Jarrod Shapiro, DPM
Practice Perfect Editor
Assistant Professor,
Dept. of Podiatric Medicine,
Surgery & Biomechanics
College of Podiatric Medicine
Western University of
Health Sciences,
St, Pomona, CA

Thoughts During A Move

It's 3:30 PM on a Sunday, and I'm diligently writing to you, my interested readers. I'm a bit on the tired side, because my wife, children and I did the one thing with which so many of us in the medical field are familiar: the dreaded move. Many of you, I'm sure, during school, training, or practice have found yourselves in the same situation. For my wife and I, this was move number sixteen – yes 16 moves! I know what you're thinking: "You're nuts Shapiro."

Thoughts During A Move And I agree with you. Starting midway through college, my wife and I moved, then we moved again a couple of times before and during podiatric medical school, then again for residency (twice), and again several times during professional practice…culminating in move 16 this past weekend.

As I mentioned, my family is by no means unique in this. Moving around the country for training and then professional practice is highly common for those of us in podiatry. In fact, it's highly common for United States society in general. Out of around 317 million people, about 40 million of us moved in 2011.¹ That seems like a lot of people, but it turns out these numbers represented a record low at the time. I'll take a dollar for every one of those "record low" movers, please!

This move was unique in the sense that I did not change jobs, but rather took advantage of some good monetary fortune to move to a more expensive area. Three years ago (literally two weeks before my daughter was born) my wife and I purchased our first house. We were fortunate because we bought our house shortly after the California housing bubble (and much of the rest of the country) burst. Over the last three years, between the housing market coming back and our own home equity, we were able to sell our house for a handsome profit and invest in a more expensive home at a location more convenient for family's' needs.

Tonight's Premier Lecture is
The Promise of Mesenchymal Stem Cells for Chronic Wound Care
Robert Frykberg, DPM, MPH

My situation also exemplifies the strength of the podiatric profession. After about nine years in practice, I have progressively moved up the economic ladder, despite the prior recession. I don't know of everyone's situations, but the economic stability of this profession should be one of our advertising points.

Moving itself has many similarities to what we do. As with all things complex (think of surgery as an example) there are many steps to successfully complete the job and preparation is key. I once helped my older brother move, and he had prepared inadequately ahead of time, which led to a very long and trying experience for everyone involved. Take this in comparison with my wife's preparation for this move. My wife plans large events like a military general going to war. Everything is boxed, wrapped and marked before the event, which made moving out a very simple experience.

On the other hand, moving into our new house was a bit of challenge, because we did too many things at the same time. On the same day of our move, we were replacing the downstairs flooring with hardwood and epoxying the garage floor. This made the actual moving part somewhat tricky, since we didn't have much space in which to work. Oh, and did I mention our flooring company had already pulled up the upstairs carpet? And…just to make things more complicated, we had painters coming to give estimates! Clearly the lesson here is to do few things well rather than many things poorly.

modified Lapidus procedure is the best option to surgical treat HAV

This situation brings up the medical idea of centers of excellence. Just as with my move being hectic with too many tasks at the same time, medicine as a profession does it better when we focus on one pathology at a time. The obvious example for podiatry is Charcot neuroarthropathy. Most of us don't spend most of our days doing Charcot reconstructions because of its relative rarity. Additionally, taking care of these patients correctly requires extensive clinical time and often heavy assistant staff time. This is where centers of excellence would so greatly improve care for these patients. Imagine regional clinics in which these patients were funneled. Experts spending their careers on these patients would be so much more successful than those of us in regular practice.

On a final note – I can't help but compare a couple of the contractors we've had working for us to good podiatric care. First, came the flooring company. At all times, the company has stood by their word, honoring their time commitment while providing quality service. Second, our painter spent a good amount of time discussing all of our needs and giving honest answers to our questions without being evasive or excessively complicated. Don't these sound like good doctor characteristics? Patients love it when we run on time, treat them with the respect they deserve by providing clear and honest answers and doing the best work we can.

When is moving like podiatry? Perhaps at first glance, they may be disparate fields with nothing in common. But on deeper thought, perhaps there's more here than one would have thought. Or then again, maybe it's just my exhaustion.

Best wishes,

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]