The number of older individuals living in the United States is projected to increase significantly over the next few decades. To help meet the health-care needs of this growing population, podiatric medicine must assure the public of the availability of specially educated teachers and practitioners who can not only provide direct patient care, but also participate in establishing national policies and priorities pertaining to foot health. Fellowship training, the traditional educational model beyond the first professional degree and residency education, is one means of accomplishing this goal. This article proposes a model for a geriatric fellowship in podiatric medicine. Implementation of such fellowship training in geriatrics can help the podiatric medical profession pursue its mission and fulfill its responsibility to the public.
The authors present evidence on the patterns and correlates of surgical referrals to podiatric physicians that suggests a surgical specialty now exists in podiatric medicine. The primary factors on which surgical specialization appears to be based are residency training, hospital medical staff membership, and increased hospital podiatric practice activity. Surgically specialized podiatric physicians tend to be younger, but such specialization is not related to either the gender or race of podiatric physicians.
Multimedia technology was once rarely found outside the realm of commercial production studios or in elaborate computer games. However, with the addition of only a few simple accessories, recent advances have made this technology readily available to the podiatric medical practitioner on a desktop office computer. The role that the application of multimedia technology using a computerized digital camera can play in a podiatric medical practice--including in such areas as record keeping, outcome measurement, patient education, interdisciplinary communications, and practice-management tools--is discussed.
The author describes the positive experiences of Cranston General Hospital, Osteopathic in establishing a 24-month program, combining an entry level rotating podiatric residency and a podiatric surgical residency. The program grew from a 12-month surgical program to become a 24-month program, using expanded training opportunities available in Brown University teaching hospitals. An improved quality of care and a greater fund of knowledge for the residents are two results of the 24-month training program. Recommendations and views about developing entry level residency programs are presented.
Homologous and heterogenous bone grafting as it might be used in podiatric surgery is reviewed with emphasis on histologic events observed. New bone proliferation, resorption, revascularization, and remodeling are contrasted with autogenous bone grafts, which are generally thought to be the preferred surgical option.
The authors present a case of massive fatal pontine hemorrhage as a complication of hypertension in a patient treated for an infected diabetic ulcer. The podiatric physician must be aware of the risks associated with concomitant medical problems such as hypertension and ensure that proper therapeutic measures are taken to avoid the potential for catastrophic complications.
Prescription medications are thought to cause less than 1% of all congenital abnormalities. However, prescribing a medication to treat the foot disorder of a pregnant patient can be a source of anxiety for the physician. The authors review some of the medications commonly prescribed in podiatric medical practice and evaluate their use and safety during pregnancy.
Issues related to residency interview and selection processes have concerned the podiatric medical profession for nearly 20 years. This article presents a chronology and summary of efforts undertaken to address these problems, including a discussion of legal ramifications of residency approval requirements related to establishment of a uniform notification date and participation in a resident-matching service.
The topic of pain management remains a minor component of the formal education and training of residents and physicians in the United States. Misguided attitudes concerning acute and chronic pain management, in addition to reservations about the legal aspects of pain management, often translate into a “fear of the unknown” when it comes to narcotic prescription. The intentionally limited scope of this review is to promote an understanding of the laws regulating pain management practices in the United States and to provide recommendations for appropriate pain management assessment and documentation based on the Model Policy for the Use of Controlled Substances for the Treatment of Pain established by the Federation of State Medical Boards of the United States. (J Am Podiatr Med Assoc 100(6): 511–517, 2010)
The inclusion of appropriate podiatric services in long-term care programs often will produce dramatic effects. Immobility can be replaced by activity. Quality of care translates into quality of life. Support and encouragement can be directed to independence and a strong sense of personal identity and worth. Isolation can be replaced by interaction. When the quality of life decreases as a result of disease, disability, or age, those precious aspects of dignity must be restored to a maximum level by caring staff and people. Because walking is a catalyst for life, podiatric care can help restore some of the lost dignity by keeping patients walking and moving about, so that they can accept and participate in the social activities provided by the facility.