Podiatry not just for nail trimming

MUSC Health
November 10, 2020
Podiatrist examining a foot

By: Michael McCann, D.P.M.
MUSC Health - Podiatry

Podiatry has been an established discipline of the medical community for centuries. Historical records have revealed podiatrists evaluating, and treating, the King of France, Napoleon, and President Lincoln for various lower extremity ailments. The first society of Podiatrists, formerly known as a chiropodist, was established in 1895 in the state of New York. Since then Podiatry as a field, has expanded to become an integrated medical profession worldwide. This integration is a direct result from the increased training and education required by the podiatric medical universities who instruct the future podiatrist and the required post-doctoral surgical based residency training programs. Unfortunately, there can be a misconception regarding which lower extremity conditions a Podiatrist is capable of treating.

Becoming a Podiatrist can follow the same path as many other physicians. The journey requires a four-year undergraduate degree, a sufficient score on the Medical College Admission Test (MCAT), acceptance into a four-year Podiatric Medical College, and a three-year surgical based residency.  After  residency, a one-year fellowship for further training can also be completed if desired. Currently in North America, 72% of state’s offer a Podiatric Residency Program equating to nearly 300 programs nationwide. Surgical residencies are divided into both forefoot, and forefoot with rearfoot training. During residency training, physicians rotate through various sub-specialties in other medical disciplines such as Vascular Surgery, Orthopaedic Surgery, Plastic Surgery, General Surgery, Infectious Disease, Dermatology, Endocrinology, Family Medicine and/or Internal Hospitalist, and Wound Care.

After residency graduation the state where the Podiatrist practices determines the scope of practices and procedures the podiatrist can, or cannot do. A scope of practice defines the “procedures, actions, and processes a physician is permitted to undertake within their professional license.” Last year, the South Carolina state legislature passed legislation to increase the scope of practice for Podiatry, which now mirrors the states bordering South Carolina. The new scope of practice includes the ability to perform surgical intervention bone and soft tissue structures in the rearfoot, including fixation of ankle arthritis through ankle arthroscopy or arthrodesis (fusion), fixation of ankle fractures, repair of Achilles Tendon ruptures and other “rearfoot conditions.” In order to perform these procedures, the Podiatrist has to meet specific requirements from their Podiatric Medical Licensure Board. Additionally, the podiatrist must have permission, or privileges, to perform these surgeries granted at the facility where the surgery is to be performed. A facility (ie. a hospital) can deny any surgeon from performing any procedures after a thorough investigation of the surgeon’s capacity to perform certain surgeries.

When choosing a podiatrist you should consider the scope of practice the podiatrist practices. Their scope can be limited based on their own desire. A podiatrist may not want to perform surgical intervention, even if they underwent surgical training necessary to preform the procedure. As with any medical profession, a podiatrist can choose to focus their practice on treating only specific diseases.

The field of Podiatry has made tremendous leaps and bounds over the last decade in the medical field. Podiatry is already becoming integrated into multiple level one trauma health systems to assist in treating their patients. During my training, it wasn’t out of the ordinary to fixate an ankle fracture, surgically correct a flat foot, and surgically close a diabetic foot wound/ulcer with a skin flap.  When looking for a foot care provider it’s always a good practice to choose one that is well-trained to help you with concerns, both now and in the future.

Dr. Michael McCann is a podiatrist who specializes in all aspects of lower extremity surgery which encompasses rearfoot or ankle injury, ankle arthritis, achilles injuries, diabetic limb salvage, traumatic injuries, flat foot reconstruction and general forefoot pathology. Dr. Michael McCann is accepting new patients at MUSC Health – Podiatry on the main campus of MUSC Health Florence Medical Center. To schedule an appointment please call 843-674-1480.

About the Author

MUSC Health

Keywords: Orthopaedics, Florence Medical Center