Why do Podiatry, Dentistry, and Optometry exist?

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Please read before you respond, this topic is not quite as dumb as it looks at first glance- I promise.

Why are these things in particular singled out as warranting their own 4 year degree programs if virtually every other part of the body is simply delegated to being a specialty of MD/DO's?

Not meant to insult anyone pursuing careers in any of the fields mentioned- I completely understand the necessity for them. Perhaps a better question to ask in this topic is: Why are there not more of these specialty four year degrees? Why don't they split off many of the specialties from things generally performed by a Physician specialist and create their own degree programs aimed solely at those subjects?

 

[deleted128562]

Please read before you respond, this topic is not quite as dumb as it looks at first glance- I promise.

Why are these things in particular singled out as warranting their own 4 year degree programs if virtually every other part of the body is simply delegated to being a specialty of MD/DO's?

Not meant to insult anyone pursuing careers in any of the fields mentioned- I completely understand the necessity for them. Perhaps a better question to ask in this topic is: Why are there not more of these specialty four year degrees? Why don't they split off many of the specialties from things generally performed by a Physician specialist and create their own degree programs aimed solely at those subjects?

Optometry makes some sense to me - kind of think MD vs PA. An optomotrist has great training and can do A LOT of stuff with eyes, but obviously not as much as an ophthalmologist. If there weren't both Ophthos and Optos, there'd probably be a real shortage of eye care. Dental makes some sense, though perhaps not as much as optometry. Simply because you need a lot of dentists to support the population, much like primary care docs.

Podiatry is the one I don't get though. They do a 4 year curriculum with many of the same classes as med school and some of the same rotations as well. Then they do a 3 year residency much like an MD. And then they treat problems which are quite medical in nature. It seems like this one could easily be integrated into medical school. Honestly, you could probably have a separate school for a lot of medical specialties, but the advantage to med school is it helps you get the overall picture no matter what you go into. Which would probably help with podiatry as well.

 

[VneZonyDostupa]

In my opinion, and I could be way off on this, it has to do with the interaction of the different specialities.

For example, if you go to your family practitioner with a kidney problem, they are able to rule out certain diseases within their field of practice, but are also able to realise that something out of their scope would be best treated by a nephrologist. This knowledge only comes through a broad medical education. Podiatrists and dentists have no need for this knowledge, as the diseases/conditions they treat very rarely crossover into other specialities.

Again, just my opinion.

 

[LossForWords]

I have wondered why they don't split up surgery and medicine into separate schools. That seems like the most obvious division to me.

 

[diosa428]

I have wondered why they don't split up surgery and medicine into separate schools. That seems like the most obvious division to me.

I hope you're being sarcastic.

 

[Kaya12]

Interesting post.....

However, I was trying to explain to my 94 year old grandmother that her podiatrist did not acutally go to "medical school" (as in M.D., to which I am applying) when she tried to convince me to shadow her podiatrist . She laughed and told me I must be mistaken, she did have an M.D. degree... Interesting question you have here. Anyone want to explain this to my 94 year old grandma? She is quite sharp........ 🙂

 

[Dirt]

Because most doctors decided they did not want to look at or smell feet all day so when podiatrists came about they said "it's all yours".

 

[bozz]

In my opinion, and I could be way off on this, it has to do with the interaction of the different specialities.

For example, if you go to your family practitioner with a kidney problem, they are able to rule out certain diseases within their field of practice, but are also able to realise that something out of their scope would be best treated by a nephrologist. This knowledge only comes through a broad medical education. Podiatrists and dentists have no need for this knowledge, as the diseases/conditions they treat very rarely crossover into other specialities.

Again, just my opinion.

 

[GoldShadow]

Because specialists in these areas made enough noise and pushed to turn them into their own specialties with their own education and regulation. If a niche exists and the existing framework doesn't push to fill it, someone else will.

 

[VneZonyDostupa]

Noooo! It's Wilford Brimly Cat! The meanest, most aggressively diabetic cat of them all!

 

[T12]

This is one of the funniest things I've ever seen. Oh My God. Diabeetus.

 

[brianmartin]

Podiatry probably could be an orthopedic sub-specialty. I don't understand why admissions requirements are so low either...considering many pods are basically foot surgeons.

Optometrist...well, they aren't doctors and don't treat medical problems of the eye so they don't need an MD.

Dentists, it's called OMFS and they are surgeons with equivalent training to MD

 

[IHeartNerds]

Podiatrists and dentists have no need for this knowledge, as the diseases/conditions they treat very rarely crossover into other specialities.

Whoa there killer, I have quite a few friends in the school of dentistry that would .... enthusiastically ... disagree with that statement. Dentists in this country are trained absurdly well on things that, for the most part, they will not see again on a regular basis. This does not mean they forget; my dentist and I had a nice chat about CV physiology last time I went in.

Podiatrists exist separately from ortho mostly for historical reasons, I believe. While orthopods were still generalized in the early 20th century, podiatry had arisen as a separate field, and so when ortho began subspecialization into things like hand surgery and spine surgery, feet were just already taken by an established group of professionals.

 

[LizzyM]

Look at the matriculant stats for podiatry schools (avg MCAT < 22, avg gpa 3.3) and you might find that the opportunity for a good balance of work and leisure, the option to focus on surgery or not, and the satisfaction of treating pain and helping people improve their quality of life is very appealing.

http://www.aacpm.org/html/statistics/stats_mar.asp

 

[JeanLuc]

You've made my day with that photo. Thanks!!

 

[Depakote]

 

[Dmitry Malayev]

Well Optometrists in my opinion or at least from what i've been told are not doctor's of the eye. Ophthalmologists which are MD's are doctors of the eye. Optometrists are doctors of lenses, and eye being a complex lens.

Dentistry...well they have there own specialties for example Ortho, Perio, Endo, and much more. If you are an Oral Surgeon you have an MD and DDS/DMD. If let's say you were an MD, you would then have to specialize to become a Dentist, which would require you to become a surgeon first in my opinion and then if you wanted to put on braces you would need to go and specialize to become an orthodontist. It would just take too long.

Podietry...well i don't know!

 

[NurWollen]

One interesting thing about these fields is that some of them are pretty unique to the the US, or at least aren't found everywhere. For example, I lived in South America for a couple of years and once had to see an ophthomologist. He said that in South America, optometry doesn't exist. If you want to be an eye doctor there you have to go to med school and then do a residency in ophthomology. They do both the work of an ophthomologist and that of an optometrist. I don't know if podiatry there and in other parts of the world is its own field or a subspecialty of medicine. Obviously, dentistry is its own very separate field just about everywhere, as far as I know.

Some healthcare fields are an example of America's pluralism. Osteopathic medicine, for example, is uniquely american. Osteopaths, of course, exist in other countries, but not as full-fledged physicians as in the US.

I think chiropractic is pretty unique to the US as well, though I could be wrong.

 

[zephryus14]

Podiatry is the one I don't get though. They do a 4 year curriculum with many of the same classes as med school and some of the same rotations as well. Then they do a 3 year residency much like an MD. And then they treat problems which are quite medical in nature. It seems like this one could easily be integrated into medical school. Honestly, you could probably have a separate school for a lot of medical specialties, but the advantage to med school is it helps you get the overall picture no matter what you go into. Which would probably help with podiatry as well.

I am a current Podiatry student, so I can probably help with this question. A number of podiatry schools are associated and integrated with their MD or DO counterparts. Our curriculum is almost the same (except we don't take Genetics and Behavioral Sciences). Really the only difference is that we know what we want to do when we come in, so some aspects of our classes can relate it's material to what we'll be doing in practice.

I chose podiatry for a few reasons:
1) To improve people's quality of life
2) Average podiatrist works 40 hours/week and makes $189K per year (newest figure). This affords me the opportunity to make a very comfortable living and allows me to spend time with my family.
3) Every MD and DO I shadowed disliked their job and repeatedly told me that medicine isn't what it used to be (a red flag). Every podiatrist I shadowed really seemed to love their job, weird I know, but true.

 

[zephryus14]

In my opinion, and I could be way off on this, it has to do with the interaction of the different specialities.

For example, if you go to your family practitioner with a kidney problem, they are able to rule out certain diseases within their field of practice, but are also able to realise that something out of their scope would be best treated by a nephrologist. This knowledge only comes through a broad medical education. Podiatrists and dentists have no need for this knowledge, as the diseases/conditions they treat very rarely crossover into other specialities.

Again, just my opinion.

We absolutely do need to know this information. Last I checked, the foot and ankle is connected to the rest of the body. You have bones, muscles, vasculature, nerves, etc. running there. We prescribe medication that affects much more than the foot and ankle. Often times we're the first to catch diabetes, HTN, etc. Our patients often have many different systemic problems that we absolutely need to know about. We perform surgery, anyone who performs surgery better know more than just one small area of the body. That goes for dentistry as well.

 

[CountinCavities]

Optometry makes some sense to me - kind of think MD vs PA. An optomotrist has great training and can do A LOT of stuff with eyes, but obviously not as much as an ophthalmologist. If there weren't both Ophthos and Optos, there'd probably be a real shortage of eye care. Dental makes some sense, though perhaps not as much as optometry. Simply because you need a lot of dentists to support the population, much like primary care docs.

Podiatry is the one I don't get though. They do a 4 year curriculum with many of the same classes as med school and some of the same rotations as well. Then they do a 3 year residency much like an MD. And then they treat problems which are quite medical in nature. It seems like this one could easily be integrated into medical school. Honestly, you could probably have a separate school for a lot of medical specialties, but the advantage to med school is it helps you get the overall picture no matter what you go into. Which would probably help with podiatry as well.

great points

 

[TehDoc]

Because people have feet, teeth and bad vision.

 

[Chuck's Right Foot]

We absolutely do need to know this information. Last I checked, the foot and ankle is connected to the rest of the body. You have bones, muscles, vasculature, nerves, etc. running there. We prescribe medication that affects much more than the foot and ankle. Often times we're the first to catch diabetes, HTN, etc. Our patients often have many different systemic problems that we absolutely need to know about. We perform surgery, anyone who performs surgery better know more than just one small area of the body. That goes for dentistry as well.

I've been to podiatrists and have benefited from their expertise. I'm not sure they need tobe separate from MD school but I also don't see a need to merge them either. The training seems good and diverse. I know there is some bad blood between Ortho and Podiatry regarding where on the leg DPMs can work....

Also, being 6'7 and 235lbs, I think people underestimate feet. So important for overall posture and functioning!

 

[cpants]

I've been to podiatrists and have benefited from their expertise. I'm not sure they need tobe separate from MD school but I also don't see a need to merge them either. The training seems good and diverse. I know there is some bad blood between Ortho and Podiatry regarding where on the leg DPMs can work....

Also, being 6'7 and 235lbs, I think people underestimate feet. So important for overall posture and functioning!

Is there really a turf war between ortho and DPM's? I would think an ortho would be able to operate on feet if he so chose. Kind of like a dermatologist could remove a wart from the foot. An internist could drain an abscess on the foot. Is that wrong? Do DPM's have exclusive rights to all things foot?

 

[edfig99]

Is there really a turf war between ortho and DPM's? I would think an ortho would be able to operate on feet if he so chose. Kind of like a dermatologist could remove a wart from the foot. An internist could drain an abscess on the foot. Is that wrong? Do DPM's have exclusive rights to all things foot?

they don't have exclusive rights to all things foot, however, states often do limit podiatrists scope of practice (i.e. in New York, for example, they are limited only to diseases of the foot and can't touch the ankle or lower leg, even though many podiatrists here have done foot and ankle surgery as part of their training.) Anytime the podiatrists try to creep up towards the ankle, there are lobbying efforts by the orthopedic societies.

 

[Chuck's Right Foot]

Is there really a turf war between ortho and DPM's? I would think an ortho would be able to operate on feet if he so chose. Kind of like a dermatologist could remove a wart from the foot. An internist could drain an abscess on the foot. Is that wrong? Do DPM's have exclusive rights to all things foot?

it's not like the gang war in Anchorman, but DPMs want to work more on the ankle (and in some states up to the thigh!) and Ortho wants to keep the ankle.

It's scope of practice stuff, just like DNPs, PAs, etc.

 

[Captain Fantastic]

they don't have exclusive rights to all things foot, however, states often do limit podiatrists scope of practice (i.e. in New York, for example, they are limited only to diseases of the foot and can't touch the ankle or lower leg, even though many podiatrists here have done foot and ankle surgery as part of their training.) Anytime the podiatrists try to creep up towards the ankle, there are lobbying efforts by the orthopedic societies.

Very state dependent. I know a DPM who trained in Georgia and she once told me they could do BKAs there.

 

[cpants]

Makes sense. So basically it's DPM offense, ortho defense. DPM's aren't trying to keep MD's from doing foot stuff.

 

[pietachok]

This is something about which I have actually gotten into very involved discussions with my father. He is a highly specialized dentist--maxillofacial prosthodontist to be exact, whereas my mom's an M.D. and I'm on my way to becoming one. There is quite a bit of emphasis on not going into med school interviews cocky and saying you know what field you want to enter--so I don't know why you should be expected to rule out the mouth so early! Indeed, at Harvard, when my father went to school, the medical students and dental students did not separate onto different paths until after they were accepted; they all applied to one program, and dentistry was treated as a medical specialty.

The problem is that the mouth is actually incredibly unique. The teeth and their problems are just incredibly unique. The nerves and musculature are exceptionally small and plentiful, as is the microbiology of the oral cavity, so there is a ridiculous amount to learn. If you talk to my father, one of the problems is that too many of today's new dentists aren't actually learning this stuff well. There aren't other fields of medicine where you need to learn to craft something like a denture! The orthopedist isn't generally involved in the development of a prosthesis, but a good dentists *does* know how to make every type of prosthetic for your mouth (or at least did when s/he was in school). There aren't really other parts of the body where we go in regularly and remove/kill the nerves while patients are under local/no anesthesia, and no other living body parts that we lose and regenerate like teeth. While all that gave rise to a separate field, as dentistry branched off, it further differentiated itslef by creating a need for business/management classes. In med school, you do not get courses in how to manage your practice, but since most dentists practice independently or in a small group, they *do* have at least one term where they learn how to do that. This is also another reason why dentistry doesn't fit so well in the M.D. structure--the type of residency program used in medicine doesn't work b/c of the common independent practice, rather more apprenticeship-type education does. Accordingly, their clinical exposures need to be organized differently rather than presented in the regimented rotation schedule used by med schools.

Can't speak much to optometry and podiatry, but optometrists obviously need to know how to make things as well as knowing a lot about the eye (much like the dental field)...did podiatry just get separated b/c the foot was to often overlooked but often in pain?

 

[funkymunkytoes]

Why do Podiatry, Dentistry, and Optometry exist?

Because Feet, Teeth, and Eyes exist.

 

[Captain Fantastic]

I have wondered why they don't split up surgery and medicine into separate schools. That seems like the most obvious division to me.

A hundred years ago (+/-), this is exactly how schools were divided. To this day, in my state, MD's are licensed as both "Physician and Surgeon." It's a hold over from the time when they were licensed separately and a reflection that today's MD degree satisfies the two lineages.

I do think it is a valid point. I think you could shave a year or more off of training if people went through specialized programs.

 

[scrambizle]

There is so much medicine in involved in surgical practice. Take a look in the SICU.
And we do have specialized training in med school for surgeons - 4th year surgery electives (I could do 5 out of 9 blocks).

 

[Slowpoke]

I chose podiatry for a few reasons:
1) To improve people's quality of life
2) Average podiatrist works 40 hours/week and makes $189K per year (newest figure). This affords me the opportunity to make a very comfortable living and allows me to spend time with my family.
3) Every MD and DO I shadowed disliked their job and repeatedly told me that medicine isn't what it used to be (a red flag). Every podiatrist I shadowed really seemed to love their job, weird I know, but true.

why does your career need to specifically be podiatry to improve someone else's quality of life? Are you saying the other health professions don't improve on someone's quality of life?

The benefits of going podiatry, so it seems, is the regular schedule and the easy admission (relative to MD/DO) - as LizzyM has pointed out.

I really have a problem with your #3 reason for going into podiatry. As much as I would like to take people's feedback on careers into consideration, it is so hard to justify that as a legitimate reason for why you shouldn't go DO/MD - it is simply too subjective. In other words, not everyone is going to like vanilla ice cream, some people may even suggest choosing chocolate instead, but when it all comes down to it just because the next person doesn't like vanilla it doesn't mean you won't like it.