Podiatry is losing

[ehwhatsupdoc]

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I see podiatry's inevitable collapse on the horizon. This will mainly be due to a public relations problem, also the failure of podiatric medical schools in recruiting more students as well as lengthy residencies. Tuition prices are becoming too exorbitant. Less and less students will consider podiatry. Some people think this will increase salaries since there will be a shortage of podiatrist due to waning interest, but I see this shortage being met by other health care professionals like NPs. They have a large surplus and are very opportunistic as a group. They will take over if things keep going the way they are.

 

[ehwhatsupdoc]

Not really a troll thread. More like a debate thread. I don't have the same experience as many of you residents and practicing podiatrists. I'm just curious to hear stories from the front lines where you think podiatry is headed. I would consider podiatry, but I feel like there are major issues caused predominantly by podiatry organizations and lack of advocacy. There really needs to be more practicing podiatrists out there to defend the profession and increase scope.

 

[torontopharm]

If podiatry collapsed the only thing NPs could pick up on would be wound care. But even still wound care issues of the feet have multiple etiologies. Some are due to their comorbidities which NPs would not manage. Some are are due to biomechanical issues which NPs have no direct training in. Wounds can be directly related to congeners or acquired deformities of the foot which would need surgical intervention to correct. NPs are not legally allowed to cut on anyone in the OR.

How could NPs pick up the slack?

If podiatry collapsed the only practitioners who would be capable of treating what we treat are other MD/DOs. But they don't want to treat feet either. Podiatry stays. Sorry.

BTW I understand this is just a troll thread designed to agitate the online community.

Not to stir to debate up or anything but i'm just curious..how about those "surgical" Physician Assistants? Are they allowed to do any of the surgeries the Pods perform?

 

[Moose A Moose]

Not to stir to debate up or anything but i'm just curious..how about those "surgical" Physician Assistants? Are they allowed to do any of the surgeries the Pods perform?

I'm assuming no as they perform under the supervision/jurisdiction of an attending

 

[dyk343]

:troll:

 

[Mad Jack]

Residencies will help podiatry, as they allow those of us on the MD/DO side of things to know that you have standardized, reliable graduate medical education that prepares you to operate in a competent and independent manner. Requiring residencies is probably the savior of podiatry, not its downfall. Tuition is exorbitant across the board at all professional schools.

As long as there are enough bodies to fill the seats available, podiatry won't die. I highly doubt that there will be less applicants than seats anytime soon. Finally, neither nurses nor PAs can do what you do, and the only people that could competently compete with you are foot and ankle orthopods, but there is a lot you do that they don't want to, as well as a general shortage of F&A orthopods willing and able to take on the bulk of what you do.

Podiatry is a respected (more and more every day, with increasing standards and training) and necessary part of the American health care system, it isn't going anywhere anytime soon.

 

[ehwhatsupdoc]

The problem is that not everyone wants to practice surgery or have the opportunity to work in a practice where you do a lot of foot and ankle surgery. To force everyone to go through that is misguided. Opening up residencies everywhere is a ploy by hospitals to have cheap labor. Why hire more full time podiatrists when you have a steady stream of eager and smart residents every year that are able pick things up quick and do the routine foot care once they hit the ground running (general dentists are able to do it, why not podiatrists, why do they all need a 3 year surgical residency) . Hospitals didn't have this option when there were a lot less residency spots in the past.

Residencies will help podiatry, as they allow those of us on the MD/DO side of things to know that you have standardized, reliable graduate medical education that prepares you to operate in a competent and independent manner. Requiring residencies is probably the savior of podiatry, not its downfall. Tuition is exorbitant across the board at all professional schools.

As long as there are enough bodies to fill the seats available, podiatry won't die. I highly doubt that there will be less applicants than seats anytime soon. Finally, neither nurses nor PAs can do what you do, and the only people that could competently compete with you are foot and ankle orthopods, but there is a lot you do that they don't want to, as well as a general shortage of F&A orthopods willing and able to take on the bulk of what you do.

Podiatry is a respected (more and more every day, with increasing standards and training) and necessary part of the American health care system, it isn't going anywhere anytime soon.

 

[g squared 23]

The problem is that not everyone wants to practice surgery or have the opportunity to work in a practice where you do a lot of foot and ankle surgery. To force everyone to go through that is misguided. Opening up residencies everywhere is a ploy by hospitals to have cheap labor. Why hire more full time podiatrists when you have a steady stream of eager and smart residents every year that are able pick things up quick and do the routine foot care once they hit the ground running (general dentists are able to do it, why not podiatrists, why do they all need a 3 year surgical residency) . Hospitals didn't have this option when there were a lot less residency spots in the past.

Hundreds of hospitals across the country have all schemed together to take advantage of the cheap labor podiatry residents provide??? That one's a little hard to follow.


Everyone in Podiatry should receive the minimal surgical training, but this functions more to train the podiatrist how pathology CAN be fixed surgically. The beauty is that they can choose to practice as conservstively or surgically as they feel comfortable. For some, that's bunions and hammertoes. Others choose no surgery at all, and instead focus on biomechanical treatment of deformities and then refer when a surgical consult is necessary. There is a lot of work that can be done outside the operating room. There are some orthopaedic SURGEONS who have an entirely NON-surgical practice.

(Warning, tangent):
As far as NPs and lower levels performing wound care: my opinion is only doctors with surgical training should be performing wound care. If you're a hammer, all you see is nails. So the NP/non-surgeon sees a wound, does not recognize that it's secondary to a charcot collapse, and does the standard nonsurgical debridement. Then puts a W2D on and bills accordingly, even though they gave that person a zero percent chance of healing that wound.

Any surgeon realizes the underlying problem and adjusts accordingly. I've seen a few non-surgical MDs work in a wound care center, and most of them will string patients along who obviously need an operation, maybe enrolling the patient in a long phase of HBO that happens to pay them handsomely. Not all, but most. The MD/DO/DPM surgeon is quicker to pull the trigger on the operation simply because they can, and they wouldn't have to refer the patient out. (End tangent)

 

[Mad Jack]

The problem is that not everyone wants to practice surgery or have the opportunity to work in a practice where you do a lot of foot and ankle surgery. To force everyone to go through that is misguided. Opening up residencies everywhere is a ploy by hospitals to have cheap labor. Why hire more full time podiatrists when you have a steady stream of eager and smart residents every year that are able pick things up quick and do the routine foot care once they hit the ground running (general dentists are able to do it, why not podiatrists, why do they all need a 3 year surgical residency) . Hospitals didn't have this option when there were a lot less residency spots in the past.

I'd say the number of people drawn to podiatry for the surgical opportunities far outweighs the number of people drawn to it for the nail clipping, custom insoles, and bunion removals.

 

[heybrother]

What's with the bunion hate?

 

[newfeet]

I'd say the number of people drawn to podiatry for the surgical opportunities far outweighs the number of people drawn to it for the nail clipping, custom insoles, and bunion removals.

Bunion removal isnt surgery?

 

[Mad Jack]

Bunion removal isnt surgery?

It's surgery, but I'd hardly call it an opportunity 😉

 

[g squared 23]

Bunion removal isnt surgery?

It isn't to people who don't know what they're talking about.

 

[BruceWilly]

Not to stir to debate up or anything but i'm just curious..how about those "surgical" Physician Assistants? Are they allowed to do any of the surgeries the Pods perform?

The PA on my surgical rotation passes the suction.

 

[g squared 23]

The PA on my surgical rotation passes the suction.

In the actual operating room, this is the norm in my experience. Surgeons will let them close and apply dressings/casts, but that's it.

The most autonomy I've seen a PA have was in a dermatology office. They would see patients and book skin grafts and then do cases in their "surgical suite". They would "scrub in" with Dial soap, and the PA would tremble through cases that were out of her comfort/skill level. She could suture well, but that was about it. The dermatologist would occasionally stop by and ask how things were going, but he in no way supervised or helped with the cases.

 

[Pronation]

The PA on my surgical rotation passes the suction.

I'm guessing it widely varies for PA's then. I saw a PA harvesting the great saphenous vein for a CABG.

 

[dyk343]

What's with the PA hate? I love PAs they are very helpful.

Edit: I suppose that's the underlying theme of this whole thread. Everyone hates someone else in medicine. Doesnt matter what initials are behind your name. It's kinda sad really....