Public Health & Podiatry… A Perfect Match
Public health as it pertains to foot health plays an
important role in the daily work of podiatric physicians in the Commonwealth of
Massachusetts. The Massachusetts Foot & Ankle Society through its
membership is working to keep people healthier by promoting disease prevention
and educating patients on issues that pertain to their general health as well
as their foot health. Whether they are instructing a child athlete about injury
prevention on the soccer field or a teenager on the dangers of tobacco use,
today's podiatric physician is often at the forefront of public health issues.
In their daily care of the elderly and the indigent, podiatrists are
increasingly concerned with the greater issue of health disparities among
American citizens. In their quest to obtain for their patients better access to
specialty medical care services and in their drive to change podiatry services
under Title XIX they often find themselves in the role of patient advocate as
they seek legislative changes to end discrimination in health care
of podiatry receive formal public health training both in schools of podiatric
medicine and in their post graduate residency training. In addition, a growing
number of podiatrists are receiving advanced degrees in public health, law,
medical science research and epidemiology. Information on some general medical
and public health topics pertaining to foot health and the services of
podiatric physicians follow. This information is provided to the public to
promote improvement in health education and is consistent with the mission of
the MFAS and its membership.
It is estimated that 18 million Americans have diabetes and
of this number over 5 million (roughly one third) are unaware and undiagnosed.
The inability to produce and/or appropriately utilize insulin in our bodies
creates a whole host of health problems. A blood test is used to screen
patients for hyperglycemia (the greater than normal level of glucose sugar in
your blood). Podiatrists are acutely aware of the signs and symptoms of
diabetes and are often the first to detect this disorder. Patients with
diabetes have a greater risk of lower extremity amputations, are slow to heal,
and are at a greater risk of infection. It is therefore imperative that
patients with diabetes have access to podiatric physicians and receive periodic
professional foot care. For information about diabetes and your feet check out
the following links.
Peripheral Arterial Disease
Recent studies have estimated the increased prevalence of
peripheral arterial disease (PAD) in the United States at 12 million persons.
The vessels that supply blood to the feet ankle and legs become occluded
(narrowed) in PAD due to atherosclerosis. We now know that patients with PAD
have triple the risk of death from all causes compared to others without the
disease and that PAD is an independent risk factor for coronary artery disease
(heart disease). A good tool to test for PAD is the ankle-brachial index or
ABI. The Massachusetts Podiatric Medical Society has taken on the initiative to
bring access to this screening test through visits to its member podiatrists.
Ask your healthcare provider if you should be tested. Treatment for PAD
involves risk factor modifications which include smoking cessation, control of
hypertension and diabetes, as well as the use antiplatelet agents like aspirin
and clopidogel. Occasionally, surgical care for revascularization may be
needed. Your podiatrist is well trained to advise and make appropriate referral
when this alternative is needed. For more information on PAD follow the links
Although the dangers of smoking are well known and the
campaign to ban smoking has gain success in more and more places, nearly one
out of every four Americans continues to smoke. Smoking, in addition to causing
lung cancer is closely associated with peripheral arterial disease (PAD), heart
attack and death. Because smoking plays such a large role in the progression of
poor circulation to the feet and legs, podiatrists are continually called upon
to counsel and advise patients on the dangers of cigarettes and when necessary
refer patients for professional counseling and/or pharmacological treatment. To
learn more about smoking cessation and the impact of smoking on your health
follow these links.
Many of us have become aware in recent years of the growing
increase in the incidence of obesity and the alarming number of overweight
obese children in the United States. As weight reduction programs require both
changes in dietary habits as well as physical activity, podiatrists are
increasingly called upon to get people back on their feet. The American
Podiatric Medical Association has been at the forefront in its campaign on the
Best Walking Cities in America to promote the benefits of regular exercise and
walking. Many foot problems are aggravated by obesity. Podiatric physicians are
available to answer questions you might have about your exercise and weight
loss program. Concerns about the appropriateness of walking and athletic shoes
should be addressed to podiatrists who are the health care professionals who
specialize in the medical and surgical care of feet. The beneficial effects of
weight loss on your foot health should not be underestimated. Increase weight
and inactivity have a profound impact on the many bones and joints in your
feet. To learn more about this growing public health problem and to obtain guidance
on ways you can combat this problem see the following links.
The most common cancer of the foot is malignant melanoma,
which is a potentially limb threatening and life threatening condition. It is also
more likely to be misdiagnosed than a melanoma detected elsewhere. Other
cancerous and precancerous lesions may present in the foot and ankle area.
Podiatric physicians through inspection and when indicated, biopsy, are able to
properly assess these skin changes. However, daily inspection of your feet will
provide you the ability to alert your podiatrist early on to any change in
appearance or color of pedal skin lesions. For articles and reports on skin
cancer and your feet follow the links below.
As Americans strive to become more fit and live healthier
lifestyles the need for injury prevention rises. Injuries to the foot and ankle
account for a significant amount of these injuries overall. Ankle sprains, foot
and ankle fractures, shin splints, plantar fasciitis, and turf toe are but a
few of the more common foot related sports injuries treated by podiatrists on a
regular basis. Your podiatrist may order X-rays, bone scans and other
radiographic imaging studies in the diagnosis and treatment of sports injuries.
However, podiatric physicians are also anxious to educate and instruct patients
on proper conditioning, equipment needs, and other preventative measures to
lower the incidence of sports related injuries. See the following links related
to this topic.
A growing concern of our elderly is the risk of injury from
a slip or fall. Although not as common as hip or wrist fractures, we are seeing
an increased number of injuries to the foot and ankle including fractures.
Podiatric physicians are equipped to manage a variety of injuries that occur in
the foot and ankle of our senior citizens. A growing number of podiatrists are
receiving further training in the surgical repair of ankle fractures. It is
important that post menopausal women who are at risk of osteoporosis be
screened and appropriately treated when indicated. Podiatrists are uniquely
prepared to assist patients in the planning of a weight bearing exercise
program for the treatment and prevention of this disorder.
As a responsible member of the health care team podiatric physicians encounter the growing problem of access to health care services by those of lesser means. As a leading proponent of antidiscrimination practice, podiatrists are constantly advocating for the poor and the elderly in their quest to receive specialty care services, hospital access, HMO coverage, and equality in managed care plans. Recently, members of the US Congress have joined with podiatrists in petitioning for a change in Title XIX legislation to better serve the podiatric needs of the poor and indigent.