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ABPM Encourages Those with Diabetes to “Save Your Soles”

During National Diabetes Month, the American Board of Podiatric Medicine (ABPM) encourages people with diabetes to “Save Your Soles” by taking steps toward better foot health.  Nerve damage from diabetes, also known as diabetic neuropathy, can cause feet to lose feeling. Injuries can go unnoticed, which is dangerous because untreated injuries can lead to infection. While up to 50% of patients have no symptoms, neuropathy may cause pain, burning, tingling, and/or numbness in your feet.

“Minor foot issues, such as an ingrown toenail or small cut, can lead to bigger problems for people with diabetes,” said Dr. Sari Priesand, ABPM-certified podiatrist and fellow at Michigan Medicine. “They may not notice that something is wrong until the situation is serious, or there may be no symptoms.”

People with diabetes may also have poor circulation, which can slow the healing process. So infections can worsen, and sometimes, result in ulcers or even the need for amputation. In 2014, approximately 108,000 U.S. adults had diabetes-related amputations.

“Diabetes-related foot issues can greatly reduce quality of life,” said Dr. Priesand. “However, by properly managing your diabetes, making foot care part of your daily routine, and getting checkups, most diabetic foot issues can be prevented.”

The ABPM recommends these steps to keep your feet as healthy as possible:

  • Get checkups. See an ABPM-certified podiatrist at least once a year for a diabetic foot assessment and risk assessment. Depending on your condition and risk factors, you may need to see your podiatrist more often.
  • Check your feet daily. Wash your feet every day and dry them thoroughly. Check for blisters, cracks, redness or sores. If you are unable to check your own feet, use a handheld mirror, or ask a friend or family member to help.
  • Apply a light coating of petroleum jelly or lotion to the bottom of your feet to help prevent skin cracking. However, don’t put it between the toes because it can cause infection.
  • Keep your toes dry. Apply cornstarch or powder between your toes to keep the skin dry.
  • Stop smoking. Smoking restricts blood flow to the skin, which impairs wound healing. Visit the Centers for Disease Control and Prevention (CDC) Web site for more information about smoking and resources to help you quit.
  • Get help. Don’t remove callouses, bunions, corns, or warts by yourself. Get assistance from an ABPM-certified podiatrist.
  • Protect your feet.
    • Always wear shoes or slippers.
    • Pick shoes that are comfortable, have a closed-toe and fit well. If you have difficulty finding shoes that fit correctly, talk to your doctor or podiatrist about prescription diabetic shoes.
    • Avoid pointy shoes.
    • Trim your toenails straight across, and try not to cut them too short.
    • Never soak your feet.

Hospital Appointment and Surgical Privileges Simplified

By Dr. James Stavosky

As a residency director and ABPM Board member, I have noticed some confusion among residents and new practitioners when applying for staff appointment and hospital and/or surgical privileges. The primary purpose of credentialing and privileging is to ensure that a practitioner is competent and meets the education, training and experience required by governing  bodies such as the Joint Commission of the Accreditation of Healthcare Organizations (JCAHO) and the Center for Medicare and Medicaid Services (CMS) . While the application process can be complex, sometimes even inconsistent, below, is a general summary of hospital requirements and what ABPM’s certification means to this process.

Credentialing

To work for, or provide services at, a hospital you will need to provide the medical staff office with your education, training and experience including primary source verification of your DPM degree, state license, DEA registration, residency training and board certification, as part of the credentialing process. Once the medical staff verifies this information, it typically goes to the Medical Executive Committee who reviews the material and approves you r appointment to the medical staff of the hospital.

There are various levels applied to the medical staff.  You may begin as “provisional staff” until you’ve been at the hospital and attended medical staff meetings for a defined period (6 months or a year); then, depending on your level of activity at the hospital you may be promoted to “active staff”.  Hospitals also have a “courtesy staff” designation for individuals who are not regular providers of services in the hospital.  As a member of the medical staff, you may be required to pay annual dues and attend meetings.

Privileging

Once on staff, you apply for privileges. While every podiatrist completes similar education (podiatric medical school and three years of residency training), experience is the differentiating factor for privileging.

Experience matters

Case logs will be used to determine your level of privileges.  During residency you may have met minimum case requirements for the Council on Podiatric Medical Education (CPME) but some residents will have experience beyond minimums in, e.g. trauma, diabetic foot and/or reconstruction. Privileges for podiatric surgery vary from hospital to hospital because of state law regarding scope-of-practice, as well as how the hospital bylaws are written. Some podiatry privileging forms are more simplified, granting core privileges (hospital admissions, consults, basic surgeries) and then privileges for advanced procedures in groups.  Other processes for privileging may require that each procedure be individually requested (e.g. 15 different types of bunions).  If you don’t have the case volume to receive privileges for a particular procedure, the department may require proctoring of a certain number of cases before those privileges are granted.  This is also true if you already have privileges and request to do a newly learned procedure.

Podiatry or another department?

Podiatry may be in its own hospital department or under another department such as surgery, vascular, plastics or orthopedics.  The department chair runs the privileging process.

ABPM Board Certification

Board certification is only one component of hospital credentialing and privileging.  The Council on Podiatric Medical Education (CPME), through the Joint Committee on Recognition of Specialty Boards (JCRSB) recognizes two certifying boards:  The American Board of Podiatric Medicine (ABPM) and the American Board of Foot and Ankle Surgery (ABFAS).

ABPM’s primary duty is to protect the public by ensuring the competence of those applying to become board certified.  Podiatrists completing a 3-year, CPME-approved residency, may take both the ABPM qualification and certification examination the year they complete their residency. We encourage you to maintain well-documented, thorough logs so you can show your experience and provide these when applying for credentialing and privileges, but they are not required for ABPM certification.   This requirement was lifted a few years ago after extensive correlation analysis on the pass rate by those with appropriate case documentation, making submission unnecessary. Since hospital bylaws generally require you to become certified within 5 years of residency training or lose your staff appointment, we encourage all podiatrists to take both the ABPM qualification and certification examinations in the year they complete their residency. .

Yet remember, your surgical privileges are not based on your certification alone, but on your education, training and experience; This is why ongoing case documentation and logs remain important.  Hospital departments that specifically require ABFAS certification for surgical privileges may have included this at a time when podiatric education was not standardized and did not include the level of education and residency required of today’s podiatrists.  These may require updating.  ABPM can assist hospital credentialing and medical staff offices with privileging language that is compliant with the requirements of the medical governing bodies.

If you have experienced any challenges in obtaining privileges or have any further questions, please contact Dr. Marc A. Benard, ABPM’s Executive Director, who will initiate a review of the situation to assist you however possible.

 

A Profile of Excellence: Rosemay Michel, DPM

Podiatry wins!

Rosemay Michel, DPM

Rosemay Michel, DPM

Dr. Rosemay Michel describes her path to podiatric medicine as “not glamorous!” As a child, she wanted to be a pediatrician, but when medical school didn’t work out, she looked into other medical professions. “Podiatry was the lucky winner,” Dr. Michel says. Podiatry may not have been Dr. Michel’s original plan, but it certainly worked out for the best. She now has a dynamic career punctuated with two fellowships, eight years as an assistant professor and a variety of volunteer work. She says that her open-mindedness, willingness to relocate and “occasionally adventurous nature” have contributed to her success and helped her navigate her post doctorate training and career path.

Dr. Michel attended the New York College of Podiatric Medicine, where she was involved in the National Podiatric Medical Association and participated in a number of community outreach projects under the mentorship of Simon Nzuzi, DPM. After residency, Dr. Michel was a surgical fellow at North General Hospital, and followed that experience with a Diabetic Foot/Limb Salvage Fellowship at University of Texas Health Science Center in San Antonio (UTHSCSA).

For the next 8 years she served UTHSCSA as assistant professor, an experience that gave her valuable confidence in her knowledge and skills, and helped prepare her for her current role as a podiatrist at the VA Medical Center in Fayetteville, NC.

Dr. Michel says that during her training years, mentors like Stephen Albert, DPM, Renato Giorgini, DPM and Lawrence Harkless, DPM, “greatly contributed to my professional and personal growth.” She encourages young podiatrists to find mentors who inspire them. She also advises residents to be open-minded, patient and prepared for any path you may be faced with.

“Life doesn’t always go as you plan or envision,”she says. “Go with the flow!”

Dr. Michel became ABPM certified in 2006 and ABFAS certified in 2005. She says that her experience in academic medicine taught her the value of being dual board certified. Being dual certified serves as testimony to the excellent knowledge and skills I have acquired, giving equal emphasis to both medical and surgical aspects of podiatry, since they work in tandem! Dr. Michel also recently received her Certification of Added Qualification in Amputation Prevention and Wound Care by the ABPM.

Dr. Michel is passionate about giving back  inside and outside of the podiatric community. During her fellowship years, Dr. Michel was involved with the in the Denver Boys and Girls Club and her local church. She also served on a medical mission to Haiti after the devastating earthquake in 2010. This experience had a particularly profound effect on her, as she is of Haitian descent. She was grateful to be able to serve in a variety of ways, from helping establish temporary medical camps to working at the local hospital in patient care and surgical procedures.

Currently, Dr. Michel is heavily involved with the ABPM. She serves on the Qualification/In-Training Subsection Examination Committee, Credentials Committee and MOC Committee, and is a liaison for the ABPM Residency Review Committee (RRC). She is also a Board Member for the American College of Foot and Ankle Orthopedics and Medicine, and serves on the Council of Podiatric Medical Education as a member of the RRC, one of the ABPM liaisons, and as an onsite residency program evaluator.

In her free time, Dr. Michel enjoys traveling, learning about different cultures, reading and spending time with family.

Congressman Brad Wenstrup, DPM interviewed on 60 Minutes

Wenstrup

Rep. Brad Wenstrup, DPM

Last June, during a practice baseball game, Congressman Steve Scalise was shot multiple times by a gunman. In the 60 Minutes interview that aired October 1, he shares his amazing recovery story and recollections of the day. The interview highlights the support Scalise has experienced and the bipartisan welcome he received on his first day back at work as Majority whip. Also interviewed is Congressman Brad Wenstrup, one of the first to his aid to apply pressure and later a tourniquet to the wound, that horrific day. Wenstrup, a veteran who served in Iraq, is a combat surgeon and colonel in the Army Reserves.

Dr. Wenstrup is also a podiatrist and a strong advocate for veterans’ access to services. He has been an advocate for H.R. 1058, the VA Provider Equity Act that passed July of this year that improves veterans access to specialty care physicians by enabling the VA to better recruit and retain experts in lower extremity conditions. The Senate portion of the bill (S. 1871) was introduced just last week for deliberation.   Everyone is encouraged to contact their respective U.S. Senators to support the bill.   Visit the APMA website for guidance on the proper language and use of eAdvocacy.

Earlier this year, Dr. Steve Goldman, ABPM immediate past president, also testified on behalf of the bill.

ABPM Board of Directors 2017-2018

Drs. Nicole DeLauro and William Chagares

Drs. Nicole DeLauro and William Chagares

 

The American Board of Podiatric Medicine is pleased to announce the results for the 2017-2018 Election of Directors.  Congratulations to Dr. Nicole DeLauro, elected to her first term on the Board, and Dr. William Chagares, elected to his second term on the Board.

 

Officers:

Gina M. Painter, DPM, President
Mitchell D. Shikoff, DPM, Vice President
William E. Chagares, DPM, Treasurer
Stephen M. Geller, DPM, Secretary
Steven L. Goldman, DPM, Immediate Past President

Directors:

Nicole M. DeLauro, DPM
Melissa J. Lockwood, DPM
Lee C. Rogers, DPM
James W. Stavosky, DPM

We would also like to express our sincere thanks to Dr. Lester J. Jones and Dr. Samuel J. Spadone, who went off the Board of Directors in 2017.  

ABPM Honored by APMSA National Students Association

The American Board of Podiatric Medicine (ABPM) was honored recently as the American Podiatric Medical Students’ Association (APMSA) 2017 Partner of the Year at the APMSA’s House of Delegates meeting in Nashville, Tennessee.  The APMSA Partner of the Year is presented annually to a valued Partner who has displayed meritorious service and support to the APMSA and is their highest honor and expression of gratitude.

Heather Keith, Executive Director, stated, “The American Board of Podiatric Medicine is a valued leader in the APMSA Partners Program. The student leaders of podiatric medicine selected your organization as the 2017 Partner of the Year for your continued commitment to student support and educational programming.”

“We are extremely honored to be selected as APSMA’s Partner of the Year,“  stated Dr. Gina Painter, ABPM Board President.  “As an organization, we feel very committed to the education process and understand the importance of providing students access to as much knowledge and mentorship as possible. We encourage all students to get engaged in the profession’s organizations to enrich their knowledge and prepare themselves for a strong future in podiatric medicine and surgery.”

The ABPM has conducted numerous lectures and receptions enabling students to learn about the value of certification and, in a program spearheaded by Dr. William Chagares, launched a Merit Award program in 2016 to recognize one outstanding graduate student from each of the nine podiatry colleges with a monetary award and certificate.

“The ABPM understands the investment needed in the future of our profession – namely the students,” explained Dr. Lee Rogers, ABPM Board member and Liaison to the APMSA.   “We are honored to receive this award and plan to continue reaching out to the students to provide educational opportunities, merit awards, mentoring and networking opportunities.”

ABPM President Dr. Gina Painter, Vice President Dr. William Chagares and Liaison to the APMSA Dr. Lee Rogers were in Tennessee to accept the award on behalf of the ABPM.

Dr. Nichol Salvo: Embracing Opportunity

Early impressions Can Have Lasting Influence

Salvopicture

Dr. Nichol Salvo

When Dr. Nichol Salvo was in high school, she always thought she would practice oncology until an injury landed her in the podiatrist’s office.  “Dr. Greg Black showed me about the practice, the interesting blend of medicine and surgery and the opportunity to sub-specialize,”explained Salvo. “It was Dr. Black’s passion and enthusiasm for podiatry that changed my direction. He remains my mentor today.”

Dr. Salvo graduated from Ashland University with a degree in biology and then received her DPM from Kent State University College of Podiatric Medicine. While there, Salvo was extremely involved in the American Podiatric Medical Students Association (APMSA), serving as delegate of her class and student liaison to the PAC board of the American Podiatric Medical Association (APMA). “I learned early to appreciate the important role APMA plays in the legislative process and why participation from every member is critical.” She feels that participating at a grassroots level or collectively as an organization is how change happens, and points to this kind of advocacy as the reason the profession of podiatry has evolved to where it is now.

Dr. Salvo’s three-year residency in Medicine and Surgery was at the Atlanta VA Medical Center. “I chose a VA residency program because I was deeply interested in wound care and limb salvage. I understood that podiatry college and residency training was a very limited time to learn as much as I could before I started practice and took advantage of as many educational opportunities afforded to me as possible,” she explained. “My residency program at the VA was busy, rigorous, and I had the opportunity to see and treat a large number of wound care and diabetic limb salvage patients.” Dr. Salvo explains that the veteran population is somewhat unique and often faces greater socioeconomic, psychosocial and co-morbid components than the private sector population. “I learned quickly that I had to consider the entire patient when developing a care plan and that it was equally important to bring in the right specialists to create an effective interdisciplinary approach to patient care – a concept I teach and write about even today.”

While Dr. Salvo feels her path was a bit circuitous, she sees that with each opportunity she learned something that would later be an important step in her career. “I entered private practice following my residency at the Atlanta VA, but then learned quickly that my practice was better served in the VA, and I returned to the VA system in Cleveland, Ohio for four years. I then took a role with APMA where I served as the Director of the Young Physicians Program for three years.” Interestingly enough, it was the skill and experience in administration, collaboration and advocacy she gained in that role that she feels prepared her most for her current role as Chief of Podiatry and Residency Program Director back at the Atlanta VA, where she started.

Dr. Salvo is dual boarded with both the American Board of Podiatric Medicine (ABPM) and the American Board of Foot and Ankle Surgery (ABFAS). “Residents need to remember that they have the privilege of completing a three-year comprehensive residency training program that allows them to become board-certified in both ABPM and ABFAS. The profession has worked for decades to advance podiatry, where the education and training is equitable to allopathic medicine,”explains Salvo.

“In the past, many podiatrists didn’t have the opportunity to complete residency training and those who did, still couldn’t sit for both boards.” Dr. Salvo believes all PMSR graduates should sit for both ABPM and ABFAS qualification examinations. “ABPM certification increases my credibility and demonstrates to the medical community at large that I am competent in medicine. With the dual certification, it demonstrates that I can comprehensively care for my patient medically and surgically to the extent of my scope and licensure,” she explains.

Along her impressive path, Dr. Salvo has collected a long list of accolades and publications, most recently the Kent State University College of Podiatric Medicine Young Physicians Professional Achievement Award. As a well-respected practitioner, she also recently co-authored, with a vascular surgeon and plastic surgeon with whom Dr. Salvo works, an article entitled Promoting Limb Salvage through Multi-Disciplinary Care of the Diabetic Patient published in the July 2017 issue of Current Treatment Options in Cardiovascular Medicine.

Dr. Salvo is a big advocate for publishing, especially during your residency training. “Research and publication not only advance our profession, but it is also a career builder. I know from personal experience that it is much easier to draft papers under the guidance of a mentor than to do this on your own once you enter practice. Take advantage of your teaching faculty during residency and publish with them,” she advises.

Dr. Salvo emphasizes that residency training is challenging, but rewarding, and shares some wisdom that may have a lasting impression on current or future residents. “I never expect my residents to do anything that I don’t expect of myself. If you are in residency training, understand that this is a three-year period of rigor and discomfort. It will not be gentle nor passive.  It is intended to develop you into a physician who can manage any medical challenge or complication presented before you. Embrace the discomfort and labor that comes with your residency education. Every experience, every patient interaction, every article you read, develops you and will improve you as a practitioner and as a surgeon. You will never have this opportunity ever again,” says Salvo. “Be reminded of your fortune to complete a comprehensive program and take advantage of all opportunities afforded.”

Once in practice, Dr. Salvo says it is important to stay as involved and engaged with the profession as possible. In addition to being the residency program director and routinely publishing, Dr. Salvo is becoming more active with the Council on Podiatric Medical Education (CPME), serving as an on-site residency evaluator and as a a member of the Society for Vascular Surgery (SVS) where she works closely with vascular surgery colleagues, with patient care and publications. She is active and loyal to APMA through her component society, Federal Services Podiatric Medical Association (FSPMA), serving on the Board of Directors and as a delegate to the APMA House of Delegates.

“During residency, I could have never imagined the path my career would take. I have learned that career decisions are never easy and sometimes developing your career requires relocating or stepping out of your comfort zone for a short time “but it is worth it.”

In her spare time, Dr. Salvo is a devoted mother to her 8-year-old daughter who she says “keeps her grounded and reminds her of happiness in simple things.” She also loves to run and play trumpet but admits, right now at least, she has little time for either.

 

Nichol Salvo, DPM Featured in Wound Care Paper On Limb Salvage of the Diabetic Patient

June Vascular JournalABPM Diplomate, Dr. Nichol L. Salvo, was featured in an article entitled “Promoting Limb Salvage through Multi-Disciplinary Care of the Diabetic Patient”, which was published in the June 2017 issue of the Journal of Vascular Surgery.

Dr. Nichol Salvo along with vascular surgeon, Dr. Luke Brewster, and plastic surgeon, Dr. Mark D. Walsh, discuss the high volume of patients who still are undergoing major amputations as a result of diabetes. In this article, the doctors present literature and introduce the successes that a multi-disciplinary limb salvage center could have on the lives and limbs of patients with diabetes.

Read the full article here.

 

Dr. Dyane Tower: A Profile of Enthusiasm

Dyane Tower

Dyane Tower, DPM

Dr. Dyane Tower’s career is shaped by her inquisitiveness and passion for learning. Because of these traits, her career has been filled with what she describes as a series of happy “twists and turns.”

A job with an orthopedic surgeon while in college inspired her career in the podiatric profession. “I was intrigued. As I researched the profession and shadowed podiatrists in the field, I became convinced that this was the career for me. The podiatric specialty offers so many opportunities to develop meaningful relationships with my patients, provide care and perform surgeries, and improve the quality of life for so many.”

Having earned her Doctor of Podiatric Medicine from Dr. William M. Scholl College of Podiatric Medicine in 2009, Dr. Tower is currently the Director of Clinical Affairs for the American Podiatric Medical Association (APMA). In this role, her responsibilities include serving as a scientific spokesperson on the practice of podiatric medicine, overseeing the development of a Qualified Clinical Data Registry for the profession, and coordinating the APMA Young Physician’s Program to name key responsibilities.

Educating and sharing knowledge about podiatric medicine is critical to Dr. Tower. As a podiatrist in the Department of Orthopedics at Dartmouth-Hitchcock Medical Center from 2014 to 2016, Dr. Tower provided foot and ankle care, including high-risk wound care, to patients. During those years, she also shared her passion with residents, educating and supervising residents and undergraduate students interested in foot and ankle medicine and surgery. “I would not be where I am today without the mentorship of many throughout my career, she says. I am honored to be able to mentor others.”

A believer in life-long education, scholarship punctuates Dr. Tower’s career and life. She is very active in advanced research, scholarly publication, and professional conferences. She has been a faculty member at the Geisel School of Medicine at Dartmouth and the Scholl College of Podiatric Medicine.

After receiving her Doctorate, Dr. Tower went back to school to earn her Master of Public Health from the Geisel School of Medicine. She also holds Master and Bachelor of Science degrees from the College of Health Professions at Rosalind Franklin University of Science and Medicine. Her first degree was a Bachelor of Science from Truman State University.

But while her inquisitiveness may have lead her on a career path that included a few twists and turns, Dr. Tower never wavered on her focus and determination to become ABPM board certified. She took her exam as soon as able, and encourages others to do the same. “Being able to refer to yourself as board certified soon after residency really opens many opportunities,” she says. “I took my ABPM qualification and certification in the same year and found the process very manageable and not at all cumbersome.”

She also stays active in the podiatric community through her committee and volunteer work, and has supported a range of great causes, including serving as a podiatry crew member supporting walkers in the Avon Walk for Breast Cancer, and providing education on foot health at various events. She has also repeatedly supported the Yucatan Crippled Children Project in Mexico, performing surgery for underserved community members and training local surgeons on advanced methodologies.

Dr. Tower encourages residents to get involved and remain active. “As the future of the profession, we need your ideas and creativity, your dedication and perseverance, especially as the healthcare climate changes,” she says. “Ours is a very dynamic profession and you never know how your experiences may open up new career opportunities.”

 

 

Founding Dean, Lawrence Harkless, DPM, is Honored at Western University Commencement

(L-R) Drs. Lawrence Harkless and Lester Jones at the WesternU Commencement Ceremony.

(L-R) Drs. Lawrence Harkless and Lester Jones at the WesternU Commencement Ceremony.

Western University of Health Sciences held its annual Commencement ceremony for the College of Podiatric Medicine at the Pasadena Civic Auditorium in Pasadena, California. WesternU honored College of Podiatric Medicine Founding Dean Lawrence Harkless, DPM, who will retire June 30, 2017 after spending the past 10 years launching and growing the college. CPM Executive Associate Dean for Academic Affairs Lester J. Jones, DPM, MS, will serve as interim dean while the university conducts a search for Harkless’ successor.

Harkless will leave WesternU with a legacy of excellence and achievement very few members of the podiatric medicine profession have the opportunity to accomplish in a lifetime, Jones said. Harkless said we must all remember to give and share because we are all instruments made by God to help others. “As I watch one season come to an end, I welcome the beginning of a new season and the journey ahead,” Harkless said. “Wherever you are in life, don’t be afraid to try new paths. I’m sure our paths will cross again.”

Dr. Lawrence Harkless has been board certified with the ABPM since 1994.

Dr. Lester Jones, past president of ABPM, has been board certified with the ABPM since 1985.

 

 

The American Board of Podiatric Medicine
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