FUSSPFLEGE AKTUELLThe magazine

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1 Issue 2/2011 FUSSPFLEGE AKTUELLThe magazine for the practice Cooperation brings strength CONCEPT F-Series: GERLACH TECHNIK bets on partnership n Technology CURRENT New autoclave SK07S - exclusively with GERLACH TECHNIK n We can all protect ourselves Foot fungus a people s disease n View, check, work Safety checks of operating equipment

2 Table of contents NEW NEW Pressure protection offers Pressure relief The new GEHWOL pressure relief display Product offers Christmas event in 2011 GEHWOL FUSSKRAFT BLUE, GEHWOL FUSSKRAFT RED for dry skin Technology offers Ergonomics in their most beautiful form Treatment chair CONCEPT F2 and foot care cabinet AT/NT clean Autoclave SK07S Secure sterilisation with the premium model Expert knowledge CURRENT Fungal foot infections: we can all protect ourselves Interview with Prof. Dr. med. Isaak Effendi Everything clean GEHWOL survey Product information CURRENT Details that are worth it High quality innovation performance in foot care chairs Trust BLUE 50 years of GEHWOL FUSSKRAFT Care consultation CONCRETE Monthly spa treatment supports the skin s self-cleaning processes GEHWOL med Callus Cream GEHWOL on tour Diabetes consultation Practice CURRENT Trusting in your own abilities A new judgment: podology versus foot care Comprehensive general liability etc. What types of insurance are required Part 1: securing business risks View, check, work Safety checks of electrical operating equipment Marketing CURRENT No fear of sales conversations Therapy Support Extra CURRENT Life for the well-being of the feet A Life of Beauty award Service CURRENT Until we meet again... Study: Early training Exhibition dates Imprint New: CONCEPT F2 and AT/NT clean Ergonomics in their most beautiful form Survey 2011: everything clean Safety check: view, check, work Our title photo Ergonomics, hygiene, freedom of movement, high performance drive technology and functionality in their most beautiful form all around! This claim applies both to the new treatment chair CONCEPT F2 and to the foot care cabinet AT/NT clean with its sophisticated form. You can find a cabinet and a treatment chair with a high performance foot care unit on pages 8 13 Hygiene behaviour within the profession is better than its reputation. This was shown by the GEHWOL Survey In detail, however, the information provided by the participants shows hygiene deficits e.g. when using the prescribed hygiene plan or in continued education. Diabetes consultation: GEHWOL on tour pages A big day for diabetes, the people s disease: on 19 March of this year, the diabetes tour of the Kirchheim publishing company started for the third consecutive time. Among them: GEHWOL. During a foot check-up, visitors informed themselves about the risks of diabetic foot syndrome. pages When operating equipment such as foot care units, treatment chairs or autoclaves are properly started in operations, they support the foot care pro in his or her work. But what about safety tests? Do all tests have to be done by an expert? Read what you can do yourself on pages South Korean artist Do Ho-Suh gives visitors to an art exhibition in HongKong the opportunity to have themselves borne on hands: the floor sculpture Floor consists of tiny plastic figures which are stretching their hands upwards. Secured by a glass plate, visitors can walk around on the figures, giving them the sensation that others are catching them. 2

3 Pressure protection CURRENT NEW: Pressure relief sales display Pressure relief Our feet are often under pressure. GEHWOL pressure relief articles optimise plantal pressure distribution and prevent the formation of excess callus. The new display clearly shows the types of protection for all events and provides handy access for consultations. More than half of all adults suffer from foot problems. Toe malpositions cause pain. If they lastingly cause skin damage, things can get even more unpleasant causing painful weals or corns. Particularly during the summer, many patients also have burning feet, painful pads and sore toes again. Relieving crush zones These developments can be prevented by highly elastic pressure relief articles a good opportunity to recommend the ready-to-use GEHWOL pressure relief articles, e.g. from self-moulding polymer gel, to customers. The soft and transparent crush zones fit into any shoe and are the ideal companions for a smooth walk through the city, museum visits or hiking vacations. Polymer gel is an excellent material for such challenges. A special injection moulding process makes it possible to produce three-dimensional shapes which precisely replicate the form of the body areas being protected. Due to the noticeable pressure relief, sensitive skin areas are effectively protected, with high wearer comfort. Since nearly any foot regions can have deformities, a whole series of specific aids is needed to balance anatomical irregularities. The pressure relief sales display gives foot care professionals a sensibly equipped selection for numerous applications. The comprehensive combination and clear arrangements of the display support foot specialists in their consultations. Nails are part of it The product range is completed by the GEHWOL med Nail protection pen in the newer, more noticeable blister pack. With high quality jojoba oil, vitamin E acetate, panthenol and bisabolol, it provides lasting care for nails, effectively protects against fungal infections, and renders the nails beautiful and elastic. Your GEHWOL pressure relief sales display NEW! Description Quantity Toe Separators G, medium 3 Cushion for hammer toe G, right 3 Cushion for hammer toe G, left 3 Toe Protection Ring G, mini 5 Toe Protection Ring G, small 5 Toe Protection Ring G, medium 5 Toe Cap G, small 3 Toe Dividers GD, small 5 Toe Dividers GD, medium 5 Bunion Cushion G 3 Protective Plaster, thick 5 Sponge for Hard Skin 3 Toe Rings, oval 5 Blister plaster 5 Nail protection pen 3 3

4 Products CURRENT Christmas event in 2011 Joy to the World Christmas is at the door once more sooner than thought. But the pleasure is quickly ruined if you don t think of the right gifts for loyal customers in time. To keep stress out of Christmas, Gerlach lends a hand with small Christmas gifts: surprise and spoil faithful customers with GEHWOL FUSSKRAFT Blue and GEHWOL FUSSKRAFT RED for dry skin in 25 ml speciality tubes. Cold feet are common in wintertime. If the body is cold, it reduces circulation; also constricting the blood vessels in the mucous membranes of the nose and pharynx. This makes it easier for viruses to enter the body, increasing the risk of colds. Due to poorer circulation, cold feet also suffer from dry skin. Cold and dry feet If your customers frequently complain of cold feet, this might be something for their doctor. Sometimes the phenomenon is due to illnesses such as thyroid dysfunction, iron deficiency or rheumatic complaints. But cold feet are frequently just due to the weather. A few minor actions prevent and relieve the problem: GEHWOL FUSSKRAFT BLUE renders your customers feet naturally fresh, while GEHWOL FUSSKRAFT RED ensures warm, well nourished feet. Both GEHWOL products also solidify the bond with your customers and encourage demand for the care products exclusively available from you. Weather-beaten customers value this support through the cold season, kindly think of you and remain loyal to you in the following year as well. GEHWOL FUSSKRAFT BLUE Cold, poor circulation and tight shoes are hard on the skin of the feet. It becomes dry, brittle, cracked and often itchy due to reduced moisture supplies. The proven care substances of GEHWOL FUSSKRAFT BLUE prevent foot odour, foot fungus and itchiness. Natural and skin-friendly lipids such as lanolin, combined with moisturising aloe vera and urea, provide stressed, dry skin with needed care. They fill up the moisture reservoirs of foot skin, rendering it elastic, smooth and supple. The effect is intensified by select lipids which are similar to human skin lipids. GEHWOL FUSSKRAFT RED for dry skin GEHWOL FUSSKRAFT RED is a valuable care cream with an additional effect for customers who suffer from cold feet more frequently: aside from the nourishing and moisturising substances, the warmer of the two products also contains paprika and ginger extracts. Together with enlivening camphor and essential oils of rosemary and mountain pine, they encourage circulation, expand blood vessels and activate the heat receptors of the skin. Massage the 6

5 Products CURRENT care cream into your customers feet this intensifies the warming effect. A relaxing foot bath can also support the warming feel-good effect. The plant oils contained in GEHWOL FUSSKRAFT RED also deodorise and disinfect, so that feet remain lastingly free of foot odour even in thick socks and warm winter boots. Act quickly Act quickly before time gets short and you get cold feet because you still don t have any presents for your customers. Punctually for Christmas, surprise your customers with the double care of GEHWOL FUSSKRAFT BLUE and GEHWOL FUSSKRAFT RED and be well remembered. The products are available starting in September. But you can already order now and profit from the favourable conditions while supplies last. Festive or neutral! Two products in one gift container Our offer n GEHWOL FUSSKRAFT BLUE and GEHWOL FUSSKRAFT RED for dry skin 2 x 25 ml special tube with a choice of a festive or neutral gift container Packaging unit 50 containers, each containing two products. Gift containers are available in neutral or festive Christmas designs. Order units can be combined. 7

6 Technology CURRENT Erg 8

7 Technology CURRENT NEW: treatment chair CONCEPT F2 and foot care cabinet AT/NT clean onomics in their most beautiful form Top of the line equipment at a fair price supported by the proven service of our house! That s what Gerlach TECHNIK offers you. And it s what our service looks like too: ergonomics, hygiene, freedom of movement, high performance drive technology and functionality in their most beautiful form all around! This claim applies both to our new CONCEPT F2 treatment chair and to the foot care cabinet AT/NT clean with its sophisticated form. Cabinet and treatment chair with a high performance foot care unit: this pro equipment with its matched design, which is manufactured according to strict quality standards, is yours for less than Or take advantage of one of our attractive financing models. 9

8 Technology CURRENT NEW: treatment chair CONCEPT F2 Continuation for a s Artificial leather tested for safety according to EU Chemicals Ordinance The F2 is the second model of the new CONCEPT treatment series from Gerlach TECHNIK. CONCEPT stands for a production philosophy which lives by strict internal and external quality standards. The result is a chair which, with its numerous adjustment options and high performance drive technology, guarantees ergonomic work at the highest levels. Like all other chairs in this series, the CONCEPT F2 combines this ergonomic claim with a modern design. Gently swung lines lend the chair a harmonic, graceful appearance, telling nothing of the two powerful, processor-guided electrical motors which are easily accessible and easy to maintain right under the seat, quietly, smoothly and effortlessly moving even heavy patients to the desired working height. And the strong formed cushions, the solid joints, the smooth mechanics, the massive impression of the base and the weight bearing telescopic column show: the elegant form hides pure high value and dynamics. The new CONCEPT F2 of GERLACH TECHNIK Open to all sides Despite its numerous functions, the F2 needs little space. The chairs of the CONCEPT series excel in terms of their compactness. The linear height adjustment is responsible for this: on the electromechanically operated telescopic lifting column, the chair only moves vertically up and down. This attribute saves space, cre- The foot and leg rest is in two parts in the premium variant. The second, separate pullout carriage has a variable support for heel positioning. The foot and leg rest is in two parts in the premium variant. The second, separate pull-out carriage has a variable support for heel positioning. The foot and leg rest is in two parts in the premium variant. The second, separate pull-out carriage has a variable support for heel positioning. 10

9 Technology CURRENT uccessful concept ating openness and room for movement to all sides, so that ergonomic work is possible even in smaller treatment rooms. Both in the standard variant with a single part leg rest and in the premium variant with a two part leg and foot rest, the chair is easily moved to a work position which is easy on the back. The leg rests pull out and also swing outward. In the combination with the electromechanically controlled seat incline, the working height is therefore very easily and flexibly adjustable. Practice hygiene even simpler The F2 also has a convincing ergonomic solution for patients who are very heavy or have restricted mobility: unlike most chairs, the seat incline in the base position is not the same as the plan position (0 ), but the seat is tilted slightly forward ( 3 ). This makes it easier for patients to get in and out. It s ergonomic after the treatment as well when floor disinfection requires physical efforts. But not with the F2! There are two optional central rollers under the base which can be swung out. With the rollers, it s a simple matter to move the chair around in your practice. This allows you to disinfect the standing area effortlessly. This is also true for the chair itself; its materials are resistant to common disinfectants and cleaners. Our offer n Foot care chair CONCEPT F2 Standard colour with one part leg rest, neck support and foot switch n Extras / accessories Custom colour Premium variant (two-piece leg rest) Hand switch Insert cushion in the chair colour Outward adjusting castors Technical data n min. seat height: 52 cm n max. seat height: 92 cm n maximum working height: 137 cm n Inclination of seat: 3 to 26 degrees n Chair can be rotated: 2 x 90 degrees n Leg supports swing out: 70 degrees to each site, foldable n Pull-out leg supports: 35 cm to 70 cm (one-piece) n Pull-out leg supports: 36 cm to 76 cm (two-piece) n max. load bearing: 220 kg n Weight: 80 kg n Dimensions: 53 cm x 49.5 cm Standard colours mint cream anthracite/chrome chrome/pearl The foot and leg rest is in two parts in the premium variant. The second, separate pull-out carriage has a variable support for heel positioning. The new CONCEPT F2 is available in four standard colours, in one or two colours. Individual needs can also be met, with a wide selection of a total of 40 custom colours. 11

10 Technology CURRENT Sophisticated form: Foot care cabinet AT/NT clean with a unit of your choice A modern cabinet for a harm The new foot care cabinet AT/NT clean also presents itself in a sophisticated form in new, modern colours. For instance, all front modules have a polygloss surface with a high shine. The modern, high quality coating is solid and resistant to chemical cleaners and disinfectants. This makes the cabinet very easy to care for. Always accessible never in the way The drawers glide quietly; below them: a UV cabinet for low pathogen storage of instruments on roller guided full drawouts. The drawers close just as gently and quietly due to the Airmatic automatic dampening system. It is simply easier to work in such a relaxed atmosphere, especially since the foot care unit is perfectly integrated into the cabinet left or right at your option. The hand piece holder which intelligently holds the hose back and out of the opening area of the drawers can be mounted on both side plates. The hand instruments are also more accessible during work, since the cabinet has continuous aluminium grip rails and the drawers are easily opened from any position, and closed again with a quick push. Cabinet front colours The AT/NT clean foot care cabinet sophisticated form in new colours castello blackberry basalt grey grey brown icy white Perfection in detail: Drawers on quiet full draw-out rails, with automatic dampening systems and continuous grip rails. The hand piece cable is now out of the way as well. Solid high-value construction: All components fit together perfectly, forming a jointfree unit with which you can work hygienically. Polished to a high shine: The polygloss front module coating appears sophisticated while offering solidity and resistance to chemicals. 12

11 Technology CURRENT onic overall presentation High value due to sturdy construction The cabinet easily passes the hygiene test. The joint-free construction of the structural elements is an advantage here. Neither fine dust nor dirty water can penetrate the cabinet or the wood. The side sections of the AT/NT cabinet are coated with a sturdy varnish which is resistant to common disinfectants and cleaners. The work surface folds up and is made from Corian, an acrylic-bonded modern material which is massive but easily formed during processing. This material attribute makes it possible to integrate a slightly raised surrounding protective edge into the work surface. Freely selectable unit When choosing a unit, you can freely select from among three high performance, user friendly alternatives - the SIRIUS spray unit with a lit hand piece (winner of the Reader s Choice Award 2009/2010) or a suction unit either the SATURN with a suction performance of 150 litres per minute and a hand piece speed of max rotations per minute or the slightly more cost effective variant LUNA with 120 litres of suction performance and a maximum hand piece rotation speed of RPM. Our offer n Foot care cabinet AT/NT clean without device n Foot care device SIRIUS NT MICRO n Foot care device SATURN AT MICRO n Foot care device LUNA AT MICRO n Extras / accessories Custom colour astral silver or platinum silver for SIRIUS Custom colour astral silver or platinum silver for SATURN Custom colour platinum silver for LUNA Foot switch Multichannel, cable-free Instrument tray for pull-out table ! the Suction quality: Performance at the smallest bottleneck is the decisive factor. Therefore unlike other manufacturers we measure at hand piece tip! Improved performance: RPM, 120 litres/min suction volume Spray unit SIRIUS NT MICRO n Performance ranging from 2200 to RPM n Hand piece with connectable light Suction unit SATURN AT MICRO n Performance ranging from 5000 to RPM n Suction capacity: max. 150 litre/min. Suction unit LUNA AT MICRO n Performance ranging from 6000 to RPM n Suction capacity: max. 120 litre/min. 13

12 Technology CURRENT New autoclave SK07S exclusively with GERLACH TECHNIK Secure sterilisation with the p Hygiene is everything in a foot care practice. Instrument processing is hygienically secure with a type S autoclave, is gentle on sterilised goods and fulfils the general hygiene plan. The new type S autoclave SK07S is available only from GERLACH TECHNIK and excels with its specifications. The components which are installed in the SK07S are carefully selected, making the new autoclave a premium model. The reliable and modern electronics ensure optimal sterilisation which fulfils all requirements for podology and foot care practices according to the current general hygiene plan. Three automatic programmes ensure perfect instrument processing (see insert box). All programmes finish with a drying process. This means that the sterile goods can be taken out and are immediately ready for use. Noise is low due to the most modern technology. The drying process takes only four minutes. Yet the GERLACH SK07S only reaches the noise levels of a normal conversation (approx. 54 db(a)) while standard autoclaves are noticeably louder for much longer times. Simple handling An intelligent safety system provides a warning when there are abnormalities or deviations in the sterilisation cycle. No water vapour comes out of the SK07S during the process. Aside from its fresh water tank, it also has a residual water tank which collects the condensed water vapour instead of releasing it out. Therefore no moisture condenses on the walls or furnishings. SK07S simple handling with three programmes Programme Temperature Duration - Loading incl. drying Universal programme 134 C min max. 4 kg for unpackaged instruments Universal programme 134 C min. max. 2 kg for packaged instruments Gentle programme for porous 121 C min. max. 1.3 kg materials and textiles Validly processed and documented But a safe process which can be validated is not enough: complete fulfilment of the hygiene regulations requires documentation that instrument processing corresponds to qualified standards. The new autoclave from GERLACH TECHNIK is equipped for this just as much, and available in two variants: with a printer or a memory card module. The records can be printed out directly via the integrated printer. Alternatively the files are saved on a memory card using the builtin CompactFlash compartment. The records can then be transferred to the practice computer, for which the SK07S is supplied with the right software. Equipped for the future But while the internal components of the SK07S look good, so does its exterior. The high quality materials are easily cleaned and the modern, futuristic design matches any practice. The SK07S uses state-of-theart technology. But it s also ready for expansions. If needed, the type S autoclave can be upgraded to a type B autoclave, although its range of functions is not currently required in podology and foot care practices. With its expandability, however, the SK07S autoclave is already set for a future solution an alternative for any foot care pro who looks ahead. Despite its compact exterior dimensions, the SK07S has a convincing chamber volume of 16 litres. The trays can be loaded with a maximum of 4 kg of instruments. The new Gerlach autoclave is equipped with a choice of a printer or a Compact- Flash compartment. All sterilisation processes can therefore be easily documented in a few steps. The CompactFlash memory slot saves the records directly onto a memory card, so that they can be transferred to the practice computer. 14

13 Technology CURRENT remium model Our offer n Autoclave GERLACH SK07S New and exclusive from GERLACH TECHNIK SK07S details n External housing dimensions: (W/H/D) 45 x 39 x 66 cm n Chamber volume: 16 litres n Maximum load: 4 kg of instruments n Power connection: 230 Volt, 50 Hz All programmes are easily selected using the ergonomic keypad. The integrated display shows all operating instructions in an easy to read view. n Power consumption: 1750 Watt n Noise emission: max. 54 db(a)) n Tray: (W/H/D) 18 x 1.5 x 28.5 cm 15

14 Expert knowledge CURRENT Foot fungus a people s disease We can all protect ourselves Foot fungus is the most common skin disease anywhere. Estimates state that nearly 32 percent of all citizens in Europe are affected by foot or nail fungus. Regular foot care contributes to reducing the risk. FUSSPFLEGE AKTUELL talked to Prof. Dr. med. Isaak Effendy, Chief Physician at the Bielefeld Skin Clinic, about the use of foot care products with antifungal protection. Professor Effendy, why are there so many fungal foot infections? Simple transmission is one reason. It usually occurs from one person to another. But skin fungi can last for many months in between on objects like shoes, socks and floors. Consequently infections can be acquired anywhere where barefoot persons come in contact with infectious skin scales especially in saunas, pools, shower rooms, change rooms and even in shoe stores when trying on new shoes. One important aspect: who gets fungal foot infections? An increased fungus concentration is accompanied by a higher risk of infection. But that doesn t mean that anyone who is exposed to these fungi will necessarily acquire a fungal infection. Aside from the general defences against infection, skin conditions are particularly important. Healthy, intact skin will not easily become infected. But the risk is higher in patients who have illness or hygiene related foot skin problems. For instance, this is true for many diabetics, which is why fungal disorders are more frequently seen in them. In view of the high prevalence figures, can one effectively protect oneself from foot and nail fungus at all? Healthy skin is the most reliable protection against fungal infections. The skin barrier must be intact neither dry and cracked nor moist and swelled. Nearly all patients who have fungal foot infections do not care for their skin sufficiently or in the right ways, giving the infection an advantage. Regular and correct foot care is an absolute requirement. This is already the case because the soles of the feet have no sebaceous glands, but many sweat glands. The surface film which forms from skin lipids together with sweat is less pronounced here. If the surface film is disturbed by severe dryness or excess moisture, for instance in the spaces between the toes, the primary protection factor against fungi and pathogens is lacking. Then the actual skin barrier, which consists of epidermally formed lipids (skin fats) in combination with bound moisture, is all the more important. So what prerequisites should there be for foot care products? Aside from the barrier-stabilising properties of the cream base and here, particularly balanced hydrolipids, the composition of the ingredients plays an important role. For instance, antimycotic additives may be a sensible addition to the recipe. Moisturisers and lipids stabilise the skin barrier, rendering it resistant to fungi and pathogens. If the skin is continuously stressed, e.g. the skin of a diabetic, but also of a healthy athlete, small injuries and cracks may occur at any time, and fungi will reproduce in them. People in whom sweat collects on the feet and between the toes have the same problem. The warm, humid climate means that fungi reproduce at a rapid rate. In these cases, which are accompanied by increased fungal colonisation, antimycotic additives can complement the antifungal protection of the recipe. That sounds complicated but it really isn t. After all, the care recipes do not have to be individually mixed. Suitable products whose hydrolipid balance ensures a resistant skin barrier and protects the skin from excessive colonisation by the causative agents of fungal foot infections with other antimycotic substances are readily available, for instance from GEHWOL. Excessive colonisation? The use of antimicrobial ingredients in cosmetic products is limited. Naturally, keeping the skin healthy and protecting it is always the focus of skin care. Therefore foot care products should not heal fungal infections, but prevent them. In this regard, the focus is on fungistatic effects i.e. effects which inhibit fungal growth and spread. In brief, foot care is primarily about maintaining the natural skin flora. Antimycotic substances can be used for this purpose in cosmetics as well. Regular care with creams which provide lipids and moisture strengthens the skin barrier. Antimycotic additives also provide antifungal protection. 16

15 Expert knowledge CURRENT Prof. Dr. med. Isaak Effendy, Specialist in dermatological and sexually transmitted diseases (dermatologist) Isaak Effendy studied medicine and earned his doctorate in Hamburg. After specialising in dermatology and venerology, he continued to work at the University of Marburg, qualified as a professor there and was a research stipend recipient from 1993 to 1995 at the University of California in San Francisco (USA). In 2001, as a Chief Physician, he took over as head of the Clinic for Dermatology and Allergology at the City Clinics of Bielefeld. Among other things, his scientific fields of specialisation include the skin barrier, nail mycoses, antimycotics and skin infections. Can you state examples? Certain azole derivatives such as climbazole are options. Azoles have a very long tradition in fighting fungal pathogens. Among other things, they inhibit ergosterol synthesis. Ergosterol is a main component of the fungal membrane and is important for fungal growth and reproduction. This explains the fungistatic effects of climbazole. Other protective substances come to us from nature in the form of essential oils. The volatile components of plant oils serve as more than scent and attractant substances in nature. They also protect the flora from attacks by bacteria, fungi and viruses. Humans can benefit from this protection. For instance, rosemary oil, lavender oil and eucalyptus oil are effective against various yeasts, mould fungi and dermatophytes. Occasionally, however, the use of these substances in cosmetics is criticised with reference to the problem of resistance. What is your opinion about this? This question is justified. If the use of antimycotic substances in skin care would mean that some medications which are used to treat fungal infections would lose their efficacy, this would indeed be a problem. However this question only comes up if at all when the same active substances are used in foot care and in medicamentous therapy. This is not the case with essential oils and climbazole. At least in Germany and Europe, they are not used against fungal afflictions in medicamentous therapy. In azole substances, which also include the substance clotrimazole which has been in use since years, no development of resistance has furthermore been observed so far with external use. The criticism is based almost solely on effects which result out of long-lasting systemic use of azole substances in immune suppressed patients with organ mycoses. In patients who are infected with HIV or have had transplants, for instance, all pathogens can grow excessively, including normal skin fungi. Spontaneous mutations of fungal strains may occur, and they can then develop relative resistance. As has been said, this was only observed with oral ingestion of the active substances, and only in patients with pronounced immune weakness. However the resistant fungal strains are mycologically inferior to the wild types, so that unlike bacteria there is generally no risk that the resistance will spread. Rapid transmission of resistance through an exchange of genetic information, as in bacteria, is likewise not observed in fungi. Therefore, should one only pay attention to the ingredients? Unfortunately, it s not quite that simple. Patients who are at risk are well advised to pay attention to proven quality, which is available e.g. in specialised sales. It would clearly be easy to reach for a low-cost product from a discounter which contains rosemary or lavender oil according to its statements. But first, the patients know nothing about the quality of the ingredients in this case. Precisely in essential oils, there are considerable differences in production and purity levels which are reflected in quality. But that s only one aspect. Just as in medicine, another aspect also plays an important or even decisive role in cosmetics. I m talking about galenics. This is the way in which a product is prepared. It includes the combination of various ingredients and their interplay. This results in numerous recipe synergies which make it possible to obtain an optimal effect even within the permitted dosage range for cosmetics. This also includes a suitable carrier system (vehicle) which transports the active ingredients and releases them in the right place at the right time on or in the skin. But good galenics must be researched and are expensive to produce. Here the bottom line is: the quality of a recipe cannot be read only from the list of ingredients. Patients are dependent on being advised on how to choose the right product. Who can provide this advice? Proper foot and nail care is a fundamental requirement for avoiding fungal disorders for all patients who have skin problems on the feet. Foot specialists are the first choice for competent care advice. First, they have a trained eye for the state of their patients skin, so that they can assess whether there is an increased risk of fungi based on the history and a visual inspection. Second, they have a broad and partly exclusive product range from which they can select proven products with antifungal protection. Finally and this is the exclusive advisory service of a foot care professional they are able to explain the protective effects of the products to their patients. Professor Effendy, thank you for the discussion. Tiniest injuries to the dry, cracked foot skin become entry routes for pathogens and fungi. 17

16 Expert knowledge CURRENT Survey 2011: Everything clean? Hygiene behaviour within the profession is better than its reputation. This was shown by the GEHWOL Survey In detail, however, the information provided by the participants shows hygiene deficits e.g. when using the prescribed hygiene plan or in continued education. The subject of hygiene is a burning matter for the profession. One indicator of this is the lively participation in the current survey by FUSSPFLEGE AKTUELL. 493 colleagues completed the extensive questionnaire and returned it to the editing staff. The questionnaire contained ten questions about the subject of hygiene from disinfection via hand and mouth protection to questions about using the hygiene plan (multiple choices were allowed). There were usually comment fields, however they were little used. The exception consisted of questions about the subjects of mouth and hand protection. Numerous factors which restrict the ability to wear these hygiene accessories were stated here. Only half It is not surprising that only barely 59 percent always wear mouth protection during treatments. Another 27 percent protect themselves from flying particles from time to time, usually when performing grinding work on the feet. No less than ten percent of survey participants checked rather rarely, and approximately five percent never wear mouth protection while working. The limited use of mouth protection is reflected in the comments. Nearly 28 percent of participants stated that their glasses fog up when they wear mouth protection. Nearly eleven percent of survey participants regard mouth protection as restricting the conversation with customers and thereby, personal contact. A large amount of heat development and the associated problems of sweating, difficult breathing or unpleasant wearing sensations are listed as other problems. However this is opposed by more than 50 percent of foot care professionals who have none of the listed problems with mouth protection. Hand protection There are fewer inhibitions with hand protection. More than 65 percent have no problem with this. But some foot care professionals state difficulties. For instance, 15 percent of those surveyed state that their ability to finely perceive touch is restricted. Five percent complain of skin reactions such as allergies, and about ten percent have sweaty hands which significantly impair wearing comfort. Fit, price and having the gloves caught in the grinding tool disturb individual persons. The low numbers of problems are also reflected in the use of hand protection in daily work. 79 percent of those surveyed stated that they put on hand protection for every treatment, while another 15 percent used it only for wetting or bleeding skin areas on patients feet, and six percent used it rather rarely. Three percent never use it. Vinyl and latex (unpowdered) are the materials which are most commonly used, at 35 and 33 percent. High value placed on disinfection According to the survey results, disinfection behaviour is very good. More than 88 percent of those surveyed disinfect surfaces and equipment after every treatment. Nine percent do it once daily, and five percent as needed. However only 58 percent of participants use products licensed by the Robert Koch Institute or the Association for Applied Hygiene for disinfection. This is similar for self-protection. 85 percent of those surveyed disinfect their hands before and after every treatment. 18

17 Expert knowledge CURRENT However 13 percent only do it once daily, and 4 percent occasionally. Cleaning and disinfection of instruments after every use was shown to be the most common measure of instrument hygiene. More than 75 percent of survey participants confirmed this. However there seems to be a differentiation by instruments here. More than 51 percent of surveyed persons sterilize their instruments after every use, while 30 percent only perform sterilisation as needed, for instance when there is adhering blood. 70 percent of foot care professionals use an ultrasound cleaning unit for processing instruments. About 60 percent use a hot air steriliser. It was noticed in the responses that both units are often used in the practice. A combination with an autoclave the preferable recommended method is less common though; only 14 percent have a type S autoclave, and 17 percent have another type of autoclave. No full protection Despite all hygiene efforts, infections occur in practices. Nearly 15 percent of those surveyed stated that they had a patient in their practice who became infected with a pathogen. Other general statements also show that there is still need for information in hygiene matters. Only approx. three fourths of questioned foot pros maintain a hygiene plan. The question of whether this is easily accessible to all employees was answered positively by 84 percent. In this statement, however, it must be taken into account that many foot care professionals have no employees. As far as information procurement about the required hygiene measures is concerned, there is a major deficit. Only approx. 60 percent of survey participants stated that they have the important general hygiene plan. (This is available for download on the internet at The general hygiene plan is found in the Service menu under Worthwhile information ). Continued education also tends to be used sporadically. A lack of closeness There is a lot of willingness as far as continued education is concerned. But in the comments, many foot care pros listed a lack of closeness and high costs as reasons which hindered them. Therefore the survey concludes: there is an awareness of hygiene, but improvements are definitely needed in many areas, such as information procurement or mouth protection. Yes Yes Yes Yes Yes Yes How often do you wear mouth protection? For instrument processing, we use Detectable deficits Have you ever had an infection due to transmission of pathogens in your practice? 2.5 % 97.5 % Have you ever had a patient who became infected with a pathogen? 14.7 % 85.3 % Do you maintain a hygiene plan in the practice? 58.4 % always 26.6 % from time to time, especially in grinding work 9.9 % rather rarely 5.3 % never 69.4 % an ultrasound cleaning unit 58.8 % a recirculated air hot air steriliser 14.8 % a type S autoclave 17.0 % another type of autoclave 77.4 % 22.6 % Is the hygiene plan easily accessible for all employees in the practice? 84.0 % 16.0 % Do you have the general hygiene plan for foot care professionals? 62.0 % 38.0 % Do you regularly attend continued education events on the subject of hygiene? 56.7 % 43.3 % No No No No No No 19

18 Expert knowledge CURRENT High quality innovation performance in foot care chairs Details which pay The foot care chairs of the CONCEPT series from GERLACH TECHNIK are developed and produced in precise detail work. In cooperation with a competent partner nearby, this results in exclusive innovations which are maturely and intelligently developed down to the details. Quality and customer satisfaction are the focus in the products offered by GERLACH TECHNIK. Where are there still options for improvements? How can everyday practice life be made easier with them? Who can assess this better than the foot care pros and podologists who work with the equipment and practice furnishings every day? Therefore external services are always open to hearing about such tips, and pass them on to development personnel. This is the only way of letting such ideas mature into innovations as in the new foot care chairs of the CONCEPT series from GERLACH TECHNIK. Standard or individual? Standardised offers do not permit an individual development process and specific production of foot care chairs. Therefore GERLACH TECHNIK trusts in partners who are willing to advance product novelties. For the new foot care chairs of the CONCEPT series, the foot care specialist from Luebbecke works together with a nearby partner. The cooperation partner brings in know-how in the construction of treatment chairs from dental and dialysis medicine. The partner has also combined technical experience and specialised knowledge from the fields of drive technology and ergonomics since nearly 30 years. Combined with the knowledge provided by GERLACH TECHNIK about the needs of foot care pros and their customers, the result was the CONCEPT series. This is the only way for the CONCEPT chairs to unite technology and furnishings which convince in every way: patients feel good in the comfortable seating position with its clever and effective cushioning systems. Foot care professionals enjoy the openness of the treatment chairs to all sides, allowing ergonomic work. Sophisticated production When the individual concept for a foot care chair which is adjusted to the wishes of the foot care pro is in place and all technical specifications have been worked out, the approx. 14 week production process begins. There is no conveyor belt work in this production hall. The foot care chairs are designed on the computer in cooperation with a designer. Instead, every treatment chair is individually produced, and each supplier gets the time which they need to guarantee the right quality. In the CONCEPT series, layerglued formed wood is used in the body of the seat and back areas as well as the arm rests and this takes time: the wood is brought into the desired shape under 20

19 Product information CURRENT In the in-house cushioning shop, the foamed formed wood elements are manually covered with a solid artificial leather. The treatment chairs are available in 40 custom colours in order to fit into the practice. Before the seat cushion is assembled, the drive motors are installed on the telescopic lifting column. pressure and heat. This is followed by injection foaming to produce resting surfaces and arm rests which ergonomically fit the body and offer high long term stability. This process also makes it possible to apply more foam in places which require more cushioning. Clever details This unique process results in a contoured support surface with the highest possible seating and lying comfort. Other foot care chairs simply use a cushion. This usually has a continuous thickness and increases the entry height of the foot care chairs. With its specific cushioning, the CONCEPT series has a cushion thickness of a mere approx. 6 centimetres in the thickest parts of the seat - without losing comfort, and gaining a lower entry height. In the in-house cushioning shop, the foamed formed wood elements are covered with a solid artificial leather. The material can be treated with common cleaning agents and disinfectants without losing its appearance or quality. With 40 custom colours, the colours of the treatment chairs can be coordinated to match the existing practice inventory. Up, up and away When the seat cushion and the chair frame are brought together, one more detail receives a supporting role: in the CONCEPT series, GERLACH TECHNIK makes use of the proven linear height adjustment. Here the height is adjusted with a telescopic lifting column saving space. Other treatment chairs use a height adjustable arm. However this needs more space, not lastly because the chair shifts its centre of gravity when it moves without linear height adjustment, so that a wider base is needed for stability. Confirmed quality The entire production with the exclusive GERLACH TECHNIK partner takes place according to strict internal and internal standards and guidelines. The production, including inline quality assurance and certification of the company in accordance with ISO 13485, guarantee outstanding, consistent product quality made in Germany! The ISO standard requires an overlapping management system for designing and producing medicinal products. Supplied parts and elements for the CONCEPT chairs all come from quality companies with a long standing tradition within a radius of 30 kilometres. Made in Germany Short distances allow short communication routes and close links between developing ideas, designing products, preparing for work, and production. Made in Germany stands not only for quality and reliability, but also for a guarantee that spare parts will be quickly available if anything should become defective or worn despite high quality work. This is also a selection criterion when looking for partners to the benefit of foot care professionals and with consideration of the service concept. When there is a concrete order for a treatment chair, the desired leg rests are mounted. 21

20 Product information CURRENT 50 years of GEHWOL FUSSKRAFT Trust BLUE Customers product selections are very strongly based on trust and recommendations as well as compliance with the promised product benefits. GEHWOL FUSSKRAFT BLUE is not only available exclusively from foot care professionals, but also excels in its exclusiveness in matters of recipe and efficacy. Foot care pros and podologists have now been able to rely on this for 50 years. How could a quality product range be better managed than with a pro in matters of foot health. Here, consumers rightfully expect quality and not just in recommendations and provision of exclusive products for home foot care. The fact that foot care pros can fulfil this expectation makes their practice a seal of quality in customer perception. There are indicators of this connection from customer research. A sociological investigation has shown that most people are certainly willing to accept responsibility of their own. But they do not concretely know what to do. This is where expert advice and treatment by foot specialists is important to provide effective support to people as they take on responsibility. Familiarity is a benefit When it s about recommendations for home foot care, customers need reliable products in which they can trust. Product quality and familiarity have a particularly significant influence on trust. According to a communication analysis by the magazine BRIGITTE, GEHWOL is the best known, most commonly used and most popular foot care brand in Germany. Continuous brand maintenance stands behind this customer vote. Recognition through advertisement Within the past year, GEHWOL invested approx. 1.8 million Euros into advertising its products. That is by far the largest amount in comparison to other brands which are sold in specialised trades. This was shown by a list of advertising expenses for 2010 in the foot care sector according to Nielsen: a worthwhile expense. Gerlach uses nearly 93 percent of advertising funds to advertise in public media those newspapers, magazines and journals which are regularly read by end consumers. GEHWOL uses the remaining seven percent to inform the service sector and specialised trade about its products. The total advertising budgets for foot care products from other specialised trade brands are somewhat lower. Some of them focus exclusively on informing expert circles. Consistent sensitisation and addressing the general public does not occur in this manner. The power of the brand Even though not every individual product is equally taken into account in advertising, the existing familiarity of the umbrella brand radiates to the entire product range. This already lends the GEHWOL product range exclusivity. With the FUSSKRAFT foot care series, which turns 50 in this year, foot care pros also have an exclusive brand available solely from them. This gives them a clear competitive advantage in customers perceptions. GEHWOL FUSSKRAFT BLUE is one example of this. The proven specialist against dry, brittle foot skin is one of the most sold products in foot care. This success is largely based on a highly effective and exclusive recipe. With a combination of moisturizing aloe and the moisturizing factors of urea and glycerine, GEHWOL FUSSKRAFT BLUE unfolds immense care powers. The cream fills up the moisture reservoirs of the skin. Aloe vera also relieves the sensation of tension in severely dry skin. The recipe reduces excess callus formation as well as itching, while its natural lipids such as lanolin intensify the care effect. The cream provides protection against foot and nail fungus, and lastingly deodorises with the active substance farnesol as well as the essential oils of rosemary, mountain pine and lavender. Enlivening camphor and cooling menthol soothe burning feet and foot pain immediately. 22

21 Product information CURRENT More than ingredients Aside from the proven recipe, however, there are also other criteria which contribute to the success factors. Neither brand familiarity nor a recipe and loyalty to the service sector alone are enough to describe the position of the GEHWOL brand and the exclusivity of the FUSSKRAFT products. The high brand value of GEHWOL and therefore also GEHWOL FUSSKRAFT is also measured e.g. in terms of its production. The standardized production process which always takes place at the same level, for instance, is also part of it. Exclusive is inclusive with us Patrick Bonner, Coiffeur It starts with the selection of the utilised raw materials. GEHWOL uses natural active substances for its products. Essential oils in particular have excellent properties. The natural healing powers of the plant extracts have a soothing effect on our mental state and act on the organism directly through the skin as well. The threesome of rosemary, lavender and mountain pine in particular have properties which have shown to be especially effective in foot care. Rosemary oil encourages the circulation, enlivens and activates. Mountain pine oil refreshes and deodorises, while lavender is known for its calming effects which encourage healing. These essential oils are also regarded as natural pathogen killers. They disinfect, inhibit the growth of sweat decomposing bacteria, and prevent foot fungus all very naturally. The brand image of GEHWOL includes the understanding that good products can come only from good ingredients, for poor raw materials always lead to poor results. Value for the price The differences can often be seen as early as in the purchase. For lavender oil, for instance, there is a wide price range. But the better the quality for this active substance, which is also contained in GEHWOL FUSSKRAFT BLUE, the higher the price. By using high quality lavender, the value of the product is increased. Despite this quality orientation, the price for the FUSSKRAFT product remains nearly the same. An optimal price-performance ratio as in the GEHWOL FUSSKRAFT products is also an important determining factor for the value of a brand. It s also important to know how the product is produced. GEHWOL FUSSKRAFT BLUE is subjected to a standard, prospectively validated process during the entire production. The investments into technical equipment at Gerlach allow consistent compliance with quality criteria. And these are high. GEHWOL products are manufactured according to internationally recognized quality standards as they apply according to EU standards for the cosmetic, pharmaceutical and medical products sectors. Exclusivity strengthens competence All of these criteria mean that trust in the products rises. It s not without reason that GEHWOL FUSSKRAFT BLUE is the most sold product at GEHWOL. Just as with the entire product series, foot specialists have products at their disposal which, aside from their high brand value, also support the professionals expertise in foot care. Finally, care success is the central focus in foot care. Competent advice needs effective products. In this way, foot care can be shifted to the home environment, ensuring well cared for, healthy feet even after the appointment at the practice. The advisory expertise of the foot care pro is a mandatory requirement for this. Here, GEHWOL FUSSKRAFT offers a spectrum for nearly all fields of application. This delimitation from other GEHWOL products namely the exclusivity secures a major competitive advantage for the foot care professional in everyday practice work. Cornerstones of the exclusivity of a brand n Brand value: this includes all criteria which represent value to the customers and users, such as product benefits, efficacy, price and product quality. n Quality of production in a prospectively validated production process (quality assurance) n Product acceptance and product loyalty, including a willingness to use the product regularly n Brand familiarity and market leadership: GEHWOL is not only the best known foot care brand, but also a market leader in the specialist trade. 23

22 Care Consultation CURRENT GEHWOL med Callus Cream Information on this subject for your patients is available at Monthly spa treatment to support the skin s self-cleaning processes The new GEHWOL med Callus Cream has already proven itself. The start of sales is barely twelve months ago. In this short time, the monthly spa treatment advanced to the most successful new introduction to the GEHWOL product range of all times. The product promise and the strong care performance are partly responsible for this success. The active substance combination of the callus cream makes use of the natural regeneration of the epidermis (desquamatio insensibilis). In its progression, the dead callus cells are detached by the vital cells from the lower epidermis which are continually newly formed. Approximately four weeks pass from the new formation of cells to the detachment, which approximately corresponds to the time window of the callus treatment. During the four week application, the callus layer is completely renewed, receiving a normally smooth appearance with no callus. Movement helps Shearing forces also play an important role in regeneration. These forces occur even during simple movement processes such as normal walking. Abrasion detaches and scales off the cells even more quickly from the softened callus layer. For the use of the callus cream, this means: continue to use the feet insofar as possible to avoid delaying the regeneration and self-cleansing processes of the skin. This makes the callus spa treatment a success. Other care tips GEHWOL med Callus Cream is only applied to callused areas. The product promise is dermatologically confirmed: excess callus is almost completely removed in four weeks, resulting in a normally smooth, attractive skin appearance. This is confirmed by more than the measurements conducted by the proderm Institute for Applied Dermatological Research. 83 percent of the additionally questioned cream users also confirm that their callus completely normalised after they completed the four week spa treatment. Less than half showed the effects after less than five days. The protagonist of this strong care performance particularly consists of the combination of highly concentrated urea, glycerine and allantoin. The three skin tolerated substances do not detach the callus like aggressive corrosive substances such as salicylic acid, which due to its potentially irritating effects can be used for cosmetic foot care products only to a very limited degree. Rather, its effect is keratoplastic it intensively bonds moisture in the skin s outer callus layer, loosening the compact cells and rendering the callus softer, more supple and elastic overall. n Only apply to strongly callused skin areas (e. g. the toes, pads and heel)! n Do not bring the callus cream into contact with injured skin! n Limit the use in terms of time! n For long-term foot care after the callus spa treatment, use GEHWOL med Lipidro Cream! n Urea and lipids regulate the lipid and moisture balance of the natural skin barrier. n First treat cracks using GEHWOL med Salve for cracked skin! n Skin care substances such as panthenol and bisabolol encourage rapid healing of cracks. 24

23 Care Consultation CURRENT Diabetic consultation GEHWOL on tour A big day for diabetes, the people s disease: on 19 March, the diabetes tour of the Kirchheim publishing house started for the third consecutive time. Among them: GEHWOL. During a foot check-up, visitors informed themselves about the risks of diabetic foot syndrome. Visitors feet were in the best of hands with podologist Heike Podesta. The diabetes tour, which is meanwhile regarded as Germany s largest diabetic exhibition, picked the right location for its start. Mainz has been the home of the Kirchheim publishing house, which specialises in diabetes with numerous journals and specialised books, since 250 years. The regional capital of the Rhineland-Palatinate region is also the German City of Science 2011 and has brought forth the Future Initiative Diabetes as such. Mainz can therefore be called the diabetes capital of Germany. So what would make more sense than having the tour start with a health day onsite in the city on the Rhine? Once again, the organisers had put together a varied programme. Regional specialists Other tour dates: n in Hanover n in Nuremberg made a valuable contribution here. The Children s University of Mainz, for instance, surprised the approx visitors particularly young patients with a special star guest: weight lifter, Olympic champion and vice world champion Matthias Steiner, himself a diabetic, explained to the public how to become the strongest man of the world even with diabetes. In 20 question periods, expert presentations, workshops, a large industry exhibition and an exchange of experiences with other patients, visitors were able to deepen their subject knowledge. But not just that! In an exclusive preventive care course, they were also able to obtain measurements of ten body parameters which are relevant to diabetes and discuss the results with experts. Among them: GEHWOL Among other things, a foot inspection with a subsequent consultation was available at no charge. This important part of the course was handled by podologist Heike Podesta. With strong support from GEHWOL and GEHWOL external services, the Rhineland Palatinate regional representative of the ZFD (Zentralverband der Podologen und Fußpfleger in Deutschland = Central Association of Podologists and Foot Care Professionals in Germany) and her employees took time to look at the state of exhibition visitors feet, provide helpful tips for home foot care and provide the interested public with product samples and care information. Sometimes the check-up even became an unexpected reacquaintance. Many visitors were already among the patients of the specialist, who operates a specialised podology practice in Stadecken-Elsheim near Mainz since many years. Three questions to the expert 1. You looked after the foot check-up at the diabetes tour in Mainz. How satisfied were you with the findings of the exhibition attendees? Heike Podesta: Very satisfied overall. One can see: patients who obtain information at specialised exhibitions are often diabetes specialists in themselves. This is also true for foot care. Unfortunately this is not the case for all diabetics. Care consultation is an important contribution to preventing diabetic foot problems. 2. You also advised the visitors. What simple measures do patients use to keep their feet healthy and well cared for? Heike Podesta: Heike Podesta: The daily foot inspection is most important always including between the toes. This is mandatory for diabetics. It s also helpful to bathe the feet regularly, but not too long and especially not too hot, and then carefully apply cream to them. The specialised associations recommend the following guidelines for foot baths: 3 5 minutes at C. 3. At the tour, you handed out ware samples to visitors. Are there particular products which you would recommend specifically for diabetics? Heike Podesta: Dry skin and excess callus are among the most common problems of diabetics. Here the GEHWOL med Lipidro Cream has proven itself with its balanced ratio of lipids and moisturisers. For patients who like something lighter, the GEHWOL FUSSKRAFT Hydrolipid- Lotion is an alternative. 25

24 Practice CURRENT A new judgment: podologist versus foot care professional The judgment can be seen on the internet: Trusting in your own abilities The Higher Regional Court of Hamm denied a foot care professional the description Practice for medical foot care. This brought the dispute about titles, title protection and activities into a new round. But is it all worth it, or should foot care pros and podologists focus on their work? The advertisement of a foot care professional was the cause of the new dispute case. In the local daily newspaper, the defendant drew attention with the words Practice for medical foot care. This disturbed a podologist who then sued, but lost before the District Court of Münster. The court referred to the podologists act which protects the title, but not the activity. The District Court followed previous judgments with this. The suing podologist did not give up, and filed an appeal against the district court judgment with the Higher Regional Court in Hamm. She won here, and the defendant was ordered to cease and desist. With this judgment, the Hamm court contradicted the jurisprudence of the Higher Regional Court of Naumburg in the year 2004 and the Higher Regional Court of Frankfurt in the year They had both judged that a foot care professional may post medical foot care on their door even if they do not bear a title that is recognised in accordance with the podologists act.... Violations of the competition laws, the medicinal products advertising laws and the healing practitioners laws... Reasons The Higher Regional Court at Hamm founded its deviating legal assessment on the reasons that the foot care professional was allegedly violating three laws, namely the law against improper competition, the healing products advertising laws, and the healing practitioners laws. The description Practice for medical foot care would mislead the public. The public consisted of those persons who regularly use the foot High quality work is the best advertisement. Satisfied customers tell their friends, colleagues and relatives about their experiences and make recommendations. care services. After many years of advertising by podologists associations and health authorities, they were able to clearly differentiate between the designations of podologist, medical foot care provider, cosmetic foot care provider and foot care provider. However there is no clear data situation as to whether this actually applies. The reasons for the act of misleading are therefore based on an assumption which is made by the court, supported by the Zentralverband der Podologen und Fußpfleger Deutschlands e.v. (Central Association of Podologists and Foot Care Professionals of Germany e.v.). More than title protection? It s still uncertain what the judgment from Hamm will mean for the future in detail. However it appears that a new era has begun in the dispute between podologists and foot care professionals. If other courts were to follow the allegation of misleading the public, the description of medical foot care might also receive critical attention. The uncertainty among foot care professionals is therefore fed again, particularly since the Higher Regional Court of Hamm does not address the discussion of the Higher Regional Court of Frankfurt. The judgment from the year 2005 also points out that even if the knowledge of the public should change, a prohibition of advertising would likely not result. It is still a permitted activity. The dispute about advertising with the addition of medical foot care has already gone on for many years. There is still the question as to what consequences each individual should draw from this. Is advertising with the addition of medical foot care important for economic success at all? Many foot care professionals look back on a long and successful professional career. The experience which they have gained helps the customers and makes the foot care professional a qualitative instance. There are surely some black sheep as well. But the quality of a treatment cannot be determined simply from a title. Just as in physicians, they are not all the same. So does the foot care professional who is not trained in accordance with the podologists act and has no corresponding documentation absolutely have to advertise with these added words? There are surely many formulations which also generate trust and emotions such as: 20 years in the service of feet or Keeping you on healthy feet. Lastly, the best advertisement is word of mouth in any case. Recommendations by friends, neighbours and relatives is effective and direct. And the most effective motivation for making a recommendation is high quality work. The profession should trust in its abilities and not be paralysed by disputes. 26

25 Practice CURRENT What types of insurance are required, part 1: securing business risks Comprehensive general liability etc. Everyday work has many risks which may also threaten the existence of your business. Foot care professionals and podologists should therefore secure the risks of their business and their own risks (part 2 in the next issue of FUSSPFLEGE AKTUELL) with insurance policies. But which ones are absolutely necessary? There are two forms of business risks: damages to one s own business and damages to third parties such as customers and business partners. Comprehensive general liability insurance secures independent business owners for the work which they practice, against property damage and personal injury to third parties, explains Andreas Dietrich, an insurance broker from Dresden. This includes liability for property damage and personal injury to patients or their valuables and defence against unjustified claims. Third party damages It happens more quickly than one might think: during the treatment, you knock a cream container from your treatment cabinet, and it falls on your customer s designer handbag. Comprehensive general liability insurance covers the costs e.g. for cleaning or replacement. Or a customer trips over a cable in your practice and breaks their femur. The customer s statutory accident or health insurance demands compensation in four-digit sums from you. There are hazards everywhere, and they can threaten your existence if the costs of damage or injury are too high. Therefore comprehensive general liability insurance is an absolute requirement for any foot care professional who works for himself, states Dietrich. Own damages However comprehensive general liability insurance does not cover you against own damages. This requires business insur- ance similar to private household and building insurance, states the insurance expert. This business content insurance is usually available as a package with the most important components: damages due to fire, break-in/theft, vandalism during break-ins, line water, storms and hail. Depending on the insurance sum, your insurance premiums will be higher as your insurance is more comprehensive. Nonetheless, a business owner should not pinch pennies here, Dietrich emphasises. For instance, fire insurance does not merely pay for damages causes by fire, lightning strike and explosions, but also covers the costs incurred out of extinguishing and clearing work. Break-in/theft insurance covers stolen practice equipment as well as repair costs for break-in damages. Pipes can also break unexpectedly. Line water damage insurance covers the costs. These obligatory basic insurance forms can be expanded as desired. Particularly for foot care professionals and podologists, electronics insurance is recommended. It refunds office and communication technologies in overvoltage damage, operating errors and lack of skill and can also be expanded for medical technology such as foot care units, the expert recommends. Interruption of business In cases of damage, the insurance merely repays the costs for the restoration or new purchases to restore the initial situation. But what if a fire breaks out in the practice and customers cannot be treated for four weeks? In this case, the business interruption insurance provides financial compensation. This insurance must be closed in addition to the business content insurance. It replaces not only lost profits, but also continuous costs such as rent, lease payments and employee remuneration, states Dietrich. Costs There is a suitable insurance policy for nearly all eventualities. Costs are important for independent business operators. The insurance premiums result mainly out of the insurance sum, are calculated in advance and can be planned and deducted as business expenses, while damage events are not. The insurance sum covers all costs incurred due to damages. What is decisive is the new value (purchase costs / list price) for property insurance and the gross earnings (sales without use of materials) in business interruption insurance. Insufficient insurance should absolutely be avoided, since a reduction of the sum to be refunded is therefore possible in case of damages, Dietrich explains. Since insurance is always a very individual matter which requires a lot of advice, a detailed consultation with an insurance consultant or independent insurance broker is fundamentally always recommended. 27

26 Practice CURRENT Safety check View, check, work When operating equipment such as foot care units, treatment chairs or autoclaves are properly started in operations, they support the foot care pro in his or her work. But what about safety tests? Do all checks on an electrical piece of equipment have to be done by experts, or can foot care pros also do this themselves? The proper function of all commercially utilised electrical equipment and systems (operating equipment) and their use in accordance with instructions are a significant prerequisite for guaranteeing the safety of the users and patients. Regular checkups are therefore part of the operators duties. This duty affects all operating equipment which has an electrical plug. This concerns both medicinal products and non-medicinal products. There are regulations and laws in this regard. For non-medicinal products, the control regulations, such as the accident prevention regulations of BGVA3 of the workers compensation boards, apply. For medicinal products, on the other hand, the Medizinprodukte-Betreiberverordnung (MPBetreibV = Medicinal Products Operator Regulations) apply. Both regulations lastly have the objective of ensuring that the use of operating equipment does not result in health hazards for the operators or patients. Regular check-ups and inspections are intended to recognise possible hazards at an early time and correct defects. Everyone is obligated Electrical units and systems are commercially utilised in the foot care practice. Consequently the regulations apply here as well. Whether it s a foot care unit, chair or autoclave, the foot care professional must check whether everything is in order. This should be done for one s own benefit regardless to exclude possible dangers. The procedure is basically similar to a toaster, coffeemaker or washing machine at home. Fundamentally, these may only be operated when they are in proper condition. This obligates the foot care pro and podologist in the practice to check their electrical systems and operating equipment for proper condition. Visual checks are frequently sufficient for this purpose. In a coffeemaker, no one would measure the voltage before switching it on for the first time. If no wiring is loose or damaged and there are no discernible cracks in the housing, it s started up. What to check in detail in a visual The experts at GERLACH TECHNIK skilfully perform all required maintenance work and function checks in electrical equipment. 28

27 Practice CURRENT inspection is stated in the operating manual in the case of products from GERLACH TECHNIK (see the box). Gauging function Medicinal products can also be visually checked. In rotating instruments which are operated with foot care devices, GERLACH TECHNIK supplies devices which can be used for tests beyond pure visual checks. A gauge can be used to find whether the shaft of an instrument is bent. If it slides into the gauge very easily with no resistance, the instrument is rotating smoothly. On the other hand, resistance indicates bending. Such instruments should no longer be used to avoid damage to the hand piece bearings. This also applies if the head is bent; however this is detected not with a gauge, but with a visual check.. The foot care pro can use the gauge to check whether the shaft of a grinder or polisher is bent or not. The units from GERLACH TECHNIK are very easily cleaned as well. For instance, checking with a testing pin will show whether there is dirt in the tensioning device on the hand piece. This small metal rod has a coloured ring. If it is still visible when inserted into the tensioning device, cleaning should take place. Only by the experts Not all checks can be done by the foot care pro himself. Most manufacturers plan for electrical check-ups at regular intervals. This is reflected in the respective DIN standards and applies to all moveable electrical equipment which is utilised. The authorised expert tests onsite and then issues a testing certificate. A more detailed investigation prior to the first start-up is often unnecessary if the manufacturer attests to the operator that the electrical systems and operating equipment meets the requirements of the accident prevention regulations. This is confirmed in the manufacturer s documentation. More cost MPBetreibV has significantly higher requirements for the inspection of operating equipment: In medicinal products for which the manufacturer has prescribed safety technology check-ups, the operator must carry these out or have them carried out in accordance with the manufacturer s specifications and the generally recognised rules of technology as well as at the intervals required by the manufacturer. Even if the manufacturer does not specify any safety technology check-ups, the operator must carry them out. However the time intervals are then determined based on experience. In other words: if the manufacturer makes no specification, the foot specialist himself must assess when to check equipment so that no defects occur. He is generally not able to perform the check-ups himself. MPBetreibV specifies that only a person who provides a guarantee for the proper implementation of the safety technology check-ups based on their training, knowledge and practical activities can carry out safety technology check-ups. Aside from experience, there must also be no dependence. For instance, an employee of the practice is bound by instructions and may be restricted in terms of an objective assessment. Finally, an inspecting person must also have suitable, often very expensive measuring and testing systems, e.g. for measuring voltage. No pressure In general, foot care pros are not obligated to use a medicinal product. This is with the exception of being licensed for health insurance. If you have or want this, you are obligated to use medicinal products to a significant degree in your own practice. Fundamentally, however, no one is forced to do this. For instance, less cost may be incurred for a treatment chair which is not a medicinal product without causing hazards to personnel or patients. For one s own certainty of having a well maintained and therefore performance-ready piece of equipment, it is at least recommended to have regular maintenance done. All operating equipment, such as a foot care unit, must be subjected to safety checks. Safety checks in the Concept F3 The new treatment chair CONCEPT F3 from GERLACH TECHNIK is not a medicinal product, which simplifies the safety check. Foot care professionals can perform many check-ups on their own. For instance: Recommended implementation before every treatment: n Check for damage to the outer cables such as breaks, cracks, cuts, squeezed or bent parts, discolouration on the cable covering, areas which have been rubbed off, protruding areas, brittle places and visible inner insulation or metal wiring n General visual check to find damage of any type to the visible housing and framework parts, cushions, foot switch and its cable n Perform standard checks and check whether there is sufficient distance from walls or window sills Implementation recommended daily: n For instance, drives should be moved to their home positions for this purpose. When the home positions are reached, it should click. Indicators of defects are abnormal noises or difficult motion. The adjustment options of the leg and heel rests should also be checked. 29

28 Marketing CURRENT Therapy Support No fear of sales The willingness to engage in home foot care is increasing. This is noticeable judging by the rising number of products which are purchased in Germany overall. Many foot care professionals, however, are still afraid to recommend products even if it supports therapeutic success. The amygdala, our neuronal danger radar, becomes active if there s danger. It has the task of protecting us from possible harm by preparing us for adequate behaviour in critical situations. For instance, this may consist of tensioning the muscles, weak knees, a racing heartbeat, goose bumps or rapid breathing. From the adrenal cortex, the formed reservoirs of adrenaline enter the blood circulation, spurring our body to an automatic counter-reaction. But the assessment of what is a danger is very subjective. Even entering into a sales conversation can seem like danger to some of us. Particularly in the foot care profession, there is often still a lot of scepticism or even fear concerning sales, so that an active amygdala is certainly possible. This is unnecessary, for clients are often grateful for a good recommendation. The will to be well The rising sales of foot care products are one sign of this. Both in specialised sales and in drugstores and warehouses, sales are rising steadily. This indicates that there is an increasing will to perform home foot care. This is supported by a study done by Roland Berger Strategy Consultants. According to this, people increasingly want to do something for their health and are using health-supporting products and services regardless of their income. This is a potential which foot care pros can put to good use. Particularly in foot care, it s not just about sales. Recommending the right products supports the therapy. The primary treatment service, paired with the availability of exclusive foot care products which secure the treatment success as well as the knowledge and willingness of the foot care provider to provide information about these products founds the stand-alone position of the foot care practice in competition with non-specialised trade, making it a sign of quality in matters of foot health. The dermatological and dermocosmetic knowledge of the foot care pro creates trust. expertise. Investigations show that customers do not equate good advice with sales. The HanseMerkur health insurance company found out in a study on integrated care in private health insurance that customers certainly want good and individual service, good medical and human care and the right price to service ratio. Everyone lives by selling something. Robert Louis Stevenson ( ), Scottish author Therefore qualified advice can combine various requirements. Customers feel trust and the good sensation of getting a solution for their problem. Foot care professionals fulfil their calling and ensure attractive and healthy feet in their customers, even beyond treatment. The commercial product range also helps them to secure and increase the economic success of their practice. Knowing how For a believable consultation, it s very important to select the right product with the right product benefits for the customer s problem. If the customer s problem is not evident, open questions while taking the history can help, such as: How does this show itself? When did you notice the corn for the first time? What shoes do you normally wear during the day? The foot care pro should actively listen to the customer s explanations with interest, understanding and attention. If a product is recommended to solve the subject, it helps to explain the choice to the customer. Acceptance for the selection increases if emotions are raised, such as: GEHWOL FUSSKRAFT BLUE will soon take care of brittle callus. Customers want advice By recommending high quality products, e.g. from the GEHWOL FUSSKRAFT series, foot care pros underline their subject A trust relationship develops between the foot care pro and the customer. This continues through the use of a product for home care. 30

29 Marketing CURRENT At the BEAUTY exhibition in March of this year, Jobst-Peter Gerlach-von Waldthausen received the A Life of Beauty award. The prize stands for special engagement in professional cosmetics. Award A Life of Beauty Life for the well-being of the feet At the BEAUTY exhibition in March of this year, Jobst-Peter Gerlach-von Waldthausen received the A Life of Beauty award. The prize stands for special engagement in professional cosmetics. It s the people behind the brands GEHWOL and GERLACH TECHNIK who have ensured reliability in terms of quality and benefits since decades. As the CEO of Eduard Gerlach GmbH, Jobst-Peter Gerlach-von Waldthausen particularly takes this responsibility into account. The jurors of the A Life of Beauty award, which was awarded to the successful entrepreneur on 18 March at and by the BEAUTY INTERNATIONAL exhibition in Düsseldorf, also thought so. The Düsseldorf awards this prize to honour personalities who have made special efforts in professional cosmetics and are impulse drivers in the industry. The prize stands for the life work of the CEO of Eduard Gerlach GmbH, but also for the performance of the employees who support the company s success. Among other things, the more than 140 years of foot care expertise were decisive for the jury: in the year 1868, druggist Eduard Gerlach took over a grocery business from his father and expanded it into a drugstore. His interest in foot care came up early, and in 1882, he brought out the world s first industrially produced foot care cream. The jury of the prize regarded it as positive that Gerlach is domiciled within the country and does its own production. In 1978, Klaus Gerlach-Meinders and Jobst-Peter Gerlach-von Waldthausen took over the company in its fourth generation and expanded it into one of the most important complete providers of foot care products and equipment to equip foot care practices and cosmetics institutes. Innovation and reliability With the introduction of the GEHWOL FUSSKRAFT series in the year 1961, Eduard Gerlach GmbH first offered foot care products exclusively for foot care professionals. This loyalty to the profession of foot care pros has remained a fundamental maxim of the company to the present day. This partnership is based on seven principles. n Closeness to the specialist trade creates trust. n GEHWOL FUSSKRAFT is reserved for professional foot care pros. n Everything from a single provider: products, technology and instruments n Research and continued development are based on market requirements. n Provable market leadership: GEHWOL FUSSKRAFT BLUE the largest individual product in the foot care market n More than 140 years of experience n A clear brand image and efficient advertising create familiarity. The jury also took the engagement to provide constant innovation into account. At the same time, the traditional use of natural active substances has proven to be a concept which is on trend more than ever today. Modern research facilities and advanced product systems guarantee the optimal quality standards of the entire product range. The prize is associated with a total of 5000 Euros. The prize money is traditionally donated for a worthy cause. To express their engagement for the region and the location of Lübbecke, Eduard Gerlach GmbH added another 5000 Euros to the prize money. The check for now Euros was presented to representatives of the Outpatient Children s Hospice Service Minden-Lübbecke on 30 March 2011 by the management. 31

30 Service CURRENT Until we meet again... Do you have other questions about the products? Would you like to test the functionality of devices or sit in a foot care or work chair to try it out? Just come to one of the exhibitions which are of interest for foot care professionals in The employees of GEHWOL will be happy to be available to you for a personal discussion at the following exhibitions: at the GERLACH stand! Exhibition dates 2011 Study Early training In a federation-wide survey of the work group of state approved and recognised schools for podology within Germany, podology practices were able to evaluate their students and therefore also their cooperation schools. Satisfaction with successors received an average grade of good. Questions were also asked about the most important abilities expected by podology practices. Complex treatment, hygiene measures and theory implementation in practice were listed most frequently. This project, which is unique thus far, came into existence in cooperation with the School for Medical Documentation in Düsseldorf BEAUTY FORUM Leipzig COSMETICA Stuttgart COSMETICA Wiesbaden FUSS 2011 Kassel Forum for podiatry and foot care BEAUTY FORUM Munich COSMETICA Berlin Imprint Editorial staff and publishing company Dorothea Küsters Life Science Communications GmbH Leimenrode Frankfurt am Main Phone: Fax: info@dkcommunications.de Internet: FUSSPFLEGE AKTUELL is published on behalf of Eduard Gerlach GmbH Editorial management team: Dorothea Küsters (responsible), Dirk Fischer Editorial staff: Stefan Dudzinski-Lange, Stefan Dietrich Graphic concept and realisation: PUNKTUM Werbeagentur GmbH, Bad Vilbel Photos: Eduard Gerlach GmbH, ddp images/ap Photo/Kin Cheung (picture on front page), tarei - fotolia (page 4-5), pavel Cherno-brivets fotolia (page 6-7), Medical GmbH (page 20-21), Visual Concepts fotolia (page 22), iqoncept fotolia (page 26), Ramona Heim fotolia (page 27) All rights reserved. May only be reproduced even in part with the approval of the publisher and stating the source. Rights of translation and other uses reserved. No liability for manuscripts, discussion examples etc. which are submitted without being requested. If FUSSPFLEGE AKTUELL cannot be published or delivered, this does not result in claims against the publisher. Place of jurisdiction: Frankfurt am Main. 32