Vitals for Routine Foot Care: Survival

Vitals for routine foot care: survival. What every podiatrist needs to know about safety, dust exposure, new techniques, and profitability. By Dr. Robert Spalding We are the podiatrists, and we're supposed to be the experts in routine foot care, and we should be delivering routine foot care better than what occurs in nail salons, but that's not always the case.

There are three steps in routine foot care. Number one, protect yourself and protect your staff. Anyone who is providing that care needs to protect themselves. Number two, protect your patients from injury and infection. Number three, provide ethical routine foot care services.

Quality care with integrity. You would be surprised what you breathe every time you trim just a normal thumbnail without air filtration as it explodes in dust. You can see the video at DrSpalding.com. But if you don't have some kind of air filtration to capture just the simple nail nippers, not even your electric files.

But imagine if this was a fungal nail. Imagine what kind of exposure you would have had. This was taken with a high-speed camera with high-intensity direct LED lighting from this particular air filtration device below. Remember in that video, nail dust can stay aerosolized in a treatment room for up to eight hours. That you're going to continue to breathe it, patient after patient, client after client.

Articles show that podiatrists may have up to three times higher rates of asthma or COPD-related problems in podiatrists who don't take preventive action to protect their lungs. Okay, let's switch gears. The second step in routine foot care is protecting patients. So what are your disinfection practices?

Almost every one of those infections had to do with lack of sterility controls, improper reliance on cold sterilization, or failure of proper servicing and training of autoclaves. So what is the number one surface vector other than humans to bring in bacteria, fungus, and viral contaminants in a medical office, a surgery center, or hospital?

The answer is shoes. You can read this flyer and understand why we're saying this. There's only one sporicidal agent on the market that's safe enough for skin, and that's hypochlorous acid. It will kill C. diff. Nothing else out there but bleach is going to kill C.

diff. Now, if you can kill C. diff and not injure the skin, and it's the strongest disinfectant as well as strongest antiseptic that's, again, pH neutral for skin, you can't find anything better. It's also part of our own immune system.

If the tool cuts or abrades you, you need to autoclave sterilize. That means it's a critical surface. Nippers are not non-critical. You can stop all the finger pointing and controversy by just autoclaving. Definitely invest in an autoclave for routine foot care.

Here's a research study out of Penn State that shows that almost every disinfectant out there does not kill the HPV virus. In fact, bleach was about the only thing and peracetic acid were the only thing that killed it. Alcohol didn't touch HPV and neither did quats had no ability in killing the human papillomavirus.

Good routine foot care is appreciated, and it helps draw other services to your practice. And we're going to get into some of the profitable approaches. Most routine foot care is not covered by Medicare, so you can charge pretty much what you want to, especially if you're delivering a high-quality routine foot care. Again, you can pick your number for your practice as to what it costs to properly sterilize and provide gloves and the ventilation equipment that you need.

You're measuring skin moisture index, or SMI, which is your golf score for your skin, and it's amazing how many people link on to this and they want to know what theirs is each and every visit, and you can treat them for xerosis when that's an issue, when you're, you can start using a lot more prescribing products that you have in your inventory.

Okay, this lecture boils down to three sets of three concepts. Number one, protect yourself, your patients, and provide ethical, routine foot care treatment. Number two, obtain air filtration, autoclave, and hypochlorous acid. And finally, financially, the LEAP program, you should really look into it. If you don't have a laser, think about getting one.

And try the patches. They're very helpful for a lot of people. In summary, if you don't wanna perform routine foot care, train a staff member, but don't refer or send them to salons.