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Podiatry in Pittsburgh is a medical specialty, much like dentistry or pediatrics. Doctor of Podiatric Medicine (DPMs) treat all conditions of the foot, ankle, and muscles and tendons of the lower leg. The treatments available to podiatrists can fall anywhere within the gamut of least-invasive to most-invasive. DPMs take care of minor conditions such as an ingrown toenails and sprained ankles, yet at the same time also perform highly complex foot surgeries. They’re familiar with physical therapy for foot and ankle injuries, and can write prescriptions. Many sub-specialties exist within podiatry.
What are podiatrists?
Podiatrists are designated by the title “Doctor of Podiatric Medicine” (DPM), and specialize in treating all manner of diseases and conditions of the foot at foot clinics in Pittsburgh. They also treat the ankle, and some soft tissue of the lower leg. Podiatrists are respected members of the medical community, and routinely work with a patient’s primary care doctor and other specialists.
The training of podiatrists is similar to that of medical doctors, and they receive extensive education in general medicine such as anatomy, physiology, pharmacology, and infectious diseases of the entire body, not just the feet. In terms of scope of practice, however, DPMs are limited to treating the foot, ankle, and the muscles and tendons for the lower leg.
What is a podiatrist’s education and training like?
Podiatrists are formally acknowledged as doctors, not physicians, which is reserved for medical doctors (MDs) and osteopaths (DOs). In this respect they’re much like dentists and chiropractors. Even so, the education of podiatrists can be just as rigorous as that of a medical doctor, and podiatric medical college has many similarities to medical school.
As alluded to earlier, there is considerable overlap between what exactly Medical Doctors (MDs) and Podiatrists (DPMs) can and can’t do. The language can also prove to be confusing.
The preeminent example of this are MDs who perform surgery, usually orthopedists, and podiatric surgeons, who routinely perform orthopedic surgery on the bones and joints of the foot and ankle. When choosing a provider, base your decision on the experience and training of the providing doctor, not his or her specific title. Do your research, and ask qualified individuals whom you trust such as your primary care doctor for recommendations. As a very general rule, look for a doctor who performs whatever procedure you’re a candidate for regularly, and who has many happy patients and good online reviews.
Podiatrists are often highly specialized. A DPM may specialize in areas such as diabetic foot care, wound care, minimally invasive methods of alleviating foot pain such as customized orthotics, geriatric podiatry, and pediatric podiatry (podopediatrics). This last specialization is often viewed as especially important, as foot problems developing in infants and young children can affect weight bearing activities and gait for the rest of a patient’s lifetime if not dealt with promptly.
Podiatrists, a.k.a foot doctors, doctors of podiatry, doctors of podiatric medicine, podiatric surgeons, and doctors of podiatric surgery.
Podiatrists, prescribe drugs, use imaging technology like MRIs and ultrasound, set fractures apply casts, and perform all manner of surgery on the foot. Podiatrists are well accepted in the medical community and work in conjunction with a patient’s other doctors.
Individual podiatrists are often highly specialized in a wide variety of areas. These include orthopedic surgery, pediatric podiatry, diabetic foot care, and many others. In addition to these formally certified specialties, many pursue sub-specialties including sports podiatry, geriatrics, podopediatrics (pediatric podiatry), and wound care. Doctors of Podiatric Medicine (DPMs) receive more specialized medical and surgical training regarding the lower extremity than any other type of doctor.
In many ways, they can be thought of as primary care doctors for the foot and ankle. A large part of what they do is patient education and prevention, and almost all primary care DPMs treat common conditions such as the following everyday:
- Athlete’s foot and other skin diseases of the foot
- Excessive foot odor and sweating
- Dry, cracked, thickened skin and other skin problems
- Corns and calluses
- Flat feet and other mechanical issues
- Heel pain, such as plantar fasciitis
- Geriatric foot issues
- Diabetic foot issues
- Sports injuries
- Nail problems, such as fungal infections and ingrown nails.
Patients often seek the help of a podiatrist for foot pain, toenail problems like thick, misshapen, discolored nails, skin problems such as warts, rashes, and ulcers, or injuries including sprained ankles to broken bones.
Most Doctors of Podiatric Medicine (DPMs) also offer custom made orthotics. These are arch supports molded specifically for each patient designed to support the arch of the foot, and are a mainstay in the treatment of many types of foot and heel pain. They ensure that the foot is in the proper alignment to improve the mechanics of the foot and ankle
Even if you aren’t experiencing acute foot problems, it’s still advisable to consult a podiatrist for a foot health assessment. During this appointment, the podiatrist may file down or remove excessive callus formation, trim the nails properly, and discuss footwear issues. Think of it as a check up to see if you’re taking care of your feet properly.
Podiatrists provide the complete spectrum of foot care, from the treatment of calluses to reconstructive surgery of the foot. They are generally considered to be the authority in medical matters pertaining to the feet, ankles, and muscles and tendons of the lower leg.
Choosing between a podiatrist and an orthopedic surgeon in the treatment of severe foot and ankle issues.
America’s healthcare system is nothing if not complex–especially when choosing a specialist to address a complex problem which may require advanced care, including surgery. A question many patients have is how to choose between a podiatric surgeon and an orthopedic surgeon who specializes in the treatment of the joints and bones of the foot and ankle. Is one better than the other?
All things considered, the two specialties are more similar than different. In simple terms, an orthopedic surgeon is trained to operate on all of the body’s joints, bones, and associated tissues such as tendons and ligaments. This can include the feet. A podiatric surgeon can perform all types of foot surgery, not just procedures affecting joints, bones, and soft tissue. This usually means issues of foot dermatology such as advanced ulcer care and the correction of biomechanical deformities.
In terms of training, the two specialties have much in common as well. Both are exposed to common core medical sciences such as anatomy, physiology, and pathology. Both podiatric surgeons and orthopedic surgeons have lengthy residencies, and many choose highly specialized areas of practice. However, as any podiatric surgeon will tell you, their education and practical training focused on the foot and ankle directly after this general medical education common to doctors of all stripes.
Podiatric medicine, or simply podiatry, is the medical specialty devoted to researching, diagnosing, and treating disorders of the foot, ankle, and lower extremity. A full spectrum of treatment options are used, ranging from non-invasive ointments to open surgery of the foot. The word “podiatry” began to be used in the early 1900s in America, where podiatry was first recognized as a distinct medical specialty. Today practicing podiatrists can be found around the world.
Podiatry is referred to by different terms in other countries, but by whatever name they’re called the scope of practice is the same. The term “podiatry” is used in many countries, yet in some English speaking countries the term “chiropodist” is sometimes used, which is an older term (not to be confused with “chiropractor,” which is a separate, unrelated medical specialty. Graduates of accredited programs in Australia register through the Podiatry Board of Australia to earn the title, and those who pursue additional training may also be allowed to prescribe some restricted drugs and perform podiatric surgery. These are known, not surprisingly, as podiatric surgeons.
In non-English language countries, terms such as “podologist” or podólogo are used. By whatever title, the scope of practice of these foot doctors may differ slightly, but their core functions remain the same.
The American Association of Colleges of Podiatric Medicine defines a podiatrist as a medical specialist who diagnoses and treats conditions specific to the foot, ankle, and lower leg. The abbreviation “DPM” after a doctor’s name is used to designate them as a podiatrist. In terms of education, all recognized, accredited podiatry schools teach general gross anatomy, lower extremity anatomy in great detail, physiology, pharmacology, physical and orthopedic examination, neurology, sports medicine and injury rehabilitation, microbiology, histology, women’s health issues, and general principles of orthopedic surgery. Podiatrists are also educated in medical ethics and jurisprudence.
Just as with any other doctor, American podiatrists take part in several rotations during their residency. These can include orthopedic surgery, general surgery, radiology, pathology, biomechanics, sports medicine, and physical therapy, emergency care, critical care, vascular surgery, pain management, pediatric podiatry, geriatric podiatry, and wound care. All things considered, podiatry has a broad scope of practice, and many sub-specialties exist within the profession.
In terms of origin, professionals who specialized in care of the feet existed in ancient Egypt, as can be seen most famously in stone carvings found at the entrance to Ankmahor’s tomb. These date from about 2400 BC, and depict people medically treating the feet.
The Greek physician and philosopher Hippocrates recognized corns and calluses as treatable conditions, and invented specialized skin scraping tools used for corn removal. These are among the oldest verifiable use of a surgical tool resembling a modern scalpel.
Up until the turn of the century, what we now know as podiatrists were referred to informally as chiropodists, and these practitioners weren’t recognized as medical specialists. These chiropodists were indeed licensed physicians who focused their practice on the care of the feet, ankle, and lower leg. Lewis Durlacher was one of the first doctors to advocate the recognition of podiatry as a separate, distinct medical specialty.
Historical records show that various French Kings retained personal podiatrists, which Napoleon Bonaparte did as well. American President Abraham Lincoln had many foot problems, and retained the services of podiatrist Dr. Isachar Zacharie. In an amazing twist, on several instances Dr. Zacharie was sent of classified missions to serve as a Liaison between the North and leaders of the Confederacy.
The first professional organization of podiatrists was formed in 1895 in New York City, and is still in operation today. This is the NYSPMA, the New York State Podiatric Medicine Association. The first dedicated podiatry school was opened 16 years later in 1911, and one year later The London Foot Hospital was formed, which had its own podiatric doctoral program. In australia, podiatrists were first officially recognized as such in 1924. The very first American scholarly journal appeared in 1907, with one appearing in England in 1912. The first Australian podiatry school was founded in 1939.
Podiatric and orthopedic podiatric surgery
Some podiatrists choose to receive additional training to become podiatric surgeons. These clinicians perform surgery for all manner of conditions which affect the foot and its joints, the ankle, and the muscles and tendons of the lower leg. Their goal is to enhance and preserve optimal functioning of this complex of joints.
Often their work is reconstructive. It’s common for patients to come in with joint and ligament problems, and this usually requires arthroscopic or even open surgery. Podiatric surgeons also correct deformities of the foot such as clubfoot and bunions. Minimally invasive surgery is always preferable to full open surgery, but DPM surgeons routinely perform full reconstructions of the foot and ankle.
Sports medicine podiatric specialty
Sports medicine is a quickly growing subdivision of podiatry. These specialists perform the full duties of a DPM, but also act in a role similar to a Doctor of Physical Therapy (DPT). Such practitioners excel at diagnosing specific foot and ankle problems using orthopedic tests, administer joint manipulations in much the same way as chiropractors, and are experts in assessing the biomechanics of the foot in motion. They provide specialty treatments as well, most notably prolotherapy (sclerotherapy), which is an injection based treatment which greatly aids in the healing of ligaments. Platelet-Rich Plasma (PRP) is another similar method. Not surprisingly, these Doctors of Podiatry primarily treat amateur and professional athletes, but are also needed when specific lower extremity physical therapy is required.
Podopediatrics, or pediatric podiatry
This is widely known as pediatric podiatry, although the technical term is podopediatrics. Much as it sounds this sub-specialty focuses solely on foot, ankle, and lower leg muscles and tendons found in children. This branch is particularly important, since structural and mechanical problems which aren’t resolved promptly can worsen over time, causing potentially severe weight bearing, gait, and pain issues. The overall goal of a podopedriatic DPM is ensuring the proper growth and maturation of the foot.
Children’s feet are more vulnerable to podiatric conditions because they’re still developing and many of these issues can complicate development. Children also tend to have high pain tolerances so they’re injured more often, and tend to not pay attention to details like ill-fitting footwear. They can also be extremely active.
This breed of DPM is also responsible for the care of the feet of very young children and infants. Once the potential podopediatrician graduates from an accredited podiatry program, their education continues, as they are mandated to take more continuing education credits than most other branches of podiatry. These requirements are set forth by national health agencies such as the Health and Care Professions Council (CPC), and they are not optional.
Podiatrists can, and routinely do, refer patients for imaging studies. All DPMs may send patients for Medicare rebate plain film X-Ray studies, and do so commonly since many podiatric patients are covered by Medicare plans. When plain film isn’t sufficient, DPMs can order advanced studies such as MRI, CT scans, and ultrasound exams of the soft tissues of the lower extremity. Podiatrists can send out tissues for pathology testing, and can order lab work as well.
Podiatric Colleges, a.k.a podiatric medical schools
To date, there are 9 active podiatric medical schools in the US. They are overseen by the American Association of Colleges of Podiatric Medicine (AACPM), which has the goal of certifying and regulating podiatry programs, ensuring that they are rigorous and complete enough to graduate effective podiatrists. These schools are:
- Arizona School of Podiatric Medicine (AZPod) at Midwestern University
- Dr. William M. Scholl College of Podiatric Medicine
- Temple University School of Podiatric Medicine
- The College of Podiatric medicine at Western University of Health Sciences
- Barry University School of Podiatric Medicine
- The California School of Podiatric Medicine
- Kent State University College of Podiatric Medicine
- Des Moines University College of Podiatric Medicine and Surgery
- New York College of Podiatric Medicine
- Kent State University College of Podiatric Medicine
Podiatrists have traditionally boasted an extremely wide variety of sub-specialties and certifications. These are largely governed by The American Board of Podiatric Orthopedics and Primary Podiatric Medicine (ABPOPPM). This organization sets forth comprehensive board qualifications and associated certification processes. The following is a non-exhaustive list of podiatric sub-specialties:
- Geriatric Podiatry
- Podopediatrics, or pediatric podiatry
- Podiatric Diabetologist, specializing in wound care and limb salvage
- Neuro-podiatry, specializing in the nerve supply of the lower extremity
- Podiatric orthopedics, specializing in orthopedic surgery of the foot and ankle
- General podiatry
- Reconstructive foot and ankle surgeon
- Sports medicine podiatrist
- Podiatric rheumatology
- Podiatric radiology, specializing in imaging studies of the lower extremity
- Podiatric dermatologists
- Vascular specialists
- Podiatric oncologist, specializing in cancers of the lower extremity
- High-risk wound care podiatry
- Cosmetic Podiatry