02/06/2026    Sev Hrywnak, DPM, MD

Why Podiatry Should Pursue Broader Licensure Beyond Foot and Ankle Care

Podiatry has historically focused on foot and
ankle pathology, but the evolving healthcare
landscape demands a wholesale shift in how this
profession prepares its graduates. A limited
license that restricts practice to foot and ankle
care constrains the potential impact podiatrists
can have on population health, collaboration, and
cost-effective care delivery. Here are key reasons
for pursuing planetary/full licensure and broader
scope:

Competitive relevance in a crowded market:
Healthcare professions are expanding scope to meet
comorbidity management and aging populations.
Licenses that affirm competency in a wider set of
musculoskeletal and systemic health issues
differentiate practitioners and attract patients
seeking comprehensive foot-to-knee care in a
single provider.

Integrated care and multidisciplinary teams:
Population health management relies on teams that
coordinate across specialties. A full license
enables podiatrists to participate more fully in
primary care settings, clinics, hospitals, and
accountable care organizations, improving care
coordination for diabetes, vascular disease,
neuropathy, and obesity—conditions with major
lower-extremity implications.

Cost reduction and value-based care: Managing
vascular risk, wound healing, and preventive foot
care at the primary care level can reduce
hospitalizations, amputations, and emergency
visits. A broader license allows podiatrists to
bill for preventive and chronic disease
management, aligning incentives with value-based
models.

Expanded patient access and equity: In many
regions, podiatry services are limited by scope. A
full license can increase access to timely,
comprehensive care, especially in underserved
communities where foot and ankle health signals
broader systemic issues.

Education and training alignment with population
health: Curricula that prepare graduates for full
licensure emphasize epidemiology, data analytics,
preventive strategies, and care transitions. This
equips cohorts to contribute to public health
surveillance and population-level interventions.

Professional resilience and adaptability: The
healthcare workforce is rapidly evolving with
telehealth, AI-assisted diagnostics, and chronic
disease management. A broader license positions
podiatrists to adapt to these innovations and
maintain professional relevance.

Ethical and comprehensive patient care: Patients
often present with comorbidities affecting foot
health. A full licensure model supports holistic
evaluation and treatment planning, improving
outcomes and patient satisfaction.

Global workforce considerations: As healthcare
systems reform toward universal access and
standardized quality, a broader licensure
framework helps podiatrists participate in
international collaborations, research, and
education.

Policy and reimbursement alignment: Payers
increasingly reward comprehensive, preventive, and
coordinated care. Full licensure enables
podiatrists to maximize reimbursement
opportunities for preventive services, wound care,
diabetic foot risk reduction, and vascular
assessments.

Future-proofing the profession: The line between
specialties is blurring. By expanding licensure,
podiatrists can respond to emerging needs without
outsourcing care to other specialists.
Case in point: A diabetic patient with an
ulceration sub second meta-head can be treated by
the podiatric physician with a limited license.
The same patient can be treated by an MD, DO, PA,
NP with a full license and at the same visit
adjust the patient's blood pressure medication and
insulin dosage.

Parity: Podiatry cannot claim educational or
clinical parity with Allopathic and Osteopathic
physicians without presenting factual evidence. In
a recent podiatric journal the author stated, "
For all intense purposes, the end-products of
medical, osteopathic and podiatric educational
processes- MD, DO and DPM degrees, are equivalent
and indistinguishable."

Parity implies equal standing in outcomes, scope,
reimbursement, training, and impact on population
health, which must be demonstrated with data.
Relying on status, prestige, anecdotes or a vote
of parity by the APMA House of delegates, alone
leads to assumptions, not truth. To assert parity,
you need measurable indicators: licensure breadth,
scope of practice, patient outcomes, access to
care, cost-effectiveness, pilot programs and
comparative studies. Without transparent data,
policy decisions risk misallocation of resources
and erosion of trust. Evidenced based claims
ensure credible comparisons and informed workforce
planning.

Implementation considerations:

Curriculum expansion: to cover primary care
skills, systemic risk assessment, and chronic
disease management. Clinical rotations in Ob/Gyn,
Psychiatry, Pediatrics, Internal medicine
Competency-based licensing: with clear milestones
across foot, ankle, and related musculoskeletal
and systemic health domains.

Collaborative practice agreements that define
roles within primary care and specialty teams.
Regulatory reform at state and national levels to
recognize expanded scope and reimbursement.
Most Importantly: All podiatry organizations, from
APMA, CPME, the colleges of Podiatric Medicine,
the state associations and all the boards must
align around one single objective, to secure
plenary licensure which will secure longevity.

In sum, granting podiatric physicians a broader
license supports competitive differentiation,
enhances population health impact, improves access
and value, and ensures the profession remains
resilient in a transforming healthcare system
through the coming years.

Sev Hrywnak, DPM, MD, Chicago, IL

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02/06/2026    Sev Hrywnak, DPM, MD

Why Podiatry Should Pursue Broader Licensure Beyond Foot and Ankle Care

Podiatry has historically focused on foot and
ankle pathology, but the evolving healthcare
landscape demands a wholesale shift in how this
profession prepares its graduates. A limited
license that restricts practice to foot and ankle
care constrains the potential impact podiatrists
can have on population health, collaboration, and
cost-effective care delivery. Here are key reasons
for pursuing planetary/full licensure and broader
scope:

Competitive relevance in a crowded market:
Healthcare professions are expanding scope to meet
comorbidity management and aging populations.
Licenses that affirm competency in a wider set of
musculoskeletal and systemic health issues
differentiate practitioners and attract patients
seeking comprehensive foot-to-knee care in a
single provider.

Integrated care and multidisciplinary teams:
Population health management relies on teams that
coordinate across specialties. A full license
enables podiatrists to participate more fully in
primary care settings, clinics, hospitals, and
accountable care organizations, improving care
coordination for diabetes, vascular disease,
neuropathy, and obesity—conditions with major
lower-extremity implications.

Cost reduction and value-based care: Managing
vascular risk, wound healing, and preventive foot
care at the primary care level can reduce
hospitalizations, amputations, and emergency
visits. A broader license allows podiatrists to
bill for preventive and chronic disease
management, aligning incentives with value-based
models.

Expanded patient access and equity: In many
regions, podiatry services are limited by scope. A
full license can increase access to timely,
comprehensive care, especially in underserved
communities where foot and ankle health signals
broader systemic issues.

Education and training alignment with population
health: Curricula that prepare graduates for full
licensure emphasize epidemiology, data analytics,
preventive strategies, and care transitions. This
equips cohorts to contribute to public health
surveillance and population-level interventions.

Professional resilience and adaptability: The
healthcare workforce is rapidly evolving with
telehealth, AI-assisted diagnostics, and chronic
disease management. A broader license positions
podiatrists to adapt to these innovations and
maintain professional relevance.

Ethical and comprehensive patient care: Patients
often present with comorbidities affecting foot
health. A full licensure model supports holistic
evaluation and treatment planning, improving
outcomes and patient satisfaction.

Global workforce considerations: As healthcare
systems reform toward universal access and
standardized quality, a broader licensure
framework helps podiatrists participate in
international collaborations, research, and
education.

Policy and reimbursement alignment: Payers
increasingly reward comprehensive, preventive, and
coordinated care. Full licensure enables
podiatrists to maximize reimbursement
opportunities for preventive services, wound care,
diabetic foot risk reduction, and vascular
assessments.

Future-proofing the profession: The line between
specialties is blurring. By expanding licensure,
podiatrists can respond to emerging needs without
outsourcing care to other specialists.
Case in point: A diabetic patient with an
ulceration sub second meta-head can be treated by
the podiatric physician with a limited license.
The same patient can be treated by an MD, DO, PA,
NP with a full license and at the same visit
adjust the patient's blood pressure medication and
insulin dosage.

Parity: Podiatry cannot claim educational or
clinical parity with Allopathic and Osteopathic
physicians without presenting factual evidence. In
a recent podiatric journal the author stated, "
For all intense purposes, the end-products of
medical, osteopathic and podiatric educational
processes- MD, DO and DPM degrees, are equivalent
and indistinguishable."

Parity implies equal standing in outcomes, scope,
reimbursement, training, and impact on population
health, which must be demonstrated with data.
Relying on status, prestige, anecdotes or a vote
of parity by the APMA House of delegates, alone
leads to assumptions, not truth. To assert parity,
you need measurable indicators: licensure breadth,
scope of practice, patient outcomes, access to
care, cost-effectiveness, pilot programs and
comparative studies. Without transparent data,
policy decisions risk misallocation of resources
and erosion of trust. Evidenced based claims
ensure credible comparisons and informed workforce
planning.

Implementation considerations:

Curriculum expansion: to cover primary care
skills, systemic risk assessment, and chronic
disease management. Clinical rotations in Ob/Gyn,
Psychiatry, Pediatrics, Internal medicine
Competency-based licensing: with clear milestones
across foot, ankle, and related musculoskeletal
and systemic health domains.

Collaborative practice agreements that define
roles within primary care and specialty teams.
Regulatory reform at state and national levels to
recognize expanded scope and reimbursement.
Most Importantly: All podiatry organizations, from
APMA, CPME, the colleges of Podiatric Medicine,
the state associations and all the boards must
align around one single objective, to secure
plenary licensure which will secure longevity.

In sum, granting podiatric physicians a broader
license supports competitive differentiation,
enhances population health impact, improves access
and value, and ensures the profession remains
resilient in a transforming healthcare system
through the coming years.

Sev Hrywnak, DPM, MD, Chicago, IL