What are the policies between Pods and Orthopods?

[doclm]

Hello again,

I was just curious if an Orthopod and a Pod could run a business together like equal physicians? I once heard that laws prohibit that and Pods have to be hired under the Orthopod business or own their own business. Is that true or some myth? Also, can Podiatrists own a ambulatory surgery center and hire Orthopods for their services?

While shadowing another Pod just this last week, he said that in MN you could do foot + ankle + tissue up to the knee and then some Hands.

Have you heard of other states allowing some sort of work being done on hands? He mentioned something about being able to remove warts.

Also, where is this legislation for universal scope of practice? Does anyone know where this is heading if anywhere? What ever happened to the PMD discussion from the past?

Thanks for you input

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[jonwill]

Hello again,

I was just curious if an Orthopod and a Pod could run a business together like equal physicians? I once heard that laws prohibit that and Pods have to be hired under the Orthopod business or own their own business. Is that true or some myth? Also, can Podiatrists own a ambulatory surgery center and hire Orthopods for their services?

While shadowing another Pod just this last week, he said that in MN you could do foot + ankle + tissue up to the knee and then some Hands.

Have you heard of other states allowing some sort of work being done on hands? He mentioned something about being able to remove warts.

Also, where is this legislation for universal scope of practice? Does anyone know where this is heading if anywhere? What ever happened to the PMD discussion from the past?

Thanks for you input

A guest speaker at our school just talked about hiring an orthopod into their practice so it's possible. They also own a surgery center.

Because of chiropody (old-school pods), hands are still on the books in some states but I would say that's a no-no (especially surgery).

There is talk of universal scope of practice but I've heard of no real attempts. Most states now include ankle (40) and most of the others have legislation in the works. Beyond that, you have to look up state law for complete scope. APMA is pushing "vision 2015" for unlimited scope but I'm not sure how realistic that is.

PMD = "little man syndrome" in my opinion. DPM's are the best in the world when it comes to foot & ankle medicine/surgery. There is no need to change the degree.

 

[IlizaRob]

PMD? Please tell me that will never happen. I dont see how changing the letters behind your name will make any difference. I agree with Jon, if anyone is pushing for conversion to PMD or to MD for that matter they are obviously insecure. Instead of trying to blend in with MDs we should be distinguishing ourselves more as the foot and ankle specialists. There really is no doctor better trained trained than DPMs to handle foot and ankle pathology. If I wanted to be an MD I would have gone to a different school. Although there is some arrogance in medicine (surprise surprise), I love that we are seperate. With that said, I dont think our scope should ever include the knee or above unless its minor tissue problems. It just makes us less of a specialist.

 

[Dr_Feelgood]

PMD? Please tell me that will never happen. I dont see how changing the letters behind your name will make any difference. I agree with Jon, if anyone is pushing for conversion to PMD or to MD for that matter they are obviously insecure. Instead of trying to blend in with MDs we should be distinguishing ourselves more as the foot and ankle specialists. There really is no doctor better trained trained than DPMs to handle foot and ankle pathology. If I wanted to be an MD I would have gone to a different school. Although there is some arrogance in medicine (surprise surprise), I love that we are seperate. With that said, I dont think our scope should ever include the knee or above unless its minor tissue problems. It just makes us less of a specialist.

I want to keep DPM b/c when I googled DPM and PMD, I came up w/ a few things. You tell me what is cooler.

DPM helmet cover

PMD mixer

You be the judge. Are you a dorkie mixer or kick-butt bullet-proof helmet?

 

[jonwill]

I don't know, that mixer is tempting.

 

[Dr_Feelgood]

I don't know, that mixer is tempting.

Your a mixer not a fighter

 

[doclm]

I want to keep DPM b/c when I googled DPM and PMD, I came up w/ a few things. You tell me what is cooler.

DPM helmet cover

PMD mixer

You be the judge. Are you a dorkie mixer or kick-butt bullet-proof helmet?

 

[doclm]

A guest speaker at our school just talked about hiring an orthopod into their practice so it's possible. They also own a surgery center.

QUOTE]

Sounds good to me.

Thats the way it should be.

 

[dpmgrad]

While shadowing another Pod just this last week, he said that in MN you could do foot + ankle + tissue up to the knee and then some Hands.

Have you heard of other states allowing some sort of work being done on hands? He mentioned something about being able to remove warts.

There are a few states in US still include hands in the scope of practice of Podiatrists and they usually include minor soft tissue procedures, such as wart removal. However, most Podiatrists do not touch the hands in those states. In some states such as Florida, Podiatrists can go up to the knee. There are some Podiatrists in Florida who are administering knee injections. I guess those Podiatrists are money hungry. Perhaps, this might be one of the reasons why the legislation to limit the scope of practice of Podiatrists in Florida was introduced.

 

[circle]

I am a student at Barry and this is what we were told as to why the orthos wanted to take away the leg for pods. Apparently a pod that worked with an ortho group went to a knee surgery conference with the group. This angered several of the orthos and what do you know, a new bill on the floor! The bill was dropped, but the orthos have made it clear that they will push it again in May. Hopefully it will never pass because it could have a domino effect on other states.

 

[k-wire]

just curious, but why wouldnt the ortho guys just tell that pod not to go to the conference or even decide to fire him or something rather than go to the trouble of tying to introduce a bill and all that. it seems like there is something fishy about that story.

 

[jonwill]

I am a student at Barry and this is what we were told as to why the orthos wanted to take away the leg for pods. Apparently a pod that worked with an ortho group went to a knee surgery conference with the group. This angered several of the orthos and what do you know, a new bill on the floor! The bill was dropped, but the orthos have made it clear that they will push it again in May. Hopefully it will never pass because it could have a domino effect on other states.

This may anger some but I'm not against Florida reducing scope to ankle for podiatric physicians. I believe that Florida and Georgia are the only two states in the nation that have a scope that includes the knee (correct me if I'm wrong). In fact, I think the law in Florida actually says tibial tuberosity, which would make knee out of scope anyway (concerning osseous structures). Plus, we get very little training in the knee (if any besides ortho rotations). We are known to many as foot and ankle specialists. But more importantly, I would like to see a uniform scope of practice nationally. Realistically speaking, that would NEVER include the knee. In most states, podiatrists have foot and ankle privileges although the ankle law differs (some include all structures affecting the ankle, some include all structures 6 inches proximal, etc). Anyway, the sooner all states have similar scopes, the sooner we can figure out a uniform scope of practice. With that said, no specialty likes a reduction in scope.
I'll be at the University of Florida in a few months, where podiatry is in the ortho department (as with many hospitals these days). In fact, nearly every program I will be at next year is in the ortho department. They have great relationships with ortho. I'd like to keep it that way! The foot and ankle keep us busy enough.

 

[Dr_Feelgood]

This may anger some but I'm not against Florida reducing scope to ankle for podiatric physicians. I believe that Florida and Georgia are the only two states in the nation that have a scope that includes the knee (correct me if I'm wrong). Plus, we get very little training in the knee (if any besides ortho rotations). We are known to many as foot and ankle specialists. But more importantly, I would like to see a uniform scope of practice nationally. Realistically speaking, that would NEVER include the knee. In most states, podiatrists have foot and ankle privileges although the ankle law differs (some include all structures affecting the ankle, some include all structures 6 inches proximal, etc). Anyway, the sooner all states have similar scopes, the sooner we can figure out a uniform scope of practice. With that said, no specialty likes a reduction in scope.
I'll be at the University of Florida in a few months, where podiatry is in the ortho department (as with many hospitals these days). In fact, nearly every program I will be at next year is in the ortho department. They have great relationships with ortho. I'd like to keep it that way! The foot and ankle keep us busy enough.

I agree that we don't know pooh about the knee and DPMs have no business working on it. But I don't want to limit the scope too much that it prevents DPMs from harvesting skin grafts from the upper thigh. I think that it is a joke to have a general surgeon in there watching you harvest the skin and then billing for something that they didn't do.

Back on the topic of the knee, DPMs scream that orthopods that they don't have enough training to mess w/ the foot and ankle. So on this topic are we playing the pot or the kettle?

 

[jonwill]

I agree that we don't know pooh about the knee and DPMs have no business working on it. But I don't want to limit the scope too much that it prevents DPMs from harvesting skin grafts from the upper thigh. I think that it is a joke to have a general surgeon in there watching you harvest the skin and then billing for something that they didn't do.

Back on the topic of the knee, DPMs scream that orthopods that they don't have enough training to mess w/ the foot and ankle. So on this topic are we playing the pot or the kettle?

I would like a national scope that includes osseous structures of the foot and ankle, and soft tissue up to the thigh (allowing us to take grafts, aggresively treat venous stasis ulcers, etc). I'd be all for that. Let the orthos do their knee thing. And you're absolutely right. We always talk about how many orthos don't have the training to touch the foot. Where would we get the training to touch the knee?

 

[IlizaRob]

I would like a national scope that includes osseous structures of the foot and ankle, and soft tissue up to the thigh (allowing us to take grafts, aggresively treat venous stasis ulcers, etc). I'd be all for that. Let the orthos do their knee thing.

Im not sure why any pod would fight to include the knee in scope. I mean, who would be comfortable doing it when we arent trained in it? Its like an FP wanting to surgically correct PTT dysfunction. Sure with an unlimited medical licence they can do it but...good luck. On a side note they would have to do it at their own surgical suite because there is no hospital that would allow them near the OR.

 

[Dr_Feelgood]

Im not sure why any pod would fight to include the knee in scope. I mean, who would be comfortable doing it when we arent trained in it? Its like an FP wanting to surgically correct PTT dysfunction. Sure with an unlimited medical licence they can do it but...good luck. On a side note they would have to do it at their own surgical suite because there is no hospital that would allow them near the OR.

I'll tell you why they want to do knees b/c they are easy and they pay a lot. Think it would you like to get paid ~4000 an ankle fusion or ~2000 for the 4 knee scopes that you can do in the same amount of time? (That is a Dr. Grambart quote). That is why orthopods are willing to hire and give away the foot and ankle. It is more difficult and worse pay.

 

[IlizaRob]

I'll tell you why they want to do knees b/c they are easy and they pay a lot. Think it would you like to get paid ~4000 an ankle fusion or ~2000 for the 4 knee scopes that you can do in the same amount of time? (That is a Dr. Grambart quote). That is why orthopods are willing to hire and give away the foot and ankle. It is more difficult and worse pay.

True, but my point being was that since the training is not there the risk outweighs the benefits. But if you apply the common medical notion, "see one, do one, teach one", additional training wouldnt take too long at all. Alright, sign me up.

 

[circle]

the orthos invited him to go. it was one certain ortho that was pissed and started the whole thing. anyway, there are a ton of ortho groups down here that hire pods to do all of the foot and ankle. most have great relations, but there will always be those against us. its just like ent surgeons and maxillofacial surgeons arguing over who is more qualified to do a certain procedure.

also, most pods that we are in contact with have no desire to ever touch the knee. just a few want the knee for whatever reason$$$.

 

[Dr_Feelgood]

the orthos invited him to go. it was one certain ortho that was pissed and started the whole thing. anyway, there are a ton of ortho groups down here that hire pods to do all of the foot and ankle. most have great relations, but there will always be those against us. its just like ent surgeons and maxillofacial surgeons arguing over who is more qualified to do a certain procedure.

also, most pods that we are in contact with have no desire to ever touch the knee. just a few want the knee for whatever reason$$$.

Yeah I can see where the invite to the conference was innocent, but like you said other want the $$.