Treating gangrene is beyond the scope of a podiatrist

[cool_vkb]

According to latrobe univ (a podiatry school in aussie), "When presented with gangrene, the clinician must determine the cause of the pathology, so as to address it and prevent further damage. Whilst ischaemia may be evaluated as being the cause, it should be determined whether it was from atherosclerosis, myocardial infarct, valvular heart disease or emboli. Also ascertain if they are a smoker, have diabetes mellitus, and history of vascular problems. Treating gangrene is beyond the scope of a podiatrist, so if gangrene is found, refer to a vascular surgeon."

http://www.latrobe.edu.au/podiatry/vascular/gangrene.html

Whats the policy of Pods in USA when it comes to treating gangrene?

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[jonwill]

According to latrobe univ (a podiatry school in aussie), "When presented with gangrene, the clinician must determine the cause of the pathology, so as to address it and prevent further damage. Whilst ischaemia may be evaluated as being the cause, it should be determined whether it was from atherosclerosis, myocardial infarct, valvular heart disease or emboli. Also ascertain if they are a smoker, have diabetes mellitus, and history of vascular problems. Treating gangrene is beyond the scope of a podiatrist, so if gangrene is found, refer to a vascular surgeon."

http://www.latrobe.edu.au/podiatry/vascular/gangrene.html

Whats the policy of Pods in USA when it comes to treating gangrene?

A few different scenerios:

1) If it is stable gangrene, we consult vascular surgery who does stenting, bypass, etc and cleans out the plumbing. We then do an amp.

2) If it is acutely infected gangrene (wet or gas), we generally do an open amputation first as vascular doesn't want to do any re-vasc procedure while there is an acute infection. After the amputation and some abx, vascular will take them for the necessary procedure.

Either way, we closely work with vascular surgery.

 

[cool_vkb]

A few different scenerios:

1) If it is stable gangrene, we consult vascular surgery who does stenting, bypass, etc and cleans out the plumbing. We then do an amp.

Cant we do all this stuff by ourself. I mean are we trained in vascular stuff during residency or college?

Or calling vascular surgeon will be a good idea.

 

[JEWmongous]

According to latrobe univ (a podiatry school in aussie), "When presented with gangrene, the clinician must determine the cause of the pathology, so as to address it and prevent further damage. Whilst ischaemia may be evaluated as being the cause, it should be determined whether it was from atherosclerosis, myocardial infarct, valvular heart disease or emboli. Also ascertain if they are a smoker, have diabetes mellitus, and history of vascular problems. Treating gangrene is beyond the scope of a podiatrist, so if gangrene is found, refer to a vascular surgeon."

http://www.latrobe.edu.au/podiatry/vascular/gangrene.html

Whats the policy of Pods in USA when it comes to treating gangrene?

Remember, the US has the best scope of practice for "pods" in the world. The pods in australia and elsewhere are not doctoral level practioners.

 

[cool_vkb]

Remember, the US has the best scope of practice for "pods" in the world. The pods in australia and elsewhere are not doctoral level practioners.

Thats true. they have a BSc degree.

 

[NatCh]

Cant we do all this stuff by ourself. I mean are we trained in vascular stuff during residency or college?

Or calling vascular surgeon will be a good idea.

Even if your state laws and hospital privileges permitted you to do fem-pop bypasses (doubtful), you should consult Vascular.

During Residency I was trained to do hernia repairs and laparoscopic cholecystectomies, but I can't schedule one now.

 

[Dr.Millisevert]

Remember, the US has the best scope of practice for "pods" in the world. The pods in australia and elsewhere are not doctoral level practioners.

This has nothing to do with it!

Medical doctors and surgeons in Australia, the UK, and elsewhere hold a Bachelor of Medicine/Surgery too. This degree is equal to the US MD degree.

If a doctor who graduated with an MBBS degree gets a US state medical license, then every US state medical board allows them to use the title "MD" if they so wish because they hold the exact same license and have the exact same scope of practice as any US MD.

Its not the degree that matters, but the type of license held. Podiatrists outside of the US simply haven't pushed for a wide scope of practice or a license that allows such procedures. Again, it has nothing to do with the title of their degree.

I hope that makes sense.

by the way.. the US is the only country in the world that considers the MD (or any other first professional degrees for that matter) to be "graduate degrees". Even Canada (whose medical schools are also accredited by the LCME) considers their MD programs to be "undergraduate". Also, over half of Australian medical schools are 4 years long and require a previous bachelors degree prior to being admitted just like US and Canadian schools, but the degree they grant is still called a "bachelor". Likewise.. there are medical schools in Europe that are 5-6 years straight out of High school and they grant a "doctorate". What the degree is titled is simply a matter of tradition.

Another example is physical therapy. 15 years ago all PTs graduated with a 4-5 BSPT degree, then they switched to the 2-3 year MSPT and now all programs are switching to a 2-3 year DPT degree. Guess what, at the end of the day they are all still just physical therapist, and the graduates with a "bachelors" hold the exact same license to practice PT as any DPT grad these days. Another example that it is not the degree but the "license" that determines your practice.

... and lastly. There are vet schools in Australia and New Zealand that are fully accredited by the AVMA (same body that accredits all US and Canadian vet schools). These vet schools grant a BVS (bachelor of Vet surgery) but this too is 100% equivalent to a US DVM degree and is even US accredited so is not looked at any differently than if you went to a vet school in any other US state.

 

[JEWmongous]

This has nothing to do with it!

Medical doctors and surgeons in Australia, the UK, and elsewhere hold a Bachelor of Medicine/Surgery too. This degree is equal to the US MD degree.

If a doctor who graduated with an MBBS degree gets a US state medical license, then every US state medical board allows them to use the title "MD" if they so wish because they hold the exact same license and have the exact same scope of practice as any US MD.

Its not the degree that matters, but the type of license held. Podiatrists outside of the US simply haven't pushed for a wide scope of practice or a license that allows such procedures. Again, it has nothing to do with the title of their degree.

I hope that makes sense.

by the way.. the US is the only country in the world that considers the MD (or any other first professional degrees for that matter) to be "graduate degrees". Even Canada (whose medical schools are also accredited by the LCME) considers their MD programs to be "undergraduate". Also, over half of Australian medical schools are 4 years long and require a previous bachelors degree prior to being admitted just like US and Canadian schools, but the degree they grant is still called a "bachelor". Likewise.. there are medical schools in Europe that are 5-6 years straight out of High school and they grant a "doctorate". What the degree is titled is simply a matter of tradition.

Another example is physical therapy. 15 years ago all PTs graduated with a 4-5 BSPT degree, then they switched to the 2-3 year MSPT and now all programs are switching to a 2-3 year DPT degree. Guess what, at the end of the day they are all still just physical therapist, and the graduates with a "bachelors" hold the exact same license to practice PT as any DPT grad these days. Another example that it is not the degree but the "license" that determines your practice.

... and lastly. There are vet schools in Australia and New Zealand that are fully accredited by the AVMA (same body that accredits all US and Canadian vet schools). These vet schools grant a BVS (bachelor of Vet surgery) but this too is 100% equivalent to a US DVM degree and is even US accredited so is not looked at any differently than if you went to a vet school in any other US state.

You are not getting the point dingus...at all. Podiatry outside the US is not an MBBS degree (which yes, is equal to the MD degree). They range from 3 year post high school degrees where they do NO surgery and just derm(podologues in france) to masters degrees for pod surgeons in Australia and etc. The United States has the BEST scope of practice for podiatric medicine (if you have the DPM degree).

Ex: I get my MBBS degree in India, then I can practice in the United States and call myself an MD (as both degrees are equal). On the other hand, I get a bachelors in pod from australia...I cannot come to america and practice as a podiatrist. The degrees are not equal.

 

[Dr.Millisevert]

You are not getting the point dingus...at all. Podiatry outside the US is not an MBBS degree (which yes, is equal to the MD degree). They range from 3 year post high school degrees where they do NO surgery and just derm(podologues in france) to masters degrees for pod surgeons in Australia and etc. The United States has the BEST scope of practice for podiatric medicine (if you have the DPM degree).

Ex: I get my MBBS degree in India, then I can practice in the United States and call myself an MD (as both degrees are equal). On the other hand, I get a bachelors in pod from australia...I cannot come to america and practice as a podiatrist. The degrees are not equal.

I never said podiatry outside the US was an MBBS degree ... so, no.. you're not getting the point, dingbotafufus.

I was just making an analogy.

Someone else stated that the reason Australian podiatrists couldn't do surgery was because they didn't hold a "doctorate", I was simply pointing out that this was not the reason why and that it had nothing to do with the title of the degree. I was pointing out that it was because they simply didn't teach it in the program and/or allow podiatrists to do surgery within their "license".

That's all.

Legally speaking.. they "could" teach surgery and be licensed to do the same things as US podiatrists and still graduate with a "bachelors", they would simply have to push for more rights of practice in those regions just like podiatrists have done in the US.

Does that make sense now?

If the Australian College of Podiatrists granted the same scope of practice to podiatrists that they have in the states and if the curriculums were similar... Then yes, it might be possible for an Australian trained Podiatrist with a Bachelors to go to the US and complete a US podiatry residency and get a US license similar to the medical model. Because that form of a Bachelors or Masters in Podiatry would hypothetically equal a US DPM. (this of course would also be up to state boards to grant licenses in this manner).
But again.. just wanted to point out that it had nothing to do with the degree being called a BPM or BPod and not a DPM.

 

[krabmas]

Cant we do all this stuff by ourself. I mean are we trained in vascular stuff during residency or college?

Or calling vascular surgeon will be a good idea.

you will do a vascular surgery rotation this may or may not teach you enough to do bypasses.

The things that you will do the most of in residency are forefoot and rearfoot cases (reconstruction).

The vascular surgeons do bypasses and angioplasties day in and day out. Even if you think you can do it and if the hospital credentials you to do it... why would you want to? Let them do what they trained to do and they will let you do what you trained to do. They to no really want to amp toes and feet and will refer to you, but you must also refer back.

 

[cool_vkb]

you will do a vascular surgery rotation this may or may not teach you enough to do bypasses.

The things that you will do the most of in residency are forefoot and rearfoot cases (reconstruction).

The vascular surgeons do bypasses and angioplasties day in and day out. Even if you think you can do it and if the hospital credentials you to do it... why would you want to? Let them do what they trained to do and they will let you do what you trained to do. They to no really want to amp toes and feet and will refer to you, but you must also refer back.

ThankYou boss