People who phone Kizer Pharmacy in Union City, Tenn., sometimes ask for “the shoe lady.”
They mean Brittney Caldwell, CFts, an ABC-certified fitter-therapeutic shoes. She does not mind the nickname.
“A lot of people don’t look at this as a profession,” she said. “But when they come in and I do an assessment, measure them and take time to fit them, they realize that this is a little bit more than a shoe store.”
Certified in 2011, Caldwell is the only certified shoe fitter in Union City.
The pharmacy opened in 2003 and began carrying diabetic footwear the next year. “We were the only place that did diabetes shoes then,” she said.
“Getting certified has given me more understanding of the anatomy of the foot and why special shoes are needed for diabetics. It also helps me explain diabetic shoes to the patients more in depth.”
Someone to talk to
Yet she said there is more to her job than just fitting feet to footwear and orthoses.
“A lot of my patients are elderly people who want somebody to talk to. A lot of them can’t get out or they can’t get somebody to drive them except once or twice a month. They may come in and have their fitting, but once their shoes come in, instead of them having to wait a month or so, I will take the shoes to their house,” Caldwell said.
Caldwell also calls at nursing homes and assisted living facilities in and around Union City, the seat of Obion County in northwest Tennessee. “A lot of them don’t get out, so I go to them.”
Elderly patients tell Caldwell about more than their foot woes. She learns about their kids and grandkids and dogs and cats.
Many of Caldwell’s diabetes patients are unaware that therapeutic footwear can save their limbs and lives. “They think of shoes as more like an option, and not a necessity. But a lot of people do get them every year when it is time. They come like clockwork.”
Focus on benefits
Caldwell explains to all of her patients that the special footwear can help ward off calluses, blisters and other seemingly minor injuries to the feet that can ulcerate and become major problems.
Caldwell sometimes sees foot issues that are not noted in the referring physician’s information that the patient brings to her. To qualify for the prescription therapeutic shoe benefit under Medicare, patients must have certification from a physician that they have diabetes and need the footwear.
“If I see that a patient has an open wound on his foot and I don’t see it on the doctor’s clinical notes, I will stop and call the doctor,” Caldwell said. “I don’t feel comfortable putting them in shoes if a wound is red and oozing.”
Caldwell wears a pair of athletic shoes made for diabetes patients. “I don’t have diabetes, but the shoes are beneficial for me when I am exercising and walking.”
Caldwell said telling patients that she has a pair of diabetic footwear helps sell them on the shoes. She understands that having to wear therapeutic footwear means the loss of independence, especially for older people.
“But the fact that there are so many styles to choose from helps cushion the shock. Some of the shoes look like SAS and other comfort shoes people wear.”
Dr. Comfort and Orthofeet are Caldwell’s shoe line. But no matter how well shoes blend comfort and style, they will not help a patient if they are not properly fitted, Caldwell said.
Good fit improves compliance
She starts with a visual foot assessment which helps her match patients with the shoes the doctor says they need. Caldwell added that patients accustomed to shopping in retail shoe stores are surprised at the service she provides.
“You got to a shoe store today and they don’t even measure you,” she said.
She said putting patients into the proper size shoe helps improve compliance.
“But style is important, too,” Caldwell said. “Years ago, some people would get the diabetic shoes and put them in their closet and leave them.”
Caldwell said most of her patients do wear the shoes she provides them. “This is a small town, so I see them out in public and they say, ‘Oh, I love my shoes. They’ve helped so much.”
Caldwell loves hearing that. She said she also loves her job — both of them. She is also the pharmacy billing manager.
She said knowing the business side of her profession helps make her a better fitter, and vice versa.
“The pharmacy is very busy. I am constantly reconciling numbers, numbers, numbers. Getting to sit down with patients and getting to know them gives me a good break.”