Jarrod Shapiro, DPM
Practice Perfect Editor
Assistant Professor,
Dept. of Podiatric Medicine,
Surgery & Biomechanics
College of Podiatric Medicine
Western University of
Health Sciences,
St, Pomona, CA

Should We Train "Others"?

Over my short time in podiatry, I've heard various clinicians debating whether we should train other professionals outside of our specialty. For example, a common issue I've heard about is training family doctors to do toenail procedures. Should we be proprietary about our skills?

My simple answer is: of course we should train others. Podiatry as a profession benefits many-fold from our interactions with the other professions.

Podiatry benefits from interactions with the other professions

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Use of Topical Wound Oxygen in
Complex Diabetic Wound Care
by Francis Derk, DPM

Let's talk first about teaching family practice physicians to treat ingrown toenails. In case you don't know, the FPs are already treating these patients. Most of them will start the patient on an oral antimicrobial to treat the "infection." When the problem doesn't resolve fully (if at all) they'll refer to us. First of all, it's just good patient care for the FPs to know how to treat their patients, reducing the risk of mistaken treatment or prolonging patients' suffering. Second, the majority of primary care doctors either do not want or do not have the time to perform digital nail procedures in the office. Third, what better advertising can we as a profession have than by working with the very doctors who are most likely to refer patients to us? I'll remind you that podiatry is, in most communities, largely a referral-based specialty. We need these doctors to know we have their backs (and vice versa).

So then, what about training orthopedic surgeons to do foot and ankle surgery? There are, in fact, locations around the country where podiatric surgeons teach orthopedic residents. This is OK also. Again, the majority of orthopedic surgeons have no desire to treat foot and ankle disorders. When I was practicing in Michigan, I consistently had orthopedists send me patients. One in particular, who knew my capabilities, sent me all of his diabetic limb salvage patients and asked that I send them back if they needed limb amputations. It was a very collegial attitude without the classic back biting we often hear between orthopedists and podiatrists. But he was a general orthopedist, you might argue. True, but there was also a foot and ankle orthopedist who also sent me patients (and vice versa). Interestingly, these were both relatively young physicians who'd been in practice around five years, who had trained along with podiatrists.

We should remain open to training orthopedists

Granted, there are some surgeons who have a chip on their shoulders when it comes to podiatrists, but do you think isolating ourselves is going to make anything better? I don't think so. Let's mix it up. Train with every other specialty, and train every other specialty. We have nothing to lose and so much to gain.