Is it true that in New York, if you are a podiatrist, you are only allowed to practice on the foot, and not all the other lower extremities (leg, ankle, etc)?
Podiatry in New York State
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This is true. No surgery on the malleoli (ankle bone). No soft tissue of the leg either. New York is probably the 2nd most restrictive state for scope of practice in the US. The NYSPMA has been trying to change the laws in the new york state senate and assembly the past few years but the bills have failed. The most recent scope of practice bill was to increase to osseous (bone) surgery of the ankle and soft tissue work up to the tibial tuberosity.
Even if the bill does pass eventually in new york, hospitals have to re-write their bylaws on pods and ankle work. I don't think its going to be an automatic change from no ankle to ankle.
Overall, I'm not exactly sure why the scope of practice is strict in New York. I heard that the past (mid to late 80's I believe) medicaid fraud at the Foot clinics of New York at the New York College of Podiatric Medicine obviously did not help put things in our favor. The scandal was pretty large, involving both instructors and 2 former deans.
I'm from suburbs of new york city but planning on going to pod school and residency out of state. I don't feel I would practice here as well. It does not make sense in one way....if I do a 3 year residency in pod med and surgery, I would be fully trained to do ankle work but would not be able to touch the ankle if practicing in new york. It's a pretty interesting situation as I know a podiatry practice on the border of new york and Pennsylvania. The group has a general pod practice on the new york side, then drives less than 10 minutes to a penn hospital/surgery center to do ankle surgical cases.
Even if the bill does pass eventually in new york, hospitals have to re-write their bylaws on pods and ankle work. I don't think its going to be an automatic change from no ankle to ankle.
Overall, I'm not exactly sure why the scope of practice is strict in New York. I heard that the past (mid to late 80's I believe) medicaid fraud at the Foot clinics of New York at the New York College of Podiatric Medicine obviously did not help put things in our favor. The scandal was pretty large, involving both instructors and 2 former deans.
I'm from suburbs of new york city but planning on going to pod school and residency out of state. I don't feel I would practice here as well. It does not make sense in one way....if I do a 3 year residency in pod med and surgery, I would be fully trained to do ankle work but would not be able to touch the ankle if practicing in new york. It's a pretty interesting situation as I know a podiatry practice on the border of new york and Pennsylvania. The group has a general pod practice on the new york side, then drives less than 10 minutes to a penn hospital/surgery center to do ankle surgical cases.
Oh really? Okay thanks. Yeah, I'm from New York City too. I hope to go to NYCPM, but if that is the case, I don't want to practice here in NY. Do you know how it is for pods in Connecticut? (That's where me and hubby are thinking about moving to). Thanks!
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Connecticut just passed a new law allowing everything up to the tibial tuberosity except Ankle Replacements. It was crafted together with the ortho community and they have a great relationship at least on paper. Again, the laws get relooked at every year so even if it doesn't say TAR on it now, it might just be added on in a few years. Vision 2015 wants a national standard SOP law, but again, it'll be based on the training you receive before you end up practicing.
http://www.rosalindfranklin.edu/scpm/clerkship/8.2.06.Scope.of.Practice.study.pdf
here's the Scholl Scope of practice study that include commentary about each state. hope this helps, Good luck! and merry christmas, new years, and all the other holidays!
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thanks for that info...it's really helpful
so, I guess Alaska is the only state that allows work on hands?? i didn't know that...I'm an Alaskan and that's definitely good news because I plan on practicing medicine here!
Happy Holidays!
so, I guess Alaska is the only state that allows work on hands?? i didn't know that...I'm an Alaskan and that's definitely good news because I plan on practicing medicine here!
Happy Holidays!
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Ohio has superficial lesions (NOT bone work, just warts and such) of the hand included in the scope of practice too. I hope you are joking though. I do not know of any pods who are doing hand "work" these days. This is an ancient part of the scope that was created during the old chiropody days and never removed. I'd like to see a podiatrist in court who did a hand procedure.....not gonna fly at all in this day and age. We are foot and ankle (some states lower leg) specialists. Don't do hand work, it's not good for the profession and you will just confuse the public more.
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haha, it's mostly like soft-tissue stuff like wart removal.
I did do a wrist frx and I&D of the radius a few weeks ago (my attending was a general ortho). it's really amazing how similar everything is, but yeah, not likely to do it in practice.
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I agree with you guys...i just got excited to see that Alaska allowed that! it seemed like a big deal when i talked to some students at NYCPM and barry...but didn't know that my home state allowed it...that's all
but yes, of course, as foot and ankle specialists...why bother with something else you're not all that well trained in...i totally agree!
but yes, of course, as foot and ankle specialists...why bother with something else you're not all that well trained in...i totally agree!
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Some NY and Barry students made a big deal about superficial lesions of the hand being included in the scope of practice? Or you meant it seemed like a big deal to you?
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You dont have to practice in NY. yes in the state of NY scope of practice is limited but, the exposure you will get at NYCPM and the diversity in patients is valuable. Also things are changing here in NY so hopefully things might change by the time you graduate.
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At the FCNY and NYCPM affiliated hospitals in New york state, you cannot touch the ankle. You learn about everything about the ankle through lectures but cannot apply it in the clinic. I believe the one option would be to complete your externships outside of New york state, as pods can do ankle procedures in the majority of other states.
Residency is a different story. If you do a 3 year PM and S in New York State, you will do ankle cases. This is because the scope of practice depends on the attending/supervising physician. So pods will be scrubbing in with foot surgery cases while orthopedic surgeons will be scrubbing in with you for ankle, tib/fib, etc.
However, if you complete a 3 year PM and S residency in NY, you are not allowed to do ankle work if you decide to practice here. As you know, the scope limits cutting on the maleoli and I am pretty sure no soft tissue of the distal leg.
If you wanna hear something funny, one group of pods I know has practices in both upstate NY and PA. They do foot procedures/work at the NY offices and then drive less than 10 minutes to their Penn office/affiliated hospitals to do ankle cases. This just shows how bogus scope of practice can be!!!
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seriously!.NY is very lunatic state. They talk all abt rationality and liberalism. yet they appear to be the most old school state and irrational. cant even understand such a simple theory on education of pods. Its classical hippocricy. A state which by itself (leave aside US) is known all over the world for its advancement in tech and education. I find it suprising that NY is so backward when it comes to giving credit to people what they are really capable of.
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I could be wrong but I don't think it's because they are stupid or don't know what pods can do, I have the impression the orthopods have a strong hold on the state so they keep the pods in check on what they can do and have a very powerful political influence that impedes the advancement of pods.
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If it is correct then that is very dangerous. Here we are fighting all over the world to spread freedom,truth and rationalism i and get rid of dictatorships in places where no one even understands the meaning of those words.
And here in a US State, we have a bunch of people who are controlling the government to do whatever they want or feel is right no matter their actions are irrational.What would you call this kind of behavior
. yeah had Pods be demanding for knee or shoulder scope and people objecting is understandable. But being trained for more than 8yrs in F & A and still not getting their privedledges thanks to the strong Ortho lobby is beyond my understanding.- Joined
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Back in the 80's, a few pods from NYCPM committed medicaid fraud through the Foot Clinics of New York (FCNY). This even included two deans. I'm sure this put a bad taste in the mouths of orthopods, who do seem to hold strong power in NY. It definitely did not look good for our cause, especially with expanding the scope of practice.
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medicaid fraud is not the reason for the non-expanded scope of podiatry in NYC. True that this did leave a bad taste for podiatry.
This is about lobbying. Orthos have more money and the Orthopedic and medical society behind them. That is more dollars and more people represented. Politicians believe MDs before DOs or DPMs or DC or any other specialty (not dentists - they have their nich). So if big ortho surgeon goes to lobby and says pods do not get good training and can't do certain things the politicians believe this. It does not matter how many times we say our training has improved.
Politicians have little time and understanding our profession and education takes time. It is easier to just believe the MD when he says what ever we say is untrue.
The NYSPMA talks to the orthos and MDs all the time. Everytime the NYSPMA comes back and says it is looking better and better. Unless the NYSPMA gets the MD groups to sign on the dotted line - it don't look so good.
