Question about specialties and being a DO

[diabeticfootdr]

So the world of health insurance calls you a 'podiatric physician' for billing stratification. You're still a podiatrist, not a physician.

Next time you apply for a job, tell the hospital admin you're a 'physician'...their next question is "what specialty?"

"Well I'm a DPM."

..."Soooo you're a podiatrist?"

"Well, yes, I'm a podiatric physician."

"Sure, yea, ok...you're a podiatrist. I'm with physician recruiting. You'll have to contact someone in the podiatry department."

Anyway, the WHO states only those that attend the WHO Directory of Medical Schools can apply for medical licensure, and hence practice "medicine" (as opposed to "podiatric medicine", as the Bureau of Labor states).

I don't know why this issue irks you. I'm employed by a hospital actually. My ID reads "Name, DPM" and under it reads "Staff Physician."

Of course I refer to myself as a podiatrist, just as a gynecologist doesn't refer to themself as a gynecologic physician

I was licensed in IL as a "podiatric physician", a quick google search of "podiatric physician license" reveals that CT, DE, TX, UT among others use the same terminology.

It's just that, terminology. Terminology doesn't change the fact that I am a foot and ankle surgeon limited to my scope of practice by whatever state I practice. But, I am an independent practitioner. I admit my own patients to the hospital, I perform my own surgeries, thus a physician.

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[DrRoast]

So I'm reading this thread and still haven't really found what I'm looking for. I'm starting at CCOM in the fall, and right now I want either an ortho or anesthesiology residency. I don't care if it is AOA or ACGME, I just want it (at least right now). Do I have a legit shot of making that happen? Or are the odds against me?

 

[homeboy]

So I'm reading this thread and still haven't really found what I'm looking for. I'm starting at CCOM in the fall, and right now I want either an ortho or anesthesiology residency. I don't care if it is AOA or ACGME, I just want it (at least right now). Do I have a legit shot of making that happen? Or are the odds against me?

First, the odds are you'll develop other interests and change your mind sometime during the course of your education...not surely, though...if anything, the ortho people were the ones that maintained interest in a field all the way through. But in general, people honestly change their minds all the time.

Second, if you don't care if it's AOA or ACGME, not sure what your question is...if you want something, go for it...the only barrier you'll run into perhaps is if you have your heart set on ACGME ortho as a DO...that won't happen.
Anesthesia is much easier. Good friend of mine matched at Mayo with no USMLE, but he did rotate there and had a great LOR from a recent grad. Either way, it's completely doable.

Additionally, ortho programs tend to take VERY few people each year (only a handful even at large institutions) whereas anesthesia takes TONS of new residents, so the chances are much better.

 

[DrRoast]

First, the odds are you'll develop other interests and change your mind sometime during the course of your education...not surely, though...if anything, the ortho people were the ones that maintained interest in a field all the way through. But in general, people honestly change their minds all the time.

Second, if you don't care if it's AOA or ACGME, not sure what your question is...if you want something, go for it...the only barrier you'll run into perhaps is if you have your heart set on ACGME ortho as a DO...that won't happen.
Anesthesia is much easier. Good friend of mine matched at Mayo with no USMLE, but he did rotate there and had a great LOR from a recent grad. Either way, it's completely doable.

Additionally, ortho programs tend to take VERY few people each year (only a handful even at large institutions) whereas anesthesia takes TONS of new residents, so the chances are much better.

My question is will I be able to match ortho? Your saying its easier in AOA I believe, fine with me. I know its competitive, but what are the numbers in terms of applicants/spot for AOA ortho, and average COMLEX. My concern is the boards. I wasn't that great of an MCAT taker, so I'll work very hard, but still I'm afraid I won't do stellar on the boards either. So, do most people that want AOA ortho get it? I can't seem to find the stats anywhere online. I'm so concerned with this, that I'm almost considering doing HPSP just in case I do suck at the boards and have to do Fam Med, then at least I won't be in debt with CCOM style loans that I can't pay on a Family doc salary.

 

[spicedmanna]

So I'm reading this thread and still haven't really found what I'm looking for. I'm starting at CCOM in the fall, and right now I want either an ortho or anesthesiology residency. I don't care if it is AOA or ACGME, I just want it (at least right now). Do I have a legit shot of making that happen? Or are the odds against me?

I'd say the odds are always going to be against you with any highly competitive residency choice. Currently, ortho is one of them. It's going to be an uphill battle and you have to be very good to match into it. This has nothing much to do with MD or DO, although if you want to match into an ACGME ortho slot, good luck. You are going to have to be a stellar applicant and play a smart game if you want a good shot at it. Gas is pretty accessible, probably more so than ortho, but you still have to be a pretty solid applicant.

Many people want to match into these highly competitive slots, but few are actually able to do so. Basically, you need to be a good applicant if you want to match into a highly competitive residency. Of course, playing a smart game helps a lot. That's the bottom line.

 

[bth7]

So I'm reading this thread and still haven't really found what I'm looking for. I'm starting at CCOM in the fall, and right now I want either an ortho or anesthesiology residency. I don't care if it is AOA or ACGME, I just want it (at least right now). Do I have a legit shot of making that happen? Or are the odds against me?

If you don't mind going to an AOA residency, then you're chances are golden. No problem whatsoever.

You still need good grades, decent COMLEX scores, etc. But for an AOA residency in those specialties, your chances are really good.

bth

 

[rkaz]

This is the type of **** that is fueling the DO desire to change their degree name to make themselves more recognizable. All these ancillary medical professions trying to creep into a long white coat.

You're making semantic arguments, and all it does is expose your insecurities. I don't fault you for it, I'd be doing the same thing if I were a podiatrist. Hell, maybe you'll be successful in deluding patients (with a hushed voice, looking over your shoulder) into thinking you went to medical school - hooray for you.

But don't expect medical doctors to accept your efforts to dilute what it means to be a physician. And don't be surprised if your efforts are met with an increasing disdain for what you're doing. I hope it bites you in the ass.

Insecurities??? What?.... I thought he/she was being incredibly polite in dealing with you and homeboy. I feel honored that practicing clinicians (whether they be MD, DO, DDS, DPM etc) spend their time coming to this site to provide information to students.

In my book, podiatrists are certainly a type of physician, just like dentists. They just specialize in one area of the body. My sister is a dentist... she doesn't call herself a physician per say, but she would say that she is a doctor practicing dental medicine. But it's essentially the same thing as she is a physician in her own right... but it's mere terminology.

I am planning on starting med school this year, and I am appalled by people like yourself. Where do you get off having that kind of snotty attitude? It reeks. Get over yourself and stop having to one-up everyone else.

I don't mean to be unkind here... but seriously, don't you have better things to do with your time than to come to an anonymous forum to insult someone else's degree? The way I see it, if we didn't have podiatrists and dentists taking over a portion of the body, that would leave us a whole lot more to study in med school. I am grateful for these clinicians (real doctors) who have taken that load off me.

 

[JaggerPlate]

Insecurities??? What?.... I thought he/she was being incredibly polite in dealing with you and homeboy. I feel honored that practicing clinicians (whether they be MD, DO, DDS, DPM etc) spend their time coming to this site to provide information to students.

In my book, podiatrists are certainly a type of physician, just like dentists. They just specialize in one area of the body. My sister is a dentist... she doesn't call herself a physician per say, but she would say that she is a doctor practicing dental medicine. But it's essentially the same thing as she is a physician in her own right... but it's mere terminology.

I am planning on starting med school this year, and I am appalled by people like yourself. Where do you get off having that kind of snotty attitude? It reeks. Get over yourself and stop having to one-up everyone else.

I don't mean to be unkind here... but seriously, don't you have better things to do with your time than to come to an anonymous forum to insult someone else's degree? The way I see it, if we didn't have podiatrists and dentists taking over a portion of the body, that would leave us a whole lot more to study in med school. I am grateful for these clinicians (real doctors) who have taken that load off me.

a. What he brings up is a valid point. Mid-level providers and NON physicians waltzing around hospitals in long white coats, introducing themselves as physicians is inaccurate and wrong. A physician goes to medical school and should be the ONLY person at the hospital with the title of physician. He's not bashing podiatry, everyone here knows they worked hard for their degree and have their place in health care, but it's not trying to squeeze into the physician category.

b. Your sister is a dentist. She doesn't practice 'dental medicine,' she practices dentistry. Her focus is the mouth. The same with a podiatrist. If you had a heart attack in the middle of a restaurant ... you'd be blessed to have an Family physician, dermatologist, plastic surgeon, OBGYN, etc there, because these people attended medical school and are physicians. I don't think anyone here would want someone to stand up and run across the room shouting 'Don't worry, I practice dental medicine ... I'll restart the heart.'

He's not being insulting ... he's being realistic. Honestly, go to a hospital for 20 minutes and just look at the people in long white coats, trying to pass themselves off as something they aren't. You'll see everyone and their mom trying to fib what they have done into a 'medical education' for god knows why.

I'm not trying to bash any profession here ... I honestly have plenty of respect for dentists, pods, RNs, PAs, etc ... but they aren't doctors, they don't practice x type of medicine, and they shouldn't misrepresent themselves.

 

[tkim]

I honestly have plenty of respect for dentists, pods, RNs, PAs, etc ... but they aren't doctors, they don't practice x type of medicine, and they shouldn't misrepresent themselves.

Dentists and podiatrists have doctoral degrees and have every right to be called 'doctor' in the clinical setting, unlike those who have Phd's and should not be called 'doctor' in the clinical setting.

Are they physicians? Not in the sense MD/DOs are, but it's a fine distinction to make since they are specialists.

Lots of people on this thread who aren't any of the above - saying what's what.

 

[spicedmanna]

You shouldn't place podiatrists in the same category as the other mid-level clinicians. That would be unfair. They are independent, doctoral-level, practitioners and their training is pretty similar to ours. I see podiatrists and dentists as being on the same level as physicians, just dealing with highly specific aspects of the human body, with a corresponding scope of practice.

In all fairness, too, if I were having an AMI at a restaurant, no type of clinician is going to be able to help me more than any other in the absence of proper ACLS drugs and a defibrillator. Anyone with BLS training would be able to do as much, until someone with ACLS training and the right equipment came along. Hopefully they come with an ambulance so that I could quickly get definitive care. Early defibrillation and time/access to definitive care are going to be the more critical factors to my survival and recovery.

 

[JaggerPlate]

In all fairness, too, if I were having an AMI at a restaurant, no type of clinician is going to be able to help me more than any other in the absence of proper ACLS drugs and a defibrillator. Anyone with BLS training would be able to do as much, until someone with ACLS training and the right equipment came along. Hopefully they come with an ambulance so that I could quickly get definitive care. Early defibrillation and time/access to definitive care are going to be the more critical factors to my survival and recovery.

Totally what I was getting at ... thanks.

I'll never understand epenis flexing on SDN. God, unreal.


I wasn't trying to put pods in with mid-levels, and they have a doctorate in their respective field .... ergo, I am not saying they aren't 'doctors,' but they shouldn't be called a physician in a hospital setting anymore than an PhD or psychologist should. Both doctors, but not an MD/DO in a hospital.

 

[spicedmanna]

Totally what I was getting at ... thanks.

I'll never understand epenis flexing on SDN. God, unreal.

I wasn't attempting to flex anything and I have no interest in making myself appear better than you. What I am pointing out is that your example didn't seem to apply to the point you were trying to make. In a non-clinical setting, such as the restaurant in your example, it doesn't matter who is around to "rescue" the patient as long as they have basic CPR training and can get him quickly to definitive care, which likely consists of cardiac drugs, defibrillation, perhaps lytics and a visit to the cath lab, if indicated. A physician wouldn't have a significant advantage over any other clinician, or any bystander with appropriate CPR training for that matter, in a restaurant because in that setting, clinical skill isn't the determining factor to the survival of the patient. Additional clinical skill would require the appropriate drugs and equipment to be of benefit.

If I have slighted you in any way, I apologize. I assure you, it was unintentional. I just don't understand how your example pertains to dentists and/or podiatrists not being physicians. Anybody with CPR/BLS training would have responded the same to the patient having an AMI at a restaurant.

I wasn't trying to put pods in with mid-levels, and they have a doctorate in their respective field ....

I suppose I should have specified to whom I was referring. I didn't mean to imply that I was responding to you specifically. I just got tired of seeing several responses lumping podiatrists in with mid-levels. I felt the need to say something about that.

ergo, I am not saying they aren't 'doctors,' but they shouldn't be called a physician in a hospital setting anymore than an PhD or psychologist should. Both doctors, but not an MD/DO in a hospital.

Actually, I would call a psychologist named Smith, "Dr. Smith," in a clinical setting because they are clinicians and they manage the care of patients. It seems appropriate in that setting, but that's beside the point. I understand what you are getting at. I agree that podiatrists should not be considered physicians in the traditional sense any more than dentists would be. However, in terms of patient management per scope, being called doctor, and wearing a white coat, these are completely appropriate, I think. I generally see dentists and podiatrists as cousins to physicians. We are on the same level.

 

[JaggerPlate]

I understand what you are getting at. I agree that podiatrists should not be considered physicians in the traditional sense any more than dentists would be. However, in terms of patient management per scope, being called doctor, and wearing a white coat, these are completely appropriate, I think.

Yes, that was my exact point. My reaction, which was a reflex, was to situations on SDN where one is simply trying to make a point, and examples are nitpicked apart, which demoralizes the basic message. Trust me, I understand what you are saying ... but please, understand that my example was just a simple, hypothetical situation to establish my point, nothing more. I think we are on the same page (from above comment) and that's what matters. No harm, no foul.

 

[justtesting]

I wasn't attempting to flex anything and I have no interest in making myself appear better than you. What I am pointing out is that your example didn't seem to apply to the point you were trying to make. In a non-clinical setting, such as the restaurant in your example, it doesn't matter who is around to "rescue" the patient as long as they have basic CPR training and can get him quickly to definitive care, which likely consists of cardiac drugs, defibrillation, perhaps lytics and a visit to the cath lab, if indicated. A physician wouldn't have a significant advantage over any other clinician, or any bystander with appropriate CPR training for that matter, in a restaurant because in that setting, clinical skill isn't the determining factor to the survival of the patient. Additional clinical skill would require the appropriate drugs and equipment to be of benefit.

If I have slighted you in any way, I apologize. I assure you, it was unintentional. I just don't understand how your example pertains to dentists and/or podiatrists not being physicians. Anybody with CPR/BLS training would have responded the same to the patient having an AMI at a restaurant.



I suppose I should have specified to whom I was referring. I didn't mean to imply that I was responding to you specifically. I just got tired of seeing several responses lumping podiatrists in with mid-levels. I felt the need to say something about that.



Actually, I would call a psychologist named Smith, "Dr. Smith," in a clinical setting because they are clinicians and they manage the care of patients. It seems appropriate in that setting, but that's beside the point. I understand what you are getting at. I agree that podiatrists should not be considered physicians in the traditional sense any more than dentists would be. However, in terms of patient management per scope, being called doctor, and wearing a white coat, these are completely appropriate, I think. I generally see dentists and podiatrists as cousins to physicians. We are on the same level.

you are right on. people who say podiatrists dont deserve to wear white coats are full of themselves. pods do a three year residency- same as fp, im, em etc (who all wear white coats). they do forefoot and rearfoot ankle surgeries. yes they do complex surgeries. they are not midlevel and they absolutely should be introducing themselves as dr so and so. after a 4 year undergrad, 4 year podiaty school and a 3yr surgical residency, they deserve it as much as anyone else. they may not be physicians in the typical md/do sense but i think cousin is an appropriate way to describe their relationship with md/do.

 

[tkim]

You don't need to have a degree to know what it entails. You're not a board certified Emergency Physician. Are you thus ignorant to the specialty?

BTW, the pod is clearly trying to play himself off as being a specialty-trained physician. Either you're an idiot and don't see that, or you're a fool and don't see the ramifications of not correcting the falsehood.

Next to premeds, there's nothing worse than a know-it-all, newly-admitted-to med-school-premed. Have a good one. See you in the trenches.

 

[homeboy]

In all fairness, too, if I were having an AMI at a restaurant, no type of clinician is going to be able to help me more than any other in the absence of proper ACLS drugs and a defibrillator...

Yeah, if I were in a restaurant, I'd feel more comfortable with a paramedic or ER nurse covering me until the bambulance arrived than a freaking dermatologist or psychiatrist...worse, a pathologist. AEDs don't require an advanced degree to operate...they're pretty dummy proof. Granted most MDs/DOs have HAD ACLS (or at least BLS) training, it might have been 10 yrs ago in med school.

Every health care professional practices in the field of medicine, but the historic understanding of terms like "medical practice", "physician", etc, implies that one is a physician, IE. MD (or DO).

 

[homeboy]

The bottom line with podiatry is YES, they attend 4 yrs of school, and perhaps residency, perform surgeries, Rx some drugs, they are doctors of podiatric medicine.
They are not physicians in the classic or universal sense of the word "physician."

The more important question to ask is "Does podiatry require 4 yrs of post-grad training and a residency?"
Knowing the admission standards of podiatry school and the material covered in those 4 yrs (at least from the one at my med school), I have to say emphatically no.

It's stretched out to 4 yrs for the explicit purpose of being able to acquire the title of "DOCTOR", plain and simple. You could EASILY cram podiatry school into a 2 yr degree, and perhaps a 1 yr internship, but this is the basis of the entire argument:
EVERYONE wants to be a doctor, so if you can justify making the training 4 yrs, you can do it.

Even medical school (ie. physician training) never even used to be 4 yrs until this last century, not to mention the only recent (past 50 yrs) requirement for post grad training. But NO ONE can deny the fact that medicine has gotten infinitely more complicated the past 100 yrs and probably DOES require at least 3 or 4 yrs, plus residency...can that same argument be applied to focusing a career entirely on the FOOT?
In my mind, no.

 

[homeboy]

My question is will I be able to match ortho? Your saying its easier in AOA I believe, fine with me. I know its competitive, but what are the numbers in terms of applicants/spot for AOA ortho, and average COMLEX. My concern is the boards. I wasn't that great of an MCAT taker, so I'll work very hard, but still I'm afraid I won't do stellar on the boards either. So, do most people that want AOA ortho get it? I can't seem to find the stats anywhere online. I'm so concerned with this, that I'm almost considering doing HPSP just in case I do suck at the boards and have to do Fam Med, then at least I won't be in debt with CCOM style loans that I can't pay on a Family doc salary.

Go to NRMP.org for the exact stats, for the MD match anyway.

 

[cliquesh]

My question is will I be able to match ortho? Your saying its easier in AOA I believe, fine with me. I know its competitive, but what are the numbers in terms of applicants/spot for AOA ortho, and average COMLEX. My concern is the boards. I wasn't that great of an MCAT taker, so I'll work very hard, but still I'm afraid I won't do stellar on the boards either. So, do most people that want AOA ortho get it? I can't seem to find the stats anywhere online. I'm so concerned with this, that I'm almost considering doing HPSP just in case I do suck at the boards and have to do Fam Med, then at least I won't be in debt with CCOM style loans that I can't pay on a Family doc salary.

I don't think the AOA or natmatch is very good at tracking data, so, to my knowledge, there is no information regarding applicants per spot or average comlex score. However, if you don't know this already, last year there were 74 AOA Ortho spots and there were ~1650 individuals that participated in the AOA match. So about 4.4% of those applying for the match, matched ortho, which is similar to the percentage of MDs matching ortho. But are these AOA residencies the same quality as ACGME? I don't know.

I'd suggest checking out the surgical forums, and other fields you may be interested, and search for 'osteopathic.' From these posts, it seems that if you want an AOA residency in a competitive field, you MUST do audition rotations. However, there seems to be a disagreement about what scores and class rank you need. Some of the posts say you just need to do above average and rotate at the program, whereas other posts say you need to score in the 85th percentile, graduate in the top 15% of your class, and rotate at the program. Nevertheless, the common theme is that you need to rotate there.

 

[dpmPOD]

A few things to fix here.

1) Residency for podiatry is required. The minimum is two years, however the two year programs are being replaced by a mandatory three year residency within the next few years.

2)Your comments on the length of podiatry school again are off, and lets be honest you really have no idea what the curriculum of podiatry school entails. It's pretty obvious you're at DMU, so yea you've had a few classes with the Pod students, but you're not really aware of what they're doing when not in classes with you. The med students at my school thus far have had an easier time than we have as far as scheduling, test frequency, and course work load. If anything they've been a bit coddled.

3)Saying one could learn podiatry in two years is absurd. You must know we are educated in a lot more than just the foot.... Last I checked the lower extremity was connected to the rest of the body. Do you really think we would do what we do if we just took a couple of "foot" classes?? The only classes I've seen at my school so far for first year that the med students take that I don't are embryology and behavioral science. Instead I take lower extremity anatomy (after already taking gross anatomy with the M1's) biomechanics, and podiatric medicine and surgery. It evens out.

3) Podiatry entrance requirements will hopefully being improving. My stats were higher than most DO schools and quite a few MD programs. While it is true that podiatry entrance requirements are lower, these applicants are usually "weeded" out; the attrition rate for podiatry is much higher than MD/DO. Yea, they may get in but they won't make it through.

The bottom line with podiatry is YES, they attend 4 yrs of school, and perhaps residency, perform surgeries, Rx some drugs, they are doctors of podiatric medicine.
They are not physicians in the classic or universal sense of the word "physician."

The more important question to ask is "Does podiatry require 4 yrs of post-grad training and a residency?"
Knowing the admission standards of podiatry school and the material covered in those 4 yrs (at least from the one at my med school), I have to say emphatically no.

It's stretched out to 4 yrs for the explicit purpose of being able to acquire the title of "DOCTOR", plain and simple. You could EASILY cram podiatry school into a 2 yr degree, and perhaps a 1 yr internship, but this is the basis of the entire argument:
EVERYONE wants to be a doctor, so if you can justify making the training 4 yrs, you can do it.

Even medical school (ie. physician training) never even used to be 4 yrs until this last century, not to mention the only recent (past 50 yrs) requirement for post grad training. But NO ONE can deny the fact that medicine has gotten infinitely more complicated the past 100 yrs and probably DOES require at least 3 or 4 yrs, plus residency...can that same argument be applied to focusing a career entirely on the FOOT?
In my mind, no.

 

[homeboy]

A few things to fix here.

1) Residency for podiatry is required. The minimum is two years, however the two year programs are being replaced by a mandatory three year residency within the next few years.

2)Your comments on the length of podiatry school again are off, and lets be honest you really have no idea what the curriculum of podiatry school entails. It's pretty obvious you're at DMU, so yea you've had a few classes with the Pod students, but you're not really aware of what they're doing when not in classes with you. The med students at my school thus far have had an easier time than we have as far as scheduling, test frequency, and course work load. If anything they've been a bit coddled.

3)Saying one could learn podiatry in two years is absurd. You must know we are educated in a lot more than just the foot.... Last I checked the lower extremity was connected to the rest of the body. Do you really think we would do what we do if we just took a couple of "foot" classes?? The only classes I've seen at my school so far for first year that the med students take that I don't are embryology and behavioral science. Instead I take lower extremity anatomy (after already taking gross anatomy with the M1's) biomechanics, and podiatric medicine and surgery. It evens out.

3) Podiatry entrance requirements will hopefully being improving. My stats were higher than most DO schools and quite a few MD programs. While it is true that podiatry entrance requirements are lower, these applicants are usually "weeded" out; the attrition rate for podiatry is much higher than MD/DO. Yea, they may get in but they won't make it through.

I had quite an intimate understanding of the DPM curriculum, despite your assumption I have no idea what I'm talking about, and saw the 3rd/4th yrs on a regular basis in one of the large hospitals.

Yeah, the foot is connected to the rest of the body, but it's still the FOOT, and your scope of practice IS and SHOULD BE limited to the FOOT, so talking about the body is what's ridiculous. This is how the whole push for increased DPM practice rights starts: "because we learn other body systems, we should be able to Rx drugs for those systems, if in some obscure way they are tangentially related." But that's another thread...

I don't really care how extensive you THINK your training is, it amounts to the technical equivalent of a well-trained PA or NP, who goes to school for 2 yrs. PAs/NPs specialize in all sorts of surgical practice, and in many settings perform the majority of procedures comparable to an MD, including Rx's. Not to mention the fact that the more complicated cases which you speak of could--techinically--be performed by an orthopedic surgeon.

Claiming it takes 7 yrs of post-undergrad training to clip diabetic toenails, saw off bunions, and remove shards of glass and bone spurs is silly. You want to do that for a living? Fine, I don't really care...I think there's a perfectly legitimate place for such a position in our medical system. But the notion that to get there requires an extensive, gruelling, 7-yr course--resulting in, of course, a doctorate degree-- is completely ridiculous.

 

[dpmPOD]

I don't believe I made any push here for an increased scope of practice. We are specialists of the foot and ankle and we are quite happy with our role. The fact that you "interacted with 3rd/4th year students" and yet you think podiatrists only "clip diabetic toenails, saw off bunions, and remove shards of glass and bone spurs" is quite enough to prove to me that you have no idea what you're talking about. I don't think you have any idea what a podiatrist does. This is going to be a problem for you in medicine; you're bigoted and you think you know it all. I hope your attendings beat this attitude out of you by the time you've finshed your residency. Shame.

I had quite an intimate understanding of the DPM curriculum, despite your assumption I have no idea what I'm talking about, and saw the 3rd/4th yrs on a regular basis in one of the large hospitals.

Yeah, the foot is connected to the rest of the body, but it's still the FOOT, and your scope of practice IS and SHOULD BE limited to the FOOT, so talking about the body is what's ridiculous. This is how the whole push for increased DPM practice rights starts: "because we learn other body systems, we should be able to Rx drugs for those systems, if in some obscure way they are tangentially related." But that's another thread...

I don't really care how extensive you THINK your training is, it amounts to the technical equivalent of a well-trained PA or NP, who goes to school for 2 yrs. PAs/NPs specialize in all sorts of surgical practice, and in many settings perform the majority of procedures comparable to an MD, including Rx's. Not to mention the fact that the more complicated cases which you speak of could--techinically--be performed by an orthopedic surgeon.

Claiming it takes 7 yrs of post-undergrad training to clip diabetic toenails, saw off bunions, and remove shards of glass and bone spurs is silly. You want to do that for a living? Fine, I don't really care...I think there's a perfectly legitimate place for such a position in our medical system. But the notion that to get there requires an extensive, gruelling, 7-yr course--resulting in, of course, a doctorate degree-- is completely ridiculous.

 

[homeboy]

This is going to be a problem for you in medicine; you're bigoted and you think you know it all.

No, it just irks me to have podiatry students come into a physician forum and talk about how long, arduous and justifiable their career track is.

I never said you specifically are pushing for more rights, but every non-physician field has slowly expanded over the years, justifying increased pay & titleship with increased training, regardless of the fact they're overlapping another already established field, or if the training is entirely justifiable.

The Doctor of Nurse Practitioner is the perfect example. Another is Optometrists performing minor eye surgeries. Podiatry not too far off.

Physicians have had their roles chipped away over the decades, and many people justify this using cost analysis. But if jobs / responsibilities / procedures that used to be performed by physicians are slowly taken over by other providers, and those providers up the ante & increase their training, and consequently their pay, what's the point?

It comes down to people wanting a slice of the pie but not wanting to work for it, or at least not wanting the responsibilities of being a full-fledged physician. ~6 figure salary, but light call, nice hours, relatively non-competitive...hey, who wouldn't want to do podiatry?

Podiatrist: Elaine, I’m used to it. I’m a doctor.

Elaine: Well… podiatrist.

Podiatrist: Huh?

Elaine: No no, I’m just saying you didn’t really go to medical school, you

went to podiatry school. Which I’m sure is very grueling in it’s own way.

Podiatrist: I went to podiatry school because I like feet. I chose to work with

feet.

Elaine: I like feet too. I’m just saying…

 

[JaggerPlate]

I've never seen people more defensive than pod students/attendings in these forums, and that includes pre-DO in an MD vs DO debate. Seems a little odd ...

 

[dpmPOD]

Elaine: No no, I'm just saying you didn't really go to medical school, you

went to podiatry school. Which I'm sure is very grueling in it's own way.

Podiatrist: I went to podiatry school because I like feet. I chose to work with

feet.

Elaine: I like feet too. I'm just saying…

I'm not really sure why you keep quoting Seinfeld here. For one thing, at the end of that episode Jerry states that Podiatrists are in fact doctors; I guess you forgot about that part. Jerry Seinfeld sees a podiatrist regularly in "real" life. See below for a clip:

http://www.youtube.com/watch?v=Fu5Qk3fDJbU

I think the fact that you keep referring to a comedy show from the 90's as a sort of "evidence" speaks for itself. While we're at it how about we talk about how Larry David portrays DO's on Curb your Enthusiasm. I sure do love Cheryl's "osteopath," maybe that's how DO's really are?

 

[JaggerPlate]

I'm not really sure why you keep quoting Seinfeld here. For one thing, at the end of that episode Jerry states that Podiatrists are in fact doctors; I guess you forgot about that part. Jerry Seinfeld sees a podiatrist regularly in "real" life. See below for a clip:

http://www.youtube.com/watch?v=Fu5Qk3fDJbU

I think the fact that you keep referring to a comedy show from the 90's as a sort of "evidence" speaks for itself. While we're at it how about we talk about how Larry David portrays DO's on Curb your Enthusiasm. I sure do love Cheryl's "osteopath," maybe that's how DO's really are?

Totally not defensive.

 

[dpmPOD]

Totally not defensive.

Hey if you're gonna quote Seinfeld at least quote it right.

 

[JaggerPlate]

Hey if you're gonna quote Seinfeld at least quote it right.

It's like people misquoting the junior mint bit ... just shameful.

 

[homeboy]

I think the fact that you keep referring to a comedy show from the 90's as a sort of "evidence" speaks for itself. While we're at it how about we talk about how Larry David portrays DO's on Curb your Enthusiasm. I sure do love Cheryl's "osteopath," maybe that's how DO's really are?

No I just love Seinfeld. Sorry, don't know who Larry David is or what curb your enthusiasm is.

Evidence? No, it's just hilarious, along with the fact you rebut my jab at podiatry with a youtube clip.

 

[JaggerPlate]

No I just love Seinfeld. Sorry, don't know who Larry David is or what curb your enthusiasm is.

Evidence? No, it's just hilarious, along with the fact you rebut my jab at podiatry with a youtube clip.

Larry David is the creator of 'Seinfeld,' and now has a show on HBO called 'curb your enthusiasm' which is basically Seinfeld 2.0, but it's shot in a reality type style, is about David's life, and is much more raw/hilarious (IMO). Definitely check it out ... seriously a hilarious show. However, they do have one episode called 'the osteopath' where Cheryll (his wife) sees a DO or something (I haven't seen the episode) and Larry tries to figure out what he is/does the entire episode.

 

[diabeticfootdr]

It's like people misquoting the junior mint bit ... just shameful.

you also can't forget about pimple popper, md! what was great about seinfeld was the satire was very close to real life. i did my residency in NYC, and it took living in NYC to truly understand how real it was. one of my favorites was the argument over the parking spot!

 

[diabeticfootdr]

Physicians have had their roles chipped away over the decades, and many people justify this using cost analysis. But if jobs / responsibilities / procedures that used to be performed by physicians are slowly taken over by other providers, and those providers up the ante & increase their training, and consequently their pay, what's the point?

It comes down to people wanting a slice of the pie but not wanting to work for it, or at least not wanting the responsibilities of being a full-fledged physician. ~6 figure salary, but light call, nice hours, relatively non-competitive...hey, who wouldn't want to do podiatry?

I find this comment interesting from a DO. How you have forgotten (or never learned) the history of your own profession. It wasn't too long ago that those in your own profession weren't considered physicians. And they improved their training and proved themselves worthy. Then once you've achieved that status, automatically you discount others who follow in your footsteps.

 

[homeboy]

I find this comment interesting from a DO. How you have forgotten (or never learned) the history of your own profession. It wasn't too long ago that those in your own profession weren't considered physicians. And they improved their training and proved themselves worthy. Then once you've achieved that status, automatically you discount others who follow in your footsteps.

Podiatry is not following the footsteps of osteopathic medicine (nice pun, though).

Yes, we've had to fight for practice rights, but our profession was derived from an MD, and we've never portrayted ourselves as anything other than full-fledged physicians.

Osteopaths did not originate as a non-physician entitiy, only to evolve over time into full-fledged physicians. We've been physicians from the get go, and the dispute has been solely acceptance from our counterparts.

There is no full physician counterpart that podiatry has been comparable to from inception...it has evolved from the foot to more of the foot, to include surgery, Rx's, etc...

 

[dpmPOD]

Podiatry is not following the footsteps of osteopathic medicine (nice pun, though).

Yes, we've had to fight for practice rights, but our profession was derived from an MD, and we've never portrayted ourselves as anything other than full-fledged physicians.

William Mathias Scholl (1882 - 1968) was a podiatrist and the founder of Dr. Scholl's. Scholl went on to found the Illinois College of Chiropody and Orthopaedics

Scholl began his career in Chicago, 1899, in a small shoe store specializing in comfort and specialist footwear. His concern for customers with painful foot conditions motivated him to enroll in medical school to study the anatomy and physiology of the foot.
By 1904 he had graduated from the Illinois Medical College (now Loyola University) as a doctor of medicine (M.D.)

-wiki

Hrm...fancy that, podiatry was started by an MD too. Yep, you still don't know what you're talking about.

 

[DrRoast]

Not trying to be a jerk, but this podiatry debate has gone on far too long in this thread. Seriously no offense to anyone though.

 

[BruceBanner]

A few points on this ever-redundant topic:

-Notice how the only people who put time and intensity into arguing the semantics of degrees and designations are pre-meds, and a few medical students. Physicians are past it and too busy to care.

- I can understand the reasoning behind the DO degree change. It makes sense for the only fully licensed and recognized physicians in the country to have similar designations when their training is nearly identical. However--dont hold your breath. This is not going to happen any time soon, if ever. If you go to a DO school, accept that you will be so-and-so, D.O. for your career. Frankly, who cares? Youre going to be a physician and that's what you wanted, right?

-As Jaggerplate pointed out, step into any hospital and you will see where the "white coat" laments are borne from. Every RN, PA, PT, NP, et al is donning a white coat and waltzing around like a physician. On the one hand, you cant blame someone for wanting to feel important and respected, but on the other, this is just plain misleading and there needs to be some lines drawn. The white coat thing is just a symptom of a larger issue--which is certain midlevels (not all of them) inching their way into autonomous medical practice. This is misleading to patients and insulting to physicians.

If a podiatrist or a chiropractor wants to call himself doctor, power to 'em. They went to professional school and they certainly have legal right to. What bothers me is that the perception is becoming blurred between a physician and an ancillary clinician (NP, DNP, DPT, etc.)---at least to the lay public. Lines need to be drawn, and there is no way to accomplish this without stepping on some toes.

 

[homeboy]

If a podiatrist or a chiropractor wants to call himself doctor, power to 'em. They went to professional school and they certainly have legal right to. What bothers me is that the perception is becoming blurred between a physician and an ancillary clinician (NP, DNP, DPT, etc.)---at least to the lay public. Lines need to be drawn, and there is no way to accomplish this without stepping on some toes.

That point is key.

 

[homeboy]

William Mathias Scholl (1882 - 1968) was a podiatrist and the founder of Dr. Scholl's. Scholl went on to found the Illinois College of Chiropody and Orthopaedics

Scholl began his career in Chicago, 1899, in a small shoe store specializing in comfort and specialist footwear. His concern for customers with painful foot conditions motivated him to enroll in medical school to study the anatomy and physiology of the foot.
By 1904 he had graduated from the Illinois Medical College (now Loyola University) as a doctor of medicine (M.D.)

-wiki

Hrm...fancy that, podiatry was started by an MD too. Yep, you still don't know what you're talking about.

Congratulations, you can quote wiki.

So what you're saying is, he went to medical school--where one becomes a physician--to focus a career on feet, and subsequently started a college that focused solely on the feet, meaning the people he trained were not MDs but podiatrists.

My POINT was and is that, regardless of Scholl's background, he set in motion a profession that from it's inception focuses solely (no pun intended) on feet, compared to DOs which have been physicians from the get go (AT Still did not renounce his physician status and go chiropractic...he retained the status of physician but merely emphasized muskuloskeletal & lymphovascular over calomel & blood letting).

Scholl's INTENTION from the START was to focus on the feet, and the feet alone, but had to go to medical school to learn the material. Just because Scholl had the credentials of an MD doesn't translate into podiatry obtaining the rights & responsibilities of a physician from the ankle down.

I have no arguments with the notion that the DO route is just another route to becoming a physician; the whole concept of osteopathy died with AT Still--a physician is a physician.

 

[dpmPOD]

the rights & responsibilities of a physician from the ankle down.

That's what podiatrists do. Again, I know you think now that you're a resident you're House or something, but you don't know everything and you certainly don't know as much about the foot/ankle, its pathologies, or its treatments as a podiatrist does. I personally don't care if you call us physicians or not, but that's certainly our role for the foot/ankle. I liked the "cousin" analogy from earlier in the thread; we're different than you, not subordinate to you. Saying we're just like you diminishes the quality of our education. You don't have the same training, or qualifications as us when it comes to that area, despite your assertions that you could learn podiatry in "two years." My problem with you is that you keep insisting that because you're a physician, you're pretty much as competent at podiatry as a podiatrist, which is simply absurd. We are the specialists for that area, not you. You simply don't get the training and education. Show some respect for your future colleagues, stop acting like podiatrists have a throwaway degree, and do read up on what podiatrists actually do. I think you'd be doing your future patients a disservice by remaining ignorant. I won't post anymore on this thread as it has been beaten to death. If you feel like arguing more, bring it to the podiatry forums.

 

[goosedander]

That's what podiatrists do. Again, I know you think now that you're a resident you're House or something, but you don't know everything and you certainly don't know as much about the foot/ankle, its pathologies, or its treatments as a podiatrist does. I don't care if you call us physicians or not, but that's certainly our role for the foot/ankle. I liked the "cousin" analogy from earlier in the thread personally; we're different than you, not subordinate to you. Saying we're just like you diminishes the quality of our education. You don't have the same training, or qualifications as us when it comes to that area, despite your assertions that you could learn podiatry in "two years." My problem with you is that you keep insisting that because you're a physician, you're pretty much as competent at podiatry as a podiatrist, which is simply absurd. We are the specialists for that area, not you. You simply don't get the training and education. Show some respect for your future colleagues, stop acting like podiatrists have a throwaway degree, and do read up on what podiatrists actually do. I think you'd be doing your future patients a disservice by remaining ignorant. I won't post anymore on this thread as it has been beaten to death. If you feel like arguing more, bring it to the podiatry forums.

Why don't we just forego medical school altogether and have schools for every area of the body? Should there be a hand school? A brain school? A heart school? It would be consistent with your educational assertions. Maybe the medical world just hasn't caught up with you guys.

 

[spicedmanna]

*sigh* With all this territorialism, how does the work ever get done? The fact of the matter is that podiatrists aren't going away. We need to afford them the respect that they deserve. They are without a doubt our cousins.

Also, midlevels are going to continue to push the line. Our role is eroding in part because we don't want to step up. We don't want primary care. We'd rather be highly paid subspecialists. If we are so worried about being taken over by midlevels, then retake what's ours. If there wasn't a need, a space to be filled, I doubt midlevels would have the room to encroach.

Anyway, let's all be professionals and lead by respect and example.

 

[homeboy]

My problem with you is that you keep insisting that because you're a physician, you're pretty much as competent at podiatry as a podiatrist, which is simply absurd.

No, not me, I have no idea how to operate on the foot, and I don't pretend to even care. But ORTHOPEDIC SURGEONS do, and the remainder of your education can be summed up EASILY with a 2 yr degree.

The idea that you are privy to medical knowledge that an orthopod is NOT is hilarious. I'm pretty sure I've said this in previous posts.

Anyway, I'll stop hounding away at this because I know we both have better things to do, but I stand by my original assertion that the more complicated cases you undertake can be performed by a competent orthopedic surgeon, and the remainder is NOTHING that requires a freakin' doctorate degree.

 

[homeboy]

*sigh* With all this territorialism, how does the work ever get done? The fact of the matter is that podiatrists aren't going away. We need to afford them the respect that they deserve. They are without a doubt our cousins.

Also, midlevels are going to continue to push the line. Our role is eroding in part because we don't want to step up. We don't want primary care. We'd rather be highly paid subspecialists. If we are so worried about being taken over by midlevels, then retake what's ours. If there wasn't a need, a space to be filled, I doubt midlevels would have the room to encroach.

Anyway, let's all be professionals and lead by respect and example.

-----------
Yes, midlevels / ancillary 'doctors' do have a role, but to assume we have GIVEN them FP is innacurate.
Everyone wants to be a subspecialist because
1.) FP doesn't pay crap compared to subspecialties, and it's hard to justify taking an extra 10 yrs to pay off your loans for egalitarian reasons.

2.) it's a mental mindjob knowing that your function can be performed, for the most part, by an experienced PA/NP. Back in the day, physicians (FPs) did EVERYTHING. Today, they do nothing because of litigation and/or poor reimbursement.

People don't want to be a matyr for the cause of medicine, mainly because it's all crap nowadays anyway...it's all politics, insurance, drug companines...it's ALL ABOUT PEOPLE GETTING A PIECE OF THE PIE.

My whole argument was not to suggest that there isn't a place for podiatrists, or for that matter PAs, NPs, RNs, CRNAs, optometrists, etc...but there's historically been a push from these fields (excluding maybe PA) to expand practice rights, responsibilities, and consequently, SALARY.

I understand there's a shortage of health care professionals, especially physicians, but other fields use this reality as an excuse to broaden their spectrum.

Ok, 'nuff said...I'll stop raggin' on podiatry and the like...less a chiropracter comes along...let's not go there...

 

[diabeticfootdr]

Sometimes these dialogues back and forth are a form of chest thumping, but I find most of them useful, learning about the attitudes and impressions of other practitioners. And hopefully I can impart a picture of what my profession has become and is becoming. In that, DPMs received an email today from our national organization about "high-level" talks between AOA and APMA. It is nice to see the organizations collaborate and use each others strengths.

From APMA eNews 2741
"AOA Leaders Meet at APMA Headquarters
The American Osteopathic Association (AOA) leadership, including President Carlo J. DiMarco, DO, President-elect Larry Wickless, DO, Executive Director John B Crosby, JD, and Director of Governmental Relations Shawn Martin, met with APMA President Ross E. Taubman, DPM, Executive Director Glenn B. Gastwirth, DPM, and Director of Legislative Advocacy Faye Frankfort in Bethesda on Wednesday, January 21.

The meeting with AOA is part of the ongoing dialogue between APMA and AOA to discuss issues of common concern and synergistic strategies. Among the subjects discussed were the American Medical Association Scope of Practice Module on Podiatry, student indebtedness, residency genesis in osteopathic hospitals, and collaboration on professional and public education initiatives.

AOA and APMA agreed to have our leaders continue to meet at least twice a year in addition to attending one another's House of Delegates meetings."

 

[Peptoboy]

*sigh* With all this territorialism, how does the work ever get done? The fact of the matter is that podiatrists aren't going away. We need to afford them the respect that they deserve. They are without a doubt our cousins.

Also, midlevels are going to continue to push the line. Our role is eroding in part because we don't want to step up. We don't want primary care. We'd rather be highly paid subspecialists. If we are so worried about being taken over by midlevels, then retake what's ours. If there wasn't a need, a space to be filled, I doubt midlevels would have the room to encroach.

Anyway, let's all be professionals and lead by respect and example.

Good post! I am planning on family medicine, we need midlevels, but they need to be practicing under physician license and supervision. Not because they are bad practitioners, but because of the education and clinical exposure disparity. I think that the broad scope of practice makes Family medicine very enticing, and I can live on $150,000 per year. I am still not understanding why the Podiatrists keep posting in the Osteopathic forum though. Don't they have their own?

 

[rkaz]

Good post! I am planning on family medicine, we need midlevels, but they need to be practicing under physician license and supervision. Not because they are bad practitioners, but because of the education and clinical exposure disparity. I think that the broad scope of practice makes Family medicine very enticing, and I can live on $150,000 per year. I am still not understanding why the Podiatrists keep posting in the Osteopathic forum though. Don't they have their own?

Um, most of the pre-osteo and osteo students post on the pre-allo thread, and have never been told to 'go back to your own forum'. I'd say the same applies here. People are allowed to come into whatever forum they want to dispel any misinformation as they see fit.

 

[Peptoboy]

Um, most of the pre-osteo and osteo students post on the pre-allo thread, and have never been told to 'go back to your own forum'. I'd say the same applies here. People are allowed to come into whatever forum they want to dispel any misinformation as they see fit.

Hey rkaz, its not really that they are Podiatrists and posting in our forum, its that I am sick of coming on to look at the "Specialties" forum and having to read posts by a bunch of *****s trying to one up each other!!!

 

[DrRoast]

Hey rkaz, its not really that they are Podiatrists and posting in our forum, its that I am sick of coming on to look at the "Specialties" forum and having to read posts by a bunch of *****s trying to one up each other!!!

Touche Salesman

 

[biomechanicsrox]

I am a podiatry student. And I am not trying to start any wars. I just thought I would share the curriculum at Midwestern University. We sit in class along side our DO counterparts. We take the same basic science classes. When DOs are learning Clinical Medicine we are learning podiatric surgery and biomechanics, etc. Our education is not identical (which is why we are DPMs and not DOs in the end), but we do complete a rigorous amount of course work throughout our four years. Upon completion we complete a three year residency where we work alongside MD and DO residents. We are trained in forefoot and rearfoot reconstructive surgery in addition to the routine care. This does not just consist of bunions and heel spurs, but also fracture repairs, amputations, etc. Yes orthopedic surgeons can do the same thing, in fact many of us will be trained by F&A orthos during residency. But the truth of the matter is that they make up a small percentage of orthos. We can and do fill that void.

http://mwunet.midwestern.edu/administrative/Registrar/documents/0809_Curriculums/AZCOM_2012.pdf
http://mwunet.midwestern.edu/administrative/Registrar/documents/0809_Curriculums/PMS_2012.pdf

 

[JaggerPlate]

I am a podiatry student. And I am not trying to start any wars. I just thought I would share the curriculum at Midwestern University. We sit in class along side our DO counterparts. We take the same basic science classes. When DOs are learning Clinical Medicine we are learning podiatric surgery and biomechanics, etc. Our education is not identical (which is why we are DPMs and not DOs in the end), but we do complete a rigorous amount of course work throughout our four years. Upon completion we complete a three year residency where we work alongside MD and DO residents. We are trained in forefoot and rearfoot reconstructive surgery in addition to the routine care. This does not just consist of bunions and heel spurs, but also fracture repairs, amputations, etc. Yes orthopedic surgeons can do the same thing, in fact many of us will be trained by F&A orthos during residency. But the truth of the matter is that they make up a small percentage of orthos. We can and do fill that void.

http://mwunet.midwestern.edu/administrative/Registrar/documents/0809_Curriculums/AZCOM_2012.pdf
http://mwunet.midwestern.edu/administrative/Registrar/documents/0809_Curriculums/PMS_2012.pdf

Holy ****. We get it ... DPMs do stuff, have a place in medicine, and aren't midlevels. Honestly though, I say this without a doubt ... I have never (and this includes pre-DO students who are afraid their parents won't love them for not getting the MD) seen more defensive and reflex responses from a population on SDN. EVER.