Key Takeaways

• Diabetic foot care (multidisciplinary setting): Coordinated care among podiatrists, nurse practitioners, wound nurses, physical therapists, diabetic educators, and nutritionists addresses surgery, wound management, gait analysis, offloading, orthotics, and diabetes education.
• Team-based care: The speaker identified working in silos as a common barrier; integrating specialty roles improves coordination for medically complex patients.
• Patient education: Reinforce education at every patient encounter, including daily foot checks, appropriate footwear, avoiding barefoot walking, diabetes management, teach-back, and repeated messaging to improve understanding in complex patients.

Please note: This content is a direct transcript, capturing the authentic conversation without edits. Some language may reflect the flow of live discussion rather than polished text. 

Transcript

So I'm really excited about the multidisciplinary panel because it is looking at the approach from different angles. So what is your role? So what is the DPM's role? What is the nurse practitioner's role, the nursing role? What is the physical therapist's role? We all know that these patients are very complex and it requires a team approach to helping them. 

The facility that I'm at right now is kind of nice because I'm integrated into a podiatry clinic and a hyperbarics clinic. So with that practice, we do have a podiatrist on staff at all times. So between myself and the podiatrist, we do a lot of working together for these patients. Kind of everybody, instead of working in silos, we're working together as a team. So the podiatrist might do the surgical intervention for the patient. They will take them to the OR. They'll do the tendon lengthening. They will help with their gait. And then they may follow up with myself or one of the wound nurses, depending on the setting. 

And what we'll decide is what their dressing changes are going to be. How are we going to manage the wound? How are we going to educate the patient on all the other things that goes on with diabetic foot care? Are we going to get them to a diabetic educator? We need to get them to a nutritionist, possibly—looking at those aspects. And then, of course, our physical therapist is very important because they're going to help the patient with their gait analysis. They're going to help them get fitted for custom orthotics. They're going to help them with their offloading. So it's kind of nice because every person in the panel or in the team can do some component of the therapy, but when you have somebody that specializes in a certain part, it just seems to work a lot better for the patients. 

The most common breakdown that I see I think is when people try to work in silos. So they're not working together as part of the team. They're trying to do everything themselves. And you might not have the best access to stuff. Or you might not have, in the case of the podiatry, podiatrists have very busy schedules. So they might not have the access or time that's needed to coordinate the care of the patient. But their aspect or their part in managing this is very different than what the nursing part management is. But everybody still needs to come together as a whole. 

I think it's important to address patient education at any level, regardless of who is seeing the patient. So upon any time you're touching the patient, you can give them some education. So for example, myself, I often educate the patients on making sure, with diabetic foot in particular, that they're checking their feet daily, making sure that they're wearing good footwear, they're not going barefoot. We also talk to them about managing their diabetes and who they need to get to for referrals for that. I think everybody has their role and it's important that everybody works together as a team to educate the patient about these things. 

And I also think it's important that, you know, reiterating it with the patient is okay. Sometimes people will say, well, so-and-so should have told you that already. Well, that's fine. But reiterating it and saying it again, it's not going to hurt anything. It's better because you can say something to a patient, walk out the door, somebody else can come in and then they'll be like, I never heard that before. So making sure we're really driving home patient education, reiterating, doing teach back, because a lot of times these patients are already overwhelmed or they're already medically complex. So they have a lot of things going on. So they might not necessarily understand the way one person is saying it versus the way another person would say it.