My Scope of Practice: A Podiatrist`s Thoughts on the Importance of Education

Words are, in my not-so-humble opinion,
our most inexhaustible source of magic. — JK Rowling, Harry Potter and the Deathly Hallows

As physician, instructor, and father, Jeffrey D. Lehrman, DPM, FASPS champions the value of education. The board-certified foot surgeon finds numerous opportunities to share his knowledge with patients and podiatric residents and constantly seeks ways to enhance what he knows, particularly regarding evidence-based wound care. 

After graduating with a Bachelor of Science degree in Biology from Ursinus College (Collegeville, PA) in 1997, Dr. Lehrman earned his Doctor of Podiatric Medicine degree in 2001 from the Ohio College of Podiatric Medicine (now the Kent State University College of Podiatric Medicine, Independence, OH). After a 3-year residency program in podiatric medicine and surgery, Dr. Lehrman went into private practice, where he has been for the past 12 years. Dr. Lehrman also is a Professor to the residents of the Crozer-Keystone Health System Podiatric Surgical Residency, and he trains students from the Temple University School of Podiatric Medicine (Philadelphia, PA) who rotate through his practice. “I enjoy working with my residents,” he says. “They’re youthful, energetic, anxious to learn, and  excited about their budding careers. I often learn more from them than they do from me.” 

Dr. Lehrman’s practice involves a great deal of wound care. He treats lower extremity wounds, most often diabetic or neuropathic ulcers, pressure ulcers, ischemic ulcers, gangrene, osteomyelitis, and venous stasis ulcers. As a surgeon, he performs debridements, limb salvage surgeries, and amputations. In 2008, his hospital opened a wound care center; he was one of the original panel physicians and still on staff, seeing patients and supervising hyperbaric medicine. 

“Our goal is always to heal wounds and prevent amputations,” Dr. Lehrman says. “I hope modeling the practice of evidence-based medicine can have an impact on future medical personnel. I stress to students and residents the importance of making decisions based on literature and evidence.”  

Dr. Lehrman also appreciates the importance — and challenges — of educating patients on how much diet, lifestyle, activity, and hygiene contribute to their health. “It can be frustrating to want so much for a patient to get better, want his or her wound to heal, and want to save a leg when the patient does not take an active role in his/her care,” he says. “Even after thorough education, we sometimes see patients continuing to make lifestyle choices that can have a negative impact on their ability to heal. Saving a patient’s limb remains one of the most rewarding aspects of my career. I don’t think anything beats that. Patients often present with limb-threatening problems, and they often require care over a long period of time. Going through this process with someone and ultimately being successful at saving a leg is a great feeling.”

In addition to serving on the Coding Committee of the American Podiatric Medical Association, the Board of Directors of the American Professional Wound Care Association, and the Wounds Editorial Advisory Board, Dr. Lehrman hopes to join the Pennsylvania State Board of Podiatry and continue to work as a consultant with wound care product companies over the next few years. He believes developing a stronger foothold in the wound care niche will allow him to educate himself as well as his peers, students, and companies, an effort enhanced by conference and symposia attendance. 

“Did you know 49% of diabetic foot ulcers never heal?” Dr. Lehrman says. “It’s terrible to think almost half of the people who develop a diabetic foot ulcer either require an amputation or die with the ulcer still present. I think we can do better. Not adhering to evidence-based medicine and using modalities that lack evidence to support their use contributes to poor outcomes. I want to improve these troubling statistics while educating my colleagues about how they can contribute to better wound care outcomes.” 

To reduce the stress of his busy schedule, Dr. Lehrman runs 6 days a week and reads to his 3 young children. “Reading is a big activity for us,” he says. “I love reading with my kids, especially Harry Potter.”

The most important chapter in Dr. Lehrman’s wound care playbook is education. “It’s important to educate yourself about options and stay on top of emerging technologies,” he says. “Nothing we do works 100% of the time. Not every treatment or product is right for every patient. There’s no such thing as a one-size-fits-all approach. You have to have options, and you have to be prepared with a Plan B.” Magical  words from Dr. Lehrman’s scope of practice. 

This article was not subject to the Ostomy Wound Management peer-review process.