Building Effective Multidisciplinary Wound Care Teams in Podiatric Practice

Multidisciplinary collaboration isn’t limited to academic medical centers—it’s achievable in private and community-based podiatric practices as well. In this interview, Dr. Johnson outlines practical strategies for assembling decentralized wound care teams that improve efficiency, continuity, and patient outcomes – and points out where this model applies to podiatry outside of wound care. 

Key Takeaways

• Multidisciplinary wound care significantly improves outcomes. Coordinated care involving podiatry, vascular surgery, endocrinology, infectious disease, orthopedics, and primary care consistently leads to higher healing rates for diabetic foot ulcers and chronic wounds by addressing both local and systemic drivers of delayed healing.
• Podiatrists are uniquely positioned to lead these teams—inside and outside of wound care. With specialized expertise in foot and ankle pathology, podiatrists often serve as the central coordinator—or “captain”—of multidisciplinary care across multiple settings, guiding treatment plans, facilitating communication, and ensuring continuity across specialties.
• Clear communication enables multidisciplinary care in any practice setting. Even without shared EMRs or colocated specialists, decentralized wound care teams can succeed through proactive communication, defined roles, and strategic use of telehealth and remote monitoring—particularly in rural or resource-limited regions.

From your experience, what are the most significant benefits of a multidisciplinary approach to wound care, particularly for improving patient outcomes in DFUs and chronic wounds?

From an outcomes standpoint, the benefits are very clear: multidisciplinary care leads to better healing rates and better overall outcomes. When we look specifically at diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs), recent data suggest that when a true multidisciplinary team is involved, healing rates improve.^1,2

Beyond the numbers, the real value lies in the built-in “safety net” that multidisciplinary care provides. This is not about reducing accountability; quite the opposite. It’s about the additive effect of multiple areas of expertise working together. If a provider is less comfortable managing infectious disease, an infectious disease specialist can step in. If there are questions about offloading or devices, orthotists and prosthetists can contribute. Even frontline team members, such as medical assistants, often notice subtle changes between visits before the provider ever enters the room.

Endocrinologists play a critical role in optimizing glycemic control or managing other metabolic factors. Primary care physicians (PCPs) help manage the many comorbidities these patients may carry. When all of these roles align, there is a cohesion that allows us to move patients toward closure of chronic wounds more efficiently.

Another advantage is continuity of care when patients miss visits. If a patient doesn’t see their podiatrist one week but does see their endocrinologist or PCP, the team still has insight into wound progression. Ideally, having multiple specialists in the same location reduces visit burden, but even when that’s not possible, multidisciplinary communication helps prevent patients from falling through the cracks.

Many podiatrists work in private practice or community settings rather than academic centers. How can clinicians in these environments start to build effective multidisciplinary teams?

As an academic podiatrist, I have the advantage of built-in access to multidisciplinary care. In private practice or community and rural settings, clinicians have to build that structure themselves. I often refer to this as a decentralized multidisciplinary wound care model. The team still exists, but members may not be physically colocated.

The first step is simply letting other specialists know what you want to do. If you want to treat diabetic foot ulcers, chronic foot wounds, or venous leg ulcers, make that known at hospital meetings, committee meetings, and local professional gatherings. When other providers know you have a genuine interest in wound care, they are more likely to refer those patients to you.

Equally important is clarifying roles. Many community-based specialists hesitate to accept referrals because they worry they are being asked to “take over” the patient. That’s often not the case. I make it very clear: I am taking ownership of the wound. I am asking for your expertise—infectious disease management, glycemic control, hypertension management—not to offload responsibility.

Open communication is essential, especially when you don’t share an electronic medical record (EMR). Picking up the phone goes a long way. Calling an endocrinologist to say, “This patient’s glucose was uncontrolled this morning,” or a PCP to explain why elevated blood pressure prevented debridement that day, builds trust. Overcommunication is far better than undercommunication, I feel, in decentralized care models.

I’ve seen this approach succeed across the country. The common denominator is consistent, proactive communication and clear ownership of the patient’s wound care plan.

In regions where access to vascular surgeons, infectious disease specialists, or advanced wound care centers is limited, what strategies can podiatrists use to maintain multidisciplinary coordination?

Rural and underserved settings present real challenges, especially when key specialists are hours away. In these situations, the goal is to maximize every interaction and every visit.

Telehealth has become one of the most powerful tools we have. Coordinating telehealth visits from the podiatry office—with vascular surgery or endocrinology, for example—can significantly reduce barriers for patients. Within your own practice, performing as many diagnostic tests as possible, such as ankle-brachial index (ABI) studies or necessary lab work, helps streamline care.

Before sending a patient on a long drive to see a specialist, I recommend calling or emailing that specialist to ask exactly what studies they want completed in advance. That prevents wasted visits and delays in care. Patients become discouraged when they travel hours only to learn they need additional testing before an intervention can even be discussed.

In my experience, digital imaging, thorough documentation, and remote monitoring all support this process. I have patients in very remote areas—literally in the woods of Michigan—and we still make it work through careful planning and telehealth. It is challenging, but with intentional coordination, multidisciplinary care is still achievable.

What are best some practices for communication and role definition within a multidisciplinary wound care team?

The most important concept is identifying a clear leader, or what I often call the “captain,” for each patient. Someone has to guide the ship. In many cases, that role falls to the podiatrist, but in others, such as severe vascular disease, the vascular team may take the lead.

Once the captain is established, roles are defined early—ideally on day one. If vascular disease is the primary driver, I communicate clearly that my role is supportive and advocacy-based, while respecting their expertise. That doesn’t mean disengagement; it means coordinated leadership.

We also discuss practical questions upfront: Who is seeing the patient most frequently? Who is monitoring progression? When should other team members step in? Some patients are stable and only need intermittent vascular input; others are fragile and require close, shared surveillance to prevent limb loss.

Establishing these expectations early prevents confusion and delays. Clear leadership and role clarity are foundational to effective multidisciplinary care.

Given the podiatrist’s expertise in lower extremity pathology, how can we position ourselves as leaders within multidisciplinary wound care teams?

In many settings, leadership naturally falls to the podiatrist when it comes to lower extremity wounds. Orthopedic surgeons, vascular surgeons, and infectious disease specialists often look to podiatry for guidance on chronic foot and ankle ulcerations.

That leadership comes with responsibility. The podiatrist must be in the driver’s seat; coordinating therapy, nursing care, offloading, vascular referrals, labs, imaging, and patient education. Communication flows through us. Patients often reach out to us first when they notice changes or signs of infection.

Over time, our specialty has built a reputation for being the most knowledgeable in lower extremity wound care. That trust allows us to lead effectively, but it also requires us to remain accountable, organized, and proactive.

As telemedicine and remote monitoring tools evolve, how do you see technology extending multidisciplinary collaboration?

Technology is no longer optional—it’s essential, especially in decentralized care models. When manpower is limited, we rely on computing power: digital imaging, remote patient monitoring, AI-supported tools, and machine learning. These tools supplement and enhance, but should never replace, human decision making and expertise, however. 

I find that proper implementation of these tools can help not only with wound healing but also with preventing reulceration after closure. Without them, I see that staff burnout becomes a real concern, as nurses and medical assistants struggle to manage increasing patient complexity.

In my observation, digital innovation allows us to scale care safely and efficiently while maintaining quality outcomes. For this patient population, embracing technology is not just helpful, it’s progressively more and more necessary.

For podiatrists oriented primarily to solo clinical practice, what mindset and skills are most important for multidisciplinary collaboration?

Leadership and communication are the most critical skills. Whether or not you’re formally designated as the leader, patients and team members look to the podiatrist for direction in lower extremity care.

That leadership must be supported by education. Continuing medical education is essential. Today, there are accessible options—such as conferences and virtual education platforms—that simply did not exist when I was in training.

Wound care is now a bread and butter part of podiatry. We are not limited to bunions and hammertoes. Owning that identity—and being well-trained in it—is essential for success in modern podiatric practice.

Beyond wound care, what additional professionals should podiatrists include in a multidisciplinary network for lower extremity care?

Physical and occupational therapists are invaluable for restoring function, managing lymphedema, and supporting postoperative and chronic care. Infectious disease specialists are critical for both postoperative and chronic wound infections. Endocrinologists support patients with diabetes and autoimmune disease. Primary care physicians remain essential frontline partners.

Orthopedic colleagues, dermatology, oncology, and neurology also play important roles, given the broad range of pathologies podiatrists encounter. You never know what will walk through the door, and even simple conditions can deteriorate quickly.

The more collaborative relationships you build at the local or institutional level, the better prepared you are to manage complex cases. Ultimately, multidisciplinary collaboration makes us better providers and leads to better outcomes for our patients.

Dr. Johnson is a fellowship-trained Clinical Assistant Professor of Orthopaedic Surgery at the University of Michigan Medical School. He is board certified by the American Board of Podiatric Medicine and the American Board of Wound Management. Dr. Johnson serves as an Executive Board Member of Kent State University College of Podiatric Medicine and Past Chairman of the Board of Directors for the American Society of Podiatric Surgeons. He was recent elected President of the Save a Leg Save a Life Foundation. Dr. Johnson is a Fellow of The Royal College of Physicians and Surgeons of Glasgow.

References
1.     Meloni M, Izzo V, Giurato L, Gandini R, Uccioli L. Effectiveness of multidisciplinary team care in diabetic foot management: a systematic review. J Diabetes Metab Disord. 2024;23(1):1-10. 
2.     Oo MZ, Siribumrungwong B, Orrapin S, Sermsathanasawadi N, Papanas N, Rerkasem K. Comprehensive Management of Venous Leg Ulcers: Evidence-Based Strategies and Treatment Options. Int J Low Extrem Wounds. 2025;24(2):257-259. 

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