Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Update need

Posted by Ralph on 3/19/05 at 07:30 (171557)

Vince are you a doctor or someone that possibly uses the Dornier machine or has some type of financial connection to this machine?

The reason I ask is that you seem to really push this machine and also because of the type of medical information your able to provide in your response to others.

Here is an example of what I mean. 'Re: Dornier vs OssaTron View Thread
Posted by vince on 3/12/05 at 06:43

It is important for you to consider that the problem your having with your right foot may not significantly be traction degeneration of the plantar fascia at the medial tubericle but possibly be complicated by another problem like a Baxter's nerve entrapment? If this exists then you would probably have diminished results no matter what ESWT method was used. A important fact to consider is whether or not you have post kinetic dyskinesia or whether you have pain only following activity.

I'm just wondering how many others here would be able to generate a response using this terminology?

Someone mentioned they thought this site was rigged. I dismissed rigged, but I think it truly pushes only the Dornier Machine provided by two groups United or Dr. Z's group.

Message Number 170908

Re: Update need

Dr. Z on 3/19/05 at 08:36 (171558)

I noticed this post also. I will point out that I am the first and only doctor/company that revealed that they do use the dornier and do advocate ESWT. I was was the first to report back any ESWT treatment in the USA to this site over five years ago. There are alot of posters who hide. Why ??

Re: To Raklph

Julie on 3/19/05 at 09:43 (171559)


In the short time you have been posting here, you have several times voiced suspicions of this nature.

I have no connection with Dr Z (other than knowing him through my five years' participation at heelspurs) or with his company, or with the Dornier machine. Sure, I expect that some of his patients find out about him here, and go to him for ESWT. His openness about the treatment he provides and the machine with which he provides it could be seen as touting business. I think of it as fair compensation for his time and trouble, and as long as he does what he does with the intention to help, and does it professionally, skilfully, and well, I have no problem with it.

Before you next make a post about the 'rigging' and 'pushing' which strikes you as biased, why don't you go out and find two more podiatrists who provide ESWT, one with the Ossatron and one with the Sonocur, to come and give their time and their advice (free, for years on end) on this website. They can talk about their machines as much as they like as long as they're prepared to commit themselve to giving half as much time as Dr Z does to answering people's questions.

Re: To Ralph

Julie on 3/19/05 at 09:47 (171562)

Sorry for the typo in your name, above.

I hit the Send button before pointing out that Vince has said, a number of times in response to the suspicions of others', that he has no connection with Dornier. And any intelligent person with a medical problem can easily learn enough about it to make a post like the one of his you are questioning.

Re: To Ralph

Ralph on 3/19/05 at 10:35 (171565)

I don't mean to be suspecious call me dumb, but I honestly could never use
'post kinetic dyskinesia' correctly in a sentence to anyone. I have no idea what that means.

You probably know a lot more than I do about medical conditions and terms and perhaps you too can have these words roll off your tongue easily too. I honestly haven't seen a lot of lay people use these kinds of words accept for the doctors here.

That's just my observation. The reason I asked Vince is because I thought perhaps I'd missed a post where he said he was a doctor.

Re: To Ralph

Dr. Z on 3/19/05 at 10:55 (171566)

This is what caught my eye. Only a podiatrist would use this term. I really don't care who Vince is but that post would have had a jury more the podiatrist verdict into enought to convince me. But who knows and who cares.
It still amazes me how all of the companies except Excellence and Pain-Free are the only willing to identify and tell you who they are. The rest hide. If you tell the truth you should have nothing to hide.

Re: To Ralph

Julie on 3/19/05 at 11:06 (171569)


The word 'kinetic' refers to movement. Dyskinesia is a medical term that means impaired movement, so post-kinetic dyskinesia is impaired movement following activity: i.e. a typical symptom of PF and one that a person who has researched their condition might well be familiar with. But that wasn't my point. My point was that it isn't that difficult or unusual for lay people to become familiar with the medical terms that relate to their condition, and one doesn't need to be a doctor to be able to use them (you should have heard me talking about the finer points of my ruptured disc a couple of months ago!)

I didn't think you were suspicious of Vince: I knew your question to him was sincere. But I have been concerned about your suspicion, which you've voiced several times, of the biased nature of this website. I can see why someone like yourself, in search of answers, coming here for the first time during a time of lively discussion of ESWT as you did, might infer that there is bias in favour of the Dornier. But this is really due to the fact that the Doctors Z and Ed, who help out here the most, use that machine. They think it's the best, and they say so. That doesn't mean that the site itself is 'rigged', or that it 'pushes' Dornier, and to say so is unfair to Scott Roberts, the webmaster. As I said - find us some more podiatrists who use other machines and you'll surely hear plenty of enthusiasm for them.

Re: To Dr Z

Julie on 3/19/05 at 11:13 (171570)

Not true. Anyone who knows the term, or any other medical term, could use it. I'm familiar with it from reading your and the other doctors' posts, and although I've had no occasion to use it until today, I could use it if I wanted to. :)

As for Vince, he has said several times that he is not a doctor and has no connection with Dornier. Isn't it time we took him at his word?

Re: To Dr Z

Dr. Z on 3/19/05 at 11:23 (171571)

It really doesn't matter who he is . I just don't enjoy the games.but its
part of heelspurs.com life. Either love or leave it.
PS: I still belie ve that Vince works for United or is a podiatrist who uses United. Again it does matter.
----- Original Message -----
To: <(email removed)>
Sent: Saturday, March 19, 2005 12:13 PM
Subject: bbs: Re: To Dr Z

Re: To Julie

Ralph on 3/19/05 at 11:50 (171573)

Maybe for others but certainly not for me. Do you remember explaining Osteo something or other to me when I thought it refered to the colon?
I didn't know about that either.

Re: To Dr Z and Ralph

Julie on 3/19/05 at 12:10 (171574)

No, sorry: I think we've got to take people at their word when they've said again and again that our suspicions are unfounded. Otherwise we're accusing them of lying. Do you think Vince is lying? I've had my concerns about some of his non-medical posts, but I've appreciated his medical knowledge, and I don't think he is a liar.

Now, Dr Z: you underestimate lay people. What's so strange about a person referring to 'lateral epicondylitis' if s/he knows that term, instead of saying 'tennis elbow' (which in most cases has nothing to do with tennis)? It's just accurate: you don't have to be a doctor to use it. I use it rather more often (though not very often) than I use 'post-kinetic dyskinesia' (which I have never used until today) :)

My name is Julie, by the way. When I was little our family dentist always called me Julia - it's a lovely name, but not mine.

Ralph, if this keeps up you're going to start thinking I'm a doctor. I'm not: just an educated patient.

Cheers - and I hope you'll stop suspecting heelspurs.com of bias now.

Re: To Dr Z and Ralph

Ralph on 3/19/05 at 12:30 (171575)

And I hope you will excuse those of us who are unfamiliar with most medical terminology accept for the word injection. A doctor Julie, no way not until you begin to use more medical terms to describe treatments and conditions.

Here is my sentence with my new words. My fingers are suffering from post kindic dyskinesia. I hope they will be better by dinner time:*

Re: To Dr Z and Ralph

Dr. Z on 3/19/05 at 13:23 (171577)

The strange part is not that he used the term CLE or lateral epicondylitis but that he stated that United used the procedure all over the country.
This isn't on the United web site. If it smells like a rose it is a rose
That is my point. Vince is in some way has a relationship with United. Again I really don't care but the games are ridiculous, and when someone does tell you who they are how can you believe anything they say

Re: To Ralph

Julie on 3/19/05 at 14:54 (171585)

There's nothing to excuse, Ralph. Don't worry.

Now look after your dyskinetic digits. ;)

Re: To Dr Z

Julie on 3/19/05 at 15:00 (171586)

I see what you mean. But - he could know it from his acquaintance with United personnel, of course, or from reading about it. How would I know? I just would rather not think Vince is lying - not when he's been asked the same question, and has given the same answer, a dozen times.

But you clearly feel otherwise, and you could be right. I think it's for Vince to speak again for himself.

And I have to say again: the point of my post to Ralph was to say what I felt about his suspicions of 'rigging' and 'pushing', which were directed not only at you, but at this website. I'd have thought you would be as concerned about that as I. Vince, whoever or whatever he is, isn't any more important here than anyone else. You are. Scott is. And the integrity of the site is.

Re: To Dr Z

Dr. Z on 3/19/05 at 16:44 (171592)

I agree WITH all you are saying. Sometime I may get away from what is important and that is this site.

Re: To Raklph

elliott on 3/19/05 at 21:25 (171605)


You lavish praise on Dr. Z for his time spent here; this is not your first post along those lines. Yes, there is something lovable about Dr. Z's personality, and he does offer appreciated medical advice too. But don't you think, given he is soliciting patients here, Dr. Z (and the web site he directs patients to) should be held to a high standard of accuracy? And I'm not talking about things you need a PhD in statistics or maths to figure out. He seems to be held to no standard of accuracy at all, and his inaccurate claims, numerous they are, are almost always biased in favor of the machine he uses. I don't see the other ESWT providers here doing this. I don't care whether it's carelessness or intentional, it shouldn't happen on this site--people might seek his treatment based on his inaccurate claims. Why doesn't that bother you? I honestly believe that curbing inaccurate claims is necessary for the integrity of this site, and am disappointed that at the least there aren't a few voices who chip in and say, you know Dr. Z, what you said is clearly wrong, so can it. If it's just me pointing it out, I come across as a troublemaker.

Re: To Raklph

Dr. Z on 3/19/05 at 23:17 (171612)

Could it be that maybe people think Elliott is wrong and that is the silence. I have many times stated that Excellence is willing to discuss your point of view on the phone.
This site has nothing to do with any other site, especially http://www.eswtusa..com
I will ask very nicely to stop with the slander Elliott.

Re: To Elliott

Julie on 3/20/05 at 03:19 (171614)

Yes I do think that all the doctors who post here should be held to a high standard of accuracy. And so, having studied the Dornier-Ossatron comparison on the Excellence website a week or so ago, I suggested to Dr Z that he drop it, it being misleading and there being no necessity for it. And he replied that he might do so. Since you had said that this was all you were asking, I'd have thought you'd regard this as progress.

Elliott, you have been trying to get me 'on your side' in this crusade of yours for the past two years at least. You're not going to succeed, because while I may agree with some of your concerns, I will not come to your assistance because I dislike very much the way you harry Dr Z. It strikes me as a personal, as well as an intellectual/professional crusade, and it's offensive to me. Others may feel as I do, or may not think about it at all, or may simply be keeping their heads down. No-one wants to get involved in heated discussions (apart, of course, from you and me, and I don't especially enjoy it).

I'm not sure that people do see you as a troublemaker, but if they do, I'd say you've only yourself to blame. Express yourself less abrasively, be less confrontational, and you might come across as more of a helper.

Take care. I hope you're healing well.

Re: To Dr Z

Julie on 3/20/05 at 03:34 (171615)

I wish Elliott would express himself less harshly too. But I think you're forgetting something?

I wrote, on March 11:

'I've stayed out of the discussion because I've not liked the acrimony being directed at you and your business, but having looked at the links Elliott posted to the Ossatron study and to your website, I must say that I'm wondering why you feel the need to post the comparison between the two machines at all. Whether it's a valid apples-to-apples comparison or not, and to my statistically-untrained eye it doesn't look as though it is, is it really something your audience needs to know when they come to your website?

Mightn't it be better to remove the machine comparison altogether and stick to the real point, the important point, which is that you are offering a treatment that has been proven to be effective for PF. Why do you feel it necessary to prove to visitors to your website that the machine you use is better than the other machine, or to offer them percentages? Most people at that stage are seeking a doctor they can trust, who can deliver a treatment that might help them, and couldn't care less about which machine is used and may never even have heard of either. Clarity and precision in the description of the treatment, and accurate information about yourself and your background, qualifications, and experience, are what they are looking for - certainly what I would be looking for.

You and Ed have always said that the most important factor in the delivery of ESWT is not the machine but the skill and experience of the treating doctor. I am sure that is true, so why not try at the website stage to build trust in you as a practitioner, and in the treatment itself, and ditch the machine comparison?'

You replied:

'I will speak with my partner about this. We are making some major graphic changes on our site and this just may be the opportunity seriously consider whether anything about the Ossatron should be on our site.'

Has any progress been made?

Re: To Dr Z

Dr. Z on 3/20/05 at 10:26 (171618)

I have brought this up to her. We are in the process of an upgrading for the entire web site and the comparison issue is something I have mentioned.
We are changing alot graphics and information that will help posters/patietns

Re: To Dr Z

Julie on 3/20/05 at 11:11 (171622)

Thank you Dr Z.

Remember: Julie, not Julia.

Re: To Dr Z

Dr. Z on 3/20/05 at 13:19 (171627)

Thanks. I do also want to point out that this change has nothing to do with Elliott and what ever his goals. are. We are doing this due to our new logo changes. It is very interesting how it is only Dr. Z and no other ESWT providers including Canada that Elliott choices to review. I will also repeat that you can make comparison between the ossatron and the dornier and in no way is Elliott the final say on what can and can't be done.

Re: To Julie

elliott on 3/21/05 at 11:23 (171684)


I appreciate your speaking out on that comparison. I'm not trying to get just you on 'my side', but I do believe at least some here look up to you and might be hesitant to speak out on their own.

I appreciate your stating that the docs here should be held to a high standard. Well, the only way they will be held to a high standard is if we hold them to a high standard. He gets unequivocable praise lavished on him and I get criticized for my writing style--sort of distorts the importance of that high standard. Anyway, it's not just that he's a doctor. I am not soliciting customers. He is, ones in pain no less. He asks why I single him out. Here's why: no one else here so aggressively solicits patients and at the same time is as inaccurate with their claims as he is. He has a responsibility to get it right, whether one likes my tone to him or not.

Regarding my tone to him, it wasn't always that way. It started a long time ago, when Dr. Z and I were on friendly terms. He was claiming the Dornier FDA study included only patients who had PF symptoms for a *minimum* of two years. He kept repeating the claim, and I told him a few times I'm sure I read somewhere it was just an *average*, not a minimum, and maybe if he could doublecheck on that. Instead, he got angry, called me names, etc., never checked it out, and continued to repeat the claim. Not exactly the high standard I was looking for. Finally, I produced a link to an abstract and eventually the FDA report itself stating that it was a two-year average. So I end up looking combative while others (with the exception of Pauline--where is she?) said absolutely nothing, as usual. Do I deserve all the blame for that?

Over time, I noticed repeated misstatements of his, all biased in favor of his machine, and I corrected many of them (blame me again for appearing combative rather than him for wearing me down with his numerous inaccuracies otherwise left unchallenged). But they kept coming, and I realized that, even if unintentional, he could no longer be given the benefit of the doubt, since he made no effort to be more careful. While soliciting patients here, he gleefully and repeatedly posted that Dr. Z has the better machine, 94% to 81%, not a minor selling point, until that statistical myth was uncovered, yes, by me, in those dramatic but in retrospect somewhat corny Ossatron vs. Dornier posts. So he's known about the fallacy of that comparison for over a year now, and Scott in fact banned him from making it here (Dr. Z has abided by that). But the good Dr. somehow failed to see the need to remove that comparison from his web site he directs patients here to. He's still making misstatements regularly, and for the most part no one but me says anything. If he gets caught red-handed--as in offical links for all to see directly contradicting what he said, he sometimes acts like that guy in that movie trying to walk off the stage with an elephant who, when asked, 'Where are you going with that elephant?' he responds, 'Elephant? What Elephant?' 'Just Elliott's opinion, that's all it is.' Yeah, right. And that works, since no one else says anything. Again, not much of a standard, let alone a high one. No one said anything to him this time either until you chimed in at the end.

Again, if others would say something, I think that kind of stuff would disappear quickly, and then we get both the high standard we need and the harmony everyone wants. It's worth a try at least. It is that not saying anything that gets me fed up of these boards and why I keep dropping out for a break. Seems like I need another break soon.

Re: To Julie

Dr. Zuckerman on 3/21/05 at 15:33 (171715)

So all you do is watch Dr. Z. What a life. Scott banned me from what?

Re: To Elliott

Julie on 3/21/05 at 16:21 (171727)

Elliott, I said yesterday that I agreed that doctors should be held to a high standard, but I'm going to qualify that now. I think they should hold themselves to a high standard. It isn't up to you, or to me, or to anyone else here except for Scott to judge them. I suggested to Dr Z last week, that he ditch the misleading comparison from his website, and reminded him yesterday that he'd agreed to consider it. But that's it. I'm not going to police him, and I don't think you should either.

So enough already. I think that if you continue to feel strongly about this, you should give over expressing your animosity in public, stop trying to rope in supporters, and pursue it privately with Dr Z. And/or with Scott. Forshtay? (I always thought it would be spelled 'vershtay'. Just shows you.)

Re: To Elliott

Dr. Zuckerman on 3/21/05 at 16:40 (171730)

Strange why Elliott won't call me ???? Vershtay. I have been told that people hide about e-mails This will all pass cause I am making major chances. I wish elliott knew how to change

Re: To Dr Z

Julie on 3/22/05 at 02:35 (171745)

Dr Z, I think I do understand why Elliott doesn't call you. He has said what he thinks clearly and cogently, many times, and I guess he sees no need to talk on the phone about it. He thinks you should remove the Ossatron-Dornier comparison, which is based on different criteria and is therefore misleading, from your website. I think so too, and I hope that you will.

There is no need for the comparison. People will come to you for ESWT if they feel that is their next step, You, as an ethical professional, then establish whether they are good candidates for the treatment and whether it is likely to help them or not. Whether you do the treatment with an Ossatron or a Dornier or a lawnmower is irrelevant to the patient: what matters is that YOU are a capable, trustworthy practitioner who can deliver helpful treatment.

Don't you see how this continuing harrying of you by Elliott, and your continuing defense of the indefensible, may be causing readers here to wonder about that?

I don't doubt for a second that you are a trustworthy professional. But I do think Elliott is right about this and that it would be not only right, but to your advantage, to remove the comparison.

You know that I appreciate all you do here, and that there is no animosity in what I've said, and that I wish you well.

Re: To Dr Z

Dr. Z on 3/22/05 at 07:06 (171746)

This will be my last post on this subject. I feel a need to repeat this since it just passed by this entire discussion. Whether you use a five point four point six point or what every point you use a you can't have an excellent result and still have pain whether it be subjective or objective no matter what criteria you use. The pain is pain free period. So you can make a comparison between pain free patients that either had the ossatron and the dornier. You can also compare failures. These are the laws of nature.


Re: To Dr Z

Julie on 3/22/05 at 10:01 (171755)

It didn't pass me by: of course I noticed it, but I still think the comparison is (a) misleading and (b) unnecessary: why sell the machine so hard when what you're offering is treatment?

When I pointed this out earlier you seemed to agree that there might be no need to include facts about Ossatron on your site.

No need to respond to this.

Re: to Julie

elliott on 3/22/05 at 10:35 (171757)

Julie, just a few more posts by you on this and you'll also be hooked trying to get Dr. Z to change his ways. :-) FWIW, my opinion of you will also go up.

Maybe it's not just about the provider. Some patients have to shell out thousands for this and want to be darned sure they've picked what they think is the best machine for their money. That comparison may be the thing that sways them.

Re: to Julie

Julie on 3/22/05 at 10:59 (171759)

Elliott, please. Stop.

Re: Dr. Z

elliott on 3/22/05 at 11:37 (171764)

Dr. Z,

I'm getting tired of this too and want to move on, honest. One last post on this, since you keep asking me if I will come out of 'hiding' to call you. Does it have anything to do with getting my phone number to appear on the logs? I told you, if you really want me to call, and especially if you can give me a valid reason for doing so, I'll give you a call from a nondescript payphone when able. I should've asked more questions pre-surgery from my orthopedist. He told me 6 weeks of no weightbearing, so I thought that meant walking immediately thereafter. In reality, at 6 weeks I start with 20 lbs of pressure and increase it by 20 lbs every 5 days until I reach half my body weight, when I can attempt walking with assistance from a crutch. I figure I might get there sooner if I go on a diet. Anyway, another 6 weeks or so before I can get to that nondescript public payphone.

A friendly suggestion: you could take the comparison down now from the internet until the logo change and revised web site are ready. That way, you won't risk feeling remorseful in case someone pays for treatment in the interim based on that comparison.

One final question for which I'd appreciate an answer: It appears that Ossatron has now published one-year 4-point R&M success rates for its FDA study, just like Dornier did. After obtaining the comparable figure, would you be willing to change the comparison to 4-point R&M vs. 4-point R&M (apples vs. apples), or do you feel the current comparison will still be more accurate?

Re: Dr. Z

Dr. Zuckerman on 3/22/05 at 11:46 (171765)

Are you really serious. A phone log. I know who are, where you and have met you before.
Isn't the ossatron article under peer review investigation? You do read the comments by Dr. Rompe and Buchbinder ?

Re: a little reframing of things

Ed Davis, DPM on 3/22/05 at 13:17 (171772)

I think we have had numerous 'shills' on this board, so Eliiott, I am not going to pass judgement on your opinion of Dr. Z's 'bias' (and really don't want to get into the argument) but at least he does identify himself; something I have not been able to get various industry shills here to do.

As far as I am concerned I am long fed up with the US based arguments (and politics) in the area of ESWT, feeling that the good experience and science has emanated from Europe for the most part.

Re: whoops

Ed Davis, DPM on 3/22/05 at 13:39 (171773)

I cleaned out my brief case too thoroughly becasue I could not carry all the stuff back exhibitors loaded on me at the New Orleans ACFAS convention. I may have accientally tossed all the Doloclast information. Arrgh! I am sure we will hear more of it. The speaker was an MD researcher from Germany who knows Rompe. You will probably run into him if you are going to Vienna to ISMST this year. I wish I could go but my family insists on coming so its 5 plane fares, time off from work, expensive Austrian hotel, etc. I will have to wait this one out. If you are going, as I understood you were, we will all anxiously await your report!

Re: ISMST--DON'T Forget

Ed Davis, DPM on 3/22/05 at 13:45 (171774)

For the rest, keep watching the http://www.ismst.com website as it is the primary organization overseeing ESWT and has a wealth of information.
Each year, new papers are presented and the abstracts are available at that website.