Your Complete Livingston County Health Team — Every Specialist You Need

Livingston County has developed a strong healthcare ecosystem over the past decade. For patients managing complex conditions — diabetes, peripheral arterial disease, musculoskeletal issues — knowing how to navigate that ecosystem and connect the right specialists is as important as the care itself. Here’s your guide.

The Livingston County Healthcare Map

Primary Care — The Coordinator

Your PCP coordinates your overall health. For Livingston County patients, Vassallo Medical Group in Howell is our most frequent PCP collaborator — they refer to us regularly and we communicate back with every visit note for shared patients.

Endocrinology / Diabetes Management

For complex diabetes cases, Grunberger Diabetes Institute (Bloomfield Hills — same building as our Bloomfield Hills office) provides world-class diabetes management. For Livingston County patients, the Trinity Health system also provides endocrinology services through their Livingston Hospital network.

Podiatry — Balance Foot & Ankle Specialists

We serve as the podiatric anchor of the Livingston County healthcare ecosystem. We accept referrals from PCPs, cardiologists, vascular surgeons, endocrinologists, and nursing facilities. We send visit notes back to every referring provider.

Our role in your care team:
For diabetics: Annual foot exams + ongoing foot care + wound management
For cardiac/vascular patients: PAD foot complications + wound care
For orthopedic issues: Biomechanical evaluation + orthotics + conservative care + surgery when indicated
For nursing home patients: Regular facility visits + comprehensive foot care

Vascular / Cardiac

For patients with peripheral arterial disease (PAD), vascular surgery consultation is often part of wound healing planning. We coordinate with vascular teams — our wound care improves outcomes when combined with adequate perfusion.

Physical Therapy

Post-surgical recovery and gait retraining often require PT collaboration. We refer to local PT practices and receive their referrals for patients who need advanced foot/ankle care alongside PT.

Trinity Health Livingston Hospital

For conditions requiring hospital-based care — major surgery, complex infections, IV antibiotics — Trinity Health Livingston in Howell is the regional hospital. We have hospital privileges and can coordinate care for admitted patients who need podiatric management.

How to Build Your Team

1. Start with your PCP — they coordinate referrals and maintain your overall health picture
2. If you have diabetes: annual diabetic foot exam with us + endocrinology if A1C is suboptimal
3. If you have foot or ankle pain: call us directly — no PCP referral required for most plans
4. If you have a wound that isn’t healing: call us immediately — this is urgent

We are proud to be part of the Livingston County healthcare community. Call us to discuss how we can work with your existing care team: (810) 206-1402

Clinical Foot Care Beyond Products: Michigan’s Balance Foot & Ankle

Michigan patients using foot care products — wound care supplies, topical treatments, foot supplements, compression garments, orthotics, or stretching devices — as part of their foot health routine benefit from occasional clinical evaluation to ensure the products they are using are appropriate for their specific condition and that no developing pathology requires professional intervention. At Balance Foot & Ankle, our clinical evaluation confirms the diagnosis, assesses whether current product-based management is adequate, and identifies cases where professional treatment would produce better outcomes than continued self-management.

For Michigan patients managing chronic conditions — diabetic foot care, neuropathy management, post-surgical recovery, or persistent tendinopathy — regular podiatric check-ins at appropriate intervals ensure that small changes are caught before they become significant complications. The right interval varies by condition and risk level: high-risk diabetic patients benefit from quarterly visits; stable patients using products for minor chronic conditions may need only annual check-ins. At Balance Foot & Ankle, we help patients identify the appropriate visit frequency for their specific situation. Livingston and Oakland County patients can call (810) 206-1402 to schedule at our Howell or Bloomfield Hills office.

Related Treatment Guides

• Peripheral Arterial Disease Foot Care
• Plantar Fasciitis & Heel Pain Treatment
• Custom 3D Orthotics
• Sports Foot & Ankle Injury Treatment

Michigan patients experiencing foot or ankle problems can schedule an appointment at Balance Foot & Ankle — with locations in Howell (4330 E Grand River) and Bloomfield Hills (43494 Woodward Ave #208). Call (810) 206-1402 for same-week availability.

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

Dr. Tom Biernacki, DPM

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.