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Home > CA Providers > Foot & Ankle Surgeons

Richard Charles Lavigna, DPM

Accepting New Patients

(5 Ratings)

Specializes in: Foot & Ankle Surgery and Podiatry (Foot & Ankle Medicine)

Kent State University College of Podiatric Medicine (1989)

Professional interests include: athlete's foot, injections, elbow problems, and more.

Bay Area Foot Care Inc 2844 Summit St 107
Oakland, CA 94609

(510) 647-9364

Richard Charles Lavigna, DPM is a podiatrist in Oakland, CA specializing in foot & ankle surgery and podiatry (foot & ankle medicine). He graduated from Kent State University College of Podiatric Medicine in 1989 and has 36 years of experience. Richard Charles Lavigna, DPM is affiliated with Sutter Health, Hill Physicians and BAY AREA FOOT CARE INC.

Office Locations

2844 Summit Street Suite 107
Oakland, CA 94609

open_in_new

Hill Physicians

Bay Area Foot Care Inc 2844 Summit St 107
Oakland, CA 94609

(510) 647-9364

open_in_new

Some issues Richard Charles Lavigna, DPM can help you with:

Replacement Arthroplasty (Joint Replacement)

Joint replacement, sometimes also called arthroplasty, is an option when a joint becomes severely damaged by disease or injury. The damaged cartilage of the joint is surgically removed, the ends of the bones in the joint are resurfaced, and a prosthetic is installed. Most prosthetic joints are made of a metal piece that fits into a plastic sleeve so that they glide smoothly. A joint replacement increases stability in the damaged area and decreases pain. The hip and knee are the two joints most commonly replaced, but joint replacement can also be performed on the ankle, shoulder, elbow and even fingers.

Although joint replacement is one of the safest and most reliable medical procedures available, it is still a major surgical procedure. All surgical procedures carry risks, such as infection or blood clots. For this reason, doctors try to help their patients avoid surgery for as long as they can. Taking arthritis medications, losing weight, avoiding high impact sports such as running, taking supplements such as glucosamine or chondroitin, or having joint injections may allow a patient to enjoy life without the need for surgery.

After having joint replacement surgery, patients can expect some pain the first few days as they recover. Physical therapy is an important part of recovery, and it can decrease complications and increase future mobility. As soon as possible, returning to low impact sports such as swimming, walking or biking can stretch and heal the new joint. A prosthetic joint can last 15 - 20 years and cannot be further damaged by degenerative diseases such as arthritis, so once it is done patients should be pain-free for many years.

Noteworthy Medicare Patient Procedures Performed by Richard Charles Lavigna, DPM in 2023

Click on any procedure below to see further details on volume and pricing among Medicare patients.

Top 10%

By Volume:

removal of benign hyperkeratosis

In 2023, Richard Charles Lavigna, DPM performed more removal of benign hyperkeratosis procedures for Medicare patients than 90% of providers in related specialties within California.

Top 25%

By Volume:

nail avulsion surgery

By Affordability:

immobilization

immobilization treatment

In 2013, among providers in related specialties within California, Richard Charles Lavigna, DPM performed more nail avulsion surgery (nail removal surgery) procedures for Medicare patients than 75% of them and he also had a list price for immobilization, and immobilization treatment that was lower than the list prices billed to Medicare by 75% of them. Actual amounts paid by patients can vary widely depending on a number of factors, including insurance coverage. A lower list price, however, might mean lower fees when paying without insurance.

Medicare Procedure and Patient Information

2013 Medicare Procedure Volume

The top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA during 2013 were X-rays, musculoskeletal imaging, nail procedures and nail avulsion.

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

debridement (removal of unhealthy tissue)	36
diagnostic procedures	16
doctor visit	454
immobilization	65
injections	12
musculoskeletal imaging	145
nail avulsion	108
nail procedures	144
removal of lesion (e.g. growth)	67
skin procedures	67
X-rays	159

2013 Medicare Patient Data

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	121
Female	160

**Ethnicity**
Non-Hispanic White	75
Black	178
Hispanic	0
Asian	15
Other	0
Native American	0

**Age**
From 65 to 74	97
From 75 to 84	56
85 and over	32
Less than 65	96

Conditions of Medicare patients treated by Richard Charles Lavigna, DPM in 2013

The most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated during 2013 were hypertension, diabetes, high cholesterol and chronic kidney disease.

Hypertension	66
High Cholesterol	41
Stroke	0
Ischemic Heart Disease	23
Depression	16
Chronic Kidney Disease	28
Asthma	8
Osteoperosis	0
Atrial Fibrilation	7
Heart Failure	19
Chronic Obstructive Pulmonary Disease	12
Diabetes	46
Dementia	9
Cancer	8

Medicare Procedure and Patient Information

2014 Medicare Procedure Volume

The top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA during 2014 were nail procedures, nail avulsion, debridement (removal of unhealthy tissue) and immobilization.

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

debridement (removal of unhealthy tissue)	99
doctor visit	562
immobilization	92
injections	23
musculoskeletal imaging	75
nail avulsion	166
nail procedures	265
removal of lesion (e.g. growth)	75
skin procedures	75
X-rays	75

2014 Medicare Patient Data

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	124
Female	159

**Ethnicity**
Non-Hispanic White	65
Black	188
Hispanic	0
Asian	13
Other	0
Native American	0

**Age**
From 65 to 74	109
From 75 to 84	63
85 and over	39
Less than 65	72

Conditions of Medicare patients treated by Richard Charles Lavigna, DPM in 2014

The most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated during 2014 were hypertension, diabetes, high cholesterol and chronic kidney disease.

Hypertension	70
High Cholesterol	42
Stroke	0
Ischemic Heart Disease	22
Depression	13
Chronic Kidney Disease	27
Asthma	7
Osteoperosis	0
Atrial Fibrilation	7
Heart Failure	19
Chronic Obstructive Pulmonary Disease	10
Diabetes	46
Dementia	10
Cancer	9

Medicare Procedure and Patient Information

2015 Medicare Procedure Volume

The top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA during 2015 were removal of lesion (e.g. growth), skin procedures, nail procedures and nail avulsion.

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

compression therapy	24
debridement (removal of unhealthy tissue)	60
doctor visit	504
immobilization	95
injections	14
musculoskeletal imaging	73
nail avulsion	199
nail procedures	239
removal of lesion (e.g. growth)	243
skin procedures	243
X-rays	73

2015 Medicare Patient Data

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	220
Female	340

**Ethnicity**
Non-Hispanic White	116
Black	378
Hispanic	28
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	214
From 75 to 84	124
85 and over	84
Less than 65	138

Conditions of Medicare patients treated by Richard Charles Lavigna, DPM in 2015

The most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated during 2015 were hypertension, diabetes, high cholesterol and chronic kidney disease.

Hypertension	72
High Cholesterol	41
Stroke	6
Ischemic Heart Disease	21
Depression	18
Chronic Kidney Disease	34
Asthma	9
Osteoperosis	5
Atrial Fibrilation	9
Heart Failure	22
Chronic Obstructive Pulmonary Disease	12
Diabetes	47
Dementia	13
Cancer	10

Medicare Procedure and Patient Information

2016 Medicare Procedure Volume

The top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA during 2016 were removal of lesion (e.g. growth), skin procedures, nail procedures and nail avulsion.

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

compression therapy	39
debridement (removal of unhealthy tissue)	75
doctor visit	635
immobilization	122
injections	16
musculoskeletal imaging	82
nail avulsion	178
nail procedures	253
nursing home care	115
removal of lesion (e.g. growth)	334
skin procedures	334
X-rays	82

2016 Medicare Patient Data

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	191
Female	261

**Ethnicity**
Non-Hispanic White	99
Black	284
Hispanic	0
Asian	40
Other	0
Native American	0

**Age**
From 65 to 74	167
From 75 to 84	107
85 and over	86
Less than 65	92

Conditions of Medicare patients treated by Richard Charles Lavigna, DPM in 2016

The most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated during 2016 were hypertension, diabetes, chronic kidney disease and high cholesterol.

Hypertension	75
High Cholesterol	36
Stroke	12
Ischemic Heart Disease	27
Depression	28
Chronic Kidney Disease	43
Asthma	20
Osteoperosis	5
Atrial Fibrilation	9
Heart Failure	25
Chronic Obstructive Pulmonary Disease	14
Diabetes	49
Dementia	26
Cancer	10

Medicare Procedure and Patient Information

2017 Medicare Procedure Volume

The top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA during 2017 were removal of lesion (e.g. growth), skin procedures, nail procedures and debridement (removal of unhealthy tissue).

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

aspiration	15
debridement (removal of unhealthy tissue)	193
doctor visit	910
immobilization	60
injections	34
musculoskeletal imaging	31
nail avulsion	142
nail procedures	306
nursing home care	85
removal of lesion (e.g. growth)	440
skin procedures	440
X-rays	31

2017 Medicare Patient Data

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	294
Female	391

**Ethnicity**
Non-Hispanic White	205
Black	370
Hispanic	42
Asian	47
Other	0
Native American	0

**Age**
From 65 to 74	258
From 75 to 84	176
85 and over	111
Less than 65	140

Conditions of Medicare patients treated by Richard Charles Lavigna, DPM in 2017

The most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated during 2017 were hypertension, diabetes, chronic kidney disease and high cholesterol.

Hypertension	74
High Cholesterol	39
Stroke	11
Ischemic Heart Disease	29
Depression	27
Chronic Kidney Disease	45
Asthma	10
Osteoperosis	5
Atrial Fibrilation	9
Heart Failure	25
Chronic Obstructive Pulmonary Disease	15
Diabetes	49
Dementia	25
Cancer	12

Medicare Procedure and Patient Information

2018 Medicare Procedure Volume

The top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA during 2018 were removal of lesion (e.g. growth), skin procedures, nail procedures and debridement (removal of unhealthy tissue).

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

aspiration	38
debridement (removal of unhealthy tissue)	247
doctor visit	968
immobilization	55
injections	55
nail avulsion	78
nail procedures	281
nursing home care	83
removal of lesion (e.g. growth)	596
skin procedures	596

2018 Medicare Patient Data

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	374
Female	454

**Ethnicity**
Non-Hispanic White	309
Black	394
Hispanic	38
Asian	66
Other	0
Native American	0

**Age**
From 65 to 74	310
From 75 to 84	250
85 and over	150
Less than 65	118

Conditions of Medicare patients treated by Richard Charles Lavigna, DPM in 2018

The most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated during 2018 were hypertension, high cholesterol, diabetes and chronic kidney disease.

Hypertension	74
High Cholesterol	51
Stroke	10
Ischemic Heart Disease	32
Depression	28
Chronic Kidney Disease	42
Asthma	9
Osteoperosis	6
Atrial Fibrilation	10
Heart Failure	26
Chronic Obstructive Pulmonary Disease	14
Diabetes	45
Dementia	22
Cancer	13

Medicare Procedure and Patient Information

2019 Medicare Procedure Volume

The top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA during 2019 were removal of lesion (e.g. growth), skin procedures, nail procedures and debridement (removal of unhealthy tissue).

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

aspiration	67
compression therapy	18
debridement (removal of unhealthy tissue)	329
doctor visit	893
immobilization	49
injections	81
nail avulsion	110
nail procedures	439
nursing home care	77
removal of lesion (e.g. growth)	495
skin procedures	495

2019 Medicare Patient Data

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	330
Female	446

**Ethnicity**
Non-Hispanic White	290
Black	379
Hispanic	36
Asian	53
Other	18
Native American	0

**Age**
From 65 to 74	288
From 75 to 84	239
85 and over	127
Less than 65	122

Conditions of Medicare patients treated by Richard Charles Lavigna, DPM in 2019

The most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated during 2019 were hypertension, high cholesterol, chronic kidney disease and diabetes.

Hypertension	71
High Cholesterol	49
Stroke	9
Ischemic Heart Disease	29
Depression	27
Chronic Kidney Disease	45
Asthma	9
Osteoperosis	7
Atrial Fibrilation	10
Heart Failure	26
Chronic Obstructive Pulmonary Disease	15
Diabetes	45
Dementia	20
Cancer	10

Medicare Procedure and Patient Information

2020 Medicare Procedure Volume

The top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA during 2020 were removal of lesion (e.g. growth), skin procedures, nail procedures and debridement (removal of unhealthy tissue).

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

aspiration	65
debridement (removal of unhealthy tissue)	226
doctor visit	636
immobilization	48
injections	85
nail avulsion	95
nail procedures	321
removal of lesion (e.g. growth)	436
skin procedures	436

2020 Medicare Patient Data

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	229
Female	292

**Ethnicity**
Non-Hispanic White	215
Black	249
Hispanic	19
Asian	27
Other	11
Native American	0

**Age**
From 65 to 74	188
From 75 to 84	178
85 and over	90
Less than 65	65

Conditions of Medicare patients treated by Richard Charles Lavigna, DPM in 2020

The most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated during 2020 were hypertension, high cholesterol, diabetes and chronic kidney disease.

Hypertension	65
High Cholesterol	49
Stroke	5
Ischemic Heart Disease	27
Depression	21
Chronic Kidney Disease	40
Asthma	10
Osteoperosis	9
Atrial Fibrilation	8
Heart Failure	20
Chronic Obstructive Pulmonary Disease	11
Diabetes	43
Dementia	13
Cancer	9

Medicare Procedure and Patient Information

2021 Medicare Procedure Volume

The top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA during 2021 were removal of lesion (e.g. growth), skin procedures, nail procedures and debridement (removal of unhealthy tissue).

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

aspiration	70
debridement (removal of unhealthy tissue)	229
doctor visit	717
excision	30
immobilization	37
injections	93
nail avulsion	57
nail procedures	256
removal of lesion (e.g. growth)	585
skin procedures	585

2021 Medicare Patient Data

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	246
Female	349

**Ethnicity**
Non-Hispanic White	245
Black	261
Hispanic	0
Asian	37
Other	27
Native American	0

**Age**
From 65 to 74	218
From 75 to 84	220
85 and over	89
Less than 65	68

Conditions of Medicare patients treated by Richard Charles Lavigna, DPM in 2021

The most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated during 2021 were hypertension, high cholesterol, diabetes and chronic kidney disease.

Hypertension	66
High Cholesterol	50
Stroke	5
Ischemic Heart Disease	22
Depression	24
Chronic Kidney Disease	38
Asthma	8
Osteoperosis	10
Atrial Fibrilation	12
Heart Failure	18
Chronic Obstructive Pulmonary Disease	10
Diabetes	39
Dementia	12
Cancer	11

Medicare Procedure and Patient Information

2022 Medicare Procedure Volume

The top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA during 2022 were removal of lesion (e.g. growth), skin procedures, nail procedures and debridement (removal of unhealthy tissue).

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

aspiration	46
debridement (removal of unhealthy tissue)	225
doctor visit	696
excision	54
immobilization	14
injections	72
nail avulsion	73
nail procedures	244
removal of lesion (e.g. growth)	867
skin procedures	867

2022 Medicare Patient Data

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	298
Female	383

**Ethnicity**
Non-Hispanic White	305
Black	260
Hispanic	30
Asian	55
Other	31
Native American	0

**Age**
From 65 to 74	248
From 75 to 84	261
85 and over	115
Less than 65	57

Conditions of Medicare patients treated by Richard Charles Lavigna, DPM in 2022

The most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated during 2022 were hypertension, high cholesterol, diabetes and chronic kidney disease.

Hypertension	75
High Cholesterol	71
Stroke	9
Ischemic Heart Disease	21
Depression	22
Chronic Kidney Disease	30
Asthma	11
Osteoperosis	15
Atrial Fibrilation	17
Heart Failure	18
Chronic Obstructive Pulmonary Disease	12
Diabetes	41
Dementia	10
Cancer	17

Medicare Procedure and Patient Information

2023 Medicare Procedure Volume

The top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA during 2023 were removal of lesion (e.g. growth), skin procedures, nail procedures and debridement (removal of unhealthy tissue).

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

aspiration	38
debridement (removal of unhealthy tissue)	204
doctor visit	527
excision	30
immobilization	15
injections	38
nail avulsion	50
nail procedures	224
removal of lesion (e.g. growth)	860
skin procedures	860

2023 Medicare Patient Data

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	256
Female	353

**Ethnicity**
Non-Hispanic White	274
Black	239
Hispanic	30
Asian	39
Other	27
Native American	0

**Age**
From 65 to 74	213
From 75 to 84	246
85 and over	108
Less than 65	42

Conditions of Medicare patients treated by Richard Charles Lavigna, DPM in 2023

The most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated during 2023 were hypertension, high cholesterol, diabetes and chronic kidney disease.

Hypertension	75
High Cholesterol	72
Stroke	10
Ischemic Heart Disease	22
Depression	20
Chronic Kidney Disease	30
Asthma	12
Osteoperosis	16
Atrial Fibrilation	18
Heart Failure	17
Chronic Obstructive Pulmonary Disease	12
Diabetes	42
Dementia	10
Cancer	16

Medicare Procedure and Patient Information

Average Medicare Procedure Volume From 2013 - 2023

Volume of procedures performed by Richard Charles Lavigna, DPM for Medicare patients.

The highest averages for the top procedures that Richard Charles Lavigna, DPM treated as a podiatrist in Oakland, CA were removal of lesion (e.g. growth), skin procedures, nail procedures and debridement (removal of unhealthy tissue).

aspiration	48
compression therapy	27
debridement (removal of unhealthy tissue)	174
diagnostic procedures	16
doctor visit	682
excision	38
immobilization	59
injections	47
musculoskeletal imaging	81
nail avulsion	114
nail procedures	270
nursing home care	90
removal of lesion (e.g. growth)	454
skin procedures	454
X-rays	84

Average Medicare Patient Data From 2013 - 2023

Information about Medicare patients treated by Richard Charles Lavigna, DPM.

**Gender**
Male	243
Female	326

**Ethnicity**
Black / African American	289
Asian / Pacific Islander	35
Non-Hispanic White	199
Hispanic	20
Native American / Alaskan Native	0
Other	10

**Age**
75 to 84	174
85 and over	93
Less than 65	91
65 to 74	210

Average of Total of Conditions of Medicare patients treated by Richard Charles Lavigna, DPM From 2013 - 2023

The highest averages of the most common conditions of Medicare patients that Richard Charles Lavigna, DPM treated were hypertension, high cholesterol, diabetes and chronic kidney disease.

Hypertension	71
High Cholesterol	49
Stroke	7
Ischemic Heart Disease	25
Depression	22
Chronic Kidney Disease	36
Asthma	10
Osteoporosis	7
Heart Failure	21
Chronic Obstructive Pulmonary Disease	12
Diabetes	44
Atrial Fibrillation	10
Dementia	15
Cancer	11

Education & Training

Richard Charles Lavigna, DPM graduated from Kent State University College of Podiatric Medicine in 1989. He completed residency at Worcester City Hospital. He has a state license in California.

Medical School: Kent State University College of Podiatric Medicine (1989)

Residency: Worcester City Hospital

Licensed In: California

Affiliations & Hospitals

Richard Charles Lavigna, DPM is associated with these hospitals and organizations:

Sutter Health

Hill Physicians

BAY AREA FOOT CARE INC

Insurance Information

Please note: Insurance information may change at any time, and the provider may accept your insurance plan even if it is not listed below. Please contact the provider's office to confirm that your insurance is accepted.

Richard Charles Lavigna, DPM appears to accept the following insurance providers: Cigna, Aetna, Blue Shield of California, Anthem, UnitedHealthcare, Health Net, Chinese Community Health Plan, Central Health Plan and Canopy Health.

Insurance Accepted by Provider includes:

According to our sources, Richard Charles Lavigna, DPM accepts the following insurance providers:

Cigna

Aetna

Blue Shield of California

Anthem

UnitedHealthcare

Health Net

Chinese Community Health Plan

Central Health Plan

Canopy Health

Ratings & Reviews

Richard Charles Lavigna, DPM has a good overall rating with an average of 3.4 out of 5 stars based on 5 ratings. We collect ratings and reviews of Richard Charles Lavigna, DPM from all over the web to help you find the right in Oakland, CA.

3.4

Overall Rating

(5 Ratings)

Leave a Review

General Payments

These charts describe general payments received by Richard Charles Lavigna, DPM. Doctors may receive payments for a number of reasons, including meal compensation, travel compensation, and consulting.

**Payments by Company**
Treace Medical Concepts, Inc.	$236 Lapiplasty System $236
Organogenesis Inc.	$234 Apligraf $234
Smith+Nephew, Inc.	$221 COLLAGENASE SANTYL $133	Taylor Spatial Frame $32	Pico $32	MemoFix $25
Nevro Corp.	$209 Senza $149	Omnia $60
Sandoz Inc.	$202 KERYDIN $202
Other	$1,544 Infinity $168	ENTRE PLUS $147	Stimulan $146	PriMatrix $142	CLARIX $124	Other $817

**Types of Payments**
Food and Beverage	$2,645

Biography

Dr. Richard Lavigna specializes in foot & ankle surgery and podiatry (foot & ankle medicine). For his professional training, Dr. Lavigna completed a residency program at Worcester City Hospital. Clinical interests for Dr. Lavigna include deformity correction, strains, and neuroma. He is rated 3.5 stars (out of 5) by his patients. He can accept Blue Shield, Health Net, and Anthem, as well as other insurance carriers. He is professionally affiliated with Hill Physicians and Sutter Health. Dr. Lavigna welcomes new patients at his office inOakland, CA as reported by Hill Physicians.