Podiatrists, or doctors of podiatric medicine, are special-treating disorders and diseases of the foot and lower leg. The most common problems that they treat are bunions, calluses, corns, warts, ingrown toenails, heel spurs, arch problems, and ankle and foot injuries. Podiatrists also treat deformities and infections. A podiatrist may prescribe treatment by medical, surgical, and mechanical or physical means.
The human foot is a complex structure, containing 26 bones plus muscles, nerves, ligaments, and blood vessels. The 52 total bones in your feet make up about one-fourth of all the bones in your body. Because of the foot’s relation to the rest of the body, it may be the first body part to show signs of serious health conditions, such as diabetes or cardiovascular disease. Podiatrists may detect these problems first, making them an important part of the health care team. There are approximately 10,000 podiatrists employed in the United States.
Podiatrist Career History
Doctors who treat feet first began making rounds in larger U.S. cities in the early 1800s. During that century, podiatrists were called chiropodists, after the Greek word chiropody. Chiropody refers to the study of the hand and foot. Most other physicians and surgeons of that era ignored the treatment of foot disorders.
The first offices devoted exclusively to foot care were established in 1841. The chiropodists of this period had difficulty competing with physicians in the care of ingrown toenails. The law read that a chiropodist had no right to make incisions involving the structures below the true skin. Treatments included removal of corns, warts, calluses, bunions, abnormal nails, and general foot care. The term chiropody was eventually replaced by podiatry, likely because chiropody dealt mainly with the foot.
Modern podiatric medicine emerged in the early 1900s. More recently, surgery has become a necessary part of podiatric care. Today, the skills of podiatric physicians are in increasing demand, because foot disorders are among the most common and most often neglected health problems affecting people in the United States.
Podiatrist Job Description
Podiatrists see patients who are having problems with their feet. To determine the nature of foot problems, podiatrists talk with patients and visually examine their feet. Sometimes, in order to make diagnoses, podiatrists take X rays, perform blood tests, or prescribe other diagnostic tests.
Podiatrists treat many common disorders, including corns, calluses, warts, ingrown toenails, and athlete’s foot. Bunions, deformed toes, arch problems, and cysts are other examples of common foot disorders treated by podiatrists. Among the relatively uncommon foot disorders treated by podiatrists are infections and ulcers related to diabetes. Podiatrists also treat injuries to the foot and ankle, such as breaks and sprains.
The method of treatment varies considerably depending on the patient’s problem. For some patients, podiatrists prescribe physical therapy sessions or give instructions on how to perform certain exercises. For other patients, podiatrists prescribe medications, either to be injected, taken orally, or applied in ointment form.
Some foot disorders, such as ingrown toenails and warts, may require minor surgical procedures. Podiatrists typically perform these kinds of procedures in their offices. Other disorders require more extensive surgery, for which patients may be anesthetized. For this kind of surgery, a podiatrist must use a sterile operating room, usually either in a hospital or an outpatient surgery center.
Another responsibility of podiatrists is to fit patients with corrective orthotic devices, or orthoses, such as braces, custom-made shoes, lifts, and splints. For a patient who needs an orthotic device, a podiatrist makes a plaster cast of the patient’s foot, determines the measurements and other characteristics needed to make the device, and sends the information to a manufacturing plant called a brace shop. When the device is complete, the podiatrist fits it to the patient and makes follow-up evaluations to ensure that it fits and functions properly. The podiatrist may also make any modifications or repairs that are needed.
Podiatrists frequently treat patients who have injured their feet or ankles. A podiatrist may wrap, splint, or cast a foot to keep it immobile and allow it to heal. In more complicated cases, podiatrists may perform corrective surgery.
A key responsibility of podiatrists is recognizing serious health disorders that sometimes show up first in the feet. For example, diabetics are prone to foot ulcers and infections because of their poor blood circulation. Symptoms of kidney disease, heart disease, and arthritis also frequently appear first in the feet. A podiatrist must be alert to symptoms of these diseases in his or her patients and refer them to the appropriate doctors and specialists.
Podiatrists provide foot care in private offices, hospitals, ambulatory surgical centers, skilled nursing facilities, and treatment centers or clinics. They also work in the armed forces, government health programs, and on the faculty in health professional schools.
Podiatrist Career Requirements
High school students should take as many courses in biology, zoology, and inorganic and organic chemistry, and as much physics and math as possible to determine whether they have an interest in this field. The profession requires a scientific aptitude, manual dexterity, a good business sense, and an ability to put patients at ease.
A minimum of 90 semester hours of prepodiatry education is required for entrance into a college of podiatric medicine. Over 95 percent of podiatric students have a bachelor’s degree. Undergraduate work should include courses in English, chemistry, biology or zoology, physics, and mathematics.
There are eight accredited colleges offering the four-year course leading to a Doctor of Podiatric Medicine (D.P.M.). All colleges of podiatric medicine require the Medical College Admission Test (MCAT) as part of the application procedure.
The first two years in podiatry school are spent in classroom and laboratory work in anatomy, bacteriology, chemistry, pathology, physiology, pharmacology, and other basic sciences. In the final two years, students gain clinical experience in addition to their academic studies.
To practice in a specialty, podiatrists need an additional one to three years of postgraduate education, usually in the form of an office- or hospital-based residency.
Certification or Licensing
There are three subspecialties of podiatric medicine recognized by the American Association of Colleges of Podiatric Medicine: surgery, orthopedics, and primary medicine. Although any licensed podiatrist is considered qualified to address all areas of podiatric medicine, certification as a specialist in one of these three areas requires completion of specialized training. Contact the American Board of Podiatric Orthopedics and Primary Podiatric Medicine and the American Board of Podiatric Surgery for more information on specialty board certifications.
Podiatrists must be licensed in all 50 states, the District of Columbia, and Puerto Rico. A state board examination must be passed to qualify for licensing. Some states allow the exams to be taken during medical podiatric college, from the National Board of Podiatric Examiners, as a substitute for the state boards. About two-thirds of the states require applicants to serve an additional residency of at least one year.
The podiatrist must have a capacity to understand and apply scientific findings, the skill to manipulate delicate instruments, and, for those with their own practices, good business skills. Most importantly, they should like all kinds of people and have a sincere desire to help those needing care and attention.
Exploring Podiatrist Career
If you are interested in podiatric medicine you should arrange an interview with a trained podiatrist. To gain experience, you may obtain a summer job or volunteer your time in a clinic specializing in podiatric medicine.
Approximately 10,000 podiatrists are employed in the United States. A newly licensed podiatrist might begin working in a multispecialty group, a clinic, a hospital, or in an established solo or group podiatric medical practice. There are jobs for podiatrists in the armed forces, too. Most offices are found in large cities. The majority of podiatrists set up practices in the eight states where the colleges of podiatry are located (California, Florida, Illinois, Iowa, New York, Pennsylvania, Arizona, and Ohio). Other states with a high number of podiatrists are Delaware, Montana, and Pennsylvania.
College career services offices are usually the place to start the job search. Checking the classifieds in professional journals and applying directly to area clinics and practices are other ways to uncover job leads.
Most podiatrists provide all types of foot care. However, some specialize in such areas as surgery (foot and ankle), orthopedics (bone, muscle, and joint disorders), podo-pediatrics (children’s foot ailments), podogeriatrics (foot disorders of the elderly), or sports medicine (treating athletes who have sustained foot or ankle injuries).
A podiatrist can also advance his or her career by becoming a professor at a college of podiatric medicine or the head of a hospital’s podiatric department.
Podiatrists had median annual earnings of $100,550 in 2005, according to the U.S. Department of Labor. Salaries ranged from less than $43,990 to $145,600 or more annually. Podiatrists who worked in the offices of other health practitioners had annual mean salaries of $114,160 in 2005, while those employed by general medical and surgical hospitals earned $84,950. Podiatrists who are self-employed must provide for their own health insurance and retirement.
Most podiatrists work independently in their own offices or in a group practice. The workweek is generally 40 to 44 hours per week. Podiatrists usually can set their own hours to coordinate office hours with hospital staff time or teaching schedules.
Podiatrist Career Outlook
Demand for podiatrists’ skills is rapidly increasing, as the profession gains recognition as a health care specialty and as foot disorders become more widespread. More people are involved in sports and fitness programs, which can cause foot problems or make existing foot problems more apparent or unbearable. Also, a rapidly growing aging population, many of whom may have neglected their feet, will seek podiatric care. The demand for podiatric services is expected to grow even more as health insurance coverage for such care becomes widespread. Although foot care is not ordinarily covered by health insurance, Medicare and private insurance programs frequently cover acute medical and surgical foot services, as well as diagnostic X rays, fracture casts, and leg braces. Many HMOs and other prepaid plans provide routine foot care as well.
The outlook for podiatrists through 2014 is favorable throughout the country, but especially in the South and Southwest, where a shortage of practitioners exists.
Competition for residency positions is strong. If a state’s licensing board requires residency, as two-thirds of the states currently do, it must be done before a podiatrist can begin practicing. With the heavy competition for these posts, it is unlikely that students with average grades will be able to secure employment in those states.