What REALLY separates a podiatrist?

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DrRicky23

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Let me start by saying this is by no means a start-up for an MD vs. DPM battle.

I'm interested in podiatry but don't completely understand the specialty. Being that pods are the only docs that specialize in a specific "body part" as opposed to an organ system, why was a completely separate school ever started for those who wanted to practice medicine on feet only? Why isn't it feet and hands? For that matter, why is there not a 4-year medical program devoted to ONLY hands?

I'm interested in podiatry for the diversity. I hear pods say it's great they do a little derm, lots of surgery, a little neuro, lots of ortho, and maybe some sports medicine or radiology all applied to a specific area ... the foot. That sounds cool to me but what's to stop the person w/ a broken ankle from going to an ortho, or the person with the foot fungus to go to a family doc who might then refer the patient to a dermatologist? I think several different specialties can do diabetic would care. Even chiropractors can make orthotics. It just seems like the only time one would go to a podiatrist is if they broke their ankle AND had toe fungus and didn't want to pay 2 copays to see the derm and ortho on separate visits.

I'm being honest in saying that I wanna do pod, but I don't want to enter the field thinking I'll do all these cool diverse procedures and end up clipping toe nails all day. Someone please help me understand the role podiatrists play in the medical system.
 
these are all good questions you have. I would say the first place to start is by shadowing a few pods. Try and get some diversity. Find one who does a fair amount of surgery, one that does more wound care, and one that does more palliative care. Good luck on your journey, get as much education about the profession and then make the decision that is best for you.
 
The answers to all your questions are easily available if you do some digging and leg work.

This site actually has some good (and bad) info in the archives. Try the search or just click back through previous pages.

Your best bet in a living breathing pod though. Shadow and ask questions.


Good luck.
 
Ill try to answer a few of these questions. Im numbering them for ease, not trying to sound snotty.

1) research chiropody.. Podiatry evolved from there. A long time ago the medical association "avoided" teeth, eyes, and the feet. We now have dentists, optometrists, and podiatrists that evolved separately to fill these niches.

2) feet take a lot of abuse. Hands do as well, but they usually do not carry all the weight of a human body around for 80 years. Therefore people usually have problem with their feet. It is unfortunate that pods can not touch the hand as they are so similar.

3) From what I have gathered, and I am by no means an expert as I am still a student, but many family doctors refer cases out to podiatrists. Most diabetics see a podiatrist regularly. Orthopedics do not refer to podiatrists all that often.

4) as others have said its best to shadow a few pods to get a feel of what they do, and how you would feel about doing that for the rest of your career.

Hope this helps and please, correct me if I am wrong.
 
Let me start by saying this is by no means a start-up for an MD vs. DPM battle.

I'm interested in podiatry but don't completely understand the specialty. Being that pods are the only docs that specialize in a specific "body part" as opposed to an organ system, why was a completely separate school ever started for those who wanted to practice medicine on feet only? Why isn't it feet and hands? For that matter, why is there not a 4-year medical program devoted to ONLY hands?

I'm interested in podiatry for the diversity. I hear pods say it's great they do a little derm, lots of surgery, a little neuro, lots of ortho, and maybe some sports medicine or radiology all applied to a specific area ... the foot. That sounds cool to me but what's to stop the person w/ a broken ankle from going to an ortho, or the person with the foot fungus to go to a family doc who might then refer the patient to a dermatologist? I think several different specialties can do diabetic would care. Even chiropractors can make orthotics. It just seems like the only time one would go to a podiatrist is if they broke their ankle AND had toe fungus and didn't want to pay 2 copays to see the derm and ortho on separate visits.

I'm being honest in saying that I wanna do pod, but I don't want to enter the field thinking I'll do all these cool diverse procedures and end up clipping toe nails all day. Someone please help me understand the role podiatrists play in the medical system.

You are practicing "theoretical" medicine. In theory, all of these specialties CAN do some foot/ankle stuff. Infact, if you study the different medical specialites period, you will find a fair amount of overlap. In the end, all of these other specialties have enough to do and don't have much training in foot and ankle. So, depending on the location and healthcare system, the majority of patients with a foot problem are sent to a podiatrist. I'd say we have the most overlap with ortho in theory but in reality, very few orthopods will touch a foot anymore. Sure, they do some of the ankles, we do some of the ankles (depending on who is on call), and everybody gets along for the most part. I'm sure there are some dermatologists out there treating fungal nails and there are some FP's doing ingrowns and treating athletes foot. Due to medical-legal reasons, they seem to be doing less and less. But we still do more. There will always be various specialties doing some of the "bread and butter" stuff, which is the case with all of medicine. But the complex stuff comes to us.
 
What I've determined is if you want real, reliable info on any topic on these threads, then just read what jonwill has had to say about it. I don't mean to sound like a groupie haha... but for the last 3 years, jonwill was a consistent voice of reason while Ive been on this sight. Thank you jonwill!
 
I am often asked the question, mostly by medical students, of why there is a separate school for podiatry. The dean at my school said something similar to this: in the past, doctors were "above" working on feet. I have never taken the time to research this, but am curious if this was the primary reason that podiatry evolved.

I do believe that the podiatry model is an excellent model for contemporary medicine. In an era when reimbursements are falling and medical costs are rising, if there is a way to reduce the length and cost of training this is a good thing. The podiatry model is focused on the specialty from day one of school. Dentistry is the same. If you want to be a foot and ankle orthopedic surgeon, I believe that you have to train 3 additional years compared to podiatry training. (5 years of residency plus one year of foot and ankle fellowship). I may be off on the exact years, correct me please if so. If other specialties followed a similar model, perhaps training could be shortened and thus the expense of training reduced.
 
You are practicing "theoretical" medicine. In theory, all of these specialties CAN do some foot/ankle stuff. Infact, if you study the different medical specialites period, you will find a fair amount of overlap. In the end, all of these other specialties have enough to do and don't have much training in foot and ankle. So, depending on the location and healthcare system, the majority of patients with a foot problem are sent to a podiatrist. I'd say we have the most overlap with ortho in theory but in reality, very few orthopods will touch a foot anymore. Sure, they do some of the ankles, we do some of the ankles (depending on who is on call), and everybody gets along for the most part. I'm sure there are some dermatologists out there treating fungal nails and there are some FP's doing ingrowns and treating athletes foot. Due to medical-legal reasons, they seem to be doing less and less. But we still do more. There will always be various specialties doing some of the "bread and butter" stuff, which is the case with all of medicine. But the complex stuff comes to us.

Thanks ... this helped put it in perspective. Can you throw in a few examples of the complex stuff you see? The obvious one I can think of is reconstructive ankle surgery/ankle replacements. I've shadowed a couple podiatrists before and the most complicated thing I saw was a toe joint replacement ... that was a cool experience. Aside from that, I just saw a bunch of fascitis, flat fleet, bunyons, clipping nails, and diabetic checkups. Like I said earlier, I find the diversity of podiatry interesting, but surgery interests me the most (however, I also shadowed an ortho who does ONLY knee replacements and found his job somewhat boring). I assume these complex foot problems you speak of are mostly corrected through surgery, so can you think of a few complex things most people don't know podiatrists do until they get to school? That might help deepen my interest and separate the role of a podiatrist for me.
 
The answer is simple, almost everyone has foot problems. Just like how everyone usually has a PCP and dentist, I feel that everyone eventually will also be seeing a pod regularly. The only problem right now is politics, especially since pods are not considered a doctor under medicare, other insurance companies can abuse that and refuse to cover pod services but even so, there are so many problems that insurance covers a lot of the services and procedures done by pods that most make a good living as it is right now. APMA is fighting that and will be on top of it, and I'm confident that by the time I'm done with residency we'll be covered.
 
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