Podiatric physicians' perspectives on their role in promoting self-care in high-risk patients with diabetes

Jennifer Tinloy, Shailja Kaul, Jan Ulbrecht, Eric Schaefer, Robert A. Gabbay

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background: Foot self-care is key in preventing morbidity in high-risk diabetic patients. Motivational interviewing (MI) is an approach to encourage behavior change by patients that can be used in medical settings. The goal was to explore how podiatric physicians promote self-care in such patients and whether they use MI techniques. Methods: We conducted a 19-question online survey of US-based practicing podiatric physicians. Most answers were on a 5-point scale. The MI index was the sum of answers to five relevant questions. Results: Of 843 podiatric physicians, 86% considered foot self-care to be very important for high-risk diabetic patients, and 90% felt that it was their role to discuss foot self-care with them; 49% felt that they had training and were successful in promoting behavior change, but most were definitely (38%) or possibly (46%) interested in learning more. Only 24% of respondents scored at least 15 of 20 on the MI index. Higher MI scores were associated with more face time and more time discussing foot self-care but were not related to podiatric physicians' age, sex, geographic location, percentage of time in surgery, or years in practice. Reported barriers to counseling were lack of reimbursed time and poor patient engagement. Conclusions: Most podiatric physicians view self-care behavior among high-risk diabetic patients and their role in promoting it as very important; most feel already proficient, but only a few demonstrate MI skills; most are willing to learn more. Success in behavioral counseling, such as MI, is likely to require more time and may be encouraged by a move from fee-for-service to outcome-based reimbursement.

Original languageEnglish (US)
Pages (from-to)387-393
Number of pages7
JournalJournal of the American Podiatric Medical Association
Issue number4
StatePublished - Jul 2014

All Science Journal Classification (ASJC) codes

  • Podiatry
  • Orthopedics and Sports Medicine


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