• Dr. Jennifer Nicole Falk

What Doctor Should I See For My Foot Pain?



To me, podiatry has always been a well-known profession. After sustaining multiple foot fractures as an adolescent, the podiatrist’s office was very much a familiar one. However, after becoming a podiatrist, I realized that this familiarity is not shared among all. Between being asked how I like treating children (because it was thought I was a pediatrician) to wondering if I just make orthotics or trim toenails, I learned that there is a lack in the understanding among the general public, and sometimes even among physicians, with regards to what a podiatrist can do and the conditions we can treat. This may be, in part, due to the significant progression in the field of podiatry over the years that others are not aware of or have recognized. So before you schedule your next doctor’s appointment for your foot problem, please read below to see what the CURRENT differences are between the various related doctors when it comes to their education, training, and scope of practice.

SPORTS MEDICINE DOCTOR

Education/Training: 4 years of undergraduate school + 4 years of medical school + 3 years of residency (typically in family medicine or other non-surgical subspecialty) + 1-2 years of sports medicine fellowship.

A sports medicine doctor is a medical doctor (MD) or osteopathic doctor (DO), who has undergone 4 years of medical school followed by 3 years of residency. The type of residency program may differ, but most go into family medicine or other non-surgical program. After completing residency, they must pursue a sports medicine fellowship program (usually 1-2 years in length), where they learn about specific sports injuries (1,3). Once done with their education and training, these doctors are able to treat non-surgical sports medicine and orthopedic injuries, as well as conditions within their original specialty (e.g. family medicine, pediatrics, internal medicine, rehabilitation medicine, etc) (3). It is not uncommon to see this type of physician working with sports teams.

ORTHOPEDIC SURGEON

Education/Training: 4 years of undergraduate school + 4 years of medical school + 5 years of orthopedic surgical residency + 1 year of orthopedic subspecialty fellowship (e.g. foot & ankle, sports).

Like a sports medicine physician, orthopedic surgeons first go to medical school, but their residency training is focused on orthopedic injuries. During residency, they rotate through the different subspecialties within orthopedics, including total joint replacement surgery, hand, spine, foot & ankle, and sports. After residency, if one wishes to pursue a specific subspecialty, they may do an additional fellowship year for further training (2). Unlike the primary care sports medicine doctors, orthopedic surgeons have been trained to do surgical procedures, but they often specialize in one of the subspecialties of orthopedics.

PODIATRIST

Education/Training: 4 years of undergraduate school + 4 years of podiatry school + 3 years of podiatric surgical residency +/- fellowship (e.g. foot & ankle reconstructive surgery, sports medicine)

Unlike an MD or DO, who go to medical school, a podiatrist attends podiatry school, which is four years of postgraduate education focusing on the lower extremity. The first two years may be similar to a medical student’s, where basic science courses are completed, but the last two years, including clinical rotations, are mostly foot and ankle-related. After earning a Doctor of Podiatric Medicine (DPM) degree, one must complete a comprehensive 3-year podiatric surgical residency program with rotations not only in podiatry, but also in other specialties, which may include internal medicine, anesthesia, and vascular surgery. The podiatric rotations and focuses will differ depending on the program, but to give an example, my residency program had concentrations in biomechanics, forefoot & rearfoot/ankle surgery, along with trauma. This well-rounded training experience allows for a podiatrist to build their practice to their liking or skill set after residency. That is why you may see anything from a generalized non-surgical podiatrist that mainly sees every day common foot problems (e.g. heel pain, ingrown toenails, warts) to wound care specialists that treat diabetic and vascular wounds to surgical podiatrists that do reconstructive surgery for flatfoot deformities. Some podiatrists even perform total ankle replacements. The scope of practice (what the podiatrist is allowed to do) differs depending on the state in which one practices; however, in general, the training and scope of practice of a podiatrist today is significantly more advanced compared to prior generations.

CHIROPRACTOR

Education/Training: 4 years of undergraduate school + 4 years of chiropractic school +/- residency in a particular field (e.g. sports medicine, radiology)

Similar to a podiatrist’s education, a chiropractor attends a specialty school (chiropractor school) before earning a Doctor of Chiropractic (DC) degree. Also like podiatry, the scope of practice of a chiropractor varies from state to state. It is legal for all chiropractors to use manipulation for musculoskeletal conditions; however, the ability to use of modalities, perform acupuncture, and provide nutritional therapy is determined at the state level (4). Chiropractors can also further their education and training through specialty residency programs.

As you can see, there are multiple healthcare professionals that are qualified and capable of diagnosing and treating foot problems. I just hope this gives you a little better insight into each of their backgrounds, training, and scope of practice to help you make the best decision when it comes to choosing who YOU want taking care of your feet :)

Disclaimer: The above information is meant for educational purposes only and should not be construed as medical advice. Please consult your own healthcare professional with questions or concerns related to your health.

References:

1. How to Become a Sports Medicine Doctor in 5 Steps. Learn.org. Retrieved from http://learn.org/articles/Sports_Medicine_How_to_Become_a_Sports_Medicine_Doctor_in_5_Steps.html

2. Orthopedic Surgery. Washington University School of Medicine in St. Louis. Retrieved from https://residency.wustl.edu/Choosing/SpecDesc/Pages/Orthopedic%20Surgery.aspx

3. Sports Medicine FAQ. American Osteopathic Academy of Sports Medicine. Retrieved from http://www.aoasm.org/about/sports-medicine-faq/

4. Sandefur, R, Coulter, I.D. Chapter V: Licensure and Legal Scope of Practice. Chiropractic in the United States: Training, Practice, and Research. Retrieved from https://www.chirobase.org/05RB/AHCPR/05.html

#footpain #podiatrist #podiatry #sportsdoctor #orthopedist #chiropractor #residency #doctor39sappointment

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