Addressing Psychology And Mental Health Issues In Podiatric Care

According to the Myers-Briggs Type Indicator, an individual’s traits can be summed up by eight different characteristics. The combination of traits permutates into 16 possible personality combinations. As a result of various personality combinations, patients with grossly different personality traits and perspectives will walk across your doorstep.

For healthcare providers, the multitude of interactions with patients warrants the necessity for the awareness of and education in topics not only regarding foot and ankle etiologies but those of sociology, public health and psychology. The academic curriculums offered by podiatric medical schools and residencies often only vaguely cover behavioral health topics.

I agree that first and foremost, it is important to be an expert in your specialty, but recognition of other health conditions that may be contributing to a patient’s foot and ankle conditions is important as well. This often does not happen until a podiatrist begins to practice and the number of patient encounters increases exponentially. Now more than ever, we are becoming aware of, accepting and properly treating patients who have mental health conditions. Even as podiatric physicians, it is extremely important to be cognizant of patient psychology.  

It is important to keep in mind that a majority of patients present to the podiatry office with a degree of discomfort. When I was first researching this occupation, one of the most appealing aspects of podiatric medicine was the almost instantaneous relief of symptoms that most patients received after their visit. I found this to be very rewarding.

Treating patients who demand a little more of your efforts than the average patient may unfortunately lead to negative transference, and could even be harmful to the treating physician and staff. A fundamental concept of patient care is being able to be empathetic toward a patient without being sympathetic. I learned this very early in my career from a senior nurse practitioner on one of my medicine rotations.

One can partly manage levels of discourse through good bedside manner and developing a trustworthy patient-physician relationship. A certain level of trust must exist between the doctor and patient, which is particularly important when podiatrists have to perform life-altering procedures for high-risk patients.

As doctors, we choose to dedicate our lives to the well being of others, sometimes at the sacrifice of our own. In addition to personal sacrifice, some doctors may feel they are constantly “under the radar” and being evaluated with patient surveys, surgical and treatment outcomes, and more recently, consumer websites. With the fairly recent economic and social challenges in today’s society, along with the rising costs and unpredictability of healthcare and health insurance policies, morale is generally low among physicians and patients alike.

Despite the rewards of practice, healthcare professionals such as doctors, nurses and pharmacists historically have some of the highest rates of drug and alcohol use.¹ Additionally, doctors and dentists suffer from the highest rates of suicide as well.₂ With such dire statistics, it is imperative that physicians not only provide superb care for their patients but for themselves as well.

Certain companies require applicants to answer detailed ethics and personality surveys before granting an interview or before hiring the potential employee. Perhaps this approach could be one of the requirements for admittance to podiatric medical school. Physicians make up less than 1 percent of the world’s population, and experience different career milestones and professional challenges than the majority of the population. Could a glimpse into one’s psychological makeup help predict his or her ability to handle the dynamics and challenges of patient care, and the demands of podiatric practice? It is difficult to say whether this would have any value or not.

However, we know that acceptance and adaptability to a variety of patient personality differences is vital in the podiatry profession. Cultural and even geographic behavioral differences regarding sentiments toward doctors exist. It is important to balance the concept of patient care versus the well being of self in such a demanding career field.

Dr. Ryans is completing her third year of residency at SSM DePaul Health Center in St. Louis.

References
1. Eisler P. Doctors, medical staff on drugs put patients at risk. USA Today. Available at https://tinyurl.com/lwr8rs3 . Published April 17, 2014.
2. Badkar M, Lubin G. The 13 careers where you’re most likely to commit suicide. Business Insider. Available at https://tinyurl.com/cbadq2j . Published Oct. 12, 2010.