NYS podiatry scope of practice

[jeffersonswall]

On June 22, 2010 The Great State of New York put its first foot forward into updating the podiatric scope of practice laws by passing a revision in the State Senate's Education Committee. The State Assembly must now pass the issue for it to be signed by the Incompetent Governor Patterson.

Text of the bill passed on Tuesday:
*Search S02992B* 2010 (I didn't realize it wouldn't link to the actual legislation)
http://public.leginfo.state.ny.us/menugetf.cgi (click 'text' in the menu bar, and 'sponsors memo' to read the author's justification...i.e. The APMA/NYSPMA reasoning)

It is -at least to me- a good sign, especially considering the opposition it was up against:

New York State Osteopathic Medical Society/AOA:
http://www.nysoms.org/news/viewarticle.asp?a=1155

New York State Society of Orthopaedic Surgeons:
http://www.nyssos.org/www.nyssos.org/Web_Podiatry.pdf

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Members don't see this ad.

 

[jeffersonswall]

This link is a lot better- but it is a bit touchy:
http://open.nysenate.gov/legislation/bill/A2518A

some highlights (if none of my links work correctly)-
Scope since 1996: 1. The practice of the profession of podiatry is defined as diagnosing, treating, operating and prescribing for any disease, injury, deformity or other condition of the foot

New Scope: 1. The practice of the profession of podiatry is defined as diagnosing, treating, operating and prescribing for any disease, injury, deformity or other condition of the foot, ANKLE AND ALL SOFT TISSUE STRUCTURES OF THE LEG BELOW THE DISTAL TIBIAL TUBEROCITY. SURGICAL TREATMENT OF THE ANKLE SHALL NOT EXTEND BEYOND THE TIBIAL METAPHYSEAL FLAIR; PROVIDED, HOWEVER, THAT SUCH SURGICAL TREATMENT MAY EXTEND TO THE DISTAL TIBIAL TUBEROCITY AS NECESSARY FOR THE TREATMENT OF THE ANKLE, INCLUDING, BUT NOT LIMITED TO, THE APPLICATION OF EXTERNAL FIXATION; AND PROVIDED, FURTHER, THAT SUCH TREATMENT SHALL NOT INCLUDE PILON FRACTURES.
(sorry about the insane CAPs)

Also:

PODIATRISTS LICENSED TO PRACTICE PRIOR TO THE EFFECTIVE DATE OF THIS SUBDIVISION MAY PERFORM SURGICAL TREATMENT OF THE ANKLE ONLY AFTER CERTIFICATION BY THE DEPARTMENT IN ACCORDANCE WITH THE QUALIFICATIONS ESTABLISHED BY THE COMMISSIONER. QUALIFICATIONS TO OPERATE ON THE ANKLE, PURSUANT TO THIS SUBDIVISION, SHALL INCLUDE, BUT NOT BE LIMITED TO: THE SUCCESSFUL COMPLETION OF A RESIDENCY PROGRAM OR PROGRAMS, APPROVED BY THE COUNCIL ON PODIATRIC MEDICAL EDUCATION; OR COMPLETION OF A POST-SEC ONDARY ACCREDITED EDUCATIONAL PROGRAM ACCEPTABLE TO THE COMMISSIONER WITH DEMONSTRATED COMPETENCY IN THE SURGICAL TREATMENT OF THE ANKLE; OR CERTIFICATION BY THE AMERICAN BOARD OF PODIATRIC SURGERY OR A NATIONAL CERTIFYING BOARD HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE COMMISSIONER.

woah, a lot of CAPS... I didn't want to have to re-write it all.

 

[edog10]

Do you know when it goes up for vote in the general assembly?

 

[Black Surgeon]

This link is a lot better- but it is a bit touchy:
http://open.nysenate.gov/legislation/bill/A2518A

some highlights (if none of my links work correctly)-
Scope since 1996: 1. The practice of the profession of podiatry is defined as diagnosing, treating, operating and prescribing for any disease, injury, deformity or other condition of the foot

New Scope: 1. The practice of the profession of podiatry is defined as diagnosing, treating, operating and prescribing for any disease, injury, deformity or other condition of the foot, ANKLE AND ALL SOFT TISSUE STRUCTURES OF THE LEG BELOW THE DISTAL TIBIAL TUBEROCITY. SURGICAL TREATMENT OF THE ANKLE SHALL NOT EXTEND BEYOND THE TIBIAL METAPHYSEAL FLAIR; PROVIDED, HOWEVER, THAT SUCH SURGICAL TREATMENT MAY EXTEND TO THE DISTAL TIBIAL TUBEROCITY AS NECESSARY FOR THE TREATMENT OF THE ANKLE, INCLUDING, BUT NOT LIMITED TO, THE APPLICATION OF EXTERNAL FIXATION; AND PROVIDED, FURTHER, THAT SUCH TREATMENT SHALL NOT INCLUDE PILON FRACTURES.
(sorry about the insane CAPs)

Also:

PODIATRISTS LICENSED TO PRACTICE PRIOR TO THE EFFECTIVE DATE OF THIS SUBDIVISION MAY PERFORM SURGICAL TREATMENT OF THE ANKLE ONLY AFTER CERTIFICATION BY THE DEPARTMENT IN ACCORDANCE WITH THE QUALIFICATIONS ESTABLISHED BY THE COMMISSIONER. QUALIFICATIONS TO OPERATE ON THE ANKLE, PURSUANT TO THIS SUBDIVISION, SHALL INCLUDE, BUT NOT BE LIMITED TO: THE SUCCESSFUL COMPLETION OF A RESIDENCY PROGRAM OR PROGRAMS, APPROVED BY THE COUNCIL ON PODIATRIC MEDICAL EDUCATION; OR COMPLETION OF A POST-SEC ONDARY ACCREDITED EDUCATIONAL PROGRAM ACCEPTABLE TO THE COMMISSIONER WITH DEMONSTRATED COMPETENCY IN THE SURGICAL TREATMENT OF THE ANKLE; OR CERTIFICATION BY THE AMERICAN BOARD OF PODIATRIC SURGERY OR A NATIONAL CERTIFYING BOARD HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE COMMISSIONER.

woah, a lot of CAPS... I didn't want to have to re-write it all.

haha, Great win! Especially after that Texas lost 😀.

 

[G0dFather]

I agree with black.... NY is a mecca for medicine and if pods get this one down the four or three remaining states will follow... some type of scope unity should come real soon after this hopefully.

 

[Brodiatrist]

Does NY really consider DPMs allied health professions and not physicians?

 

[jeffersonswall]

Does NY really consider DPMs allied health professions and not physicians?

The State of New York doesn't consider DPM an allied health profession. It is a NYS "licensed profession" under the State Education Department (architecture, engineering, podiatry, CPA, MD, social worker etc)- and more exactly, a licensed health care professional- (DMD/DDS, MD/DO, DPM, OD, all levels of nurses, PA's, etc). Physicians are MD/DO; DMD/DDS, DPM, OD, AuD, and DC are all under their own classification- no allied health grouping, just the 'licensed health care professional' grouping that includes MD/DO.

The various state specialty associations do however refer to us as allied health professionals and the like. Obviously it's not true, but it sure helps when writing letters to lay state senators and assemblymen to scare them into thinking that a change in scope would harm the residents of NY (and it sure feeds the superiority complex quite healthily).

Some state associations do, not surprisingly, take full advantage of the fact that we are not physicians under state law and will always refer to us as non-physician clinicians when scope legislation comes up. This is not distinct to podiatry though... the dentists are referred to in the same manner by the plastic surgeons and ENTs when OMFS issues come up, and optometrists with the ophthalmologists as well.

 

[jeffersonswall]

The NYSPMA did a great job in showing exactly what our education entails though.

When the orthopedists write a letter to the State Senate regarding the issue with a subheading of "INADEQUATE Training" in reference to podiatrists--- and the AOA state component "explains" our education as:..."In comparison (to a medical education), podiatrists are not required to attain an undergraduate degree, although a majority of podiatric school applicants have attained one. Podiatry education consists of two years of didactic study and two years of clinical rotations...Currently, most states require podiatrists to complete a minimum of one year of postgraduate residency training to obtain a license. Podiatrists trained prior to the educational and residency training reforms were uniformly implemented (1990s) have little formal education or clinical training beyond the anatomy of the foot, and may have little, if any, formal surgical training"...... then it can get very murky for us.

Besides the AOAs gross mischaracterization of our education, the bill explicitly states that only new graduates and those who are deemed qualified by the office of the Commissioner of the Education Dept (it is explained exactly how in the bill) will be able to work on the ankle... i.e. someone like the first podiatrist I ever shadowed, who graduated in the early 70s and did no residency (and basically does orthotics and C&C)... will obviously not be legally allowed to perform ankle surgery by the Education department. So in essence, the AOA didn't even bother to read the f*&%ing bill before spewing nonsense that makes it sound like no podiatrist in the nation is allowed to touch the ankle and letting us do it in NY would be unheard of and would herald the AntiChrist.

The NYSPMA, with help from the APMA, provided literature that combated every convoluted and false claim that was presented by any of the MD/DO state associations or nationwide components, and explained exactly how we are trained and the scope of practice in 75% of States ... and it worked, they actually read it and we won (at least in the State Senate).

 

[krabmas]

The NYSPMA did a great job in showing exactly what our education entails though.

, podiatrists are not required to attain an undergraduate degree, although a majority of podiatric school applicants have attained one. .

Do the people of the AOA realize that the medical schools that they attended are also considered professional schools and to get into medical school to obtain an MD a bachelors degree is not required?

 

[jeffersonswall]

Do the people of the AOA realize that the medical schools that they attended are also considered professional schools and to get into medical school to obtain an MD a bachelors degree is not required?

apparently not (from the AOA in the link above):

The requirements to become a physician are more extensive than those required of podiatrists. Prior to being admitted to medical school, a candidate must obtain a Bachelor's degree. DOs complete four years of osteopathic medical school, which include two years of didactic study and two years of clinical rotations. Clinical rotations in the third and fourth years are done in community hospitals, major medical centers and doctors' offices. Students also learn osteopathic manipulative treatment (OMT) for prevention, diagnosis and treatment of disease. This is followed by three to seven years of postgraduate medical education (i.e. residencies) where DOs develop advanced knowledge and clinical skills relating to a wide variety of patient conditions. The requirements for an allopathic physician are substantially similar.

I think they are confusing the word extensive and different... different than medical school yes, but there are plenty of DOs with 3yr residency training just like DPMs.

 

[215353]

I think they are confusing the word extensive and different... different than medical school yes, but there are plenty of DOs with 3yr residency training just like DPMs.

I agree there are plenty of MD and DO physicians with three years of residency training but wouldn't these be primary care doctors?

 

[UNMorBUST]

apparently not (from the AOA in the link above):

The requirements to become a physician are more extensive than those required of podiatrists. Prior to being admitted to medical school, a candidate must obtain a Bachelor's degree. .

Can I be admitted to medical school after my junior year in a college or university?
Students with outstanding academic records are considered for admission after the junior year. Very few are actually admitted. The last several years, all accepted applicants have earned at least a Bachelor's degree prior to matriculation.

http://hsc.unm.edu/som/admissions/faq.shtml

Degree and Course Work Requirements
The University of Colorado Denver, School of Medicine requires that students complete 120 semester hours at an accredited college prior to matriculation. Normally, 99% of students have a baccalaureate degree, although one is not required.

http://www.ucdenver.edu/academics/c...tion/Admissions/apply/Pages/Requirements.aspx
It is a possibilty to be accepted to med school without a bachelor's. However, it is slim.

 

[krabmas]

Most of the students admitted to medical school without a bachelors degree are in a 6 year BA/MD program. This means that the last 2 years of college are spent as the 1st 2 years of medical school and a bachelors is awarded after the 1st 2 years of medical school are completed.

This is similar to podiatry school.

Barry has a program that combines these years into 6 insread of 8.

I'm not sure about the other schools' policies, but I know NYCPM has agreements with several colleges in the US for matriculation to NYCPM after the 3rd year of college with the completion of the BA/BS with the completion of the 1st year of podiatry school.

So, no one graduates podiatry school or medical school with out completing a BA/BS.

I think the NYSPMA and other state organizations should consider lawsuits against associations that constantly pass along written/documented false information about our training and eduacation on the grounds of libel.

I understand the theory of making more friends with honey.... But at some point you have to stand up for yourself.

 

[jeffersonswall]

Well said krabmas, I am in accordance with you.

 

[shenanigans327]

Am I the only one that finds it funny that the AOA/DO's in general have been preaching about equality between MD's/DO's for decades only now to turn around and claim that another profession is unequal in their training??


🙄

 

[215353]

Am I the only one that finds it funny that the AOA/DO's in general have been preaching about equality between MD's/DO's for decades only now to turn around and claim that another profession is unequal in their training??


🙄

Yes it is kind of funny. What's more funny is that DOs are starting to lose their identity within medicine because MOST (not all) graduates don't practice OMM/OMT in the real world.

Despite this scenario btw the AOA and Pods in NY, I feel most of the animosity, between Pods and MDs/DOs overall, is derived from the ignorant students with large egos rather then the professionals. There are exceptions to this statement though. Out of all the DO students I feel students from DMU, AZPOD, and Western would be most understanding because both Pod students and DO students attend the same classes at these instutions.

The on-going ortho campaigns against pods are contrived simply because they don't want to give up surgical rights to the ankle. That would be more cases going to other health professionals and less money in their pockets...end of story.

 

[shenanigans327]

agree fully👍

 

[janV88]

It is a possibilty to be accepted to med school without a bachelor's. However, it is slim.

Of the 4 random NY med schools I searched only 1 required a bachelors. The others required three years or 90 credits.

The argument was "Prior to being admitted to medical school, a candidate must obtain a bachelor's degree" not most likely have to.