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.

NEW QUESTIONS AND COMMENTS

Question: Does anyone know the lifespan of Clyde Edwards, founder of pedorthic education - Ball State University?

- Pamela Haig, C. Ped.

Comment: This is an update to C. Ped. licensure in Texas. We have sent our proposed amendment to the law that currently exempts C. Peds from licensure to David Olvera. Mr. Olvera is the Executive Director of the Texas Board of Orthotics and Prosthetics. He is currently reviewing our proposed amendment. We hope to have his evaluation of our proposal this week, and we send you a working copy of the amendment.

The leaders for this movement are currently:

Antonio Davila, C. Ped., San Antonio, TX

Richard S. Ravel, C. Ped., Austin, TX

Jimmy Dustin Milner, C. Ped., Lubbock, TX

Michael S. Cavel, C. Ped., CFo, Texarkana, TX

Advisory Board:

Ladd Fowler, vendor                                                                                             Allan Johnson, vendor

If you have a strong interest in serving in a leadership role, please contact me.

- Antonio Davila BSN, RN, C. Ped.

Comment: I commend Bob Schwartz for his postings. He is posting questions to instigate pedorthic issues for discussion that really count.

- Ernesto G. Castro, C. Ped.

PREVIOUS QUESTIONS AND COMMENTS WITH RESPONSES

Question: Many Americans love to wear flip-flop sandals in the warmer weather. We have always warned against flip-flops that have no arch support and recommended flip-flops with good arch support (Birkenstock, Finn Comfort, FitFlop, Mephisto, Merrell, Naot, Reef, and Teva just to name a few). What are PNW readers learning about the effects of this footwear on various population demographics, teens and young adults; overweight individuals, pronators, cavus feet, and others? What problems are they experiencing, heel pain, tired and aching feet, Achilles related problems, forefoot pathology, etc? Are certain types of flip-flops causing the problem more than others? What flip-flop brands are readers recommending as good for their client's feet?

- Robert S. Schwartz, C. Ped.

Response: As far as flip-flops go, I have recently started carrying the Orthaheel line of sandals. They have a built-in medial heel wedge and great arch support. Of course, they're not for everyone...but they are awesome for people with flat feet and or posterior tibial tendonitis/dysfunction. They're a good summer option for people who need the support but don't wish to wear shoes and orthoses all day every day. They come in several colors and are unisex, so I don't need to keep a massive inventory on hand. I sell a ton of them as they are unique, functional and reasonably priced compared to some of the other sport sandals or Euro sandals.

-Erick Janisse, C. Ped., CO 

Response: Upon evaluating a person's feet, I ask, "Do you have any problems with your feet, pain, and discomfort?" 

"Yes! When I get out of bed it feels like I'm stepping on a nail. My knees hurt and my calves cramp up sometimes at night." 

"What kind of shoes do you generally wear?"

"Well... I love my flip flops. And I don't wear shoes around the house." 

I can't help but see a consistency. I could totally get up on a soap box about flip flops, but I'll keep it short.  Going barefoot on hard flat surfaces is making our arches collapse and tear up our plantar fascia. Wearing flip flops is as close to walking around barefoot as you can get. Enough said. Seven year olds are coming in to my store with super flexible flat feet that aren't being supported by a shoe with symptoms of knee pain, foot pain, leg cramps, pressure calluses, etc. All the instability and poor alignment the feet and ankles already had are being exasperated by these flat pieces of foam. It'd be nice if there were a warning label on flip flops. Even the flip flops with a bit of arch in them doesn't have the lateral stability that the calcaneous needs. Just my opinion.

- Beth Jensen, C. Ped., Denver, CO

Question: I was wondering what the regulations on prescription are regarding RX/DX information on the prescription. I get several prescriptions for Therapeutic footwear and all that is written on the prescription is "Diabetic shoes." Most of the time there is no DX at all or it may say "diabetic." Is this enough to go ahead and see/evaluate the patient (covered under Medicare) and order footwear under the therapeutic footwear bill?

Is the prescription or the physician statement for therapeutic footwear the priority document when providing diabetic footwear?

- Cped2005

Response: The Rx that you mention is not enough to bill Medicare. You must have an Rx that either specifically states Diabetic shoes and pre-made insoles or Diabetic shoes with custom made insoles or Custom Diabetic Shoes. And if the Rx is for custom shoes you had better have an additional letter of necessity for the MD/DPM/OD et all and it would be wise to have pictures and notes in the patient's file. You must also have a Certifying Statement of Medical Nec. from the MD/DO.

- Chris

Question: The use of rocker soles in pedorthic practice has been a staple of treatment for generations. What effect has the availability and use of ready-made rockers had on this treatment modality? Is it creating more prescriptions or has it reduced the number of rocker sole Rx's?

- Robert S. Schwartz, C. Ped., Eneslow Pedorthic Enterprises, Inc.

Response: In my experience, I don't think we've seen a fall-off regarding prescription rockers vs. people coming in with the Skechers shape-ups, et al. They certainly do start a conversation, though.

In our more clinically-based practice, I often talk people out of that type of footwear, secondary to stability issues.  What I have seen is that local orthopods and podiatrists, when asked that question by the same patients, think "rocker shoes" are not a bad idea for them, which does surprise me somewhat. Should I need to discuss with them the differences between a prescription rocker sole vs. a shape-up, they are usually willing to listen.

Having been fortunate enough to do the research on the "rocker sole study," I know that different muscle groups can be activated with certain prescription modifications, including the double. I also know how they affect motion but also reduce plantar pressure. Extrapolating, it makes sense with the "unstable" versions from a toning aspect.

One of my mottos is "always be marketing."  If you have a patient who needs a prescription mod, and you can market your services for modifying a shoe, and you have the science to back it up, you can efficiently go over the differences with your doctors, explaining to them why a prescription mod may be better. Again, it opens the door to conversation, and keeps your central fab moving.

- David Castellanos, C. Ped., National Pedorthic Services, Madison, WI

Comment: Shane Hayes has posted that my comments on the abhorrent state of affairs of being a pedorthic Medicare TSD supply company were on the money [for both comments see the July 21 Issue #374] . . . .  but took issue with my comment about questioning the need to incur the costs of being 'certified' any longer since I no longer owned a Medicare supply company.   Shane's response did not address the issue I raised of what is ABC and/or PFA doing to "brand" certified pedorthists from all the non-certified pedorthists that put Pedorthist on their business card and tell their customers why as a pedorthist they are qualified to provide SOLUTIONS to their foot problems.  

At least these individuals are not falsifying their credentials relative to actual certified pedorthists.

This week I had the opportunity to be in another local shoe store that the owner who is not certified, who has never has been certified, yet who over the years has portrayed himself as being a certified pedorthist in our community. And lo and behold, there is his Certificate of Attendance for a PFA conference from several years ago on display behind the cash register. And after his name on the certificate is C. Ped. Now I have reported this individual multiple times to ABC about his PNW posting where he added C. Ped. to his name and about his putting signage on his store about the availability of a board certified pedorthist when no C. Ped. worked for him, and previously for displaying this PFA seminar attendance certificate that has C. Ped. after his name. Yet every customer still gets to see at check out that he is a C. Ped. according to PFA. 

Not that any of the customers would know the difference between a C. Ped. and a Pedorthist, except for whatever he tells them.

Is ABC toothless in its ability to protect real certified pedorthists from knock offs?  Is PFA so oblivious about anyone who registers at a PFA seminar may or may not be a C. Ped. so no one at PFA checks their credentials (or lack of) on the ABC or BOC websites before putting C. Ped. or BOC Pedorthist on an attendance certificate? I think the answer to both these question is obvious in my community. How many other C. Peds. are spending a great deal of money each year to renew their ABC or BOC certificate, spending money to get the continuing ed. hours to maintain their certification only to have individuals falsely pose as a C. Ped. in their market? Or due to the lack of public understanding (branding), the uncertified pedorthist gets to tell the customer their version of their skills and knowledge.

So Shane, the question I posed early about whether or not I should keep spending money to be a C. Ped. now that I shut down my Medicare TSD supply company is a real question that needs a legitimate answer.  And meaningful actions to protect its paying C. Ped. practitioners, ABC. And common sense before handing out certificates, PFA.

- John Mishasek, BOC Pedorthist, C. Ped.

Response: There have been comments made on the Newswire recently that may have the potential of misleading readers as to the role and responsibility of the American Board for Certification in Orthotic, Prosthetics and Pedorthics (ABC) in regard to protecting, or "branding" the Certified Pedorthist. ABC actively protects the titles and designations that represent our credentialed professionals. If we are provided evidence that our titles and designations are being misused, we will take action.

Another issue that was raised pertains to the term "Pedorthist." ABC has trademarked and will protect the term "Certified Pedorthist" and the designation "C.Ped." As said earlier, if anyone misuses these terms, and we are provided evidence of this misuse, we will actively enforce their correct usage. What we are not able to do is prevent an individual from using the term "pedorthist." It is not within our ability to prevent someone from using this term. This holds true for all of our credentialed professionals. For example, individuals who are not ABC certified as orthotists are not allowed to refer to themselves as a "Certified Orthotist," however we have no jurisdiction over individuals who call themselves an "orthotist."

Additional information about our ethics program may be found in the Code of Professional Responsibility at www.abcop.org.

- Catherine A. Carter, ABC Executive Director

Response: The Pedorthic Footwear Association last issued certificates of attendance to its annual Symposium and Exhibition in 2006, before the merger between the Board for Certification in Pedorthics (BCP) and the American Board for Certification in Orthotics and Prosthetics (ABC). As such, ABC had no attachment to the certificate of the individual that John is referring to. At that time, an individual self-reported their credential when they registered for the Symposium, and the attendance information was given to BCP post-Symposium. Due to limitations in its membership database then, PFA didn't have the ability to store and verify the credential of everyone who registered. However, if they weren't a C. Ped., and they reported that they were, it would have been a moot point as far as their continuing education points were concerned since there wouldn't be a credential record to match the attendee and points to. Furthermore, PFA, as a professional membership organization, does not make any claims as to the credentialed status of a member or Symposium attendee.

Now, PFA and ABC share information prior to the start of the Symposium registration process, pre-populating as many records as possible on-line to facilitate accuracy in reporting post-Symposium, and also for the functionality of PFA's on-line searchable database of credentialed PFA members. However, one does not need to be a credentialed pedorthist or a member of PFA to attend a PFA Symposium, as the symposium is offered at non-member prices for industry related individuals seeking further information regarding Pedorthics.

That an individual has a certificate of attendance to a PFA Symposium hanging in their facility, indicating or not indicating a credential, doesn't bestow on that person anything other than the fact that they attended that Symposium. Again, as stated earlier, PFA did away with certificates in 2006, and has moved to attendee session scanning to more accurately record attendance. It's true that this could easily confuse a person entering the facility, however, a good amount of businesses nationwide also display old Better Business Bureau Certificates, which technically is fine because at the time they were awarded, the business WAS a member in good standing.

John made an interesting point alluding to the fact that people attend the Symposium only for their continuing education points. I would hope, given the time, effort, expertise and expense that goes into producing the Symposium and Exhibition, and the money that attendees pay to be there, that they are there for more than the CEUs...that they are there to actually learn something new, network with colleagues, visit the exhibitors and share their knowledge. 

- Brian K. Lagana, Executive Director, Pedorthic Footwear Association

PREVIOUS QUESTIONS WITHOUT RESPONSES

Question: Does anyone have a clear understanding of the issue(s) concerning physicians with and without PECOS numbers and billing Medicare for therapeutic shoes, and medical supplies for that matter? Also, Does anyone have a clear understanding on physician's PROGRESS NOTES and documentation now required?

- Stuart Pressman, Florida

ANNOUNCEMENTS

The Robert M. Palmer Institute will be offering two Pre-certification in Pedorthics courses in Brea, California on December 4 - 13, 2010 and April 2 - 11, 2011.  Levels 1 and 3 can be performed online while Level 2 will be held at Biomechanical Services at 1050 West Central Avenue, Brea, California, 92821-2200. To enroll in this course please visit the RMPI website at www.rmpi.org or email the RMPI at online@rmpi.org. Be sure to mention the "Biomechanical Services Scholarship" which reduces our published tuition from $4K to $3K due to the generosity of Biomechanical Services who believes in the mission and vision of the RMPI - education for everyone!

MASTERFIT UNIVERSITY TRAINING CENTERS EXPANDS OFFERINGS FOR PEDORTHISTS SEEKING CONTINUING EDUCATION CREDITS

Masterfit University, the snowsports industry's official fit education centers, has expanded its focus on hiking boots and trail running shoes and its Backcountry Connection course now includes a separate track for hiking boots and trail shoe specialists. There is also a track for specialists in Alpine touring and Telemark ski boots.

Masterfit U's Masters, Masters-Backcountry Connection and Masters Plus courses individually qualify for continuing education credits from both the American Board for Certification in Orthotics Prosthetics & Pedorthics (ABCOP, 14 credits) and the Board for Orthotist/Prosthetist Certification (BOC, 14.08 credits).

The Master's Course, is an intensive two-day session for pedorthists and experienced fit technicians packed with practical information. Students learn everything from biomechanical analysis techniques that let them better match skiers and snowboarders to the right boots to advanced modification and stance balancing strategies and footbed construction techniques. The course provides extensive experiential learning sessions in seminar-style workshops with top industry pros.  

Backcountry Connection is a two-day program that parallels MFU's core Master's Course curriculum and teaches the techniques necessary for fitting and modifying Alpine Touring, Telemark and hiking boots as well as trail shoes for both comfort and performance.

The Masters Plus ("Dark Arts") Course, is a two-day "doctorate" in boot fitting. The advanced curriculum is designed for prior attendees who are already near the pinnacle of experience and knowledge and want an immersion experience to study more complex modification techniques and strategies. (Master's Plus is held only at Stratton, Breckenridge and Reno locations and is open only to Masters Course graduates.)

Most MFU trainers (including founder Jeff Rich, Backcountry Connection curriculum developer Bob Egeland and curriculum director Mark Elling) are ABC Certified Pedorthists and have extensive experience in fitting and adapting active sports footwear.

Masterfit University's content has been recognized by several national professional certification organizations. All Master's Course versions including The Backcountry Connection qualify for continuing education credits from:

· The American Board for Certification in Orthotics, Prosthetics & Pedorthics (14 CEPs)

· Board for Orthotist/Prosthetist Certification (14.08 CPEs)

· Board of Certification for the Athletic Trainer (13.25 CEUs)  

· Professional Ski Instructors of America-East (Update credit)

The New European Ecological Criteria for Footwear

The European Commission's new ecological criteria and related assessment and verification requirements (2009/563/EC) for awarding the EU Ecolabel to footwear has come into effect.

Decision 2009/563/EC effectively replaces Decision 2002/231/EC. Applications for ecolabel footwear submitted between 1 July 2009 and 31 March 2010 may be based on the criteria set out in either Decision. However, from 1 April 2010 onwards, only the criteria in Decision 2009/563/EC may be used in the evaluation and awarding of the EU Ecolabel award to footwear products.... The new criteria are aimed at promoting more durable footwear with lower environmental impact in the European Union. Full Text

Source: istockanalyst.com

Aetrex Named One of Top 100 Privately Held Companies in New Jersey

Aetrex Worldwide has been named one of the top 100 privately held companies in New Jersey, according to NJBIZ Magazine.  "Leading a successful business in today's economy requires hard work," writes Thomas J. Marino, CPA, partner and CEO at J.H. Cohn LLP. "Reaching the NJBIZ list of Top 100 Privately Held Companies in New Jersey calls for much more. Whether you've been in the Top 100 for years or just recently made it to the list, this success comes to companies that work smarter and have a passion for excellence."  Full Text

Source: NJBIZ Magazine

Ulrich Grimm's Focus on Footwear

By Elisa Anniss

Seasoned shoe designer Ulrich Grimm recently stepped out from behind the scenes at Calvin Klein Inc.

In June, the 45-year-old, German-born creative director of Calvin Klein men's and women's shoes and accessories was inducted into the Council of Fashion Designers of America. And last month, he appeared at the brand's staging of the "World of Calvin Klein" in Berlin during the city's Fashion Week, featuring 70 models showing every aspect of the business, including ready-to-wear, underwear and accessories. It was the company's largest European event to date, with a reported cost of $1 million. Full Text

Source: Footwear News

Feds Accuse Memphis Podiatrists of Defrauding Medicare

American Home Podiatry LTD Inc. and two physicians associated with the business are accused of defrauding Medicare in a civil complaint filed this week by the U.S. Attorney's office in Memphis.

The podiatrists named as defendants are Dr. James D. Luvison and Dr. Robert Ramoska.

The complaint, which only gives one side of a legal dispute, alleges that the doctors "developed a scheme to defraud by submitting false claims and/or causing false claims to be submitted" through the company. Full Text (scroll to story)

Source: Memphis Daily News

Submit course listings to: editor@pedorthicnewswire.com

MONTHLY AND ONGOING

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. 

Traveling Courses To Your Area sponsored by The Robert M. Palmer, M.D., Institute of Biomechanics, Inc. a not-for-profit pedorthic school. Please contact us to discuss your needs at phone: 765-557-7216. Email: pam@pedorthicbiomechanics.org or visit our Web site at: http://www.pedorthicbiomechanics.org/.

The Robert M. Palmer, M.D., Institute of Biomechanics, Inc. a not-for-profit pedorthic school: Advanced Manufacturing - 50 Hour Course - Approved for 49.5 CME's for Pedorthists by the ABC. This course is designed to teach BAPFOL standards in manufacturing functional feet orthoses and provide an introduction to advanced biomechanical posting. Class size is limited to two students. For more information or to customize a course to meet your manufacturing educational needs, please email pam@rmpi.org or phone 765-557-7216. Tuition cost: $2K - includes housing and transportation to and from the airport and school. 

The National Shoe Retailers Association is pleased to bring training and CEs directly to you, without the additional cost of travel, food, lodging, registration fees or lost work time. Our affordable WISER Sales Training DVD makes in-house training easy and there's now an online exam for Continuing Education credits from ABC and BOC.

WISER Sales Training provides quality training for new sales associates and re-motivates experienced sales staff. The DVD format makes it easy for employees to train at times convenient for them, and for employers to offer quality training without hiring outside trainers or taking the most experienced staff off the sales floor. ABC's Category 1 CEUs for WISER Sales Training total 21.75 credits (2.5 scientific, 19.25 business), good through year 2010. BOC's credit total is 20.34 (6.42 CPE Category 1, 13.92 Category 2).

Pricing for the program is as follows:

DVD, workbook and guide for trainers Members: $295 (Non-Members $395)

Additional Handbooks: $10 each

Online Test Members: $100 (Non-Members: $200)

For more information or to order, click http://www.nsra.org/wiser_intro.php?ad=pn

or call or email Veanne Lupia at 1-800-673-8446, ext. 7006, veannel@nsra.org.

Aetrex Worldwide Pedorthic Results Seminars

Attendees will learn the importance of a thorough evaluation using traditional and computerized methods.  The differences of various foot types and their individual requirements in choosing the proper footwear, foot orthoses and external shoe modifications will be discussed.  A hands-on workshop is also included.   ABC - 7.5 Scientific Credits; BOC - 7.75 CPE Category 1

For information on Aetrex Worldwide Pedorthic Results Seminars, please contact the Aetrex Marketing Department at: marketing@aetrex.com. 

2010 Pedorthic Results Seminars Calendar:                   

August

          26      Las Vegas, NV                  

September

          14      Minneapolis, MN       

October

          4        Seattle, WA            

          6        Oakland, CA            

          11      Los Angeles, CA                                   

          19      Teaneck, NJ            

          26      McCallen, TX                     

          28      Baton Rouge, LA      

November

          9        Indianapolis, IN                 

December

          7        Orlando, FL

AUGUST, 2010

INTERNATIONAL SCHOOL OF PEDORTHICS SUMMER SCHOOL SCHEDULE

HUGO MN

AUGUST 30^th- SEPT 4^th CEU CLASSES

For more information contact 702 449 0974 or email kathymeanwell@yahoo.com. 

SEPTEMBER, 2010

The Midwest Chapter of The American Academy of Orthotists & Prosthetists is holding its annual meeting in the Grand Geneva Resort, WI in September.  The scientific meeting will be held Sept. 17 & 18.The chapter has created a Pedorthic specific educational component, with 4 hours of CEU education.  For more information please log on to www.mwcaaop.org.

The Masters Plus ("Dark Arts") Course, is a two-day "doctorate" in boot fitting. The advanced curriculum is designed for prior attendees who are already near the pinnacle of experience and knowledge and want an immersion experience to study more complex modification techniques and strategies. (Master's Plus is held only at Stratton, Breckenridge and Reno locations and is open only to Masters Course graduates.)

Most MFU trainers (including founder Jeff Rich, Backcountry Connection curriculum developer Bob Egeland and curriculum director Mark Elling) are ABC Certified Pedorthists and have extensive experience in fitting and adapting active sports footwear.

For more information on all Masterfit University courses or to register, visit www.masterfituniversity.com or contact: (914) 944-9038, info@masterfitinc.com

NOVEMBER, 2010

2010 North American Pedorthic Congress - Pedorthics and the Global Footprint - jointly produced by PFA and the Pedorthic Association of Canada.  November 18 - 21, 2010, Hilton Walt Disney World Resort, Orlando, FL.  For more information, visit http://www.pedorthiccongress.org