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It’s in Her Sole

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Doogie Howser she isn’t, but it is fair to say that Dr. Nicole Freels, FACFAOM, began her medical journey much earlier than most.

Her grandfather, Dr. Arthur O. Kelly, was a podiatrist in Portsmouth, Ohio. Freels grew up on a horse farm in nearby South Portsmouth, Ky., and spent much of her time at her grandfather’s office.

“I think I started helping when I was about 12 years old, sweeping up toe nails, rooming patients, doing everything, learning the entire process,” Freels says. “I graduated into trimming toenails when I was about 15.”

Freels completed her undergraduate degree at the University of Kentucky before attending her grandfather’s alma mater, the Ohio College of Podiatric Medicine in Cleveland, Ohio. Freels began a comprehensive podiatric surgical residency with the first two years at James H. Quillen Veterans Affairs in Mountain Home, Tenn. The third year was spent in Atlanta, Ga., learning from world-renowned podiatric surgeons, Drs. Douglas H. Elleby and Alan Shaw, and leading wound care specialist and podiatric surgeon Dr. Michael K. Bednarz.

At that point, Freels and her husband Rob, who has an extensive business and entrepreneurial education, decided to start Lexington Podiatry on their own in the fall of 2008. “It was challenging at that time to get an unsecured loan to start a practice,” Freels said. “We found a small bank in Ashland. I had a 10-year old car and lived in an apartment but they gave me a start up loan of $100,000. That was the benefit of growing up in a small town.”

Lexington Podiatry was officially open for business in January of 2009. To build up her customer base, Freels went back to her roots cutting toenails in her grandfather’s practice. “I cold-called every nursing home in a 20-mile vicinity of Lexington and got 10 job offers,” she says of her efforts to drum up business. “I was a traveling toenail clipper.”

Today, Lexington Podiatry serves a much larger patient population, seeing everyone from infants with ingrown toenails to diabetic patients to routine check-ins with nail care and calluses. But the marketing efforts of Freels and her staff have helped them develop one core demographic. “We conduct free foot exams all over the state,” Freels says. “Now we work with many large corporations – Toyota, Sylvania, JIF, Amazon, and others. Manufacturing makes sense because the employees work on concrete and stand all day long.”

Freels takes pride in helping these patients, who often endure pain and discomfort on a daily basis to keep their jobs and support their families. “Often these patients have a difficult time maintaining a healthy lifestyle while working a job where they are taking 20,000 steps per day,” says Freels. “These people don’t feel like going for a run after work. They’ve been on their feet all day, so they have lack of movement and flexibility. We work to keep them on their feet.”

One of the most common complaints is plantar fasciitis. Treatments include stretching, steroid injection, physical therapy, and custom orthotics. Freels notes that many patients diagnosed with plantar fasciitis actually suffer from tarsal tunnel syndrome. Freels calls upon diagnostic neurophysiologist Dr. Mark Brooks, PT, DSC, ECS, OCS, who comes in every week to conduct nerve conduction velocity tests to determine if a patient has tarsal tunnel.

Whether treating plantar fasciitis, flat feet, heel pain, ankle sprains, or tendinitis, Freels prefers a conservative approach to treatment, avoiding surgery if possible. “I stopped doing surgery about six years ago because I had so many patients coming to me with failed procedures,” Freels says. “I feel like foot and ankle surgery has an underserved negative reputation. We do many more minor procedures that focus on shifting the bones and the joints, tailoring the treatment plan to the lifestyle of the patient.”

That said, Freels understands fully that there are times that surgery is necessary and wants to bridge the perceived communication gap between orthopedic foot and ankle physicians and podiatrists. “I strongly believe in a collaborative effort,” Freels says. “There are patients who need surgery and there are times when non-surgical treatment is best. By working together, we’ll achieve the best outcome for the patient.”

Relationships are Key

Relationships are Lexington Podiatry’s specialty. Every part of the practice is designed to enhance the patient experience. Out-of-the-box thinking and staffing has led to a focus on patient care and comfort that is central to the practice’s mission.

“Many of us used to be restaurant servers,” Freels says of herself and her staff. “We know about customer care. So here, you get a comfort menu when you walk in the door. Older patients tend to get cold so we offer them airplane blankets. ‘Would you like something to drink’? People who are having injections—‘Have you eaten today? Let’s get you a snack.’ We bring the hospitality full circle. It’s not an office visit. It’s more of a spa experience.”

Lexington Podiatry staff are hired based largely on personality with an understanding that most of the necessary office skills can be trained. One benefit to this comfortable patient environment is that Freels finds that she can communicate more effectively with patients when they are relaxed.

Another benefit of this model is that it is helping Lexington Podiatry find its niche in an age when smaller practices often find it difficult to compete. “Everyone in podiatry is looking to diversify. How we can be unique, like having the ped-spa. That’s not covered by insurance, but our patients love it.”

Following her grandfather’s lead and emphasizing patient experience? For Freels, it seems to be a step in the right direction.

These people don’t feel like going for a run after work. They’ve been on their feet all day, so they have lack of movement and flexibility. We work to keep them on their feet.– Dr. Nicole Freels