Maximizing Our Impact During The COVID-19 Pandemic

An unprecedented lifetime event has uprooted the current state of being around the world. As the COVID-19 pandemic continues, it has had a powerful and dramatic impact on health-care professionals, including podiatric physicians. The roles that podiatrists play range from serving on the front lines to innovating new uses for telemedicine. Regardless of how podiatrists involve themselves with the crisis, a unique opportunity to fully use our medical training is presenting itself. 

In a pandemic, health-care systems stretch beyond capacity, including physical infrastructure and human capital. While engineers are busy building temporary medical units and transforming large structures into facilities capable of accommodating hospital beds and other equipment, podiatrists are now, in some cases, expeditiously practicing in alignment with their full scope of training, education, experience and expertise. As restrictions on elective surgeries continue, some podiatry residents, fellows and physician attendings are now working on various medical wards treating a variety of illnesses.  

Another cohort of podiatrists who are on the frontlines battling the COVID-19 crisis are those serving in the United States Armed Forces. Soldiers, airmen and sailors are deployed on various platforms while others are under assignment by their local commands to triage and test coronavirus patients along with other crisis-related duties.  

Podiatrists are also playing an essential role in helping to redirect trauma patients from hospitals so space and facilities can remain available for critical care patients. Aside from combat, in recent years, military medicine, and certainly not civilian medicine, has not dealt with mass casualties of this magnitude. The all hands-on deck approach solidifies the importance of podiatrists in health care. As specialists who have had a plethora of medicine rotations during our residency training, we are an untapped resource.    

As clinicians of certain specialties are in higher demand to work directly in patient care, podiatrists may have expanded opportunities to serve as administrators. Appointments may include various hospital committees, such as infection control and prevention, and occupational safety as well as positions essential to daily operations. Podiatrists may also exhibit their practice management expertise in enhanced ways due to the disruption of traditional operating models. Multiple sources now exist on how to survive financially during this time.  

Additionally, podiatrists have taken on an instrumental role in the implementation of telemedicine, maximizing patient encounters and allowing for continuity of care while practicing social distancing and eliminating the risk of unnecessary virus exposure to individuals. This popularized method of delivering health care may be a lasting one. Patient satisfaction may benefit the convenience and flexibility that telehealth provides. Surveys show that full utilization of technology is one factor that helps reduce physician burnout.¹ For many reasons, virtual health care appointments may become the norm in the future. Just as electronic medical records have revolutionized traditional paper charting, virtual health care may substantially replace face-to-face visits.

Another emerging trend is virtual podiatric medical conferences that have become necessary for attaining continuing medical education credits. The organizers and expert speakers alike display ingenuity in navigating a novel and productive learning arena.    

Another niche in which podiatrists can excel during this time is in evidence-based medicine. Like many other medical conditions, early COVID-19 symptoms may manifest themselves in the lower extremity. Research on “COVID toes” is ongoing by leading dermatologists and podiatrists. Partnerships with other specialties have led to the establishment of SARS-CoV-2 clinical symptomology registries.² In addition, a COVID-19 Foot Registry now exists with “the goal to improve treatment and prevention of COVID-19.”³ 

We have also seen the expeditious emergence of a “Pandemic Diabetic Foot Triage System” to help podiatrists manage patients who are at increased risk while reducing the COVID-19 risk.⁴ 

Final Thoughts         

Podiatric physicians have numerous reasons for choosing to pursue the specialty. Early in training, each student of podiatry pledged the Hippocratic Oath. The gist of this oath is more essential than ever. Regardless of the title or initials behind your last name, now is a chance to make an impact of a lifetime. 

I express my most sincere gratitude to the mission essential heroes serving in all capacities.    

“Healing is a matter of time but it is sometimes also a matter of opportunity.”
- Hippocrates   

Dr. Ryans is in private practice in St. Louis. 

References

1. Physician’s Weekly. 3 Ways Telemedicine Reduces Provider Burnout. Available at: https://www.physiciansweekly.com/3-ways-telemedicine-reduces-provider-burnout/ . Published July 20, 2018. Accessed May 7, 2020.
2. American Academy of Dermatology. COVID-19 dermatology registry. Available at: https://www.aad.org/member/practice/coronavirus/registry . Accessed May 7, 2020.
3. COVID-19 foot registry. Available at: https://covidfootregistry.com/ . Accessed May 7, 2020.
4. Rogers LC, Lavery LA, Joseph WS, Armstrong DG. All feet on deck – the role of podiatry during the COVID-19 pandemic: Preventing hospitalizations in an overburdened healthcare system, reducing amputation and death in people with diabetes. J Am Podiatr Med Assoc. 2020. (In Press) Available at: https://www.japmaonline.org/doi/10.7547/20-051 . Accessed May 7, 2020.