Could Falls Prevention Be Podiatry's 'Next Big Thing'?

During a plenary lecture at The National, Rachel Albright, DPM, MPH, and Adam Fleischer, DPM, MPH, will explore the topic of falls prevention, a major focus of public health efforts and an expensive problem for America’s health-care system. The National Today caught up with Dr. Albright to learn more about the impact falls have for patients and the healthy system and how podiatrists could play a central role in addressing this problem.

TNT: Why is falls prevention such an important topic, both from the perspective of patient care and podiatry’s ability to have an impact?

Falling in adults aged 65 and over has major impacts on our health system. Not only does it cost our system billions of dollars every year, but it impacts both the person affected and their loved ones. Falls can have devastating consequences including loss of independence, bodily injury, and death. In fact, it’s one of the leading causes of death in adults over 65. We have learned over time that this event is preventable. With podiatrists being one of the primary providers serving this age group, we have multiple exposures to patients and can make each encounter impactful toward prevention.

TNT: What are some of the risk factors podiatric physicians should be aware of among their patients?

The risk factors for falls are numerous, ranging from things we cannot change (such as age and cognitive decline) to things we can change (such as foot pain, gait instability, and medications). Some factors are modifiable, but difficult to tackle in our clinics (like uneven sidewalks and stairs without railings). We need to focus on the risks we can modify and elicit the help of our peers to ensure multiple factors are being addressed at the same time. As podiatrists, we can perform gait assessments and shoe and orthotic evaluations, and resolve foot pain to make big impacts. 

TNT: What kinds of interventions can podiatrists implement to mitigate falls risk?

Podiatrists can intervene at multiple points in the care continuum. Probably the most important thing is finding the “at-risk” population. Podiatrists can make a big impact by screening all adults 65 and over for falls using the STEADI screening method to find people who are at risk before a fall happens. Podiatrists can then perform assessments as needed. Podiatrists should assess for gait and balance issues; muscle weakness; medications that can cause falls; and foot pain that may require orthotics, shoe modifications, braces, or even surgery. 

TNT: What advice do you hope the audience takes back to practice with them from this session?

I hope the audience feels empowered about the influence they can have on falls prevention. This could be a big way that podiatrists prove their worth within the health-care system, similar to the way we did with diabetic foot care. No one can deny how essential a podiatrist is to the diabetic foot—but it wasn’t always like that. It required years of research and the whole profession getting on board with taking ownership in the care for these patients. Falls can be the “next big thing” that we have an impact on. It could be the next place where our fellow providers say, “I need a podiatrist!”