What do an ex-limo driver and a former medical assistant have in common?

They are teammates in a combination pedorthics practice in Dayton, Ohio.

“We’re two hormonal, 50-year-old women, and we work together well,” said Rhonda Smith, CPed. “I know what I can do and what Reggie is best at. If I can’t handle something, I pass it on to her. If she can’t handle something, she passes it on to me. We’re not about just making money. We’re about doing the best job we can for our patients.”

“Reggie” is Regina Swickard, owner of Foot Focus Pedorthics Laboratory. Smith divides her time practicing pedorthics with Swickard and working as the staff pedorthist at Bryan’s Family Pharmacy in nearby Lebanon.

Swickard and Smith say they are more than health care professionals and colleagues. They are friends whose paths converged in middle age.

 

 Rhonda Smith, CPed, pays close attention to her clients’ feet to help them keep foot sores at bay.

 Images: Craig B, O&P Business News.

 

No plan for pedorthics

Neither of them planned to be a pedorthist. “I drove limos, school buses and made deliveries,” said Swickard, who was certified in 1997. “But I got really tired of driving.”

So she answered a help wanted ad in a local newspaper that led to a 5-year stint stitching leather and cloth orthotic components at Dayton Children’s Hospital.

Swickard said that experience gave her an edge when she became a pedorthist.

“I deal with the hard-to-fit foot — the foot that won’t fit in a normal shoe because of medical conditions such as edema, lipidemia or because part of the foot is missing. I had a technical background.”

In addition to amputees, her clients include people with Charcot foot.

 

 Regina Swickard specializes in hard-to-fit feet.

 

“I have this one man who works on his feet all day, and his feet are like rocking chairs. I took Drew work boots, removed the steel shanks and made a pocket in each shoe for his feet. He’s a very active guy. He even square dances.”

Almost all of her clients are physician referrals. “From podiatrists, orthopedists and endocrinologists mainly,” she said.

Physicians also send patients to Smith, who was certified in 2011. “More and more pharmacists are hiring pedorthists because of Medicare,” said Smith, who also sees clients at Swickard’s lab and in their homes and nursing care facilities.

Smith, who is an ABC-certified fitter of therapeutic shoes, became acquainted with diabetes when she worked as an assistant to surgeons. “I learned that if you have diabetes and get even a little sore on your foot or a toe, you can end up losing your legs and then your life.”

She said many people, especially seniors, often have other foot problems that put them at even greater risk for limb loss. “With hammertoes, claw toes and bunions, you don’t have the room in your shoe that you need. If you wear shoes that don’t fit, you are setting yourself up for some type of sore or ulcer.”

Foot education

Thus, client education is a big part of her practice. “For example, I remind them that they want to keep their feet dry. The inside of a shoe is dark and wet and harbors bacteria. So you need to have a sock that wicks away moisture.”

Smith added, “I also tell them how important it is to look at the bottom of their feet. If they can’t do that, then I tell them to lift their feet up and put a mirror under them on the floor and look.”

Smith said some of her clients with diabetes, especially women, are reluctant to give up fashion footwear. “A patient may want to stuff her feet into a Mary Jane. I tell her if she does that, she can lose a foot. It might not happen today or tomorrow, but eventually it is going to happen.”

Smith said she learned more about the diabetic foot when she interned with Swickard. “You have to have patience. You can’t let your clients dictate to you what they want. I want them to have the shoes they need, not necessarily want. I’m all about saving their feet.”

 Tip

Rhonda Smith, CPed, said there is more to measuring for shoe size than just putting a foot on a Brannock device. “It’s a good guideline and a good starting point,” she said, but added that its measurements are linear. “When you are determining shoe size, you must incorporate the foot’s volume and circumference into it. That is where experience comes in.”