Podiatry - Does not include the ankle

[TexasPhysician]

Does this mean podiatrists can't practice medicine that includes the ankle or above in TX? I found this recent court decision, and I was wondering what the counter-argument by you all would be.

Texas Orthopaedic Association v. Texas State Board of Podiatric Medicine
2008 Tex. App. LEXIS 1819 (Tex. Ct. App. 3rd Dist. 2008)

This "scope of practice" suit challenges the validity of a regulation adopted by TSBPM. The Texas podiatric statute restricts podiatric care to medical conditions concerning the "foot." Under the TSBPM regulation, the "foot" is defined to include "the ankle and the tibia and fibula in their articulation with the talus…inclusive of all soft tissues…that insert into the tibia and fibula in their articulation with the talus."

Courts ruled in favor of TOA. Podiatry does not include the ankle or above in TX. An appeal is likely.

Separately, the Texas Podiatric Medical Association (TPMA) brought its own suit against TOA, the TMA, and the TOA president, claiming that the defendants violated the Texas antitrust laws by urging hospitals to refuse to credential podiatrists to treat diseases of or injuries to the ankle. In that case, the court granted summary judgment in favor of TOA, TMA, and the TOA president.

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[DPMstudent]

its all been discussed before. use the search function to check the archives.

 

[jonwill]

Does this mean podiatrists can't practice medicine that includes the ankle or above in TX? I found this recent court decision, and I was wondering what the counter-argument by you all would be.

Texas Orthopaedic Association v. Texas State Board of Podiatric Medicine
2008 Tex. App. LEXIS 1819 (Tex. Ct. App. 3rd Dist. 2008)

This "scope of practice" suit challenges the validity of a regulation adopted by TSBPM. The Texas podiatric statute restricts podiatric care to medical conditions concerning the "foot." Under the TSBPM regulation, the "foot" is defined to include "the ankle and the tibia and fibula in their articulation with the talus…inclusive of all soft tissues…that insert into the tibia and fibula in their articulation with the talus."

Courts ruled in favor of TOA. Podiatry does not include the ankle or above in TX. An appeal is likely.

Separately, the Texas Podiatric Medical Association (TPMA) brought its own suit against TOA, the TMA, and the TOA president, claiming that the defendants violated the Texas antitrust laws by urging hospitals to refuse to credential podiatrists to treat diseases of or injuries to the ankle. In that case, the court granted summary judgment in favor of TOA, TMA, and the TOA president.

No, they are still doing ankles. Ultimately, it will bounce around the courts for years and in the end, nothing much will happen (except the TOA spending way too much money for nothing).

 

[165007]

I shadowed a program director from Texas, and from what I have heard, I highly doubt Texas will lose the ankle.

 

[Paulywog]

Orthos are getting jealous that PODs are superior to them in the lower extremity. Not really, maybe. Scope of practice is different for each state. Depends who wants to fork out the money, time, and energy is who will win the lower extremity territory. By the time I am done with residency, I am hoping everything will pan out and I can go to work on the whole lower extremity in the state that I settle down in. Sorry Ortho's, PODs are here to stay.

 

[cool_vkb]

Does this mean podiatrists can't practice medicine that includes the ankle or above in TX? I found this recent court decision, and I was wondering what the counter-argument by you all would be.[/B]

There has not been one incidence where pods were restrcited or their scope reduced. Infact all the time, the scope was increased or unaffected.

some cases that i remember that happened over the past few years:

1) Conneticut : They increased their scope to Ankle
2) Florida : This one is my fav, the Florida ortho association lobbied heavily to reduce the scope of practice of pods. The bill failed and the scope of practice was unaffected.
3) The center of medicaid and medicare now allows Pods to do their own independent H & Ps for their patients.
4) the state of california: A podiatrist can first assist in any surgery (whole body) and can charge the physician fee.
5) This summer, Pods won a major legislative battle over the prescripton of durable medical equipment, prosthetics, orthotics, and supplies (DME) supplier accreditation requirements.(previously pods were supposed to be certified before they could bill, now they dont need to go thru all that procedure).
6) In 2007, American Orthopaedic Foot & Ankle Society (AOFAS) issued a very encouraging new position statement on Podiatry. this is totally different from what they used to say before.

This is just a small list. Over all the profession is making great advancement and i dont think there is any chance there will be any reduction in scope of practice or restrictions. Infact we might even see scope of practice being increased

 

[215512]

There has not been one incidence where pods were restrcited or their scope reduced. Infact all the time, the scope was increased or unaffected.

some cases that i remember that happened over the past few years:

1) Conneticut : They increased their scope to Ankle
2) Florida : This one is my fav, the Florida ortho association lobbied heavily to reduce the scope of practice of pods. The bill failed and the scope of practice was unaffected.
3) The center of medicaid and medicare now allows Pods to do their own independent H & Ps for their patients.
4) the state of california: A podiatrist can first assist in any surgery (whole body) and can charge the physician fee.
5) This summer, Pods won a major legislative battle over the prescripton of durable medical equipment, prosthetics, orthotics, and supplies (DME) supplier accreditation requirements.(previously pods were supposed to be certified before they could bill, now they dont need to go thru all that procedure).
6) In 2007, American Orthopaedic Foot & Ankle Society (AOFAS) issued a very encouraging new position statement on Podiatry. this is totally different from what they used to say before.

This is just a small list. Over all the profession is making great advancement and i dont think there is any chance there will be any reduction in scope of practice or restrictions. Infact we might even see scope of practice being increased

lets hope! give all the trauma ankle cases to pods only!!!

 

[cool_vkb]

..

 

[Feli]

...give all the trauma ankle cases to pods only!!!

Statements like that can be a bit abrasive. I think the cases should go to the most qualified and competent surgeon who is available in the immediate area.

Degree doesn't matter. There are guys doing remarkable ankle work and guys doing crummy work with DPMs and MDs alike. It's all a matter of training, experience, and work ethic.

 

[PMSIII]

There are alot of really great foot and ankle orthos out there, so before people get excited and post statements that discount orthopedic surgeons, please do some research before making uneducated statements.

The Texas situation is an example of politics in medicine. This happens with turf wars and territories. There's nothing new with that and as jonwill previously mentioned, decisions like that typically bounce around the court - so there's no need to hit the panic button. The reality of the situation is that although we have quite a few old-timers practicing out there who are NOT qualified to do reconstructive procedures, and ankle traumas, we do in fact have more well-trained foot and ankle surgeons doing great things for our profession. These guys paid their dues and are getting the respect they earned from medical colleagues including Orthopedic surgeons. I want to clarify to the pre-pods and new pod students that the Ortho vs Podiatry "issue" is some what exaggerated from what your schools tell you. I can't speak for all residency programs and hospitals, but you'll generally see in programs with well-trained pods, a very healthy pods-ortho relationship. Believe it or not, but this is fairly common.

I don't want to mislead anyone and say that EVERY pod is respected by orthos or say that EVERY pod is qualified for ankle trauma and reconstructive procedures, but what I am saying is that our training has gotten better, the quality of our residents and attendings has been consistently improving in the right directions, and our relationship with other medical specialties has improved significantly as we all work together to improve the quality of care for our patients.

 

[cool_vkb]

There are alot of really great foot and ankle orthos out there, so before people get excited and post statements that discount orthopedic surgeons, please do some research before making uneducated statements.

 

[cool_vkb]

Statements like that can be a bit abrasive. I think the cases should go to the most qualified and competent surgeon who is available in the immediate area.

Degree doesn't matter. There are guys doing remarkable ankle work and guys doing crummy work with DPMs and MDs alike. It's all a matter of training, experience, and work ethic.