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ABPM Spotlight! Meet Director, Lee C. Rogers, DPM

Lee C. Rogers, DPM

Lee C. Rogers, DPM

Lee C. Rogers, DPM became a Diplomate of the ABPM in 2008. After serving several years on the ABPM Exam Committee, he was elected to the Board of Directors in 2015.

As a Director, Dr. Rogers led the initiative to start ABPM’s first Certificate of Added Qualification (CAQ), which was first offered in 2017, and is currently the sub-Chair of the CAQ in Amputation Prevention and Wound Care. He is also co-authored the ABPM’s document on Privileging and Credentialing Doctors of Podiatric Medicine which has been instrumental in helping ABPM Diplomates obtain and keep their hospital privileges.

“I have seen ABPM grow and it’s on the path to be the largest and most influential certifying board in podiatry within the next 5 years. As an ABPM Director, I will continue to be a leading force in efforts that will help to drive this change. I will also promote policies to help those podiatrists who are single-board-certified, by ABPM, like me.  I have been working to connect ABPM with the many international organizations of podiatrists.  We are now a very young organization, with 60% of our membership being less than 10 years out of residency.  I support getting our younger members involved in committees and nominating them for Board positions.  I advocate for improving processes in the Board Headquarters, including the adoption of new technology to make the busy lives of our Diplomates easier.”

Originally from Gallatin, Missouri, he completed his undergraduate education at Truman State University and received his Doctor of Podiatric Medicine (DPM) from Des Moines University in 2004. Following graduation, Dr. Rogers completed a PM&S-24 residency at Saint Vincent Catholic Medical Centers in New York in 2006, and a fellowship in diabetic limb salvage and wound care at Scholl College of Podiatric Medicine in 2007.  Since then, he has focused much of his practice and research on the diabetic foot and currently sits on several committees for many organizations around the world that promote podiatry or diabetic foot care.  He has authored over 150 papers or book chapters and delivered almost 500 lectures in all 50 states and more than 40 countries.

ABPM Spotlight! Meet Director, Mitchell Shikoff, DPM

Mitchell Shikoff, DPM

Dr. Mitchell Shikoff has been a Diplomate of the ABPM since 1989 and has served on the board since 2009. Dr. Shikoff has several roles as a Diplomate of ABPM; he is currently the Vice President, Chair of the Case Document Review Committee, Chair of the Credentials Committee, serves on the Speakers Bureau, and formed the Marketing Committee on which he is extensively involved. Dr. Shikoff is also the ABPM representative to the American Podiatric Medical Association (APMA), the American Board of Foot and Ankle Surgery (ABFAS) and the Joint Committee on the Recognition of Specialty Boards (JCRSB), where he has served as the Chair. He represents both the ABPM and the ABFAS as a residency program reviewer for the Council on Podiatric Medical Education (CPME).

“My time serving as a Director of the ABPM for the past ten years has been challenging and rewarding. I’ve been able to be part of a transformational process of the ABPM and witness astounding growth in membership and Diplomate value. I am proud of the significant changes and encourage all residents to attain certification promptly. Finally, get involved with the Board on one of the many committees and run for a position as a Director. It will keep you at the forefront of your chosen profession.”

Originally from Northeast Philadelphia, Pennsylvania, he completed his Bachelor of Science and Bachelor of Arts undergraduate degrees at the Pennsylvania State University in 1979. Dr. Shikoff received his Doctor of Podiatric Medicine in 1983 from the Dr. William M. Scholl College of Podiatric Medicine in the Rosalind Franklin University of Medicine and Science. He completed his post graduate surgical training in St. Louis, Missouri. Dr. Shikoff has offices in Bensalem, PA and Feasterville, PA since 1985 and continues to take advanced training in various aspects of Podiatric Medicine, Surgery, and Wound Care which most recently includes new biologic wound dressings and Hyperbaric Oxygen Therapy. Dr. Shikoff has served as a residency director of a three year PMSR program, and thoroughly enjoys training residents at the hospitals where he is an attending.

As a dedicated husband and father of two, Dr. Shikoff has many interests outside of Podiatry. He enjoys bicycling, skiing, scuba diving, fishing, traveling, and spending quality time with the family.

Outpatient vs. Inpatient Workup of Diabetic Foot Infections

By: Marisse Lardizabal, DPM,

Diabetic foot infections (DFI) are both challenging and common amongst all podiatrists. Treatment of DFI’s require a level of comfort and training as well as resources available to clinicians. ABPM has traditionally been a great source of information for podiatrists which makes the board certification by ABPM paramount.  Like many podiatrists, you may encounter these types of patients initially in the clinic/outpatient setting, where you can catch the potential signs and symptoms of a diabetic foot infection waiting to happen.

First, nothing can substitute a thorough History and Physical Exam on a patient.  A complete NLDOCAT will give one a lot of information as well as develop a story as to why the patient is presenting with a diabetic foot infection.  For example, time frame of the ulceration, how well the patient’s diabetes is controlled, and any prior and/or current ulcerations will help you formulate a treatment plan. This may also foreshadow how compliant a patient will be with their recovery.  A thorough physical exam is of significant value when looking for classic clinical signs of infection, as well as the status of the neurovascular structures. Does the patient have enough circulation to heal an ulcer? Is a referral to a vascular surgeon necessary? Obtaining radiographs and necessary labs (CBC, CMP, ESR, CRP) should be obtained for a complete work up.

The Infectious Disease Society of America Diagnosis and Treatment of DFI, also known as IDSA Classification, is one of the most helpful guidelines that should be utilized by clinicians who treat DFI routinely. This guideline classifies DFI based on severity of the infection, clinical signs, and constitutional symptoms presented. IDSA also makes recommendations of what the appropriate treatment course should be.  For example, consider a patient who presents with erythema <2 cm around the ulcer with 2+ signs of infection. According to the IDSA guidelines, the patient’s infection is classified as “uncomplicated soft tissue infection” or Mild DFI. Therefore one may feel comfortable sending the patient home with oral antibiotics, local wound care and offloading as well as a 3-5 day follow up to see if the signs of infection have resolved.

Moderate DFIs (erythema > 2cm with 2+ signs of infection present) are the most challenging to classify and treat. Without close observation, these patients can potentially get worse and can be very much considered as admitting criteria depending on presentation of the infection.  At times, these patients can benefit from a decompression of the infected foot in the clinic setting, while making sure wound cultures are obtained prior to discharge. If patients are discharged home, close follow up and monitoring is essential. If symptoms do not improve, the safest course of treatment may be hospital admission for IV antibiotics and possible surgical interventions.

 

Lastly, severe DFIs are complicated local infections in conjunction with the patient endorsing constitutional symptoms as well as presence of SIRS criteria. These are the patients that will be admitted to the hospital for surgical management of the infection due failure of conservative treatment.  The IDSA guidelines are key elements to be familiar with as they will guide your treatment and tell you which patient will need a higher level of care.

Once the patient is admitted to the hospital, inpatient work up of DFI is very much similar to the outpatient setting.  If admitting the patient under Internal Medicine, it is important to communicate necessary labs, imaging, choice of IV antibiotics, NPO status as well as plan for surgical intervention to the service for an efficient and effective hospital course.  One may consider advanced imaging, such as an MRI (preferably prior to surgical intervention), whether there is concern for osteomyelitis or abscess in the foot.  The advanced imaging should by no means delay surgical intervention if it is considered emergent.

This brief overview of triaging DFIs can hopefully streamline how DFIs are treated in one’s practice.  Effective treatment of DFIs is our expertise and it will benefit our patients to have a standard of how it is treated.  Being board certified by ABPM, I feel confident in treating DFIs with the knowledge and background that I continually use in my daily career as a Podiatrist.

 

References:

Clinical Infectious Diseases, Volume 54, Issue 12, 15 June 2012, Pages e132–e173, https://doi.org/10.1093/cid/cis346

Dr. Charles C. Southerland – In his own words: Why not Med School?

“During the first year of my fellowship, I encountered a patient, a beautiful young woman in her early 20’s with a burgeoning career as a model in Miami, who was experiencing intense heel pain.  She had been treated by other physicians for Plantar Fascitis and tendonitis without any resolution. I diagnosed her with Tarsal Tunnel syndrome and confirmed that with a neurology consultation for NCVS and EMG.  The patient was taken to surgery for a Tarsal Tunnel release.  During the course of the procedure, we encountered a tumor pressing on the posterior tibial nerve. The tumor was removed and the pathology report defined the tumor as a Synovial Sarcoma, Stage 4.

The patient was sent to Sloan Kettering Cancer institute in New York, along with lab results and 35mm slide photographs of the tumor. The Sloan Kettering team confirmed the diagnosis and recommended that the patient undergo a below the knee amputation with follow up chemotherapy.  During the chemotherapy, she lost her hair, and the surgical site on the stump of her leg dehicsed.  She dropped to about 60 pounds from an original weight of 120 lbs.  However, in the end, she survived both the chemotherapy and the cancer.  She kept in touch with me throughout the entire process. I developed a close relationship with the patient and her parents. After arriving back from New York, the patient related to me that the Sloan Kettering team had kept the 35 mm slides I had sent with her (in those days, it was not so easy to make photographic duplicates). When she explained that a podiatrist had made the diagnosis, they told her that podiatrists did not make diagnoses for cancer and that she should credit the neurologist who caught the abnormality on the nerve conduction study. The patient asserted to them that she credited the podiatrist with saving her life. The folks at Sloan Kettering told her that podiatrists were “not real doctors” and so had no real part in the process of treating her cancer. She later related to me that she found them to be arrogant and egotistical.

I remember being very much offended by what she told me, frustrated at being recognized as “only” a podiatrist. At the time, I was reading a book by Victor Frankl, “Man’s Search for Meaning”. Victor Frankl was an Austrian Neurologist and Psychiatrist during World War II.  He was Jewish and became a concentration camp prisoner by the Nazis during the war. He was tortured and emasculated by his captors. One day, as he hung helpless before his tormentors he came to an amazing realization. In order to do what they were doing to him, they could not help but to hate a fellow human being. In a moment of remarkable clarity, Victor Frankl realized that while they could not choose to not hate him, he could choose to NOT hate them back. In this seemingly small thing, he had power over them to determine how he would react to the terrible things they were inflicting upon him. They could not choose mercy, but he could.  In reviewing this, I came to a nexus moment question:  “If I could do it all over again, would I choose to have encountered this beautiful young woman as an MD or as a DPM?”  Two MD’s had treated her before  I saw her, one an orthopedist, the other a general surgeon, and both missed the diagnosis. IF I had chosen to attend St. Louis University School of Medicine, instead of podiatry school, and encountered this patient, would she have lived or died because of this tumor? I realized at that moment, that I was totally, completely, absolutely content to be a podiatrist. If the only thing I would ever accomplish as a podiatric physician was to catch this diagnosis and intervene in a way that saved this young woman’s life, it was all worth it – four years of college, four years of podiatry school, one year of residency training and two years of fellowship. What a wonderful lesson, one that has caused me to be very happy in the practice of Podiatric Medicine for over 30 years now. By the way, my patient returned to her modeling career as a poster model for lower limb amputee snow skiers. She could be found in a number of ads for outrigger ski poles and single limb skiers. To this day, she has lived a good life and remains a good friend.”

Practice Profile: Charles C. Southerland, DPM

Dr. Southerland and studentWhile serving in the U.S. Army during the Vietnam War era, Dr. Charles Southerland was a Special Forces Medic, a role that helped him develop a deep appreciation for the practice of medicine. Later, while on a mission for the Church of Jesus Christ of Latter Day Saints, he met a team of podiatrists who were caring for migrant farmers in the San Joaquin Valley in California. He was impressed with their work ethic and lifestyle – he saw that they were practicing medicine and enjoying the satisfaction that comes with delivering patients from pain, disease and deformity. Then, while an undergrad at Brigham Young University, he applied to podiatry and medical school. After being accepted to both, Dr. Southerland chose podiatry, a decision that he says has led to “lifelong contentment.” (Click here to read Dr. Southerland explain, in his own words, the experience that caused him to be very happy that he chose to practice Podiatric Medicine, instead of going to medical school.)

Dr. Southerland attended the California College of Podiatric Medicine, where he worked as an audio visual technician for his class during the day. At night, he worked as a security guard, a job that allowed him to study 6-8 hours during his shift, while getting up for 10-15 minutes every hour to make rounds and punch a Detex Clock.

After completing a first year podiatric surgical residency at Southeastern Medical Center, he completed a two year fellowship with Dr. Stephen Spinner. Toward the end his fellowship, Barry University School of Podiatric Medicine was starting its clinical program and Dr. Southerland was invited to be one of the first clinical faculty members at the school. He has been a professor at the Barry University School of Podiatric Medicine since 1987.

Through periodic sabbaticals – a privilege he says is one of the great perks of being a full time educator – Dr. Southerland has had the opportunity to expand his view of podiatry and appreciate how podiatric medicine fits in to a worldwide collaborative of providers for foot and ankle pathologies. Dr. Southerland’s diverse educational experiences include fellowship training with AO International in Switzerland, Podopediatrics at Hadassah Hospital System in Israel, Ilizarov Training at the Russian Ilizarov Scientific Center in Russia, and Ponsetti technique training with Dr. Ignacio Ponsetti at the University of Iowa.

When he looks back at his training, he credits hard work, carefully balanced finances and an active interest in technology as laying the groundwork for his approach to Podiatric Medicine. He’s also grateful for the privilege of working with some of medicine’s great minds and believes those experiences helped make him the podiatrist and educator he is today. His mentors include Dr. Stephen Spinner, Dr. Dock Dockery, Dr. Mary Crawford, Dr. Dan Hatch, Dr. Ignacio Ponsetti, Dr. Terrance Barry, Dr. Kieth Kashuk, Dr. Russel M. Nelson, Dr. James Stelnicki, and Dr. Eric Stelnicki.

Dr. Southerland originally sat for the boards when they were the ABPO boards in 1988. He then recertified with ABPOPPM in 1998 and most recently with ABPM in 2016. He also certified with what is now ABFAS in 1987 and has reassessed every ten years to keep his foot and ankle certification current. Over the years, he has served as an item writer, observer and oral examiner for the ABPM.  He feels they have always set high standards for certification and offer a very worthy confirmation of academic excellence.

Dr. Southerland’s advice for residents is to “get the most you can out of your training – even if it means long hours and little sleep. Just remember it is an investment in a lifetime of practice to follow.” He also says that residency is the time to build a foundation for the person you would like to be, and recommends prioritizing family and faith. He also feels that taking good care of your patients will result in them taking good care of you.

When he reflects on his career, Dr. Southerland feels great pride in his former students/residents that go on to noteworthy achievements.  He is also very proud of his accomplishments as the founder and program director of the Yucatan Crippled Children’s Project.  Through this work, Dr. Southerland has seen many of the program’s beneficiaries grow up to be productive, capable members of their society – many of whom might have otherwise been prevented from attending school or obtaining jobs.  Dr. Southerland feels strongly that no one can stand taller than those who will bend over to help a child.

In addition to the Yucatan Crippled Children Project and helping educate more than half the practicing podiatrists in the state of Florida, Dr. Southerland has served as elected Chair of the National Council of Faculties for the AACPM, and a local television medical commentator for first few months after 9/11/2001. Dr. Southerland was also among the first group of Podiatrists to go to Kurgan, Russia in October 2001 and learn Ilizarov technique at its source. He was also part of a group of physicians that attended to victims in Haiti after the 2010 earthquake.

On a more personal level, Dr. Southerland participates in the Everglades 300 challenge every year, a 300 mile kayak race on the west coast of Florida. However, his favorite hobby is being married to his wife Suzanne for more than 40. They have five “nervewrackingly wonderful” children and five grandchildren.

The Honor of our Life Derives from this
To Have a Certain Aim Before Us Always
Which Our Will Must Seek Amid the Peril of Uncertain Ways
Then, Though We Miss the Goal
Our Search is Crowned with Courage
And We Find Along Our Path
A Rich Reward of Unexpected Things
~ Henry Van Dyke

ABPM Spotlight! Meet ABPM Director, Coleen Napolitano, DPM

Coleen Napolitano, DPM

Coleen Napolitano, DPM

The ABPM welcomes Dr. Coleen Napolitano as the newest member of the ABPM Board of Directors. Dr. Napolitano has been a Diplomate since 1994 and has been active with the ABPM for the past 15 years, primarily with the Examination Committee, where she is the current Chair of the certification exam (Part 2) sub-section.

“I am quite familiar with the ABPM’s past and present and have witnessed first-hand the significant strides it has made in the medical community, said Dr. Napolitano.  “I look forward to contributing to the future of ABPM and believe that ABPM certifies specialty skills that represent the majority and the best of podiatric care, witha focus on medicine and podiatric orthopedics.”

Dr. Napolitano did her undergraduate at Florida International University on a running scholarship.  She obtained her doctorate and Bachelor of Science from Dr. William Scholl College of Podiatric Medicine and completed her residency training at Hines Veterans Administration Hospital in Illinois.  Dr. Napolitano followed her certification with the ABPM by becoming ABFAS certified and encourages podiatry residents to recognize the benefits of dual certification.

She is currently an Associate Professor in the Department of Orthopaedic Surgery & Rehabilitation in the Section of Podiatry at Loyola University Medical Center and is the Program Director for the podiatry residency training.

Clinical Presentation Skills: Communication with your Patients

Faith A. Schick, DPM

Faith A. Schick, DPM

By: Faith A. Schick, DPM

The ability to communicate with your patients is integral to successful outcomes.   This is an important practice skill that should be developed and mastered prior to graduating residency.

As a resident, I recall spending time shadowing multiple physicians.  After a period of time, I was able to know what the physician was going to say before the words came out of his/her mouth.  This wasn’t because I was getting smarter at understanding how I was supposed to treat a specific condition,  but because I became familiar with the conversation the attending was going to have with the patient.  As time went by, and after many experiences, I was able to synthesize different versions of what I was hearing, and have specific treatment plans I would share with my patients when the time came.

Developing this organized thought process helped to ease the transition from resident to attending.  When the time came I was ready.  I knew how I wanted to treat my patients and what supplies I needed to perform an appropriate physical examination and render care.  Being board certified with ABPM and though my experiences I knew I could handle any situation. I was able to walk into the treatment room with confidence and explain to my patients what I thought their condition was, and how we were going to manage it without faltering.  I knew what I wanted to say before I said it, similar to the physicians I had observed.    This confidence reassured my patients.

Realize that just because what you are saying makes sense to you, it doesn’t necessarily mean that it is going to make sense to your patients.  During residency you are surrounded by peers who easily communicate using medical terminology.  Once in practice this changes, and your audience becomes your patient population.  Language needs to become more simple; you need to still speak intelligently, but use words that your patient will understand.  For example, instead of saying “calcaneus”, explain by saying “heel bone”.  While it may make sense to you that a patient should sleep in their CAM boot, you need to very clear with patients giving them instructions.  Make sure to ask if your patient has any questions before leaving the room.

Think about the message you are trying to convey.  How do you sound?  What does your posture look like?  Are you making good eye contact?  As time has gone by, I have come to appreciate the value this has on my office workflow.  I am able to review my chart notes with ease knowing that there is an organized thought process as to how I treated my patient during their last visit, and depending upon their outcome how I plan to proceed with care.  My staff is able to anticipate my needs and the needs of my patients.  Appointments are scheduled in an organized fashion based upon the diagnosis.  With the advent of electronic health records, I have been able to develop templates that facilitate my documentation process.  Patients are able to leave the office with organized instructions explaining their diagnosis and plan of care.

This level of organization assures that I do not miss any step in my patient’s treatment.  By the time the patient has completed their visit to the office they have an established diagnosis with plan of care, all questions have been answered, necessary studies having been ordered, medical supplies have been dispensed, and a follow up appointment has been made as needed.  This limits my liability and the chance that something gets overlooked or forgotten.  All too often physicians are multi-tasking throughout the day and a simple distraction can lead to error.  Having an organized treatment algorithm keeps things on track to make sure nothing gets missed, and communication with your patients is of utmost importance.

 

Congrats to Western University, CPM’s Class of 2019!

Western University, CPM

Message from ABPM Past President, Lester Jones, DPM:

I want to send congratulations to the members of the WesternU College of Podiatric Medicine Class of 2019 who recently learned that they achieved a 100% pass rate on both the APMLE Part 2 written exam and the Clinical Skills Performance Exam. This stellar outcome represents the diligence and hard work that are hallmarks of the students at CPM. You are a class apart!

This is the second year in a row that the fourth-year class has scored 100% on both of these board examinations. The College leads the nation in residency placement as well as with a five-year history of 100% placement of all graduates into some of the best hospitals in America for their three-year residency programs.

I also want to thank the WesternU community of faculty and staff who work hard to make this College and University such an outstanding place for learning. Strong work all.

Lester Jones, DPM, Interim Dean, WesternU College of Podiatric Medicine

Source: PM News, Online

Meet ABPM President, Dr. Gina Painter

Dr. Gina Painter, ABPM President

Dr. Gina Painter, ABPM President

Current ABPM President Dr. Gina Painter has been a diplomate of the ABPM since 1998 and a member of the Board of Directors for the past five years. She currently serves on the Examination Committee and the Speaker’s Bureau. Past committee involvement has included  Credentials, Budget, Bylaws and Case Review.  Dr. Painter also represents the ABPM as a site-evaluator for the Council on Podiatric Medical Education and is the Board’s liaison to the APMAIn November she was inducted into the Royal College of Physicians and Surgeons of Glasgow. Dr. Painter is a graduate of the Temple School of Podiatric Medicine and practices in Great Falls, Montana.  Her practice experience is extensive and has included solo practice, partnership in a multi-specialty group, where she served as Chair of the Executive Governing Board and, most recently, as a hospital-based physician.

From Dr. Painter:

Podiatric Medicine has evolved as a whole, with increased integration into hospitals and health networks. Along the pathway toward parity within the framework of the health care delivery system the role of podiatric medicine will rely increasingly on the medical aspect of podiatric care and care of the diabetic foot.

ABPM has a strong presence in the podiatric community.  We have recently escalated our informational efforts to hospitals and insurance panels regarding the value of ABPM certification.  Within the next month new documentation will be provided on the website to members.

The ABPM will continue to act as a staunch advocate for our current and future members.  We hope to be a unifying force within the Podiatric Medical community.  The practice of Podiatry is “diagnose and treat the diseases, disabilities, and deformities of the foot by physical therapy special shoes and other mechanical devices, pharmaceuticals and surgery.”  Let us all excel at it!

ABPM Board of Directors Announces Additional Pathway for Certificate of Added Qualification in Amputation Prevention and Wound Care!

The American Board of Podiatric Medicine has announced a third pathway for its diplomates to achieve a Certificate of Added Qualification (CAQ) in Amputation Prevention and Wound Care.  Now ABPM diplomates who have an office-based practice can be eligible to sit for the CAQ exam by submitting 10 wound care cases for review by the committee.  Previously, the only way to be eligible to sit for the CAQ exam was to either have completed a CPME-approved fellowship in limb salvage or wound care, or have documented 1000 hours of wound care experience in a hospital setting.

Lee Rogers, DPM and Chair of the CAQ Sub-Committee, stated “This new pathway gives ABPM Diplomates the opportunity to demonstrate their limb salvage and wound care knowledge by obtaining a CAQ”.

Diplomates should be mindful of specific deadlines associated with the third pathway.  To allow for the full case submission process, those diplomates interested in testing in this cycle using the case review pathway should submit their applications and cases no later than November 20, 2018. For those not submitting cases, the application deadline is December 14, 2018. 

For more information regarding the ABPM CAQ in Wound Care and for all deadlines, examination dates and applications, please visit https://www.abpmed.org/pages/exam-info/caq-amputation-prevention.

Note: The CAQ in amputation prevention and wound care is issued solely by the ABPM to its diplomates.  The Joint Committee on Recognition of Specialty Boards (JCRSB) of the Council on Podiatric Medical Education recognizes the certification process of the ABPM but has not developed a recognition process for certificates of added qualification.  Therefore, at this time the ABPM’s recognition by the JCRSB does not extend specifically to the CAQ

The American Board of Podiatric Medicine (ABPM) offers a comprehensive board qualification and certification process in podiatric medicine and orthopedics. Increasingly hospitals, surgical centers, managed care organizations and insurance carriers require board certification. ABPM is the only board recognized by the Joint Committee on the Recognition of Specialty Boards, under the authority of the American Podiatric Medical Association to certify in podiatric orthopedics and primary podiatric medicine.

 

 

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