04/15/2026    Bob Smith, DPM, MSc, RPh

Podiatrists and Chiropodists Move the World with Their Best Foot Forward

Last evening, I was reading my LinkedIn account
and came across a well summarized, hopeful, and
inspiring message from Dr. Patrick DeHeer,
President of APMA describing his keynote speech:
From Purpose to Proof: Defining and Advancing
Podiatry Worldwide. My hope is that perhaps I may
someday read the transcript of his keynote
address. Further he wrote describing his belief
system: “our future will be determined by how we
describe ourselves. What we can prove with data
and how we lead.”

I definitely concur and applaud this statement.
As student, resident, podiatrist, nurse, allopath,
osteopath, pharmacist, and paramedic who I have
lectured, presented, and written in the classroom,
conference, or in the field know very well my
position on medication ordering, prescribing, and
dispensing that our licenses direct our scope but
we are all held at the standard of care of
responsible use of therapeutics. As I have summed
up many times this is my belief of “pharmaceutical
utilization parity”.

I am very familiar with and support FIP—
International Federation of Podiatrists by first
researching the art of prescribing and ordering
opioid analgesics by podiatrists and or
chiropodists.I began this research by reaching out
to the representatives of each member country in
FIP and then contacting the country’s Patient
Safety Authority, Medical Products Agency,
Country’s Society of Podiatry, Directors of
Health, and the country’s Medical Secretary’s
General.

Sadly, these responses all relayed the same
message: podiatrists or chiropodists healthcare
providers do not have the legal authority to
prescribe opioid analgesics and in some cases no
legal authority to prescribe other prescription
medications. I will acknowledge that these
responses were obtained in 2024. If one was to
electronically search an information engine today
some misleading information will appear that I can
only attribute to artificial intelligence.

I strongly believe that the way a society treats
pain either with pharmaceutical agents or non-
pharmaceutical therapies defines their humanity.
Armed with the responses I began working on a plan
with educational, practical, and mentor components
to form a rational strategy for having mostly
country health ministers and license physicians
and dentists to allow for a creative method to
shrink the gap between practice disparities when
ordering, prescribing, monitoring, and dispensing
opioid analgesics worldwide among podiatrists and
chiropodists.

Over the last 45 years, as a pharmacist as well as
a podiatrist, and a pedorthist, I have been
involved in discussions and initiatives to enhance
pharmacists and pedorthists to be allowed to
enhance their abilities legally with the authority
boards responsible with defining a profession
legally allowed skills. During the 1980s and
1990s, Florida pharmacists were allowed to suggest
Rx-OTC products from an approved list. Then
Florida consultant pharmacists were given the
practice right to order and interpret laboratory
values. In the 2000s pharmacist vaccine
administration was ushered into the state and now
collaborative agreements to have the pharmacist
act as an extension of an allopathic or
osteopathic physician are legal in all 50 states.

My vision is for countries that presently do not
allow podiatrists or chiropodists to prescribe
opioid analgesics, monitor these analgesics, and
watch for signs of substance use disorder and
alcohol use disorder that country licensed
physicians may develop and execute podiatrist-
physician or chiropodist-physician collaborative
agreements as a matter of treating pain and public
safety. I am fully aware of the challenge of
different healthcare systems, economy, and
national-governmental healthcare hurdles that are
present. Yet, I believe these hurdles can be
overcome. My hope is that I can present this
strategy in Dublin for the Global Summit in 2028.
Thank you again Dr. DeHeer.

Bob Smith, DPM, MSc, RPh,Ormond Beach, FL

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