Dr. Alap Shah has certainly had his share of adversity, first living through the terrorist attacks on New York City on Sept. 11, 2001, then losing the man who recruited him as a podiatrist straight out of residency to a plane crash.
But the Fort Worth, Texas, native hasn't let those heartbreaking experiences set him back. In fact, Shah said it all has made him that much stronger and appreciate life each and every day.
Ten years into his practice at Foot and Ankle of West Georgia, located on Warm Springs Road in Columbus, Shah, 38, finds himself very busy in a profession which has a basic mission of keeping people on their feet without pain and suffering.
The U.S. Bureau of Labor Statistics estimates there are nearly 13,000 podiatrists in the U.S., with a faster-than-average 20 percent job growth estimate through the year 2020. That equates to the need for at least 2,600 new podiatrists by then, with a current median annual salary of $118,030 or nearly $57 per hour.
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The Ledger-Enquirer talked with Shah recently about his job, its various challenges and why the profession appears so promising. This interview has been edited for length and clarity.
Let's start with New York City and 9/11. What was that experience like?
It was this crazy, crazy situation that you could only dream of. It was a ghost town in New York for about three months afterward. And there was racial profiling. Everything that you saw in the media was pretty much true as to how it went.
We were in residency and waiting for victims to come in and, of course, none did. We treated a lot of firemen and helpers and volunteers, but that was pretty much it.
I would say it took about six months for people to get back to normal and functioning without the thoughts and fear of getting another terrorist attack. You could smell burnt concrete in all of Manhattan for about six months afterwards just because of the devastation of the buildings.
How did you land here in Columbus?
I was done with my residency and was looking for work down South. Dr. Bartley, who passed away over the summer due to a plane accident, recruited me through a podiatry web site. So, I came down here and interviewed, and Columbus reminded me of Fort Worth, Texas, which is where I am from originally. So, I decided to go ahead and start working here.
The plane Dr. Bartley was flying with his wife and daughter aboard crashed in July. How has that affected you?
I think it's made us stronger. We've all picked up the pieces and felt like, in honor of him, we just needed to carry this practice forward. And we've felt like we've done that, and we're still going to continue to do that ... When you overcome such tragedies, emotionally more than anything, you learn how to cope with certain things and everything else becomes pretty simple.
Why did you decide to become a podiatrist?
I worked with one in college and helped out in his front office with secretarial work and scheduling. I was fortunate enough to see procedures. He allowed me to watch things and observe him during surgeries, and taught me a lot of things. It wasn't anything hands on, but I was really up close there and that's what got me interested in the field. Up until then I didn't even know what a podiatrist was.
You specialize in wound care?
I do a lot of wound care. I've affiliated myself with hospitals here and see a lot of diabetic patients. Podiatry is one of those fields that can be a specialty among a specialty. You're already limited in the scope of what you do, but a lot of podiatrists sort of find their niche and become experts in those fields.
For instance, I'm more adept in wound care, whereas Dr. (Michael) Schreck is really good with kids and pediatric pathology of the feet. Dr. (M. Carter) Hyneman is more of a sports-related specialist. It's almost as if the front office acts as a triage and when patients come in, the staff knows who to send who to. But we all practice general podiatry, so any one of us can handle everyday common problems.
Just the thought of dealing with wounds and ulcers sounds a little queasy?
You'll definitely smell odors that you've never smelled before. If you can imagine the worst smell and multiply that times 10, you'll probably would have the slightest idea of what an infected gangrenous diabetic ulcer can be. But you get used to it and it becomes part of it. A lot of the clues and diagnostics you end up ordering are based on what a wound looks and smells like and what kind of drainage is coming through.
What's a typical day like for you?
Tuesdays and Thursdays we usually do surgeries. We have blocked times at the hospitals. A typical week would be office hours three to three and half days of the week. The remaining day and a half we usually have blocked times scheduled for surgeries either at the hospital or our own surgery center here.
There's a few things, such as MRIs and CT scans, that we obviously have to go to the diagnostic centers at the hospitals for ... But it's usually 8 a.m. to 5 p.m. (office) hours, and then you have consults at the hospitals before or after when a doctor may call on you to evaluate a foot wound or foot condition. We'll run up to St. Francis or Doctors Hospital.
The bottom line is you're looking at a lot of feet everyday?
That's pretty much it. (laughs) There's an old podiatrist saying that we're not just treating the hole in the foot, we're treating the whole patient. That does come into play because not only do you look at their feet, but you also have to see how their diabetes is running and what other issues they're having and do they relate to their foot problems.
It can be complicated. But with your everyday patients, we see a lot of heel pain and a lot of bunions. We see a lot of patients and kids with in-grown nails and warts and athlete's foot. Then we'll see more unique things like diabetic wounds or fractures or sprained ankles. It varies quite a bit.
How many people do you see each day?
My usual schedule will be anywhere between 15 to 20 patients in the morning and 15 to 20 patients in the afternoon. So you're looking at somewhere between 30 and 40 patients per day per doctor.
What's the most challenging thing about your job?
I think, especially with diabetic patients, you're hoping that they will be compliant with the treatment. That can be frustrating when you tell them to follow a specific set of orders and they don't, or they're not able to, and they come back and things get worst. They're looking at you to save their leg or their foot.
Any other aspects of it that are difficult?
There are the challenges of reimbursement with insurance and Medicare and trying to figure out how you can successfully run a practice and still provide good quality care without cutting in on patient times. And being able to maintain a career.
That's getting harder and harder with some of these cuts that have been made and I'm sure that we're going to have a lot more.
Specialists get hit pretty hard because (insurers) are using more primary doctors to triage a lot of the problems and handle them, and then referring them out only as necessary. So you can see how we're sort of limited by the gate controller.
As we go forward, it becomes more and more of a managed-care guided insurance. We're going to see a lot less walk-in patients. It will be more about patients having to go to their doctor just to see us ...
It's all about cost control. I understand that. But that's going to be a big challenge going forward, how to maintain an overhead and still run a business.
You plunged into the business world more than two years ago with the nail spa Footique. Why was that?
I felt like there was a need. I saw a lot of patients who came in with fungal infections and in-grown nails. We've actually had patients who lost toes from a botched technician job.
So maybe five years ago I had this idea. I never facilitated it until I spoke with my wife (Pinki), who was working at Synovus at the time and ready to get out of the corporate world.
She was ready to start handling the financials and management of it. That's when we decided to put everything together and develop Footique.
Now I feel comfortable about sending patients there simply for aesthetic purposes for getting their nails done.
Podiatry has a faster-than-average job growth rate. Why is that?
I think a big part of that is it's one of the professions that allows you to have a lifestyle outside of staying on call and the rigorous (physician) schedules that have you running in at 3 in the morning. We usually have just normal business hours. We do stay on call for patients who have had surgeries and emergencies. But you're not having to live at the hospital.
And there's definitely a need for it. We're expanding as far as the population is concerned, with more elderly and people living longer. And diabetics are always going to have foot problems because of the tendencies of that condition. Aside from that, you're always going to have sports-related injuries.
Everybody's got two feet, so there's plenty of business around.