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Public Health & Podiatry
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Public Health & Podiatry… A Perfect Match

Public health as it pertains to foot health plays an important role in the daily work of podiatric physicians in the Commonwealth of Massachusetts. The Massachusetts Podiatric Medical Society through its membership is working to keep people healthier by promoting disease prevention and educating patients on issues that pertain to their general health as well as their foot health. Whether they are instructing a child athlete about injury prevention on the soccer field or a teenager on the dangers of tobacco use, today's podiatric physician is often at the forefront of public health issues. In their daily care of the elderly and the indigent, podiatrists are increasingly concerned with the greater issue of health disparities among American citizens. In their quest to obtain for their patients better access to specialty medical care services and in their drive to change podiatry services under Title XIX they often find themselves in the role of patient advocate as they seek legislative changes to end discrimination in health care

Today, students of podiatry receive formal public health training both in schools of podiatric medicine and in their post graduate residency training. In addition, a growing number of podiatrists are receiving advanced degrees in public health, law, medical science research and epidemiology. Information on some general medical and public health topics pertaining to foot health and the services of podiatric physicians follow. This information is provided to the public to promote improvement in health education and is consistent with the mission of the MPMS and its membership.

Diabetes Mellitus

It is estimated that 18 million Americans have diabetes and of this number over 5 million (roughly one third) are unaware and undiagnosed. The inability to produce and/or appropriately utilize insulin in our bodies creates a whole host of health problems. A blood test is used to screen patients for hyperglycemia (the greater than normal level of glucose sugar in your blood). Podiatrists are acutely aware of the signs and symptoms of diabetes and are often the first to detect this disorder. Patients with diabetes have a greater risk of lower extremity amputations, are slow to heal, and are at a greater risk of infection. It is therefore imperative that patients with diabetes have access to podiatric physicians and receive periodic professional foot care. For information about diabetes and your feet check out the following links.

Peripheral Arterial Disease

Recent studies have estimated the increased prevalence of peripheral arterial disease (PAD) in the United States at 12 million persons. The vessels that supply blood to the feet ankle and legs become occluded (narrowed) in PAD due to atherosclerosis. We now know that patients with PAD have triple the risk of death from all causes compared to others without the disease and that PAD is an independent risk factor for coronary artery disease (heart disease). A good tool to test for PAD is the ankle-brachial index or ABI. The Massachusetts Podiatric Medical Society has taken on the initiative to bring access to this screening test through visits to its member podiatrists. Ask your healthcare provider if you should be tested. Treatment for PAD involves risk factor modifications which include smoking cessation, control of hypertension and diabetes, as well as the use antiplatelet agents like aspirin and clopidogel. Occasionally, surgical care for revascularization may be needed. Your podiatrist is well trained to advise and make appropriate referral when this alternative is needed. For more information on PAD follow the links below.

Smoking

Although the dangers of smoking are well known and the campaign to ban smoking has gain success in more and more places, nearly one out of every four Americans continues to smoke. Smoking, in addition to causing lung cancer is closely associated with peripheral arterial disease (PAD), heart attack and death. Because smoking plays such a large role in the progression of poor circulation to the feet and legs, podiatrists are continually called upon to counsel and advise patients on the dangers of cigarettes and when necessary refer patients for professional counseling and/or pharmacological treatment. To learn more about smoking cessation and the impact of smoking on your health follow these links.

Obesity

Many of us have become aware in recent years of the growing increase in the incidence of obesity and the alarming number of overweight obese children in the United States. As weight reduction programs require both changes in dietary habits as well as physical activity, podiatrists are increasingly called upon to get people back on their feet. The American Podiatric Medical Association has been at the forefront in its campaign on the Best Walking Cities in America to promote the benefits of regular exercise and walking. Many foot problems are aggravated by obesity. Podiatric physicians are available to answer questions you might have about your exercise and weight loss program. Concerns about the appropriateness of walking and athletic shoes should be addressed to podiatrists who are the health care professionals who specialize in the medical and surgical care of feet. The beneficial effects of weight loss on your foot health should not be underestimated. Increase weight and inactivity have a profound impact on the many bones and joints in your feet. To learn more about this growing public health problem and to obtain guidance on ways you can combat this problem see the following links.

Skin Cancer

The most common cancer of the foot is malignant melanoma, which is a potentially limb threatening and life threatening condition. It is also more likely to be misdiagnosed than a melanoma detected elsewhere. Other cancerous and precancerous lesions may present in the foot and ankle area. Podiatric physicians through inspection and when indicated, biopsy, are able to properly assess these skin changes. However, daily inspection of your feet will provide you the ability to alert your podiatrist early on to any change in appearance or color of pedal skin lesions. For articles and reports on skin cancer and your feet follow the links below.

Sports Injuries

As Americans strive to become more fit and live healthier lifestyles the need for injury prevention rises. Injuries to the foot and ankle account for a significant amount of these injuries overall. Ankle sprains, foot and ankle fractures, shin splints, plantar fasciitis, and turf toe are but a few of the more common foot related sports injuries treated by podiatrists on a regular basis. Your podiatrist may order X-rays, bone scans and other radiographic imaging studies in the diagnosis and treatment of sports injuries. However, podiatric physicians are also anxious to educate and instruct patients on proper conditioning, equipment needs, and other preventative measures to lower the incidence of sports related injuries. See the following links related to this topic.

Osteoporosis

A growing concern of our elderly is the risk of injury from a slip or fall. Although not as common as hip or wrist fractures, we are seeing an increased number of injuries to the foot and ankle including fractures. Podiatric physicians are equipped to manage a variety of injuries that occur in the foot and ankle of our senior citizens. A growing number of podiatrists are receiving further training in the surgical repair of ankle fractures. It is important that post menopausal women who are at risk of osteoporosis be screened and appropriately treated when indicated. Podiatrists are uniquely prepared to assist patients in the planning of a weight bearing exercise program for the treatment and prevention of this disorder.

Health Disparities

As a responsible member of the health care team podiatric physicians encounter the growing problem of access to health care services by those of lesser means. As a leading proponent of antidiscrimination practice, podiatrists are constantly advocating for the poor and the elderly in their quest to receive specialty care services, hospital access, HMO coverage, and equality in managed care plans. Recently, members of the US Congress have joined with podiatrists in petitioning for a change in Title XIX legislation to better serve the podiatric needs of the poor and indigent.