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THE PROFESSION OF PODIATRY
Podiatrists are defined by law as physicians and surgeons of the lower extremities. They provide comprehensive evaluation, diagnosis, and treatment of diseases and injuries to the human foot and ankle. Treatment may include palliative care, biomechanical modalities, physical therapy, surgical intervention, and the prescription of both systemic and topical medications. Commonly recognized conditions include heel (plantar fasciitis), calf and arch pain as well as painful bunions, hammertoes, flat feet, ingrown/infected nails, warts and callous formation.
Over the past twenty years, podiatry has evolved from a palliative care profession to a medical and surgical specialty of the lower limb. Due to its ongoing evolution, there is no federal legislation governing the proximal extent of the human body with which podiatry may concern itself, and so the legal definition of podiatry varies from stat to state. In the state of Colorado, surgical intervention by qualified podiatrists is limited to any condition of the human toe, foot, ankle and/or tendons that insert into the foot. However, non-invasive treatment of the lower limb extends proximal to just below the knee. Indeed, many general manifestations of musculoskeletal overuse and strain are caused by a lack of stability or imbalance in the foot. The etiology of these conditions are well understood and treated by the podiatrist who is knowledgeable in biomechanics of the lower limb.
A doctor of Podiatric Medicine (D.P.M.) has spent a minimum of four years in an undergraduate institution, and must hold a Bachelors degree before he/she is allowed to take the Medical College Admission Tests (MCAT), as do A.M.A. medical school applicants. Contingent on undergraduate grades, board scores, and rigorous interviews, he/she is selectively chosen to enter a College of Podiatric Medicine. Podiatric medical school entails four additional years of study, during which the student receives a general medical education comparable with that of the A.M.A. and D.O. medical schools. The primary advantage is the podiatric student is involved in additional specialty courses dealing with lower extremity anatomy, biomechanics, podiatric medicine, sports medicine, and surgery. Upon completion of medical school and passing a National Podiatric Medical Board Examination, he/she is required to complete a two to three year residency program. Upon completion of the residency, the podiatrist may elect to undergo the certification process in Foot and Ankle Surgery. This involves taking the American Board of Podiatric Surgery (ABPS) board qualifying exam in Forefoot surgery and Rearfoot and Ankle surgery. The candidate may sit for the ABPS board certification exam only after passing the board qualifying exams and appropriate case documentation after residency.
A Doctor of Podiatric Medicine is truly a physician uniquely qualified to treat disorders of the human foot and ankle.
IS A PODIATRIST A DOCTOR?
Yes, a podiatrist is a licensed physician and/or surgeon who specialize in the evaluation and treatment of the foot, ankle, and lower leg. Treatment can be medical, surgical or biomechanical. DPM stands for Doctor of Podiatric Medicine.
DO PODIATRIST PERFORM SURGERY?
Yes, podiatric surgeons are qualified to perform surgery for bone, joint, muscle, ligament, and tendon pathology of the foot, ankle and lower leg. Levels of surgical services do vary amongst DPM’s based on their training; this is true among MD’s and DO’s as well. Some DPM’s treat only the forefoot, some focus on the rear foot and still others specialize in the entire foot and ankle. Likewise, there are general orthopedists who treat only foot and ankle and those who treat neither. Because of the large diversity in this specialty, patient research is crucial. It is advisable to inquire about a doctor’s training, to obtain references and to seek second opinions.
WHAT TYPE OF SURGERIES DO PODIATRISTS PERFORM?
Podiatric surgeons perform surgeries to repair such ailments and injuries as: Achillies tendon ruptures, foot and ankle fractures, ankle instability, arthritic disorders, flatfoot deformities, Neuromas, toenail disorders, bunions and hammertoes.
WHAT ELSE DOES A PODIATRIST DO?
Podiatrists treat corns, calluses, ingrown toenails, bunions, heel spurs, plantar fasciitis, and arch problems; ankle sprains, Achilles tendonitis, deformaties, and foot complaints associated with diabetes and other diseases. To treat these problems, podiatrists prescribe drugs and physical therapy, set fractures, and perform surgery.
PODIATRISTS or ORTHOPEDIC SURGEON?
A podiatrist (DPM) is a doctor with the same undergraduate prerequisites as an MD or DO physician and who attends a four-year medical school preparation in diagnosing and treating the foot, ankle, and lower leg. Orthopedic surgeons study for four years in a college or university, four years in medical school, five years in a postdoctoral residency program studying the whole body. Podiatrists study for four years in a college or university, four years in medical school, and typically 2-3 years in a postdoctoral residency program where they receive advanced training in podiatric medicine and surgery and serve clinical rotations in anesthesiology, internal medicine, pathology, radiology, vascular surgery, infectious disease, emergency medicine, and orthopedic and general surgery. The major difference is that while orthopedic surgeons are trained to operate on the entire muscle and skeletal system, podiatrists focus solely on the foot and ankle. So while an orthopedic surgeon may have a better general medical background, a podiatrist has spent more time studying the foot and ankle. DPM’s generally are better educated in regard to lower extremity anatomy, surgery, biomechanics, and bracing. DPM’s chose their specialty (foot and ankle) from day one, thus giving focus toward the specialty years before MD’s.
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