Timothy K. Fisher, DPM ’02 Brings Innovative Podiatry and Wound Care Treatment to the Middle East.
There are more than 15 million people in the Middle East with diabetes, and it is estimated the United Arab Emirates (UAE) has the second highest incidence of the disease in the world. As many as 20% of these people will develop a foot ulcer due to complications of diabetes and amputation of a lower limb will be a harsh reality for many of them. Timothy K. Fisher, DPM ’02 is working to change that.
Dr. Fisher is a Podiatric Surgeon and certified physician in wound care. The first licensed Doctor of Podiatric Medicine (DPM) in the UAE, Dr. Fisher founded the American Diabetic Limb Salvage Institute in Dubai. The institute is the first dedicated center in the Middle East focused on preventing and reducing the rate of amputations in people living with diabetes. Under Dr. Fisher’s leadership, the center partners podiatric and vascular surgeons who use state of the art techniques to diagnose and treat those with lower extremity complications of diabetes. Cutting-edge wound care therapies, preventive medicine and education all combine to reduce amputation rates among the center’s patients.
The institute and his work in Dubai form the latest chapter in a remarkable medical career that Dr. Fisher says actually began during his studies at Daemen.
Dr. Fisher grew up in Cape Cod, Massachusetts, and had always wanted to be a physical therapist. His father was a nurse educator and Dr. Fisher was exposed early in life to the medical field. During high school, he says he observed physical therapists at work through his father’s contacts at area hospitals and he developed a keen interest in the PT profession. This interest led him to choose Daemen for college.
“Daemen had a good reputation for its physical therapy program and I was attracted by the smaller size of the school,” he notes. “That, and the fact that I could play college basketball there influenced my decision to attend Daemen.”
Dr. Fisher enrolled in Daemen’s physical therapy program and he played as a shooting guard on the basketball team for a couple of years. He says he liked the personal atmosphere of the college where faculty members were always easily accessible to answer questions or address any concerns. He became a Residence Assistant (RA) on campus and served as the head RA for two years.
There were a couple of occurrences at Daemen that would ultimately influence the course Dr. Fisher was following toward his medical career. First, he met his future wife, Elmira, at Daemen in an anatomy lab, as she too was studying physical therapy. Next, as he reached the final year of his PT studies, he decided to change majors to biology, aiming to broaden his career prospects. He says in the back of his mind he had always thought about becoming a doctor but was not sure which discipline interested him most.
Around this time, one of his biology professors at Daemen, Dr. Brenda Young, gave him some information on a podiatry school she thought might interest him. After reading the information and researching the field, he found the versatility of a career in podiatry intriguing. Following graduation from Daemen, he and Elmira headed to Florida where he enrolled at Barry University to study podiatric medicine and surgery, and she secured a job as a physical therapist in a Miami hospital.
Developing a specialty
Dr. Fisher notes his Daemen education was a great advantage during his studies in podiatry school, as he was already familiar with required courses such as anatomy and biology. Hands-on learning assignments — known as externships at Barry — took him to Fort Benning, Georgia, a podiatry program at Harvard University, and the Veterans Affairs (VA) Medical Center in Miami. Upon earning his DPM degree, Dr. Fisher entered a three year program as a resident podiatric surgeon at the VA in Miami. He began working with a diversity of patients including diabetic and wound care clients. Responsibilities included managing a wound care clinic at the VA where an array of wound care techniques were used, including preventative surgical measures and diabetic limb salvage.
“As a resident at the VA, we would see between 40 to 60 patients a day,” Dr. Fisher recalls. “It could at times seem overwhelming, but it was an important growth period in my career.”
The doctor again points to his Daemen education as a great help during his time at the VA. He notes that he first studied wound care at Daemen in the biology program while working on a research paper required for graduation. He worked with a number of doctors at Daemen researching Platelet Derived Growth Factor (PDGF) techniques aimed at helping wounds heal faster. His residency at the VA put him in contact with many veterans who had diabetes and often times suffered from intense wounds due to complications of the disease.
Focusing on diabetic patients
Dr. Fisher says he found that working with diabetic patients as a resident at the VA was the most rewarding. Upon completion of his residency, he chose to pursue a fellowship at the University of 27 Arizona College of Medicine in the Vascular Surgery Department. Essentially an additional year of training, the Fellowship involved Dr. Fisher in the Southern Arizona Limb Salvage Alliance (SALSA), an innovative initiative that teams podiatrists and vascular surgeons in treating complicated diabetic foot wounds. The aim is to prevent amputations among diabetics due to foot wounds and other problems.
The work he did with SALSA exposed Dr. Fisher to a groundbreaking approach of bringing two specialties together — podiatry and vascular surgery — in one center, on one team, to better treat diabetic patients. In involving vascular surgeons, the aim is to improve circulation in the patient’s limbs to prevent and/or promote faster healing of wounds, and thus prevent amputations that may result from infected wounds.
“Podiatrists and vascular surgeons made rounds together, we treated patients as a team, and worked around the clock together,” he explains. “It was a unique situation, since my colleagues were right across the hall.”
Dr. Fisher was a Fellow, but he also had an academic position at the University of Arizona and was a clinical instructor within the Department of Vascular Surgery. In addition, he and the SALSA team were heavily involved in research and at any given time, they had 10 to 15 research studies underway related to their work in limb salvage.
Moving to Dubai
When his Fellowship in Arizona was completed, Dr. Fisher began planning the next step in his career. His wife’s sister lived in Dubai and on a visit, Dr. Fisher began to look at opportunities for podiatrists. He saw a great lack of podiatry care and also the high rate of diabetes in the UAE.
The couple decided to move to Dubai and Dr. Fisher found an opportunity to establish a diabetic foot clinic in a brand new diabetes care center in the nearby emirate of Ajman funded by the UAE government. He was able to use his experience with SALSA to set up the clinic and introduce a similar approach to patient care in Dubai. Before leaving the clinic to start the American Diabetic Limb Salvage Institute, Dr. Fisher was seeing between 20 and 30 patients a day.
At the American Diabetic Limb Salvage Institute, Dr. Fisher has partnered with a vascular surgeon to create a model of diabetic foot care like SALSA. The private practice continues to grow with Dr. Fisher as its director, along with two vascular surgeons and nurses.
Dr. Fisher says he finds the people of Dubai extremely warm, respectful and welcoming and enjoys living in the UAE. His plans are to continue directing the institute and promoting diabetic care, but he says a return to the United States is not out of the question.
When informed about the establishment of the Daemen College Physical Therapy Wound Clinic, Dr. Fisher applauded the initiative. “It is extremely important for universities and colleges to teach and promote wound care — wounds are a harsh reality that have to be dealt with,” he explains. “The more education, and the more people trained in how to help wounds heal faster, the better treatment will be for patients.”