Foot Soldiers in the Battle for Recognition

Despite evidence that care by a podiatrist has a significant impact on outcomes in patients with diabetes, we podiatric physicians still are not a fully recognized arm of our patients’ diabetes care. Today’s podiatrist is uniquely qualified to treat the foot and ankle based on education, training, and experience, but too many podiatric physicians still are waiting for that recognition. Armed with concrete evidence of our value to patients, to the economy, and to the medical profession, I believe we must redouble our efforts to gain the recognition we deserve in the medical community.

Fortunately, we have new and dramatic evidence to support our demands. Patients with diabetes who receive medical and surgical care from a podiatrist are significantly less likely to suffer hospitalization or amputation than patients who do not receive care from a podiatrist. This podiatry-affirming finding comes from an APMA-sponsored study from Thomson Reuters, an independent, internationally respected research firm with expertise in the health-care market.

The study examined claims records for more than 32,000 patients with diabetes ages 18 to 64 and more than 43,000 patients over the age of 65. Thomson Reuters matched health and risk factors for those who had podiatry visits to those who did not. Care by a podiatric physician, defined as at least one pre-ulcer visit, was associated with significantly lower risk of hospitalization and amputation: 29 percent lower odds of amputation and 24 percent lower odds of hospitalization in the 18- to 64-year-old population, and 9 percent lower odds of hospitalization and 23 percent lower odds of major amputation in patients over 65 years of age. Vickie Driver, DPM, MS, associate professor of surgery at Boston University School of Medicine, presented these astounding results during the APMA Annual Scientific Meeting in July in Seattle.

Diabetes is an epidemic in the United States. According to the American Diabetes Association (www.diabetes.org/diabetes-basics/diabetes-statistics/), nearly 24 million Americans have diabetes, and an additional 1.6 million new cases are diagnosed each year. As the number of patients with diabetes grows, so too will the number of amputations and hospitalizations. These patients have a chronic illness, and they need preventive care from a podiatrist to keep them out of hospitals and off the operating table.

Hospitalizations and amputations ultimately will add to the skyrocketing costs of health care in America. An investment in care by podiatrists, however, could save close to $200 million, according to the Thomson Reuters data.

Our states have responded to our call to action. The Colorado Podiatric Medical Association (CPMA) recently achieved victory when the Association convinced not only state regulators, but also the state medical society, to support an updated scope of podiatric practice. In Virginia, a solid grassroots advocacy strategy helped retain Medicaid coverage for podiatric medicine for this year. The Virginia Podiatric Medical Association (VPMA) already has requested the results of the Thomson Reuters study in order to put them to use in ongoing advocacy efforts.

We owe a great deal to state components like CPMA and VPMA for their tireless advocacy efforts. We need every APMA member to continue doing battle for our profession in order to take this message to a national level and achieve recognition under Title XIX.

That is why it is critically important that APMA members become actively involved in Today’s Podiatrist, APMA’s campaign to increase awareness about the benefits of podiatry among medical professionals, the general public, and students. I am excited to tell you that the campaign makes its public debut this month with new tools, including a dedicated Web site, an online video, a “widget,” and more. Go to www.todayspodiatrist.com to learn more and find out how you can be involved.

Today’s Podiatrist is an outstanding opportunity for every member to help elevate the perception of podiatric medicine, create and solidify relationships with medical allies, further Vision 2015, and unify the profession.

I know how frustrated many of you are. We have waged a long battle for recognition as physicians, surgeons, and specialists. We have struggled with politics, bureaucracy, and ignorance. But we must channel our anger and frustration into advocacy. Madeleine Albright has said she is both an idealistic realist and a realistic idealist. I feel the same: As an idealistic realist, I know it will be difficult to achieve our goals. But as a realistic idealist, I know that we can and must achieve them, despite the sacrifice they may require.

Please be involved, be active, and be part of the battle to defend our profession! With more determination and more soldiers, we can be victorious.