Podiatry

[Perrotfish]

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I'm an MS4, going into Peds. I recently found out that the HMO I'm attached to likes to refer to podiatry for almost all issues below the ankle, with no triage or oversite by Ortho. They also handle the majority of lower extremity surgery at that HMO.

For the sake of my future referals and choice of employer, where do you think that the responsiblities of poldiatry end and the responsibiliies of Ortho begin? When is it appropriate to refer to Podiatry and when will only an Orthopaedic surgeon do?

 

[RockFoot]

foot and ankle are definite pod specialties

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[skiz knot]

Trauma can easily be shared by both peds ortho and podiatry. For things like "in-toeing", bow legs, knock-knees, neuromuscular disorders causing foot problems, and high arches, there is probably good reason to only send them to peds ortho.

P.S. All podiatrists work without triage/oversight by ortho.

 

[Buckeye(OH)]

foot and ankle are definite pod specialties

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🙄

 

[skiz knot]

I'm an MS4, going into Peds. I recently found out that the HMO I'm attached to likes to refer to podiatry for almost all issues below the ankle...

They prefer you refer to podiatry because in many instances they can reimburse them less.

 

[Perrotfish]

They prefer you refer to podiatry because in many instances they can reimburse them less.

I figured that. That's also why most of their PCPs are actually nurses. I wanted to know when I should be pushing back and when a Podiatrist is sufficient.

Trauma can easily be shared by both peds ortho and podiatry. For things like "in-toeing", bow legs, knock-knees, neuromuscular disorders causing foot problems, and high arches, there is probably good reason to only send them to peds ortho.

P.S. All podiatrists work without triage/oversight by ortho.

This helps, thank you

 

[MaxillofacialMN]

I'm an MS4, going into Peds. I recently found out that the HMO I'm attached to likes to refer to podiatry for almost all issues below the ankle, with no triage or oversite by Ortho. They also handle the majority of lower extremity surgery at that HMO.

For the sake of my future referals and choice of employer, where do you think that the responsiblities of poldiatry end and the responsibiliies of Ortho begin? When is it appropriate to refer to Podiatry and when will only an Orthopaedic surgeon do?

Depending on the state, (california?) anything ankle or below a podiatrist is trained to take care of. Surgical, invasive, wound, arches, etc etc, a podiatrist is trained to take care of.

So to answer your question, I think the responsibilities of podiatry end above the ankle. As for where ortho begins..... that's an entirely different debate.

 

[skiz knot]

Depending on the state, (california?) anything ankle or below a podiatrist is trained to take care of. Surgical, invasive, wound, arches, etc etc, a podiatrist is trained to take care of.

So to answer your question, I think the responsibilities of podiatry end above the ankle. As for where ortho begins..... that's an entirely different debate.

It's not what they are trained to take care of. It's what they haven't been trained to recognize. I can recall multiple times that I have seen patients (young) treated with shoe inserts and braces for various problems when the (unrecognized) root pathology is not in the foot (hip dysplasia, Charcot Marie Tooth, tethered cord, Chiari, etc...). It's sad and unfortunate.

 

[densmore22]

And I've seen when a young patient (multiple times) had unnecessary surgery and others when the flat out wrong procedure was chosen. You can find examples good and bad on both sides of the fence so don't paint a picture like Podiatrists are the only ones doing the wrong or bad thing, it's just ignorant.

 

[DHT]

As for where ortho begins..... that's an entirely different debate.

There is not a debate. Ortho begins at C1 and ends at the toes.

Now can we please stop talking about podiatry on this forum?

 

[Buckeye(OH)]

There is not a debate. Ortho begins at C1 and ends at the toes.

Now can we please stop talking about podiatry on this forum?

Occiput if you do peds😀

 

[skiz knot]

Occiput if you do peds😀

Regular spine will fuse to the occiput also.

Some crazy old timers will still "treat" TMJ.

 

[skiz knot]

And I've seen when a young patient (multiple times) had unnecessary surgery and others when the flat out wrong procedure was chosen. You can find examples good and bad on both sides of the fence so don't paint a picture like Podiatrists are the only ones doing the wrong or bad thing, it's just ignorant.

Sorry, that wasn't what I meant to imply. In my community the podiatrists generally do a great job. Both ortho and podiatry mismanage things on occasion. It is just that your average podiatrist is much more likely (IMO) to neglect pathology outside of the foot/ankle/leg as the cause of the pathology than your average pediatric orthopod.