In an effort to honestly educate myself about other medical professionals, I was hoping someone here would tell me exactly and bluntly podiatrists are not allowed or trained to do. In my research on the subject, I found a lot of material on what they do and what the similarities are to MD/DOs, but virtually nothing (except the old "limited to the lower extremity" thing) on what is "out of bounds". Keep in professionalism in mind when responding and realize that I am inundated by PC flowery language about how similar they are and am just looking for where the lines are by people who know - straight from the horse's mouth, so to speak.
God, if it weren't for the trolls, I'd be able to make this thread without cringing, but I respect podiatrists as equals and colleagues enough to want to learn. I realize that asking what podiatrists are not allowed to do is a little inflammatory, but I am hoping professionalism will win out and the defensiveness will be kept to a minimum.
e.g. "Podiatrists are not allowed to treat diseases unrelated to the lower extremity" (is this true, by the way?)
Your question is very fair and reasonable. Before I explain to you what podiatrists are NOT allowed to do. I have to give you a bit of background about what is happening in our field.
You will see that there are podiatrists practicing for more than 30 years and some of which have no training beyond a 1 yr "residency" - i say residency in quotations because some have no surgical training whatsoever. Typically, those podiatrists are NOT allowed to foot surgery. However, as you might have noticed from the posts, our training has changed vastly. If I can refer you to this link, you can see for yourself how our training has improved dramatically to parallel that of a medical route:
http://forums.studentdoctor.net/showthread.php?t=284170
When defining what we can and cannot do, you will have to take into consideration the state laws. Each state has its law defining the scope of podiatry. Some states will allow you to do surgery upto (not including) the knee, with soft-tissue workup upto the hip - I believe Georgia has that scope. However, that doesn't mean that the podiatrists over there do hip replacements. Rather, it means that they have the freedom to operate on a reconstructive foot surgery and use soft-tissue from the thigh region. On the other hand, some states will only let u operate on the foot and nothing more - I believe that is the case for New York.
The "average" or typical scope of practice will include Foot and ankle surgery - some states, will allow you to perform amputation. Now, I'm sure all this sounds a bit confusing because of the variations in scope. This is something being addressed by the APMA and we are in the works for getting a set national unified scope by 2015. The first step to doing so was standardizing our training which we have with the new 2 and 3 year surgical residency model. The idea here, is that for us to lobby for unified scopes in all states - we need to maintain a consistent and high level of training. So definately there is quite a bit of politics involved here.
Now in terms of the typical day's work, the podiatrist is not allowed to operate anywhere beyond his state-defined legal scope of practice - the foot and ankle usually. He is expected to manage conditions that affect the lower extremity inorder to make sure that the patient is still able to walk. Some of those conditions are systemic by nature but manifest in the lower extremity - i.e. diabetes. Therefore, we help manage diabetic patients (wound and ulcer treatments) to make sure they are ambulating, while the internist is able to manage their overall medications and dosages, and the opthamologist will of course manage their vision as of course vision problems are typically one of many manifestations of that systemic disease in particular. There are other examples of course like Deep Vein Thrombosis where podiatrists help manage the patient (from the respect of the lower extremity) along with other medical physicians (Vascualr surgeons in this case). But, the idea here is that we manage the conditions manifesting in the lower extremity because this is our area of expertise.
A podiatrist is not allowed (legally) to do go beyond what is defined by his/her state podiatry scope. So you will not see them treating a patient for Pulmonary tumors or peptic ulcers. However, we are expected to understand how those types of patients are treated by other physicians because when we prescribe medications, for instance, we take into account that drug interactions do occur and that the foot is attached to the rest of the body.
