From: James DiResta, DPM, MPH
Not withstanding the risks and concerns expressed by Dr. Jacobs in treating our patients with recurring gout, I do feel that treating gout, including the prescribing of xanthine oxidase inhibitors, is within the scope of practice of every podiatrist. I feel the legal ramifications of stating this is outside our scope is simply dangerous in this forum. There is an excellent webinar for APMA members to learn more on the treatment of gout: The Illusion of Simplicity in the APMA online learning center.
Not every podiatrist is going to feel comfortable or capable in treating all conditions of the foot and ankle as there are risks in everything we do and treat. You can be unfortunate enough to have a patient suffer from renal failure after prescribing a course of Bactrim or a patient that suffers a ruptured Achilles tendon after prescribing a quinolone. I often will monitor my patient's renal function when I have them on long acting NSAIDs.
Most treatments are not without some level of risk. Denying patients treatment when we know what to do and how to manage them and be alerted to adverse issues is part of every podiatric medical practice. The days of sending everything back to the primary care provider, nowadays often a PA or NP, will keep us practicing as glorified pedicurists.
James DiResta, DPM, MPH, Newburyport, MA
