Last week I received a consult from a primary care resident referring a patient with diabetes to the podiatry clinic for treatment of “Coins and Callosities.” Really, those were the exact words that were written on the consult request. I could not make this up. At first I thought this was some Freudian slip, perhaps it was pay day, or the resident physician was thinking about lunch and how much it was going to cost? Or was there something more subtle going on here?

An issue that is of constant concern for me is that when it comes to foot vocabulary, most patients and providers don’t really have a large one. I would guess that the three most commonly known foot related words in the English language are toenail, bunion, and wart.

With that limited vocabulary it gives us only a few choices of what to call something on the foot. No matter what the problem with a toenail is, it is a fungus infection. No matter what the deformity might be on the foot, it is a bunion. And, no matter what the skin lesion is, it is a wart. That makes things fine and easy to describe.

But wait, then what is that pigmented skin lesion on the foot, a nevi, a melanoma, a giant comedion? It is easy to see where we might end up in big trouble with such a small vocabulary of foot words.

Looking backward over my shoulder at how we educate patients and providers about foot health and foot care, I think we need to do a better job. One of the first priorities should be a better education and an expanding vocabulary about our feet including how to tell a “Coin” from a “Callosity.”

-drhinkes