From: Steven Kravitz, DPM
The ability for podiatrists to treat systemic disease affecting the lower extremity, especially the leg and foot is generally accepted in the medical community based on our current level of training. The question pertains more to the point of the amount of systemic treatment required by the specific case.
Generally speaking, good quality practice requires podiatrists to have good general knowledge of systemic disease affecting the lower extremity. This does not mean that we have to independently treat these conditions. I generally referred neuropathy, vascular disease, and similar cases to appropriate specialists, and generally, cases requiring relatively simple treatment such as various medication, etc. were referred back to me to monitor and follow up. Podiatrists, as all practicing physicians, are not necessarily required to fully treat everything...
Editor's note: Dr. Kravitz's extended-length letter can be read here.
RE: Podiatrists Treating Systemic Conditions Affecting the Foot
From: Daniel Chaskin, DPM
In different states, podiatrists are licensed to carry out physical exams that involve ordering tests and other examinations alongside foot care treatments. The APMA and local podiatry groups should advocate for the licensing of podiatrists to manage all systemic conditions linked to any foot condition. The podiatric medical colleges offer a solid base of studies to support this argument. I recall that NYSPMA offered classes in anatomy, neuroanatomy, biochemistry, histology, pathology, internal medicine, and emergency medicine, etc.
If nurse practitioners have the authority to treat the whole body, podiatrists should also have the authority to treat any systemic condition that causes foot symptoms. If nurse practitioners do not remove a patient's shoes or socks during an examination and a podiatrist does, that podiatrist should be the one authorized to treat systemic conditions related to foot symptoms, since the feet are likely to be examined during every follow-up appointment. Patients are protected because a podiatrist’s code of conduct includes not independently treating conditions they lack current competence to treat.
Daniel Chaskin, DPM, Ridgewood, NY
