrote [a prescription] for one corticosteroid in seven years,” he said. “That’s incompetence. I was led to believe every time you saw a rash on the foot, it was tinea.”

Like many podiatric physicians, Dr. Bakotic said, he commonly writes prescriptions for antifungals.

“If you get the prescription data, you’ll see it’s an absolute fact. Only 25 percent of podiatrists prescribe a topical corticosteroid at least once a month. That’s ridiculous.”

After sharing results of studies that show nearly two-thirds of skin biopsies thought to be tinea pedis are not, Dr. Bakotic shared 10 photos with the audience, asking them to identify how many were cases of tinea pedis.

The answer? None.

“Many of us were just taught to assume everything’s a fungal infection,” Dr. Bakotic said. “When I was a student, if someone came in with dermatitis I was already running to the cabinet with the Spectazole samples.”

Source:
APMA

Beware the Flip Flops This Summer!

Summer is upon us – cookouts, laying by the pool, strolling around in your favorite flip flops.  It’s a wonderful time of year!

But recent studies are providing a warning concerning our favorite summertime footwear; “While fashionable and fun, flip-flops can actually lead to weakened and fallen foot arches — and that’s just the beginning,” says Dr. Dawn Sears, a New York City doctor of podiatric medicine and surgery. “The danger with flip-flops is that they cause both short-term and long-term harm to your feet.”

Oh no!  Does this mean summer is ruined forever because our dreaded flip flops are going to revolt and destroy all of our feet?!?

No.  Take it easy now.  Even though a press release from Dr. Sears revealed that other serious injuries from flip-flops may include plantar fasciitis, Achilles tendon injury and stress fractures of the long bones in the foot, these injuries normally occur in patients who wear their flip flops all the time.  So here are some tips on how to avoid the flip flop blues:

  • Avoid wearing flip flops 24/7: There is just not enough support for the foot to keep from causing discomfort and possibly long-term damage. Stick to short trips where you won’t be walking all that much, like to the beach and the pool.
  • Avoid wearing flip flops in challenging conditions: All that foot exposure can result in broken toes and toe nails. Never, ever wear them when operating any type of lawn equipment.
  • Don’t forget sunscreen: Feet can get sunburned too!  Don’t forget to put sunscreen down there.
  • Consider your age: If you’re older, you’re more prone to some of the above issues
  • Consider your weight: As you can imagine, bigger people are more prone to foot damage, especially in flip flops

Enjoy your summer but be sure to keep conscious of your footwear!  As always, contact the We Treat Feet Staff with any questions on the above article (or anything else!).

Source:
Livingston County News

Prom Season is Almost Upon Us! How to Choose the Right Shoes (for Your Foot Style & Health!)

Get Your Feet Ready For Prom!
Choosing prom shoes for girls isn’t always easy and oftentimes critical factors such as comfort and fit are overlooked because you fall in love with a certain style or color, a decision that is frequently regretted about 30 minutes into the big night.  Our goal is to encourage you and your friends/family to make smart decisions from a health perspective while still keeping it stylish on Prom Night!

Comfort, Comfort, Comfort!
Comfort needs to be the number one thing you consider with these shoes.  Period.  You’re going to be spending a really long time standing, dancing, running, etc throughout the night and the last thing you need to worry about is discomfort on your feet.

Heels or No Heels?
Heels are obviously a very popular choice for prom but they should bring some consideration before you choose the wear them – do you wear them often?  Have you had issues with them before?  Have you spent long periods of time in them?  There’s no crime in not wearing heels because if you think you may have an issue, you probably will.  Wedges can be a good compromise between giant heels and the more comfortable flats – but just make sure you give it some honest thought!

Go Your Own Way!
Don’t worry about fitting in with what all the other girls are doing – go with your own style!  It’s very likely that you’ll be able to pick out what shoes most girls are going to wear so it wouldn’t be a crime to choose something completely different.  Sure you may get some weird looks from other (jealous) girls but at least you’ll be comfortable and doing your own thing!

Have any questions or comments about choosing the right Prom shoes?  Drop us a line at info@wetreatfeetpodiatry.com or 410-363-4343.

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