Making Rounds
Podiatry clinic’s new continuity model is the first of its kind in the nation
Billy Richardson is enjoying an active retirement. He tends a garden that is bursting with fresh tomatoes and cucumbers. And when he can get away to his favorite place on Bald Head Island, he loves to spend a day surf fishing.
“I’m as active now as I’ve ever been,” he said.
But he didn’t always feel this good. Years ago, back trouble led to complications that affected his feet. He developed neuropathy, a condition where nerve damage can cause weakness and loss of sensation in the extremities. When this happens, small injuries to the foot can become big problems.
“The problem is I don’t feel it,” Richardson said. “Because of the nerve damage, I don’t feel the problem starting. So what happens is it gets out of control.”
His doctor advised him to see a podiatrist, and the timing was perfect: Cape Fear Valley’s growing residency program had just added podiatry to its offerings, opening a clinic in which new doctors would train in the specialty under the guidance of an experienced podiatrist.
Kristen McGinness, DPM, is the director of the podiatry residency program and a practicing podiatrist herself. When she arrived in 2020 to establish the residency program, she walked into an already bustling practice.
“Cape Fear Valley Podiatry has been here since the 80s and has grown to be a very large practice,” she said. “We see more than 50,000 outpatient visits annually.”
With such a high demand for podiatry in the area, the need for a residency program was clear. Each year it has admitted four residents to complete a three-year program of increasing responsibility in podiatric practice, including surgeries of the foot and ankle.
This year, as its first class graduated, the residency program took a big step forward. It has changed its clinic to a continuity model, which means patients will see the same resident on every visit.
“This residency clinic is the first of its kind in the country,” said Dr. McGinness. “It allows residents to build a rapport with the patient because they’re not always meeting someone for the first time.”
This continuity is associated with faster healing and fewer complications. It also gives patients time to build trust with the resident they see on every visit.
“It’s also great for the residents and their education,” said Dr. McGinness. “It lets them follow up with the things that they’ve recommended for patients, to see what’s working and how it looks over time.”
Usman Javed, DPM, is a second-year resident who was happy to see this development.
“It means when I sit down with a patient, we are both on board with the treatment goals. We can see if we’re achieving them appropriately instead of trying to figure things out with someone you haven’t seen.”
– Usman Javed, DPM, Resident
Being able to build an ongoing relationship with patients is one of the reasons he chose this work.
“Mobility is so important, in terms of exploring this world and being engaged in it,” he said. “It’s nice to be able to help people enjoy that freedom and enjoy their lives.”
Dr. Javed has appreciated his experience so much that he plans to choose a similar setting after graduation.
“I would really love to join a hospital-based practice like we have here,” he said. “I really like the fact that we’re able to see the patients in clinic and then coordinate with other teams. Sometimes we need to consult with vascular specialists or infectious disease or endocrinologists. Having them at our disposal really offers the best for our patients quickly.”
That is music to Richardson’s ears. Before his retirement, he served in the North Carolina General Assembly and took a special interest in the state’s healthcare capacity.
“I was able to work with the delegation in ensuring that we got permanent funding for the residency program,” he said. “It has improved the quality of medical care in this area immensely already. And it’s only going to get better.”
Richardson has been happy to see how many residents choose to make the Fayetteville area their home after graduation.
“We heard this during the planning, and now we’ve seen it in real life,” he said. “At least half of the residents that go into this program will stay within a 50-mile radius of the area. That’s so important.”
After all the work to assist in Cape Fear Valley’s progress, Richardson says it has been gratifying to be a patient and see the benefits up close.
“The team there is so good at what they do,” he said. “But more than that, they’re so friendly and kind. They have educated me on what to look for and how to avoid new problems. And it’s just a pleasure to see them when I’m there.”
