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- 181
- Podiatrists
-
- (D.O.T. 079.101-022)
-
- Nature of the Work
-
- The human foot is a complex structure. It contains 26 bones plus
- muscles, nerves, ligaments, and blood vessels and is designed for
- balance and mobility. Podiatrists, also known as doctors of
- podiatric medicine (DPM's), diagnose and treat disorders, diseases
- and injuries of the foot and lower leg to keep this part of the body
- working properly.
-
- Podiatrists treat corns, calluses, ingrown toenails, bunions, heel
- spurs, and arch problems; ankle and foot injuries, deformities, and
- infections; and foot complaints associated with diseases such as
- diabetes. To treat these problems, podiatrists prescribe drugs,
- order physical therapy, set fractures, and perform surgery. They
- also fit corrective inserts called orthotics, design plaster casts
- and strappings to correct deformities, and design custom-made shoes.
- Podiatrists may use a force plate to help design the orthotics and
- shoes. Patients walk across a plate connected to a computer that
- reads the patients' feet. From the computer readout, podiatrists
- may order the correct design.
-
- To diagnose a foot problem, podiatrists may order x rays and
- laboratory tests. Podiatrists consult with and refer patients to
- other health practitioners when they spot systemic diseases, such as
- arthritis, diabetes, and heart disease, of which first symtoms may
- appear in the foot. For example, diabetics are prone to foot ulcers
- and infections due to their poor circulation.
-
- Most podiatrists have a general practice. Some specialize in
- surgery, orthopedics, or public health. Besides these certified
- specialties, podiatrists may practice a subspecialty such as sports
- medicine, pediatrics, dermatology, radiology, geriatrics, and
- diabetic foot care. Podiatrists generally are in private practice,
- which means that they run a small business. They may hire
- employees, order supplies, and keep records.
-
- Most podiatrists are solo practitioners.
-
- Working Conditions
-
- Podiatrists usually work independently in their own offices. They
- may also spend time visiting patients or performing surgery at a
- hospital. Those with private practices set their own hours, but to
- meet the needs of their patients, they may have some evening and
- weekend hours.
-
- Employment
-
- Podiatrists held about 14,700 jobs in 1992. Most podiatrists are
- solo practitioners, although more are entering partnerships and
- group practices. Others are employed in hospitals, nursing homes,
- and offices and clinics of physicians. Public health departments
- employ podiatrists, too.
-
- Geographic imbalances are pronounced in podiatric medicine. Most
- podiatry graduates establish their practices in or near one of the
- seven States that have colleges of podatric medicine California,
- Florida, Illinois, Iowa, New York, Pennsylvania, and Ohio. Large
- areas of the country particularly the South, the Southwest, and
- nonmetropolitan areas have few podiatrists. In these areas, foot
- care is typically provided by primary care physicians and
- orthopedists.
-
- Training, Other Qualifications, and Advancement
-
- All States and the District of Columbia require a license for the
- practice of podiatric medicine. Each defines its own licensing
- requirements. Generally, the applicant must be a graduate of an
- accredited college of podiatric medicine and pass written and oral
- examinations. Twenty-five States also require completion of an
- accredited residency program. Some States permit applicants to
- substitute the examination of the National Board of Podiatric
- Examiners, given in the second and fourth years of podiatric medical
- college, for part or all of the written State examination. Certain
- States grant reciprocity to podiatrists who are licensed in another
- State. Thirty-one States require continuing education for licensure
- renewal.
-
- Prerequisites for admission to a college of podiatric medicine
- include the completion of at least 90 semester hours of
- undergraduate study, an acceptable grade point average, and suitable
- scores on the Medical College Admission Test (MCAT). All require 8
- semester hours each of biology, inorganic chemistry, organic
- chemistry, and physics and 6 hours of English. Over 90 percent of
- podiatric students have a bachelor's degree.
-
- Colleges of podiatric medicine offer a 4-year program whose core
- curriculum is similar to that in other schools of medicine.
- Classroom instruction in basic sciences, including anatomy,
- chemistry, pathology, and pharmacology, is given during the first 2
- years. Third- and fourth-year students have clinical rotations in
- private practices, hospitals, and clinics. During these rotations,
- they learn how to take general and podiatric histories, perform
- routine physical examinations, interpret tests and findings, make
- diagnoses, and perform therapeutic procedures. Graduates are
- awarded the doctor of podiatric medicine (DPM) degree.
-
- Most graduates complete a hospital residency program after receiving
- a DPM. Residency programs usually last 1 year. Residents receive
- advanced training in podiatric medicine and surgery and serve
- clinical rotations in anesthesiology, internal medicine, pathology,
- radiology, emergency medicine, and orthopedic and general surgery.
- Residencies lasting more than 1 year provide more extensive training
- in specialty areas.
-
- There are three recognized certifying boards for four specialty
- areas: The American Board of Podiatric Surgery, the American Board
- of Podiatric Orthopedic and Primary Podiatric Medicine, and the
- American Board of Podiatric Public Health. Certification means that
- the DPM meets higher standards than those required for licensure.
- Each board requires advanced training, completion of written and
- oral examinations, and experience as a practicing podiatrist.
-
- People planning a career in podiatry should have scientific
- aptitude, manual dexterity, interpersonal skills, and good business
- sense.
-
- Podiatrists may advance to become professors at colleges of
- podiatric medicine, department chiefs of hospitals, or general
- health administrators. They may also enter a higher degree program.
-
- Job Outlook
-
- Employment of podiatrists is expected to grow faster than the
- average for all occupations through the year 2005. More people will
- turn to podiatrists for foot care as the elderly population grows.
- The elderly have more years of wear and tear on their feet and lower
- legs than most younger people, so they are more prone to foot
- ailments.
-
- Like dental services, podiatric care is more dependent on disposable
- income than other medical services. Medicare and most private
- health insurance programs cover acute medical and surgical foot
- services, as well as diagnostic x rays and leg braces. However,
- routine foot care including the removal of corns and calluses is
- ordinarily not covered. Because disposable income is expected to
- rise, more people are expected to pay for podiatric care
- out-of-pocket.
-
- Establishing a new podiatric practice will be most difficult in the
- areas surrounding the seven colleges of podiatric medicine and in
- the Northeast since podiatrists are concentrated in these locations.
-
- Because replacement needs result mainly from retirements and deaths,
- they are low. Most podiatrists continue to practice until they
- retire; few transfer to other occupations.
-
- Earnings
-
- According to a 1993 survey by the American Association of Colleges
- of Podiatric Medicine, average net income of podiatrists was
- $100,287, but it varied greatly with years of experience.
- Podiatrists with 1 to 2 years of experience netted $35,578; those
- with 10 to 15 years of experience, $119,674.
-
- Related Occupations
-
- Workers in other occupations who apply scientific knowledge to
- prevent, diagnose, and treat disorders and injuries are
- chiropractors, dentists, optometrists, physicians, and
- veterinarians.
-
- Sources of Additional Information
-
- For information on podiatric medicine as a career, contact:
-
- American Podiatric Medical Association, 9312 Old Georgetown Rd.,
- Bethesda, MD 20814-1621.
-
- Information on colleges of podiatric medicine, entrance
- requirements, curriculums, and student financial aid is available
- from:
-
- American Association of Colleges of Podiatric Medicine, 1350 Piccard
- Dr., Suite 322, Rockville, MD 20850-4307.
-