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Career As a Podiatrist PDF

31 Pages·2006·0.153 MB·English
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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

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