Send your comments, questions, responses, articles or case studies to Pedorthic Newswire at editor@pedorthicnewswire.com. Your emails will be reviewed by pedorthists and the editors of Pedorthic Newswire, and selected submissions will be posted in an upcoming issue for feedback from other readers. Please note: the deadline for all submissions and responses is 12 noon Eastern Standard Time on Tuesday for that week's issue.

Comment: I have been in the field of Pedorthics since 1991 and have been Board Certified since 1993. After the last PFA Symposium I refer to myself as a BORED Certified Pedorthist.  The content of the symposium was disappointing to say the least. In my opinion, this has been the case for more than the past decade. Seriously, how many ways can you use a foam crush box, make a diabetic insole or grind a rocker sole? How can a presenter propose that they are an "expert" in biomechanics or that they have developed a new orthotic that is biomechanically superior, and in the same sentence say that a foam impression box was used?  Fore foot to rear foot relationships, first and lesser ray mal-alignments and fore foot equinus are obliterated when using a foam box! It also seems that to be a presenter you have to be part of the 'Good Old Boys Network.' They are the same presenters year after year after year after year.

I personally know of people whose presentations were turned down and their educational course is two days long, which is worth as many continuing education points as the entire symposium!

I propose this to the PFA: Read full comment here.

- Aaron Anderson, C. Ped., BORED Certified Pedorthist

PREVIOUS QUESTIONS AND COMMENTS WITH RESPONSES

Question: Hello everyone, my name is Rodney Johnson and I have been Board Certified Pedorthist since 2006.  I started my own orthotic lab several years ago. I am really upset with what is happening to our field. Let me give you an example: Many people with different credentials are doing our job. MD's, DPM's, DC's, PT's, AT's and now even retail pharmacies. Many of these people are not trained in biomechanics or compensation, which can and do lead to foot ulcers. These people are equipped with the terms "pronation" and "supination" and they are stealing our jobs. Can these people explain the tri-planar motions of the STJ in regards to pronation and supination?

The previously mentioned professions are dispensing one or more of these products: Feet Orthotics, AZ braces, AFO's, Richie braces, DM shoes and insoles, custom shoes, etc. This is upsetting because you don't see a DPM, MD (Orthopedist) at Walgreens filling RX's for your monthly medications. Imagine this. You walk into Walgreens and you get your meds and then the same person asks you if you need a neuroma injection, or custom molded insole. Sounds strange to me.

We are required to be trained and it is our responsibility to be the best at what we do. We also have to spend large amounts of time and money on continuing education.  Does anybody have any ideas on how to compete with a retail giant like Walgreens or others like them, when they do not have to spend time and money or training or continuing education? The point I am trying to make is this: with so many people getting on the feet orthotic bandwagon, the market is becoming oversaturated and the title C. Ped. seems to mean less and less.

The other thing is this: what is PFA thinking (Current Pedorthics) saying it's a great idea for everyone to go to library system for "Custom Orthotics?" Example: there is a wholesale company that does "Custom Orthotics" with a 60-day money back guarantee for all of their accounts.  If they don't work, the patient brings them back to the office and the patient is issued a refund. HOW DO WE COMPETE WITH THAT? I guess I will just go to pharmacy school (HA-HA). 

Please tell me what you think and I love constructive criticism.  Thanks.

- Rodney Johnson, C. Ped.  (NEXT GENERATION PHARMACIST)

Response: I am in complete agreement with you that the C.Ped. and the C.Ped. alone is the best qualified to provide diabetic footwear for the diabetic population.  Unfortunately CMS does not agree and believes that others, with far, far less training, skills and understanding of the unique problems of the Medicare-covered diabetic are suitably qualified. 

I don't hold myself up as an expert of CMS policy and the history of their regulatory language, published as it has been in fragmented segments over a period of years, but I am afraid that we as a profession cannot hang our hat on the Appendix C that you cited.  Look at the language again, particularly the phrase, "requires access to a facility with the equipment necessary to fulfill the supplier's responsibility...".  "Requiring access" is not equal to actually housing the equipment necessary on the premises. Is this an unfortunate choice of language?  Without question it is, but if CMS is fine with it, what does it matter what we as C. Ped.s think?  It isn't the first time that CMS has applied a poor understanding of professional best practices and incorporated it into a bad policy. 

I will leave it to others to debate how we came to this juncture.  I have expressed myself clearly on this subject in previous postings.  What is particularly sad to me, though, is the effect this is having and will continue to have on this vulnerable patient population.  And please know that the fact that I am also a pharmacist in no way makes me sympathetic to pharmcists' encroachment into our C. Ped. prerogatives, which at the time I trained and entered the C.Ped. ranks (mid-90's) I believed could never happen.  I, more than most I dare say, proud as I am of my pharmacy education, know without a doubt that it alone did not qualify me to provide good (or even adequate) pedorthic care--I had to study and work hard for more than a year in my spare time to get to the level of professional expertise I felt was necessary to pass the board exam and enter into our profession.

- James Garner, R.Ph., C. Ped., C.O.

Response To Mr. Johnson and similar comments:  While agreeing there are numerous egregious Medicare abuses as you aptly point out - on the flip side I've got to say you're all a bunch of whiners!  There's an absolute national, mob mentality of people lining up to get on board the diabetic Medicare gravy train.  While you kids are fighting over your corner of the sandbox as though it's your inalienable right under the U.S. constitution - the rest of us are alive and well in the other ninety-five percent of the sandbox using our FULL Scope of Practice.  

Your board exams covered a lot more than diabetics.  Your continuing education requirements are meant to broaden your horizons and keep you abreast of the latest technologies.  Instead, most people meet the absolute minimum CEU's and complain about that.  Does it occur to anyone that the NON-diabetic market is vastly bigger than the diabetic Medicare market?  Utilize your FULL Scope of Practice that in part includes diabetics.  You're mentally crippling yourself by thinking the pedorthic market is shrinking, when it's actually expanding everyday.  In the 50 plus years of pedorthics, the need has never been greater.  It's your choice to be a one-trick-pony or not.

- Shane Hayes, C. Ped.

Question: Now that OTC rocker sole shoes are commercially available, what disorders are they being prescribed for, and how has this affected your practice?

- Robert Schwartz, Eneslow Pedorthic Enterprises

Response: Having participated in the rocker sole study with Dennis, and studying rigid rocker soles for forefoot considerations, it is interesting to see what is happening with the MBT-like options out there.  I love when people walk into my office and ask me "What do you think about the new Skechers shoe?" and then I can tell them the whole back story.  The thing I do the

most right now is talk people OUT of a shoe like that, as it's usually contraindicated for the pathologic clinical conditions that we deal with.

If anything, the MBT (and other) creates discussion, which is always good. This makes the other shoe companies go and make changes and improvements (aka the PW Minor stable rockers, which I really like).

Obviously, a lot of us do exterior mods of people as a way of life.  While we don't want that to go the way of the dodo, at least the rocker is "out there", even if it isn't in the fashion that we researched.  But best believe I'll be out there telling people again in my area about the efficacy of the rocker sole study to remind people about how it can help the at-risk diabetic foot.

- David Castellanos

Stride Rite Children's Group Appoints Sharon John as New President

The Stride Rite Children's Group (SRCG) unit of Collective Brands Performance + Lifestyle Group today announced that it has appointed Sharon John as its unit president. John, who has extensive experience in Children's brands, marketing to moms and kids, and strong licensing, product development and innovation expertise at such companies as Hasbro, Inc. and Mattel, Inc., among others, will lead SRCG and its expanding portfolio of brands including Stride Rite®, Robeez®, Saucony® Kids, Sperry Top-Sider® Kids, Keds® Kids, Jessica Simpson Kids, Tommy Hilfiger Kids, and more.

John will begin in her new role in late December and report to Gregg Ribatt, president and chief executive officer of the Collective Brands Performance + Lifestyle Group. She will head up all functions of the SRCG team including product creation, sales, marketing, merchandise planning and distribution, as well as retail which includes retail merchandising and operations of more than 350 Stride Rite stores. Full Text

Source: CNNMoney.com

Walking Company Looks Ahead

The Walking Company Holdings Inc. wants to run - not walk - out of bankruptcy. After filing for Chapter 11 last week, CEO Andrew Feshbach said he is hoping the move will help convince the firm's landlords to renegotiate the majority of the retailer's store leases.

Feshbach told Footwear News that the company has "a rent problem we have not been able to solve." He stressed that despite the bankruptcy filing "business will continue" and that it has not harmed The Walking Co.'s relationships with vendors, who are still shipping to the retailer.

"Our fight here is, unfortunately, strictly with the landlords," said Feshbach, noting that the firm had expanded rapidly since the company was bought out of bankruptcy in 2004. It tripled the size of its store base over several years and until earlier this year, had 215 doors. The Santa Barbara, Calif.-based firm now anticipates closing as many as 90 unprofitable stores; five have already been shuttered.

In spite of that, The Walking Co.'s vendors were upbeat and hopeful that the firm will continue. Full Text

Source: Footwear News

Your Health: Experts View Impaired Walking as a Disorder

By Kim Painter

Geriatrician Daniel Mendelson has many ways to assess the health of his elderly patients, but one of the best, he says, is to watch them walk in from the waiting room. "A patient who can do that quickly and comfortably is probably doing pretty well," says the Rochester, N.Y. physician. "But if someone has trouble doing that, they are going to have trouble getting around their own homes."

And trouble walking is often a sign of worse things to come, say experts in aging. "Looking at somebody's gait is a keyhole into everything that's going on with them," says John Murphy, a geriatrician in Providence and board chairman of the American Geriatrics Society. Falls, bone fractures, heart disease, chronic pain and other health problems become more common as people become less sure on their feet, Murphy says. So do hospitalizations, lost independence and death. Full Text

Source: USA Today

No Need to Let Foot Pain Become Achilles Heel

By Tim Rindlisbacher

Every sport has its signature injury. "Tennis elbow" is famous. But if it's true that life is a sort of sport, then heel pain seems to be its companion. It's a pesky ailment that can hang on for weeks and frustrate the professional athlete as much as the average couch potato.

"Heel pain is treatable," says Cleveland Clinic Canada chiropodist, Megan Grantham. "But it helps to know something about what causes it."

Most heel pain is of the type that goes by the name plantar fasciitis. It's named after the plantar fascia, a thick ligamentous structure that's stretches like a bowstring from heel to toes, and supports the arch of the foot. When the foot bears weight, this supportive tissue stretches and becomes taut in a movement that is called "pronation." Full Text

Source: National Post

Diabetic Foot, Ankle Patients Have Fivefold Greater Risk for Postoperative Infection

by Gina Brockenbrough, ORTHOPEDICS TODAY

A recent study of foot and ankle surgical cases indicates that patients with diabetes mellitus have a significantly greater risk for developing a severe postoperative infection than those without diabetes.

The research also identified factors associated with the development of postoperative infection.

"Diabetic patients have about a fivefold increased risk for developing a severe infection postoperatively than nondiabetic patients," Dane K. Wukich, MD, said during his presentation at the 25th Annual Summer Meeting of the American Orthopaedic Foot and Ankle Society. Full Text

Source: OrthoSupersite.com

Beike Biotechnology CSO Speaks on Role of Stem Cells in Treating Diabetic Foot Disease at IPA Diabetic Foot Care Conference, India

Dr. Susan Jiang, M.D., Ph.D., Chief Science Officer at Shenzhen Beike Biotechnology Co. Ltd. spoke at a conference on High-Risk Diabetic Foot Care in New Delhi, India, November 22, 2009. Beike is China's leading stem cell research and regenerative medicine company.

The conference, organized by the Indian Podiatry Association (IPA), aimed to help podiatrists and researchers with an interest in foot disease to "update, interact, modernize and catch up with the advancing pace of scientific development in the field of podiatry." Dr. Jiang's talk, titled "Umbilical Cord Mesenchymal Stem Cell and Clinical Application Prospects in Diabetic Foot Disease," outlined the promise of stem cells in the healing of diabetic wounds and diabetic foot pathology.

"I am excited to have had this opportunity to discuss the role that stem cell therapy can play in healing diabetic wounds and related foot conditions," said Dr. Susan Jiang, speaking after the Conference. Full Text

Source: PRNewswire - Asia

By Tara Parker-Pope

Can you give your muscles a better workout simply by changing your shoes?

The athletic shoe giant Reebok claims you can. The new EasyTone walking shoe, a provocative new marketing campaign says, leaves leg and buttock muscles better toned than regular walking shoes.

Consumers are buying it - literally. Officials from Reebok, a unit of Adidas, say the EasyTone is the company's most successful new product in at least five years. Full Text

Source: New York Times

Submit course listings to: editor@pedorthicnewswire.com

2010 COURSES AND EVENTS

MONTHLY

Riecken's Orthotic Labs - 800-331-8040; SAFIO Class, Second Friday of every month, at 5115 Oak Grove Rd., Evansville, IN. Four casting stands provided, limited to 8 students. Contact Darlene at the above number for more information.  

JANUARY 2010

The Robert M. Palmer M.D., Institute Of Biomechanics "A Not-For-Profit School" is offering a one week "Advanced Functional Foot Orthosis Course" January 15 - 19, 2010 - Elwood , Indiana . This course awards 81.0 CME credits. Participant must have successfully completed the ABC C. Ped. Exam and have an advanced understanding of applied biomechanics.  Cost $1500.00, please contact pam@rmpi.org or 765-557-7216.

Tuition includes Dormitory Housing and Transportation to and from the Indianapolis International Airport and the RMPI school. Note: limited availability and by confirmed reservation only.

The Robert M. Palmer M.D., Institute Of Biomechanics "A Not-For-Profit School" has uniquely designed courses to provide pedorthic pre-certification education for the retail, clinical or biomechanical knowledge seeking pedorthist. Course dates for Levels 1-3 in a variety of locations in the United States, Hong Kong, Mainland China and Korea are available. Level 1 & 3 performed online - Level 2 Dates: January 16-25, 2010 - Elwood , Indiana - Scholarships Available - Please contact pam@rmpi.org or 765-557-7216.

Tuition includes Dormitory Housing and Transportation to and from the Indianapolis International Airport and the RMPI school. Note: limited availability and by confirmed reservation only.

Certified Shoe Fitter Course January 25th - 26th, 2010. Eneslow Pedorthic Institute offers the Certified Shoe Fitter Course, a comprehensive two day course leading to ABC Certified Fitter of Therapeutic Shoes (CFTS) for individuals who fit non-custom therapeutic shoes and non-custom diabetic multi-density inserts. Faculty:  Robert S. Schwartz C. Ped, Justin Wernick, Medical Director, Joan Edelstein, MA, PT, FISPO, C. Ped and Sarah Goldberg, C. Ped over a two day period. Application for ABC Certified Fitter of Therapeutic Shoes (CFTS): http://www.abcop.org/Shoe_Fitter_Registration_Application.aspEPI Certified Shoe Fitter Course January 25th - 26th, 2010 - $395.  Information:  Sarah Goldberg at 212 477 2300 x211 or sarah@eneslow.com.

FEBRUARY, 2010

Pedorthic Pre-Certification Training Course February 1st - 14th, 2010

In cooperation with the ABC requirements, the Eneslow Pedorthic Institute (EPI) is offering a three-level competency training course for aspiring CPEDS. To provide maximum benefit in a minimum of time, a portion of the level one curriculum will be administered through a distance learning program that includes required readings, and testing of all mandatory topics. Upon passing the level one test, students will attend the remainder of the pedorthic pre-certification course at the Eneslow Pedorthic Institute. The course includes the required tests for competency to sit for the ABC exam. Information: contact Sarah Goldberg at 212 477 2300 x211 or sarah@eneslow.com.

Upon completing the course and successfully passing the competency tests, and fulfilling the 1,000 hour "Clinical practice Requirement" students are eligible to sit for the ABC exam to earn their Pedorthic Certification (CPED Pedorthist). For detailed information on the ABC requirements please refer to the ABC website at www.abcop.org.

For more information on ABC Clinical Practice Requirements, please go to www.abcop.org.

SPECIAL NOTE: Aetrex is offering to all attendees of EPI pedorthic pre-certification course the following offer. Buy 40 pair of new Aetrex footwear and receive 20 pair free, a $1300 offer. Attendee must be signed and attending the course to receive special offer.Pedorthic Pre-Certification Course February 1st - 14th, 2010 - $3,995

February 8 - 19, Foot Solutions Pre-Cert class. Foot Solutions is an accredited facility that holds classes three times per year. The company's course will offer the certificate needed in all three levels to sit for the C. Ped. Exam.  The facility is located at 2359 Windy Hill Road, Suite 400, Marietta, GA 30067. For Application And Fee Information Contact:

Tracy Strickland - 1-866-338-2597 Ext: 206 Tstrickland@Footsolutions.Com

Betty Hubauer - 1-866-338-2597 Ext: 201 Betty@Footsolutions.Com

Dr. William Faddock - 1-866-338-2597 Ext: 209 Bfaddock@Footsolutions.Com

MAY 2010

May 7, Foot Solutions 1-day Cram Session. Foot Solutions is an accredited facility that holds classes three times per year. The company's course will offer the certificate needed in all three levels to sit for the C. Ped. Exam.  The facility is located at 2359 Windy Hill Road, Suite 400, Marietta, GA 30067. For Application And Fee Information Contact:

Tracy Strickland - 1-866-338-2597 Ext: 206 Tstrickland@Footsolutions.Com

Betty Hubauer - 1-866-338-2597 Ext: 201 Betty@Footsolutions.Com

Dr. William Faddock - 1-866-338-2597 Ext: 209 Bfaddock@Footsolutions.Com

May 10 - 21, Foot Solutions Pre-Cert class. Foot Solutions is an accredited facility that holds classes three times per year. The company's course will offer the certificate needed in all three levels to sit for the C. Ped. Exam.  The facility is located at 2359 Windy Hill Road, Suite 400, Marietta, GA 30067. For Application And Fee Information Contact:

Tracy Strickland - 1-866-338-2597 Ext: 206 Tstrickland@Footsolutions.Com

Betty Hubauer - 1-866-338-2597 Ext: 201 Betty@Footsolutions.Com

Dr. William Faddock - 1-866-338-2597 Ext: 209 Bfaddock@Footsolutions.Com

JUNE, 2010

June 30, Foot Solutions 1-day Cram Session. Foot Solutions is an accredited facility that holds classes three times per year. The company's course will offer the certificate needed in all three levels to sit for the C. Ped. Exam.  The facility is located at 2359 Windy Hill Road, Suite 400, Marietta, GA 30067. For Application And Fee Information Contact:

Tracy Strickland - 1-866-338-2597 Ext: 206 Tstrickland@Footsolutions.Com

Betty Hubauer - 1-866-338-2597 Ext: 201 Betty@Footsolutions.Com

Dr. William Faddock - 1-866-338-2597 Ext: 209 Bfaddock@Footsolutions.Com

AUGUST, 2010

August 9 - 20, Foot Solutions Pre-Cert class. Foot Solutions is an accredited facility that holds classes three times per year. The company's course will offer the certificate needed in all three levels to sit for the C. Ped. Exam.  The facility is located at 2359 Windy Hill Road, Suite 400, Marietta, GA 30067. For Application And Fee Information Contact:

Tracy Strickland - 1-866-338-2597 Ext: 206 Tstrickland@Footsolutions.Com

Betty Hubauer - 1-866-338-2597 Ext: 201 Betty@Footsolutions.Com

Dr. William Faddock - 1-866-338-2597 Ext: 209 Bfaddock@Footsolutions.Com

NOVEMBER, 2010

November 12, Foot Solutions 1-day Cram Session. Foot Solutions is an accredited facility that holds classes three times per year. The company's course will offer the certificate needed in all three levels to sit for the C. Ped. Exam.  The facility is located at 2359 Windy Hill Road, Suite 400, Marietta, GA 30067. For Application And Fee Information Contact:

Tracy Strickland - 1-866-338-2597 Ext: 206 Tstrickland@Footsolutions.Com

Betty Hubauer - 1-866-338-2597 Ext: 201 Betty@Footsolutions.Com

Dr. William Faddock - 1-866-338-2597 Ext: 209 Bfaddock@Footsolutions.Com

Seeking to Hire: Since our company's founding in 1923, Yale Surgical Company has been dedicated to meeting the Orthotic, Prosthetic and Pedorthic needs of Connecticut.  We are beginning a new family generation of practitioners and are eager to meet the continuing need in our area. We currently have multiple opportunities for C. Ped., CO, CP, CPO and Orthotic/Prosthetic Techs in our New Haven office. We would love to speak with you to discuss your goals and future plans. Please feel free to look at our website, http://www.yalesurgical.com/ and email your resume to info@yalesurgical.com at your earliest convenience. Comp. salary, 401k etc. - Edward N. Kaufman Ongoing

Seeking to Hire:Part time commissioned sales representative needed for pedorthic and athletic retail store sales.  We are looking for a superstar to sell a very innovative and new product into these markets. Negotiable hours that will fit into any schedule. Send e-mail to christie@cluffy.com or mail CV and contact information to Christie Scott 104 Dover Drive, Huoma, LA. 70363. 12/9

Shoe Inventory Clearance: Pedorthic Facility in CT wanting to sell start-up shoe inventory at 20% below purchase cost.  Inventory to include styles form PW Minor and Canfield lines.  For a complete list of styles and sizes available contact Lori at: stridework@aol.com  10/14

Seeking to Hire: Exciting opening for a C. Ped. in Milwaukee, WI.  Expanding Pedorthic Services Dept within 59-yr-old retail shoe store group has an opening for a C. Ped. to see patients in facility and clinics and fabricate in our lab. We are seeking a team player and good communicator -- fabrication and patient skills necessary. This is a wonderful opportunity to grow the department as well as to pursue personal professional development. Competitive compensation package. Please send resumes to info@stansfootwear.com or call Jim Sajdak,CPed at  1-262-432-4030  x102 10/14

Seeking to Hire: New York Pedorthist Needed! Join a world renowned Pedorthic facility in New York and advance your career. We are looking for a C. Ped. with a minimum of 3-5 years of Pedorthic experience including professional shoe fitting. This individual must have a thorough understanding of internal and external shoe modifications as well as knowledge of orthotic casting and design, and must be able to interact with peers and patients in a positive and friendly manner. Please email resume to nycped@gmail.com.

Classifieds will run for 90 days unless we are informed that the position has been filled.  Thank you!

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