Pedorthic Newswire Issue #474

June 20, 2012, Issue #474

DISCUSSION

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. We reserve the right to edit submissions and responses. Please note:the deadline for all submissions and responses is 12 noon Eastern Standard Time on Tuesday for that week's issue.

NEW QUESTION

Question: I read with amused interest Rick's posting and the link to what Medicare requires of a patient assessment. The question I have is that if Medicare's current focus is on the primary care physician chart notes for medical necessity documentation for auditing purposes, what is the purpose of a practitioner's assessment and chart notes of risk factors? The supplier's practitioner can no longer fill out Certifying Physician Statement, so determining a risk factor does not appear to be the responsibility of the supplier's practitioner. Before we dropped our Medicare supplier number, we found that telling the primary care physician what risk factor(s) exist can be futile in some cases, i.e. patient would have severe bunions but primary care physician would write on forms "Patient does NOT have bunions" and then check off the existence of peripheral neuropathy. But what do you want to bet there would be zero documentation of callusing that is required to be present along with DPN diagnosis (way to go whomever consulted with Medicare and Congress on the TSD legislation originally to have a dual risk factor requirement for one of the six secondary factors).

The only non-podiatric supplier left in our community (a new O&P supplier looking to break into a hyper-competitive O&P market) does not really do a lengthy assessment of feet. The few minutes spent with patient is all about what style and size of shoes using 12 pair of Dr. Comfort shoes to try to nail down what to order. Their charts end up with all the proper delivery documentation and a copy of the physician orders (Certifying Physician Statement/Rx). But very little in the way of the supplier assessing medical necessity. I guess they are hoping and trusting that the primary care physician chart notes match the risk factor(s) on the orders.

We are so glad that we dropped this suicidal book of business.

- John Mishasek, BOCPD, C.Ped

PREVIOUS QUESTION WITH RESPONSE

Question: I am wondering if any PNW readers have had an experience similar to one I had recently and, if so, how they handled it. I have a patient who has severe tarsal tunnel sydrome in her left foot. Per the patient, when she worries about it too much this, she experiences "fear pain" in the contralateral foot - fear pain apparently being some sort of psychosomatic phenomena. She proceeded to inquire as to what I could do via her orthoses to address the so called fear pain. I had no answer. Any thoughts?

- Erick Janisse, C.O., C.Ped.

Response: I suggest you treat the right foot the same as any other mechanically induced foot disorder. Evaluate and treat both feet based on her pain and functional deficiencies. And don't forget about her footwear. We have discovered that over 90% of people with foot disorders are wearing the wrong style and size.

- Robert S. Schwartz, C. Ped.

PREVIOUS QUESTION WITHOUT RESPONSES

Question: At least once a month at our pedorthic retail store, we see a customer that needs a shoe that will fit a charcot shape foot on while having a normal contralateral foot. While refurbishing a relasted PWM Leisure Time DX2 shoe and its mate for a customer for a wedding he was attending, we were discussing options to have additional shoes. He has a limited budget so he needs shoes that are not only functional but durable. When I discussed this need with the orthotist that sees her TSD patients at our store, she mentioned that APIS/Boxerdog brand advertises a charcot shoe in its catalog. Have any Pedorthic Newswire subscribers had experience with this shoe and if so, what has been the process of ordering and the ultimate satisfaction with the fit, function, and durability?

- John Mishasek, BOCPD, CPed

SPONSOR NEWS

HEALTH AND INDUSTRY

Looking at shoes may reveal key demographic, personality information

To really get to know a person, you might just have to look down at the shoes they're wearing.

In a new study, scientists have discovered that people can judge a person's sex, age, agreeableness and income by taking a peek at his or her footwear. Interestingly, study participants could also accurately spot how clingy people were just by glancing at their shoes. Read the full article here.

Source: CBS News

Lonely? Your health may suffer

By Amanda Gardner

Loneliness and isolation can affect your quality of life -- and maybe your quantity of life, too.

According to a pair of studies published today in the Archives of Internal Medicine, living alone -- or even just feeling lonely -- may increase a person's risk of premature death.

One study followed nearly 45,000 people ages 45 and up who had heart disease or a high risk of developing the condition. Those who lived alone, the study found, were more likely to die from heart attacks, strokes, or other heart complications over a four-year period than people living with family or friends, or in some other communal arrangement. Read the full article here.

Source: CNN

Shoe importers push to cut U.S. tariffs

Battles are brewing in Washington as opponents push for cuts to shoe tariffs that can reach 67.5% and add to footwear prices. In the U.S., 90% of the shoes are imported by Payless and other firms. Read the full article here.

Source: LA Times

AETREX iSTEP WEBINARS

View our Full June 2012 Schedule

DIABETES

Does America have a diabetes death wish?

By Chris Kilham

A virtual diabetes pandemic is sweeping the world, with record levels of obesity and diabetes crippling the health of hundreds of millions of people globally. As horrible as this is, what is even worse is the sobering evidence that most people appear unwilling to take the lifestyle steps that can prevent this killer disease. Do we have a death wish?

A recent article in the British medical journal The Lancet said the following: "For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention, with evidence of a 40-70 percent relative-risk reduction." Read the full article here.

Source: Fox News

Diabetes May Speed Cognitive Decline

By Kristina Fiore

Having diabetes may put older patients on a faster path to cognitive impairment, researchers found.

Over 9 years, those who had diabetes had significantly worse cognitive decline on two separate tests compared with those who didn't have the disease (P=0.008 and P=0.001), Kristine Yaffe, MD, of the University of California San Francisco, and colleagues reported online in the Archives of Neurology. Read the full article here.

Source: MedPage Today

SPORTS AND FITNESS

Turning up the heat for workouts

By Dorene Internicola

When it comes to exercise, some like it hot, some like it hotter, and some like it under the air conditioner.

Experts say heat can be help your workout, boosting circulation and increasing flexibility, but it's a relationship that can also turn nasty. Read the full article here.

Source: Chicago Tribune

But I don't want to work out

By Julie Deardorff

When Ande Frayser lacks motivation to exercise, she thinks about the day when she burned a batch of chocolate chip cookies because she was too overweight and out of shape to reach the kitchen in time.

The experience was more than a wake-up call; it was a slap in the face. "It took a mind shift," said the 40-year-old Maryland mom, who used to find all the usual excuses to avoid working out. "I now look at exercise the same way that I do eating, drinking and going to the bathroom: It is not always convenient, but it must be done." Read the full article here.

Source: Chicago Tribune

A parent's guide to foot health for athletic kids

With the Olympics approaching in July, you can expect to witness some amazing feats of athleticism this summer. But Olympic athletes won't be the only ones competing hard in summer sports - so will your kids.

Millions of American children will participate in warm weather sports this year, from softball to soccer and swimming to cycling. No matter what their sport or whether they play competitively or just for fun, they will have one important thing in common: They'll need their feet to be pain-free if they're going to play their best and prevent injuries. Read the full article here.

Source: ABC News

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.

Robert M Palmer 2012 Schedule

June

Brea / El Monte, California TBD - June 23 - July 2

August

Elwood, Indiana - August 18- 27

September

Orlando, Florida - Sept 8 - 17

Elwood, Indiana - Sept 29 - Oct 8

Fall 2012

Malaysia TBD -

November

Elwood, Indiana - Nov 10 - 19

December

Brea / El Monte, California - Dec 8

RMPI Pre Certification Training- PEDORTHIC PRE-CERTIFICATION EDUCATION
PFA Scholarship Value @ 70% Savings
Published Tuition 2010 - $4K, "Powerstep Scholarship" Tuition Total $1500
(does not include travel / books / meals)
Must Enroll Before April 30, 2012
Attendance Date Flexible - CAPE/NCOPE Compliant - Levels 1,2,3
Courses Held In Elwood, Indiana Include Dormitory Housing & Shuttle Service
By prior reservation on a first-come-first-serve basis
To learn more about our courses or how you can share our vision, visit us at:
www.rmpi.org

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.

Pedorthic Pre-Certification Training Course July 30th - August 12, 2012 In cooperation with ABC requirements, Eneslow Pedorthic Institute (EPI) is offering the 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, interactive CD's and testing of all mandatory topics.

Upon passing the level one test, students will attend the remainder of the pedorthic pre-certification course at Eneslow Pedorthic Institute for 2 weeks during July 30th, 2012 to August 12th, 2012. This class completes required education prerequisite to sit for national certification exam. It does not satisfy the requirement of 1000 documented hours of field experience.

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

Please contact Sarah Goldberg at epi@eneslow.com or 212-477-2300 x211 for more information. Pedorthic Pre-Certification Course - $3,995

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

JULY

Aetrex Therapeutic Shoe Fitter/Live Portion: July 31 (Richmond, VA), $195

2012 COURSES

2012 FOOT SOLUTIONS PEDORTHIC PRE-CERTIFICATION COURSE SCHEDULE & INFORMATION

Foot Solutions is an accredited facility that holds classes four times per year. The course will offer the certificate needed in all three levels so that you qualify to sit for the C. Ped. Exam. The facility is located at 2359 Windy Hill Road, Suite 400, Marietta, GA 30067

August 3 - 1 Day Cram Session (free with attendance of pre-cert class)

August 6 - August 17

October 8 - October 19

November 9 - 1 Day Cram Session (free with attendance of pre-cert class)

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 bhubauer@footsolutions.com

Dr. William Faddock 1-866-338-2597 EXT: 209 bfaddock@footsolutions.com

UPCOMING COURSES FOR CERTIFIED PEDORTHISTS & ALLIED PROFESSIONALS

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. Click Here for More Info

June

Brea / El Monte, California - Two Courses - June 22 - 26