Dear Doctor: Nelya Lobkova
The founder of Step Up Footcare on the challenges and rewards of starting your own practice.
As a young athlete, Dr. Nelya Lobkova understood the importance of getting back on your feet after an injury or setback. Today, Dr. Lobkova is an ABPM (American Board of Podiatric Medicine) Certified Surgical Podiatrist and founder of Step Up Footcare located in Tribeca, in downtown New York City. Passionate about providing her patients with compassionate care that makes the most of technological innovations in the field, Dr. Lobkova has become the go-to expert in diagnosing and treating sports injuries, such as those commonly incurred by runners, bikers, skiers, and dancers. Here’s how she got started and why she believes that minimally invasive procedures with reduced recovery time are the way of the future.
Finding a love of sports medicine
I loved sports as a child and enjoyed going on Nordic-style cross-country skiing trips with my dad. He and I would drive up to Vermont from my childhood home in Brooklyn and we even entered a few local cross-country skiing competitions. One year I suffered a minor injury and ended up visiting a sports medicine doctor for the first time. I had always been interested in the field of medicine, even though no one in my family worked in the industry, and quickly found a deep connection with sports medicine. I was attracted to the idea of helping people and sports medicine seemed like the perfect blend of my personal and professional interests.
On how innovation in technology shaped her practice
Before opening my practice in August 2019, I thought a lot about what was important to me in terms of building the business. Chief among my priorities was incorporating the most cutting-edge technology in regards to recording health histories, booking appointments, and facilitating patient-doctor communications. I also believed it was important to have a strong digital presence not just with a website but on other popular search and social channels as well. Recent advances in technology over the past ten years have made reaching these goals much more achievable. For example, creating a website today is extremely accessible using platforms like Squarespace. Medical professionals like myself can set up their website and run Google ads without the help of intermediary agencies, so in that respect innovation in technology has been crucial to building the fundamental elements of my practice.
Technology also plays an important role in the medical side of my practice. One particularly exciting technology that I use in the office is microwave therapy for plantar warts, which is a non-invasive but very effective technology that few other doctors are utilizing. I also have a dynamic gate scanner that I used to make custom orthotics. As I continue to build my practice, I plan to prioritize new technologies so that I can offer the best and most dynamic solutions to my patients.
On the biggest challenges of working in sports medicine
The most common challenge I face in sports medicine is working with patients who are passionate about sports and therefore expect positive outcomes very quickly. I had similar expectations after my first cross-country skiing accident, so I understand how important recovery is with a patient who is active and highly passionate about sports. Still, it can be challenging to get through to those highly motivated patients and help them understand what the healing process is really like. There is no such thing as a fast fix in sports medicine; it’s never as simple as going in for one quick shot or prescription. Often times, patients undergo a longer course of treatment or multiple treatments and adjusting to that timeline can be tough, especially if the patient has to temporarily abstain from their regular physical training routine. If they come into my office expecting a quick fix, my job is to realign their expectations so that they can have a successful recovery.
On the most exciting advances on the horizon in podiatry
Recently, there have been a lot of exciting advances in regenerative medicine. In fact, sometimes it’s hard to keep up! One example is something that I perform in the office called amniotic tissue graft injections, which is a process wherein I inject amniotic tissue from healthy placentas into areas of chronic or acute injury to promote healing and regeneration. We also use bone graft material for bone loss and have skin replacement procedures in place, but what the medical community has yet to develop is a sufficient cartilage replacement procedure. When developed, this will be a huge advancement, particularly for the aging and arthritic populations.
I’ve also noticed that in the realm of surgery, patients are beginning to request more minimally invasive procedures, as well as procedures that require less recovery time (especially in sports medicine). As a result, there’s already a small group of us in podiatry that’s performing these minimally invasive procedures. It’s not yet mainstream, but I think that’s where we’re headed simply because the patient demand is there.
On building out her podiatry practice
Since I just opened my practice six months ago, it’s very much an experience that I’m still learning from and living through, but the first piece of advice I’d give to any aspiring business owner is to have a plan. You cannot jump into this experience blindly — doing your research will go a long way. Ask your peers, collect knowledge and words of advice everywhere you can, and know what your business goals are before you get started.
Another important element of this process is finding and asking for support. I could not have built my practice without the support of my colleagues, employees, and family. Starting your own practice isn’t easy and certainly will not be a 9-to-5 gig. You have to prepare to work all day and all night, at least in the beginning! When I come home from the office my work continues, whether I’m following up with patients, checking the work that was performed, or preparing for the day ahead. Having support on both the home and office fronts makes this all the easier.
Thirdly, prepare for disappointment because there will always be something that doesn’t go exactly according to plan. Learning how to pivot and adjust your strategies is crucial to staying afloat.
Finally, it’s important to learn the ins and outs of the business world. Since the business aspect of starting your own practice is not something that’s covered in medical school, there may be some catching up that you have to do in terms of learning how to set up billing procedures, collect insurance, etc. Start learning these procedures early if you can, and you will feel more prepared once your plans are set in motion.
Despite the difficulties, I’ve found owning my private practice to be the most rewarding experience of my career to date, especially in New York City. Even though we are a practice in a city of hundreds of practices, building a client community and being able to see the difference we’ve made in their lives has made the process well worth it.
Vital Signs
What’s your go-to breakfast? I have two young children, so breakfast is somewhat of a luxury. That being said, when I can, my go-to breakfast is muesli that I prepare the night before, leave overnight in the fridge, and then is ready to eat as soon as I wake up!
Do you have a favorite getaway destination? My family and I like to go on road trips. One of our favorite spots is a bed and breakfast maple farm in Lake Placid. We’ve been there often enough that we know the owners, and now it feels like our home away from home.
What’s one healthful habit you’d love to see patients adopt? Check your feet every day, and don’t let anything fester. If something doesn’t feel or look right, go to the doctor. Don’t wait until it becomes worse.
What’s the best way to take care of your feet when living in a fast-paced, concrete-filled city? Wear proper shoes, especially according to your activity level. For example, if you know that you’re going to spend the majority of the day standing, don’t leave the house in stilettos. Be conscious of your footwear and aligning what you wear with what you do during the day.
You can learn more about Dr. Nelya Lobkova by following her on Instagram here.
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