01/21/2025    Richard M. Maleski, DPM, RPh

Why The Podiatry School Applicant Pool is So Small (Elliot Udell, DPM)

I read with interest the many opinions on the
relative lack of interest in Podiatry school, as
evidenced by the low number of applicants compared
to other medical programs. I think that all the
opinions expressed are valid. I'm sure there is no
one reason for this lack of interest. It is true
that some pre-med students don't know about
podiatry, but I believe it is also true that many
pre-med students DO know about podiatry, and don't
want to spend a large portion of their day simply
cutting toenails.

We all know that nail care is important,
especially in certain patient populations. But we
also know that cutting/trimming/debriding nails
doesn't require an extensive, rigorous and
expensive 4-4-3 training regimen. Understanding
and recognizing pathologies as manifested in nail
deformities, and knowing how to treat those
deformities is absolutely important and demands
the well-trained podiatrist.

Once the diagnosis is made and the treatment plan
has been formed, routinely
cutting/trimming/debriding the nail no longer
requires the 4-4-3 trained professional. Medical
and /or surgical treatment requires the hands- on
attention of the podiatrist, routine trimming and
debridement requires the SUPERVISION, not the
hands-on treatment, of the podiatrist. Dental
hygienists, pharmacy, physical therapy, nursing
assistants /technicians all provide the ancillary
services so that their respective professionals
can more efficiently spend their time and energy
in the more rigorous aspects of patient care. The
same should hold true for podiatrists.

Society spends a lot of money to educate and train
podiatrists. Society expects podiatrists to use
that money wisely and efficiently. Performing a
task that virtually every person has learned to do
as a child is not efficient use of a highly and
expensively trained podiatrist. That is why the
trimming and debridement codes are so poorly
reimbursed as opposed to E&M and other surgical
codes.

I believe one or the main focuses of our
profession should be to legislate that DPMs are
allowed to supervise such care, and still be
reimbursed. I understand that that is not the case
in most states currently. Until we get legislation
like that passed I'm afraid Podiatry will not look
very attractive to most pre-med students.

Richard M. Maleski, DPM, RPh, Pittsburgh, PA

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