09/05/2023    Lawrence Rubin, DPM

The Increasing Podiatric Abandonment of “Routine Foot Care”

Many podiatrists are abandoning the practice of
palliative, “routine foot care” because their
education and residency training was focused on
performing surgical procedures, not cutting corns
or grinding fungus toenails – even if many
potential patients, particularly the elderly and
those with neuropathy and artery disease, need
those “routine foot care” services to be able to
keep their legs.

Understandably, more and more patients who want
routine care cannot find a podiatrist in their
locale who provides it. And, the word is getting
out in communities that there are now pedicurists
in nail salons who will use grinding burrs and
simple nail trimming tools to thin-down thick
toenails, corns, and calluses. A pedicurist “nail
technician” is licensed to cut finger and toenails,
and is not expected to be an onychomycosis
diagnostician.

Aging itself can be responsible for thickened
nails. So it is not likely that any reactive legal
actions by any podiatry group will stop licensed
“nail technician” pedicurists from building large
clienteles of clients for “thick nail cutting and
thinning,” as well as abrasive burr reduction of
callused thick skin. These clients would ordinarily
have gone to a podiatrist – and if they had, maybe
some infections from non-sterilized nail nippers
may have been prevented.

Looking at this as part of a potentially growing
problem of continuing loss of podiatric foot care
exclusivity, unlike in the past, there is no longer
any one service provided by podiatrists that cannot
be legally practiced by some other well trained
provider or technician. This is a definite negative
factor as podiatry competes with other providers in
a new value-based care environment seeking to give
patients more health care choices and opportunities
at least possible cost to the health care system.

Hopefully, podiatric organizations such as the
American Podiatric Medical Association are working
on strategies that protect podiatry’s rightful
ability to provide optimal preventive and
therapeutic foot care. It is not impossible for a
medical specialty to cease to exist. What ever
happened to proctology?

Lawrence Rubin, DPM, Los Vegas, NV

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