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Background: Direct assessment of health professional student performance of clinical skills can be accurately performed in the standardized performance assessment laboratory (SPAL), typically by health professional faculty. However, owing to time and economic considerations, nonmedical individuals have been specially trained to perform the same function (standardized patients [SPs]). This study compared the assessment scores of the history and physical examination components of a SPAL designed for second-year podiatric medical students at Des Moines University (DMU) by a podiatry medical faculty member and SPs.
Methods: A total of 101 students from the classes of 2015 and 2016 were evaluated in 2013 and 2014 by 11 to 13 SPs from the DMU SPAL program. The video recordings of these 101 students were then evaluated by one faculty member from the College of Podiatric Medicine and Surgery at DMU.
Results: The Pearson correlation coefficient for each class showed a strong linear relationship between SP and faculty assessment scores. The associations between SP and faculty assessment scores in the history, physical examination, and combined history and physical examination components for the 2016 class (0.706, 0.925, and 0.911, respectively) were found to be stronger than those for the 2015 class (0.697, 0.791, and 0.791, respectively).
Conclusions: This study indicated that there are strong associations between the assessment scores of trained SPs and faculty for the history, physical examination, and combined history and physical examination components of second-year SPAL activity for podiatric medical students.
Hyperbaric oxygen therapy (HBOT) is a useful tool for many conditions within the scope of practice of a Doctor of Podiatric Medicine (DPM). More wound-care clinics are adding HBOT as a service line. The increasing prevalence of DPMs operating inside of these wound-care clinics has raised questions about the licensure and privileging of DPMs to supervise HBOT. This document reviews the safety of outpatient HBOT and provides guidelines for hospitals to credential DPMs to supervise treatments.
Qualitative analysis of shoe wear patterns collected from a questionnaire evaluating podiatric physicians’ experiences in this area suggests that wear patterns could indicate causative function within a known pathologic context. Several different functions are suggested by patterns associated with each of the pathologic entities involved, and analysis of the relationship between patterns and reasons given by respondents for pattern-form variations show the strongest associations to be with functionally termed conditions. A basic model is proposed to present factors important in wear pattern production, suggesting that a new concept of primary walking intention is more influential than foot pathologies in wear pattern formation and that external factors are also influential, with the combined factors being described as the “holistic foot function.” This model may provide a variety of benefits to podiatric medicine; as shoe wear patterns are records of the usual long-term activity of the functioning foot, this paradigm could form a basis for podiatric medical practice. (J Am Podiatr Med Assoc 94(3): 261–268, 2004)
This study was designed to determine the prevalence of fibromyalgia in the podiatric patient population. A total of 355 consecutive patients in a podiatric outpatient clinic were evaluated to determine whether they met the criteria for this condition. Eight of the 355 patients were diagnosed with the condition. Thirty-five of 355 patients presented with plantar heel or arch pain. Seven of these 35 patients satisfied the criteria for fibromyalgia. This small study indicates that fibromyalgia may be more prevalent in podiatric patients than previously realized and must be considered in patients presenting with foot pain, especially if that pain is in the area of the plantar aspect of the heel or arch.
Background: Surgery is a common setting for opioid-naive patients to first be exposed to opioids. Understanding the multimodal analgesic-prescribing habits of podiatric surgeons in the United States may be helpful to refining prescribing protocols. The purpose of this benchmark study was to identify whether certain demographic characteristics of podiatric surgeons were associated with their postoperative multimodal analgesic-prescribing practices.
Methods: We administered a scenario-based, voluntary, anonymous, online questionnaire that consisted of patient scenarios with a unique podiatric surgery followed by a demographics section. We developed multiple logistic regression models to identify associations between prescriber characteristics and the odds of supplementing with a nonsteroidal anti-inflammatory drug, regional nerve block, and anticonvulsant agent for each scenario. We developed multiple linear regression models to identify the association of multimodal analgesic-prescribing habits and the opioid dosage units prescribed at the time of surgery.
Results: Eight hundred sixty podiatric surgeons completed the survey. Years in practice was a statistically significant variable in multiple scenarios. Compared with those in practice for more than 15 years, podiatric surgeons in practice 5 years or less had increased odds of reporting supplementation with an anticonvulsant agent in scenarios 1 (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.11–5.18; P = .03), 3 (OR, 2.97; 95% CI, 1.55–5.68; P = .001), 4 (OR, 2.54; 95% CI, 1.56–4.12; P < .001), and 5 (OR, 2.07; 95% CI, 1.29–3.32; P = .003).
Conclusions: Podiatric surgeons with fewer years in practice had increased odds of supplementing with an anticonvulsant. Approximately one-third of podiatric surgeons reported using some form of a nonopioid analgesic and an opioid in every scenario. The use of multimodal analgesics was associated with a reduction in the number of opioid dosage units prescribed at the time of surgery and may be a reasonable adjunct to current protocols.
The College of Podiatric Medicine and Surgery was established in 1981 as a fully integrated college of the University of Osteopathic Medicine and Health Sciences, Des Moines, Iowa, becoming the only school in the profession to be part of an academic health science center. Thus, this college provides a unique opportunity for the students and the podiatric medical profession to receive a multidisciplinary education, preparing them for podiatric medical practice as an integral part of total health care.
Many podiatric physicians will never be sued during their careers, but if a suit happens, it can be one of the most stressful times in their lives. After contacting the insurance carrier, the podiatric physician must then wait as the case develops through the legal system. The deposition is when the podiatric physician will be asked questions about the case. It is important to remember to carefully answer the questions asked. Once in the trial stage, the appearance and testimony of the podiatric physician will be important in the jury's eyes. If a decision is not in your favor, you may be able to appeal the case to a higher court. Some cases may not go to trial as they could be settled or arbitrated along the way. By listening to your attorney and following the attorney's advice and recommendations, the legal process will be easier to manage and understand.
This article presents the problems and challenges facing the Ohio College of Podiatric Medicine in the view of its President and its Chief Academic Officer. It explores the progress made and the challenges facing the Ohio College overall and in the areas of education. It presents an exciting new vision of the style of podiatric medical education, and the methods that are and will be used to assess the quality of the educational program.
Medical and Economic Impact of a Free Student-Run Podiatric Medical Clinic
A Preliminary Analysis
Background
Data from the free student-run podiatric medical clinic at Clínica Tepati at the University of California, Davis, were used to analyze medical and economic impacts on health-care delivery and to extrapolate the economic impact to the national level. Clínica Tepati also provides an excellent teaching environment and services to the uninsured Hispanic population in the Greater Sacramento area.
Methods
In this analysis, we retrospectively reviewed patient medical records for podiatric medical encounters during 15 clinic days between November 2010 and February 2012. The economic impact was evaluated by matching diagnoses and treatments with Medicare reimbursement rates using International Classification of Diseases codes, Current Procedural Terminology codes, and the prevailing Medicare reimbursement rates.
Results
Sixty-three podiatric medical patients made 101 visits during this period. Twenty patients returned to the clinic for at least one follow-up visit or for a new medical concern. Thirty-nine different diagnoses were identified, and treatments were provided for all 101 patient encounters/visits. Treatments were limited to those within the clinic's resources. This analysis estimates that $17,332.13 worth of services were rendered during this period.
Conclusions
These results suggest that the free student-run podiatric medical clinic at Clínica Tepati had a significant medical and economic impact on the delivery of health care at the regional level, and when extrapolated, nationally as well. These student-run clinics also play an important role in medical education settings.
The authors examine the future of podiatric medicine through an analysis of the characteristics of students presently enrolled in the colleges of podiatric medicine and the characteristics of college graduates from 1990 to 1995. Specific attention is also given to a number of critical issues surrounding graduate podiatric medical education. The authors conclude that despite a growing number of challenges awaiting podiatric medical education, the present complement of students and graduates of the colleges of podiatric medicine appear to offer the public reasonable expectations for quality foot care.
