Learning From Heroes Within And Outside Podiatry
- Volume 20 - Issue 6 - June 2007
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Some of the real heroes in podiatry are not DPMs. I learned to think of podiatry as an isolated body during my Ohio College of Podiatric Medicine days. We learned the only thing we had to fear was fear itself and orthopods.
I met my first non-DPM hero during my residency in Seattle. Sigvard T. Hansen, MD, was the Chief of Orthopedic Surgery at one of the University of Washington hospitals. Dr. Hansen gave podiatric residents the opportunity to train with his orthopedic residents. This was unheard of in those days. He treated us like we were humans and respected our skills and dedication to good foot and ankle surgery. His textbook on foot and ankle surgery has become a bible in our profession. He demolished all the fear and prejudice I embraced about orthopedic surgeons during my days in podiatry school.
I have continued to meet heroes or angels to our profession throughout my 32-year career as a podiatrist. Isaac Pope, MD, is a pediatrician who moved to my community a few years after I started my practice. He immediately sought my help with pediatric orthopedic foot and ankle problems. He did not like orthopods for some reason. I had to draw the line for him when he started sending knee and hip problems to me to determine if an orthopedic consultation was indicated.
It was not enough that he was a fan of podiatry. He insisted that I be accepted as a member of the local medical society. He is a 6-foot-7, tough talking African-American whom nobody messes with. It has been great having him on my team. He is truly another non-DPM hero for podiatry.
I saw other non-DPM heroes in podiatry while attending the Diabetic Foot Global Conference in Los Angeles last March. The conference is sponsored by the Providence Health System and is an opportunity for a variety of specialists from all over the world to share what we have learned about the devastating effects of diabetes on feet and legs.
It is an interesting contrast to the petty turf battles we wage over who else is selling arch supports or treating sore feet. The doctors, nurses, PAs and physical therapists at this meeting were simply seeking better and more affordable ways of providing access to all people of the world who need care of diabetic foot ulcers. It was the best conference I have attended in my career.
I met another non-DPM podiatric hero who spoke at the conference. Kshitij Shankhdhar, MD, a diabetologist from India, lectured on diabetic foot ulcers and a simple, inexpensive technique for offloading lesions. His device was constructed from upholstery foam and glue. It costs practically nothing and is simple enough that patients and their families can construct and use the device.
Prior to showing us how to make the offloading devices, he explained some of the challenges he faces in his impoverished region. Many patients present with feet that were gnawed on by rodents as they slept. With insensate feet, the patients did not learn about the night visitors until they woke the next morning to discover new wounds.
Another of Dr. Shankhdhar’s problems is that there are no podiatrists in India. The healthcare system does not pay for preventive foot care. It reminds me of the quotation by George Bernard Shaw: “It is odd that they pay a surgeon handsomely to amputate a leg but nothing to save a leg.”
Dr. Shankhdhar tried to remedy the problem one year by having himself designated a podiatrist in his hospital. He planned to dedicate all his efforts toward diabetic foot care. This failed because he was paid nothing for his services.
This story made me reflect on how much we gripe about reimbursement in this country, given what others in less fortunate countries are going through.
Dr. Shankhdhar’s next effort to promote podiatry in India is to start a podiatry school. There are some hurdles. He has to convince India’s health system to accept and cover podiatric care, and he has to find students willing to risk the time and expense to study a specialty they may never get to use. And we think we have problems as DPMs in this country.