I personally know of a few DPMs who are co-owners of free standing surgery centers. There are a few DPMs who have a fully certified surgical suite in the office. These DPMs will have an Anesthesiologist (sometimes CRNA depending on arrangement) come in for the few cases that require MAC Sedation (IV Sedation). I have never seen General Anesthesia or Spinal Anesthesia done in surgical suites of private practice. Of course, General Anesthesia or Spinal Anesthesia can be done in free standing surgery centers.
As for DPMs doing reconstructive rearfoot surgery and foot / ankle trauma, they are usually done in hospital ORs or surgery centers that have arrangements with hospital for admission, since these cases require the patient to be admitted to hospital for pain management. You do NOT need to be affiliated or be part of an Ortho group to do reconstructive rearfoot surgery or foot / ankle trauma surgery. As long as the DPM have the hospital privilege to perform the reconstructive rearfoot surgery and foot / ankle trauma surgery, the DPM can perform these surgeries in the hospital OR and Surgery centers. As for DPMs getting foot and ankle trauma from the hospital ER, it really depends on the arrangement that the DPMs have with the hospital ER and the covering ortho groups. Obviously, DPMs in an ortho group would be getting the foot and ankle trauma from the ER when the ortho group takes call at the hospital. Majority of the DPMs that take foot and ankle trauma call in the ER are NOT part of an ortho group and have some sort of an arrangement with the ER and Ortho groups. For example, at Temple University Hospital (Level 1 trauma) and UMDNJ University Hospital (Level 1 trauma), DPMs and Ortho take alternating primary Foot and Ankle trauma call (eg. DPMs take call on even days and Ortho take call on odd days, etc....). In smaller communtiy hospitals, many of the DPMs take primary call for Foot and Ankle trauma call every day since the Ortho groups are usually tied up with other Orthopedic trauma (hip fractures, femur fractures, pelvic fractures, upper extremity fractures, etc....). This is the case for me, my Podiatry group takes primary foot and ankle trauma call from the hospital ER every day since the on call Ortho group are tied up with hip fractures (my hospital is surrounded by a bunch of nursing homes). In other hospitals, DPM only get the forefoot trauma cases only, while the Ortho groups get the rearfoot and ankle trauma cases. On the other hand, there are some hospitals where the on call Ortho group or the ER physician would make a decision as to what cases will go to the DPM and what goes to Ortho. Of course, there are some DPMs that do not want to take primary foot and ankle trauma call from the hospital.