question concerning scope

[IPODiatrist]

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as a podiatrist, is one allowed to prescribe medication for the treatment of diabetes since the disease relates to the foot?

or does any medication that is prescribed have to be related to injuries/surgeries/infections pertaining to the foot?

how does this work?

thanks.

 

[Dr. Gangrene]

as a podiatrist, is one allowed to prescribe medication for the treatment of diabetes since the disease relates to the foot?

or does any medication that is prescribed have to be related to injuries/surgeries/infections pertaining to the foot?

how does this work?

thanks.

Hopefully some of the more experienced students will chip in.

As I Understand it (read: take w/ a grain of salt )

If it is a systemic disease affecting the foot, it is within a pod scope. If not, I think it is a grey area where judgement is needed.
It seems like there was a similar thread a few weeks ago, and krabmas had a good response.
Try doing a search. 👍

 

[Dr. Gangrene]

Hopefully some of the more experienced students will chip in.

As I Understand it (read: take w/ a grain of salt )

If it is a systemic disease affecting the foot, it is within a pod scope. If not, I think it is a grey area where judgement is needed.
It seems like there was a similar thread a few weeks ago, and krabmas had a good response.
Try doing a search. 👍

Here is the link to krabmas response to a similar question.

http://forums.studentdoctor.net/showthread.php?p=5260184#post5260184

 

[krabmas]

Here is the link to krabmas response to a similar question.

http://forums.studentdoctor.net/showthread.php?p=5260184#post5260184

Technically you can write for these meds, but it is not wise and almost all pods will tell you that pods do not manage the diabetes. The foot manifestations of the disease are only one aspect and therefore it is important to work closely with the patient's primary doc to get the diabetes under control.

Just as a comparison to other specialties. The diabetic also goes to a nephrologist and an opthamologist, neither of these specialists will be the primary doc nor would they prescribe insulin or glipizide for these patients. They may make recomendations to the primary but they would not be the primary. And they have an MD which gives them "unlimited" scope. I use the quotes because as you can see even the MD does not have unlimited scope. They just have the option to change specialties.

I know these are just questions for understanding the profession, but it seems that many people want to become pods then want to do more (for the patient) than just being a pod. If you talk to other specialists like the orthos, you'll see that they want to do only their specialty and nothing else, they do not want to deal with all the systemic effects and they refer often because of this.

Back to the diabetic meds like insulin and oral meds... These drugs can have severe side effects and the endocrinologist/primary care doc is more equipt and better prepared to handle this part of the patient's care.

This does not include your inpatients who if they are well controlled diabetics you will be managing them. The diabetics with any complications will have consults with internal med or endocrinology to manage the diabetes, while you manage the feet.

I hope this helps clear things up a bit, probably it confused you more.

 

[Dr_Feelgood]

Technically you can write for these meds, but it is not wise and almost all pods will tell you that pods do not manage the diabetes. The foot manifestations of the disease are only one aspect and therefore it is important to work closely with the patient's primary doc to get the diabetes under control.

Just as a comparison to other specialties. The diabetic also goes to a nephrologist and an opthamologist, neither of these specialists will be the primary doc nor would they prescribe insulin or glipizide for these patients. They may make recomendations to the primary but they would not be the primary. And they have an MD which gives them "unlimited" scope. I use the quotes because as you can see even the MD does not have unlimited scope. They just have the option to change specialties.

I know these are just questions for understanding the profession, but it seems that many people want to become pods then want to do more (for the patient) than just being a pod. If you talk to other specialists like the orthos, you'll see that they want to do only their specialty and nothing else, they do not want to deal with all the systemic effects and they refer often because of this.

Back to the diabetic meds like insulin and oral meds... These drugs can have severe side effects and the endocrinologist/primary care doc is more equipt and better prepared to handle this part of the patient's care.

This does not include your inpatients who if they are well controlled diabetics you will be managing them. The diabetics with any complications will have consults with internal med or endocrinology to manage the diabetes, while you manage the feet.

I hope this helps clear things up a bit, probably it confused you more.

Great breakdown. Another way to think about it is if a cardiologist sees someone for CHF, he won't want to manage a guys ED medications. Even though both diseases maybe due to hypertension.

 

[Dr. Gangrene]

Technically you can write for these meds, but it is not wise...

This was the gist of her post I was trying to get at. 👍

 

[IPODiatrist]

thanks so much for the very informed replys.

the reason i was asking was cause my mother has diabetes, and she was like "so if you go pod school, could u write me a prescription for my diabetes medication?" i'm like "good question". TO SDN POD forumns! haha 🙂

 

[krabmas]

thanks so much for the very informed replys.

the reason i was asking was cause my mother has diabetes, and she was like "so if you go pod school, could u write me a prescription for my diabetes medication?" i'm like "good question". TO SDN POD forumns! haha 🙂

This brings up another ethical dilemma that was discussed already. Your immediate family members should not be your patients. And if you need to write an emergency prescription you should have a chart for that patient.

 

[bocajuniors]

look at it this way, i know plenty of doctors that have many different specialities and they write for immediate family all the time. though "unethical" for the most part no one will look into the situation. i wouldn't advise it but if you're on vacation for example and lets say a parent forgets their bp meds, then go ahead to the nearest pharmacy and write a script for it. now my question is for friends and extended family that's the real grey area.

 

[krabmas]

look at it this way, i know plenty of doctors that have many different specialities and they write for immediate family all the time. though "unethical" for the most part no one will look into the situation. i wouldn't advise it but if you're on vacation for example and lets say a parent forgets their bp meds, then go ahead to the nearest pharmacy and write a script for it. now my question is for friends and extended family that's the real grey area.

If they have forgotten their meds how will you know the strength, if they can even remember the name of the med?

And some one may raise a flag. The pharmacists will see the DPM after the signature and on the stamp. If a pod is writing for BP or diabetes meds it does raise a flag and a concern to the pharmacist. As well, the DPM will probably be out of state and not licensed to practice there.

Even if no one raises a flag does that make it ethical? Ethics is not about whether or not you get caught. It is about right and wrong and what is acceptable in the community.

Perhaps after 4 years of med school/pod school and some one on one with patients you will feel differently about your point of view. I know I have changed many of mine after 4 years of school.