Podiatric medicine is the profession that strives to improve the overall health and well-being of patients by focusing on preventing, diagnosing, and treating conditions associated with the foot and ankle. Doctors of Podiatric Medicine (DPMs) are physicians and surgeons who practice on the lower extremities, primarily on feet and ankles. DPMs are licensed in all 50 states, the District of Columbia and Puerto Rico to diagnose and treat the foot and its related or governing structures by medical, surgical, or other means. The vast majority of states also include ankle care as part of the podiatric physician’s scope of practice.
More than 75 percent of all Americans will experience foot and ankle problems of varying degrees at one time in their lives and thus, the need for podiatric physicians continues to grow. There are approximately 15,000 doctors of podiatric medicine practicing in the United States today. The skills of these physicians are in increasing demand as the baby boom generation swells the ranks of older Americans at almost three times the growth rate of the general population. In addition, the general public’s emphasis and interest in sports and health increases the need for healthy feet and the services of podiatric physicians are in greater demand.
Scope of Practice
Podiatrists are America’s premier foot and ankle physicians. As such, their scope of practice allows them to diagnose and treat a myriad of diseases, symptoms and disorders. Podiatrists are often the first to identify systemic diseases in patients, such as diabetes and the associated complications, high blood pressure and heart disease. Patients from all walks of life and of all ages—from pediatric to geriatric—require the kind of expertise that only a doctor of podiatric medicine can provide.
Podiatric physicians provide a vast array of medical services to their patients. They:
- perform complete medical histories and physical examinations
- prescribe drugs
- perform surgery
- set fractures and treat sports-related injuries
- prescribe and fit orthotics, insoles, and custom-made shoes
- order and perform physical therapy
- take and interpret X-rays and other imaging studies
- work as valued members of a community’s health care team
Nearly all private and public health insurance plans provide coverage for the services of doctors of podiatric medicine. Even though third-party coverage of podiatrists’ services generally includes the medical and surgical care of foot complaints, details of such coverage can and do vary among the plans. The same applies to federal health insurance plans, including Medicare, federal employee health benefits, and federal employee compensation programs.
The preparatory education for DPMs includes four years of undergraduate work, followed by four years at an accredited podiatric medical school, and then successful completion of a hospital-based residency program. There are currently eight colleges of podiatric medicine in the United States:
- Arizona Podiatric Medicine Program at Midwestern University in Glendale, Arizona
- Barry University School of Graduate Medical Sciences in Miami Shores, Florida
- California School of Podiatric Medicine at Samuel Merritt College in Oakland, California
- College of Podiatric Medicine and Surgery at Des Moines University in Des Moines, Iowa
- New York College of Podiatric Medicine in New York, New York
- Ohio College of Podiatric Medicine in Cleveland, Ohio
- Dr. William M. Scholl College of Podiatric Medicine at the Rosalind Franklin University in North Chicago, Illinois
- Temple University School of Podiatric Medicine in Philadelphia, Pennsylvania
All of the colleges go through a rigorous evaluation process by the Council on Podiatric Medical Education, which is recognized by the U.S. Department of Education and the Council on Higher Education Accreditation. The colleges all grant the degree of Doctor of Podiatric Medicine or DPM, with some also offering degrees in other academic areas as well.
Applicants for admission are required to complete the Medical College Admissions Test (MCAT) as a prerequisite, although some of the colleges accept other examinations such as the Graduate Record Examination (GRE) or Dental Admission Test (DAT). Individuals may apply to any or all of the colleges by submitting a single application through the application service of the American Association of Colleges of Podiatric Medicine (AACPM), an APMA-related organization.
The course of instruction leading to the DPM degree is four years in length. The first two years are largely devoted to classroom instruction and laboratory work in the basic medical sciences, such as anatomy, physiology, microbiology, biochemistry, pharmacology, and pathology. During the third and fourth years, students concentrate on courses in the clinical sciences, gaining practical experience in college and community clinics and accredited hospitals. Clinical courses include general diagnosis (history taking, physical examination, clinical laboratory procedures, and diagnostic radiology), therapeutics (pharmacology, physical medicine, orthotics, and prosthetics), surgery, dermatology, neurology, orthopedics, and anesthesia, among others.
After completing the four-year course and receiving the DPM degree, the graduate is eligible to take a state board examination to obtain a license to practice. Most states require at least one year of residency; the industry standard for podiatric medicine is now two years of postgraduate training.
As they near graduation, nearly all students seek postdoctoral residency programs. These programs, designed to strengthen and refine the practitioner’s podiatric medical, orthopedic, and surgical skills, are based in hospitals accredited by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) and/or the American Osteopathic Association. The programs are at least two years in duration, and may extend to four years.
Almost all states have established some continuing podiatric medical education requirements for license renewal, and there is heavy attendance at many educational programs and seminars developed and presented each year by the colleges and local, state, and national podiatric medical associations.
Special Areas of Practice
APMA's Joint Committee on the Recognition of Specialty Boards recognizes and approves two specialty boards that certify podiatrists in:
- podiatric surgery
- primary podiatric medicine and orthopedics
Podiatrists with certification in these areas have passed written and oral examinations and have demonstrated superior knowledge and experience in the specific specialty. The certification boards are the American Board of Podiatric Surgery (ABPS) and the American Board of Podiatric Orthopedics and Primary Podiatric Medicine (ABPOPPM).
Some podiatric physicians choose to do research and those doctors can usually be found at one of the eight colleges of podiatric medicine. Research opportunities are available throughout the country and many doctors are published in the peer-reviewed Journal of the American Podiatric Medical Association (JAPMA.)
Podiatric Medicine in the Community
While many podiatric physicians work in private or small group practices, DPMs also serve on the staffs of hospitals and long-term care facilities, on the faculties of schools of medicine and nursing, as commissioned officers in the Armed Forces and U.S. Public Health Service, in the Department of Veterans Affairs, and in municipal health departments.
Consistent with the podiatrist's education and licensure, JCAHO, the American Medical Association, and other organizations recognize the right of qualified podiatric physicians to serve on the staffs of hospitals and other health care facilities. Most of the podiatrists practicing in the United States have full staff privileges at hospitals; many also have surgical centers in or attached to their own offices.
There is a strong and growing role for podiatrists in public health. There has been a podiatric health section in the American Public Health Association (APHA) for over three decades, and the relationship between APMA and APHA is strong and reciprocal.
The American Podiatric Medical Association
The American Podiatric Medical Association (APMA), established in 1912, is the premier professional organization representing the nation’s doctors of podiatric medicine, or podiatrists. APMA represents the vast majority of podiatric physicians in the country. Under APMA’s umbrella of organizations are 53 component societies in states and other jurisdictions, as well as 22 affiliated and related societies.