The great thing about medically managing your own diabetic foot infections is that they can be complicated in terms of discharge course, wounds may turn south pretty quickly and being the podiatrist you can delay or expedite discharge plans based on your expertise. Usually these types of patients end up on podiatry service if they are admitted primarily for a foot infection. If they are in DKA, in septic shock, they will be admitted to the ICU and medicine will take care of it until they are stable for the floor and then you can take over. If they are stable and admitted for just the foot infection, and is having some postop chest pain, as a podiatrist you can do a quick assessment, order stat EKG, troponins, chest xray if you suspect pulmonary issues in ddx, and call cardiology, or you can just call cardiology and ask them what to order. If they develop AKI, you can again do an assessment ask about hx of obstruction/bph, order PVR, follow the Cr, if you feeling fancy order a fena, hold nephrotoxic drugs, hold ACEI and any other htn meds that affect the afferent tubules of the kidneys which I'm not remembering, and then consult nephrology. OR you can just call them and ask them what to do. If they develop a swollen scrotum... you get the picture.. evaluate, then consult urology. You're not alone, medicine would be doing the same thing, evaluate what you can, start a workup based on what you know or are comfortable with, and then consult the appropriate service, they're available as a resource and you are not expected to know everything, but you should do at least the most basic workup based on what you do know. Same for outpatient problems, only I would lean towards deferring to their PCP rather than refer directly to the specialist. Unless it's ortho related stuff then I would evaluate, order appropriate workup/imaging, then refer.
