The scope of podiatric practice has changed significantly in the past couple of decades. Despite the increased quality of training, many people outside of podiatry may not realize what our scope of practice entails.
We conducted a survey consisting of 10 items and asked internal medicine residents at Rush University Medical Center and patients whether they would feel comfortable consulting podiatrists, or being treated for each issue.
The results for residents are as follows: 1) toenail fungus, 35% yes and 65% no; 2) diabetic wound care, 87.5% yes and 12.5% no; 3) bunion surgery, 90% yes and 10% no; 4) ankle fracture surgery, 25% yes and 75% no; 5) calcaneal fracture surgery, 50% yes and 50% no; 6) tarsal tunnel nerve surgery, 62.5% yes and 37.5% no; 7) lower extremity arterial bypass, 5% yes and 95% no; 8) below-knee amputation, 5% yes and 95% no; 9) transmetatarsal amputation, 67.5% yes and 32.5% no; and 10) venous stasis wound care, 65% yes and 35% no. The results for patients are as follows: 1) toenail fungus, 72.5% yes and 27.5% no; 2) diabetic wound care, 70% yes and 30% no; 3) bunion surgery, 62.5% yes and 37.5% no; 4) ankle fracture surgery, 57.5% yes and 42.5% no; 5) calcaneal fracture surgery, 55% yes and 45% no; 6) tarsal tunnel nerve surgery, 50% yes and 50% no; 7) lower extremity arterial bypass, 32.5% yes and 67.5% no; 8) below-knee amputation, 27.5% yes and 72.5% no; 9) transmetatarsal amputation, 52.5% yes and 47.5% no; and 10) venous stasis wound care, 32.5% yes and 67.5% no.
Internal medicine residents and patients do not have an accurate perception of the scope of podiatric medicine. This proves that, as a profession, we need to raise awareness about what the podiatric scope of medicine actually entails.
Background: Silicone gel sheeting is an effective therapeutic intervention in the management of scar tissue. This pilot study was designed to examine the effect of silicone gel sheeting in preventing reulceration at former wound sites in diabetic patients.
Methods: Thirty patients with diabetes and a healed plantar neuropathic foot ulcer were enrolled and investigated in this randomized controlled trial. Participants with a newly healed ulcer were assigned to use either silicone gel sheeting or emollient cream daily for 3 months.
Results: Compared with emollient cream use, the use of silicone gel sheeting did not diminish and may have potentially increased the risk of reulceration.
Conclusions: Silicone gel sheeting does not seem to reduce the risk of reulceration in diabetic patients. The results of this trial should be viewed with caution given the small sample size. (J Am Podiatr Med Assoc 101(2): 116–123, 2011)
A survey was conducted of 248 noninstitutionalized people aged 75 years and older, residing in a designated geographical area. The effect of dependency and physical disability on the receipt of conservative podiatric medicine was examined, and, in addition, the prevalence of medical and podiatric conditions was determined.
This report presents the results of analyses of statistical data from 4,328 members of the American Podiatric Medical Association (APMA) who responded to the 1996 Podiatric Practice Survey, conducted from July through August 1996. Written comments from a sample of 200 respondents were also extracted for review and analysis.
The Department of Veterans Affairs is the single largest source of podiatric resident education. The author describes the James A. Haley Veterans Hospital and discusses the development of the podiatric residency training program. A detailed description of all aspects of the training program is presented.
The application of continuous passive motion to joints immediately after podiatric surgery stimulates the regeneration of articular tissue, eliminates adhesions, prevents joint stiffness, reduces pain, and is well tolerated by patients. The author reviews the development of continuous passive motion in animal and clinical studies and how it may be used after podiatric surgery.
The leadership of the Pennsylvania College of Podiatric Medicine sets forth the following treatise on the outlook for podiatric medical education into the 21st century. Despite the seemingly impossible challenges facing the profession and its students, it is their opinion that the future is bright and with dedicated effort the profession will become stronger in the years ahead.
The authors reviewed 322 articles in podiatric medical journals to determine their level of evidence. Only 1% of the articles reviewed were randomized controlled trials. The authors concluded that if the podiatric medical profession wishes to become a participant in evidence-based medicine, greater emphasis must be placed on studies that assess hypotheses.
The author places the history and development of podiatric biomechanics, as well as current thinking about its underpinnings and future, in the context of a theoretical framework drawn from the philosophy and sociology of science. This analysis sets the stage for an exploration of the possible future directions in which podiatric biomechanics could develop.
The author provides a general overview of the development of postgraduate residency training in podiatric medicine since 1956. The evolution of residency standards and requirements of the Council on Podiatric Medical Education are discussed. Integration of specialty organizations in the residency evaluation process also are reviewed. The author notes that the current positive number of entry level residency positions available to graduates of colleges of podiatric medicine may be a dubious facade in view of increasing college enrollments and the potential conversion of rotating podiatric residencies to residencies in primary podiatric medicine. He cautions the profession not to overlook these events as it considers the development of the PGY-1 concept in the restructuring of entry level residency training.