Wayne Jones, CPed teaches his clients that proper foot care starts with proper footwear.
Wayne Jones, CPed, says patients sometimes offer him tips when he delivers their shoes.
He always turns them down.
“This is my profession,” Jones, who practices pedorthics in Glasgow, Kentucky, said. “A handshake, a smile – their passing on a good word about what we do – that’s all the gratuity I need.”
Jones is the staff pedorthist at the Kentucky Diabetic Footwear and Pedorthic Center.
“But I got into the shoe business long before I got into pedorthics,” he said. “I sold my first pair of shoes in 1961 when I was going to college.”
Post-secondary education became his first career. He earned a doctor’s degree in higher education administration from Ohio University and retired after more than 30 years as a teacher and a college and university administrator. His career took him to college positions in Ohio, Wisconsin and Kentucky.
“When I retired, a friend of mine was in the DME [durable medical equipment] business here in Glasgow,” Jones remembered. “This was about the time the Therapeutic Shoe Bill was starting up, so I went to work for him doing pedorthics. I got certified [in 2002], and Randy and I decided to go into business together.”
“Randy” is Randall Dunham, CPed. Diabetes is so common in south-central Kentucky, where Glasgow is located, that Dunham added a diabetes branch to Tri-City Shoe Center, his pedorthics facility. He hired Jones to run it.
“Diabetes seems to be inherited,” Jones said. “It is passed down from generation to generation. But it is also lifestyle, he added. Too many Kentuckians are overweight, smoke and don’t get much exercise,” Jones explained.
Diabetes education is a big part of Jones’ practice, which is not confined to his workplace.
“We have clinics. We go out to the nursing homes, the senior citizens’ centers and the dialysis centers.” He and Dunham also educate local doctors about the services they provide.
In addition, Jones also said patient education can be a limb and even life-saving service for patients. He said that many people with diabetes suffer neuropathy in their feet. Because the neuropathy leads to a loss of sensation, patients can not feel pain. Hence, even a simple blister can become infected, lead to gangrene and necessitate amputation. Sometimes, diabetes patients who undergo amputation live shorter lives.
“We have several amputees we work with trying to save the other foot,” he said. “When diabetics come in, I talk to them about how they need to care for their feet,” Jones said. “They need to look for red spots and hot spots. But for the most part, patients have come to us from the doctor, so they have been informed about the necessity of proper foot care.”
Proper foot care starts with proper footwear, Jones added. Getting people into “sensible shoes” can be difficult, he conceded.
“People don’t want to change,” he said. “They still want to wear their dress shoes. But I tell people proper shoes won’t help them unless they wear them. I’ve had people come back and say, ‘That’s the best advice you’ve ever given me.’”
He added, “You can’t force a patient to do anything. But when they come back year after year and their shoes are worn out, you know they are wearing them. Sometimes, though, they don’t understand the importance of the diabetic insert. When they come back, they will have taken it out because they say it isn’t comfortable. You have to explain to them that the insert is important, too.”
Sometimes, Jones has to tell patients what a pedorthist is.
“Some people have no idea, or very little idea of what we do. They associate us with podiatrists. I even had one patient who confused us with orthodontics – but that’s the other end of the spectrum. I don’t make a big issue out of the ‘pedorthics’ title. I tell them we are professionals who are trained to fit them the best we can. We are part of the patient care team. We encourage patients to come back in a couple of weeks to see how they are doing. If they don’t come back, we will call and see how things are going.”
Jones is still going to work, though at age 67, he is past retirement age for most people.
“I enjoy working with Randy, and I enjoy working with people,” he said. “To be a good pedorthist, you have to have concern and care for your patients. You have to know the technical side to analyze what you see and convert, develop and adapt it to fit the needs of the patient.”
He and Dunham do the converting, developing and adapting in the facility’s full service orthotics lab. They custom make orthotics from scratch and also modify over-the-counter inserts.
While 90% of their practice involves diabetes patients, he said other doctor referrals come through the door.
“We see people with plantar fasciitis and bone spurs,” Jones said. “They see us after knee, hip or ankle surgery. We have several patients with leg length discrepancies. We also have some post-polio patients.”
He said he also fits footwear to the feet of some people who just want comfortable shoes.
“A lot of diabetic shoes work great as comfort shoes. They have extra space for the toes that have been cramped up all these years. You might add an orthotic, and they become more comfortable. The same thing that makes a diabetic shoe comfortable for a diabetic person makes the shoe comfortable for anybody – extra depth in the toe box and properly fitting in the arch length as well as the toe length.”
Jones said proper fitting starts with a Brannock Device.
“Most first-time patients are surprised when we get down on the floor, take off their shoes and measure their feet. They say, ‘I haven’t had my feet measured since I was a child.’”
Jones sometimes employs a 1930s-vintage unisex Brannock.
“It’s the type I used when I first went to work selling shoes,” Jones said with a smile. “There was an old gentleman who had a department store here in town, and when he retired and closed the store, he gave me that old Brannock. It reminds me what I started with way back when.”
Berry Craig is a correspondent for O&P Business News.