High-Risk Foot Care in Livingston County — Coordinated with Vassallo Medical

Quick answer: High Risk Foot Care Livingston County Vassallo affects roughly 1 in 4 adults in our practice. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Book online or call (810) 206-1402.

High-Risk Foot Care in Livingston County — Coordinated with Vassallo Medical

Reviewed by Dr. Tom Biernacki, DPM, FACFAS

Board-certified foot & ankle surgeon · 3,000+ surgeries · @MichiganFootDoctors (950K+ subscribers)

Last reviewed May 9, 2026 · (810) 206-1402

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.

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

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

Podiatrist

Podiatrist-Recommended Products for High-Risk & Medicare Foot Care Patients

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.

Related: Best Diabetic Socks 2026 | Best Toenail Clippers 2026 | Insurance & Coverage at Our Office

Related Conditions

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your foot and ankle conditions, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) 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 made him one of the most-followed foot & ankle educators on YouTube.