Scope of practice question...

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HenryH

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I recall reading that some states specify the scope of practice for a DPM to include the "lower leg." Let's say that I practice in one of those states; if a patient comes to me and requests that I do something about her flabby cankles, can I perform a minor cosmetic procedure (since the anatomical range is below the knee, but above the ankle/foot) to slim them down?

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Most states include ankles so you would be fine. It is safe to say that the best scope (and the one I think should be universal) is osseous to the tibial tuberosity and soft tissue to the waist.
 
I recall reading that some states specify the scope of practice for a DPM to include the "lower leg." Let's say that I practice in one of those states; if a patient comes to me and requests that I do something about her flabby cankles, can I perform a minor cosmetic procedure (since the anatomical range is below the knee, but above the ankle/foot) to slim them down?

dude, first see if you are qualified to perform the surgery. Just because it's in the scope of practice doesn't mean that EVERYONE was trained to perform that type of surgery/procedure. NO ONE should be doing anything outside of their training, so not only does the scope of practice define your practice, your training also defines your level of competence!

I say this because as foot & ankle specialists, we have to respect our own training and limitations if we truly want to be recognized for our great contributions. Just because your state may allow you to work up to the knee, doesn't mean you should unless you are certain you have been training properly.....

Get good training first, then worry about how state law can accomodate you.
 
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Most states include ankles so you would be fine. It is safe to say that the best scope (and the one I think should be universal) is osseous to the tibial tuberosity and soft tissue to the waist.

When you say Soft tissue to the wasit, does that mean Muscles, Nerves, Arteries/Veins. or just muscles. and lets say if i get a patient who got a sprain or some kind of damage in Rectus Femoris (or nerves associated to it) and having problem in extension of knee. is it covered under Podiatrist Scope of practice then?
 
If you sprain a quad, you don't surgically correct it. The soft tissue to the hips is mainly for skin grafts and spastic gastrocs.
 
I recall reading that some states specify the scope of practice for a DPM to include the "lower leg." Let's say that I practice in one of those states; if a patient comes to me and requests that I do something about her flabby cankles, can I perform a minor cosmetic procedure (since the anatomical range is below the knee, but above the ankle/foot) to slim them down?

this would not be a minor procedure. The most common people that get this procedure done are asian females for some reason and it involves cutting out a portion of muslce where medially nerves and arteries lie and laterally where a nerve is. People that have cankles have low lying soleus muscle belly, not fatty deposits that need lyposuction - usually.
 
this would not be a minor procedure. The most common people that get this procedure done are asian females for some reason and it involves cutting out a portion of muslce where medially nerves and arteries lie and laterally where a nerve is. People that have cankles have low lying soleus muscle belly, not fatty deposits that need lyposuction - usually.
Well said, Levine Jr^ :D

Hey, kinda unrelated, but we had 3 alumni of your program (Drs. Steinberg, Wu, and Kim) give lectures at a diabetes-themed mini CME event in Miami this past Saturday. Very great lectures; your Inova program is very into EBM and serves as a real credit to podiatry. :thumbup:
 
Well said, Levine Jr^ :D

Hey, kinda unrelated, but we had 3 alumni of your program (Drs. Steinberg, Wu, and Kim) give lectures at a diabetes-themed mini CME event in Miami this past Saturday. Very great lectures; your Inova program is very into EBM and serves as a real credit to podiatry. :thumbup:

Man I don't even kiss butt that much and that is saying something. :laugh:
 
Main I don't even kiss butt that much and that is saying something. :laugh:
I was actually giving her flack for knowing about cosmetic stuff.

The other stuff is pretty true, though. I'd heard Steinberg and Wu before, but Kim is really good. He is a good guy for AZPod to have on their core faculty. Was he one of the ones who was at DMU or no?
 
I was actually giving her flack for knowing about cosmetic stuff.

The other stuff is pretty true, though. I'd heard Steinberg and Wu before, but Kim is really good. He is a good guy for AZPod to have on their core faculty. Was he one of the ones who was at DMU or no?

I am actually very interested in cosmetics. Whether or not I will perform actual cosmetic surgery for pure astheitics is unknown at this point. But plactic techniques are helpful for all surgery. Not just for the asthetics either. If scar placement and formation is not ideal in amputations the patient will have shoe and prosthetic fit problems that may lead to more surgery or loss of more of the limb.
 
I was actually giving her flack for knowing about cosmetic stuff.

The other stuff is pretty true, though. I'd heard Steinberg and Wu before, but Kim is really good. He is a good guy for AZPod to have on their core faculty. Was he one of the ones who was at DMU or no?

I'm just giving you a hardtime. I dont' think that Kim was at DMU, but I don't all of the faculty that left and it is a possibility.
 
I was actually giving her flack for knowing about cosmetic stuff.

The other stuff is pretty true, though. I'd heard Steinberg and Wu before, but Kim is really good. He is a good guy for AZPod to have on their core faculty. Was he one of the ones who was at DMU or no?

No he came straight out of residency to AZPod.
 
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