Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
Quick Answer
High-Risk Foot Care in Livingston County — Coordinated relates to foot pain — typically caused by overuse, footwear, or biomechanics. Most patients improve in 6-12 weeks with conservative care. Same-week appointments in Howell + Bloomfield Twp: (810) 206-1402.
High-Risk Foot Care in Livingston County — Coordinated with Vassallo Medical
Specialized Foot Care for Livingston County’s Most Vulnerable Patients
High-risk foot care requires more than skill — it requires coordination. For patients in Howell, Brighton, Hartland, Fowlerville, and throughout Livingston County who have diabetes, vascular disease, or other systemic conditions, Balance Foot & Ankle offers truly coordinated high-risk foot management in collaboration with Vassallo Medical Group.
Why Coordination Matters for High-Risk Patients
High-risk foot complications don’t develop in isolation. They develop because of inadequately controlled diabetes, because vascular disease goes unaddressed, because medications interact with wound healing, or because systemic infections complicate foot care. When your podiatrist and your internist are in communication, these risks are managed comprehensively — not in silos.
That’s the model we use with Vassallo Medical Group. Located on the same Grand River Ave corridor as our Howell office, Dr. Vassallo’s team manages the internal medicine side — diabetes control, blood pressure, vascular risk factors — while we monitor and protect the feet. When problems arise, we respond together.
High-Risk Services at Our Howell Office
Our Howell location provides the full range of high-risk podiatric services: comprehensive vascular and neurological assessment, medical-grade nail and callus care, custom 3D-printed orthotics for pressure redistribution, Medicare-covered diabetic shoe fitting, MLS laser therapy for wound healing and circulation, wound care and infection management, and preventive monitoring for pre-ulcerative changes. We also offer home visits for Livingston County patients who are unable to travel to our office.
Our Howell office works closely with Vassallo Medical Group (3399 E Grand River Ave — minutes away on the same road) for patients with diabetes, vascular disease, and systemic conditions affecting the feet. Dr. John Vassallo, MD, coordinates the medical side while we protect your feet.
📞 (810) 206-1402 | 4330 E Grand River Ave, Howell
✅ MLS Dual-Wavelength Laser — FDA-cleared
✅ EPAT Shockwave Therapy — 80%+ success
✅ 3D-Scanned Custom Orthotics
✅ Toenail Fungus Laser
✅ In-Office X-Ray & Ultrasound
📞 (810) 206-1402 | Howell & Bloomfield Hills
Livingston County Communities We Serve
We provide high-risk foot care for patients from Howell, Brighton, Hartland, Fowlerville, Pinckney, Hamburg, Whitmore Lake, Green Oak Township, Fenton, Linden, Tyrone Township, Cohoctah, Genoa Township, Marion Township, and all of Livingston County. Call (810) 206-1402.
High-Risk Foot Care in Livingston County: Referral Resource for Dr. Vassallo and Primary Care Physicians
Livingston County primary care physicians, including Dr. Vassallo’s practice and the broader primary care community in Howell, Brighton, and Hartland, have a trusted podiatric referral resource in Balance Foot & Ankle‘s Howell office for their high-risk diabetic and vascular patients. The annual comprehensive diabetic foot examination that Medicare covers — and that clinical guidelines recommend for all diabetic patients — is best performed by a podiatrist who can document the full spectrum of neurological and vascular findings, identify preulcerative changes, prescribe appropriate footwear, and coordinate with the primary care team when findings warrant systemic attention. Our Howell office at 4330 E Grand River provides these services for Livingston County primary care patients with same-week availability for new referrals.
Livingston County primary care practices that refer high-risk patients to Balance Foot & Ankle receive timely consultation reports — typically within 24 hours of the visit — documenting examination findings, the ABI measurement when performed, neuropathy grade, footwear and orthotic recommendations, and any clinical findings requiring primary care follow-up. We coordinate closely with the referring physician when our examination identifies findings that require urgent medical management — new peripheral arterial disease findings, suspected osteomyelitis, or systemic signs of infection. The direct line for physician referral coordination at Balance Foot & Ankle‘s Howell office is (810) 206-1402 — ask to speak with our physician liaison or leave a message with the patient’s name and the referral reason, and we will contact the patient within one business day to schedule.
Related Treatment Guides
- Plantar Fasciitis & Heel Pain Treatment
- Custom 3D Orthotics
- Sports Foot & Ankle Injury Treatment
- Bunion Treatment
Livingston County patients who have received a referral for podiatric care from any physician — not only from Dr. Vassallo’s practice — can call Balance Foot & Ankle directly to schedule without needing prior authorization for most insurance plans. Our insurance verification team confirms benefits before the appointment so patients understand their cost responsibility in advance. For patients who have been told by their primary care physician that they need a foot exam “at some point,” we encourage them to schedule proactively rather than waiting for a problem to develop — the comprehensive diabetic foot examination is most valuable when it establishes a baseline before significant pathology is present, so that subsequent visits can identify changes from that baseline. Call (810) 206-1402 to schedule at our convenient Howell office at 4330 E Grand River.
Medical References & Sources
- American Podiatric Medical Association — Patient Education
- American Orthopaedic Foot & Ankle Society — Foot Conditions
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3980 E Grand River Ave, Suite 140
Howell, MI 48843
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High-risk foot care patients — including those with diabetes, blood thinners, or circulation issues — benefit from the right protective footwear and hygiene products between professional visits.
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Related: Best Diabetic Socks 2026 | Best Toenail Clippers 2026 | Insurance & Coverage at Our Office
High-Risk Foot Care — We Accept Medicare
Specialized diabetic & high-risk podiatric care — Howell & Bloomfield Hills, MI
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Or call: (810) 206-1402
Pros & Cons of Conservative Care for foot care
Advantages
- ✓ Conservative care first
- ✓ Same-week appointments
- ✓ Multiple insurance accepted
Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
Dr. Tom’s Recommended Products for foot care
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
Footnanny Heel Cream Dr. Tom’s Pick
Best for: Daily moisturizer for cracked heels
Ready to Get Back on Your Feet?
Same-day appointments in Howell + Bloomfield Twp. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
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Call Now: (810) 206-1402
About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Twp, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
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Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed for 30+ days minimum. Last verified: April 28, 2026.
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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.