Career As a Podiatrist

31 Pages·2006·0.153 MB·English

by  Institute for Career Research

CAREER AS A
PODIATRIST
Institute Research Number 310
ISBN 1-58511-310-7
DOT Code 079.101-022
O*NET SOC Code 29-1081.00
CAREER AS A PODIATRIST
DOCTOR SPECIALIZING IN FOOT HEALTHCARE
THEMAJORITYOFAMERICANS– ABOUTTHREE-QUARTERSOFUS–EXPERIENCE
problems with our feet at some time in our lives. There are many
minor problems like corns and ingrown toenails, and more serious
deformities, infections or injuries involving our feet. Podiatrists
specialize in the prevention and treatment of healthcare conditions of
the foot and ankle from the simplest to the most complex.
In fact, Americans neglect their feet for the most part, even
though that neglect may lead to often-painful conditions. As baby
boomers age, and more and more of us play sports or exercise
regularly, the need for foot healthcare professionals is increasing.
Today, over 14,000 practicing doctors of podiatric medicine care
for patients throughout the United States. Often operating out of
medical offices as solo practitioners (a physician who works alone, not
sharing the practice with other physicians), podiatrists treat patients of
2
all ages with all types of foot and ankle conditions. Once trained and
certified, they may also operate on patients for these conditions in a
surgery center or hospital.
Others work in group practices formed by several podiatrists or as
part of a physician office with several medical specialties. In any case,
the podiatrist remains largely self-employed. On the other hand, some
podiatrists work for public health agencies or other health care
providers as employees.
Becoming a podiatrist demands time and a thorough education.
Every state requires a license to practice podiatry and the
accompanying medical/podiatric education. Only seven colleges of
podiatric medicine operate in the United States and those interested in
podiatry as a career must meet the criteria for admission. The seven
accredited colleges grant the degree of Doctor of Podiatric Medicine
(DPM).
Once podiatry students graduate and enter the field, they become
licensed in the state in which they will practice. After setting up
podiatry practice, they continue to receive training. In fact, most states
require continuing education to maintain podiatry licenses.
The medical field offers a number of opportunities to those with
the right skills and training. Economic factors – how podiatrists and
other healthcare providers get paid for their services – can change,
especially affected by managed care and health insurance provisions.
But the need for medical care remains constant and will build in the
coming decades.
The American Podiatric Medical Association (APMA) reports a
strong and growing role for podiatrists. The organization works with
its members to promote the profession and to educate the public on
foot health. In addition, the APMA works with its members and
colleges to recruit the top caliber professionals to join the field.
While this career requires hard work for entry, once in the
profession, most podiatrists – particularly younger practitioners –
report that they enjoy a more balanced lifestyle and less stressful
practice than most medical providers. At the same time, they enjoy
excellent salaries.
As the need for better foot health continues in our country, the
demand for qualified podiatrists will expand. And the stature of these
healthcare professionals as essential members of the medical
community should continue to improve.
3
HOW TO BEGIN
FINDOUTMOREABOUTBECOMING APODIATRISTSOYOUCANCHOOSETHERIGHT
educational path as soon as possible. You’ll most likely need a
bachelor’s degree to gain entrance to a podiatric school of medicine.
You’ll also need to pass a medical college admission test that will
gauge your overall knowledge of medical topics.
First, decide if you have the patience, skills and desire to attend
school a minimum of at least eight additional years after graduating
from high school before beginning your career. Assess your current
likes and dislikes. Do you enjoy school, especially classes like biology
and chemistry? Are you able to handle the financial side of many years
of school, with the help of scholarships, savings, employment or
family?
You can probably complete your undergraduate education at a
school of your choosing in your home area, but will you mind moving
away to go to one of the accredited schools that offer degrees in
podiatric medicine?
Once ready to enter the field, you can work just about anywhere,
depending on the number of podiatrists already in a community or the
type of employment you want. Since many podiatrists are
self-employed, you’ll want to make sure you’re comfortable handling
the business side of the career as well.
Go online to find out more about podiatry from the APMA and
podiatric schools. Learn a little more about diseases of the foot from
APMA’s Web site and brochures, as well as from other consumer
medical Web sites. Search podiatry career listings and see what types
of jobs are currently open, as well as their locations and required skills.
If working with people’s feet seems different or even unpleasant
to you, consider the benefits of the job and the importance foot
health and comfort play for people of all ages and walks of life. You’ll
work closely with other medical providers too, so be sure you can
enjoy working with colleagues and can understand a wide range of
medical conditions.
The best way to learn about a career in podiatry is to visit with a
podiatrist near you. Most of the professionals in your community will
probably be happy to meet with you, show you around their offices,
and even let you shadow them on the job. If you can’t find a podiatrist
to talk with in your area, contact the APMA.
4
HISTORY OF PODIATRY CAREERS
COMPAREDTOTHELONGHISTORYOF THEMEDICALPROFESSIONASAWHOLE,THE
discipline of podiatry is relatively young. However, people have always
needed foot care and historians have traced early records of foot care
to ancient civilizations of the Greeks, Assryo-Babylonians and
Egyptians.
Advice about foot care is recorded as early as 2500 BC in ancient
Egyptian tombs. The famous Ebers Papyrus, estimated to date to
about 1500 BC, promotes applying olive oil and cow fat to corns.
Biblical passages also refer to ministrations of the foot.
As early as 60 BC, Hikesios of Myrna employed plaster
preparations to treat corns. The writings of Hippocrates, dating from
about 460 – 377 BC, refer to clubfoot and calluses. By around 615 AD,
Paul of Aegina describes a surgical approach to corns and calluses.
By the 14th century in northern Europe, the Guild of
Barber-Surgeons was established. The guild’s members pulled teeth,
did bloodletting, cut corns and made preparations for pain relief.
Scholars guess that the surgeon, dentist and podiatrist all evolved
from this guild. By the 1700s, medical specialization began in France.
A 1714 textbook on dermatology included a chapter on diseases of
the hands and feet including extensive mention of warts and corns.
A French surgeon named Rousselot began to specialize in foot
care, writing the first book on the subject called Memoire sur les cors
des pieds (Dissertation on Corns of the Feet) in 1755. Interestingly,
corn cutting was still not the practice of physicians and surgeons at
that time, since they considered the procedure beneath their dignity.
These foot conditions were treated mostly by corn cutters who likely
combined the trade with tooth pulling.
A German named Heyman Lion settled in Edinburgh, England in
the latter half of the 18th century. He published a book in 1802 titled
Treatise Upon Spinae Pedum (the term he used for corns). In 1826,
Lewis Durlacher, who called himself a surgeon-chiropodist,
demonstrated his method for treating ingrown toenails at the Hospital
for Surgery in Bath, England. A full account of the technique appeared
in The Lancet, a respected English medical journal, in the same year.
5
Most consider Durlacher the founder of chiropody, which later
became known as podiatric medicine. He wrote a book in 1845 titled
A Treatise – Corns, Bunions, the Diseases of Nails and the General
Management of the Feet. The book contained the first descriptions of
several foot conditions, including infected ingrown nails and plantar
warts.
In the United States in 1840, members of the family of Nehemiah
Kenison were traveling around New Hampshire treating the feet of mill
employees in cotton and shoe factories. He was later elected to the
New Hampshire state legislature and given the honorary title of
“doctor.” In New York in 1843, John Littlefield opened an office and
became the first practitioner in the United States to use the
chiropodist designation.
In 1879, the Journal of the Illinois State Medical Society published
the first podiatric bibliography entitled The Chiropodist. In 1895, a
small group of men founded the Pedic Society of New York and
petitioned its legislature for a bill that led to the enactment of the first
law regulating the field. By 1908, New Jersey legally regulated
chiropody practice.
George Erff was president of the Pedic Society of New York and in
1910, he and 166 members of the society proposed that podiatric
educational facilities be established. They also proposed a code of
ethics and examinations for candidates. In 1912, the National
Association of Chiropodists (NAC) began. NAC was the forerunner of
the American Podiatric Medical Association.
The first school for podiatry was established in New York in 1911.
The New York School of Chiropody was the forerunner of the New
York College of Podiatric Medicine, one of only seven such colleges
offering the DPM today. Shortly after that, less than a year later, the
Illinois College of Chiropody and Orthopedics was established.
Eventually, the school became the Scholl College of Podiatric Medicine,
which also still operates today.
Soon, other colleges opened around the country. The New York
Board of Medical Examiners drafted successful legislation allowing for
licensing of chiropodists by the New York State Board if the candidate
graduated from a chiropody school headed by a medical practitioner.
6
Soon, the NAC recommended that every state establish laws
regulating the practice of chiropody and that chiropodists should not
use the word “doctor” on their cards as it might antagonize
physicians. In 1918, the NAC formed a Council on Education, the
forerunner of the Council on Podiatric Medical Education, the body
that accredits all United States podiatric medical schools and residency
programs. In the same year, the term “podiatry” was coined, and the
New York School of Podiatry raised its admission criteria to require a
high school diploma.
By 1934, the Council on Education required a three-year full-time
curriculum plus one year of preprofessional college. The American
College of Foot Surgeons was formed in 1942. A Michigan State
Supreme Court ruling paved the way for podiatrists to use
postoperative analgesics, allowing them to perform more surgery.
For many years, podiatrists struggled for equal rank to physicians
in the armed services and for permission to perform a wider range of
more complex procedures. In 1958, podiatry officially became the
name of the profession. The National Board of Podiatric Medical
Examiners administered its first examination in 1962. And by 1964,
podiatric medical schools now granted only the degree of Doctor of
Podiatric Medicine (DPM).
A few years later, health insurance plans began paying for certain
podiatric services. In 1967, the Joint Commission on Accreditation of
Healthcare Organizations (JCAHO), the body that sets quality
standards for hospitals and inspects them to grant accreditation,
advanced the profession greatly. Their standards that year first allowed
podiatrists to operate in hospitals and nursing homes without the
presence of a gowned, scrubbed MD.
Throughout the profession’s course of history, podiatrists have
fought to gain acceptance in line with other physicians. Hospital
medical staffs and physicians (MDs) have debated whether or not
podiatrists should be recognized as licensed medical practitioners.
Many health maintenance organizations (HMOs) have debated the
issue as well. In 1977, the American Medical Association (AMA)
recognized the right of qualified podiatrists to hold privileges at
hospitals.
In 1978, passage of the Medical College Admissions Test (MCAT)
became required for acceptance to podiatric medical schools, and the
schools also began requiring a minimum of three years of college for
entry.
7
The evolution of the podiatry profession, especially in the past 30
years, has led to podiatrist licensing and the creation of a physician
specialty with education and training focusing on one anatomic area,
similar to other medical specialties. Disputes still arise within the
medical profession about the equality of podiatry to MD specialties,
but these concerns may arise purely from an economic or competitive
standpoint.
Over
the years, improved education programs and
ongoing discussions between medical and podiatric
medical groups, as well as better recognition from
government and those who pay for medical care have
advanced podiatry services. The profession and its
acceptance by patients and others will no doubt
continue to progress.
WHERE PODIATRISTS WORK
MANYPODIATRISTSWORKINPRIVATE PRACTICES.THEIROFFICESMAYBELOCATED
near a community’s major hospital or other physician offices. Some
podiatrists may practice in other locations that are convenient to a
certain group of patients or at a distance from competing podiatrists.
So in effect, podiatrists work in just about every town with a
population large enough to support a full-time practitioner.
The podiatrist leases or owns office space and opens a practice.
There will be several rooms in which to see patients, a waiting and
reception area and an office for the doctor. Some may also have a
room where they perform various procedures on patients’ feet.
These offices can be located in any community depending on the
need for a podiatrist. Sometimes, a podiatrist may take over the office
of a retiring professional or join one as a partner in an existing
practice. While most of the podiatrist’s work takes place in the office,
there may also be travel to local hospitals or nursing homes to visit
patients.
8
Other podiatrists join existing practices consisting of multiple
physician specialties. A large multi-specialty practice or clinic might
have a podiatrist as an employed or partner physician to complement
the care of other specialties. For example, endocrinologists care for
patients with diabetes. Many chronic diabetes patients develop
problems in their feet, some so serious that they require amputation.
In that case, the podiatrist works with the endocrinologist as part of a
treatment team caring for the diabetic patient to prevent this serious
complication.
Sometimes, the practice simply wants to provide the type of care
podiatrists provide within their office, much like they would have an
obstetrician on board for referral of pregnant women or perhaps a
cardiologist for patients with heart trouble. An increasing number of
orthopedic physicians are hiring or partnering with podiatrists to work
together caring for patients with various foot and ankle injuries or
conditions. Sports medicine practices are especially right for this kind
of coordinated approach. Most MDs today recognize how specialists
can complement each others’ expertise and work together.
Some podiatrists do not work in a private practice, but are
employed full time by a hospital. They may spend more time
performing surgeries on patients’ feet and ankles or seeing patients
after their operations on the hospital floors. The hospital might be a
privately owned facility with a board of directors and medical staff or
it may be part of a larger nonprofit or university based hospital
system.
Some hospitals are operated by the government. A podiatrist
might be employed by a veteran’s administration (VA) hospital or an
Indian hospital. Sometimes, health maintenance organizations (HMOs)
employ podiatrists to care for those patients enrolled in their health
plans. The United States Public Health Service also employs physicians
to care for patients enrolled in the public health system. Some
podiatrists also work for the Armed Forces, serving in military hospitals
in the United States and abroad.
9
WHAT PODIATRISTS DO
PEOPLERELYONTHEIRFEETFORINDEPENDENCEATALLAGESANDOFTENTAKEFOR
granted how much they depend on them to get through every aspect
of the day. Some people rely on their feet more heavily as they
participate in work which involves standing all day or recreational
activities and sports.
Podiatrists are the only medical professionals trained exclusively to
provide total care of the foot. The foot is a complex anatomical
structure that provides humans with both mobility and stability. We
balance our bodies on our feet, and they carry us where we want to
go. Those who are on their feet too much often punish them with
overuse. More and more, Americans need the help of a podiatrist to
prevent and treat foot problems from stress, injury and various
diseases and abnormalities.
A total of 26 bones make up each foot. Amazingly, the 52 bones
in our two feet make up about one-fourth of all the bones in our
bodies. In addition to bones, 33 joints, 112 ligaments, and a complex
network of tendons, blood vessels and nerves form the foot.
Podiatric physicians care for patients of all ages. The most
common types of foot disorders they treat include:
Bunions
A bunion is an enlargement of the joint at the base of the big toe
that forms when the bone or tissue at the big toe joint moves out of
place.
Heel pain and heel spurs
Heel pain can result from gait abnormalities or a number of other
causes. Heel spurs are bony growths on the underside of the heel
bone that result from strain on the muscles and ligaments of the foot.
Hammertoes
A hammertoe is a bending of the toe at the first joint caused by
an abnormal balance of the muscles in the toes.
Neuromas
These are painful conditions also called “pinched nerves.” A
number of factors can cause them, including trauma, improper
footwear and repeated stress on the foot.
10