UT Health San Antonio at 50: A Slideshow

In September 1991, Podiatry Today highlighted the thoughts of Louis Bogy, DPM, and others surrounding UTHSCSA’s podiatric residency program, the first supported by an allopathic university system. Now over 3 decades after this article, the program has yielded many landmark leaders in podiatric education and research.

Lawrence B. Harkless, DPM, FACFAS, MAPWCA, cites the uniqueness of the program, saying it was one of the few programs that was fully integrated in a major academic health science center and had state support to train residents in podiatric medicine and surgery.

Lawrence Lavery, DPM, calls the program “transformational,” and says it was driven by evidence-based medicine from an early stage. “That was the foundation for me to examine questions and then try to get answers that are better and based on evidence,” he says.

Dr. Satterfield remembers working “ridiculously hard, sometimes soul-crushingly hard” but says the work “created some purpose in us that I did not experience elsewhere. “Our UTHSCSA grads are star researchers, educators, trailblazers, here and around the world,” says Dr. Satterfield. “That reputation came at a price, whether it was with families or even health. But it all centered around one thing—the patient.”

Charcot foot has been the subject of much study at UT, including describing its natural history, how deformity leads to increased peak plantar pressure, treatment with total contact casts, and the first study to describe using skin temperature to monitor response to treatment.

Brand recognized that the most frequent sign of inflammation was pain, but with neuropathy, patients lost the “gift of pain” and temperature could be used as a sensitive indicator. As technology became more accurate and accessible, UT studied the temperature difference between feet and validated Brand’s hypothesis.

Javier La Fontaine, DPM, MS, MEd, says his time in the program expanded his capacity and ability, helping him transcend his limitations. He also cited the camaraderie he found there. “Most of my career has been dedicated to the diabetic foot and obviously the comprehensiveness of evaluating patients who have diabetes,” says Dr. La Fontaine. “Each patient is an individual and not a number. I learned that from here and I always will be gracious about the fact that I came through here and learned that aspect of managing patients that way.”

After Dr. Harkless attended a 1981 course on total contact casting (TCC), UT over the next 25 years promoted the use of the TCC, which has become the gold standard in offloading the diabetic foot. Research from UT later proved that removable cast walkers (RCW) can offload as well as TCCs.

“We're a specialty,” asserts David G. Armstrong, DPM, MD, PhD, “and the reason we're a specialty is because of programs like this that have integrated it … and made it equal. It's folks like Louis T. Bogy, and Lawrence B. Harkless that have gone through, done the work and effected change.”