The profession of podiatric medicine has made great progress in many areas. One of the most significant is in the treatment of people with diabetes. The skill and sophistication of our profession have allowed us to enhance the lives of thousands of people. We have learned to diagnose their problems and provide extensive, sophisticated, and helpful care. Without the superior care of podiatric physicians, there would be a much higher incidence of amputations and diabetic complications.
The Centers for Medicare and Medicaid Services (CMS) recognizes that our profession has the experience and the knowledge to provide vital services to patients with diabetes. When issues of care for people with diabetes arise, the CMS administration routinely turns to APMA. In turn, APMA is responsive and helpful in designing treatment protocols that CMS will implement to save lower extremities. Our Health Policy Committee and Diabetes Advisory Committee have repeatedly provided expert information on the best treatment for these patients.
The American Diabetes Association (ADA) has honored our profession by selecting Lee Sanders, DPM, David Armstrong, DPM, Larry Harkless, DPM, Robert Frykberg, DPM, and other podiatric physicians for the very highest levels of leadership. The chair of APMA’s Diabetes Advisory Committee, Joseph Caporusso, DPM, brings expertise to APMA and the ADA. We are blessed with these devoted, inspired, and competent members who are experts in diabetes and its lower-extremity complications.
No other medical specialty focuses on the lower-extremity complications of diabetes. During the past 100 years, our profession has concluded that we must gain the education to provide that care. It is not by default that we have filled the void. There are many aspects of podiatric care that we alone can provide. No other specialty better understands the biomechanics of the foot and ankle. No other medical expert has routinely been trained in the diagnosis and treatment of diabetic wounds. Podiatric physicians are the true experts in lower-extremity anatomy. Ask any other medical specialist how many layers of plantar muscles exist, or to name the muscles of the third layer, or to identify the insertion location of the dorsal interossei.
As the population of the country ages, as the epidemic of obesity spreads, and as the life expectancy of people with diabetes increases, the demand for expert podiatric care will continue to zoom. How many other physicians do a monofilament test and can diagnose diabetic neuropathy? We have an opportunity to meet this growing need for expert foot care.
As David Armstrong, DPM, puts it, “The foot is our organ.” He explains that we have learned to merge all of the tasks that are required for optimal foot care. This includes surgical wound debridement, off-loading, prevention and treatment of infection, physical therapy, major foot reconstruction, and evaluation and treatment of the vascularly compromised patient. Other medical specialists treat diabetic patients in each of these areas, but none of them combine all of the tasks as we do.
Accepting the care of people with diabetes is a serious responsibility. We must continue to work hard to improve our skills and the care of these patients.
“We have arrived!”
