Dr. Richard M. Cowin, D.P.M. Minimally Invasive And Laser Foot Surgery's response
First, thank you for reading my response. I am a podiatric foot and ankle surgeon who began practicing in 1980. In a career spanning more than four decades, I have been board certified by a number of certifying boards including The American Board of Ambulatory Foot Surgery (ABAFS), The American Board of Podiatric Surgery, and most recently, the Minimally Invasive Foot & Ankle Surgery Division of The American Board of Multiple Specialties in Podiatry (ABMSP). I understand that the reviewer has seen 3 DPM specialists between FL and NYC. Although their identities are not noted in the review, I’m sure that they, like most DPMs, are highly trained and experienced in “traditional” foot and ankle surgery. Minimally Invasive Foot & Ankle Surgery (MIFAS) is a subspecialty in and of itself. The review does not state whether or not these doctors are Fellows of The Academy of Minimally Invasive Foot & Ankle Surgery and/or board certified specifically in MIFAS by the ABAFS and/or ABMSP, as I am. If indeed they are, it is highly unlikely that they would be critical of the procedures performed in this case.

The procedures that I perform are not experimental and are in full compliance with the Standards of Care and Preferred Practice Guidelines of The Academy of Minimally Invasive Foot & Ankle Surgery (formerly The Academy of Ambulatory Foot & Ankle Surgery) who, a number of years ago, presented me with their prestigious Hall of Fame Award. I am also a human being and far from perfect, although I always try my best. Throughout my long career, I have tried my best not to meet, but to exceed the expectations of my patients. To say that I’m deeply saddened when I’m unable to do so is an understatement. I’m very sorry that my sincere efforts are unappreciated and that I was unable to please her.

In my office, we love performing new patient consultations. We usually allow a full hour for them and they are performed free of charge (including x-rays), because we believe that people have a right to know the answers to the following questions: 1) what is wrong with their feet? 2) what are their treatment options? 3) how and where are these procedures generally performed? 4) what are the potential benefits and what are the potential risks and complications of these options?, and 5) how much do these options cost By the way, we encourage potential patients to get 2nd (and 3rd) opinions and in such cases that we feel that another doctor or other medical practitioner can help the patient better than we can, we freely make such referrals.

Because we perform all of our surgical procedures in our own office operatory rather than a surgery center or a hospital, we have considerably more expense than do most of my podiatric and orthopedic colleagues who perform their surgical procedures in ambulatory surgery centers and hospitals, who, of course, charge separately for their facilities. These extra expenses include a surgical tech who assists me when I perform surgery, as well as the costs of purchasing and maintaining equipment, instruments, and medical supplies. Because we perform all of our procedures under local anesthesia, we save patients and their insurance companies from the costs of paying anesthesiologists and nurse anesthetists. Because we rarely insert surgical screws, pins, plates, or implants, we can save these sometimes considerable hardware costs to patients and their insurance companies. Because we take and interpret our own x-rays (two separate services), we save patients and their insurance companies from those costs, as well. Once we have provided new patients, with this information, there is absolutely no pressure on anyone to schedule with us. We do not reach back out to contact patients who have taken advantage of our free consultation program.

Our overall patient satisfaction with the technique we utilize for custom orthotics and the lab that fabricates them has been overwhelmingly positive. I wear them myself, as do my family members.

I thank the reviewer for her 4 star rating on punctuality, as we make every effort to see patients at their scheduled appointment times. I also very much appreciate the reviewer for her 4 star rating of my staff, who have been with me for many years and who are truly Blessings to me and my valued patients every day. It is noteworthy that in the recent past when I saw the reviewer in my office for her last appointment, my staff members came up to me afterward to tell me how pleased they were to see that the reviewer was walking so well, as they remembered how painfully she walked when she first came to us for her initial consultation.

As to the “smiles and niceties” that the reviewer mentioned; people like me and my staff who enjoy their work and who appreciate the confidence that most of our patients have shown in us by entrusting us to treat their foot maladies tend to do that.

Thank you!

Submitted Nov. 15, 2021

Dr. Richard M. Cowin, D.P.M. Minimally Invasive And Laser Foot Surgery's response
My staff and I try VERY hard not to meet, but to exceed the expectations of our patients. We are always disappointed in a case like that where we are unable to do so. HIPAA regulations prevent me from going into any specific detail, but while this pt. is very nice, the fact is that we provided the patient/reviewer with our fees and office policy in writing after performing a free comprehensive consultation and x-rays and prior to performing any additional charged services. Due to the patient/reviewer's busy schedule, additional time allowances were made. All promised services were delivered to the best of our ability and in fact, additional free visits were included. The patient was provided with fee quotes for both EPAT and orthotic therapy and the pros and cons of both were discussed in detail a number of times. It was a mutual decision made as a result of sound medical judgment. Recommendations were made by me based on many years of experience and with the patient/reviewer's best interest in mind and at no time was there any request for a refund until many months had transpired and the custom orthotics were well past the allowable time stated in our written office policy and long past the time that we could return them to the orthotic lab for credit. In our experience with EPAT for the treated condition, it generally offers only short-term relief, versus custom orthotic therapy which offers long-term relief of this condition in most cases. For us, it was about treating the patient the we would want to be treated. Further, we even offered to perform the first EPAT treatment on one of her feet for free (a $295.00 fee) as a courtesy and as she was not pleased with the results of her orthotic therapy and so that she could try it at no charge before deciding whether or not she wished to have additional treatments. I must add that I am DEEPLY offended that she would actually accuse me of stealing. As the patient/reviewer is a medical professional, I would ask the following: If a member of your medical team in good faith did their best to help a patient, accepted a fee to do so, and the patient did not get 100% better, were they stealing from the patient? If we performed EPAT rather than fabricating custom orthotics and the EPAT wasn't successful, as is sometimes the case, would we be accused of stealing because it wasn't as successful as the patient/reviewer and I had hoped it would be? In any case, it is sincerely my hope that the patient/reviewer finds complete relief for her condition elsewhere and is able to walk free of foot pain.

Submitted July 27, 2021

Dr. Richard M. Cowin, D.P.M. Minimally Invasive And Laser Foot Surgery's response
Thank you for your very nice review and comments. unfortunately, I can't take my time with patients and provide them with the highest level of care that that they deserve utilizing the best equipment and instruments available and with a very high quality staff if I accepted the low fees that most insurance carriers offer. We appreciate you coming in and wish you very Happy Holidays!

Submitted Nov. 19, 2019

Dr. Richard M. Cowin, D.P.M. Minimally Invasive And Laser Foot Surgery's response
Pt. not told that and was extremely noncompliant.

Submitted June 18, 2018

Dr. Richard M. Cowin, D.P.M. Minimally Invasive And Laser Foot Surgery's response
Our sincere thanks for your confidence and trust!

Submitted June 18, 2018

Dr. Richard M. Cowin, D.P.M. Minimally Invasive And Laser Foot Surgery's response
So nice! Thank you . This is why I love my job :)

Submitted June 18, 2018