Limited by State Law

[EK18]

I have a question for practicing podiatric physicians and graduating residents. Do you feel that you are limited in your practice of podiatry by your local state's podiatry scope legislation? What I mean to say is, do you feel that there are certain procedures that you are well trained and competent to perform for the lower extremity, but cannot because the state's podiatry law prohibits you from doing so? For example, I know that many states prohibit a podiatrist from amputating the foot or even amputating a toe. Is this a case where you feel like you are unfairly limited despite your capacity to perform such a procedure? Fortunately, only a handful of states still bar podiatrists from treating the ankle.

I ask as a curious future podiatric medical student from California. The reason I bring up amputation specifically is because one of the podiatrists I shadowed told me that diabetes was the main reason he had to perform amputations. As such, I thought amputations were the norm under a podiatrist's scope until I looked at various state podiatry legislations and saw that many states outlaw amputation under a podiatrist's scope (although I don't know why). Typically, physicians are limited not by their scope but by their post-graduate training. Are there practicing podiatrists who are limited not by their post-graduate training, but by their legal scope?

Thank you in advance for any responses.

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[PADPM]

I have a question for practicing podiatric physicians and graduating residents. Do you feel that you are limited in your practice of podiatry by your local state's podiatry scope legislation? What I mean to say is, do you feel that there are certain procedures that you are well trained and competent to perform for the lower extremity, but cannot because the state's podiatry law prohibits you from doing so? For example, I know that many states prohibit a podiatrist from amputating the foot or even amputating a toe. Is this a case where you feel like you are unfairly limited despite your capacity to perform such a procedure? Fortunately, only a handful of states still bar podiatrists from treating the ankle.

I ask as a curious future podiatric medical student from California. The reason I bring up amputation specifically is because one of the podiatrists I shadowed told me that diabetes was the main reason he had to perform amputations. As such, I thought amputations were the norm under a podiatrist's scope until I looked at various state podiatry legislations and saw that many states outlaw amputation under a podiatrist's scope (although I don't know why). Typically, physicians are limited not by their scope but by their post-graduate training. Are there practicing podiatrists who are limited not by their post-graduate training, but by their legal scope?

Thank you in advance for any responses.

No. I don't feel limited at all. In regards to amputations, at the hospitals we cover in our practice, the amputations are referred TO us from vascular, infectious disease and orthopedics.

 

[EK18]

No. I don't feel limited at all. In regards to amputations, at the hospitals we cover in our practice, the amputations are referred TO us from vascular, infectious disease and orthopedics.

That is good to hear. Thank you for the response, PADPM.

 

[diabeticfootdr]

Do you feel that you are limited in your practice of podiatry by your local state's podiatry scope legislation? What I mean to say is, do you feel that there are certain procedures that you are well trained and competent to perform for the lower extremity, but cannot because the state's podiatry law prohibits you from doing so? For example, I know that many states prohibit a podiatrist from amputating the foot or even amputating a toe.

Yes, in some states podiatrists can not operate to their fullest potential when trying to save diabetic feet from amputation. Arizona is one that comes to mind as a state where amputation (of even a toe) is not in the podiatrists scope of practice.

In other states, you may be able to do a Charcot foot reconstruction with internal fixation, but you can't put a wire across the tibia if you decide external fixation is a better modality.

Lesson is, research the various state laws before you decide where to practice.

 

[Ferocity]

Do we have a list of which states have no restrictions for pods below the knee?

 

[dyk343]

Slightly outdated.

 

[EK18]

Yes, in some states podiatrists can not operate to their fullest potential when trying to save diabetic feet from amputation. Arizona is one that comes to mind as a state where amputation (of even a toe) is not in the podiatrists scope of practice.

In other states, you may be able to do a Charcot foot reconstruction with internal fixation, but you can't put a wire across the tibia if you decide external fixation is a better modality.

Lesson is, research the various state laws before you decide where to practice.

I see. Some states like Kentucky did not state whether or not if podiatrists were permitted to perform amputations of the lower extremity. Would it be safe to do so because it still falls underneath the "surgical" scope of practice of a podiatrist, or is it dangerous to do anything that is not explicitly permitted in the legal scope?

Thank you for your response.