Why not podiatry?

[OldBlue]

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i shadowed a surgical podiatrist for a couple of days. At his practice, DPM's did ANYTHING related to foot/ankle. all of it. orthopedic surgeons did knees on up, nothing below. this guy was actually the head of the whole darn orthopedics department. what he told me is that, yes of course, podiatrists focus on the foot, but also there are symptoms of major illnesses that tend to surface in the foot first due to it's unique location at the bottom of the body. Diabetes is one example. from what i understand, DPMs, like MDs/DOs, are exposed to a huge body of medical knowledge in order to make diagnoses and provide treatments (for non-trauma stuff). For example, one patient came in and presented with symptoms appearing a lot like fibromyalgia. The DPM quickly recognized this. Although I think it is common for such a patient to be referred elsewhere, such as a rheumatologist, the fact remains that the knowledge of disease must be there for DPMs, and it is. This guy also reconstruction of birth defects, reconstruction/amputation for trauma cases (e.g. head-on collisions smash feet under the dashboard). the musculoskeletal relevance is huge...the way our feet hit the ground can cause knee/back pain. It appeared to me that all of that stuff plays into the realm of DPMs expertise. The streamlined curriculum/residencies is a very attractive feature, esp. if one wanted to take the surgery route. The only downside I can see is that you can't really decide two years into your curriculum that you want to be a neurologist or something. However, it seems like there are different directions you can go once in podiatry (reconstruction, pediatric, vascular...bypasses for blood flow, etc). I got the vibe that it is a great path to a medical career of high involvement and responsibility.

this is just my take on the matter anyway. if i'm inaccurate about anything then feel free to correct me.

 

[RoyBasch]

The streamlined curriculum/residencies is a very attractive feature, esp. if one wanted to take the surgery route. The only downside I can see is that you can't really decide two years into your curriculum that you want to be a neurologist or something.

Agree, very similar to my own sentiments.
-Roy

 

[Wylde]

I have no idea what specialty I want to practice and I definitely am not positive that I want to be a "foot specialist". UGs are generally in no-position to decide what type of medicine they want to practice.

 

[zephryus14]

Serious question here: I've worked in multiple hospitals now, and I've never seen a podiatrist do surgery on someone's foot/ankle, etc.(haven't even heard of it happening). Do yall have hospital privileges? What percentage of pods have privileges? I've seen plenty of ortho residents handle foot/ankle surgery even without this 1 year fellowship. I have seen plenty of outpatient pods practices here in TX, but 0 surgery. What percentage of your practice is invasive surgery?

Keep in mind, Podiatry is a relatively small profession. Just because you haven't seen a Pod doing surgery in a hospital doesn't mean it's not happening. Most Pods I know are doing surgery about 1/2 - 1 day per week (some pods devote their practice to surgery and surgical referrals). The other thing to note is that the profession has been undergoing change over the last few decades. Many of the old-timers don't have the surgical background and therefore do not perform surgery, while the up-and-coming pods have had a surgical residency and perform anything from a soft tissue mass removal to ankle reconstructive surgeries.
I can't comment on the percentage of podiatrists that have hospital privileges because not all podiatrists perform surgery. Even some of the newer podiatrists, after their residency, choose not to perform surgery and instead specialize in other aspects of podiatry (i.e. wound care, sports medicine, peds, etc.)
Another trend right now is to perform surgeries at a surgical center instead of the hospital. Many hospitals are charging too much to use the OR and surgical centers keep costs lower. There are even a number of podiatrists that get surgical suites in their office accredited to perform surgery there. They just need to bring in an anesthesiologist and OR assistants.

 

[engineeredout]

You need to do some research here. These are completely different career paths. A podiatrist is a foot specialist. An ortho surgeon is a surgical specialist of everything but the head. If I needed surgery on my foot, I'd call an ortho surgeon. If I get an ingrown toe-nail, I'll call a podiatrist.

I don't know about you, but if I had to get foot surgery I would want the surgon to be someone who has lived and breathed feet for four years + residency. You want to cut open my foot? You better have a ****ing doctorate in feet.

 

[Chocolate Bear]

I don't know about you, but if I had to get foot surgery I would want the surgon to be someone who has lived and breathed feet for four years + residency. You want to cut open my foot? You better have a ****ing doctorate in feet.

Nice 👍

"I hope you're a footologist!!! No?! Back the hell up, then!"

 

[215512]

sorry! was a bit mean there!

 

[unsung]

I've actually been curious about this as well, and I haven't found much in the way of commentary on the subject. My questions are- what is so darn special about the foot that it takes a special degree, special school, and 4 years of medical-school-like curriculum to work with ingrown toenails? Why can't a GP treat an ingrown toenail? Let's say you have ingrown toenail plus infection come into the ED; would the EM physician handle this, or call in a podiatrist? Are podiatrists to medicine what chiropractors are to medicine...or is podiatry more legitimate? Would it perhaps be more comparable to optometry in the optometry vs. ophthalmology realm? Is there any CAM/homeopathic/osteopathic component to podiatry education? Where does a GP draw the line between treating or referring to a podiatrist?

Great questions. I've also always been curious how podiatry got split off into its own realm... I mean, I can kinda see why dentistry got split off. But what's so special about the feet that it takes four years of feet-specific education??

 

[Adam Smasher]

ttt

 

[engineeredout]

actually they are duh do some research **** wow and you're type of ignorance is why people should realize that when you say pods arent physicians you have no idea what you are talking about and stop listening immediately. good lord

Fantastic response 👍. Only two months late. Make sure you give John McCain a call and warn him that hes in danger of losing the election.

While you're at it better warn Poland about Hitler too.

 

[UNMorBUST]

actually they are duh do some research **** wow and you're type of ignorance is why people should realize that when you say pods arent physicians you have no idea what you are talking about and stop listening immediately. good lord

👎 name calling.

 

[RoyBasch]

nevermind

 

[air bud]

actually they are duh do some research **** wow and you're type of ignorance is why people should realize that when you say pods arent physicians you have no idea what you are talking about and stop listening immediately. good lord

ThetaChiNAU actually started a thread in the pre-pod forum asking people what the cool clothes to wear were in the bay area. Because of his stupidity, hilarity ensued.

http://forums.studentdoctor.net/showthread.php?t=578396

http://forums.studentdoctor.net/showthread.php?t=578625