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A podiatrist (US English), or chiropodist (British English), is a podiatry professional, a person devoted to the study and treatment of disorders of the foot and ankle. Translated literally, chiropody refers to medicine of the "hand and foot", but today chiropody is merely another name for podiatry. In the United States both terms were used interchangeably until the mid-twentieth century.
United States
In the United States podiatry is practiced by a licensed Doctor of Podiatric Medicine (D.P.M.). Education consists of a four-year program following an undergraduate college degree. Podiatrists may independently diagnose, treat and prescribe medicine and perform surgery for disorders of the foot and in some states the ankle and leg.
Practice characteristics
Podiatrists in the main practice in solo practice. However, there has been a movement toward larger group practices as well as the use of podiatrists in multi-specialty groups treating diabetes or in multi-speciality surgical groups. Some podiatrists work within clinic practices such as the Indian Health System (IHS), the Rural Health Centers (RHC) and Community Health Center (FQHC) systems established by the Federal government to provide services to under insured and non-insured patients as well as within the United States Department of Veterans Affairs providing care to veterans of military service.
- Scope: The differences in podiatry practice are determined by state law. Each state allows or limits the practice of podiatry to the foot, ankle or and in many cases includes portions of the leg. This may include surgery above the ankle in several states. Many states require completion of a residency to practice. Many podiatrists work in hospital settings doing both medical and surgical treatments for patients. As in many other specialties some podiatrists work in nursing homes and some perform house calls for patients. Podiatry patients range from newborns and infants to the geriatric.
- Medical and orthopedic practice: Some podiatrists limit their practices to the non-(hospital)surgical treatment of patients. Because much work in podiatry involves cutting of some kind, many procedures are considered surgical by insurance companies including tasks such as the (cutting of nails, removing of corns or callus) which the general public would not ordinarily consider to be surgery. These podiatrists use their skills in handling arthritic, diabetic, and other medical problems associated with the feet and lower extremities. Some use devices fitted in shoes (orthotic devices) or modify the shoe itself to make walking better or easier. Some practices focus on sports medicine and treat many runner, dancers, soccer players and other athletes.
- Surgical Practice: Within the scope of practice, podiatrists are the experts at foot surgery. Podiatrists have specialized training and interest in the lower extremities as well as one to three year surgical residencies in the United States. Some podiatrists have solely surgical practices. Most podiatrists mix medical, orthopedic, biomechanics and surgical practices. Indeed surgical podiatric principles rest on a base of orthopedic and kinesthetic knowledge.
Job opportunities and description
The US Department of Labor, Bureau of Labor Statistics expects need for podiatrists to rise but slowly because podiatrists tend to have long practice lives, stopping practice when they retire. Podiatrists need a State license that requires the completion of at least 90 hours of undergraduate study, the completion of a four year program at a college of podiatric medicine, and in most states, a postdoctoral residency program of at least one year. Podiatrists are commissioned officers in all the armed services and serve as department heads in the Veterans Affairs system. Practice income is relatively high for most podiatrists.
Colleges and education
There are eight colleges of podiatric medicine. These are governed by the American Association of Colleges of Podiatric Medicine (AACPM). The AACPM describes its mission as to enhance both academic podiatric medicine and the education of future podiatric physicians.
List of colleges of podiatric medicine
Board specialties in podiatry
There are two recognized certifying boards for podiatry. The purpose of board certification is two-fold. Board certification primarily recognizes a level of achievement. For most examinations candidates must prepare cases, sit for written and then oral examinations to become a Diplomate of a board. In effect these are doctors who have chosen a sub-specialty. Although completion of a board does not guarantee competency, it does acknowlege that that candidate has been judged by peers to have a fund of knowledge and competence in a particular area of practice.
The second use for board certifications is so that organizations such as a hospital medical staff, surgicenter, or HMO can make decisions about the skills of the applicant.
To allow doctors of podiatry time to qualify to become diplomates of a board, there is a holding status, board qualified which permits those doctors to practice while waiting to complete the boards. Doctors who have passed their boards may say they are diplomates of the board, are board certified or are certified by a certain board. Those who are awaiting may only call themselves board qualified.
- Podiatric medicine: The certifying board for primary care in podiatry, now combined with the [podiatric orthopedic] board as the American Board of Podiatric Orthopedics and Primary Podiatric Medicine (ABPOPPM).
- Podiatric surgery: The certifying board for surgery in podiatry is the American Board of Podiatric Surgery. Until 2000 there was only a single certification; however now there is an additional certification for ankle surgery. Podiatrists must qualify for this board by completing a two year surgical residency program (three or its equivalent for the ankle certification portion).
See also
External links
US colleges of podiatric medicine
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