November 16, 2010, Issue #391

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: How many practitioners out there are using digital cameras to capture photographic evidence to support custom orthotics or shoes? How do you organize/store these? Do you only use digital photos for the "at risk" cases, or all cases?

- Rick E. Sevier - BS Ed. BOC Orthotist C. Ped. L. Ped CPOA

PREVIOUS QUESTIONS AND COMMENTS WITH RESPONSES

Original Question: Am I missing something? How are other practitioners fabricating their diabetic fo's? The descriptor for A5513 is "Diabetic multiple density insert, custom molded from model of patient foot," and the descriptor for L3020 is "Foot insert, removable, molded to patient model, longitudinal/metatarsal support, each." To me, there really is no difference here, with the exception of the "longitudinal/metatarsal support." Obviously, the A5513 has the same features, and if there are labs fabricating "custom molded" diabetic fo's by heating up a prefab and "forming" it over a patient's mold, they are not a true custom fo, as they do not take on the shape of the patient's feet. I fabricate my A5513 fo's with trilam (with a pzote or pcell topcover), with either an eva or cork archfill if needed for heavier or more active patients. If I were to fabricate an L3020 for a diabetic patient, it would be built pretty much the same way. Doesn't a diabetic need to have a soft conforming top cover to accommodate prominent bones and high pressure areas? Wouldn't you use the same type of top cover for an L3020 that you are giving to a diabetic? So, what is the difference between the A5513 and L3020?

To me, losing a patient and knowing that they might go elsewhere and receive substandard care is not something that I am OK with. An accommodative orthotic is an accommodative orthotic. Whether it is a diabetic orthotic or an accommodative orthotic for diabetes or arthritis, it's pretty much fabricated the same way (with the exception of some different materials). I think it all boils down to reimbursement.

Don't get me wrong, I am not trying to reinvent the wheel or stir the pot, but to hopefully gain a better understanding as to why, in our small profession, we do things so differently. Let's try to share our ideas and constructive criticism in a positive manner and come up with positive solutions - not just for pedorthists, but also for our patients.

- Joe Eads, C. Ped., COF

Previous Response: Joe, you MAY be missing a key point. I do not mean this disrespectfully, but it is a key nuance. I will oversimplify to make the point. "Every" accommodative diabetic custom foot orthosis (with guts/control) may be an L3020, but not every L3020 is an A5513. You cannot simply look at the description of A5513; you have to look to the elaborations in the LCD. They key point is this: "The base layer of the device must be at least 3/16 inch of 35 Shore A or higher material. [...] The specified thickness of the lateral portions of the base layer must extend from the heel through the distal metatarsals and may be absent at the toes." So, if your device has a base layer of cork (i.e. a cork shell) and that shell stops PROXIMAL to the mets rather than extending DISTAL to the mets (and being 3/16 inch at the mets), then your L3020 is NOT an A5513. You are committing fraud if you bill it as an A5513 and it does NOT HAVE THE 3/16" BASE LAYER EXTENDED UNDER THE METS. We use the A5513 all the time in custom molded shoes. However, the required design of the A5513 is rarely the best for OTS (off the shelf) shoes. Rarely is it a plus to make the device that thick at such a critical pressure area (the mets). Now, on some we may need to in order to unload one or more of the mets, however, rarely are such unloads fabricated from the base layer (i.e. extensions of the cork shell). We are usually adding our unloads from a different, firmer material, such as Nickleplast.

If you use a diabetic trilam and cork device, the cork is the base layer, not the royal blue pelite. If all you have under the mets is the royal blue pelite, your base layer does not extend to the distal mets. We may all fabricate our devices different ways and attempt to support and unload the foot in different ways. However, if your BASE layer does not extend TO THE DISTAL METS and isn't 3/16 INCH UNDER THE METS, then it is NOT an A5513 and should not be billed that way.

- PNW Reader

New Response: In regards to " PNW Reader's" comments: No disrespect taken. The base layer of my diabetic fo's runs through the met heads, so I am providing proper diabetic fo's. What I am trying to get across is that an A5513 and an acommodative L3020 are made the same as far as the positive cast is concerned in my practice. We are trying to acommodate and not biomechanically correct. The only difference, as we have both pointed out, is the material used, and every practitioner has their favorite material. The base material should taper as it goes under the met heads toward the toes.

Also stated in the LCD is: Code A5513 describes a total contact, custom fabricated, multiple density, removable inlay that is molded to a model of the patient's foot so that it conforms to the plantar surface and makes total contact with the foot, including the arch. A custom fabricated device is made from materials that do not have predefined trim lines for heel cup height, arch height and length, or toe shape.

I think that pretty much sums it up. So if there are labs heat molding prefabs to a positive model of a patient's foot, then they are not following these guidelines. Unfortunately I think this happens. I have used multiple labs for fabrication and the majority of orthotics come back with no arch, too wide of a heel cup, odd trimlines.

- Joe Eads, C. Ped, COF

Question: I recently received the following email from a PT asking for ideas. I thought I would throw it out there to the PNW readership for help, as I do not do very much in the way of pediatric pedorthics:

I am a pediatric physical therapist who does home health through Missouri and Illinois Early Intervention. I am working with a child who has such severe skin breakdown that he cannot wear shoes. The skin disease is not yet diagnosed, but he's struggled with it since birth and is now about 18 months old. He is walking, but cannot have anything on his feet without blisters/sores/breakdown. Sometimes it is the seam inside the shoe, and sometimes it is the friction of the shoe moving. We have tried shoes with good support, a "croc" shoe with no seams, and a sandal. None work. I'm looking for some brainstorming ideas. I was thinking of the material they use between skin and a prosthesis for an amputee, or a type of "diabetic" shoe for a toddler, or a special sock. Any ideas?! I would love to hear your take on this unique situation.

I will pass on any ideas. Thanks for your help, PNW!

- Erick Janisse, C. Ped., CO, National Pedorthic Services, Inc.

Response: It sounds like it could be Epidermolysis bullosa (EB). I suggest that you refer to http://www.debra.org/ for more information.

We manufacture and donate a product called weEBors for children with this disease. and our product has helped in some instances.

Please contact me directly for more information.

- Stephen O'Hare, stephenohare@pedors.com

Response: I believe the Pedors line of footwear was originally designed for children with E.B (Epidermolysis bullosa), which is a skin blistering disease. We use quite a few of these shoes with good success for people who cannot tolerate more rigid footwear.

I have found that when all else fails in terms of skin breakdown from footwear, natural sheepskin always seems to work. There are a number of sheepskin bootie-type slippers for children that can be adapted with crepe soles, Velcro or lace closures, heel counters, etc. as needed. There are also some that can be used for ambulation right out of the box, such as the UGG boots. If there are significant foot abnormalities, it is also possible to make a custom shoe that is lined with sheepskin.

I have found that in some cases, people do well with a well-fitted sock inside the sheepskin shoe, but care must be taken to watch for bunching of the socks, especially at the heel area. The sheepskin has a tendency to pull the sock down with each step if there is any heel movement in the shoe. Often we use the sheepskin against the skin with no sock, but this should never be done if there are any open lesions on the skin, since the wool fibers can irritate them. Using the sheepskin with no sock does pose more hygiene issues, but if done gently with the right cleaning agents, sheepskin can be washed. Unlike most synthetic padding materials, sheepskin has the advantage of leaving the skin relatively dry, which is important in preventing breakdown.I hope this helps.

- Karin Koelle, Assistive Technology Specialist, Sonoma Developmental Center

Response: This sounds very much like epidermolysis bullosa or "EB," a rare disorder that is largely hereditary (about 1 in every 50,000 live births is affected with some type of EB). There are several different types of the disease, including simplex (the most common, in which blistering is primarily limited to the outer layers of skin and mucous membranes), dystrophic (a more severe type in which blistering manifests in both the outer and lower skin layers as well as internally), and junctional (the rarest of the types of EB, but a very severe and often debilitating type). There are other types and sub-types of EB, but it is always a serious condition not only in terms of compromising the person's quality of life, but also in terms of the danger of infection and other corresponding conditions related to the breakdown of the skin.

We have a number of cases in which people, especially children, with EB have benefited from wearing thick cushion Thorlos sock products. The terry padding in the Thorlos design helps reduce the pressure and shear forces that lead to blistering on the feet (two peer-reviewed research studies confirm the blister reduction benefits of Thorlos). Please note that proper fitting of shoes with thick cushion Thorlos is essential for their effectiveness in pressure and shear force reduction.

More information about EB can be found here: http://www.debra.org/.

-Rick Mende, THOR●LO, Inc.

Response: I would suggest the diabetic gel sock, where the entire plantar area has gel within the interior of the sock; the sock would need to be altered to fit the child's small shoe size, but a local seamstress or most likely, your own company can alter the sock accordingly. I would also consider a Reicken's gel orthosis or insole that can be transferred from shoe to shoe. Lastly, my brother-in-law was the team podiatrist for the Indiana Pacers, and one trick he did to prevent skin breakdown was to Vaseline the athletes feet and place a woman's knee high nylon hose over the foot with plenty of Vaseline. A standard athletic sock was then applied to the foot.

- Pam Haig, Robert M. Palmer Institute

Response: http://www.healthyfeetstore.com/pedorweebors.html

- Barbara Adams, Healthyfeetstore.com

Question: This past week over 45,000 runners participated in the New York Marathon. Runners of all shapes, sizes, and stamina levels were challenged to their potential and beyond. What advice would you give to them to keep their feet in good shape, before, during and after participating in a strenuous 26.2 mile marathon? Is the RICE formula sufficient?

Rest your feet.

Ice helps keep inflammation and swelling down.

Compression with ACE wraps will also reduce swelling.

Elevation will help your feet rest up for the next big run.

What do you suggest?

- Robert S. Schwartz, C. Ped.

Response: RICE is a place to start. It all depends on where a person is starting from. If they have no foot problems to begin with, then as long as they build up their mileage gradually using the 10% rule (increasing weekly mileage by no more than 10% each week) they should be fine with RICE. If they are wearing orthotics, the same is true, as long as they have had the orthotics in their shoes during their marathon build-up. If they received their orthotics just prior to the race they better be very careful. They may get blisters, sore feet, or worse if their body hasn't had time to adjust to wearing the orthotics. As far as during the race, I've found that rubbing a lubricant, such as Body Glide, generously on the plantar surface and sides of the forefoot, toes and heels, and any other spot I've had problems with during my training helps immensely. After the race, I recommend to all my patients who are runners, that they wear a very roomy recovery shoe for a few days when they are on their feet. They should try to stay off their feet for a couple of days to let the tissues heal, removing their shoes and socks as much as possible to let the feet breathe. This is what I do personally. In fact, I am recovering from a marathon as I write this, having run the Indianapolis Monumental Marathon on November 6^th, in which I qualified for the Boston Marathon by running the race in a time of 3 hours, 29 minutes and 51 seconds (I just needed to do a 3:30:59, made it across with one minute and 8 seconds to spare!).

Do any other C. Peds run marathons? If so, I'd be interested in hearing about it!

- Kyle Roberts, C. Ped. Milwaukee, Wisconsin, 9 time marathon finisher, Footworks Orthotics, Inc.

Response:Below is the information I give to Team-in-Training participants. It is pretty basic and easy to follow, and covers everything before, during, and after the race. Foot Care Tips for Healthy and Happy Feet Before the Race Toenails too long catches on socks - trim them short. Then file toenails smooth. Use a nail file to smooth calluses. Clean out lint and junk from inside shoes. Check your shoelaces and replace if frayed. Race Morning Apply a layer of your favorite lubricant or powder. Smooth your socks around your feet. Avoid tying laces too tight. During the Race If you feel a hot spot: apply a pad, a bit of tape, a dab of lubricant, or an energy wrapper between your sock and shoe. Loosen shoelaces if you have pain on the top of your foot. After the Race Drain blisters only if they are in a pressure area. If you have blisters, soak your feet in Epson salts and warm water three times a day. Trim edges of loose skin around blisters. If feet are swollen, elevate and ice. - John Vonhof, Fixing Your Feet: Prevention and Treatments for Athletes, 4th edition, http://www.fixingyourfeet.com

PREVIOUS QUESTIONS AND COMMENTS WITHOUT RESPONSES

Question: How have Medicare's new documentation requirements for dispensing diabetic shoes affected your business? Have you seen a decrease in prescription referrals to your office? Have the doctors been cooperating with your requests? What has been the biggest challenge for you as a supplier?

- Curious and frustrated fellow C. Ped.

Comment: Went through my first prepayment review...and flunked! Thanks to the certifying doctor who checked off "poor circulation" on the certifying form...and upon receiving the patient's notes from the doctor...no mention of poor circulation! He did, however, note neuropathy, but did not check that off on the certifying form. So no pay!

It's totally ridiculous that the Pedorthist needs to worry about the Rx that the Doctor signs. Are we not filling a prescription?? Do pharmacists need to get patient notes for all their prescriptions??? PFA must make this matter their number 1 priority. I am accredited by ABC; they have seen all my forms, etc. and I am golden with them. Then Medicare pulls a facility visit and checks everything including patient files...no problem there. Because the certifying Doctor doesn't do his/her job, I am penalized. Totally unfair. Thanks for letting me vent.

- Rick Snyderman C. Ped., L.Ped

Comment: I have been reading the PNW on and off in the past months. I say it this way because there are times I can't read it, as I get so frustrated with the issues. I am disappointed in our Pedorthic Industry support system. PFA & ABC were supposed to be there to have the Pedorthic Industry best interests at "heart." I haven't seen much help. It doesn't appear to this Pedorthist, that they wish to help the industry survive. I get very frustrated with the issues, medical supply shops and others who have no real training doing our job, the lack of reimbursement...but I digress, we all know the issues. I unfortunately see the demise of the industry in the near future. No one would want to come into this industry with the problems with reimbursement and other issues, especially if they do their homework first.

I agree that educational requirements need to change, but an associate's degree is very expensive to come into an industry where you lose money by taking insurance, if you do quality work. Very sad situation. Eight years ago, when I decided to come into this industry. I thought it would continue to retirement. Unfortunately, it has retired before I was ready.

Unfortunate, as in my town there is really no quality place for the people to go, and I don't just mean the diabetic. Most places that do the orthotics do poor quality work, providing more risk than value. The quality places are either stopping altogether or, like myself, only seeing cash pay patients. This is so unfortunate for the public.

It is very sad to see where the industry is going, as it is so important.

- Lee A. Hunter

SPONSOR NEWS

HEALTH AND INDUSTRY

Special Mobility Shoes Can Help Ease Knee Pain, Slow Down Osteoarthritis

A study has suggested that use of special mobility shoes can help ease knee pain and slow disease progression in people with osteoarthritis. Osteoarthritis, or OA as it is commonly called, is the most common joint disease affecting middle age and older people. It is characterized by progressive damage to the joint cartilage, the cushioning material at the end of long bones, and causes changes in the structures around the joint. These changes can include fluid accumulation, bony overgrowth, and loosening and weakness of muscles and tendons, all of which may limit movement and cause pain and swelling. Full Text

Source: sify.com

Orthopaedic Surgeons Across the Country Announce Partnership with Soles4Souls®, Inc.

Soles4Souls announced Wednesday their participation in the Conti Project, a yearly event dedicated to providing the less fortunate people across the nation with free foot screenings and footwear. Soles4Souls has merged efforts with Our Hearts to Your Soles, which was founded by Dr. Stephen Conti,this year to form the Conti Project. This is the fifth national effort to help relieve the foot problems experienced by area homeless. The event will be held in more than 40 cities nationwide. Full Text

Source: PRNewswire

U.S. Retail Hiring Surges Ahead of Holiday Season

Retailers are on pace to hire the most temporary workers for the holiday season in three years, according to outplacment firm Challenger, Gray & Christmas, Inc. Retail stores increased payrolls by 150,900 in October - three times more than the same month in 2009 - based on data from the U.S. Labor Department. "This is a good sign that retailers feel more optimistic this year," said John A. Challenger, chief executive of Challenger, Gray. Full Text

Source: MarketWatch

Walmart and More: Online Holiday Shopping with Free Shipping, No Minimum Purchase Required

The big news today in online holiday shopping is that Walmart is offering totally free shipping-no minimum purchase requirements whatsoever-for thousands of items purchased at its website, including plenty of toys, electronics, and other popular gifts. It's not even Thanksgiving, and the retail giant is throwing its weight around, throwing down the gauntlet, and otherwise throwing everything it's got at the competition for holiday shopper dollars. But while Walmart is the biggest, it's hardly the only retailer with no-minimum-purchase free shipping. Full Text

Source: Time

AETREX iSTEP WEBINARS

View our Full November 2010 Webinar Calendar

DIABETES

Probe-to-Bone Best Test for Diabetic Foot Osteomyelitis

The best and most efficient test for diagnosing chronic osteomyelitis of the foot in patients with diabetes may be the probe-to-bone (PTB) test, according to research published in the October issue of Diabetes Care. Rosario Morales Lozano, Ph.D., of the Universidad Complutense de Madrid in Spain, and colleagues conducted a prospective study of patients with diabetic foot ulcers to compare diagnostic tests used for identifying chronic osteomyelitis of the foot, including PTB, clinical signs of infection, radiography, and ulcer specimen culture, using bone histology as the gold standard. Full Text

Source: DoctorsLounge

Patient Interactive Program Designed to Curb Preventable Loss of Lives and Limbs to Diabetic Foot Wounds

Media and the Canadian public recently got a first look at a new interactive patient education program specifically designed to address the rise in Canada of diabetic foot wounds and lower limb amputations.

'Diabetes, healthy feet and you' was developed by the Canadian Association of Wound Care (CAWC) with the support of the Public Health Agency of Canada. The multi-media program will provide information and education for effective self-monitoring, early detection, treatment and prevention of costly and life-threatening diabetic foot wounds among Canadians with diabetes. The program takes an innovative approach and is backed by the publication of the majority of the materials in 18 different languages that meet the needs of all Canadians. Full Text

Source: Digital Journal

SPORTS AND FITNESS

Plantar Fasciitis Stretching Treatment Works

Plantar fasciitis is a very common and painful problem. But the good news is that a simple plantar fascia stretch can provide relief better than getting expensive shockwave therapy, according to a study in The Journal of Bone and Joint Surgery.

The study followed 102 patients with new cases of acute plantar fasciitis. One group performed an eight-week plantar fascia-specificstretching program, while another received weekly repetitivelow-energy radial shock-wave therapy without local anesthesia,for three weeks. The results: at two months, 65% of the plantar fascia stretching group were satisfied with the pain relief, while only 29% of the shockwave therapy patients were satisfied. The same was found at four months. By 15 months, both had the same level of relief. Full Text

Source: About.com Walking Blog

BECOMING CERTIFIED IN PEDORTHICS

Pedorthics is a professional field covering the design, manufacture, modification and/or fit of footwear. Pedorthics encompasses shoes, orthoses and foot devices that prevent or alleviate foot problems caused by disease, overuse, injury or congenital defect. Certified Pedorthists work with patients and their footwear to conform to a doctor's footwear prescription as part of the patient's treatment

To earn certification in Pedorthics, you must take a pre-determined number of course hours in pedorthics and pass a certifying examination overseen by either The American Board for Certification in Orthotics, Prosthetics & Pedorthics® or Board for Certification/Accreditation, Int'l. Both the ABC and BOC are independent certification bodies that set standards for the profession and offer certifications that are recognized by the National Commission for Certifying Agencies.

More information, including FAQ's

The American Board for Certification in Orthotics, Prosthetics & Pedorthics information on the step-by-step process of becoming a certified pedorthist

Board of Certification/Accreditation International information on becoming a BOC Pedorthist.

For information on the Canadian certifying organization visit The Pedorthic Association of Canada.

ONGOING COURSES AND EDUCATIONAL OPPORTUNITIES FOR BECOMING CERTIFIED IN PEDORTHICS

The Robert M. Palmer M.D., Institute Of Biomechanics "A Not-For-Profit School" has uniquely designed courses to provide pedorthic 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. Click here to view a detailed calendar including dates and locations, information and pricing.

CFS Allied Health Education: Pedorthic Certification: Exam Review. This review is focused on supplying the student with the skills and knowledge needed to pass the ABC Certified Pedorthic exam by presenting exam-like questions, exploring possible answers, and discussing rationales for correct and incorrect answers. Contact CFS Allied Health Education at (918) 266-3678 or visit http://www.learnpedorthics.com/ for more information.

*ABC and The American Board for Certification in Orthotics and Prosthetics are registered trademarks of the The American Board for Certification in Orthotics and Prosthetics, Inc., which is not affiliated with CFS Allied Health Education and does not endorse this review.

ENESLOW PEDORTHIC INSTITUTE 1-on-1 or Group Tutoring Available; Eneslow Training & Tutoring Program, Individual and Small Group Program

WHO SHOULD COME:

Those who wish to prepare for the Certified Fitter of Therapeutic Shoes or the

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SUBJECTS: PEDORTHICS - SALES -RETAIL MANAGEMENT

Pedorthic Assessment - Pedorthic Shoe Fitting - Pedorthic Solutions Footwear - Foot Orthotics

Foot Products - Ready-made - Custom Shoe Constructions and Designs

Shoe Modifications - Casting and Evaluation Techniques for Custom Shoes & Orthotics - Business and Practice Management Finance & Administration

Forecasting & Budgeting - Buying & Inventory Control Marketing & Advertising Professional Responsibility - Safety - Human Resources Biomechanics Pediatrics

Pathology of Diseases and Malalignments

HANDS-ON 1-ON-1 INSTRUCTION

$150/ hour for individual training

GROUP TRAINING

$125/hour per person for two or more participants in the same program at the same time

$100/hour per person for five or more participants in the same program at the same time

Fee: Two hour minimum

HANDS-ON 1-ON-1 TRAINING WITH ROBERT S. SCHWARTZ, CPED, OR DR. JUSTIN WERNICK, DPM, CPED

$250/hour for individual training &

$200/hour per person for group training

Added Value: An insider's look into the retail, pedorthic, sales, store operations, and business management of Eneslow.

ABC and BOC points may be applied for.

ENESLOW PEDORTHIC INSTITUTE, 470 Park Avenue South at 32nd Street, New York, NY 10016. Call for more info (212) 477-2300 (Ask for Sarah Goldberg, CPED) (212) 353-2876 Fax

email: epi@eneslow.com or visit http://eneslow.com/epi

Pro-Learn, LLC announces its new CAPE approved Pedorthic Pre-certification program

Pro-Learn's program is accredited by the Commission on Accreditation of Pedorthic Education (CAPE) to provide Levels 1, 2 and 3 of pedorthic pre-certification coursework required by ABC and BOC to become eligible to apply and sit for board examination. ProLearn utilizes the latest technology in Distance Learning and Virtual Classrooms. This is the same Distance Learning Program technology model used by advanced O & P schools used to deliver their curriculum. This allows maximum flexibility in our programs that gives the student choices that fit their busy lifestyle, level of experience and learning style. Programs vary from three-week, live classes to completing the coursework completely online (Experienced, advanced degree holding healthcare professionals only). Our staff and faculty is composed of degree holding healthcare professionals who are Pedorthists, Nurses, O & P, Professional Pedorthic Educators and Physicians.

Please visit www.pro-learn.com or email cmartin@pro-learn.com for more information to assist you or your staff in making a decision on the right option for you, your business, your family, and your lifestyle.

COURSES

DECEMBER, 2010

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: December 4-13, 2010 - Elwood, Indiana - Holiday Scholarship Available - Please visit our website or contact pam@rmpi.org - Phone: 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. Private Apartment Housing is also available by request and comparably priced within walking distance from the RMPI.

2011 COURSES

JANUARY, 2011

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, Beijing, Mainland China and Korea are available. Level 1 & 3 performed online - Level 2 Dates: January 8 - 17, 2011 - Final Course For May Exam (Orlando, Florida)

Condensed course hours available upon successful completion of pre-entrance exam. Scholarships Available - Please visit our website at www.rmpi.org or contact pam@rmpi.org - Phone: 765-557-7216.

Pedorthic Pre-Certification Training Course January 24th - February 7th, 2011

In cooperation with the ABC and BOC 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 or BOC exams.

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 or BOC exam to earn their Pedorthic Certification (CPED or BOC 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 or www.bocusa.org.

Pedorthic Pre-Certification Course January 24th - February 7th, 2011 - $3,995

FEBRUARY, 2011

Foot Solutions Pedorthic Pre-Certification Course: Class date February 14-25, 2011

Foot Solutions is an accredited facility that holds classes three times per year. The company's course will offer the pre-certification in Pedorthics 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

Upon completing our course and successfully passing the competency tests, and fulfilling the 1,000 hour "Clinical practice Requirement" students are eligible to sit for the ABC or BOC exam to earn their Pedorthic Certification (CPED Pedorthist).

MARCH, 2011

Condensed course hours available upon successful completion of pre-entrance exam. Scholarships Available - Please visit our website at www.rmpi.org or contact pam@rmpi.org - Phone: 765-557-7216.

APRIL, 2011

The Robert M. Palmer Institute will be offering a Pre-certification in Pedorthics course in Brea, California on 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!

MAY, 2011

Condensed course hours available upon successful completion of pre-entrance exam. Scholarships Available - Please visit our website at www.rmpi.org or contact pam@rmpi.org - Phone: 765-557-7216.

JUNE, 2011

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, Beijing, Mainland China and Korea are available. Level 1 & 3 performed online - Level 2 Dates: June 4 - 13, 2011 (Orlando, Florida) and June 18 - 27, 2011 (Elwood, Indiana)

Condensed course hours available upon successful completion of pre-entrance exam. Scholarships Available - Please visit our website at www.rmpi.org or contact pam@rmpi.org - Phone: 765-557-7216.

JULY, 2011

Condensed course hours available upon successful completion of pre-entrance exam. Scholarships Available - Please visit our website at www.rmpi.org or contact pam@rmpi.org - Phone: 765-557-7216.

AUGUST, 2011

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, Beijing, Mainland China and Korea are available. Level 1 & 3 performed online - Level 2 Dates: August 20 - 29, 2011 - Final Course For November Exam (Elwood, Indiana)

Condensed course hours available upon successful completion of pre-entrance exam. Scholarships Available - Please visit our website at www.rmpi.org or contact pam@rmpi.org - Phone: 765-557-7216.

SEPTEMBER, 2011

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, Beijing, Mainland China and Korea are available. Level 1 & 3 performed online - Level 2 Dates:September 3 - 12, 2011 (Orlando, Florida) and September 17 - 26, 2011 (Elwood, Indiana)

Condensed course hours available upon successful completion of pre-entrance exam. Scholarships Available - Please visit our website at www.rmpi.org or contact pam@rmpi.org - Phone: 765-557-7216.

NOVEMBER, 2011

Condensed course hours available upon successful completion of pre-entrance exam. Scholarships Available - Please visit our website at www.rmpi.org or contact pam@rmpi.org - Phone: 765-557-7216.

DECEMBER, 2011

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, Beijing, Mainland China and Korea are available. Level 1 & 3 performed online - Level 2 Dates:December 10 - 19, 2011 (Brea, California) - To Be Confirmed Soon

Condensed course hours available upon successful completion of pre-entrance exam. Scholarships Available - Please visit our website at www.rmpi.org or contact pam@rmpi.org - Phone: 765-557-7216.

BECOME AN ABC THERAPEUTIC SHOE FITTER

For information on Aetrex Worldwide Therapeutic Shoe Fitter Courses, please contact the Aetrex Marketing Department at: marketing@aetrex.com.

AETREX WORLDWIDE THERAPEUTIC SHOE FITTER COURSES

NOVEMBER

Aetrex Therapeutic Shoe Fitter/Live Portion: November 15 (Atlanta, GA) (Medtrade Atlanta), $195.

ONGOING THERAPEUTIC SHOE FITTER COURSES

CFS Allied Health Education is pleased to announce their new ABC Approved Therapeutic Shoe Educational Course. An ABC certified fitter of Therapeutic shoes is an individual trained and qualified in the provision of non-custom therapeutic shoes and non-custom diabetic multi-density inserts. This two-day course fulfills the educational requirements needed to apply for the ABC Certified Fitter of Therapeutic Shoes credential. To learn more, please visit CFS Allied Health Education's website at http://www.learnpedorthics.com/ for course dates or call (918) 266-3678.

CFS Allied Health Education is pleased to announce its new BOC approved Orthotic Fitter Distance Learning Program. This program incorporates advanced Web-based instruction coupled with a three day live hands-on Learning Activity covering head-to-toe prefab orthotic fitting, fracture bracing, basic shoe fitting and basic mastectomy fitting. Additional modules are available at no extra charge for BOC Orthotist exam review. Tuition is $495. See www.certifiedorthoticfitter.com for schedule or call (918) 266-3678 to enroll. Fellow Pedorthists: Do not miss this opportunity to increase your scope of practice and income in these challenging times!!!

- Rick E. Sevier BS Ed. BOCO C. Ped. - CFS Allied Health Education

INTERNSHIPS

Internship Course with The Robert M. Palmer, M.D., Institute of Biomechanics: Pedorthic Clinical or Manufacturing Internships Available. Daily, Weekly or Extended Internship Courses Available. Experience clinical settings in Orthopaedic, Podiatric, Chiropractic and Physical Therapy Clinics as well as experience in a BAPFOL approved functional foot orthosis laboratory. We specialize in diabetic wound care as well as pediatric and adult biomechanics. Your internship hours can earn you an Associates Degree In Pedorthic Biomechanics or be used as continuing medical education hours. Please contact Pam Haig at 765-557-7216 or pam@pedorthicbiomechanics.org.

Comfort Shoe Specialists, state of the art retail pedorthic facility, offers internships for on the job training requirements in beautiful St. Louis. Room is available as an option. Call Edith James, Certified Pedorthist, at 314-822-3300 -- or email Edith@ComfortShoe.com

UPCOMING COURSES FOR CERTIFIED PEDORTHISTS & ALLIED PROFESSIONALS

Submit course listings to: editor@pedorthicnewswire.com

2010 COURSES AND EVENTS

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 Seminar Calendar:

December

7 Orlando, FL

RMPI Advanced Manufacturing Courses: 49.5 CME's. For info contact: online@rmpi.org

Elwood Courses Includes Dormitory Housing & Transportation From Airport To Dormitories & School

· December 15 - 19, 2010 (Brea, California)

· December 17 - 21, 2010 (Elwood, Indiana)

· January 5 - 9, 2011 - (Orlando, Florida)

· February 4 - 8, 2011 - (Elwood, Indiana)

· March 2 - 6, 2011 (Orlando, Florida)

· April 15 - 19, 2011 (Brea, California)

· May 4 - 8, 2011 (Orlando, Florida)

· June 1 - 5, 2011 (Orlando, Florida)

· July 27 - 31, 2011 (Elwood, Indiana)

· October 5 - 9, 2011 (Elwood, Indiana)

· November 2 - 6, 2011 (Orlando, Florida)

· December 7 - 11, 2011 (Brea, California) To Be Confirmed Soon

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

CLASSIFIEDS

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

Inventory for Sale: Diabetic Shoes Available. Brand name Propet, various sizes and styles available. Over 200 brand new pairs in stock.View the shoes on our website: www.plannedeldercare.com. Call 847-495-7005 or email gwinner@plannedeldercare.com.

Seeking to Hire: The Veterans Health Administration has openings for a Pedorthist/ Orthotic fitter in three locations; Danville and Peoria, Illinois and Fort Wayne, Indiana. For information on the application process please contact Mickey Howard, MA, CO, FAAOP at 317-988-3723 or via email ernest.howard@va.gov. 6/16

Seeking to Hire: SHOE FITTER WANTED FOR CHICAGO AREA - Gottlieb Memorial Hospital is seeking an applicant to help run our therapeutic shoe program. Qualified applicant should be certified (Cfts) or have experience in shoe fitting/pharmacy technology that will help them achieve certification. Pharmacy technician experience is preferred. Applicant must have excellent customer service skills. Bilingual ability is a plus, as is computer experience and knowledge of Medicare billing. Position is full time with benefits. Apply online at www.GottliebHospital.org 5/24

Seeking to Hire for Certified Pedorthic Shoe Technician/Sales Position: Comfort Shoe Specialists in St. Louis is seeking a member to join our team. This job requires attention to detail, compassion for helping others, and drive. Our perfect member would have excellent skills in shoe repair and sales. This person has an interest in ultimately becoming a Pedorthist or is already a Pedorthist. Many people can simply "sell;" we want someone that is going to truly embrace our company as their own.Comfort Shoe Specialists is open Monday through Saturday. Saturday is a required workday. If you have what it takes to practice excellence in the field of Pedorthics, we'd love to hear from you. To be considered for this position please send your cover letter and resume' to Jesse@ComfortShoe.com. PLEASE NO PHONE CALLS. 5/19

Seeking to Hire: Orthopedic Shoe Co. located in Brooklyn, NY is seeking full-time Certified Pedorthist. Please send resumes to comfortdesign@optimum.net 4/14

Seeking State-Licensed Pedorthists in the Following States:

FLORIDA

OKLAHOMA

ARKANSAS

ALABAMA

ILLINOIS

OHIO

Midwest Medical Services is seeking Certified Pedorthists for commission work.Looking for a career with longevity and growth opportunity?Leads are provided; however you must be a self-starter who can generate your own leads as well. If you are interested in working with our team on the next level of Pedorthic care, please contact us immediately.Call 913-647-4529 or e-mail at kbarth@midwestmedservices.com. 4/14

Seeking Reps: A national supplier is looking for representatives to service the entire state of Pennsylvania, Illinois, and Texas. Certification is done online.

FITTERS RECEIVE THE FOLLOWING FEES:

Product/Service	Fee
Diabetic shoe sizing and fitting	$50.00 as submitted
Diabetic supplies and training	$30.00 as shipped
Diabetic supplies with meter upgrade	$50.00 as shipped
Back brace sizing and fitting	$25.00 as shipped
Knee brace sizing and fitting	$30.00 as shipped
Ankle brace sizing and fitting	$15.00 as shipped
Night splint sizing and fitting	$10.00 as shipped

All marketing supplies are FREE
All shipping costs are FREE

The training is FREE
Leads are FREE

If interested please forward your contact information to email rosie.salas@yahoo.com. 4/14

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

To place a classified ad, please email editor@pedorthicnewswire.com

STAFF

Editor: Faye Rapoport DesPres, M.S., M.F.A.

Design/Layout: Aetrex Marketing Department

ADVISORY BOARD

Robert Schwartz, C. Ped.		John Mishasek, BOC Pedorthist, C. Ped.
Erick Janisse, C. Ped.		Jerome S. Klein, C.O., C. Ped.
Edith James, C. Ped.		Rick E. Sevier BS Ed. C. Ped. BOC Ped.

ADDITIONAL COMMENTS

Our goal at Pedorthic Newswire is to generate an active online exchange of ideas among those interested in pedorthics. Please send articles, questions, responses and courses listings to editor@pedorthicnewswire.com.

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