Can podiatrists handle basic internal medicin issues?

Discussion in 'Podiatric Residents & Physicians' started by MysteryDiagnosis, May 17, 2017 at 2:32 PM.

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  1. MysteryDiagnosis


    May 4, 2017
    So if a podiatric patient presents to the office for some regarding their lower extremety but have diabetes or a bronchitis or whatever, can the podiatrist prescribe them insulin or antibiotics
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  3. heybrother

    heybrother 5+ Year Member

    Oct 17, 2011
    Legally, podiatry's scope varies state to state, but why would you want to. This isn't a backdoor path to being an internist. This is its own unique field that will provide you with a knowledge set that in my experience - few other medical professionals have. It has value and you will have plenty of other ways to help people and satisfy your professional interests. Having completed school and residency, would you have the mental capacity - sure, nurses with far less training are apparently taking over urgent cares across the country. You will complete some variation of an internal medicine rotation - residents experience managing systemic issues will vary. But again, why would you want to. Toss a referral to the people who manage this 20 times a day. My time with other MD specialists is that they happily treat within their area of expertise and refer the rest on.
  4. dyk343

    dyk343 7+ Year Member

    Oct 5, 2008
    I frequently medically manage patients in the perioperative (hospitalized) setting all the time. I have no problem managing a relatively uncomplicated diabetic patient's insulin while hospitalized (continuing basal insulin + starting a sliding scale is not rocket science). If they are a brittle diabetic or with severe comorbidities I will get a medicine consult as they know it best.

    I don't think any of us would Rx antibiotics to treat pneumonia (bronchitis as you put it). That would be a medicine consult as that's not our place.
    NatCh likes this.
  5. hematosis

    hematosis Slappin Da Bass 7+ Year Member

    Jul 27, 2009
    Last edited: May 17, 2017 at 10:57 PM
    Pod267, NatCh and Ankle Breaker like this.
  6. I post PRN

    I post PRN 2+ Year Member

    Mar 12, 2014
    I think why would you want to is the best answer to this question. Ha
  7. Creflo

    Creflo time to eat 10+ Year Member

    May 16, 2007
    Sometimes you do need to get involved in medicine. I'm managing a delayed union and ran pth, calcium, vitamin d labs. They returned slightly abnormal so I ordered a bone density scan to see if it supports the abnormality. Now the results are in, I will turn over to medicine. Where I work the patient has been somewhat ignored by primary care, so I had to step in and do these things to justify further workup. Other times you may need to manage anti coagulation therapy when immobilizing a patient with a hypercoagulability disorder or history of blood clot. I would never get into medicine issues that don't relate to the foot /ankle.
    Weirdy likes this.
  8. Ankle Breaker

    Ankle Breaker Senior Member 5+ Year Member

    Sep 24, 2010
    Emerald City
    I would not do this. I would have a hematologist on board as well.
    hematosis likes this.
  9. FootAndAnkle

    FootAndAnkle 2+ Year Member

    Jul 6, 2013
    You could prescribe the medications, but it would be a bad idea as this would be outside of your scope and be indefensible if something went wrong. You can manage basic things like insulin if you have an inpatient and are the primary service without a consult to medicine or endocrinology. Your patients deserve excellent, well-qualified care, so just as others here have said, it's in everyone's best interest to recognize the purview of other physicians just as they recognize and value yours.
  10. hematosis

    hematosis Slappin Da Bass 7+ Year Member

    Jul 27, 2009
    In some hospitals Podiatry is a primary admit service (I think some VA hospitals, Medstar ?). In that case, they will admit from the ED or clinic any patient with F/A pathology (Open fracture, DFU, etc) that meets admission criteria. Being the admitting team, they'll have to do a full H/P, start and dose their medication and any complications as an inpatient. So for example, for the Diabetes question, you can restart their outpatient insulin regimen or if they are on an oral like metformin, u can start sliding scale, prandial, nph, based on weight, etc, etc. But even so, I imagine you'll have to consult medicine if things get too crazy. Sometimes even medicine won't manage them and defer to Endocrine.

    As a resident, my program was a consult team but we were able to admit healthy patients. Admitting and managing co morbidities was my least favorite part of residency.

    Work within your scope. Don't try to be a hero.
    Last edited: May 20, 2017 at 2:54 PM
    newfeet, Ankle Breaker and pacpod like this.

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