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The Final Frontier for the Podiatric Surgeon-Scientist: Multidisciplinary Research Teams

 

    Alton R. Johnson Jr., DPM, DABPM, FACPM, FASPS, CWSP
    Brandon M. Brooks, DPM, MPH, FACPM, FASPS

    The concept of a multidisciplinary team is not new. Multidisciplinary teams have been around for decades, and perhaps are most successful in limb preservation;1–5 however, many podiatric surgeons do not collaborate with DOs and MDs when it comes to research. You can look no further than to our own academic journals; most of our publications will not include a single osteopathic or allopathic physician. While it is true that podiatric surgeons take a backseat to no other specialty when it comes to foot and ankle surgery, we feel too many of us fail to consider the perspectives of our nonsurgical colleagues, as well as other specialties, to a fault.

    In the discipline of surgery, there is a need for more high-level evidence studies focused on long term outcomes.6,7 When podiatric surgeon-scientists are developing the parameters of these much-needed studies and preparing to go through the institutional review Board (IRB) process, it may be pertinent and beneficial to reach out to a colleague of another specialty. Adding an additional perspective can potentially bolster your research project. It also opens up a two-way street of connection between you and a colleague. When conducting a study that mirrors a previous published project, perhaps a study previously done in another specialty, reaching out to the corresponding author with an invitation may be beneficial to your own study; many researchers, if given the opportunity to “redo” a study, may do certain things differently based on the knowledge gained. For example, in survey research, this concept is often why a “pilot survey” is done.8,9 Through multidisciplinary collaboration, we advance not only podiatry but other specialties as well. Sometimes these teams are MD-led, sometimes DO-led, and sometimes they can be DPM-led.

    An example of a DPM-led multidisciplinary research team, is that of Brooks and colleagues when a collaboration between podiatry, psychiatry, and addiction medicine developed the “Diabetic Foot – Pain – Depression Cycle.”10 This team highlighted the importance of all surgeons screening the diabetic population for depression both pre- and postoperatively when performing forefoot amputations (ie, toe, ray, or transmetatarsal).10  Brooks and team concluded that patients treated for depression had significantly reduced odds of using opioids beyond the first week following surgery.10 It is well-documented that depression is underdiagnosed in the diabetic population.11–15 This is the same population that tends to have altered epicritic and protopathic sensation.10 Many don’t feel pain the same way a patient undergoing an elective first metatarsal osteotomy would. These authors also concluded that the pain felt by this population undergoing any forefoot amputation may be related to depression more so than the actual surgery.10 Ultimately, this multidisciplinary research team demonstrated the need for DPMs to  screen certain patients for depression.10

    As podiatry becomes increasingly specialized, we should not forget about the input and insight of our allopathic and osteopathic colleagues. In the same way that we can benefit their studies, they can benefit ours. As podiatry continues to flourish as a profession, we should pay homage to the giants that built our profession by continuing to advance it forward rather than being stagnant.16–21 We are experts on foot and ankle medicine and surgery, but if we are only hyper-focused on competing, then we may lose sight of the forest from the trees. The podiatric surgeon-scientist that advances our profession is the one who is open to collaborating with those both inside and outside of our profession. This is the final frontier for the podiatric-surgeon scientist.

    Dr. Johnson is the Chairman of the American Society of Podiatric Surgeons and a Clinical Assistant Professor at the University of Michigan.

    Dr. Brooks is the Chief of Podiatry at the Columbia VA Health System.

    Disclaimer: The views and opinions expressed are those of the author(s) and do not necessarily reflect the official policy or position of Podiatry Today 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.

    References

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    2.             Van Acker K, Garoufalis M, Wilson P. POINT: podiatry for international diabetic foot teams. J Wound Care. 2018;27(Sup11):1-32. doi:10.12968/JOWC.2018.27.SUP11.1
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    10.            Brooks BM, Shih CD, Brooks BM, Tower DE, Tran TT, Simon JE, Armstrong DG. The Diabetic Foot-Pain-Depression Cycle. J Am Podiatr Med Assoc. 2023 May-Jun;113(3):22-126. doi: 10.7547/22-126. PMID: 37463195.
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    Disclaimer: The views and opinions expressed are those of the author(s) and do not necessarily reflect the official policy or position of Podiatry Today 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.