Putting their best foot forward

It takes a special person to practice podiatry—someone who literally puts his or her best foot forward. There’s nearly a decade to invest in education and training. There’s a heavy workload after entering practice. And, on top of all that, there’s the specialization on a part of the body that most people don’t find too glamorous.

The foot.

With so many fields of study in medicine, what drives someone to become a podiatrist?

“For some reason, my patients all think I have a foot fetish, and I don’t,” said Dr. Dennis Trenner, a podiatrist who, along with his partner, Dr. Chelsea Smith, recently transferred his practice to Oroville Hospital. “It has nothing to do with that. It’s just a part of medicine. I met a couple podiatrists while I was working at Kaiser, they seemed like nice guys, and they were encouraging me to go in that direction.

“A lot of people are grossed out by feet,” Trenner acknowledged. “It’s just one of those things where you have to like the part of the body you’re working on. There are some specialties I wouldn’t like to venture into.” (On that list: obstetrics/gynecology and gastroenterology.)

Smith got inspired to enter podiatry after job-shadowing her future partner, Trenner.

“I explored the different specialties in medicine, and I really liked working with Dr. Trenner,” she said. “The work is very hands-on, a mix of surgery and clinic that’s very fun. A lot of the problems you encounter in podiatry aren’t life-threatening … and lifestyle is another part of it.”

Podiatry is pretty much a day job; emergency calls to the hospital are rare. So, for the select few who can handle hours upon hours focusing on feet, the specialty does have its up-sides.

Trenner sees between 35 and 40 patients per day, with most Fridays dedicated to surgeries. Smith’s practice is still growing, so she varies the days she’s in the office and in the hospital. They are not the only podiatrists in the area—Trenner said Chico has seven podiatrists, Paradise three—yet Trenner and Smith have a busy practice.

“It’s a pretty steady flow,” said Trenner, who’s practiced in Oroville since 1990.

Smith, an Oroville native, joined Trenner’s practice three years ago. Last year, they decided to forgo independent private practice to sign on with Oroville Hospital, a process that took approximately a year.

“It’s a trend,” Trenner explained. “The trend is that most doctors are going to be moving into group practices or under the umbrella of hospitals. We just jumped on the wagon.”

Added Smith: “Insurance companies are changing so much; medicine is changing so much that it’s uncertain where things are going. So I think it’s one of those safeguards, where if you’re part of a bigger organization, there’s more comfort in that.”

Fortunately, their office already was located in the vicinity of the medical center, so they didn’t need to move. They haven’t had to alter the way they practice medicine, either.

“They [Oroville Hospital administrators] didn’t want anything to change,” Trenner said. “They wanted the flow to stay the same. Patients were comfortable with our location, so they kept us here with most of our same employees.”

Trenner, who’s married with three adult daughters and three grandchildren, attended Portland State University and then the California College of Podiatric Medicine (CCPM) in Oakland (now part of Samuel Merritt University). Upon receiving his DPM (doctorate in podiatric medicine), he completed a surgical fellowship at Stanford University.

He joined the practice of Dr. Calvin Leyland, who had offices in three cities. Trenner bought the Oroville office, and it was that office where Smith made her fateful career decision.

Smith comes from a medical family: Her father, Dr. Richard Smith, practiced internal medicine in Oroville for 30 years, and her mother was an intensive-care nurse. Chelsea Smith graduated from UC San Diego, then CCPM at Merritt University, before completing her surgical residency in Hayward.

Returning to Oroville wasn’t a foregone conclusion, but …

“It worked out that way,” Smith said. “I discovered over time I wasn’t much of a city person. I really like small towns, and I was drawn to be closer to family, so that brought me back.”

Trenner and Smith are similar physicians with similar personalities.

“You’re almost getting a mirror image,” said Trenner, to which Smith agreed. Continued Trenner: “We’re both pretty laid back—not high-intensity people. We both work hard and enjoy what we do … But most podiatrists seem to be pretty laid back, kick-back. You have to have a certain mentality to do the type of profession you do.”

What do podiatrists do?

“It’s pretty diverse,” Trenner explained. “Anything that goes on with the feet and ankles, we usually address.

“We treat soft tissue to the knee and bone from the ankle down. We do everything from routine care—cutting people’s toenails—to treating sports-medicine conditions and diabetic wounds, to reconstructive surgery on the foot. It’s a vast array of things.”

Prevention can forestall some of the problems podiatrists see. Both Trenner and Smith recommend people pay attention to cleanliness and footwear.

Smith: “A lot of people tend to fall into the trap of cheap shoes, and that can lead to problems over time. Try to make sure you’re wearing decent shoes that have support, have stability, aren’t so flexible there’s no support.”

Trenner: “Be proactive on foot hygiene. We’ll get diabetics who develop cracks on their heels and they become bigger ulcers in time. Even if you’re not diabetic, we see a lot of people who don’t keep their feet in good health.

“It’s not like you go to the dentist and eat a burrito before he’s going to look at your teeth,” Trenner added with a chuckle. “A lot of people come in and you think they just got off the farm; it’s kind of shocking. But most people are pretty conscious of it.”