Doctors take steps to help valley residents keep feet

An alliance of medical professionals is trying to create a new program to ensure people have foot exams to head off treatable problems that can lead to severe infections, amputations and amputation-related deaths.

Doctors with Lower Extremity Amputation Prevention, or LEAP, met Monday with Nevada Lions Club members, medical executives and health care professionals to launch the Comprehensive Foot Examination Assistant Program.

The goal of the program is to provide primary care doctors with qualified assistants to provide diabetic and other at-risk patients with comprehensive foot examinations, said Dr. Larry Rubin, a retired podiatrist and founder of LEAP.

"We can prevent 80 percent of amputations, but unfortunately only about 10 percent of people in Nevada are getting annual comprehensive foot examinations," Rubin told the 25 people at Monday‘s meeting. "And those exams usually are done by a podiatrist, not a primary care physician."

"The latest figures show there are 85,000 diabetic amputations per year in the United States, and that number is growing every year," podiatrist Dr. Leonard Franklin added. "If we can prevent 80 percent of those, well, that‘s a hell of a big number."

LEAP members are partnering with the Lions Club to equip people with the tools and knowledge needed to prevent complications of diabetes, peripheral artery disease and other conditions that reduce a person‘s sensation.

"A simple thorn picked up during gardening or a blister that develops during walking can end up becoming a major health complication that takes time and energy and money to threat," Franklin said.

After being trained and given the proper equipment, the foot exam assistants would work with doctors in their offices to screen patients for ulcers, loss of sensation or the development of abnormal structures. The assistants would not be making diagnoses, just identifying abnormal signs and symptoms, Rubin said.

"You do not need a medical background to learn how to perform these exams," he said. "All you need is a desire to learn and we‘ll provide you the information you need."

Podiatrists say an annual comprehensive foot examination enables early detection and prompt treatment of potentially hazardous foot problems before the first ulcer develops. During the legislative session, podiatrists proposed the state spend $1 million to provide care to adult Medicaid patients, but the funding plan was not included in the final budget. Officials within the Sandoval administration said last month that the funding proposal was being reconsidered.

Dr. Kenneth Fatkin of Henderson, vice president of the Nevada Podiatric Medical Association, has said minor foot problems can become exacerbated over time, and preventing more intensive treatment procedures could result in significant savings in health care spending.

LEAP members say their program would reduce the personal and economic burdens of diabetic lower extremity amputations through a collaboration of primary care physicians and trained foot exam assistants.

The LEAP Alliance is a nonprofit organization created to prevent nontraumatic foot and leg amputations. Members distributed information Monday about the content of the training program and the options available for training and certification.

Contact Steven Moore at smoore@reviewjournal.com or 702-380-4563.