While the incidence of diabetes and foot-related complications continues to spiral out of control in this country, medical professionals need to step back and evaluate their role in preventive medicine.
Most of my podiatric colleagues are unaware of the significant role that the Internet and direct-to-consumer businesses have in the care of the patient with diabetes. Today, millions of patients with diabetes turn to the Internet and commercial companies to provide information and products to prevent the complications of diabetes.
A clear example of this issue is the growth of the therapeutic hosiery industry, which provides products designed for the patient with diabetes. Companies sell the hosiery almost exclusively to the patient outside of the normal professional referral/delivery system.
Over 18 years ago, I published research and developed specialized hosiery for protection of the diabetic foot. I spent eight years teaching and persuading doctors to embrace hosiery as a preventive modality for the diabetic foot. However, my efforts and those of other noted authorities who tried to preach this new intervention had clearly failed. Soon after that, the Internet emerged as a major tool for medical education and provider of therapies and interventions, which patients accessed directly without the input of doctors.
Today, therapeutic hosiery is a $250 million industry, fueled solely by the patient who is interested in prevention of skin ulcerations and potential amputation. While doctors failed to see the potential of therapeutic hosiery, patients became their own advocates and sought this simple intervention as an effective preventive modality. Many other products are now available on the Internet with proposed preventive benefits for patients with diabetes.
When will doctors intervene and become the advocates for legitimate preventive treatments? When will we dispel other gimmicks that have no therapeutic merit?