What Is a Podiatrist?

Medical Specialty Devoted to the Feet and Ankles

Podiatrist examining patient's foot
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A podiatrist is a doctor devoted to the diagnosis and treatment of foot, ankle, and lower leg problems. Podiatrists are unique in that they receive specialized training from an accredited college of podiatric medicine rather than entering medical school like other doctors. Although they possess extensive knowledge of human physiology, they are licensed only to treat the lower extremities and cannot pursue a residency in any other field of medicine.

A podiatrist is able to prescribe medications, set fractures, perform surgery, and utilize lab and imaging tests for diagnostic purposes. Podiatrists will often work with other health professionals to treat primary diseases of the foot or those secondary to other conditions (such as diabetes or cancer).

A podiatrist should not be confused with a pedorthist, an allied health professional who is trained to modify footwear and use supportive devices to correct foot and ankle disorders.

Concentrations

Podiatrists are able to diagnose and treat any condition affecting the bones, joints, skin, muscles, connective tissues, nerves, and circulation of a lower limb. Moreover, they trained in both the surgical and non-surgical treatment of foot and ankle problems.

Here are just some of the conditions a podiatrist is qualified to treat:

Procedural Expertise

A podiatrist relies on a variety of tools and techniques to diagnose, treatment, manage, or prevent disorders of the foot, ankle, and lower extremities.

Diagnosis

The diagnosis of foot or ankle problem usually starts with a review of your medical history and symptoms. Based on the initial examination, the podiatrist may use any one of the following diagnostic tools:

  • Arthrography is an imaging technique using an injected contrast iodine solution to pinpoint the cause of a ligament, cartilage, or tendon pain on an X-ray.
  • Blood tests may be used to measure inflammation (ESR and C-reactive protein), detect blood clots (D-dimer), or identify autoimmune diseases (like rheumatoid arthritis).
  • Bone scans, including a DEXA scan and dual-photon absorptiometry, may be used to identify bone fractures or areas of unusually active bone formation,
  • Computed tomography (CT) combines X-rays with computer technology to produce a more detailed, cross-sectional images of the lower extremities.
  • Doppler ultrasound, a device using high-frequency sound waves, can identify a blockage in a blood vessel of your legs.
  • Electromyography (EMG) records and analyzes the electrical activity in your muscles to help identify a muscle or nerve disorder.
  • Flexibility and reflex tests are used respectively to measure the range of motion in a joint and assess neuromuscular function.
  • Joint aspiration involves collecting fluid from the joint space to diagnose infections or inflammatory conditions like gout.

Treatment

Despite being limited to the lower extremities, the scope of practice of a podiatrist is far-reaching. It can involve aspects of dermatology, orthopedics, rheumatology, neurology, pharmacology, and surgery. Among the treatments commonly used by podiatrists:

In addition, a podiatrist will instruct patients on proper foot and ankle care and provide wellness counseling to maintain or improve mobility. They will also coordinate care with other providers or refer patients to specialists if a larger health concern is detected, such as diabetes or vascular disease.

Subspecialties

Many podiatrists maintain general practices, either alone with or with other doctors and allied health professionals. Others will pursue podiatry subspecialties including:

  • Dermatological podiatry (skin disorders)
  • Diagnostic podoradiology (foot and ankle radiology)
  • Forensic podiatry (the study of footprints and shoe prints for crime scene investigations)
  • Gerontological podiatrist (geriatric foot conditions)
  • Podopediatrics (pediatric podiatry)
  • Podiatric diabetology (diabetes foot care)
  • Podiatric oncology (skin cancers)
  • Podiatric orthopedics (the treatment of foot abnormalities with orthotics, prosthetics, and footwear)
  • Podiatric rheumatology (involving rheumatoid arthritis and other autoimmune diseases)
  • Podiatric sports medicine
  • Podiatric vascular specialist (circulation disorders)
  • Neuropodiatry (nerve disorders)
  • Reconstructive foot and ankle surgery (also known as consultant podiatric surgery)

Training and Certification

Podiatrists are often confused with orthopedists who also treat foot disorders but are qualified to treat any other musculoskeletal condition as well. The educational pathway of both professions are similar, but podiatrists ultimately obtain a Doctor of Podiatric Medicine (DPM) degree while orthopedists (also known as orthopedic surgeons) get either a Doctor of Medicine (MD) or Doctor of Osteopathic (DO) degree.

Medical School

To enter a college of podiatric medicine, you must first complete at least three years or 90 semester hours of college credit at an accredited institution. In addition to completing studies in biology, chemistry, physics, and other prerequisite courses, you must pass the Medical Competency Aptitude Test (MCAT).

The curriculum of a podiatric college is similar to that of any medical school but with an emphasis on the foot, ankle, and lower extremities. The first two years are devoted mainly to classroom studies, while the second involves clinical rotations in different facilities to gain experience working with patients.

Residency and Certification

After graduating, you would begin a three-year residency program, rotating through core areas of podiatric medicine and surgery. Upon completion of the residency, podiatrists can decide to become board certified by any number of medical societies, including the American Board of Podiatric Medicine (ABPM) and the American Board of Podiatric Surgery (ABPS).

Podiatrists must be licensed in the state in which they intend to practice. This involves passing the American Podiatric Medical Licensing Exam (APMLE) as well as a state board exam in some states.

According to the Bureau of Labor Statistics, the median annual salary for podiatrists in 2018 was $129,550. Those who maintained their own practice had the highest earning potential ($151,580).

Appointment Tips

Most people are referred to a podiatrist when a foot or ankle problem is serious or unsightly or fails to resolve under the care of a primary care physician. To get the most out of your appointment, take the time to prepare by:

  • Making a list of your symptoms, medications, medical conditions, and previous surgeries or treatments.
  • Preparing a list of questions to better understand your condition.
  • Bringing any relevant lab reports, medical records, or X-rays.
  • Checking with your insurance provider to see if a referral is needed.
  • Bringing your regular walking shoes if your problem involves walking.

It also helps to ensure that your feet are clean and dry for your appointment. Avoid nail polish, foot powders, ointments or gels until after your visit.

Also, be sure to take notes since much of the advice will be centered on proper foot care and preventive treatments. If cost is an issue, don't be embarrassed to ask if there less costly alternatives (such as orthotic insoles instead of custom orthopedic shoes).

You should also check which lab and imaging tests are covered by your policy and discuss this in advance with the doctor.

A Word From Verywell

When faced with a foot or ankle problem, the first question people will often ask is "Should I see a podiatrist or an orthopedic surgeon?" While it may seem fair to assume that podiatrists are needed for lesser problems and orthopedic surgeons are better suited for more serious concerns, it's not necessarily so.

Because a podiatrist's education is focused solely on the complex structure of the foot and lower extremities, they often have greater experience in treating foot and ankle disorders both surgically and non-surgically.

With that being said, many foot and ankle problems originate from the spine, low back, hip, and knees. If a mobility issue is complex or involves multiple large joints, you may be better served to see in orthopedist.

In the end, the best bet is to choose the doctor you feel the most comfortable with or who has the most experience treating your condition. Never be afraid to ask how often a doctor has performed a procedure or to seek a second opinion if you are uncertain about a course of treatment.

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