Why is podiatry not a sub-specialty of medicine?

[bears1992]

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There are MDs and DOs that specialize in hand surgery, knee repair, spinal surgery. Why is there an entirely different career path for physicians that want to specialize in foot/ankle surgery?

 

[allantois]

Cause it pays less

 

[SpoiledMilk]

🤣🤣🤣

 

[ADSigMel]

I've wondered this myself. Granted, I don't really know anything about what podiatrists do, but until I decided to go to medical school and started researching it, I didn't realize that podiatrists are not medical doctors.


Sent from my iPhone using Tapatalk

 

[Sir Alanna Trebond]

There are MDs and DOs that specialize in hand surgery, knee repair, spinal surgery. Why is there an entirely different career path for physicians that want to specialize in foot/ankle surgery?

There are orthopedic surgeons that specialize in foot and ankle surgery

 

[Lawpy]

There are MDs and DOs that specialize in hand surgery, knee repair, spinal surgery. Why is there an entirely different career path for physicians that want to specialize in foot/ankle surgery?

Historical and political reasons, which also explain why MD and DO are separate education pathways that lead to the same outcome: a board-certified practicing physician.

 

[AnatomyGrey12]

It's a historical thing.

 

[Mad Jack]

Because feet are gross

 

[Lawpy]

Because feet are gross

@Foot Fetish disagrees

 

[DexterMorganSK]

🤣🤣🤣

 

[Podstar]

It's a historical thing.

Pretty much this.

 

[RogueUnicorn]

There are MDs and DOs that specialize in hand surgery, knee repair, spinal surgery. Why is there an entirely different career path for physicians that want to specialize in foot/ankle surgery?

They are NOT physicians. Physicians who specialized in F&A surgery are orthopedic surgeons.

That pedantry aside, there really is no reason why podiatry exists separately except history in this country. But history's a heavy thing, it's hard to tell a whole group of people that their degrees are being cancelled and switched to a different one, and oh hey by the way please do a few years of residency.

 

[RogueUnicorn]

Legally, certainly for reimbursement, the term physician can refer to a broad range of medical providers. See US Code/CFR (§ 702.404)

§ 702.404 Physician defined.
The term physician includes doctors of medicine (MD), surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law. The term includes chiropractors only to the extent that their reimbursable services are limited to treatment consisting of manual manipulation of the spine to correct a subluxation shown by X-ray or clinical findings. Physicians defined in this part may interpret their own X-rays.

I know how people who know nothing about medicine "define" the term. I'm using it in the way it actually means, that is, a practitioner of medicine.

 

[RogueUnicorn]

you mean like a doctor of podiatric medicine?

adding the word medicine to things doesn't suddenly make it medicine man. if they started giving out "doctor of chiropractic medicine" tomorrow in chiro schools are they suddenly real physicians? (incidentally, the same misguided states that legally call podiatrists physicians give that designation also to chiros, possibly even naturopaths, so its legal worth is meaningless)

 

[RogueUnicorn]

I am going to suggest that your career in working with other medical professionals after residency will be much better if you get that chip off your shoulder

I suggest that one of us actually knows what he's talking about and the other is a curiously invested forumperson who could tell a 1/3 tubular from a LCDCP if his life depended on it.

Incidentally I've never met a podiatrist who would call himself a physician, but you carry on gonnif.

 

[RogueUnicorn]

And I have never a physician resident here on the forums who seems so determined to makes sure that he/she must clearly differentiate themselves so that no one would possibly lump them together with medical practitioners who they apparently deem lesser then their own education. Seems to a curious role model for a physician to make to premeds. My experience is working within medical school admissions, medical workforce policy, and process/regulations around these areas. I have worked with MD, DO, DPM institutions and associations during my now retired career, including the "physician 2015" project that was an attempt to put MD, DO and DPM under one umbrella. So please, I am sure you are a good surgeon but apparently your people skills work better on anesthetized patients then they do on the awake curious. As I said, get the chip off your shoulder doctor, you will be better off for it

In the words of the great Natalie Portman, I'm not a role model.

Like a typical bureaucrat who has circled but never entered our profession you presume to know much while Jon Snowing your way through most beyond-surface-level topics. I've called your bluff in the past and I'm happy to do so again. Congratulations on your previous career and your current one in advising other internet forumpersons, but you are out of your depth.

You're damn right I deem my education better, and it is/was as it pertains to the medical care of entire human beings, and you're also damn right I'm determined to make sure that at the very least future colleagues understand this. Never mind that out in California right now DPMs are trying to obtain the right to do total knee replacements, are emboldened to do high tibial osteotomies, but thank God we have the good gonnif to help wave away these silly distinctions like medical school and degree. This is an issue that directly affects my future practice as well as patients' outcomes and well-being but yes let's talk about "physician 2015" and follow pied piper while we kumbaya our way to harmonious ubuntuism.

 

[RogueUnicorn]

All this because I pointed out that physician for reimbursement means a broad range of providers? Residency can be stressful on some apparently. Perhaps you need a psych consult. And assumption about what I did, and who I worked for, are quite off the mark, doctor. I certainly hope you dont make similar hot headed assumptions when examining a patient else you will need to a dentist and a podiatrist to have the foot removed from your mouth. Have a good evening

No not really, all this because you're spouting your typical nonsense for things you don't understand, to prevent pollution of more impressionable minds.

What do you know about a psych consult exactly anyway? Maybe we can call a psychologist for you since they're presumably indistinguishable from psychiatrists to you.

Seems fair I get to assume things about you based on your complete ignorance if you get to assume things about me from forum posts. Goes both ways mister gonnif. But carry on, I'm sure you have some multi-colored, randomly bolded and underlined diatribe about Caribbean schools to write somewhere.

 

[bears1992]

No not really, all this because you're spouting your typical nonsense for things you don't understand, to prevent pollution of more impressionable minds.

What do you know about a psych consult exactly anyway? Maybe we can call a psychologist for you since they're presumably indistinguishable from psychiatrists to you.

Seems fair I get to assume things about you based on your complete ignorance if you get to assume things about me from forum posts. Goes both ways mister gonnif. But carry on, I'm sure you have some multi-colored, randomly bolded and underlined diatribe about Caribbean schools to write somewhere.

Dude who cares. Seriously.

 

[RogueUnicorn]

Dude who cares. Seriously.

I do, obviously, and presumably the person who posed the original question. Oh wait.

 

[bears1992]

I do, obviously, and presumably the person who posed the original question. Oh wait.

You are arguing over if a DPM can call themselves a physician. Gonnif gave you the answer.

 

[RogueUnicorn]

You are arguing over if a DPM can call themselves a physician. Gonnif gave you the answer.

Not really no. And Gonnif's "answer" will deem a chiropractor a physician. Seems trivial now to you sure, but have fun trying to explain to a patient in a couple of years that no, their chiropractic adjustments will not bring down their a1c

 

[Windom Earle]

🤣🤣🤣

LOL, Seinfeld is hilarious.

This episode aired almost 25 years ago. I imagine podiatrists get more respect now than they did back then. I mean even Jerry confessed to speaking "extemporaneously" when he said podiatrists weren't doctors lmao.

 

[deleted103644]

Because mouths and feet are gross.

 

[de Ribas]

Because mouths and feet are gross.

proctology is not

 

[de Ribas]

Because mouths and feet are gross.

years ago doctors were doing everything and did not classify what is gross or not. they practiced medicine because they loved science and loved to help people and find solutions to healthcare issues. nowadays, there are so many people who are thinking about self comfort and not welfare of others.

I don't like the idea of diminishing any area of medicine.

 

[de Ribas]

I know how people who know nothing about medicine "define" the term. I'm using it in the way it actually means, that is, a practitioner of medicine.

then DO's are not doctors either? by your reasoning they don't go to "Medical" school - they go to osteopathic school. Therefore they are not physicians, they are osteopaths. They practice osteopathy, not medicine.

 

[stickgirl390]

then DO's are not doctors either? by your reasoning they don't go to "Medical" school - they go to osteopathic school. Therefore they are not physicians, they are osteopaths. They practice osteopathy, not medicine.

The proper, full title is "osteopathic medical school". The schooling is the same as MD, with the added OMM portion. Just saying "osteopathic school" would imply that the students ONLY learn OMM and not much else.

 

[de Ribas]

The proper, full title is "osteopathic medical school". The schooling is the same as MD, with the added OMM portion. Just saying "osteopathic school" would imply that the students ONLY learn OMM and not much else.

Oh, I know. I was speaking from the perspective of those who think otherwise that only MD's are physicians.

 

[stickgirl390]

Oh, I know. I was speaking from the perspective of those who think otherwise that only MD's are physicians.

Ooooh ok

 

[Mad Jack]

adding the word medicine to things doesn't suddenly make it medicine man. if they started giving out "doctor of chiropractic medicine" tomorrow in chiro schools are they suddenly real physicians? (incidentally, the same misguided states that legally call podiatrists physicians give that designation also to chiros, possibly even naturopaths, so its legal worth is meaningless)

*coughdoctorofosteopathicmedicinecough*

 

[Mad Jack]

The proper, full title is "osteopathic medical school". The schooling is the same as MD, with the added OMM portion. Just saying "osteopathic school" would imply that the students ONLY learn OMM and not much else.

The full term for podiatry schools are School of Podiatric Medicine, for the record. And their official title is Podiatric Physician in many states.

 

[DexterMorganSK]

years ago doctors were doing everything and did not classify what is gross or not. they practiced medicine because they loved science and loved to help people and find solutions to healthcare issues. nowadays, there are so many people who are thinking about self comfort and not welfare of others.

I don't like the idea of diminishing any area of medicine.

There is no point explaining anything to him/her, they have already made their mind and will not change.

Just like how some people even today believe that only MDs are real "physician's" and no one else: we cannot do anything about these individuals, but to ignore them and move on with our lives. If these people do not learn to work with other healthcare professionals then that's on them.

Whenever there is a thread like this on SDN, there always seems to be a penis-size/pissing competition (usually from seniors) and that in a pre-med forum is not healthy, imo.

 

[Lawpy]

then DO's are not doctors either? by your reasoning they don't go to "Medical" school - they go to osteopathic school. Therefore they are not physicians, they are osteopaths. They practice osteopathy, not medicine.

Apparently DOs weren’t considered physicians before the 1960s since doctors viewed osteopathy as a sham and pseudoscience. Now things have changed but due to history and politics on AOA/COCA part, there are two degree pathways that lead to the same outcome.

There is no point explaining anything to him/her, they have already made their mind and will not change.

Just like how some people even today believe that only MDs are real "physician's" and no one else: we cannot do anything about these individuals, but to ignore them and move on with our lives. If these people do not learn to work with other healthcare professionals then that's on them.

Whenever there is a thread like this on SDN, there always seems to be a penis-size/pissing competition (usually from seniors) and that in a pre-med forum is not healthy, imo.

I mean it would be easier for everyone if DO is reabsorbed into MD with OMM as an elective and COMLEX/DO shelves phased out. AOA/COCA would oppose that fervently so hence the current difference. Likewise, DPM can be reabsorbed into MD with podiatry being a residency, but the podiatric regulatory bodies would strongly oppose the move entirely due to political and historical reasons.

 

[RogueUnicorn]

then DO's are not doctors either? by your reasoning they don't go to "Medical" school - they go to osteopathic school. Therefore they are not physicians, they are osteopaths. They practice osteopathy, not medicine.

No, if you were paying attention you would notice that it wasn't I who was positing the word "medicine" in the degree as a meaningful way to determine whether or not someone actually practices medicine. Considering DOs learn, train in, and practice whole body medicine, they are quite obviously physicians in every sense of the word. DO is proof positive that the words in your degree don't mean much despite gonnif's protestations.

 

[de Ribas]

No, if you were paying attention you would notice that it wasn't I who was positing the word "medicine" in the degree as a meaningful way to determine whether or not someone actually practices medicine. Considering DOs learn, train in, and practice whole body medicine, they are quite obviously physicians in every sense of the word. DO is proof positive that the words in your degree don't mean much despite gonnif's protestations.

So, by your reasoning, only those who practice whole body medicine are considered physicians. Then, brain surgeons, proctologists (colon and rectal surgeons), pathologists, urologists are not physicians. They are limited to certain body parts. What about ENT? they do not even treat anything lower than lungs. Ophthalmologists only treat eyes. They do not practice over whole body. Every specialty is limited to something. As far as education, both MD, DO, and DPM receive same first 2 years with minimal differences.

What about medical doctors that became scientists, CEO's, leaders, or went to politics? They are not physicians anymore? Based on your argument they do not practice whole body.

 

[LizzyM]

So, by your reasoning, only those who practice whole body medicine are considered physicians. Then, brain surgeons, proctologists (colon and rectal surgeons), pathologists, urologists are not physicians. They are limited to certain body parts. What about ENT? they do not even treat anything lower than lungs. Ophthalmologists only treat eyes. They do not practice over whole body. Every specialty is limited to something. As far as education, both MD, DO, and DPM receive same first 2 years with minimal differences.

What about medical doctors that became scientists, CEO's, leaders, or went to politics? They are not physicians anymore? Based on your argument they do not practice whole body.

And let's not get started on dentists!

 

[SpoiledMilk]

And let's not get started on dentists!

At 1:20

 

[RogueUnicorn]

So, by your reasoning, only those who practice whole body medicine are considered physicians. Then, brain surgeons, proctologists (colon and rectal surgeons), pathologists, urologists are not physicians. They are limited to certain body parts. What about ENT? they do not even treat anything lower than lungs. Ophthalmologists only treat eyes. They do not practice over whole body. Every specialty is limited to something. As far as education, both MD, DO, and DPM receive same first 2 years with minimal differences.

What about medical doctors that became scientists, CEO's, leaders, or went to politics? They are not physicians anymore? Based on your argument they do not practice whole body.

Ya bruh, physc literally means medicine. You're talking a lot about things that you don't know much on. For instance, who the hell cares about the first two years of medical school, it gets distilled into an 8 hour test. I'm a physician because I do practice whole body medicine.

Sure now we're all specialized, but that doesn't mean that you can blithely have no understanding of any other part of the body. Shockingly, turns out that most body parts and functions are significantly interrelated with other parts. There's a well founded reason why surgeons go to all of medical school and do internships that force at least a foundational experience in generalist fields. I managed vents as an orthopedic intern; can you say the same about podiatrists? You don't think that's important? Tell that to the 15 patients on the ortho trauma list at any given time sitting in the TICU. You don't think ENTs have a fundamental knowledge base from non-ENT fields they use in their practice? Think again. Every field you mentioned with maybe the exception of ophtho (seriously, not sure why that's a medical field) requires at least an occasional use of general medical concepts and principles. Even in ortho where the prevailing joke is that we're bone jockeys, I intersect daily with hematology, infectious diseases, geriatrics, acute pain, and crit care medicine. That's just off the top of my head. If you don't think there's value in me being able to intelligently converse with these colleagues, then I don't know what to say.

Instead of viewing this as a zero-sum game as some of you are keen on doing, realize that this isn't a rip on podiatry or dentistry or anything else, but rather an effort to draw distinctions where they exist. Podiatrists are super important to our system and I refer patients to them at least weekly. But that doesn't change any of the above.

 

[Matthew9Thirtyfive]

Every field you mentioned with maybe the exception of ophtho (seriously, not sure why that's a medical field)

You’re joking, right?

 

[Matthew9Thirtyfive]

All this because I pointed out that physician for reimbursement means a broad range of providers? Residency can be stressful on some apparently. Perhaps you need a psych consult. And assumption about what I did, and who I worked for, are quite off the mark, doctor. I certainly hope you dont make similar hot headed assumptions when examining a patient else you will need to a dentist and a podiatrist to have the foot removed from your mouth. Have a good evening

Just out of curiosity, do you consider dentists physicians?

 

[Matthew9Thirtyfive]

The full term for podiatry schools are School of Podiatric Medicine, for the record. And their official title is Podiatric Physician in many states.

And the full term for naturopathic schools is school of naturopathic medicine.

 

[bears1992]

Seems no one reads the posts here, I never mentioned what I considered, I cited federal law on the subject as I repeat below. My issue here that medicine is a collaborative effort and respect and trust of members of your team should be second perhaps to only ethics.

Gonnif is the least opionionated user on here. All he does is post data and statistics that help answer questions.

 

[Matthew9Thirtyfive]

Seems no one reads the posts here, I never mentioned what I considered, I cited federal law on the subject as I repeat below. My issue here that medicine is a collaborative effort and respect and trust of members of your team should be second perhaps to only ethics.

I read your posts, but apparently you didn’t really read mine. I was simply asking if you personally consider dentists physicians, purely out of curiosity.

You also said this:

My experience is working within medical school admissions, medical workforce policy, and process/regulations around these areas. I have worked with MD, DO, DPM institutions and associations during my now retired career, including the "physician 2015" project that was an attempt to put MD, DO and DPM under one umbrella. So please, I am sure you are a good surgeon but apparently your people skills work better on anesthetized patients then they do on the awake curious. As I said, get the chip off your shoulder doctor, you will be better off for it

Which would seem to indicate you view DPMs as physicians. I’m simply wondering if that extends to dentists too.

 

[drmantistobbogan]

they practiced medicine because they loved science and loved to help people

And here I thought I was the only one...

 

[Matthew9Thirtyfive]

Again, not my personal opinion. The project "physician 2015" was sponsored by AMA, LCME, ACGME on the MD side, with AOA and COCA on DO side, along with many of major medical associations in the country. so apparently the MDs and DOs considered DPMs as physicians. At no time do I indicate what I think or believe in this discussion. Indeed, I never use the word physician in this thread except for noting what either the law or what the medical establishment says about them. Hence my bemusement over the brouhaha the last day or two

I don’t really have a dog in the fight. I was just curious what your opinion was, but you seem oddly reluctant to give it. That’s fine. I wasn’t planning on debating the topic. Was just curious.

But you being involved in something and describing it the way you did implies pretty hard that you consider them physicians. Again, I’m not arguing one way or the other.

 

[RogueUnicorn]

You’re joking, right?

yes, even in a "heated" debate it's hard to pass up an opportunity to take a dig at the eyeball docs 😎

Seems no one reads the posts here, I never mentioned what I considered, I cited federal law on the subject as I repeat below. My issue here that medicine is a collaborative effort and respect and trust of members of your team should be second perhaps to only ethics.

it's a collaborative effort until the noctors come eat your lunch.

Gonnif is the least opionionated user on here. All he does is post data and statistics that help answer questions.

lol are you serious? the reason he posts internet data is because he doesn't have anything else to go by; at one point i remember him saying that DO clinical rotations were on average on par with MD ones, or something to that effect, which needed correction. this isn't to say that his many, strongly held and often stated opinions are usually wrong. to the contrary they're often on the money. but let's call a spade a spade.

Indeed, I never use the word physician in this thread except for noting what either the law or what the medical establishment says about them.

at no point did you provide what the "medical establishment" says about "them"

I don’t really have a dog in the fight. I was just curious what your opinion was, but you seem oddly reluctant to give it. That’s fine. I wasn’t planning on debating the topic. Was just curious.

But you being involved in something and describing it the way you did implies pretty hard that you consider them physicians. Again, I’m not arguing one way or the other.

obviously he's reluctant to give it, he's (wisely, shockingly) at this point probably realized he's painted himself into the wrong corner and is trying to smoke and mirror his way out. let's see how many more three letter words are going to be thrown out next.

 

[LizzyM]

Someone here fears that a podiatrist will eat his lunch. In the end, these turf wars all come down to money.

 

[Matthew9Thirtyfive]

For purposes of medical school admissions, physican tends to refer to MD and DO, for purposes of medical practice, the term doesnt really exist between doctors. They tend to refer to each other by their specialty. At that level, podiatrists are just another specialist on par with all the other docs in a hospital. The nursing and midlevels would consider them physican as they are the doctor on a case. If the DMD oral surgeon was in on a patient, he/she would be considered the doctor on the case and therefore a physician. So the reality is how do things work and what role the provider plays. In the end it is just semantics that dont matter

edit: misread your post. Agree with you. Thanks for answering.

 

[Matthew9Thirtyfive]

yes, even in a "heated" debate it's hard to pass up an opportunity to take a dig at the eyeball docs 😎

Lmao. I figured.

 

[Mad Jack]

yes, even in a "heated" debate it's hard to pass up an opportunity to take a dig at the eyeball docs 😎

it's a collaborative effort until the noctors come eat your lunch.

lol are you serious? the reason he posts internet data is because he doesn't have anything else to go by; at one point i remember him saying that DO clinical rotations were on average on par with MD ones, or something to that effect, which needed correction. this isn't to say that his many, strongly held and often stated opinions are usually wrong. to the contrary they're often on the money. but let's call a spade a spade.

at no point did you provide what the "medical establishment" says about "them"
obviously he's reluctant to give it, he's (wisely, shockingly) at this point probably realized he's painted himself into the wrong corner and is trying to smoke and mirror his way out. let's see how many more three letter words are going to be thrown out next.

Fun fact: the associated press only allows the honorific title of Dr. to be used by MDs, DOs, dentists, and podiatrists. Podiatrists can legally call themselves podiatric physicians/surgeons in my state, and have hospital privileges and the ability to direct hospital staff. So, at least here, they're physicians, albeit limited ones. But ultimately we all are, because while we can do anything, hospital privileges, insurance rules, and liability often bar us from stepping out of our specialties.