Advertisement - Members don't see this ad
There has recently been a rise in what could be described as “mid-level podiatry,” with nurse practitioners (NPs) and physician assistants (PAs) increasingly being recruited by both hospital systems and private equity groups for non-operative podiatry positions. These institutions often employ podiatrists as well; however, many of these positions appear to be non-operative roles that are being used to replace older podiatrists who are retiring or otherwise leaving the workforce.
The creation of these positions appears to be driven largely by both orthopedic and podiatric leadership. The responsibilities assigned to NPs and PAs can encompass many of the functions traditionally performed by non-operative podiatrists—and, in some settings, potentially more—because these providers may practice under broader institutional or state-defined scopes of practice than podiatrists whose practice has become restricted by hospital-system policies.
There have also been discussions regarding [redacted] podiatry school(s) developing two-week “boot camps” or certification programs intended to train NPs and PAs in podiatric care, potentially further expanding this workforce.
These developments raise significant concerns about the future of the podiatric profession. At the same time that mid-level providers are increasingly entering areas traditionally occupied by non-operative podiatrists, podiatry has faced declining school admissions, an abundance of residency and fellowship positions with varying degrees of standardization, and limited opportunities for young podiatrists following graduation. Some new graduates are consequently turning to less desirable mobile-podiatry models or private equity employment, while the profession continues to face concerns regarding market saturation and inadequate reimbursement.
Taken together, these trends raise serious questions about the long-term sustainability and professional identity of podiatry. Without meaningful changes to reimbursement, scope of practice, training standardization, workforce planning, and the integration of podiatry within health systems, the profession risks continuing down a trajectory that could substantially diminish opportunities for future podiatrists.
See below for an example from a Mayo Clinic job advertisement illustrating this trend.
Responsibilities
The Department of Orthopedic Surgery, in collaboration with Primary Care, is seeking a Nurse Practitioner or Physician Assistant to join the Podiatry team. The selected candidate will practice independently in an outpatient clinical setting, providing comprehensive foot and nail care services to employee and community Mayo Clinic patients within the designated Rochester campus locations.
This position practices within the Podiatry service and is administratively aligned with and reports through Primary Care. Responsibilities include diabetic and high-risk foot evaluations, toenail trimming and debridement, toenail avulsion procedures, corn and callus paring, wart treatment (including cryotherapy), patient education regarding foot care, and recommendations for appropriate footwear and orthotics. The role also includes the evaluation and nonsurgical management of foot and ankle conditions.
Qualifications
Nurse Practitioner: Masters-prepared graduate of an accredited school of nursing and Nurse Practitioner program. Current Minnesota RN and APRN license and certification as a
Registration with the U.S. Drug Enforcement Agency (DEA) is required. BLS, is required.
External and Internal candidates for this position are asked to attach 2-3 letters of reference to their online application to be considered for this position.
New graduates please upload 3 letters of reference from preceptors that can attest to your clinical abilities.
Mayo Clinic employees applying for this position are asked to attach 3 most recent performance evaluations to online application to be considered for this position.
Exemption Status
Exempt
Compensation Detail
$119,870.40 - $167,273.60
Benefits Eligible
No
Schedule
Full Time
Hours/Pay Period
80
Schedule Details
Monday - Friday
The creation of these positions appears to be driven largely by both orthopedic and podiatric leadership. The responsibilities assigned to NPs and PAs can encompass many of the functions traditionally performed by non-operative podiatrists—and, in some settings, potentially more—because these providers may practice under broader institutional or state-defined scopes of practice than podiatrists whose practice has become restricted by hospital-system policies.
There have also been discussions regarding [redacted] podiatry school(s) developing two-week “boot camps” or certification programs intended to train NPs and PAs in podiatric care, potentially further expanding this workforce.
These developments raise significant concerns about the future of the podiatric profession. At the same time that mid-level providers are increasingly entering areas traditionally occupied by non-operative podiatrists, podiatry has faced declining school admissions, an abundance of residency and fellowship positions with varying degrees of standardization, and limited opportunities for young podiatrists following graduation. Some new graduates are consequently turning to less desirable mobile-podiatry models or private equity employment, while the profession continues to face concerns regarding market saturation and inadequate reimbursement.
Taken together, these trends raise serious questions about the long-term sustainability and professional identity of podiatry. Without meaningful changes to reimbursement, scope of practice, training standardization, workforce planning, and the integration of podiatry within health systems, the profession risks continuing down a trajectory that could substantially diminish opportunities for future podiatrists.
See below for an example from a Mayo Clinic job advertisement illustrating this trend.
Responsibilities
The Department of Orthopedic Surgery, in collaboration with Primary Care, is seeking a Nurse Practitioner or Physician Assistant to join the Podiatry team. The selected candidate will practice independently in an outpatient clinical setting, providing comprehensive foot and nail care services to employee and community Mayo Clinic patients within the designated Rochester campus locations.
This position practices within the Podiatry service and is administratively aligned with and reports through Primary Care. Responsibilities include diabetic and high-risk foot evaluations, toenail trimming and debridement, toenail avulsion procedures, corn and callus paring, wart treatment (including cryotherapy), patient education regarding foot care, and recommendations for appropriate footwear and orthotics. The role also includes the evaluation and nonsurgical management of foot and ankle conditions.
Qualifications
Nurse Practitioner: Masters-prepared graduate of an accredited school of nursing and Nurse Practitioner program. Current Minnesota RN and APRN license and certification as a
- Family Nurse Practitioner Certification (FNP)
- Adult Nurse Practitioner Certification (ANP)
- Acute Care Nurse Practitioner Certification (ACNP)
- Adult-Gerontology Primary Care Nurse Practitioner Certification (AGNP or AGPCNP)
- Adult-Gerontology Acute Care Nurse Practitioner Certification (AGACNP or ACNPC-AG)
Registration with the U.S. Drug Enforcement Agency (DEA) is required. BLS, is required.
External and Internal candidates for this position are asked to attach 2-3 letters of reference to their online application to be considered for this position.
New graduates please upload 3 letters of reference from preceptors that can attest to your clinical abilities.
Mayo Clinic employees applying for this position are asked to attach 3 most recent performance evaluations to online application to be considered for this position.
Exemption Status
Exempt
Compensation Detail
$119,870.40 - $167,273.60
Benefits Eligible
No
Schedule
Full Time
Hours/Pay Period
80
Schedule Details
Monday - Friday
