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20 Questions: Lee C. Rogers, DPM [Diabetic Limb Salvage]

Created March 15, 2008 by Sarah M. Lawrence
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Lee C. Rogers, DPM is the director of the Amputation Prevention Center at Broadlawns Medical Center in Des Moines, IA. Dr. Rogers graduated from podiatric medical school at Des Moines University and completed a residency in foot surgery at Saint Vincent Catholic Medical Centers of Brooklyn/Queens in New York City.

He completed a fellowship in diabetic limb salvage and research at Scholl’s Center for Lower Extremity Ambulatory Research (CLEAR) in Chicago, IL. Dr. Rogers has approximately 50 publications, in press or in print, including scientific articles, book chapters, and editorials concentrating on the treatment and prevention of foot complications in diabetes.

Describe a typical day at work.
I am a hospital-based podiatrist and work in a group of 4 DPMs. We typically round on inpatients at 7, then perform surgery or see patients in our Amputation Prevention Center until 5 or 6 PM and usually finish the day by attending to any inpatient consultations that were requested. In addition to wound debridements, off-loading surgeries, and skin replacements, we perform seemingly complex surgeries like Charcot reconstruction or plastic procedures to close soft tissue defects. We also have a lot of emergent/unplanned cases involving diabetic foot abscesses or amputations. These types of emergent surgeries are usually “walk-ins” or come from the emergency department.

If you had it to do all over again, would you still become a doctor?
Absolutely. I’m sure you’ll hear the same pessimistic outlook on medicine that I did by some disgruntled doctors, but doctors make a big impact in the lives of our patients. Of course, no field is perfect, but you can expect to make a nice living as a doctor. Of Forbes magazine’s highest-earning professions, physicians and physician specialists occupy 13 of the top 15 spots.

Why did you choose your specialty?
I was interested in medicine and surgery. Podiatry allows you this mix. The limb salvage patient is complicated. They often have diabetes with 10+ comorbidities and we have to work closely with other medical specialists like endocrinologists, nephrologists, and cardiologists. Almost all limb salvage patients are surgical patients requiring debridement of wounds or stabilizing surgeries to maximize limb function.

Now that you’re in your specialty, do you find that it met your expectations?
I’ve been very happy with my subspecialty. Much of this was due to good direction by mentors earlier in my education. It’s important to find a successful, ethical doctor that you can strive to emulate.

Are you satisfied with your income?
I am salaried and receive raises dependent on professional fee generation for the hospital (production-based model). Having completed a fellowship and declared a subspecialty helped tremendously to increase my base salary. As a researcher and a medical author, my salary is also supplemented by lecturing and consulting for pharmaceutical and medical device companies.

What do you like most about your specialty?
Often when I see a patient, they’ve been “offered” an amputation by another doctor. Patients are often depressed and desperate. Many times we are successful at salvaging the limb, which gives me great personal satisfaction and results in the most grateful patients!

If you took out educational loans, is paying them back a financial strain?
Podiatry schools are private and expensive. I borrowed the maximum federal loans to pay for school. I am lucky that I consolidated the loans when the interest rates were at an all-time low. I opted to take a graduated repayment plan and can afford my loan payments without difficulty.

On average: How many hours a week do you work? How many hours do you sleep per night? How many weeks of vacation do you take?
I generally work 50-60 hours a week. I am on call one night per week and one weekend per month. Sleep is a luxury, not because of an overly hectic hospital work schedule, but due to research and authoring articles. I am contracted to receive 7 weeks of vacation plus CME time but it will be difficult to actually take that much time off.

What types of outreach or volunteer work do you do, if any?
I volunteer as a member of the Des Moines Citywide Institutional Review Board (IRB), which oversees research for the city hospitals. We are a board of physician-scientists and community laypersons and we’re responsible for the protection of human research subjects.

From your perspective, what is the biggest problem in healthcare today?
I have heard some say our system would be more appropriately named a “sick”-care system (not a healthcare system). Payors fail their patients by inadequately covering preventative medicine. Not only does preventing diseases improve quality of life, but in most cases prevention reduces costs, especially in diabetes and diabetic complications. An example from my subspecialty is that 85% of diabetic amputations are preventable. The 5-year mortality rate after a major lower extremity amputation is 68%. Physicians, payors, and policy-makers need to come together and act to prevent illnesses, not just treat them.

What is the best way to prepare for this specialty?
In my first week of podiatry school, one of my mentors (Dr. Vincent J. Mandracchia) said, “Read, read, read.” This is a simple concept, but undoubtedly true. Weekly I receive PubMed alerts on all the new publications with the key words “diabetic foot ulcer, diabetic neuropathy, and Charcot foot”. There are approximately 50 articles weekly; I must at least read the abstracts to stay current in my own subspecialty. We owe it to our patients to offer them the most current treatments, ones based on evidence. Plus, the best way to win a scientific argument with your peers is to quote literature!

Where do you see your specialty in 10 years?
Diabetes is a pandemic. The CDC estimates that there are 20 million people with diabetes in the United States and that this number will double by 2030. I see podiatrists becoming “America’s diabetic foot doctors.”

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