Del Rio foot physicians strive for patient education, expanding service

June 10, 2007
By SW TEXAS LIVE
Special to LIVE!

Notwithstanding a daunting caseload of nearly 7,000 patients, Dr. Anna E. Sanchez and her husband, Dr. Michael E. Roth, are troubled by public confusion about their medical specialty: Podiatry. It’s not a crisis of identity, but rather a hurdle of understanding.

There’s little need to attract more patients to the Del Rio Foot Clinic, but the husband/wife team fears that many victims of foot problems aren’t being seen simply because of misconceptions about what’s performed behind the stucco walls at 605 E. 17th St. “When you say ‘podiatrist,’ “people are thinking ‘psychiatrist,’ ‘pediatrician,’ or who knows what else,” Sanchez lamented, Wednesday (May 16).

“You can characterize us as lower extremity physicians,” Roth chimed in. “Other doctors send us patients with foot problems.” So, the initials behind Sanchez’s and Roth’s names are D.P.M., Doctor of Podiatric Medicine. “We work from the lower spine down, including the foot,” Sanchez added. To be licensed to cover that turf, the foot docs underwent rigorous training, and continue their education today.

After medical school, both Sanchez and Roth performed residencies in Veterans Administration hospitals, she in Denver, he in Albuquerque. Sanchez was born in the Dominican Republic, but raised in New York City, and Roth is a New Orleans native. The couple ended up in Del Rio for the same reason than many other physicians choose “The Best of the Border.”

Roth has long admired Texas, in general, and wanted to practice in the relative quiet of a small town. Married only four months, they arrived to hang out their dual shingle here on July 2, 1995, moving into their current offices, February 1998. Proximity to the border was attractive to Anna, but the overarching criterion was the “underserved” population, chiefly because of the high prevalence of diabetes and its ravaging effects on blood circulation and nerve health in lower extremities. “We don’t like to lose feet, period,” Roth exclaimed, considering the consequences of unattended diabetes and lower extremity wounds.

Each has subspecialty skills that color who sees what kinds of patients. Heel spur treatments are number one, according to Roth, and infections caused by stepping on sharp objects, often not even felt by diabetics with reduced nerve sensation. “With those patients, infection can set in early,” he said. “I love doing foot surgery,” Roth affirmed, quickly adding, “But I don’t just do it; I always try to do a very conservative treatment first.”

Sanchez: “I get a lot of foot ulcer patients, often from pressure in a shoe and walking on that a lot where it can be easily aggravated by a foot deformity such as a bunion.” Sanchez also sees many young patients with deformities present at birth, such as in-toe gait – “pigeon toe” – malformation. Out-toe gait patients show up, too, and for both, Sanchez begins with biomechanical assessment of the child’s lower body.

“The problems can be seen in the foot, but the cause may not be there. It can be in the hips, the knees or the ankle, resulting in improper development at the foot,” Sanchez explained. “Many times, what the patient needs is physical therapy, and we’ll prescribe that. It can develop muscles that will literally push the bones into proper alignment.” Other options for conditions Sanchez encounters range from corrective orthotics (custom-made shoe slip-in supports) to surgery.

The Del Rio Foot Clinic is divided into wings of examining rooms for each of the physicians, who also share a small surgical operating room. Though she’s still considering the viability in Del Rio of recently completed Park Avenue training in New York, Sanchez is interested in “pillow” surgical implants to relieve pressure points, and Botox® injections to prevent foot-sweating. Insurance companies may drag their feet – pun intended – on covering these new techniques, Sanchez fears. “But, I’m looking into it,” Sanchez said with a smile of optimism.

Roth and Sanchez are acutely mindful of the need and accommodation for growth in medical services in Val Verde County and beyond. “We have a booming practice, largely because of word-of-mouth,” Roth said. “We are busier than we can ever be, but we get no help from the hospital [Val Verde Regional Medical Center]. We have never had a single referral from the hospital, but we don’t feel the effects of that, because we are already so busy.”

The Sanchez/Roth team is scanning the horizon for opportunities to improve patient services. “We are feeling the need for a bigger clinic, but it’s not a huge issue for us right now,” said Roth. Sanchez and Roth are considering participation in a proposed medical complex in development on the north side of Del Rio. Sanchez said that facility and staff services pertinent to their patients’ needs will drive their decisions.

“If a wound care clinic opens, we will participate. If a surgery center opens there, we will participate,” Sanchez said.

The Del Rio Foot Clinic appointment desk may be reached at 830-774-4617 or 1-800-655-FOOT (-3668).