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Informational webinar on unique 401k solution for your medical practice

Feb 1 2021 12:52:03 AM

Join us on Tuesday, February 23 at 8:00 pm (Eastern Time) for an informational webinar to learn more about a new Diplomate benefit from the ABMSP: The Sovereign Retirement Edge – What a 401k Should Be. The Sovereign Retirement Edge is a unique 401k solution for your medical practice.

  • Would you like an easier and more cost-effective way to offer yourself and your employees a retirement plan solution?
  • Would you like to shift the fiduciary burdens of sponsoring a 401(k) from yourself to professional fiduciaries?
  • Would you like to have access to virtually all investment options and strategies available today, and get access to those investment options directly in your 401(k)?
  • Would you like to never sign a 5500 form again?

If your answer to any or all these questions is “yes”, then, you will want to attend this webinar to learn more about this new Diplomate benefit being offered by the American Board of Multiple Specialties in Podiatry:

Thanks to new legislation, small to mid-sized employers, like ABMSP Diplomates, can now pool together in the same retirement plan, providing affordable benefits similar to some of the largest companies in the country.

Overview and Advantages of a PEP

Under the SECURE Act, the first significant retirement-related legislation in more than a decade, employers can offer retirement plans to their employees through a Pooled Employer Plan (PEP). A PEP, available starting in January 2021, is a new kind of defined contribution plan similar to the 401(k) plans offered today by individual employers, but with many advantages for you and your employees. In a PEP, employers of all sizes, industries, locations, etc. can join together and become a “member employer.” The PEP is offered by a Pooled Plan Provider (PPP) who is responsible for the establishment, management, fiduciary oversight and operations of the plan on behalf of all the member employers.

The Offer

The ABMSP has negotiated special pricing for its members for this retirement plan solution being provided by Sovereign Financial Group Inc., and The Newport Group. Specifically, ABMSP Diplomates will receive a $500 annual rebate towards the plan costs each year they remain active with ABMSP.

Advantages of a PEP

  • Cost Efficiencies – Costs are lower because they are spread across a larger participant and asset base reducing the costs for each member of the plan.
  • Fiduciary Risk Mitigation – Fiduciary duties are outsourced to Sovereign Financial Group, Inc. as an ERISA 3(38) investment fiduciary.
  • Operational Outsourcing – Newport, as the pooled plan provider, assumes many of the administrative burdens on behalf of member employers including eligibility, beneficiary tracking and plan disbursements.
  • Increased Focus – Member employers use fewer resources allowing more focus on growing revenues and profits in their business.

Other Benefits

  • Integrated trust and custody services
  • Digital access to all plan functions and information
  • Payroll contribution tracking and integration
  • Integrated non-qualified plans
  • Full-function participant website and call center
  • English & Spanish website
  • Full suite of participant educational materials
  • Financial wellness program

If you are interested in joining this Zoom call, please email [email protected] or contact us online to get the Zoom link instructions for February 23 at 8:00 pm Eastern Time.

The American Board of Multiple Specialties in Podiatry Co-Sponsors World-Class Webinar in Podiatric Sports Medicine

Jun 29 2020 03:20:09 AM

Dr. Tim Dutra Assistant Professor of Applied Biomechanics with California School of Podiatric Medicine at Samuel Merritt University and Podiatric Consultant for Intercollegiate Athletics, University of California, Berkeley, Dr. Kenneth Rehm, Clinical Assistant Professor at the California School of Podiatric Medicine and Vice President of the American Board of Multiple Specialties in Podiatry (ABMSP) and Dr. Howard Liebeskind, all board-certified in Podiatric Sports Medicine by ABMSP, are proud to have facilitated the Podiatric Sports Medicine Webinar at the Virtual Western Foot & Ankle Conference, June 25-June 27th. Hats off to Dr. Liebeskind and Dr. Dutra who were the moderators and organizers of this event, sponsored in part, by the American Board of Multiple Specialties in Podiatry. The world-class speakers they arranged provided brilliant insights into the role that the podiatric sports medicine physician plays in professional, collegiate, and school sports programs. This webinar provided a pivotal opportunity for those board- certified in podiatric sports medicine to acquire knowledge in how to assert their specialized expertise. Professional certification in podiatric sports medicine is available to all medical practitioners of lower extremity medicine by the American Board of Multiple Specialties in Podiatry. This is an experienced-based, portfolio certification that requires no exam. You may find more information about or apply for certification in sports medicine at www.abmsp.org
 

Distinguished Authors Series
The opinions expressed here are those of the authors and do not necessarily reflect the positions of the American Board of Multiple Specialties in Podiatry or its Directors.

Risks of Major Adverse Limb Events in Diabetes: The Essential Role of Podiatric Medicine

Leonard A. Levy, DPM, MPH

Introduction
Epidemiology is the study of disease occurrence in human populations, its primary concerns being groups of persons rather than separate individuals. This includes the risk that people have of acquiring a disease. It helps us to understand how many people have a disease or disorder, if those numbers are changing, and how the disorder affects our society, our economy, as well as being key in identifying the critical role that podiatric medicine has with patients. (1)

Epidemiological Overview of Type 2 Diabetes and Lower Limb Amputation

Factors in adults with type 2 diabetes associated with major adverse limb events include elevated HGA1c, insulin use, neuropathy, prior laceration, and prior amputation as well as age, gender, smoking, peripheral vascular disease (PVD), and coronary artery disease, indicates W. Schuyler Jones, MD, et al in a study done at the Duke University School of Medicine. Major adverse limb events in the study included non-traumatic amputation, gangrene, and lower extremity revascularization. The risk for a major adverse limb event increased in those with PVD, prior foot ulcer, cerebrovascular disease, current and former smokers, those who used insulin, and men. (2)

Older age also was significantly associated with major adverse limb events. The majority of adverse limb events were in those with PVD with a significant minority occurring in patients without a documented history of PVD. The incidence of vascular lower limb amputation at or proximal to the transmetatarsal level is eight times greater in those with diabetes compared to those who are non-diabetic. In addition, one in four amputees may require contralateral amputation and/or re-amputation. Severe PVD is found in 5% of people age 65 years and older but in patients with diabetes PVD is found in one in four. In a ten-year study conducted in the southern part of Sweden in a health care district with a population of about 170,000, the incidence of initial amputation in the general population of all ages due to diabetes was 179 per 100,000 person-years while amputations due to PVD in non-diabetics were 10 per 100,000 person years. It is also interesting to note that the most frequent re-amputation level among diabetic patients was trans-tibial compared to trans-femoral among non-diabetic individuals. The most common level for initial amputation was the trans-tibial level. The ratio of trans-tibial to higher level amputation in diabetic patients was 8.2:1 compared to 2.6:1 in those who were non-diabetic. (3)

Epidemiology of Type 2 Diabetes and the Impact of Podiatric Medicine

Podiatric physicians should be prepared to provide care for complications due to diabetes because of the exponential increase in the incidence of the disease worldwide. Disorders of the foot represent one of the most prevalent and feared complication of diabetes. Evidence from resource-rich industrialized nations show a decrease in the incidence of diabetes-related lower limb amputations by 48-78% after the introduction of multidisciplinary foot care clinics, streamlined care pathways, and patient education in foot screening. In most lower- and middle-income countries attention is mostly focused on achieving glycemic targets with limited effort at improving patient education, self-care practices, and control of vascular risk factors such as hypertension and obesity. This includes patients lacking knowledge about foot care, delaying in seeking treatment, the lack of proper foot care. There is a need to raise awareness and increase access to services focused on diabetes-related foot health. Included is the availability of advice on such preventive podiatric measures such as appropriate footwear, strategies to offload pressure points, regular vascular and neurological (i.e., diabetic neuropathy) assessments, and other interventions. Epidemiological studies report that yearly 2.5% of patients with diabetes are affected by diabetic foot ulcers. Furthermore, 15% of patients with diabetes will ultimately be affected by diabetic foot ulcers. Approximately 20% 0f hospital admissions in people with diabetes are due to foot ulcers. The lifetime risk of developing a foot ulcer for someone with diabetes is 25%. A foot ulcer is the initial event in more than 85% of major amputations that are performed on people with diabetes. Also, throughout the lifetime of a patient with diabetes mellitus the incidence of foot problems ranges from 10-25% which is strongly correlated with mortality and lower extremity major amputations. Amputation-free survival is extremely important in assessing the management of diabetic foot problems. This is emphasized by noting that mortality following amputation ranges from 13-40% in one year, 35-60% in 3 years, and 39-80% in 5 years which is worse than most malignancies.(4)

The amputation rate of lower extremities is six times higher in patients receiving hemodialysis compared to those who do not and life expectancy of patients receiving hemodialysis therapy is 1.5 times shorter than those not receiving treatment. There is a strong correlation between diabetic foot ulcers and blood glucose control. Hyperglycemia interferes with the migration, adhesion, phagocytosis, and opsonization of leucocytes. Opsonins are proteins of the innate and adaptive immune system that facilitate phagocytosis and cell lysis. Opsonization modifies antigens by opsonins to make them more accessible to phagocytic cells and other immune cells. When other factors are eliminated, a 1% elevation of HbA1c is reported to increase the peripheral artery disease (PAD) risk by 28%. Studies report that patients with HbA1c levels over 7.5% had increased amputation rates of 20-54%. In addition, studies also show that diabetes-related amputation rates in men are higher than in female patients, suggested to be due to the negative effects of bad lifestyle habits such as alcohol consumption, smoking, and poor foot care. This is associated with ulcerations that take longer to heal in men and are more likely to end in amputation. (5)

Conclusion

Epidemiological factors help to explain the potential devastation that can occur in patients with type 2 diabetes, too often resulting in amputation and death. It is important that podiatric physicians not only focus on lesions and other symptoms locally affecting the foot in those with diabetes. Because of it multisystem involvement, diabetes requires the podiatric physician to develop close relationships with other physicians leading to coordinated and integrated care. The contribution that podiatric physicians can make in the care they provide for diabetic patients is a key factor in insuring the health and well-being of the growing population of those afflicted with the disease.

References

  1. Gary Friedman. Primer of Epidemiology- 5th edition 2004; Chapter1:1
  2. W. Schuyler Jones, et al. Predictive model identifies risk factors for major adverse limb events in diabetes. Diabetes Medicine; 2021 April
  3. Anton Johannesson, et al. Incidence of lower-limb amputation in the diabetic and non-diabetic general population. Diabetes Care 2009 February; 32(2): 275-280
  4. Osei Sarfo-Kantanka, et al. Incidence and determinants of diabetes-related lower limb amputations in Ghana. 2010-205- a retrospective cohort study. BMC Endocrine Disorders 2019 March; article number 27
  5. Salih Beyaz, et al. Factors affecting lifespan following below-knee amputation in diabetic patients. Acta Orthopaedica Traumatologic Turcica 2017 October; 51 (5): 393-297

Author Biography
Leonard A. Levy, DPM, MPH

Dr. Leonard A. Levy served as dean of three podiatric medical schools and president of one. In 2016 he was appointed Professor Emeritus at the Dr. Kiran C. Patel College of Osteopathic Medicine (KPCOM) of Nova Southeastern University (NSU) in Fort Lauderdale, Florida and, for 17 years previously, was Associate Dean for Research and Innovation, and Professor of Family Medicine/ Public Health/ Biomedical Informatics. He is listed in Marquis Who’s Who in America. In 2009 he became the first podiatric physician appointed a Fulbright Scholar, serving in Bratislava, Slovakia at the Faculty of Medicine of Comenius University and currently is a reviewer of applicants to the Fulbright Scholars Program, a component of the U.S. Department of State. After 9/11 he became Founding Director of the KCPCOM Institute for Disaster and Emergency Preparedness training physicians, other health professionals, and first responders in 48 of the 50 states and 14 foreign nations, funded by grants of more than $5 million from the US Public Health Service. He also coordinated several self-studies for the accreditation of multiple allopathic medical, osteopathic medical, podiatric medical, and academic health science centers.

Since 2013 he has been a reviewer for Academic Medicine, published by the Association of American Medical Colleges (representing all of the accredited allopathic medical schools in the U.S. and Canada), likely the most widely circulated journal on medical education in the world.
In 1972, on invitation of the chair of the Department of Dermatology of Stanford University School of Medicine, he was appointed Clinical Associate Professor of Dermatology, subsequently invited to be a member of the American Academy of Dermatology, and is now a Life Member of the Academy.

Since his retirement from NSU-KPCOM in 2016 he was invited to assist the new NSU College of Allopathic Medicine in the development of their curriculum by serving as a member of its Curriculum Committee.

Dr. Levy authored 111 peer reviewed articles in osteopathic medical, allopathic medical, public health, and podiatric medical journals and is author/editor of two major podiatric medical texts and contributing author to other medical texts. He has lectured nationwide and internationally to physicians, other health professionals, and health professional students. In the last 15 years of his tenure at NSU-KPCOM he applied for and acquired more than $20 million in grants mainly from the U.S. Public Health Service (USPHS)

In 2010 he served on a panel for the National Human Genome Research Institute of NIH focusing on primary care providers assuming a role in genetics and genomic medicine. Over his long career, he also has served on multiple USPHS grant review panels occasionally as chair.

Champions Blog

The Birth of Podiatric Sports Medicine: The Academy and Now Board Certification

A number of important figures present and past have made possible the new podiatric sports medicine certification.

BY KENNETH B. REHM, DPM

The long-awaited board certification in podiatric sports medicine is now available to all doctors who want a valuable credential allowing them to declare that they are a qualified podiatric specialist in sports medicine. It has been a long and interesting journey involving two unique organizations and a host of talented individuals. Here is the full story… highlighting those whose contributions made it possible.

The 1970’s brought about the birth of podiatric sports medicine. The impetus for most of the interest in sports medicine by podiatrists back then arose out of the running boom and the development of the American Association of Podiatric Sports Medicine. Doctors George Sheehan, Robert Barnes, George Pagliano, Richard Gilbert and Steven Subotnik brought the role of the podiatrist in sports medicine to national attention.

The momentum they created has not stopped; and now the field is in full bloom where physicians such as Dr. Jeff Ross merges his expertise in diabetic foot medicine and surgery with biomechanics and sports medicine, culminating in an efficacious bridging of podiatry with collegiate and high-school sports. Dr. Ross served as team podiatric physician for the Baylor University football team and is a consultant for the University of Houston track team, while also playing an active role in high school sports. Adding to his credentials and fueled by his intense love for skiing, his in-depth research defined its biomechanics. His incredible passion was a driving force that propelled podiatric sports medicine to the pinnacle of recognition and the establishment of the highly anticipated board certification by the American Board of Multiple Specialties in Podiatry (ABMSP).

“Dr. Richard Gilbert, podiatrist to the San Diego Chargers, was a pioneer in the development of the AAPSM.”

The Trailblazers
The idea of a board certification in podiatric sports medicine was initially seeded by the esteemed Dr. Richard Gilbert (Figure 1), pioneer in the development of the American Academy of Podiatric Sports Medicine (AAPSM) and podiatrist to the San Diego Chargers. His powerful motivation was to unite the various avenues of podiatric medicine and surgery through an amalgamation of talents vital to forming a complete spectrum of podiatric sports medicine expertise, where trained DPMs could interchange ideas and knowledge with seasoned professionals.
Arguably, the first podiatric sports medicine celebrity was Dr. Steve Subotnik, an athlete himself who was featured in Runner’s World.

Figure 1: Richard Gilbert, DPM, The Father of Podiatric Sports Medicine

Magazine and author of The Running Foot Doctor (Figure 2). Because of his groundbreaking work in surgery, biomechanics and sports medicine, Dr. Subotnik was possibly the single most influential force in putting podiatry on the map. He cut his “sports medicine teeth” as a professor at the California College of Podiatric Medicine where he taught surgery and biomechanics. This period of his 50-plus year career was especially gratifying to him, particularly when established doctors, who were students of his in those fledgling years, came up to him at meetings and told him what an impact he had on their career.

Dr Subotnik’s sports medicine career rocketed when he became a marathon runner, and his intense involvement and resulting contributions brought the podiatry profession new recognition and acceptance. His notable cabal included health-related celebrities such as Dr. George Sheehan, a cardiologist who became the legendary philosopher of the recreational running movement in the 1970’s and 1980’s.

For years, Dr.Subotnik, one of the founding fathers of the American Academy of Podiatric Sports Medicine, felt that board certification in podiatric sports medicine would take this specialty to the next level, as it separates the spectators from the players. His commitment to board certification was key to the formation of the new certification by The ABMSP. Dr. Subotnik states: “Sports medicine helps define modern podiatry because biomechanics is the defining factor in podiatry and is also an integral part of sports medicine. The podiatric practice of sports medicine is so important, now more than ever, because it will continue to keep podiatry on the map; because through biomechanics we can make a real difference.” He goes on to say, “Once you’re an athlete who sustains a foot injury, and being active is part of your life, you will seek the help of a sports medicine podiatrist at any cost, regardless of any bureaucratic or insurance limitations.”
His driving philosophy summarizes the importance of the foot and its biomechanics: “Controlling the feet controls the rest of the body”, which is philosophically apropos coming from this champion podiatric sports physician.

“Arguably, the first podiatric sports medicine celebrity was Dr. Steve Subotnik, an athlete himself.”

The Protégés
From these trailblazers came their protégés who turned out to be the innovative architects of modern podiatric sports medicine. A key figure is Dr. Tim Dutra, who has advanced the traditional teachings as well as integrated this established doctrine with up-to-date sophisticated computerized gait and motion lab analysis of the athlete. His position as an assistant professor and clinical investigator at Samuel Merritt University allows him to parlay his knowledge of biomechanics and sports medicine into skillfully watermarked ideas and principles commendably driven into his students’ psyche. His uncompromising enthusiasm for improving the podiatric health of athletes is demonstrated through his tireless engagement in the Special Olympics, consulting for the Golden State Warriors basketball team as well as working with the University of California, Berkeley as a consultant for inter-collegiate sports. He has been active with the AAPSM since he started the student chapter while at the California College of Podiatric Medicine. What Dr. Dutra brings to sports medicine is merging the podiatry profession with the community; to memorialize the podiatrist’s vast training, knowledge and experience and to encourage the sporting community to take advantage of this valuable resource.

Figure 2: What started it all: Dr. Steve Subotnik and The Running Foot Doctor

Dr. Jeff Ross, president of the Texas Podiatric Medical Association and an associate professor of surgery in the division of vascular surgery and endovascular therapy, as well as a clinical associate professor in the department of medicine at Baylor College of Medicine, brings to sports medicine a whole new perspective. He not only served as president of the AAPSM but also co-chaired the Governor’s Council on Physical Fitness, served for 12 years as a member of the Texas Department of State Health Services Council and was an esteemed member of the Texas Diabetes Council. His credentials sanction him as a national and international expert in sports medicine, biomechanics, wound healing and limb preservation. Dr. Ross’s unique contribution, therefore, is being able to fuse the disciplines and surgical principles of diabetic foot medicine with sports medicine, as there are pathways common to both that are brought to light through his extensive lecturing and vast publications. Dr. Ross, inspiring to all, is a valued and motivated partner in the creation of the new certification.


AAPSM and ABMSP

This new board certification could not have happened without the genius of Stephen B. Permison, M.D., who serves as president of Standards Based Programs, Inc. (SBP Inc.), director of the ABMSP Standards Development Organization (www.abmsp-sdo.com) and a voting member of multiple professional boards. SBP Inc. has developed and is currently developing standards, credentialing and certification programs for private industry, medical professional boards and the U.S. Government. Professional credentials, such as the ABMSP certification in sports medicine for podiatrists, assures the public that certified professionals have the proper skills to practice their designated professions with consistent medical outcomes. These intensely scrutinized policies bestow a hand of trust, allowing the public to expect quality and consistency in both in the practice of podiatric sports medicine and any products or devices that support this discipline. Dr. Permison states that “the definition of professional is quality, consistency and integrity”, exactly what his expertise imprinted into the structure of the new board certification.

“Dr. Earl Horowitz’s focus on the geriatric patient contributed powerfully to the unique quality of this new board certification.”

Dr. Victor Quijano is Chief of Podiatric Medicine and Surgery at the Veterans Administration Medical Center in Portland, Oregon. His Ph.D. and his knowledge of molecular endocrinology boosts his pursuit of comprehensiveness in the practice of podiatric sports medicine beyond the treatment of the traditional athlete. He calls for more academic and clinical inclusiveness in the discipline of podiatric sports medicine to embrace those challenges that deal with diabetes and other metabolic disorders, as well as those conditions that affect our country’s veterans. His was a needed voice in the development of this quality certification.

Dr. Earl Horowitz (Figure 3) is the president of the ABMSP and most recently became one of the first podiatrists in the United States to become board certified in Geriatric Podiatry. Dr. Horowitz is a true visionary with a passion for the health of the senior population. Preventing the geriatric patient from developing unnecessary muscle weakness, inactivity and immobility, through sports, exercise and precaution is what fuels Dr. Horowitz’s zeal for the field of podiatric sports medicine. “Maintaining foot health, balance and strength as we age are essential considerations in preventing such things as falls, which often starts a downhill spiral that can even lead to death in an elderly person. This can all be prevented by seriously addressing this part of our practice.” His focus on the geriatric patient contributed powerfully to the unique quality of this new board certification.

Figure 3: Earl Horowitz DPM, A True Visionary, President of American Board of Multiple Specialties in Podiatry

Rita Yates, executive director of the American Academy of Podiatric Sports Medicine worked hand in hand with the Executive Director of the American Board of Multiple Specialties in Podiatry, Joan Campbell, to formulate a meaningful advancement from Fellow of AAPSM to Board Certification by ABMSP. This was done in collaboration with the formative team which, in addition to those already discussed, also included the following doctors whose contributions were invaluable: David Jenkins, D.P.M; Diane Mitchell-Prey, D.P.M; Doug Taylor, D.P.M; Richard Blake, D.P.M; and Steven Tager, D.P.M.

To summarize, world-class talent representing a wide range of expertise, each having intense passion for their individual niche, brought this board certification to fruition. The intended and expected outcome is to support the highest level of practice in sports medicine for the modern podiatrist; and to secure the optimum level of care for their patients. This bright light will undoubtedly ensure a brilliant future for the unabridged formidable field of podiatric medicine and surgery.

In conclusion, podiatric sports medicine defines the future of podiatry because it’s an area where committed athletes are committed to staying in the game no matter what; and there is no better place to get help for those with sports-related problems of the lower extremity than a podiatric physician and surgeon who is board certified in podiatric sports medicine.