Joe Mills and I, along with many of our colleagues have been struck with how our population has changed, but our methods (and language) haven’t. This is explained, we believe, rather well in a dendrogram (cluster analysis) from a study from Lavery Lavery, Edgar Peters and me in 2008 (see below). Please note that component causes of ulcers (neuropathy, deformity, repetitive stress) form one cluster– one tributary if you will. The other is formed solely by peripheral artery disease.
For a long time– generations, in fact– these problems have been relatively separate. Therefore, care for them could be separate. Now, however, they’ve joined to create a torrent– a current– of pathology. We can’t keep rowing separately. We have to join up lest we be swept away. Common language and even common teams really are the way forward. We’re all in the same boat.