Drs. Robert Bertram and Sarika Parikh, as well as Deb Winterhack of Agnesian Health Shoppe business development, present on updates on their respective services.
2. Presentation Outline
Introduction
Robert Bertram, DPM
Sarika Parikh, DPM
What is podiatry?
Common foot and ankle issues
Diabetes and diabetic foot care
Agnesian Health Shoppe
Questions
3. What Is Podiatry?
Podiatry, or podiatric medicine, is a
specialized area of medicine dedicated to
the diagnosis, treatment and prevention of
diseases and disorders of the foot, ankle
and lower extremities.
Foot/ankle anatomy is complicated
26 bones, 33 joints, 100+ ligaments,
19 tendons
Many areas that can become an issue
4. Common Foot and Ankle Issues
Plantar fasciitis (heel pain)
Achilles tendonitis
Bunions/hammertoes
Flatfeet
Arthritis
Diabetic foot care (corns, calluses, toenails)
5. Plantar Fasciitis
Most common cause of heel pain in adults
Typically due to repetitive or excessive stress on the foot
Symptoms
Gradual onset of pain at bottom of the heel
Worse when taking first steps in the morning or after prolonged
sitting
Conservative treatment: Shoe
inserts/orthotics, stretching, appropriate
footwear, NSAIDs, rest, ice, other
(physical therapy, injections, etc.)
Surgical treatment
6. Inflammation often caused by
repetitive stress on the tendon
Achilles tendon runs down back of
lower leg
Symptoms:
Aching, stiffness, soreness or tenderness within
the tendon
Treatment: RICE, physical therapy, stretching
exercises, orthotics, night splints/custom
bracing
Achilles Tendonitis
7. More than just a bump
Reflects changes in the bony structure
Big toe leans toward second toe, misaligning the bones
Progressive - gets worse and bump is more prominent
Symptoms
Pain or soreness
Redness and inflammation
Burning or numbness
Difficulty wearing certain shoes
Treatment
Conservative
Surgical
Bunions
8. Hammertoes
More severe cases - open
sores
Treatment
Conservative
Surgical
Abnormal bend in the second, third, fourth or little
toe
Bend in the toe
Pain/irritation when wearing shoes
Corns and calluses
Redness and inflammation
9. Flatfeet
Structural abnormality leading to abnormal
foot alignment/positioning
Progressive weakening of supportive structures
and gradual collapse of the arch
Conservative treatment: orthotics, bracing,
functional supports, physical therapy
Surgical treatment: reconstructive procedures
to recreate arch of foot
10. Arthritis
Most common in the mid-foot, big toe or ankle
Inflammation of the joint - breakdown in joint
cartilage
Symptoms
Pain and stiffness
Swelling in or near the joint
Difficulty walking or bending the joint
Treatment
Conservative - shoes, boots, bracing, orthotics
Surgical - joint fusion or joint replacement
12. Diabetic Facts
Number of people with diabetes has risen from 108 million
in 1980 to 422 million in 2014.
Global prevalence of diabetes among adults over 18 years
of age has risen from 4.7 percent in 1980 to 8.5 percent in
2014.
Diabetes prevalence has been rising more rapidly in middle-
and low-income countries.
Diabetes is a major cause of blindness, kidney failure, heart
attacks, stroke and lower limb amputation.
13. Why Screen the Diabetic Foot?
15 percent of people with Type I and Type II
diabetes will develop one or more foot
ulcers in their lifetime.
10 percent of these will go on to have a
major lower limb amputation.
Of all non-traumatic lower limb
amputations, 85 percent are due to diabetic
foot ulcerations.
15. Foot Care Tips
Check your feet every day
Look at your bare feet every day for cuts,
blisters, red spots and swelling
Use a mirror to check the bottoms of
your feet or ask a family member for
help if you have trouble seeing
Wash your feet every day
Wash feet in warm, not hot, water
Dry feet well; be sure to dry between the toes
Keep the skin soft and smooth
Rub a thin coat of skin lotion over the tops and
bottoms of your feet, BUT NOT BETWEEN
YOUR TOES
16. Foot Care Tips, cont.
Wear shoes and socks at all times
Never walk barefoot
Wear comfortable shoes that fit well and protect your feet
Feel inside your shoes before putting them on each time to
make sure the lining is smooth and there are no objects
inside
Make sure the shoe fits properly
Take care of your diabetes and try to be more active
Work with your healthcare provider to keep your blood
sugar within a safe range
Plan a physical activity program with your healthcare
provider
17. Footwear Tips
Type of shoe
Proper fit
Shoe wear, patterns of
wear
Lining wear
Foreign bodies/objects
Insoles, orthotics
18. Agnesian Health Shoppe
How does podiatry work with the Agnesian Health
Shoppe?
Diabetic/therapeutic shoes
Compression stockings
Over-the-counter shoe orthotics
Walkers
Crutches
Roll about knee scooter
Wheelchair
Surgical shoes/boots
20. Services
Sleep management
Home oxygen
Women’s health
Mobility and home
access
Diabetic shoes
Retail DME shop
Wound care
Re-supply program
Repair and service
Benefits
Additional products
21. Sleep Management
Sleep Management Program
Respiratory therapists on-site
Four full-time respiratory therapists
Technicians on-call 24/7
Flexible schedules to meet patient’s needs
Patient education and exceptional compliance
Re-supply program for masks and
supplies
Direct mailing to patient’s home
with permission
Retail products, such as pillows
and wedges for sleep comfort
22. Home Oxygen
Home Oxygen program consists of:
Respiratory therapists and certified
delivery technicians
Provide home delivery at set-up and 10
tanks per month
Provide education on proper use of
equipment and supplies
Our team has many years of experience
and have established relationships with
our customers providing a sense of
security and compassion.
Strive for same day service, on-call 24/7
Respiratory therapists available for
consultation with patients and their
providers
23. Women’s Health
Post mastectomy supplies,
including:
Breast prosthesis, bras, swimwear, fashionable
scarfs and head coverings, wigs
Mom and baby products
Medela and Ameda Breast pumps and supplies
Earth Mama Angel Baby skin care products
Compression garments
Ready-to-wear and custom fitted (for both genders)
Two certified compression and mastectomy fitters
with a licensed registered nurse on staff
Private fitting rooms - call for
appointments
25. Staying Home Safely
Falls inside and outside are the number one
cause of injury among the elderly
Stairs lifts assist in climbing the stairs
More access to your entire home
Funding sources available
Wheelchair ramps provide access into your
home or garage
Vehicle ramps provide easier transports
Free home assessments for safety, equipment
and home modifications
27. Mobility & Home Access
Two nationally-certified assistive technology
professionals (ATP).
Work with patients and providers to ensure proper
equipment is built to fit the patient’s needs, home
and lifestyle.
High-end custom specialty mobility devices and
equipment including:
Power wheelchairs
Power lifts
Scooters
29. Diabetic/Therapeutic Shoes
Complete Dr. Comfort line of diabetic and
therapeutic shoes, inserts and socks.
Full-time certified associates dedicated to
assisting customers with their orders for
shoes and inserts.
Medicare and most private insurances
will cover one pair of shoes and three
pairs of inserts per year
for qualified diabetic
patients.
30. Lift Chairs
For patients who have trouble getting in and out of
living room furniture
Available in a variety of fabrics to complement décor
Provides safety and independence
Mattresses and covers for sleep
Wide range of styles, colors and price
Delivery and set-up provided
Hydro-lift product for any surface
31. Retail DME Shop
DME specialists assist with in-home medical
equipment and supplies, and third party
reimbursement for private insurances and
Medicare
Expanded cash and carry product lines
Exercise equipment – Zone recommended
Pain management products
Dietary supplements & chiropractic recommended
products
Podiatry orthotics and bracing
Ambulatory aids, bathroom & bedroom safety
33. Wound Care Registered Nurse
Registered nurse on-site working with patients and
providers on wound care supplies and reimbursement.
Answers questions
Product education
Liaison for patient as it relates to
reimbursement
Works hard to find products that will be
covered
Conveniently located next to the Agnesian
Wound Care
Products delivered right to the patient’s home
34. Re-Supply Program
Re-order program with trained specialists:
Place monthly reminders to patients for supplies for
CPAP, ostomy, wound care, urological, enteral or
incontinent products
Monthly and quarterly reminder calls
Never call a patient without permission
Never ship product without speaking to the patient
35. Repair & Service
On-site maintenance of all rental equipment
Repair of purchased power mobility devices,
wheelchairs, lift chairs and motorized scooters
Discuss – Did you know – it is the law that insurance companies need to pay for breast pumps.
Discuss falls and deaths from falls
Discuss trama
Discuss fire safety regarding wheel chair ramps
Discuss falls down stairs
Costs of falls multiple places
Talk about funding
Go through assessment & safety Check list
Discuss other reasons to wear the shoes.
Crop the picture
Talk about Katie
Add different picture
Discuss funding
We will load front door
Use for respiratory and sleep
Note – we will load into a truck if they need to pick up.
Cash Sales
Discuss how hard Nikki works on getting coverage – even if she has to find a different product.
She will find the best product, best overage.