During the first week of November, the eyes of all New York sports fans were on the estimated 30,000 runners who participated in the New York City Marathon. With all that attention on the fastest feet in the city, one must wonder who takes care of the foot needs of New Yorkers. For many, it's the public hospitals and health centers of HHC.
"We treat a vast number of athletic injuries of the foot, from simple ankle sprains to more severe injuries such as fractures, tendon ruptures, and many other sports-related injuries," said Alfred A. Garofalo, DPM, Director of Service & Podiatric Surgery Residency at Gouverneur Healthcare Services and Bellevue Hospital.
But the more than 30 podiatrists at HHC facilities throughout the city serve more than the weekend warriors. At Gouverneur, headquarters for a Podiatric Surgical Residency Program whose residents rotate throughout HHC hospitals in Manhattan, Brooklyn and The Bronx, podiatrists treat approximately 21,000 patients annually, ranging in age from toddlers to seniors over 80.
HHC's podiatrists treat common dermatological conditions such as warts, skin lesions and the many foot conditions that can develop from diabetes - one of the major chronic diseases the public hospital system is aggressively targeting. They also offer patients a full line of orthotics, custom made shoes and custom fitted braces. Surgical treatment is available for bunions, soft tissue masses, ganglions and other foot conditions.
Ruth Ramirez, a secretary at Gouverneur, was treated by Dr. Garofalo for a hammertoe, a foot condition that required surgery.
"He took good care of me," Ramirez said. "Dr. Garofalo explained everything I needed to know before and after my surgery. I was very moved that he called me every day the first week I was home recuperating. And once I returned to work he made sure that I was wearing the right shoes and walking correctly."
Elderly patients are of special concern to HHC podiatrists, especially when they have chronic problems such as diabetes, dermatological and vascular related disorders of the foot.
"A simple condition like an ingrown nail can result in a drastic outcome for patients with these disorders, if left untreated," according to Dr. Garofalo. "We also use special caution with diabetic, obese, and immuno-compromised patients, since they have less tolerance to fight off infections, more vascular related problems, and even numbness and loss of sensation in their feet and legs."
Gouverneur has an extensive and proactive outreach program to ensure that people are aware of the importance of proper foot care. Patients who come in for a checkup and have foot problems can often be seen the same day in the Podiatry clinic. To spread the word further, the staff participates in community-based health fairs, providing free foot screenings and education materials. They also use an outreach van and partner with other community organizations, such as the Lower East Side Substance Abuse Program.
"These programs have played a major role in getting our message to patients suffering from foot problems who otherwise would not know about how many services are available to them at HHC," Dr. Garofalo said.