Sunday, June 05, 2011
Is a podiatrist a real doctor?: California is about to find out
To many podiatrists are classified as second-class citizens in the medical world. However the foot men and women are playing a particularly vital role in improving the quality of life and preventing amputations in people living with life style disease, such as diabetes. The incidence of diabetes is now endemic in the over 45s, across the globe. Obesity is considered the primary culprit for the boom in cases of type 2, or adult-onset, diabetes. As the numbers rise, so too does the need for early treatment, especially of foot sores or ulcers that can quickly threaten the lower limbs. Sixty percent of all non-traumatic amputations in the United States are due to diabetes, according to the American Diabetes Association. Podiatrists in California do have a range of legal practice which includes open surgery on the foot and ankle, injections as well as provide other medical care, but are not licensed doctors of medicine, or M.D.s. The Sunshine State podiatrists are further prevented by law from treating many of the 7.5 million Californians insured through Medi-Cal (due to a 2009 state budget cut), partnering fully in the hospital care of diabetic patients and gaining access to first-rate residencies in their podiatric training. All this may change if the new move to become recognised is successful. In this bid podiatrists have attracted an unlikely ally in the California Medical Association (CMA). Better known for opposing creeping growth in other allied health professions, the CMA is playing the opposite role. It is teaming up with the California Podiatric Medical Association and the California Orthopaedic Association to consider putting the training of foot specialists on par with M.D. standards. The three groups are creating a task force to review the curriculum at California's two podiatry schools and, depending on the outcome, appeal jointly to the national Liaison Committee on Medical Education to reclassify the licensing for podiatrists. The first two years of podiatric training are similar to those for full-fledged physicians, with the emphasis on anatomy, physiology, pathology and other core subjects. Podiatry students jump into more specialized training the next two years, then generally spend the last two or three years as hospital residents. In the US training for licensed medical doctors generally takes several years longer, with the length for residencies determined by the specialty. With a physician shortage in California, and the aging baby boomers' growing need for care, podiatry may become a more attractive option if granted M.D. status.