Spring 2008 Issue

Spring 2008 Issue

The Pied Piper

Dr. John Steinberg ’95 has a passion for promoting wound healing and preventing unnecessary amputations

By Richard A. Webster

Each year more than 80,000 diabetics have their toes, feet or legs amputated, but it’s not always necessary and can lead to additional problems, says Dr. John Steinberg ’95, a graduate of the Barry School of Podiatric Medicine and currently an assistant professor in the department of plastic surgery at Georgetown University School of Medicine.

If a diabetic has a wound or an ulcer of the foot it’s common practice for surgeons to recommend amputating the entire limb.

“It’s easy to cut off someone’s leg because you can get them out of the hospital real quick,” said Steinberg, a Distinguished Alumni Award recipient from the School of Graduate Medical Sciences.

However, following that course of action isn’t always necessary and can lead to additional problems and complications.

In fact, more than 50 percent of patients who undergo amputations suffer infections and complications in the remaining foot and undergo additional amputations. And within five years 40 percent die.

That’s where Steinberg’s dedication to his profession becomes a true passion.

Recent advances in podiatric medicine can prevent unnecessary amputations, and Steinberg is determined to educate the medical community to promote wound healing as an alternative to the severing of a limb.

“I’m usually on a plane once a week to give a talk at a national or state meeting,” he said. “This is my real passion, to try to get more people to engage in advance wound healing [rather than resorting to] amputations.”

Steinberg is looking to change the field of podiatry much as his grandfather, Dr. Marvin Steinberg, did two generations ago.

Dr. Marvin Steinberg, considered the “father of modern podiatry,” was one of the first to successfully treat gangrenous limbs when most doctors were relying on amputations. His father, Dr. Lloyd Steinberg, and brother, Dr. Paul Steinberg, are also practicing podiatric physicians in Ocala, Florida.

Steinberg, who holds the honor of being the first doctor of podiatric medicine (DPM) to be invited onto the faculty at Georgetown University Medical School, wants to expand on his grandfather’s work by bringing together specialists who rarely work together such as podiatrists, vascular surgeons and endocrinologists. By combining their expertise Steinberg says he hopes to increase the speed and efficiency of foot care so doctors won’t have to consider cutting off a patient’s leg.

“There are new techniques, better antibiotics, artificial skin and tissue. You can get new blood flow. It’s a whole different ballgame from what it was 10 years ago,” he said. “Now we can take off part of foot and heal the remaining wound and leave them with something to walk on. And a part of a foot is better than taking a whole leg.”

Dr. David Armstrong, a Chicago-based podiatric physician, was a professor at the University of Texas Health Science Center in San Antonio when he first met Steinberg and has worked closely with him ever since. Steinberg’s leadership on the issue of amputations is indicative of his passion for the field and serves as a source of inspiration for upcoming podiatrists, he says.

“Young doctors followed [him] around in a long string of white coats,” Armstrong said. “I suppose you could say John is the Pied Piper of Podiatry. That's a tribute to his family, to his character and to his infectious enthusiasm.”

Steinberg’s dedication to reaching out to each new class of podiatrists and providing them with leadership has been vital in growing the field, Armstrong said.

“Our profession is a young one. It hasn't had a culture of mentorship in the past,” he said. “Much of this has been compensated for by excessive hubris. But John's mentoring and his characteristic humility and innate kindness has really helped to change the culture. Future doctors see this. And they're attracted to it. They benefit from it and so does our profession as a whole.”

In addition to inspiring the next generation of podiatrists, Steinberg wants to change the mindset of the current generation to help those most in need.

Diabetic-related amputations typically impact the poor and homeless, people who can’t afford medical care, Steinberg says. They can go years without seeing a doctor during which time their diabetes can worsen and once treatable wounds go unchecked.

Because these patients are poor or living on the streets, many times surgeons may not take the time to explore all options and instinctively decide to sever the limb, Steinberg says.

“But once the homeless have amputations they’re totally state-dependent and they end up in facilities and it becomes not only a physical burden for them but a financial burden for the state. Where we’re pushing is the degree of amputation. Keep it at partial foot amputation so you don’t lose the whole leg. This is the standard we’re trying to establish.”