I found Dr. Segler through a google search: ‘sports podiatry san francisco’. He had a smart web page indicating a fair amount of experience with sports injuries and specifically, running injuries which was my complaint. 

The house-call M.O. lit up two distinct regions of my brain. The amygdala weighed in first wondering if this guy was a fly-by-nighter. Docs don’t make house calls anymore (I’m actually old enough to remember when they did!). Then the cortex posited ‘Doc On The Run’ was more than a clever double entrendre but a way to beat the competition by reducing fixed overhead. Price an EMR software lately? 

Made the call and he called me back a few hours later. A brief description of my complaint, an appointment and 20 minutes later I was under the x-ray machine. 

DOTR showed up a few days later with his light box, foot skeleton and satchel of tools and information. I had previously emailed him my running history, gait video, UCSF  RunSafe analysis, injury date / circumstances, current PT regimen, expectations and a list of specific questions. I was pleased to learn he had not only reviewed my lengthy email but had printed a copy for my file. After a bit of chit chat he jumped right into pushing and prodding my dinged foot. He walked me through the x-rays and provided an enlightening anatomy lesson. Bones looked normal. He did some more pushing an prodding, strength testing and measuring before concluding that the culprit was a lesser tendon and restorable with proper rest and inflammation control. Oh, and I could be back on the trail in 2 weeks provided no pain. 

A couple remarkable things: First he uses his smartphone as an EMR. Not the most mineable medium but one that would make Occam proud. Second: What he DIDN’T say upon parting: ‘I’ll see you in 2 weeks’. Which is exactly what my previous ‘sports medicine’ doc said a week prior after waving a magnet over my  foot. Yeah.

I’m a special needs case as I do really stoopid things like run 50 miles at a time or do 3 back-to-back tempo runs followed by a 30 miler at *half-marathon* speeds :/ So I was appreciative DOTR didn’t harsh my mellow with too many borne-on date stories. In fact he almost seemed supportive of my behavior. But then again this guy does 11+ hour endurance events so despite his medical training and carnage exposure, he couldn’t really throw too many bricks in my glass house.

Podiatrists are quick to prescribe orthotics as it’s a) what they are trained to do b) it renders the whole experience ‘tangible’ and c) it’s enhanced revenue. I’m not anti orthotic as friends have benefited from them, but I do think orthotics should be the second to last attempt to correct a bio-mechanical issue. DOTR seems to share this belief, at least with respect to my particular complaint. 

So after a ~2 hour consultation, a diagnosis, a recovery plan, answers to my many questions AND A HAND DRAWN PICTURE OF MY FOOT / CULPRIT!!! I bid him farewell, confident in his knowledge / experience and appreciative of his professionalism. 

Oh and one more remarkable thing: his fee is about half of what a doc-in-the-box would charge. DOTR FTW!”

       Hugh B., San Francisco, CA