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drmoon

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Just curious....I'm wondering if the overall postings on this site are more positive about the PA profession, negative or just neutral. I'm asking because, as a podiatrist (and a DPM who is applying to be an MD) my experiences with podiatry forums are that they are overwhelmingly negative and pessimistic about the past, present and future of podiatry. Every now and then someone will say that there are negative posts on other sites, but I feel that they are nowhere near as plentiful and anguished as on the podiatry forums.

If anyone had an opinion, I'd appreciate it.
 

CVPA

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For the most part, postings on this forum have been very positive about the profession, where it has gone and where it will go. Most that post here are applying to get into PA programs or are curious about the profession.

The negative posts that have been seen were almost exclusively limited to medical students who interjected their feelings of PAs and their role in medicine. This has historically resulted in a non-productive battle of words.

Fortunately, that has not happened in a while. Lets hope it stays that way. :cool:
 

Bandit

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"This has historically resulted in a non-productive battle of words."
amen brother
 
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MrBob

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I am new to the forum but not to the profession...I agree with the above statments about non productive battles. There is plenty for all of us to do in this job of caring for folks. Those who are negative about a profession (any one of many) usually are insecure in their roles whatever they may be and are trying usually to make themselves feel better about their choices, whether it is on this forum, a runners forum and bikers forum (HD -vs- Jap bike)....well...you get the picture....
BTW Curious.....I think you guys are REAL valuable and are very close to several podiatrists who help me with a myriad of foot problems that just are beyond me....We're all just trying to achieve the same end point...Care for folks and make a living for our families, don't ya'll agree?
 

PACmatthew

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My name is Matt, and I have been a PA for 4 years now. I am starting medical school this summer because I am simply not satisfied with the ambiguity of being a PA. Do I think that what I do will be that much different than what I do now when I am done? No! But for me, it is just a matter of happiness. I think most PA's overall are very happy being PA's, but I just am not. I am sick of having to re-explain daily what it is that I do and why I am not "studying to be a doctor". The term Assistant in PA is very degrading to our profession, and I wish they (AAPA) would change our title to something different. We get confused with medical assistants, legal assistants, dental assistants, and doctor's assistants. It underemphasises what we do.

Now as for the podiatry issue. This is a very volatile subject but one I will be honest about. Podiatrists are simply not physicians though they do call themselves that in many states legally. They are not licensed to practice medicine overall. Why do we need a provider for a certain body part who is not an MD or DO, when we have no such thing for any other body area or region. If this were the case, you would see "doctors of orthopedic medicine", and doctors or "family medicine", and they would all go to different medical schools. One of my very best friends is a podiatrist whom I share an office with, but I honestly am not swayed in my opinion of them because of him. The profession is redundant, and would be better served if they were phased into medical schools. Until that time, Orthopedic Foot Specialists will continue to cream podiatrists in court with their expert testimony simply based on their higher level of credibility.

We as PA's sort of have to deal with the same level of credibility issue because we as well are not physicians. This makes life hard at times.

MJM
 

efs

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Matt,

You really ought to check your sources and refernces before you go on providing your opinion an things you might not be qualified to.

Podiatrists are physicians.

For your information, there are only a couple hundred orthopaediac surgeons that consider themselves to be foot and ankle specialists. And most of them do not restrict their practices to the foot and ankle. Podiatrists do. For the most part, I think you will find that podiatrists are the "experts" when it comes to the foot and ankle.

I do not care to start a debate on this issue, but I really think you need to look into it a bit more before you offer your opinion.
 

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Eric,

I really don't care what your paper sources tell you, because I practice medicine in the real world, not the paper world. No matter what stats you throw out about Podiatrists and the fact that they are the experts, the courts say otherwise. I also do medical malpractice consulting, and I can tell you that Podiatrists get slaughtered in a court of law when it comes to head to head expert testimony against an ortho, even if they are not a foot specialist. Pods are often limited as to how "high up" the body they can go state to state, where in some states they can not even touch an anke joint. Now how can you be a foot specialist if you cannot even perform ankle surgery. The foot is more ankle than it is foot really. Now does what I said mean that Podiatrists are not qialified? Lord no, but in this world we are only as "qualified" as our stereotype can allow us to be. I am a physician assistant, but as "qualified" as I am, I cannot stand up to a physician. Just because one assumes the title of physician does not mean they practice unlimited medicine. As I said, only DO or MD can do such. There are also Naturopathic Phsicians who go by the term physician, but they are not doctors by law. If you cannot see a Podiatrist for a cold, for herpes, or for pink eye, then they are not physicians. You can walk into a cardiologist's office and though he/she is specialized in cardiology, they can also treat your other conditions IF THEY CHOOSE TO. This is what makes them a physician.

MJM
 

efs

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I really don't care to get into any debates.

Legally podiatrists are physicians.

If you saw a cardiologist who decided that they are capable of treating the whole body because they are a "physician" and they decide to undertake the care of an OB/GYN or Ortho or ENT or whatever problem, they may likely be oversteping the scope of their training. It would be very easy for any "physician" to get in over their head if they go outside the scope of their training. It really doesn't matter that they may legally be able to treat the "whole body".

I'm also not sure what you think I am talking about when you refer to my paper sources. I have been involved in health care for over 14 years now. My observations are not simply based on what I might have read.
 

PACmatthew

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Hey Eric,
Check and see what the Army uses Podiatrists for. The don't even commission them as physicians, but instead lump them in the medical service corps along with admin medical people, and pharmacists. I highly recommend you have your podiatrist do you annual digital rectal exam, over and over again to prove my point. In fact, if we tied you down to a gurney and placed you face down in a room with a podiatrist, an ortho physician, and a tube of KY Jelly, I bet you would beg for the ortho doc to do your prostate check. If you didn't, you certainly would the next time.
 

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I was snooping by and couldn't resist this topic.
Matt, with all due respect, your example was rediculous.

I guess it all depends on your definition of physican (n. a person licensed to practice medicine----- Medicine n. The science of diagnosing and treating disease). I think that would certainly cover podiatrists, and chiropractors, dentist, optometrist etc.

But what really tickled me is the example of an ortho doing a prostate exam. Do you really think that would ever happen? I work with a number of ophthalmologist and they will be the first to tell you that they don't have a clue when it goes beyond the eye (except maybe fresh out of residency). Once you do a particular job for many years the rest of your training goes by the wayside. A GP would be a different story but your idea that a specialist would be any better or worse off than a podiatrist is wrong I think. I wouldn't let either one near my buttocks. :D
 

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TomOD,

Sorry if it pissed you off about the prostate scenario, but it really holds water. You see, whether your ophtho friends want to admit it or not, they passed this exam in three parts called the USMLE, or they wouldn't be practicing. So, even if they have fogotten everything about medicine, they prooved at some point that they did know "all about medicine". So as a society , should we simply say that they should have never learned that material in the first place only because they do not currently use all that knowledge any longer? Of course not. If that were the case, we could refrain from requiring engineers to take calculus because they could rely on their pocket palm to do the math for them right? Or I guess we should stop requiring government to undergrads because they might not become lawyers right? Every ophthalmologist (even your buddies) can say that they have done a prostate exam, a PAP smear, delivered a baby, participated in intrabdominal surgery, was called ot 3AM during their intern year for the old woman who couldn't sleep. At one time or another, every true physician has dealt with all of these problems, even if only once, and proved such by passing the USMLE/COMLEX step 1-3. That is what makes a physician a physician. If your theory were to hold water, then we should have a separate medical school for every specialty so that they would not be subjected to learning things that would one day prove to be irrelevant to them right? Food for thought.
 

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maybe someone could help clarify something for me? why is it that podiatrists seem to have a negative reputation and are always having their credibiltiy and expertise questioned, yet dentists do not go to medical school and "specialize" but nobody ever questions their ability or knowledge. To me, there seems to be a double-standard between the two professions. why is this? someone please enlighten me.
 

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This is because dentists deal strictly with teeth usually, and do not call themselves "Physicians". Yes, they are doctors, but they do not mut themselves into the mortar fire zone only to be called physicians. This should be the reality facing Podiatrists. If they simply admitted that they were not physicians, they would probably be respected by all for their area of expertise. Nobody really questions the the expertise of Podiatry, because hell, its nice to have someone to refer all those nasty foot problems to anyway. I would rather do five Paps before I had to cryo one plantar wart. The only real problem with Podiatrists is that they call themselves physicians. Dentists would get that flack too if they called themselves dental physicians.

MJM
 
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MrBob

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I think you are wrong here, Matt. Maybe medical school is what you need. You sound like a real dissatisfied practitioner.

BTW I have been a PA for 21 years so I do consider myself an expert in this field. Podiatrist is a Doc.....
 

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Mr. Bob,

No dissatisfaction with medicine or my patients, but instead I have dissatisfaction with being a PA. I just find it ambiguous. I am completely happy that you can be satisfied with being a PA. I will also be a PA advocate when I am out of school. I just don't think that PA's should be putting themselves into situations where they are competition for physicians. And Bob, ws that a slip of the tongue that you called Podiatrists "docs"? As you will see if you read all my posts, I do not dispute that Pods are docs. I simply dispute that they are physicians. If you let them go by the title physician, then you may as well let chiropractors, optometrists, and doctorate level PA's for that matter, because the same argument can be made. For that matter, lets call Pharm D's physicians of pharmacy. A physician is a person who is liscensed to practice medicine in an unlimited fashion, so why does the definition have to be adjusted for Pods and Pods alone? Name one other group for whom this exception to the definition is made? And why does an optometrist not rate the same distinction.
 

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Actually in Oregan, Oklahoma and ,I think, Washington State, Optometrist are by legislation called Optometric Physicians....sorry. And I know here in NC, Chiropractors are listed as Chiropractic Physicians.

Personally I am not really bothered with anyone calling themselves a physician....I could not care less if the trash man called himself the "Garbage physician". We have a car mechanic that call himself "The Car Doc"......You know he's not really a doctor....probably never even graduated H.S.

I have found that any bias that exist (and I see a fair share of it as an OD) between MD's and PA's, Chiroprators, Optometrists, Podiatrists, etc. is almost always due to a lack of personal worth. Any health care person (and I think Mr. Bob touched on this in an earlier post) that is good, confident and has the respect of his patients really don't have the time to worry about other professionals and if the are "real doctors". They are too busy working, taking care of people and making money. Only when they are threatened financially does it become a "superiority thing" .

I see what your trying to say but I really think your spending your time worrying about something that is irrelevant. I do congratulate your for going on the Med. school and I wish you well.
 

MrBob

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Thanks, Tom, glad I wasn't misunderstood there...

No Matt, there wasn't a slip of the tongue. Perhaps you didn't mean for it to sound so obvious but to those of us (at least me) reading your post, you were pretty obvious about your dissatisfaction. I again say that it really doesn't make any difference to most of us what anyone calls us....We're just out here trying to be a part of the medical community, do a job we were hired to do and make our places in a new occupation. Some people are comfortable in that role and some aren't.

I don't think it is of any benefit to be disparaging (did I spell that right?) to the podiatry occupation because of a title, though. First off, most aren't as put off by their title as others are, Second, It just adds to the "us-vs-them" fire.
Good luck in Medical School..................BTW...where did you get that definition of "Physician"?
 

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MrBob,
I guess I just go that definition out of my head actually. I just think of a physician as the guy or gal that is your doctor. You know in Britain they really only allow GP's to be called Dr., while everyone is a specialist and called Mr. I honetly don't care what people like Pods call themselves, but I just think it is hard for laypeople patients to understand what they are as pods. I just think it confuses patients in general for their to be different types of physicians. And just from my overall dealings with Pods in the hospital and OR, I don't see that they are honestly as knowledgable about medical processes. This could just be my experience I admit, but someone undergoing surgery really needs to know the exact skill level of the person running the OR. I promise to stop running my mouth now. Thanks for your input Mr.Bob. Hey, by chance, did you read my post for PA to Physician?

Matt
 

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Wow, can you please tell us what medical processes pods are not as knowledgeable about that relates to what they do in your expericence?
 

PACmatthew

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Since I was asked, I will cautiously answer. I get more phone calls from Pods than I do ortho's for preop issues that are actually very simple. And this is not limited to one Pod. It just seems that Pods do not have as much education in pharmaceuticals and PPID, and it shows in the dictations I get back from them. I do most all the preop PE's for our practice, and I get more phone calls regarding normals variant EKG's, and questions about meds than I do from orthos. I just think ortho docs get a better exposure to these generalities in med school, and then during their rigorous residecies. The hours that Pods get for excess "foot and ankle" issues in school in residency has to take away from the time that would be spect in a med school learning other general issues, otherwise they would not be so knowedgable about "foot and ankle". Believe it or not, ortho residents have to deal with a lot of broad medical issues, because they all have to do a year of general surgery first. The podiatric residency programs have less supervision overall, at least here in Houston. They seem to rotate through the various Pods in our area, but not to the extent to compare with a true surgical residency. Like all things, I am sure the opposite occurs in some places, but I just cannot say that I have ever known to exist an ortho residency that gave the flexibility that Pod residencies do.

Disclaimer: My opinion is only my opinion, and I still use podiatrists a great deal for my patients. I will just never understand why there is a need to have separate schools for Podiatrists, unless there is obviously a difference between Pod school and med school. What would make the most since would be to have podiatrists attend medical school and then go on to do residencies in foot and ankle surgery. What's to stop another branch of medicine from forming that deals solely with the hand and wrist, but who would also have their own school?
 

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Well, Matt reading your last post about messages or questions from Pods more so than from Orthos only tells me one thing....your opinion is well regarded among the Pods and the orthos don't think they need any medical help or they are using their Doc buddies for the pre op stuff not wanting a PA's opinion and all....Personally I would be honored that the podiatrists ask you for your input in thier patients. that means they trust you a whole bunch. I'm not sure I'd let the word leak out in my neighborhood that I felt about podiatrist like yo do If I were you <G> they might not call you anymore. I think that this means that they think YOU are a peer and the Ortho guys don't....Makes you look at it a little different when you check it out from that angle doesn't it?

I haven't read it but I'm headed that way now....want me to comment or keep my typewriter quiet?

Look Matt...we all gotta do whats right for each of us individually and if being a PA isn't your cup o tea then you gotta go for it. I once owed the nicest Roadstar (Yamaha) motorcycle anyone ever saw...but I had to have a Harley. Sold my Yammy and bought the HD,and know what all I still have under my ass is a damned motorcycle...just a different name...same with you.

i have thought about going on to med school. Little secret though..I'm just an uneducated immigrant (born in Austria) didn't need a degree back in the "old days" and got into a certificate program. I am certified and have been so for 21+ years and haven't been able to go back to school for degrees although I really want one. So for me to go would 2-3 years undergrad, 4 years med school, and 4 years residency...do the math..I'm now 50....I would be retiring before I got started not to mention the $$$ I would lose for the next 8-10 year that would NEVER be recovered. No I chose to raise children and nurture my family (part of which failed after 26 years marriage).

Good Luck to you my friend......eat life before it eats you................
 

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Cga,

Since you asked, I will answer. You simply cannot compare a physician and a PA, because they do not do the same thing. A podiatrist is more capable of treating absolutely any disorder of the lower extremity, but a PA, like a physician, is more capable of practicing "general medicine". This is only due to the difference in their training overall. I would agree that Pods have a better understanding of the basic sciences of medicine, but a PA has more clinical knowledge of "general medicine". There is just no way to answer this question because you are asking me to compare completely different professions. Neither of which are medical doctors...hence trying not to use the word physician to avoid pissing of my colleague MrBob or Eric the Pod Student!
 

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Don't worry about "pissing me off" Matt....you are entitled to your opinion. At 50 years old, that would be a mighty small thing to be angry, or pissed about. I was never angry with your post, just disagreed with it. You go for it, Big Guy.
 

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Let me help you guys out.

I started this thread some time ago and happened upon it today.

In my opinion, podiatrists occupy a "netherworld" of doctors. As my good friend in podiatry school put it, we're the "bastard children of medicine". It seems like a lot of posters here have varying definitions of what a doctor or physician is. Frankly, since I've started pod school, I've grappled with this very question. I agree that podiatrists do not have to endure the the same, exact brutal 3rd and 4th years that med students do (the on-call stuff, delivering the babies, etc.) We have our own 3rd and 4th years, which isn't as taxing and pretty much is a mixture of didactic, externships and rotations. They are pretty far away from what MD and DO students do. In this respect, I believe that we are shorted on our education to become doctors. (And, by the way, the 1st two years are essentially identical to MD/DO school as has been shown to be so in a report written in 1995 by an MD named Franklin Medio). The 3rd and 4th years are not comparable, but you also have to realize that we are (still) concentrating on pathologies of the lower extremity. MD and DO students pretty much know squat about the lower extremity at this point.

I feel that our education falls somewhere between dentistry and MD/DO school. Dentists are not responsible for the extensive pathology that we see nor are they required to know so much about internal and emergency medicine, etc.. Not to downgrade what a dentist does, but they do not have the same level of training. Now, compared with DO's and MD's, podiatrists are responsible for the same type of knowledge of the human body (with the exception of psych and OB/GYN) and do residencies just like MD/DO's. But, like I said, we don't get to have the same clinical exposure (and only part of the didactic). The residencies are the same in some respects, but different in others. For pods, residencies can last anywhere from 1 to 4 years and for the years 2-4 are basically focused on foot and ankle surgery. If you opt for a one year residency it usually encompasses about 6-8 months of rotations in a regular hospital setting which are done in concert with MD and DO interns. We are responsible for the same level of care and take care of our own patients. There's no difference.

I did a one year residency at L.A. County in 1999. Just to give you an idea of what was expected of me I was treated like any other intern and more. I had my own very sick patients in internal medicine (2 months) who suffered from end-stage AID's, lung cancer, CHF, etc. I did 4 months of orthopedic trauma and infection and once did a complete skin graft surgery on my own (an entire arm) with only a PGY-1 by my side who had never seen one done. Bottom line is that we were treated just like everyone else and were expected to tow the line. We were also required to have more than a modicum of knowledge about medicine and surgery.

What I will concede on is the patchy 3rd and 4th years that we go through and the overall lack of didactic and clinical training that other med students go through. I will say that pods are not complete physicians like MD's and DO's and should not be called as such. However, anyone who has earned a D.E.A license that allows them to prescribe the same things that MD's and DO's do, anyone who can autonomously perform recon foot and ankle surgery (and have that patient admitted and discharged as any doctor would) and gets reimbursed just like any ortho would is a doctor in my book. Just not a complete physician.

This is part of the reason why I'm planning to go back to get my MD or DO. I set out to become what I believe is a physician and, as a podiatrist, I haven't reached that goal. I've learned and done many things in my pod time that would parallel any med student or resident experience, but it has fallen short for me.

It's hard to define what a podiatrist is, but I believe that they are certainly more doctors than not. I can still carry on a conversation with any MD or DO about general medicine because, while I didn't really get too much real life exposure, I had to take the same courses.

Hope this helps.
 

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Ya know...as I think about this...I have NEVER heard of nor been exposed to an MD or DO who had anything but respect for their podiatry collegues. I have NEVER even gotten an inkling that they were not considered equal. That hasn't been the case with chiropracty, but that is a whole different thread adn let's not start that one. this whole thing was new to me when I first saw it here and it happens to be students and midlevels that are making the distinction. why do you suppose that is? I have never, for that matter, heard of or been exposed to a podiatrist who considered himself below or not equal to thier MD/DO collegues. It seems to me like we all have a task in this business of taking care of people, whatever level it is. Why is it important how "equal" any of us are? You are judged by your professionalism and demeanor when all is said and done, not by your title. Get that through yer heads, students....that is the important lesson.

I know MD's I wouldn't refer anyone to for a variety of reasons, and that too is another thread. So.........get over this "am I as good as him?....why won't they consider me as good?....am I equal?" business and get on with the job at hand....Taking care of sick and hurting people, at whatever "level" of practice you are working at. It really doesn't make any difference to anyone but you, anyway.
 
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