Walking In The Shoes Of Our Patients

In my last DPM blog, I discussed the importance of treating the “whole” patient when it comes to managing diabetic foot ulcers (DFUs).  And, during the course of a busy day, with increasingly condensed schedules, potentially limited resources and added administrative responsibilities, our encounters with patients at the highest risk for amputation, who deserve the most time and attention, can seem a bit chaotic. Thus, it becomes easier to focus on the “hole” in the patient’s foot or toe as a sort of default status. From the evaluation and management component of the visit, to procedures such as debridement or incision and drainage, to reviewing wound care instructions, offloading recommendations, orders for diagnostic testing and referrals to other members of the multidisciplinary team, there is a lot to cover. This applies to both the provider and patient over a very limited amount of time.

Now, taking a step back, let’s imagine what it must feel like to walk in the shoes of our patients.  First, keep in mind that our appointment may be only one of many that day for the patient, or their loved ones, or both, in multiple locations. Their day may have started with a regimen of medications, blood glucose and/or blood pressure monitoring, wound dressing changes, changing or feeding a family member, going to or from work, and so on. Furthermore, getting to the appointment itself may also present challenges like delays in mass transit and heavy traffic (very common occurrences in my neck of the woods!), dealing with a crowded medical center parking lot, taking on or off an offloading device, unloading a scooter or wheelchair, finding the doctor’s office or remembering which way to turn off the elevators, for example. All of this stress has already taken place, and they haven’t even made it to the appointment! 

If we can find a way to better understand some of the struggles of our patients, it may lead to better outcomes or, at least to a more personalized approach to care. It may also change the way in which we assess our own impact as providers. Recall the fictitious patient’s stressful day in the paragraph above. Is it not worth spending a few extra minutes to review the instructions one more time? Or print the instructions in a larger font or another language, if at all possible?  Could this make the difference between limb preservation and limb amputation?

Podiatric physicians and surgeons are all too familiar with the potential complications involved with treating the diabetic foot, including infection, hospitalization and amputation.  We should continue to set the bar for how other specialties treat their patients. At the end of the day, our patients don’t care very much about the letters after our names, or number of papers we’ve published or lectures given, if they know how much we care. Put differently, as said by Theodore Roosevelt and David Armstrong, DPM, MD, PhD,  “People don’t care how much you know until they know how much you care.” Here’s to walking a mile in our patient’s shoe, boot or total contact cast.

Dr. Isaac is the Director of Research with Foot & Ankle Specialists of the Mid-Atlantic (FASMA). He is a Diplomate of the American Board of Foot and Ankle Surgery.

Disclaimer: The views and opinions expressed are those of the author(s) and do not necessarily reflect the official policy or position of BRAND or HMP Global, their employees and affiliates. Any content provided by our bloggers or authors are of their opinion and are not intended to malign any religion, ethnic group, club, association, organization, company, individual, anyone or anything.