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ABPM Diplomate, Dr. Stephanie Hook, Elected to the NYSPMA Board of Trustees

Stephanie Hook, DPM

Stephanie Hook, DPM

“I have always had a heart for moving our profession forward. Being elected to the NY State Podiatric Medical Association Board of Trustees is a huge honor and opportunity,” said the newly elected Board of Trustees member, Stephanie Hook, DPM.

As a member of the Board, Dr. Hook will help their mission of supporting excellence in the practice of podiatric medicine and surgery by creating awareness of the profession’s role and value.  This includes supporting lobbying efforts for podiatric related bills, particularly those striving for parity in the medical community, and ongoing work to promote public understanding of podiatry, the level of training required, and specific expertise podiatrists can provide in overall health. She will also serve on the Insurance and Legislative Affairs committees and chair the Awards committee.

Dr. Hook has known since she was a teenager that she wanted to be a podiatrist. “I always knew I wanted to be a doctor, but after having a podiatric procedure when I was in high school and in observing what they did and learning about the profession, I knew then and there that I wanted to be a podiatrist. I know that is pretty young, but I just knew.”

She attended the Ohio College of Podiatric Medicine (now called Kent State University College of Podiatric Medicine) and did her residency at Sisters of Charity Hospital/Catholic Health System in Buffalo.  “I picked my residency pretty much based on the informal conversation I had with the residency director at the reception during the more formal interview weekend. I was the only one at the reception, which ended up being a great way for me to learn a lot about the residency led by Dr. Joseph Anian.  “I remember liking what he said both about the program and life outside the residency.”   For Dr. Hook it ended up being “a great experience.”   “We were part of the program for all residents and were not singled out as the ‘podiatry residents,’ which I have heard can sometimes happen at some institutions.”

Both in school and during residency Dr. Hook was involved in the State Associations and advocating for the profession.  “I think achieving parity and continuing to establish standards for all states is an ongoing process,” stated Dr. Hook, “but one that also needs ongoing attention and support.”

Dr. Hook worked in a podiatric practice for eight years before moving to Syracuse Orthopedic Specialists (SOS), an orthopedic practice near her home in Nelson, NY.   “I love my job,” she says.  “This is exactly the kind of practice I wanted to be part of.  It is collaborative, ethical, we provide our patients comprehensive care, and we treat our patients like they are family.  I love that I can refer cases to other in-house orthopedists and vis versa.”  One of the things Dr. Hook loves best is that this practice has opened her up to a variety of different cases ranging from sports medicine to diabetic foot care to being a part of the Acute Limb Salvage team at St. Joseph’s Hospital.  SOS is comprised of 31 orthopedic physicians and podiatrists, Dr. Hook was the first woman to become part of this practice.  “While I am proud to be part of the group, I don’t like to single out the gender piece, because I am just one of the team.”

Dr. Hook explains that her group is very active in the community providing trainers for local high school sporting events and tournaments, participating in local health fairs where she has been able to lecture about foot health, as well as sponsoring several community events and charities. “It was important to me to be part of an active and caring group,” she explains.

Shortly after completing her residency, Dr. Hook became ABPM certified. “I think it is really important that podiatrists get certified as early as possible because patients and practices are looking for that credential,” said Dr. Hook.  “Nearly every day I hear patients say, ‘I looked you up online and saw that you had your board certification, etc.’ – it’s not just a nice-to-have anymore.”  Dr. Hook selected the ABPM certification because she felt it was the most comprehensive. “In my opinion, it is much more well-rounded and demonstrates your understanding of biomechanics, medicine and surgery – not just biomechanics and medicine as it relates to surgery.”

While Dr. Hook sees the future of podiatry as very promising, she says she also knows there are pockets within all healthcare professions where financial gain can compromise integrity and optimum patient care. She wants to remind all those entering the field that if you do what you love (as cliché as it may sound) the financial rewards will be there – and be there honestly.   This is something she is very passionate about.   “Follow your heart, do what you love, and you will end up doing the right thing for yourself, your patients, your family and your lifestyle,” she shared.  “We are lucky to be in a profession where we can make choices about our day and the kind of life we want to lead.”

Dr. Hook enjoys sports, photography, travel and spending time with her husband, stepdaughter, and three dogs.  She is also proud to be a part of the DPM Mentors Network.  Enjoy more about Dr. Hook in one of the Syracuse Orthopedic Specialist videos.

Stephanie Hook, DPM, Hired as First Female Physician at Syracuse Orthopedic Specialists

Stephanie Hook, DPM

Stephanie Hook, DPM

Stephanie Hook, DPM, was recently hired by the Syracuse Orthopedic Specialists (SOS) and is also the first female physician to be part of SOS. Dr. Hook, now part of the SOS Foot and Ankle Team, is board certified by the American Board of Podiatric Medicine and, is skilled in rheumatologic conditions, pediatrics podiatry, and diabetic foot care.

Prior to joining SOS, Dr. Hook spent eight years providing podiatry services in Central New York. She received her DPM from Ohio College of Podiatric Medicine in Cleveland, and was a resident at Catholic Health System in Buffalo, from 2004 – 2006, then served as Chief Podiatry Resident there from 2006 – 2007.

Stephanie Hook, DPM has been board certified by the ABPM since 2012.

Source: Syracuse Post Standard

A Surgeon’s Perspective on the Value of ABPM Certification

By: Stephanie Hook, DPM

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Everywhere you turn, people have their opinions and thoughts on what your future should hold.  Surely, your peers, residency director, attendings, friends and family all have your best interests in mind.  All this input can become overwhelming and cause decision-making to become more difficult.  You already must decide if you will specialize within podiatry, where you want to live, if you want to join a group or be a solo practitioner, and so much more.  On top of all of that, deciding which board examination to take can cause your head to be left absolutely spinning.

When I started residency, before three-year programs were the norm, I did not want to be a surgeon.  I matched in a two-year program at Catholic Health System/Sisters of Charity Hospital in Buffalo, New York.  I was excited to start my career journey at a program that was well recognized and accepted within the hospital.  I loved everything I was doing and could not wait to get into my own office and start helping patients.  I loved the “routine” care.  I even often stated that one of the things I loved most was when patients came in, I could treat them, and send them home feeling better.  Personally, I think seeing how you were able to help someone immediately was gratifying.  I thought that was the ideal career path for me.

Becoming a Surgeon

Imagine my surprise when, within one week of surgery rotation, I was hooked.  I knew I needed to be a surgeon. I don’t recall exactly when, but early in my residency, my director asked if I would be interested in completing a third year.  I jumped at the chance to get even more surgical exposure and training.  I then completed my three-year residency, learning surgery from podiatric and orthopedic attending physicians.

After completing my residency, I joined a podiatric practice in Central New York.  At the time, there were eight podiatrists within the group that covered eleven offices in the greater Syracuse area.  My practice picked up quickly and I worked hard building my practice and my reputation.  Within a couple of months in practice, my surgical volume soared.  I was doing cases as often as I wanted, but still spending many hours a week in the office.  It was the perfect balance for me.  This was the life I was meant to have.  As my time in the group continued, I became a part of four area hospitals and also began volunteering on some New York State Podiatric Medical Association committees.   Eight years into practice, I had wonderful patients, loved my job, and loved my life.

How could it get any better from there?  Three years ago, I was asked to join an orthopedic practice.  I am part of an extremely large group, again in the greater Syracuse area.  While they were originally looking to hire a non-surgical podiatrist, I asked for that to change.  I had performed surgery for eight years while building my reputation and patient relationships and didn’t want to sacrifice my current state of practice.  I dramatically increased the number of patients seen every week in this new group, and I am an appreciated colleague in an amazing company.  The support I have is so meaningful.  It allows me to grow as a podiatrist, but also gives me the opportunity to spread my wings.  Since joining my company, I have kept my same surgical volume, increased my office visits, and have still had time to become more involved.  I am now able to serve our great profession as a Trustee of the New York State Podiatric Medical Association, the Chair of the Public Education and Information Committee of the NYSPMA, and as the Student Chapter Coordinator of the American Association for Women Podiatrists.  I also serve the ABPM as a Membership Committee Sub-Chair, working with Crisis Communication and Audit Committee.  I still am affiliated with four hospitals and now also serve as the Podiatry Division Chief at Upstate Medical University Community Campus.  In my thirteenth year of practice since graduating residency, I have shaped my career to be exactly what I have hoped it could be.

One thing I have not mentioned yet is that I am single-boarded.  To keep this story as honest and forthcoming as possible, I originally decided to take a single board because I have test-taking anxiety.  The decision of which board to take was extremely simple for me.  When reviewing both boards, I found the American Board of Podiatric Medicine certification to be more comprehensive.  Just because surgery isn’t in the name does not mean that it is excluded from the certification.  I also examined what the boards are doing to help further our profession.  I have personally witnessed the ABPM work tirelessly to promote its members and our profession, which is yet another value I receive with my certification.

The Value of ABPM Certification

I believe my ABPM certification to be better for me as it is all-inclusive.  I also find that it is a more understandable and recognizable name for my patients.  There will be plenty of patients who will be dead set against the idea of surgery. There are, of course, plenty who do desire surgery.  I believe that the simple statement “Certified by the American Board of Podiatric Medicine” conveys to both of these patients that I am accomplished and recognized in my field- which is podiatry.  All podiatry.  In the years since achieving my ABPM certification, I have tossed around the idea of sitting for my surgical boards but have elected not to do so.  I have seen no negative impact on myself, my career, or my patients from my decision.

At the end of the day, you have to do what is best for you.  I can tell you that I would not change my choices.  I am proud to be a Diplomate of the American Board of Podiatric Medicine.  As I stated earlier, I am simply sharing my story so you can see how your choices are simply that- YOUR choices.  Choose the board(s) that make sense for you, your career, and your patients.

 

 

Clinical Presentation Skills: History of Present Illness

By: Stephen Geller, DPM

Have you ever stepped in a hole and twisted your ankle? Well I recently had a 27-year-old female who was otherwise healthy accept for right ankle pain 3-weeks after a similar inversion injury. No other part of her foot or leg hurts. Her pain is sharp, graded 6/10, localized to the anterolateral ankle without radiation. Standing and walking aggravates the pain and there is still residual swelling and bruising in the area. Improvement has been noted with ice, rest, and ace wrap. She has no prior history of ankle injuries.

Presenting a case is no different than telling a story. Granted, storytelling is an artform itself, but if you can become a good story teller, your attendings will remember you and your medical records will stand out from the rest. In medicine it has become acceptable to use poor grammar, run-on sentences, and be plain old boring. It doesn’t have to be that way. I bring up documentation here because your presentation should reflect your note.

‘A 27-year-old female presents for right ankle pain. The patient states that she stepped in a hole 3-weeks-ago suffering inversion injury. The patient states that her pain is sharp. The patient grades her pain as 6/10. The patient states that her pain is localized to the anterolateral ankle. The patient states that walking and standing aggravate her pain. The patient notes that swelling and bruising remain. The patient denies prior ankle injuries or pain in other areas of her foot or leg. The patient has attempted self-treatment using ice, rest, compression in ace wrap without relief.’

Compare the two presentations. Which one do you think would catch your attention and keep you attentive for the rest of the complaint?

Story telling begins with a hook. You need something to grab your attending’s attention so that they will remain attentive throughout the rest of your presentation. One sentence that conveys the story that is to follow.

“Excuse me Dr. Jones, but my patient has a severely infected diabetic foot ulcer that will need admitting”. Ok, that one is easy. Everyone is going to pay attention as soon as you say severely infected and need admitting. Still you have cleared a path to tell the rest of the medical history.

“Mr. Smith returns for a noninfected venous leg ulcer fifty percent improved from last week”. Here is a rather mundane medical issue. The patient is doing fine and just returning for follow up care. It’s the 50% improvement that will grab the listener’s attention, so you can go on with the rather routine presentation.

Once you have your audience hooked, you must tell the story. If it were a real story you would want to demonstrate a personal tie to the problem or evoke an emotional response. Let’s face it, in medicine that is frowned upon. What your audience is listening for in medicine is the information needed to make the diagnosis. This is where you will demonstrate your medical knowledge. Regardless of which pneumonic you prefer, NLDOCAT or OPQRST, you can still make it more interesting. Success at this level will require a thorough understanding of the differential diagnosis, end-organ effects of systemic illnesses, and complications of prior treatments.

‘You know how you say that heel pain isn’t always plantar fasciitis? Well Ms. Johnson is here for left heel pain, but it’s not typical. One-week ago she began a new exercise program and developed 8/10 sharp shooting pain in the plantar left heel. No known injury is reported. This pain radiates posterior to the medial malleolus, up her calf, thigh and to the hip. She doesn’t have to be active to experience pain and there is no relation to time of day or shoe gear. Ms. Johnson has a history of low back pain but has never been worked up for this complaint. No history of joint swelling or stiffness anywhere in her body is reported. Since the heel pain began there has been no progression and slight improvement treating with ice, stretching, ibuprofen, and cessation of exercise.’

Heel pain is one of the most common complaints we see. The differential includes plantar fasciitis, nerve entrapment in the foot, tarsal tunnel, radiculopathy, systemic arthropathy, stress fracture, etc. The above history takes the listener through the differential diagnosis as told by somewhat of a story. There is enough information to have a pretty good idea of what you will find in the exam.

This is presentation of a history of present illness. If you become good at telling the patient’s story everything will flow. Apply this practice to your notes as well. Obviously, there is less leeway for a casual introduction to hook the reader but convey the information in full sentences. Try to start each sentence with a new subject such as pain, onset, treatment. It is not acceptable to begin each sentence with “the patient states…” This is the history, so it is assumed that anything in quotations is exactly what the patient states.

 

 

 

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