By Julie Budnick
Our ability to stand and walk upright is what sets us apart from other species. It is something we don’t think about, notice or dwell upon until something goes wrong. A quarter of the bones in the human body are found in the feet and ankles – 26, to be exact – yet this complex region has often been the domain of the general practice physician without a thought of the need for a specialist. Although there is a long history of foot care dating back to early Egyptian times, it has only been in recent years that the field of podiatry began to be acknowledged as an essential part of medical treatment.
Podiatrists specialize in the diagnosis, treatment and prevention of disorders of the lower extremity, namely the foot and ankle region. Podiatric training is acquired through dedicated podiatric medical schools and not within the traditional medical school system. Physicians earn a doctorate in podiatric medicine (D.P.M.) rather than an M.D. For this reason, it has often been misunderstood as a specialty. Dr. David Helfman, CEO and founder of Village Podiatry Centers in Atlanta, entered the field accidentally. “I was involved in two years of research in cardiothoracic surgery,” said Dr. Helfman. “While attending undergraduate studies at the State University of New York at Binghamton, I met a podiatrist who was an extremely positive physician. I spoke with him at length about the specialty and was intrigued.”
In the case of Village Podiatry Centers podiatric surgeon Dr. John Ruch, podiatry was the family business. “My father was a podiatrist, so I grew up seeing first hand what an impact you could have. I came to realize that the care of patients with foot problems was a unique area. The specialty involved intimate patient contact with a wide scope of both medical and surgical practices. I saw how happy Dad’s patients were and it was very rewarding.” Dr. Mohammad Sharif of Village Podiatry Centers chose the podiatric field, which allowed him to help patients and had the added benefit of lifestyle flexibility. “In college, I knew that I wanted to be in medicine. Podiatry was exciting because you could be a physician but have a family life as well,” said Dr. Sharif. Although the area of dance injuries initially interested Dr. Sharif, he eventually became very involved with patients who experience complications of the lower extremities related to diabetes.
Although Drs. Helfman, Ruch and Sharif all came to the field of podiatry down different roads,ultimately they came to Village Podiatry Centers with a common goal of providing the best possible medical and surgical treatment for their patients. Village Podiatry Centers was originally founded by Dr. Helfman in 1992 as a solo practice. Today, Village Podiatry Centers has grown into the largest podiatric surgical practice in the southeast and one of the largest nationwide. The practice currently has 26 surgeons and over 100 support staff in 23 Metro Atlanta and Middle Georgia locations. So, how did this practice evolve from a solo office into a multicenter medical practice? Dr. Helfman developed an innovative approach for how he wanted his practice to function. “I created a model where doctors would be empowered to succeed and have the opportunity for personal and professional growth,” said Dr. Helfman. The traditional medical practices, according to Dr. Helfman, were structured so that the senior physician received the majority of the income, which gave little incentive for junior partners to stay on a long-term basis. Dr. Helfman realized there was a better way to function and set to work developing his new model.
Village Podiatry Centers has consistently grown at a rate of 25% a year. The majority of their patients are referrals from primary care physicians and specialists in the United States and abroad. Although Village Podiatry Centers is large, they are extremely selective in their choice of podiatric surgeons. The highest standards in education and training are the key components to maintaining their mission of providing excellence in foot and ankle medicine. All physicians at Village Podiatry Centers have more than 10 years of training, which includes a bachelor’s degree, four-year podiatric doctorate and a minimum of three years of surgical residency training.
Benefits and Challenges
Large practices often offer many benefits to both patients and physicians, but can be faced with a host of challenges. The Village Podiatry Centers’ model embraces these challenges as positive catalysts for change. Dr. Helfman believes that although in a large group you lose some autonomy, ultimately, everyone including the patient will benefit. “Doctors in large groups have to work as a team,” said Dr. Helfman. “You must also have the appropriate infrastructure to succeed.” Village Podiatry Centers has a corporate office in Smyrna that handles the majority of the administrative tasks involved in running the practice. In addition, there are five operating committees that help manage the practice. Each of the partners sits on at least one committee.
Dr. Ruch was formerly in a small practice with podiatric legend and surgical pioneer Dr. E. Dalton McGlamry. After Dr. McGlamry’s retirement, Dr. Ruch merged his practice with Village Podiatry Centers two years ago. “In the current medical environment, it is very difficult to manage a medical practice, and I experienced a lot of pressure,” said Dr. Ruch. “I wanted to spend the majority of my time practicing medicine.” Village Podiatry Centers has an entire staff to deal with human resources, insurance issues, accounts receivables, purchasing and marketing. The central scheduling department manages patient appointment requests, further freeing the clinical staff to devote themselves to patient care.
Each physician has a local office where he or she sees patients. From the patient’s perspective, it is personalized care, the same as being treated by a solo practitioner. One of the greatest benefits of this model is the depth of expertise on staff at Village Podiatry Centers. This allows for continuity of care and a better experience for the patient. “We have excellent doctors who work well as a team,” said Dr. Sharif. This allows for leveraging each other’s talents when seeking a second opinion. “We have a range of experience that includes doctors who have literally written the surgical textbooks for the podiatric field,” said Dr. Helfman. “They are pioneers who have trained many of the podiatric surgeons today in the Atlanta area.” Village Podiatry Centers’ size further enables them to have a more positive experience when negotiating with managed care providers for reimbursements. And, the self-perpetuating model enables healthy but manageable practice growth.
Advanced diagnostics is a hallmark of Village Podiatry Centers’ standard of care. On-site digital X-ray and vascular studies are available in each office. The size of the practice allows for additional ancillary services not commonly provided in most podiatric practices. Village Podiatry Centers is affiliated with three dedicated foot and ankle surgery centers and has an in-house pathology lab. They have access to the only high-field extremity MRI unit in the metro Atlanta area. From routine ingrown toenails to the more complex limb-salvage procedures, Village Podiatry Centers offers the full range of services to a patient population ranging from pediatric to geriatric. A common referral to the practice is for second-surgery patients who may not have had a positive outcome from a prior procedure. These patientsare referred by their primary care physician or specialist for corrective surgery. “Our scope of practice encompasses the simple procedures to the most complex foot and ankle reconstructive surgery; Village Podiatry Centers’ surgeons are able to manage and treat them all,” said Dr. Helfman.
One major impact of this practice upon the Metro Atlanta medical community has been the instrumental part it has played in securing podiatrists on staff at more than 18 metro-area hospitals. Thirty years ago, when some of Dr. Helfman’s colleagues began practicing, podiatrists were not on staff at any hospitals in the area and were rarely acknowledged as a specialty. Today, the climate is much different and continues to evolve.
The medical staff at Village Podiatry Centers believes it is vital to the field of podiatry to continue to train and produce highly qualified physicians. Five of the surgeons serve as faculty members of The Podiatry Institute, an internationally recognized teaching foundation for foot and ankle surgery based in Atlanta. Dr. Ruch leads the foundation as Director of Medical Education. Many of the Village Podiatry Centers’ staff physicians participate in the surgical residency training program affiliated with DeKalb Medical Center. Dr. Alan Banks is Director of Residency Training. He and Dr. Ruch have played primary leadership roles in the program, which has been in place for 40 years. Over 100 surgical residents have graduated from the program, with 50% staying in the area to practice. Although not governed by Village Podiatry Centers, the residency program is actively supported by them. The physicians are further involved in research and have established a research arm led by Dr. Brent Nixon, a certified clinical research investigator for over 30 years. Due to Village Podiatry Centers’ large patient population, with more than 90,000 annual patient visits, the practice is often sought out to participate in clinical trials.
Podiatry is currently one of the fastest growing medical specialties due to an aging population and the increase in diabetes and other diseases affecting the lower extremity. What does the future hold for Village Podiatry Centers? “We plan to go wherever we are needed,” said Dr. Helfman. The practice recently expanded into Middle Georgia, incorporating four locations in Forsyth, Macon, Milledgeville and Warner Robins. “The need for quality podiatric care in rural communities is especially apparent, and Village Podiatry Centers will concentrate efforts in that area. We have a number of physicians who have expressed interest in joining us,” said Dr. Helfman. Ultimately, the practice will continue to expand within the region and perhaps nationally. But the growth doesn’t stop with podiatry. “Our model of high-quality patient care combined with solid business practices that we have created can be transferred to different types of medical practices,”said Dr. Sharif. In fact, Dr. Helfman has recently launched a new business entity to expand the Village Podiatry Centers’ model within the podiatric profession and to other medical specialties.
Above all else, the most rewarding part of the practice for the physicians and health care professionals at Village Podiatry Centers is the ability to make a valuable difference in the lives of patients. Every day, patients experience freedom from pain and are able to return to work, restored to a normal, active life. According to Dr. Sharif, “The most gratifying thing is to see a complex patient completely healed. That is what our work as podiatric surgeons is all about.”
Village Podiatry Centers provides treatment for bone, vascular, dermatologic and soft tissues or abnormalities of the lower extremity:
- Ankle and foot pain
- Arthritis pain
- Athlete’s foot
- Corns and calluses
- Custom-molded orthopaedic shoes and orthotics
- Cysts and tumors
- Diabetic foot care and wound care
- Flatfoot conditions
- Fractures, dislocations and sprains
- Heel spurs
- Ingrown toenails
- Joint replacement
- Nail fungus, infections and disorders
- Painful toes and hammer toes
- Pediatric foot and ankle disorders
- Plantar fascitis
- Plantar warts
- Preventive care
- Puncture wounds
- Shin splints and other lower-leg pain
- Skin rashes and disorders
- Sports-related injuries and overuse syndromes
- Surgical reconstruction
- Tendon injuries and disorders
- Workers’ comp injuries
Central scheduling: (770) 771-6991 www.VillagePodiatryCenters.com
New Middle Georgia Acquisition
Village Podiatry Centers’ expanded into Middle Georgia in January 2009. The integration of the four offices in Forsyth, Macon, Milledgeville and Warner Robins adds two surgeons to the medical team. Dr. Larry Goldstein is board certified in foot surgery. Dr. Bruce Pichler is board certified in foot and ankle surgery. Both are established podiatric physicians in the region. “We are very pleased to become a part of Village Podiatry Centers. Their leadership in the field of podiatric medicine brings additional expertise and resources to achieve a wider range of advanced care for our communities,” said Dr. Goldstein.