Phoenix-based OrthoArizona has launched its new Foot & Ankle Institute, which includes a team of fellowship-trained orthopedic and podiatric specialists treating patients in 10 locations throughout the Phoenix metropolitan area.
OrthoArizona Launches Foot & Ankle Institute

Jason Lake, M.D., senior vice president of operations for OrthoArizona, told OTW, “When I moved back to Phoenix in 2010, I noticed a large variation in care of foot and ankle patients. Lots of private practices all with a different approach to care. At the time, we had only ONE foot and ankle provider in OrthoArizona. After discussion with other providers in the community, we realized that many of us had similar goals to patient care.”
“We all believed patients with a particular diagnosis should be treated the same regardless of what doctor’s office they ended up in. All of us felt like we owe it to the patients to be consistent. Research would guide our diagnostic and treatment options and if we were lacking research on a topic, we would do our part with our own research. We decided to put our egos aside and focus on building something that will change the community as opposed to just building our individual practices.”
“We now have 12 foot and ankle providers in OrthoArizona and have begun quarterly journal clubs and a monthly clinical conference similar to academic institutions. We also have begun several clinical trials on diabetic ulcers, bunion surgery, and ankle and hindfoot fusions in an effort to improve our outcomes for our patients.”
“We have also begun a unique program with ‘Foot and Ankle Hospitalists.’ We have some providers that provide the foot and ankle care for the Cardinals, Diamondbacks, Rattlers, etc. and have a sports emphasis. Those organizations demand someone with a sports-minded approach. Essentially, we think that inpatient care for foot and ankle patients is a unique subspecialty just like sports.”
“Our ‘Foot and Ankle Hospitalists’ have a goal to provide top notch care for foot and ankle patients in the hospital that have unique needs. They are not burdened by covering clinics, sporting events, but rather work with emergency room, internal medicine and infectious disease physicians on how to get patients better the quickest and get them back home.”
“Because they are hospital-based, they can respond quicker…similar to how an Obstetrics/Trauma surgery is available but focusing on foot and ankle. Our size allows us to provide this service and we were unable to do this in our old model where we were all separate practices.”
“Our pilot facility is Mercy Gilbert Medical Center (Dignity Health) and we already have several requests to expand our program. We have also begun having resident rotations from the University of Arizona and plan on interviewing for Foot and Ankle Fellowship candidates in late 2018.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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