The American Board of Multiple Specialties in Podiatry (ABMSP) has issued a call to the podiatric community to more closely examine the psychological factors that influence non-compliance and non-adherence in order to strengthen prevention and treatment of diabetic foot wounds.
Diabetic foot wounds are now the leading cause of non-traumatic limb amputations in the United States. Podiatrists are well aware that psychology-based patient non-compliance (disobedience of a health care provider's advice) and non-adherence (failure to adopt therapeutic behaviors) are often catastrophic contributors to diseases of the diabetic foot. The American Board of Multiple Specialties in Podiatry (ABMSP) has issued a call to the podiatric community to more closely examine the psychological factors that influence non-compliance and non-adherence in order to strengthen prevention and treatment of diabetic foot wounds. In addition, the Board is actively developing standards to help podiatrists adopt a "whole-body" approach that will boost patient self-esteem by focusing on a healthy mindset.
Since its founding in 1986, the ABMSP has paved the way for board certification in foot and ankle surgery, primary care, prevention and treatment of diabetic foot wounds, and diabetic footwear?and more recently in the emerging field of limb preservation and salvage. Physicians who are board certified in this field are now creating innovative advances toward a new, comprehensive, integrative, interdisciplinary, and whole-body approach to limb preservation and prevention of diabetic foot disease; this strategy includes vigorous focus on the mindset of the patient with diabetes. Using the pioneering research of medical icon Dr. Paul Brand (1914-2003), ABMSP podiatrists are recognizing their roles as "full body and full mind" advocates for wellness in people with diabetes.
"The foot is attached to the rest of the body," said Kenneth B. Rehm, D.P.M., Diplomate of the American Board of Multiple Specialties in Podiatry, in a statement which is reminiscent of Dr. Brand's frequent advice to podiatrists to "think about the person, not just the foot."
"When we remain cognizant of this," Rehm said, "we begin to see opportunities for approaching the psychological challenges of our patients. Dr. Brand was a pioneer in the psychology, techniques, and treatment regimens we use today to deal with the problems associated with diabetic foot wounds, and his research has become pivotal to our profession. Board certification in diabetic foot wounds and limb preservation and salvage must demonstrate proficiency in all aspects of diabetes patients regarding their foot care?including those that are focused on mind, body, and self-esteem."
An all-inclusive, whole-body methodology, Rehm explained, will help prevent amputations and save lives. ABMSP certification delivers built-in support of this model. No other certification board includes this level of focus on patient self-esteem and positive "personhood."
A significant portion of the ABMSP certification examination for Limb Preservation and Salvage centers on coordination of care aspects, including: the biomechanics of an amputated foot; orthotic/prosthetic/shoe considerations; care of skin and nails; nutrition; exercise; psychosocial needs; postoperative and wound care; and coordination of referrals, counseling, and education.
"Let's consider that it is generally acknowledged that non-compliance/non-adherence rates for chronic illness regimens and for lifestyle changes can range from 50-70%," Rehm said. "As a group, patients with diabetes are no exception and are especially prone to substantial problems in this regard. This begs the questions: why? And what can be done? Board certification that includes psychological and social training is clearly part of the solution. By developing standards in these areas, ABMSP is developing a new generation of podiatric physicians. It's an exciting time to be a part of this board."
About ABMSP
The American Board of Multiple Specialties in Podiatry was originally organized by podiatrists for the purpose of granting board certification to office-based and ambulatory foot surgeons. Incorporated in 1986 as the American Institute of Foot Medicine (AIFM), the name was changed in 1992 to better reflect its mission. The Board now offers certification to qualified podiatrists in all areas of podiatric practice: Primary Care in Podiatric Medicine; Foot and Ankle Surgery, both in a hospital setting and in outpatient facilities; Prevention and Treatment of Diabetic Foot Wounds and Foot Wear; and Limb Preservation and Salvage. The California Board of Medicine, through the California Board of Podiatric Medicine, has authorized diplomates of the American Board of Multiple Specialties in Podiatry to advertise their certification from the Board in the State of California. Also, the Board's certification examinations have been approved for reimbursement by the VA as an educational benefit for eligible veterans. The American Board of Multiple Specialties in Podiatry is the only podiatric certification program accredited by URAC (formerly the Utilization Review Accreditation Commission) and by the American National Standards Institute (ANSI) under the ISO International Standards ANSI/ISO/IEC/17024:2003 for Accreditation for Bodies Operating Certification of Persons. For more information, visit
http://www.abmsp.org.
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