“9 years after creating Aesthetic Foot Surgery, I am still humbled by patients traveling to Los Angeles from all around the world trusting us to correct their foot problems. That’s why I decided to create an introductory video that brings the experience of what makes Beverly Hills Aesthetic Foot Surgery different.

…Thank you for visiting our site, I hope you enjoy our presentation and look forward to meeting you in person.”

Dr. Ali Sadrieh

“We truly appreciate our patients, and when we get such amazing feedback, we’re speechless; we just love what we do here and strive to provide our patients with the best quality care available.

Thank you to every one of you for choosing us to help create the the feet that you wanted, and putting your trust in our practice.”

Ali Sadrieh

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“Your thoughtfulness and your professionalism can not be described by words. I do sincerely appreciate and thank you on what you have done for me. Looking forward to seeing you soon.”

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“Thank you for taking the time to come to Ohio to check on my feet! Your kindness is greatly appreciated! Please tell Shu Shu and the staff that we said hello! Please have safe travels and return home soon!”

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“I have been remiss in writing. I kept hoping some kind of “verse” would come up.  I think I said it all the first time. Really.

What I have not said is thank you for the joint operation which you so generously and mysteriously made possible.  You definitely have been “Heaven”, or some place like that , sent.  A blessing.

Our feet are “everything” (well, everything is “everything” really…) I start thinking about them and they’re a miracle – so are the gifts you have.  Daily miracles because of your work.

I hope to climb mountains again! Really! You already do!”

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“I have been remiss in writing.  I found this a la Japanese style card which captures so much of you spirit, the office, the decoration – and then, I couldn’t fear to write on it!!

I’ve wanted to thank you (which falls short) for making the joint operation possible.  As I told Dr S., you both have been “Heaven” or some place like that, sent.  A blessing.  I clearly see the halos!

What is especially amazing – you don’t forget your patients after their surgery.  You take care of us till all is healed.

Take good care”.

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“Dr. Sadrieh & Staff,

Thank you so much for all your help this past year with my ankle/foot!  I actually was able to finish the marathon in 5hrs 31min thanks to all of you!!!  For the New Year I will sit it out & just donate !!! I hope you all have a wonderful holiday & a great New Year. Love Alida”

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Dr. Ali -

Just to want to thank you for all you have done for me – specially your kindness and caring.  You are one of a kind.

Thank you again,

Brenda

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To the greatest man in the world, he truly saved me from my fingers!!
Much Love Dr. Sadrieh

xo Dana

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“can’t thank you enough!”

Gracias,
Lucy D.

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“I wanted to thank you for the offer you extended to me.  Mailed a card to you but confused your Devonshire and Ventura Boulevard addresses.  If you receive them both then I doubly thank you!

I will reach out to you and your Studio City office later in the year.  Will take advantage of your offer or will wait to end of year and return with new benefits.”

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“Ali,

Love,
Holly”

Summer is here, and the season for open toed shoes begins.  But this isn’t the best time for some women.  I meet these women everyday, and I feel privileged to be the doctor they choose to give them new feet.

When I decided to create what I consider a totally new mind set in foot surgery, I knew that I was going to open a new door in the medical treatment of foot problems.  In our modern society, medicine is still catching up with the idea of preventative surgical measures in the orthopedic realm.  As I have outlined in my practice philosophy statement, this is what I hope aesthetic foot surgery will grow into.  I consider it an honor to be part of this great shift in the moral paradigm of podiatry as we know it.

Every day, women come to our practice from around the United States, and now the world, telling me how they have been hoping there would be a doctor who would take them seriously about their long toes, or the discomfort they experience when they wear high heeled shoes at work.  The reality is that the modern woman is faced with social pressures than men do not experience.

A professional woman in the 21st century is expected to wear what is considered professional women’s shoes as acceptable attire.  What is sold to the modern woman by the fashion industry as beautiful, has some sort of a high heel.  The problem they face is that what is considered a professional, or sexy woman’s shoe is not consistent with what podiatric medicine considers orthopedically correct.

During the creation of my concept practice, Beverly Hills Aesthetic Foot Surgery, I decided to consolidate these two worlds and create a specialty that provided the modern woman, simpler, easy-recovery procedures that not only address the orthopedic problem that limits their shoe choices, but also does it with respect to the appearance of the finished result.

Today, I am proud to say that we see women from all over the world, and I have had the pleasure of being part of some amazing stories.  I have met women who had unfortunate results from old fashioned hammertoe surgeries who haven’t worn open toed shoes in 10 years, to CEOs who suffer with corns  because you can’t go to the board room in tennis shoes.

My commitment to continue innovating new solutions to my patients needs will always be the driving force or our practice, so I say, take of those sandals and feel how wonderful it is to experience the sand between your toes this summer… barefoot!

Dr. Ali Sadrieh

Innovation has always been the driving force behind my practice.  I am honored to announce that on May 20, 2010 we have been invited to talk at the Apple Store in Sherman Oaks about utilizing Apple technology in the practice setting.

When I first started my practice, it was critical that we start with a paperless system.  From ground up, we developed the backbone for what was to become the most advanced practice in the country.  The only was to do this, was of course, to use the most advanced platform on the market… Mac OS X.  Apple Computer has always been known for it’s advanced industrial design and remarkable attention to detail.  We can thank Jonathan Ive for his brilliant creations that withstand the test of time.  These computers however are not just pretty slabs of aluminum.  When you turn on any Mac computer you are greeted with the most stable and well designed operating systems available on this planet. This is because of the unwavering attention to perfection that Steve Jobs brings to this already superb company.

Mac OS X provides our practice with a reliable, easy to use operating system that eliminated the need to depend on “the I.T. guy” or to keep buying Symantec anti-this and McAfee anti-that!  Amazingly, the very first computer we bought for our first practice (a 17″ iMac G4) is still operational and working!  We have never turned our servers off, and never installed anti-viral software, or made a call for technical support.

I was so impressed with the Mac OS, that I took a Mac OS X server certification course to implement OS X Server in the office and now we have the power of a server client system.  Apple has made it possible for the little guy to be empowered and expand their business where ever their imagination takes them.  Today we have iPads for patient registration, digital xray that is accessible remotely from my iPhone, MacPractice practice management and EMR which takes the pain away from billing and documentation, and a whole slew of really cool programs that just make practicing medicine what is was supposed to be, fun!

Every doctor you talk to complains of the same thing… charts!  The Mac makes this chore easy.  The simplicity that the Apple platform offers a medical platform combined with the powerful applications available today make any practice that decides to switch to Mac OS instantly jump light years ahead of the competition.

I am honored to talk at the Apple Store about how we have reinvented the digital practice.  Please join me on May 20th and allow me to share my resources and experience with you to further your practice and take medicine into the 21st century.

There’s no denying that you’ve heard about it… The iPad is here, and we are proud to announce that we are the first medical practice in the country to have fully integrated this remarkable device into our day to day operations.  As most of our patients have already experienced, we are a green practice with a completely paperless data system, solar powered computers, digital x-rays and lot’s of other cool technology.  But there was always that final step of getting rid of what I call “the unavoidable pieces of paper”.

Whether it’s the magazines that our patients read during their short waiting room experience, or the consent forms they sign that give us permission to perform surgery, paper is a difficult item to remove from the day to day operations of a medical office.

4 iPads Ready for Action!

That’s why in anticipation of the iPad, we invested numerous hours preparing our data system for the full integration of this revolutionary tablet computer, the moment it was released.  And on Monday morning, April 5th, 2010 it is!

Now when a new patient comes to the office, they are greeted with an iPad that they will use to complete their initial patient forms, their initial history and physical forms and all other registration documents.  This happens thanks to some pretty nifty software written by my friends over at MacPractice in Nebraska.  This further saves time since the information is automatically integrated into our database the moment the patient clicks the “done” button.  Less time filling out papers means, more time with the doctor, another important reason that patients should expect their doctors to technologically advance their practices.

Lot's of apps for you to test and play with

Once you have filled out your documents however you don’t have to give up this svelte, futuristic tablet computer.  You can hold on to it to browse the internet on our complimentary T1 WiFi or read the numerous magazines we have purchased for you to enjoy right on the iPad you are holding.  Everything form Popular Science, Outdoor Magazine, Time Magazine and other periodicals as they are released.  We even purchased programs that give you ideas on where to go for dinner, or which wines to choose from.  If you need to catch up on news, we have BBC News, The New York Times, AP News, NPR News, and more.  We’ve even purchased books that you can read, bookmark and come back to on your follow up visits.

We did this because we respect your time, and having free internet, access to your email or reading the news is something we think you should be able to do during those brief moments you wait for your appointment.  If you’re worried about learning how to use one, don’t.  You can go to this link and watch easy videos on the basic operation of an iPad: http://www.apple.com/ipad/guided-tours/

The iPad is also used throughout the back end of our operations.  The device is used to collect and input data during surgery.  The tablet is the perfect solution for our inventory management.  Starting in May 2010, patients will be given an iPad to watch custom made Surgical Consent Videos designed, and created specifically for my practice, by myself.  This will give you another dimension to understand in detail what procedure you are being consented for… and a well educated patient, is a successful-result patient.  A copy of the video will be made available to you after surgery online so you can refer to it as you like before surgery.

This is the part I love… I even get to use one!  Quality medicine is not just about the procedures we perform.  It’s about the patient experience and the interaction between the patient and the doctor.  Almost every doctor patient interaction is done from a distance with your doctor lecturing you while they interpret the x-rays for you.  The iPad changes all this.  Now you and your doctor can sit next to each other looking at your digital x-rays on the HD display of the iPad.  This close, personal interaction is what develops the kind of patient doctor interaction that our current medical system needs more of.

In conclusion, it gives me great pleasure to add one more facet to the already exceptional experience you will have at our practice.

The 1st iPad Doc!

This post however wouldn’t be complete without a special thank you to the fantastic team of visionary and dedicated employees at the Apple Store in Sherman Oaks.  Mark, Jeremy, Evan, Suzi, Adrian and Veen.  These are the kind of people that invest in relationships with their clients, much like how we run our practice.  Because of their hard work, and commitment to our operation, we can provide you with the cutting edge technology that Apple develops.  Thank you team… you all deserve special recognition from your company for the excellence you bring to your store!

Dr. Ali Sadrieh

This is an important first video for you to watch.  Although your surgery is advanced and allows you to function and walk after the procedure, it is very important to understand that human physiology hasn’t changed in 10,000 years.  We still heal the same way.  Skin takes an average of 2 weeks to heal, and bone takes 6-8 weeks to fuse.  So it is important to respect the rules of healing and allow your body the time to heal without irritation.

One factor that can create unwanted inflammation and result in pain and possible damage to your surgical result is not walking correctly with the Post Op Shoe.  The shoe is designed with a CAM bottom.  This allows for you to walk without having to push off the toes.  I want you to make sure that during the period you are wearing your post op shoe, you keep the weight of your body on the heel and not to allow the forefoot to have any significant weigh bearing.

The patient in the above video shows us how you walk without putting your weight on the forefoot.  This short gait style takes a little getting used to, but it will make your surgical experience that much easier and ultimately result in a well healed foot with no complications.

Key Points:

1. Keep the weight on the heel at all times
2. Always wear your surgical shoe if the foot is going to bear weight
3. Never walk or bear weight WITHOUT the surgical shoe
4. Make sure the shoe is fastened tight and correctly
5. Keep the shoe clean and out of the rain

So you’ve had your surgery and it’s time for your first shower!  What now?  That’s what this video is for.  Please make sure to read the instructions written below as well as watch the video to have a firm understanding of the concepts that are important to help you keep your foot dry, and prevent infection during your post operative experience.

Human skin takes an average of 2 weeks to heal.  This number varies in different parts of the body and regions as well.  The foot is at a disadvantage because it is in a gravity dependent position and also has less blood flow due to it’s distance from the central vascular system.  This results in a 2, sometimes 3 week window of time for this region to heal.  That is why we have to keep the skin of the foot dry while it heals.  To help you with this task and increase your chances of success in keeping your foot completely dry during the post op period, you have been given a Dry Sock Shower Boot.

The Dry Sock is a plastic sock fitted with a one way valve.  This valve allows for the user to pump the air out of the sock so they can create a sealed, airtight water proof sock around the surgical site and keep it dry.  Although this is an advanced device, it is important that yo understand that like any device, it can fail.  So despite the appearance of a sealed fit, I still recommend to patients that they keep the foot away from direct water so that there is literally no chance of getting your foot wet.

As always, if you run into any trouble at all, call me directly immediately to tell you what to do next.  If your call is during business hours, call the office.  If your call is after hours, call me on my mobile number which is on the Emergency Post Op Card you were given during your Pre Op visit.

Pay particular attention to the key points since they will also help you have a dry, successful post surgical experience without infection!

Key Points:

1. Make sure the seal point of the sock is in direct contact with skin and no hair is present (yes that means men need to shave that part).
2. Make sure when you are putting the sock on that there is no disruption of your dressings.
3. Always use a sock to cover the dressings first to catch any condensation.
4. Make sure there is a tight seal and that all the air is out of the sock before going to the shower.
5. Use a stool, and a removable shower head to make the experience easier.
6. Even though the sock is tight, do not let water directly hit the foot or the sock.
7. When you take the sock off, examine the region for any water and if it appears that water got onto your dressings, call the office immediately.

Accidents happen… this is a fact of life.  But it’s very important that you make sure to take all the precautions for a smooth and easy post operative experience.  You are a team member in your surgical care, although we have had a pleasure of providing you with cutting edge procedures that reduce your post operative recovery time, it is still very important that you play an active role in your care and do what it takes to protect your foot from water and trauma.

Attention!

But it is also important to be know how to respond to a problem if something were to go wrong.  If you get your foot wet by accident, the first thing you need to do is contact me immediately.  This is very important so that I can review some of the goals of the immediate dressing change before you continue with this step.  Once again… DO NOT CONTINUE without having called me first.  During business hours call the office line, and after hours call my mobile number that is on the Emergency Post Op Card you were given on your Pre Op visit.

If your dressing did get wet, the goal is to assess how much of it got soaked through.  I will guide you through this process on the phone.  If we determined that the dressings did not get saturated, then we will use the blow dryer to dry out the dressing.  If however the dressing is completely wet or destroyed, then you will proceed to the changing section of the video below.  Once again, I will determine which steps you need to perform after speaking with you.

If you are watching this video and have talked to me about changing your dressing, you must know that it is important for you to get to the office tomorrow so that I can change your dressing to a better fitting splint type and have the opportunity to assess the incision and the surgical site.  This will insure that the accident did not damage your procedure as well as allow us to intervene early if there is an increased risk for infection.

Key Points

1. Make sure when using the blow dryer to keep a fair distance from the skin to prevent a burn.
2. Do not apply the compressive Red Coban too tight that you block off the circulation.  You should not have severe pain with the coban.  If you do it is too tight or your foot is swelling.
3. If the dressing is going to be changed, try to use gloves to keep everything clean.  These are available at any pharmacy and are available in Non-Latex if you are allergic.
4. When removing the dressings pay close attention to them and stop when you get to a dry layer.
5. If you are removing the entire dressing make sure to prevent damage or excess moving at the surgical site.
6. DO NOT pull the incision margins apart.
7. When removing the Steri Strips, make sure to remove them PERPENDICULAR to the incision.  That means remove them in a way that the incision does not split open.

Instructional Video Coming Soon!

Imagine going to a restaurant and being given a menu.  You are ready to order and meal, and fully intend to pay for it, but when asked about the prices (because there are missing) you are told by the owner that you are not entitled to that information.

Now this scenario is actually better than what your insurance companies consider normal.  In the restaurant model, you are not paying a monthly premium for services that you expect to be rendered.  In the restaurant, you can get up and walk out, walk down the street and sit at another establishment to get the meal you expect for the price you are informed of up front.

This discussion is about the elusive Fee Schedule.  This is a point of contention for many doctors and unfortunately ends up giving many patients grief.  Ultimately it is important to remember that the consumer controls the deck, and if you as intelligent consumers demand Fee Schedules of your insurance providers and demand that your physicians are given detailed fee schedules as well, things would change.

The problem is that when you see your doctor, you are under the impression that you have insurance, so you will only be responsible for specific costs that you were informed of by your insurance broker or agent.  Costs like co-pays, deductibles, and co-insurance.  The thing that everyone leaves out is what is the fee schedule that these costs are calculated from? Most of our patients come to our practice because we provide a service, at a level that far exceeds any office they have been to before. We pride ourselves on this and are humbled by the thousands of patients who come to us from all over the globe.  And as I have discussed in previous articles, the formula to excellence and high quality care is simple… low volume.  To make this happen we choose to stay out of network with most insurance companies.  This however, places our practice in a precarious position.

Being out-of-network means we are not contracted with insurance companies and do not agree to participate with their restrictive activities.  To limit their costs, insurance companies play an unfair game of penalizing their insured if they choose to go to an out-of-network physician.  Now here is where it gets interesting… let’s say you are okay with these shenanigans because you really want to be at a high quality facility like ours; you are entitled to know what your out of pocket expenses would be… right?  According to the insurance providers, you are not.

Every week, we spend hours on the phone conference calling with our patients and their insurance providers demanding that the insurance provider play fair and give a clear fee schedule to the insured so that they can know in advance what they can expect to pay out of pocket for the expenses of their procedures.  We do this because we feel strongly about this issue.  The insurance company works for you.  You pay them a premium and they in return are providing you a service.  The fact that they consider it acceptable to restrict your access to their Fee Schedule is a clear indication how they perceive their role in this relationship.

We conference call with you because the insurance company has call center employees answering the phones who have no vested interest in your well being.  There is no reason for them to help you get quality care, after all, they are not providing you the care, we are.  They are only the middle man determining where your premium dollars should go.  When we get on the phone with you, the insurance company cannot get away with snowing you with terms you are unfamiliar with and explanations that make no sense to the patient.  Rather, you have an advocate on the phone with you that deals with insurance companies every day and is going to serve as your liaison, standing up for your rights.

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I’ve been told by colleagues and patients that I take this insurance thing way to seriously.  There is a reason for this.  The health insurance industry has been instrumental in destroying the quality health care system our country had.  They have controlled both sides of the field and have created a closed market that doesn’t allow for quality care to flourish without restriction.

As an ethical American, I cannot cower and let this continue.  An article published in the Wall Street Journal, June 25th, 2009 outlines how United Health Care and their subsidiary Ingenix Inc. underpaid doctors and hospitals who were out-of-network due to flawed databases.  It is crucial that you understand that Ingenix acquired the Lewin Group who released the most optimistic assessment to date of President Obama’s health insurance reform plan.  Lewin is a leading source of independent, nonpartisan health policy analysis for the U.S. Government.  Despite assurances given in June 2007, however, no corporate policy has been written to protect Lewin from interference by it;s parent companies… Ingenix Inc., which is United Health Care.

This form of corruption has to stop.  You as the consumer can stop it, and you can count on us to support you.