07/15/2024    James DiResta, DPM, MPH

APMA Members Asked to Vote on Revised Definition of Podiatry (Kathleen Neuhoff, DPM)

I read with great interest the recent comments
concerning the revised definition of podiatry
specifically as to the removal of the "treatment of
the local manifestation of systemic disease".
Elimination of this phrase is absolutely paramount
for the survival of podiatry. Increasing our scope
by inching our way proximal from the tibial
tuberosity is not the answer.

If we have increased our level of education to that
of a true single track medical school which
provides us an equal foundation to our allopathic
and osteopathic colleagues during our 1st and 2nd
year curriculum in the anatomical sciences and body
systems course of study and we then provide a
carefully planned and more focused series of
clerkships and classes during our 3rd and 4th years
that emphasizes the diagnosis and treatment of
systemic illnesses in addition to surgery and
general podiatry training we ought to be prepared
to do a heck of a lot more than what we are
presently doing in clinical practice. Our graduates
follow their four years of podiatric medical school
with a minimum of three years of residency training
in medicine and surgery.

I would hope that our graduates could move forward
initiating treatment for a condition that may be
delaying a surgery like a UTI. Patients who present
with local manifestation of system illnesses in the
future should expect the podiatrist to initiate
treatment for gout, type II diabetes, hypertension
etc... as this should be the natural scope of
practice for a well-rounded and newly trained
podiatrist. Knowing when to refer and consult with
medical colleagues is paramount but sending all of
these patients out to specialists is neither
necessary, cost effective or in their best
interest. Our resident graduates should be able to
compete with a PA or a NP in following an algorithm
for prescribing these treatments and if not then
something in our training is severely lacking.

It's unfortunate but several of our older
colleagues are holding our newly trained
podiatrists back as they themselves are
uncomfortable expanding their own scope of
practice. We are not training future diabetologists
or neurologists but we can at least initiate
workups and prescribe treatments for common
systemic diseases that we encounter daily. We owe
this to our patients, our profession and our
healthcare system. It's time to let go and move our
profession forward. Once we do this, achieving
parity with our DPM degree or moving our degree to
a DO or MD will be achieved.

James DiResta, DPM, MPH, Newburyport, MA

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