Foot care: who cares?

Abstract

Foot disorders are common in elderly people and lead to significant difficulties in the form of immobility, pain and gait imbalance. Neuropathic changes associated with systemic disease, such as diabetes, carries the potential for ulcer development leading to possible foot or lower limb amputation. The role of the podiatric surgeon and the podiatrist/chiropodist in the prevention of foot problems in elderly patients is an important and often neglected element of health care for this group. Foot care is at present provided by podiatrists/chiropodists, nurses, orthotists, general practitioners, rheumatologists, geriatricians, casualty specialists, orthopaedic surgeons and podiatric surgeons. Sadly, foot care provision by these professionals is poorly co-ordinated. In most cases this is the result of the general lack of knowledge most professions have about the role of others; however, in at least one instance (orthopaedics), the issue is one of professional rivalry.