“Good Doc! Got me right in, took care of the problem, gave me a valid and helpful lecture on diabetes.”Google · Bob Swartz · May 2018
“Dr. Patish is amazing! He has transformed my huge swelling legs over the past months.”Yelp · Marie K. · Aug 2019
“He is amazing — he truly cares about my quality of life.”Healthgrades · Mar 2019
“He helped my mom who has dementia. He was perfect.”Yelp · Elizabeth F. · Mar 2018
“Staff is always friendly. Dr Patish takes his time and explains everything in detail.”Yelp · Barbara P. · Nov 2023
“Dr. P, Ms. Theresa, and Ms. Maria are some of the kindest people you'll ever meet.”Google · Charles Ward · Jan 2026
“For fifteen years I saw countless doctors for pain in the ball of my foot. Dr. Patish's diagnosis was dead on.”Google · A. Holston · Jan 2023
“A front office that runs smoothly — you know the doctor MUST be a true professional.”Google · Jerika Steele · Oct 2023
“Good Doc! Got me right in, took care of the problem, gave me a valid and helpful lecture on diabetes.”Google · Bob Swartz · May 2018
“Dr. Patish is amazing! He has transformed my huge swelling legs over the past months.”Yelp · Marie K. · Aug 2019
“He is amazing — he truly cares about my quality of life.”Healthgrades · Mar 2019
“He helped my mom who has dementia. He was perfect.”Yelp · Elizabeth F. · Mar 2018
“Staff is always friendly. Dr Patish takes his time and explains everything in detail.”Yelp · Barbara P. · Nov 2023
“Dr. P, Ms. Theresa, and Ms. Maria are some of the kindest people you'll ever meet.”Google · Charles Ward · Jan 2026
“For fifteen years I saw countless doctors for pain in the ball of my foot. Dr. Patish's diagnosis was dead on.”Google · A. Holston · Jan 2023
“A front office that runs smoothly — you know the doctor MUST be a true professional.”Google · Jerika Steele · Oct 2023
When Should You Actually See a Podiatrist?
Not every foot ache needs a doctor. But some do — and waiting can make things worse. Here's how to tell the difference.
Diabetes affects the whole body, but the feet often take the worst of it. Nerve damage dulls sensation. Changes in the blood vessels slow healing. Shifts in foot structure create pressure points. By the time a patient notices a problem, it may already be well along.
That is why the partnership between endocrinologists (diabetes and hormone specialists) and podiatrists (foot and ankle doctors) matters so much. It is also why regular diabetic foot screening helps prevent the ulcers (open sores) that lead to amputation.
A quick note before we start. This article is general education for referring clinicians and patients, not medical advice. A red, hot, swollen foot, a new open sore, or drainage in a person with diabetes is urgent. Call right away or go to urgent care rather than waiting for a routine visit.
What a Comprehensive Foot Exam Actually Involves
A proper diabetic foot exam goes well beyond a quick look. It includes monofilament testing (touching the foot with a thin nylon thread) to map where sensation is lost, and a tuning fork to test vibration. We check the pulses, inspect the skin and nails, note every deformity, and look for pressure points. This kind of exam takes time. It is also exactly what podiatrists are trained to do, visit after visit.
The goal is to sort patients by risk. Which patients are at low, moderate, or high risk of an ulcer? The answer sets the prevention plan and how often we need to see them. The 2023 International Working Group on the Diabetic Foot guideline (Bus and colleagues, Diabetes/Metabolism Research and Reviews) sets the schedule. Lowest-risk patients get screened at least yearly for loss of protective sensation (no longer feeling a pin or a pebble) and poor circulation. Visits get more frequent as risk rises.
Pre-Ulcer Lesions: The Window of Opportunity
A callus with bleeding underneath. A deep crack in the heel. A warm, red patch over a bony bump. These are the signs that an ulcer is forming. Caught early, simple steps can stop it: trimming the callus, taking pressure off the spot, and protective footwear. The same guideline lists treating pre-ulcer lesions and prescribing pressure-relieving footwear among its core advice.
This is where regular podiatric visits earn their place. A prevented ulcer is a prevented infection, and often a prevented hospital stay.
When Things Get More Serious
An open diabetic foot ulcer needs coordinated care. Careful removal of dead tissue so the wound can heal. Offloading with a cast or a walker boot to take the weight off. Checking for infection and treating it. Close follow-up until the wound closes. Deep infection, bone involvement, or poor blood flow means a vascular surgeon (blood-vessel surgeon) or a hospital wound team joins the case. We make that call early, not late.
Charcot foot is the hot, swollen foot that can collapse from the inside. Catching it early and getting it into a cast or a boot right away can be the difference between a foot that works and a lasting deformity.
What We Offer at Fallbrook Podiatry
Our practice covers diabetic foot care from routine screening and custom orthotics through office wound care and the minor procedures that go with it. All of it is done under local anesthesia in the office. Larger reconstructive or vascular work is referred. We work with endocrinologists, primary care physicians, and vascular specialists across North San Diego and Riverside County.
If you are a physician who wants a referral relationship for your patients with diabetes, we keep it simple. See our endocrinology referral page or browse all the specialties we partner with. Patients can call (760) 728-4800; most are seen within a few days.
Learn more from the American Diabetes Association: Foot Care, NIH: Diabetic Foot Problems, and the IWGDF 2023 prevention guideline.
Frequently Asked Questions
How often should a patient with diabetes have a podiatric foot exam?
At least once a year for patients at the lowest risk, and more often as risk rises. Nerve damage, poor circulation, a deformity, or a past ulcer all move a patient into a higher-risk group with closer follow-up. That matches the 2023 International Working Group on the Diabetic Foot guideline.
What should I do if my patient has a new foot ulcer?
Call us the day you find it. Early wound care, offloading, and infection control matter most in the first days. If there is deep infection, exposed bone, or poor blood flow, the patient may need a hospital wound team or a vascular surgeon, and we help arrange that.
Do you provide therapeutic shoes and inserts for patients with diabetes?
We evaluate for them and prescribe custom orthotics when they are appropriate. Coverage rules for therapeutic footwear require documentation from the physician managing the diabetes, and we coordinate that paperwork with your office.
