Foot and Ankle Orthopaedics?

[anxietypeaker]

just found out that orthopedicians can subspecialize is Foot and Ankle Orthopaedics. That DIRECTLY competes with DPMs more so than just general orthos. What are the ramficiations of this? Do orthos even choose that subspecialty since DPMs are around? anyone have ANY info on this. thanks

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[DrBlaze]

just found out that orthopedicians can subspecialize is Foot and Ankle Orthopaedics. That DIRECTLY competes with DPMs more so than just general orthos. What are the ramficiations of this? Do orthos even choose that subspecialty since DPMs are around? anyone have ANY info on this. thanks

Hi anxietypeaker,

It's something I've wondered about too... very interested in the reponses.

David

 

[LloydBanks]

I dont think many orthos go into foot and ankle surgery. In fact, I'd say the majority of them don't even mess with it, they just hand it off to the pods.

 

[drbeesh]

Orthopoedic surgeons can and some actually do take a fellowship in foot and ankle surgery...I won't argue who has more or better training because its irrelevant...look at it this way...there are less than 20,000 podiatrists around the country and an even smaller number for those who have board certification to do...so simply there aren't enough podiatrists out there to do all foot and ankle surgery...despite this fact...podiatric surgeons are high in demand and are actually employed by specialty orthopoedic surgery groups. The new trend in podiatry is to move towards a surgical subspecialty...this doesn't mean that as soon as u see a patient you're gonna cut him open...not at all...u will use ur knowledge in biomechanics, etc. to asess the injury, condition, etc. and work from there...what i'm trying to say is that podiatric surgeons are very well respected by MD's and their opportunities are very vast with the right training regardless if they 'compete' with foot and ankle orthopoedist surgeons...remember....u have a very small number of podiatric surgeons doing ALOT of surgery, so they are not going to take over completely ALL foot and ankle cases...takes time...and so far they are on the right track...i read that more than 70% of all hospitals in the US have a podiatrist on staff so this is a healthy sign for the profession....

 

[anxietypeaker]

what do you mean on staff? does that mean a DPM thats salaried by the hospital, exclusively contracted out with the hospital, or not exclusively contracted out with the hospital?

 

[dpmgrad]

just found out that orthopedicians can subspecialize is Foot and Ankle Orthopaedics. That DIRECTLY competes with DPMs more so than just general orthos. What are the ramficiations of this? Do orthos even choose that subspecialty since DPMs are around? anyone have ANY info on this. thanks

Yes, there is an one year Foot and Ankle Fellowship option available for the Orthopedic Surgeons. In fact, there is even a society for the Orthopedic Surgeons who specializes in Foot and Ankle Surgery. According to the American Orthopedic Foot and Ankle Society (www.aofas.org), there are actually a good amount of unfilled positions for the Foot and Ankle Fellowships. I think that alot more Orthopedic Surgeons are more interested in going into Adult Reconstruction / Total Joint Fellowships since that is a much more lucrative field (pays quite well). Of course, this is my opinion and do not have exact statistics as to how many Orthopedic Surgeons are entering into the Adult Reconstruction / Total Joint Fellowships and Foot and Ankle Fellowships.

As mentioned earlier, both the Podiatric Surgery and Orthopedic Foot and Ankle Surgery are rather small compared to the rest of the medical specialities. Hence, there is sufficient amount of work for both Podiatric Surgeons and Orthopedic Surgeons.

There have been Orthopedic Foot and Ankle Surgeons that have given lectures at various Podiatric Surgeon meetings. For example, the former president of the American Orthopedic Foot and Ankle Society, Mark Myerson, MD, had given a bunch of lectures at one of the annual American College of Foot and Ankle Surgeons meeting a few years back. The vice versa is also true. Lowell Scott Weil, DPM, has given some presentations at one of the annual American Orthopedic Foot and Ankle Society meeting.

 

[diabeticfootdr]

Read some of the opinions written by Michael Pinzur, M.D. in Foot and Ankle International. He is a leader in this field and is the director of a fellowship in foot and ankle for orthos. He opines that gen ortho residency poorly trains orthos to perform foot and ankle surgery. From what I remember, they only need 10 cases for board certification!!!

There are few foot and ankle fellowships for ortho in the country. And many of them sit empty. Mark Myerson, M.D. was looking for a fellow to fill one of his spots last year, and he's probably the most notable foot and ankle ortho in the country.

I work with a device company on some design changes/development, etc. They did their own market research and found that 60% of all foot and ankle surgeries in the US are performed by DPMs.

I wouldn't worry about foot and ankle orthopods. Since there are so few, unless you practice in a larger metropolitan area, you're unlikely to encounter one.

 

[dpmgrad]

what do you mean on staff? does that mean a DPM thats salaried by the hospital, exclusively contracted out with the hospital, or not exclusively contracted out with the hospital?

What Dr. Breesh meant by a Podiatrist being on staff at the hospital is that there are Podiatrists on the Medical Staff rosters at the hospital. If there is a consult for Podiatry (whether it is on the hospital floors or in the Emergency Room), a Podiatrist on the hospital Medical Staff roster would be contacted for the consult. Being on the Medical Staff roster also helps in terms of referrals because many of the hospitals have physician referral services and would refer patients in need of Podiatric care to one of the Podiatrist listed on the Medical Staff roster. Personally, I do not know of any Podiatrists that are salaried by the hospitals for Podiatric care. The only exception to this rule would be the Podiatrists whom are contracted to work in the VA Hospitals. The Podiatrists in the VA Hospital are salaried. Another possibility that a Podiatrist would be salaried from a hospital system would be a Podiatrist working for a health system such as Kaiser Permanente. Perhaps someone in California can elucidate this further.

 

[anxietypeaker]

so i understand what youve said so far...and it makes a LOT of sense to try to get on the staff roster for referrals. But i was wondering, how does one get on the staff list for a hospital? It seems that it would be quite competitive.

Also, from the staff list, i was able to get several DPMs' office numbers. Is it difficult to shadow one, in particular observe a surgical procedure (dont i have to get scrubbed down etc etc? I REALLY want to shadow him/her AND watch the surgical procedures. thanks

 

[krabmas]

so i understand what youve said so far...and it makes a LOT of sense to try to get on the staff roster for referrals. But i was wondering, how does one get on the staff list for a hospital? It seems that it would be quite competitive.

Also, from the staff list, i was able to get several DPMs' office numbers. Is it difficult to shadow one, in particular observe a surgical procedure (dont i have to get scrubbed down etc etc? I REALLY want to shadow him/her AND watch the surgical procedures. thanks

Most podiatists are more than happy to let you shadow. I'm not sure about the OR though. Just call and ask, the worst that happens is they say no. If you get to shaddow try to shaddow a few to see different techniques and styles.

If you are having trouble getting in to shaddow you can call NYCPM for a podiatrist to shaddow in your area of the country. The other schools might offer the same service (I don't know).