Duncan Stang
Duncan Stang
Chief Podiatrist, Hairmyres Hospital, NHS Lanarkshire
I qualified in 1980 from Glasgow School of Podiatry and have worked in diabetes foot-care for the last sixteen years.
In my current position in Hairmyres Hospital I work solely in Diabetes concentrating on the treatment of the high risk and ulcerated foot running a very busy multidisciplinary foot clinic.
I lecture as part of a multidisciplinary team at Strathclyde University in Glasgow on the course ‘ORTHOTIC MANAGEMENT OF THE DIABETIC FOOT’ and have travelled as part of the team to present this course in Germany and Portugal.
I have set up and chair “The Scottish Diabetes Specialist Podiatrist Group” who’s aim is to share good practice and to set and raise standards of Podiatry care for people with Diabetes across Scotland. (This group has now become the Scottish ‘branch’ of FDUK).
I lead currently the Podiatry group working with the Scottish Care Information Diabetes Collaboration (SCI-DC) rewriting the screening and ulcer management areas of the system to establish a National I.T. system to support Diabetes Clinical Networks across Scotland.
Describe your typical working day
My working day starts at 8.45am (can be 8.55am depending how organized my children have been as it’s me who runs them to school !!).
Turning on my computer is the first thing I do to check my e-mails and by the time it has booted up the secretary has usually informed me my first patient has arrived. During the course of the morning I will probably have about six patients booked in for dressings and will probably have two or three referred by the consultants for treatment/advice from the clinic.
The phone goes constantly in the clinic with referrals from GP’s, DN’s, PN’s community Podiatrists and patients etc and can quite often end up with it being ignored until the end of the clinic for the calls to be dealt with at lunchtime.
The afternoons run very much the same as the mornings but some time is generally set aside to visit any patients who I have admitted to the ward to review their progress and liase with the medical staff regarding treatment, discharge planning and follow up regimes.
Wednesday pm is when we run the multidisciplinary foot ulcer clinic which is staffed by two Podiatrists a Podiatry technician a Consultant an Orthotist and a Diabetes specialist nurse, this clinic generally runs till about 6pm. Also attending this clinic for education are SHO’s, JHO’s Nursing students and Orthotic students.
We used to carry out quite a substantial amount of screening in the Diabetes centre but this is now mostly taking place in primary care.
How did you first become interested in working with the foot in diabetes?
My interest in Diabetes foot-care started after providing sickness cover one day per week for the Podiatrist in the Diabetes Centre of Gartnavel General Hospital in Glasgow, which was a very busy but rewarding clinic.
Why does this speciality appeal to you as a career choice, and who, if anyone influenced / motivated / guided you in this area of work?
I was fascinated by the complexity of the condition and the fact of working as part of a team rather than in isolation. The chance to make a real difference and influence outcomes also appealed greatly.
I do remember a lecturer at college called Mr George Clarkston being interested in the Diabetic foot and I think it was he who planted the ‘seed’ of interest in me and when the opportunity presented itself I recognised the potential.
What have been your best and worst moments working in this area and why?
The best moments are usually around Christmas when grateful patients appear bearing nice gifts (especially the ‘Malt’ variety)!
But seriously the best moments are putting a treatment plan in place and ending up with a satisfactory outcome with a happy and grateful patient.
The worst moments usually arise when watching the disease process result in an amputation and not being able to prevent it, especially when you know that even with good counselling and management the patient will not do well.
Do you have any coping strategies you can share with us that get you through the worst bits?
Skiing, Fishing and the odd drop of the strong stuff. Not necessarily in that order!!
Do you have any new related projects in development at the moment?
I am presently in talks with ConvaTec regarding the setting up a study
to investigate the effect of a topical anti-microbial dressing in holistic management of DFU using local best practice (LBP) in a real-life setting.