Famed doctor also has critics

OLYMPIA – To foot-surgery students in half a dozen countries, he’s Professor Stephen Isham, with five surgical procedures named after him.

He’s past president of the Academy of Ambulatory Foot and Ankle Surgery, and – in the words of a Spanish physician he taught – “the foot surgeon of the world.”

But there’s one thing that Stephen Isham can no longer be, at least in Washington state: a foot doctor.

Isham, a Spokane-area podiatrist for nearly three decades, has promised state regulators to “not ever resume his practice” in Washington after a complaint over foot surgery he’d done – in Idaho – four years ago.

Isham, the Washington’s Podiatric Medical Board ruled, “performed unnecessary surgery” on a patient’s toes. The initial charges had blamed him for a post-surgical infection that landed the woman in the hospital and deformed her right foot.

In an agreed-to order, Isham disputed the board’s finding but agreed to not work as a foot doctor in Washington, even as a volunteer or in an emergency, for the rest of his life.

In an interview, Isham said that the same allegations were rejected by both a judge and the Board of Podiatry in Idaho, where the surgery took place.

“They said I didn’t do anything inappropriate,” said Isham, 55.

But in Washington, he said, he’s up against a biased state podiatry establishment that’s overly skeptical of the minimally invasive surgical techniques Isham’s helped pioneer. The bone surgery is done through a small incision via small burrs and drills, instead of opening a large incision on the foot. The state Podiatric Medical Board that reviews complaints, he said, is made up largely of traditionalists.

“It’s a kangaroo court,” he said. “The system is not a fair system.”

Isham, whose curriculum vitae is nine pages long, has for years brought in doctors from Spain, China and other countries to study his techniques. He’s taught in Mexico, China and France and soon will teach in Argentina.

He decided not to fight the Washington charges, he said, because it was a moot point. He sold his Washington practice – the Spokane Foot and Ankle Clinic – in 2002. Without a practice, he let his Washington podiatrist license expire the next year.

“Why should I spend $10,000, $20,000, $30,000 fighting for a license that I didn’t have?” he said.

He continues to practice in Idaho, at the Coeur d’Alene Foot and Ankle Clinic. Idaho’s Bureau of Occupational Licenses lists no disciplinary actions against him in that state.

Isham has repeatedly had to defend his techniques. Court records show that he’s faced five malpractice-related lawsuits in Washington since 1994 and been disciplined by state medical regulators four times since 1989.

Among the cases:

“In 1996, a patient developed gangrene after foot surgery, leading to the amputation of two of his toes.

“In 1997, Isham treated a patient with a sore foot, giving him an injection, some pills and suggesting an orthotic insert for his shoe. But the patient developed a severe infection. Isham suggested an infection specialist, but the patient said he’d wait to see his usual doctor. The infection worsened, and he spent nearly a month in the hospital, getting a muscle transplant and skin graft.

For those cases, Isham was fined $15,000, ordered to get more training, and told to write an article detailing how to manage surgical complications and infections.

“In the late 1980s, five patients complained of serious problems with Isham’s work. All came in for foot pain. One, a secretary, had five foot surgeries, one of which allegedly shortened one of her toes too much. Another, a nurse, had surgery on six toes that left some toes “completely out of alignment” according to the board report. She ended up quitting her job due to foot pain. Like the secretary, the nurse ended up having follow-up surgery done by another foot doctor.

Based on those and other cases, in 1999 Isham was fined $21,000, ordered to take two weeks of courses at foot school in Georgia, and told to get a second opinion for some diagnoses.

“The Board recognizes that good results do not always follow from surgeries properly performed,” the ruling reads. The same types of surgery had worked well in other patients of Isham’s, the board acknowledged.

Isham echoes that, saying that he’s had thousands of patients over the years, and that minimal-incision surgery has grown widely accepted in many types of surgery.

“I have very good results as a whole, comparable to traditional procedures, with less pain,” he said. “The world is coming to this (technique), but a small group of podiatrists is resisting it.”

But why so many lawsuits and complaints? Isham says he was unfairly targeted by a Spokane lawyer in the mid-1990s, who ran ads soliciting lawsuits by Isham’s patients. None of the patients prevailed in court, he said, although Isham settled with some.

“All those cases are easily defendable from a medical standpoint,” he said. “But if you have a licensing board that’s against you, you’d automatically lose.”

“I don’t think he should be a doctor,” said Phumee Ralston Elleseg, a Spokane woman who filed suit. She alleged that an injection at Isham’s clinic deformed her hand. She later dropped the case. “I never want to see him again,” she said. “Ever.”

“From all I’ve heard, he did a lot of damage. I’m glad to see the state did something,” said Carlos Creeger, a retired Greenacres telephone installer who went in for foot pain and, years after the surgery, said he still can’t walk more than half a block without agony.

Isham maintains that time will vindicate his techniques.

“All pioneers have to go through it,” he said. “Anybody that comes out with a new procedure or philosophy gets nailed. Internationally, I’m famous. But right here, through a group of podiatrists, I’m a target.”