Physicians universally believe that their profession is tough on the feet – long hours, bounding from exam room to exam room, making hospital rounds and rummaging through radiology departments for images without reports. Actually chefs, waiters, clerks, policemen and many others are on their feet more than most physicians I know, but physicians are adamant that foot discomfort is epidemic in their profession.
A couple of decades ago, only conventional leather shoes pounded the hallways of the now flood-closed Memorial Medical Center, the hospital on Napoleon HEALTH: On their feet all day long, physicians explain why they wear the shoes they do.Avenue still referred to as “the Baptist” by devoted physicians and patients. Many of the surgeons had favorite tennis shoes in their lockers off the surgery lounge, but these more casual shoes were kept out of the sight of the general public.
Dr. Walter Becker, an imposing surgeon and self-appointed preserver of the traditional, operated only in his black dress shoes covered by surgical booties. He once told a young physician who showed up without a tie, “Young man, this is not a Saturday and you are not at the country club.”
After Becker’s death in the 1980’s, medical students and physicians in training began to infuse “the Baptist” with more informal footwear. The first physician to come out of the closet and wear tennis shoes to work was Dr. Gregory Vorhoff, a cardiologist who valued comfort over convention. His choice footwear was, and remains, comfortable black tennis shoes.
Funny looking shoes or clogs are contagious, and the local epicenter seems to be the practice of otolaryngology. Bands of otolaryngology residents and staff are shod en mass in the same kind of funny looking clogs with no laces, said to be quite comfortable. When they all make rounds together, you can hear them coming. A nurse once dubbed a group of them “the clog patrol.”
Dr. Maynard Garrett, a distinguished otolaryngologist who now practices in Slidell, is a Birkenstock devotee. “Birkenstocks have kept me on my feet for 30 years. I have a size 13 foot with huge arches. I almost considered giving up surgery before I discovered Birkenstocks. Some of my pediatric patients call them monster shoes but they have been a real career saver,” says Garrett.
Pediatric pulmonary specialist Dr. Jody Gates wore Birkenstocks in the past, but she has moved on. “I have worn Birkenstocks off and on over the years. They were OK and quite comfortable, but I really need a negative heel. I found that Earth shoes are the only answer and have been wearing them for two to three years,” says Gates.
The term “negative heel” is new to me. Gates patiently explained that most shoes have a heel higher then the toe portion of the shoe. Molded shoes with missing or negative heels position the forefoot slightly higher than the heel.
Crossing over to Tulane Pediatric Pulmonology, Dr. Bob Beckerman swears by Z-Coils, a shoe that makes clogs look downright old fashioned.
“Z-Coil shoes and sneakers are manufactured in New Mexico. The coils are shock absorbers that reduce the impact on your ankles, knees and lumbosacral spine by 50 percent. They are not stylish, but they have really helped my lower back condition. There are two shops locally that handle Z-Coils, one on the Westbank and one on Causeway Blvd. in Metairie,” says Beckerman.
Urologist and magician Dr. Neil Baum concurs. “My mother–in-law bought me a pair of Z-coils several months ago and the pain and discomfort in my feet and some mild low back pain disappeared … like magic. The shoes aren’t the most attractive piece of footware that I own, but the trade off is worth it.
“The shoes are also a great conversation piece with my patients, and I have recommended them to dozens of patients who also report back that the shoes do relieve the discomfort associated with standing on their feet for long periods of time. From a teleological standpoint, the shoes make sense. The heavy duty coil on the heel of the shoe absorbs the compression associated with each step relieving the impact on the foot, the ankle, knee and back. For me, they are better than American Express … I wouldn’t leave home without them!” says Baum.
The testimonials covering a wide variety of shoe brands and styles treasured by physicians are clear proof that one size does not fit all (see box). Other physicians cited the importance of socks and inserts. Dr. Michael S. Ellis packs extra shoes and socks in his golf bag each summer.
“My tip for walking golfer colleagues is to change socks after each nine holes during our hot New Orleans months. I urge them not to wear the same shoes for several rounds so as to allow them to dry. It helps to dry the shoes out in the sun for couple of hours. Wet socks and shoes are the primary cause of foot fungus in my golfing and Vietnam experience,” says Ellis
“I also suggest gel-cushioned shoe inserts especially for uneven surface walking,” adds Ellis.
“Knee-high, medium weight, elastic, dress support stockings are important to prevent varicose veins,” says Ochsner cardiovascular surgeon Dr. Michael McFadden who must stand for hours, especially during long cases such as lung transplants and thoracic aneurysm repairs.
“The merger of Cole-Haan with Nike was an excellent asset to foot comfort. They now make a capped toe dress shoe that looks great and you feel like your walking on a cushion of air,” adds McFadden.
The gel inserts received praise from all over. “The Dr. Scholl ‘gel’ inserts are just great. I wouldn’t say they are really an ‘attitude adjustment’ as advertised, but they are comfortable and I have no ache at the end of a long twelve hour E.R. shift,” e-mails Dr. Gene Saltzberg from Highland Park, Ill.
Psychiatrists may not be on their feet all day, but they analyze such things. “I use Spenco PolySorb® Insoles which has heel strike cushioning,” says Dr. Irwin Marcus. “They are pads that you place in the shoe that fit from toe to heel with extra padding under the heel. I bought them in the shoe store at the Riverwalk. I have been using them for years, replacing when worn.”
Without the type of foot support they need, all of these doctors might be in search of a good podiatrist.
Illustration by Byron Humphrey