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This article reviews the extent of health-care students’ computer literacy and presents the results of a survey of podiatric medical students’ computer literacy. The results of this survey indicate that podiatric medical students are more likely than other health-care students to rate their computer literacy as good or very good. There was no gender difference in this self-reported computer knowledge. The implications for designing and using Web-based instructional materials and technology for podiatric medical students are discussed. (J Am Podiatr Med Assoc 94(4): 375–381, 2004)
The Role of Podiatric Medicine in the Health-Care Team
A Paradigm Shift
As physicians, podiatric medical doctors should not define themselves as medical professionals who treat the foot and ankle but rather as medical professionals who prevent, diagnose, and treat people who have foot and ankle problems. Patients who come to see podiatric physicians often have other health-care issues, and because of the education and training that doctors of podiatric medicine receive, they are uniquely qualified to identify and respond to findings not only related to the pedal extremity but also that may affect overall health, have a major effect on quality of life, and even help reduce overall health-care costs. The role of podiatric medicine as a truly integrated branch of medical care needs to be reassessed.
Patients undergoing podiatric surgery should receive a thorough perioperative evaluation. Medical “clearance” is no longer sufficient; rather, formal risk assessment should be performed and risk-reducing strategies provided. A collaborative, multidisciplinary approach involving practitioners in internal medicine, anesthesiology, and podiatry is generally most appropriate. Unfortunately, expertise and training in this critical dimension of clinical practice are variable. Thus podiatric physicians should develop independent competence in perioperative evaluation in order to ensure optimal care for their patients. A general systematic approach is described that can be readily incorporated into clinical practice. (J Am Podiatr Med Assoc 94(2): 86-89, 2004)
This article discusses the need for and the advantages of a dual degree program between podiatric medicine and public health. The authors expand on the existing program for public health education at the first professional degree level to include a conceptual model for a dual degree program developed at Temple University’s Department of Health Studies, through the Graduate School and the School of Podiatric Medicine. The model combines didactic and clinical education at the graduate level to ensure that clinicians involved in determining health policy are prepared to represent the profession in the restructuring of the health-care system. (J Am Podiatr Med Assoc 91(9): 488-495, 2001)
Nephrogenic systemic fibrosis (NSF) is a severely debilitating disease that was first described in the literature by Cowper and colleagues in 2000. It is pertinent to the field of podiatry because patients with NSF first manifest cutaneous symptoms in the lower extremity in the form of fibrosing lesions. To date, these lesions have been documented only in people with moderate to severe kidney failure. There is speculation that gadolinium, used as a contrast agent for imaging, might be the inciting factor that triggers a cascade of events that results in the inappropriate fibrosis both in the dermis and in deeper tissues. Nephrogenic systemic fibrosis has been shown to cause these lesions in the lungs, pleura, diaphragm, myocardium, pericardium, and dura mater, the presence of which are typically indicative of severe progression of NSF. In cases where the lesions are manifest in the periarticular tissue, joint contractures and restricted range of motion can often result. We provide a quick synopsis of NSF, and a short case study that describes the authors’ experience with one of their patients who requested a surgical consult as a result of being wheelchair-bound due to NSF’s sequelae. (J Am Podiatr Med Assoc 102(5): 419-421, 2012)
Background: Burnout and medical resident well-being has become an increasingly studied topic in medical degree (MD) and doctor of osteopathic medicine (DO) fields and specialties, which has led to systemic changes in postgraduate education and training. Although an important topic to address for physicians of all experience levels and fields of practice, there is little research on this topic as it pertains specifically to the podiatric medical community.
Methods: A wellness needs assessment was developed and distributed to podiatric medical residents via electronic survey to assess overall wellness levels of residents and to highlight several subdomains of well-being in the training programs of the podiatric medical profession.
Results: A total of 121 residents completed the wellness needs assessment. Survey respondents indicated that they experienced high levels of professional burnout, with large numbers of them experiencing depression and anxiety. When analyzing the different subdomains of wellness, levels of intellectual and environmental wellness were high, and levels of financial and physical wellness were reported as low. In addition, free response answers were recorded in the survey regarding well-being initiatives that have been implemented in residency programs, and in many cases no such programs are reported to exist.
Conclusions: Podiatric medical residents experience compromised well-being similar to their MD/DO counterparts. These exploratory survey group results are concerning and warrant further investigation as well as organizational introspection. Analyzing well-being and implementing changes that can support podiatric physicians at all levels of training could decrease the deleterious effects of burnout in all its forms.
Approximately 36 million women in the United States are in the postmenopausal phase of life, creating unique challenges for the provision of compassionate, comprehensive podiatric medical treatment. Long-term estrogen deprivation arising from menopause in association with age-related factors disproportionately increases the risk of ischemic heart disease, osteoporosis, and concomitant podiatric complications. This article discusses the physiologic basis of menopause, hormone replacement therapy and its effects on osteoporosis, and other podiatric implications of menopause. Podiatric physicians caring for larger numbers of peri- and postmenopausal women must formulate a comprehensive management plan for treating fractures that arise from a combination of estrogen-deprivation osteoporosis and abnormal foot biomechanics. (J Am Podiatr Med Assoc 92(8): 437-443, 2002)
In 2002, the American Podiatric Medical Association initiated a “walking city competition.” The objective of the study was to identify the best cities for walking in the United States. (J Am Podiatr Med Assoc 93(2): 161-163, 2003)
Clinical podiatric medical practice encompasses a wide spectrum of podiatric medical and surgical problems. Technological advances such as imaging have greatly improved diagnostic acumen; however, physical diagnosis and blood testing remain extremely important factors in reinforcing diagnostic hypotheses as a part of differential diagnosis. There are certain blood tests of importance that the podiatric medical practitioner should be familiar with in everyday medical and surgical practice. The purpose of this article is to identify and highlight which blood tests are truly essential and practical in terms of diagnosis. This article encompasses blood tests pertinent to the clinical areas of hematology, hemostasis, electrolytes, endocrine, cardiac, rheumatology, nephrology, and gastroenterology. Careful selection of these tests and proper interpretation of their results will help reinforce diagnostic hypotheses.
Infection Prevention and Control in the Podiatric Medical Setting
Challenges to Providing Consistently Safe Care
Unsafe practices are an underestimated contributor to the disease burden of bloodborne viruses. Outbreaks associated with failures in basic infection prevention have been identified in nonhospital settings with increased frequency in the United States during the past 15 years, representing an alarming trend and indicating that the challenge of providing consistently safe care is not always met. As has been the case with most medical specialties, public health investigations by state and local health departments, and the Centers for Disease Control and Prevention, have identified some instances of unsafe practices that have placed podiatric medical patients at risk for viral, bacterial, and fungal infections. All health-care providers, including podiatric physicians, must make infection prevention a priority in any setting in which care is delivered.
