Do I need a referral to see the doctor?
Generally speaking, if you have a "PPO" type health insurance, you do not need a referral. Most "HMO" patients do require a referral. Examples of HMO's in Phoenix include HealthNet, Aetna, and others. BCBS HMO, however does not require a referral. Mercy Care and APIPA insurance plans require referrals. All patients with insurance that require referrals will need to obtain authorization prior to scheduling an appointment.
Can you take x-rays in your office?
Yes. Our offices are equipped with digital processors so that your x-ray images will display on a computer monitor. Your x-rays are stored in digital format on a computer and can be easily copied to a CD or JPEG file.
Will I be required to pay a copayment at your office?
That depends upon your particular insurance contract. Most PPO and HMO policies require the insured to pay a copayment each time they visit a physician's office, whether it is a primary care physician or a specialist. It is best to check your benefit booklet prior to visiting our office. If you do have a copay per your insurance contract, then you will be expected to pay the copay prior to seeing the doctor. Our office accepts cash, credit or debit cards.
Do you only treat adults?
No. Our practice is not limited to only adult patients. We treat people of all ages who are in need of podiatric care. There are a wide range of problems that are specific to children which we can treat.
When should I seek treatment by a podiatrist?
Many times this is determined by your primary care physician, if you have an HMO policy. Most PPO, indemnity and Medicare policies allow you to self refer to a specialist. If you are having any problems or concerns about the lower leg below the knee, then you should seek advice and treatment by a podiatrist.
What expectations should I have when I visit your office?
You can expect to be treated with respect and kindness. Our patients are important to us and we want them to feel welcome. You can expect us to work with your insurance company to resolve claims issues. Most importantly, you can expect to be treated with the best medical treatment that we can provide.
Is there anything you can do for toenail fungus?
The latest and "high tech" treatment option includes the use of lasers to kill the fungus in your nails. Dr. Fishco uses the Pinpointe laser which is the gold standard FDA approved laser device. Research has shown the efficacy of the Pinpointe laser to be better than Lamisil in eradicating fungal infections. The procedure takes about 30 minutes to treat all your nails. There is no need for local anesthesia. Lasers eliminate the need for taking medication that can potentially harm the liver.
Should children be treated by a podiatrist?
Yes. It is important to remember that pain is not normal. Your child should not have pain. Your family physician may describe your child's discomfort as "GROWING PAINS," however that can be a sign of something more serious. Dr. Fishco is well-trained in pediatric-specific foot and ankle disorders. The most common disorders involving our pediatric patients include: heel pain, flat feet, ingrown nails, warts, and sprains/fractures. Dr. Fishco treats children of all ages.
I have a heel spur. Do I need to have it removed?
No. Most people who have heel pain caused by a "heel spur" do not need surgery. The reason is that there is a ligament-like structure on the bottom of the foot that courses the arch and connects into the heel. At times, this tissue which is termed the plantar fascia, becomes inflamed. As a result, there is an inflammatory process which the body calcifies creating a heel spur. The pain comes first, the spur comes later, and the spur generally does not cause the pain. It is important to remember that there are many people who have heel pain without a spur and plenty of people who have heel spurs, but no pain. Dr. Fishco can show you how heel pain can be treated without surgery. You should know that heel pain is one of the most common foot ailments, and 95% of those who obtain treatment for plantar fasciitis go on to full recovery without the need for surgery.
My child has flat feet. Should he/she be treated?
Yes. Flat feet in children are common. In fact, all children have flat feet until the age of 5 or 6 when the arch develops. Many times "flat feet" are not painful. However, if your child is having pain, is clumsy when running, or chooses to sit on the side lines when others are playing, then that might be a sign of a problem. Also, if you see your child's ankles "rolling in" especially when viewed from behind, then you should have him/her examined. Often times, doctors will prescribe orthotic devices, custom made inserts to be worn in the shoe to help realign the bones and joints of the foot. This allows the foot to mature in a good position. In rare instances, your child may need reconstructive surgery. Dr. Fishco has extensive training in reconstructive flatfoot surgery.
What are orthotics?
Foot orthotics are custom-made devices that are worn in your shoes. Dr. Fishco will either take a mold of your feet with plaster or use a computerized digital scanner to obtain "impressions" of your feet. This makes an identical picture of your foot. We then send the molds/scan to an orthotic laboratory for fabrication. Orthotics are more than arch support. Orthotic devices are used for a variety reasons. The orthotic devices control the foot and help realign the structures of the foot. Orthotics have influence on the spine, hip, knee, ankle, and foot. Orthotic devices are useful in treating a myriad of disorders that cause pain or dysfunction of the lower extremity.
What type of surgeries do you do?
The most common foot and ankle surgeries include fixing bunions, hammertoes, neuromas (pinched nerves between the toes), fractures, removal of bone spurs, and surgical care related to infections and ulcers.
Less common surgeries that Dr. Fishco performs include flatfoot (pediatric and adult) and high-arched foot reconstructions, fusions or joint replacements for arthritic joints, Charcot reconstruction, tarsal tunnel and other nerve decompressions, ankle ligament repair, and tendon repair (i.e. achilles ruptures).
Dr. Fishco has had specialized training in revisional surgery and in complicated reconstructive surgery. Dr. Fishco is a referral source for other foot and ankle surgeons who do not perform these types of surgeries.
What is the difference between a podiatrist and an orthopedic surgeon?
An orthopedic surgeon is a medical doctor who treats the entrire musculoskeletal system, head to toe. A podiatrist has specialized training to treat disorders of the foot and ankle. A podiatrist limits his or her practice to treating the conditions affecting the foot and ankle. Podiatrists have the ability to treat disorders in a conservative fashion in the office as well as performing reconstructive surgery at your local hospital if necessary.
What is peripheral vascular disease?
Peripheral vascular disease (PVD) also known as peripheral arterial disease (PAD) is a condition where there is diminished blood flow to your legs and feet caused by narrowing of the arteries (atherosclerosis). It has been estimated that 12 million people in the U.S. have PAD and more than half of those people are asymptomatic. This condition is seen more often in diabetic patients and those who smoke. Common symptoms may include cold feet, calf pain when walking short distances, and/or slow to heal wounds on your feet. Diagnosis usually involves testing your circulation with a doppler ultrasound and/or an angiogram. Treatments include certain medications, an exercise program, and sometimes surgical procedures. Our office can perform vascular testing that is non-invasive and coordinate consultation with a specialty-trained peripheral vascular physician.
Is the doctor board certified?
Yes. Dr. Fishco is board certified by the American Board of Podiatric Surgery. Dr. Fishco has double board certification in foot surgery and reconstructive rearfoot and ankle surgery.
I don't have health insurance. Can I still see the doctor?
Yes. Our office is understanding that some people do not have insurance, have high deductables (major medical only) or want to be seen even though Dr. Fishco may not be contracted with your insurance company. Dr. Fishco gives a generous discounted rate, usually a 25% discount of Medicare allowed rates. A payment plan can be arranged if necessary.
Do you accept credit cards?
Yes. We accept cash, credit (MC, Visa, and AMEX) and debit cards.
I am diabetic. How often should I be seen by a podiatrist?
All diabetic patients should have a podiatrist. On your initial exam, your podiatrist will tell you if you are at low or high risk for complications in your feet. Generally speaking, a diabetic patient that has good ciruculation and no neurologic deficit (numbness/burning/tingling) can be seen on an annual basis. However, if one is at higher risk with poor circulation and/or numbness in the feet, then exams/treatments should be done every 2-3 months.