Doctor Heals Heels Without Surgery

Tuesday, February 17, 2004

By Bob Shryock
bshryock@sjnewsco.com

Dr. David Zuckerman says his business partnership with Denise Ashcraft originated "through a fluke."

Hired by the Woodbury podiatrist to get his computers on target, Ashcraft came up with the idea for an equipment provider for physicians who practice ESWT, or Extra-Corporeal Shock Wave Therapy, an 18-minute non-surgical procedure that enables them to cure chronic heel pain without the risk of surgery and long recovery periods.

Three years later, Zuckerman is podiatric medical director and Ashcraft managing partner of ESWT. Zuckerman and Ashcraft deliver equipment -- the Dornier EPOS Ultra machine -- through their mobile treatment center or in-office. Zuckerman claims the Ultra is the highest quality equipment available for ESWT treatment.

"ESWT benefits patients because their condition can be treated extracorporeally, meaning outside of the body," says Zuckerman. "Because the treatment is non-evasive, many of the expenses and risks of surgery are eliminated."

Zuckerman, a 1972 Salem High School graduate who has specialized in heel pain during his 22 years as a Gloucester County podiatrist, learned about the ESWT procedure through correspondence with doctors in Europe. Developed by Dornier MedTech to break up kidney stones and later discovered to aid orthopedic use in treatment of soft tissue and some bone injuries, the process is 10 years old and was used first in Europe and Canada as a cure for chronic plantar fasciitis and Achilles tendonitis.

The Zuckerman/Ashcraft FDA-approved machine has in line ultrasound, which permits doctors to view the injury. Ultrasound sends shockwaves to the unhealthy tissue.

The process is provided in a comfortable treatment center where "you can read, watch TV, enjoy a refreshment and relax."

Zuckerman is the son of well-known Salem County podiatrist Dr. Sam Zuckerman, with whom he practiced for a few years before opening his Woodbury office in 1982. He has an undergraduate degree from Upsala and his medical degree from the Ohio College of Podiatric Medicine.

Zuckerman began using the ESWT procedure before meeting Ashcraft. Half of his practice is now ESWT and he has taught more than 100 doctors, most of them on the East Coast.

That represents about a sixth of the 600 doctors capable of doing the procedure. There are now more than 100 machines nationwide and the 2,000th procedure was recently performed.

"Forty-five minutes when we started, 18 now," says Zuckerman. "Ultrasound has increased the success rate to 94 percent from 80."

Although Zuckerman may have the higher profile of the two, Ashcraft is an organizational expert "who runs the entire office," which includes an office staff of eight. They're busy and getting busier. Even a member of the Philadelphia Eagles' medical staff sent Zuckerman a patient.

And the process soon will expand to include other areas of the body, such as tennis elbow.

"I don't do heel spur surgeries anymore. We used to have (kidney) stones cut out. Now we shock them out. It makes sense to avoid surgery."

Zuckerman says that can equate to a lot of people -- 75 percent of Delaware Valley residents will have a foot problem at some point in their lives, 15 percent of that number will have a heel spur, and 10 percent will need surgery "or face living in pain."

ESWT studies using the Zuckerman/Ashcraft protocol reveal significant success. The average pre-treatment pain level among 150 tested patients was 7.7. After one ESWT treatment, the average dipped to 0.6.

"That's a much higher rate of success than any non-surgical or surgical procedure," Zuckerman says. "And ESWT can't cause further harm such as nerve damage or infection, as we know surgery can."

Ashcraft, a Mullica Hill resident who has a business management background in the toy industry, says she "brings the consumer market to medicine. We treat people so they have a positive experience the whole way through."

Ashcraft saw a need and demand for shock wave therapy and reasoned there was a financial burden on a solo practice like Zuckerman's. Hence her idea for the EPOS Ultra.

There's at least one concern: Insurance remains the No. 1 current issue.

"We're standing at the crossroads," Dr. Zuckerman says. "But major insurance companies are working with us and evaluating treatment. After all, we're offering an alternative for surgery."