Meet New ABPM Executive Director, Dr. James Stavosky

James Stavosky, DPM

James Stavosky, DPM

“Enjoy what you do every day. Be quick to listen, and slow to talk and anger.” These are the words that Dr. James Stavosky, the new Executive Director of ABPM, lives by. He enjoys golfing, fly-fishing and playing tennis with his two sons and his wife (who he refers to as his best friend.) Another thing Dr. Stavosky enjoys? His career in podiatry.

In his 35 years of experience in podiatry, Dr. Stavosky has built an impressive career focusing on wound care. Besides running his own private practice in Daly City, California, he is also the Chief of Podiatric Surgery at Seton Medical Center, the Medical Director of Wound Care at Seton Medical Center, and a Professor of Podiatric Medicine at California School of Podiatric Medicine.

How he found podiatry and how his career took surprising turns

Dr. Stavosky didn’t always know he was destined for a thriving career in wound care. He was first introduced to podiatry during graduate school at The University of the Pacific, where he worked as a student trainer. His advisor at the time “introduced me to her podiatrist, and he set me up to meet and work with some very progressive DPM’s in the area.” From there, he set on a course to study sports medicine.

Later, as a doctorate student at the California School of Podiatric Medicine, Dr. Stavosky got even more involved in the profession. “I volunteered to work on Saturday free clinics every week, and I was a TA for classes,” he says. “Plus, I attended all CME education seminars put on by CSPM—I even volunteered to work AV at those seminars.”

During his residency, even though he initially set out to work in sports medicine, Dr. Stavosky discovered his true passion was elsewhere. “I also developed an interest in foot and ankle surgery, but then found my calling in wound care,” he says.

After completing his residency, Dr. Stavosky worked in academic medicine as a volunteer until he was hired full-time as a professor. He began his career in a full-time position at the Seton Medical Center, teaching four days and tending to private patients two half-days per week.

His career took a turn for the better when he was given the opportunity to take over the wound care department. “No one else wanted to do it, but it put me on the map nationally,” he says. So, from 1987-1998, he was the Department Chair and professor at the Seton Wound Care (Medical) Center.

In 1998 Dr. Stavosky was appointed Chief of Podiatric Medicine and Surgery and opened a full-time private practice.

Board Certification

 Dr. Stavosky was a founding member of ABPM (then ABPOPPM), in 1993. Sitting for this certification was highly important to him, “first for academics, and later for medicine and wound care.”

He is also certified with ABFAS, which he pursued because he “was teaching in the surgery department at CCPM, but in the process realized just how important podiatric medicine was.” He went on to become Chair of the podiatric medical department as a result.

Although the sequence of Dr. Stavosky’s board certifications began with ABFAS, he notes “I would now do it the other way around.”, and advises his students and residents as such.

Teaching the next generation

 In addition to helping patients through his work in wound care, Dr. Stavosky notes that he’s most proud of his experience teaching.

His advice to aspiring podiatrists: “Enjoy what you do, it’s the greatest job in the world. If you don’t want to spend time in a particular facet of podiatry, such as surgery, there’s a tremendous amount elsewhere that our specialty offers, like wound care or sports medicine.”

Along with his academic position he does his best to stay involved in the podiatric community. “I volunteer as faculty for residents and students for both ABPM and ABFAS and am, or have been, on each of their Board of Directors.” He’s also on the Board of Directors at the alumni associations of the California School of Podiatric Medicine and The University of the Pacific. Plus, he lectures on wound care around the country.

What he plans to bring to ABPM

 Dr. Stavosky doesn’t take his latest honor and challenge as the Executive Director of ABPM lightly. He looks forward to “taking our organization, ABPM, to yet another level in the future.  He plans to “guide the ABPM Board of Directors and continue to grow our membership,” along with “getting even more young practitioners involved at the committee and director levels.  With our significant increases in membership, especially over the past five years, we’ve experienced a demographic shift.  We’re getting younger.”

He has ambitious plans, but if Dr. Stavosky’s career proves anything, it is that he is capable of achieving some impressive goals.

Clinical Presentation Skills: Evaluation and Management

By: Nichol Salvo, DPM

When a patient presents in any medical setting for initial evaluation, it is easy to focus on your area of specialty. That being said, having “tunnel vision” may cause you as the clinician to falter. A concerted effort must be made to consider the patient’s co-morbidities that factor into the etiology of their current lower extremity condition. How will this play into the treatment plan?

Consider the following case and the importance of whole patient consideration:

A 68 year-old male presents to the emergency department complaining of increased pain in the right foot with new onset edema and malodor. The patient indicates that pain was his initial symptom which presented approximately three days prior. The patient has a past medical history significant for DM, CKD, stage 3 lung cancer currently treated with chemotherapy, and major depressive disorder. Upon triage, the patient is noted to be febrile at 100.4 degrees Fahrenheit with all other vitals normal. The right foot is noted to have an ulceration to the right sub first metatarsal head with surrounding boggy, necrotic desquamation, heavy with foul odor. The right foot is noted with palpable pulses. The patient denies any knowledge of ulceration to the foot. Labs were obtained by ED staff and the white blood cell count is noted to be 16.1. Radiographs obtained reveal subcutaneous emphysema localized to the plantar medial and plantar central midfoot.

It is clear that an emergent incision and drainage is required to save the extremity. It is easy to get lost in the emergent conversion and transfer from ED to OR. The patient will require consent and it is discussed with the patient that given the circumstances, conservative options are not an option. However, what are the other details that must be considered with the current plan? What other questions will you need to present to your attending?

The patient is diabetic.

  1. What is the hemoglobin A1c? The patient should be advised during the time of consent whether this will impact his outcome.
  2. What is his current serum glucose? Is it elevated and must you consider a concomitant ketoacidosis?
  3. Is the patient NPO? When did the patient last eat or drink and will anesthesia have to be modified?
  4. The patient is on chemotherapy to treat his lung cancer. What are the other pertinent lab values? What are his neutrophils, platelets, hemoglobin, hematocrit, etc.? Based on this review, does the patient necessitate a type and screen in anticipation of a transfusion?
  5. Given his CKD and need for antimicrobial therapy, what is his kidney function at this time? Does your planned antibiotic regimen require renal adjustment to accommodate creatinine clearance?
  6. The patient may potentially require some level of amputation in addition to the planned incision and drainage. Is the patient’s depression managed or should mental health services be consulted to assist the patient in processing and managing the magnitude of what he is facing?
  7. Given his diabetic and malignant state, what is his nutrition status? Have you considered how to optimize his long-term healing by consideration of albumin and pre-albumin?

Having thought of these questions and their answers will not only provide a complete presentation but , also render better patient care. Considering the whole patient when treating the lower extremity is a necessary and critical component of your evaluation and management. There are almost always other things to consider.

 

 

 

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