Epi 70-min

The foundation of your health starts where you may ask? Your feet! I got to chat with Mohammad Rimawi, DPM, a board-qualified foot, rearfoot, and reconstructive ankle surgeon with specializations in traumatic foot and ankle injuries. We start off the show talking about the importance and the pivotal role your feet play in the alignment of the rest of your body, proper care for your feet after a long day on your feet and more. We also get into BURNOUT and Dr. Rimawi shares his take and experience with burnout, along with the courage he mustered up to take action.

Dr. Rimawi earned his doctorate from the New York College of Podiatric Medicine, where he made his mark. Not only did he graduate above the 90th percentile of his class and serve as class president for four years, but he was also recognized with the Student Service Award. That award goes to the student voted by the graduating class as making the biggest impact on the field of podiatry. Beyond his peers’ recognition, Dr. Rimawi was inducted into the Pi Delta Honor Society for his achievements in his research and his studies.

Dr. Rimawi continued on to a three-year reconstructive foot and ankle surgery residency at DeKalb Medical Center and Jefferson Health. His colleagues and the hospital staff at the latter named him the Podiatric Resident of the Year. Dr. Rimawi is still impressing in his field. He’s a published author and accomplished lecturer, as well as an associate of the American College of Foot and Ankle Surgeons.

Here are takeaways from our conversation:

TREAT THE PERSON AS A HOLISTIC BEING, NOT LIKE A BODY PART

Dr. Rimawi found his calling within the podiatry field and shared the power of a holistic approach when it comes to healthcare. You may think that by working with one specific body part that you turn your head to other systems in the body. Dr. Rimawi has spotted the signs of diabetes in his patients just by examining their feet for example and referred those patients to the appropriate specialists. Some of the best qualities in healthcare professionals include playing detective and understanding that our systems are all connected.

THE FOUNDATION OF YOUR HEALTH IS WHERE?

With 26 bones and 25% of all your body’s bones in your feet, along with 33 joints, 19 muscles, and over 100 ligaments in each foot, the complexity of our feet can easily be overlooked. I remember when I was in gross anatomy, I thought one of the hardest body parts to study were the feet! This is Dr. Rimawi’s job. The things we demand on our feet is remarkable. If you’re a clinician, your feet must be strong enough to withstand the 8-12+ hour days where you’re standing and walking all day long. The foundation of stability lies within your feet. When you look at the body as a kinetic chain, you’re only as strong as your weakest link. If problems begin to develop in your feet, you may also experience a trickling up effect of pain in your knees, hips, and back. If you have leg-length discrepancy or flat feet for example, that can lead to other muscles and joints upwards to deviate. Proper arch support for your feet gets to the root of the problem by providing structure so that your knees, hips, etc. will be better supported. If you have back pain due to improper shoe wear and you get a back massage, it may feel good at the moment but it’s not addressing the root of problem according to Rimawi.

The foundation of stability lies within your feet.

Mohammad Rimawi, DPM

WHEN IN DOUBT, GET AN EVALUATION

The best preventative measures is to get an evaluation by your podiatrist. If you’re on your feet all day, you can’t afford to have improper footwear. Period. We tend to only seek help when it’s needed or once you’ve reached the point of pain. According to Rimawi, 80% of people experience foot pain, yet only half will go visit a podiatrist. Listen to your body. If you have limb length discrepancy, there are signs that it is impacting your posture, such as shoulder tilts and even head tilts. A podiatrist will help you get the proper footwear you need to accomodate for your leg length discrepancy.

BURNOUT FROM A TOXIC RESIDENCY

Unfortunately, physician suicide and stories of injustice stemming from the workplace are common yet are swept under the rug. You can have empathy reading the stories about the residents that had 90 hour work weeks, missed breakfast, lunch, and dinner, and were subjected to consecutive 30+ hour shifts. In some cases burnout is being described as moral injury. Nevertheless, there is a problem to be dealt with. In Rimawi’s experience of his residency in Philadelphia, he described that the workload and work hours were long, but the culture and community was supportive. During his prior residency in Georgia, Rimawi experienced the height of loneliness and injustice. He did observe a colleague go through alcohol and substance abuse to cope with the injustices at work and unfortunately lose his ability to practice podiatry.

We are resilient in healthcare already. To approach solutions to burnout, we don’t need a resilience class because we already have it in us. When Rimawi gave a speech to his graduating class, he listed all the stats of all the tests his class took, all the grads, etc. Then he said: “This is not why everyone should be proud of themselves today. Everyone should be proud of themselves because no matter what life threw at us throughout this four years of obstacles, we still managed to make it through.”

An inefficient doctor is ineffective with their patients.

BREAK THE CHAIN

Despite where you are in the country, a high-powered program is usually high demanding on your resources. The fix? According to Rimawi, the fix has to be internal. Chief residents have to take care of their under-year residents. When things get out of hand, they have to report it to their attendings or director of the program. Someone has to make their voice heard and often times in the medical field, people may be afraid to do so because of an old cultural mindset. Rimawi admits that it is scary to make change. Sometimes, it may not be possible or you may face consequences of doing so. In Rimawi’s experience, it takes one good year of actively working together to change the work culture to begin turning things around for future residents. If you truly believe there is a violation of your human rights, negligence, fraud, (i.e. residents forging the time table) etc., no shame in being a whistleblower. An inefficient doctor is ineffective with their patients. When the cons outweigh the pros, you have to make a decision- whether that be talking to someone in the hospital or leaving that job/residency altogether.  Even if you have to click restart and start over again, then do it. It’s hard especially knowing that you’ve invested so much time and work in your career path.

AND IF NOTHING ELSE…

Leave a toxic program or job with grace. Be a part of the CHANGE in a system. Role model the desired behavior. Don’t ‘get back’ at people, but take the higher road of dignity when possible.

Connect with Dr. Rimawi:

https://www.grandcentralfootcare.com/

https://www.instagram.com/nycfootdoc/


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