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ESWT Questions

Posted by Kim B. on 8/22/00 at 11:39 (026016)

Now that it is approved by the FDA, will other POD and physcians start using it? Will insurance start covering it as a proceedure? Amy I making any sense? Will it become more readily avialable?

Regards, Kim B.


Re: ESWT Questions

john h on 8/22/00 at 11:49 (026018)

after reading the fda report it appears to me the OssaTron will be approved for use by Orthopedic Physicians only. Is that how you read it Dr Z. at any rate the doctor will have to be trained by Healthtronics before he/she will be authorized to perform treatments. Probably the first doctor to perform the OssaTron in the U.S. will be Dr. Alverez a foot and ankle surgeon out of Chattanooga, Tn. He was on the FDA panel, participated in the pre FDA and FDA studies and has performed the procedure on numerous patients. He has a machine available in Chattanooga. I talked to the Healthtronics rep in Chattanooga today. She works out of Dr Alverez's office and is keeping a list of people who are seeking treatment. She said they are still awaiting word from the FDA on 'Final' approval. I should think the Podiatric society should be approaching the FDA before they get left at the sarting gate.

Re: John, more ESWT Questions

Kim B. on 8/22/00 at 16:00 (026034)

John, Are Podiatrists considered Orthopedists?
btw, is Dr. Z a pod or orhtopedist?
What do you make of the notion of insurance companies taking this on as a covered expense? It seems it would be cheaper for them in the long run, to heal us rather than to let the severe cases drag on for so long.

Scott's list shows chicago, new jersey, california, as having dr.s who are offer ESWT. Am I missing something? Where did you hear about the Chattanooga Dr.? Are you our resident ESWT Expert?

Any information you can provide is greatly appreciated.

Regards, Kim B.



Re: John, more ESWT Questions

john h on 8/22/00 at 17:09 (026039)

dr zuckerman is a poditrist one who specializes in feet and is the only non medical doctor who is qualified and authorized to perform surgery on the feet. dr alverez is an orthopedic surgeon (medical doctor) who is a foot an ankle surgeon. insurance companies will be slow to jump on board for paying for ESWT as they are slow to jump on anything new. scotts list is correct in that there are poditrist in chicago (dr weil), california, and new jersey (dr zuckerman) who perform ESWT with the Orbasone machine. The machine about to be approved for the treatment of ESWT by the FDA is the OssaTron and functions much like the Orbasone which the above doctors use. The OssaTron is not available yet but should be available in the next couple of months. All the various ESWT machines have been in use in europe and canada for some time. and many on this board have gone to canada for treatment. the resident expert on these machines is dr zuckerman since he uses one on a regular basis and has hands on experience.

Re: ESWT Questions

Dr. Zuckerman on 8/22/00 at 17:12 (026042)

Podiatrist can use the ossatron. All physicians will have to take a course by Healthronics. The point that the FDA was making was you have to have the ability and the doctors to train other doctors. This is a requirement for FDA approval. Healthronics must have the course available. No doctor will be allowed to just use or buy this machine without any training. This is very typical with any new machine. I had to take a special course to use a laser years ago.

Re: John, more ESWT Questions

Dr. Zuckerman on 8/22/00 at 17:22 (026043)

What the FDA doesn't want to happen is your family doctor doing this procedure without any experience in treating feet. That was what they were concerned about. Actually in the state of New Jersey, a podiatrist is a medical and surgical doctor of the foot. The scope of practice and the the training of podiatrists is different for each state and each podiatric training. In the state of New Jersey in order to get a liscence I had to take an additional one year surgical and medical training based in a hospital. I have an associate who did three years of surgical training in foot and ankle surgery at the university of Pennsyvania . With both orthopedic and podiatric doctors you have to make sure what type of training they had in foot and ankle. You can be a great orthopedic surgeon who does knees but
knows nothing about feet. To be sure that your orthopedic doctors know feet they should be foot and ankle orthopedic surgeons. They will be members of the American College of Foot and Ankle Orthopedic.
The best bet for a podiatrist is that he or she is board certified and a fellow of The American College of Foot and Ankle Surgeons. I hope that this isn't confusing anyone. Any way just ask the doctor if he has a foot and ankle practice. Find out what hospitals he is one.

Re: ESWT Questions

john h on 8/22/00 at 11:49 (026018)

after reading the fda report it appears to me the OssaTron will be approved for use by Orthopedic Physicians only. Is that how you read it Dr Z. at any rate the doctor will have to be trained by Healthtronics before he/she will be authorized to perform treatments. Probably the first doctor to perform the OssaTron in the U.S. will be Dr. Alverez a foot and ankle surgeon out of Chattanooga, Tn. He was on the FDA panel, participated in the pre FDA and FDA studies and has performed the procedure on numerous patients. He has a machine available in Chattanooga. I talked to the Healthtronics rep in Chattanooga today. She works out of Dr Alverez's office and is keeping a list of people who are seeking treatment. She said they are still awaiting word from the FDA on 'Final' approval. I should think the Podiatric society should be approaching the FDA before they get left at the sarting gate.

Re: John, more ESWT Questions

Kim B. on 8/22/00 at 16:00 (026034)

John, Are Podiatrists considered Orthopedists?
btw, is Dr. Z a pod or orhtopedist?
What do you make of the notion of insurance companies taking this on as a covered expense? It seems it would be cheaper for them in the long run, to heal us rather than to let the severe cases drag on for so long.

Scott's list shows chicago, new jersey, california, as having dr.s who are offer ESWT. Am I missing something? Where did you hear about the Chattanooga Dr.? Are you our resident ESWT Expert?

Any information you can provide is greatly appreciated.

Regards, Kim B.



Re: John, more ESWT Questions

john h on 8/22/00 at 17:09 (026039)

dr zuckerman is a poditrist one who specializes in feet and is the only non medical doctor who is qualified and authorized to perform surgery on the feet. dr alverez is an orthopedic surgeon (medical doctor) who is a foot an ankle surgeon. insurance companies will be slow to jump on board for paying for ESWT as they are slow to jump on anything new. scotts list is correct in that there are poditrist in chicago (dr weil), california, and new jersey (dr zuckerman) who perform ESWT with the Orbasone machine. The machine about to be approved for the treatment of ESWT by the FDA is the OssaTron and functions much like the Orbasone which the above doctors use. The OssaTron is not available yet but should be available in the next couple of months. All the various ESWT machines have been in use in europe and canada for some time. and many on this board have gone to canada for treatment. the resident expert on these machines is dr zuckerman since he uses one on a regular basis and has hands on experience.

Re: ESWT Questions

Dr. Zuckerman on 8/22/00 at 17:12 (026042)

Podiatrist can use the ossatron. All physicians will have to take a course by Healthronics. The point that the FDA was making was you have to have the ability and the doctors to train other doctors. This is a requirement for FDA approval. Healthronics must have the course available. No doctor will be allowed to just use or buy this machine without any training. This is very typical with any new machine. I had to take a special course to use a laser years ago.

Re: John, more ESWT Questions

Dr. Zuckerman on 8/22/00 at 17:22 (026043)

What the FDA doesn't want to happen is your family doctor doing this procedure without any experience in treating feet. That was what they were concerned about. Actually in the state of New Jersey, a podiatrist is a medical and surgical doctor of the foot. The scope of practice and the the training of podiatrists is different for each state and each podiatric training. In the state of New Jersey in order to get a liscence I had to take an additional one year surgical and medical training based in a hospital. I have an associate who did three years of surgical training in foot and ankle surgery at the university of Pennsyvania . With both orthopedic and podiatric doctors you have to make sure what type of training they had in foot and ankle. You can be a great orthopedic surgeon who does knees but
knows nothing about feet. To be sure that your orthopedic doctors know feet they should be foot and ankle orthopedic surgeons. They will be members of the American College of Foot and Ankle Orthopedic.
The best bet for a podiatrist is that he or she is board certified and a fellow of The American College of Foot and Ankle Surgeons. I hope that this isn't confusing anyone. Any way just ask the doctor if he has a foot and ankle practice. Find out what hospitals he is one.