PODIATRISTS/DOCTORS OF PODIATRIC MEDICINE California Occupational Guide Number 298 Interest Area 13 1995
THE JOB
PODIATRISTS, also known as DOCTORS OF PODIATRIC MEDICINE, are medical specialists concerned with the diagnosis and treatment of disorders and diseases affecting the foot, ankle, and the lower leg such as foot deformities, ankle and foot injuries, infections, ingrown toenails, and bunions. Podiatrists also treat conditions like warts, arch disorders, flat feet, and athlete's foot. They are fully trained in the latest medical and surgical techniques to diagnose and treat diseases, injuries, and abnormalities of the feet and ankles through medical, surgical, and biochemical means.
To aid in diagnosis, they take medical histories, conduct physical examinations, take x-rays, and perform laboratory tests or other pathological tests as needed. Treatment may include prescribing medications, corrective devices, physical therapy, or surgery. In California, but not all states, podiatric physicians are restricted from amputating the whole foot, but they can surgically remove toes. They cannot administer a general anesthetic, but when a general anesthetic is required, Podiatrists rely on anesthesiologists, like other surgeons. Podiatric physicians are trained to identify symptoms of medical disorders such as arthritis, diabetes, or heart disease. While continuing to treat related foot problems, they may refer the patient to another physician for further appropriate treatment.
Most podiatric physicians practice as generalists, treating all kinds of foot ailments. Some specialize in foot surgery, orthopedics (bone and joint disorders), children's foot disorders, foot disorders common to older persons, or sports medicine.
WORKING CONDITIONS
Podiatric physicians have offices just like those of other physicians. Some are employed in group practices or in clinics. They generally employ podiatric assistants, nurses, clerical personnel, and other health professionals. Most podiatric physicians are in private practice, and there is growing recognition of their value in PPOs (Preferred Provider Organizations) and HMOs (Health Maintenance Organizations). In California many of the podiatric physicians are on hospital staffs.
California podiatric physicians generally belong to the American Podiatric Medical Association, the California Podiatric Medical Association and may also belong to other professional organizations such as the American Public Health Association and the Academy of Ambulatory Foot Surgery.
Podiatrists generally work from 35 to 40 hours a week which may include some evening hours. Those who work for hospitals may be required to work evenings or weekends.
The costs of operating an office depends on its size and location and whether it is a group practice or independent.
EMPLOYMENT OUTLOOK
In 1993 there were about 13,500 to 15,000 Podiatrists licensed to practice in the United States, of these, there were about 2,100 licensed Podiatrists in California, an increase of 30 percent from the total in 1987. Opportunities to establish new practices, as well as to enter salaried positions should be favorable into the late-1990's. The California Projections of Employment published by the Labor Market Information Division indicates that Podiatrist is one of the fifty occupations with the fastest expected job growth between 1990 and 2005 with a potential growth rate of 44 percent.
Broader participation in physically active sport activities such as running, softball, basketball, volleyball, tennis, and aerobics that tend to aggravate foot disorders and a growing older population in need of care for foot ailments and injuries should also should spur demand for podiatric services.
Many private health plans and Medicare will cover acute medical and surgical foot care, including leg braces, x-rays, and foot casts but will not cover the costs of routine care of the feet such as the removal of corns and calluses. Since disposable income is expected to rise, more people will be paying Podiatrists for those services not covered by health insurance.
WAGES, HOURS, AND FRINGE BENEFITS
Newly licensed Podiatrists with less than four years of experience may earn from $30,000 to $35,000 a year. However, setting up a new podiatric practice entails an investment of about $50,000 to $100,000 for equipment and space. Some of those who have opened new facilities reported that it took them the first few years in practice to just "break even" because of the considerable start-up expense.
Earnings for Podiatrists, who have been in practice for six to ten years, average from $75,000 to $100,000 per year. Those who have been in practice from 10 to 15 years earn approximately $120,000 to $150,000 a year. Podiatrists working for the State of California earn from $4,563 to $5,506 per month at the first state civil service level. More experienced staff earn from $4,782 to $6,055 a month.
ENTRANCE REQUIREMENTS AND TRAINING
Licensing requirements for California Podiatric Physicians are administered by the California Board of Podiatric Medicine of the California Board of Medical Quality Assurance. Podiatric physicians must have graduated from a program containing 4,000 course work hours at an accredited college of podiatric medicine and complete a one-year resident surgery training program in a general acute care facility. Candidates must achieve a passing grade on state written and oral licensing examinations. Since states vary in their licensing requirements, students planning to practice outside California should investigate the requirements of the state in which they are interested. Podiatric physicians renewing their California licenses must submit evidence of 50 hours of continuing education and current CPR certification. Personal qualities of all physicians should include a high standard of ethics and integrity, a desire to expand one's knowledge and skills, and the ability to inspire confidence.
There are only seven schools of podiatric medicine in the United States. The California College of Podiatric Medicine in San Francisco and the Osteopathic Medical School in Des Moines, Iowa, are the only colleges west of Chicago that offer this medical specialty education. The four-year curriculum leads to the degree of Doctor of Podiatric Medicine (DPM). About 100 undergraduate students are accepted each year. They must have at least three years of undergraduate premedical studies, and must pass the new Medical Colleges Admissions Test (MCAT). Ninety-seven percent of entering students have baccalaureate or advanced degrees.
High school or college students considering podiatry as a career should take a premedical educational program. Courses include the biological sciences, chemistry, physics, mathematics, social sciences, and English. Students should have scientific aptitude, manual dexterity, interpersonal skills, and good business sense.
ADVANCEMENT
Professional advancement, rather than promotion, is the usual long-range goal for the Podiatrists since most work in private practice. With expanding clientele, Podiatrists will earn higher pay and greater recognition in their field. Success generally means an increased number of referrals from other medical professionals.
For some Podiatrists advancement may mean becoming a specialist in surgery, working with children, or obtaining certification to practice a podiatric specialty through the American Board of Podiatric Surgery, the American Board of Podiatric Orthopedics and Primary Podiatric Medicine, or the American Board of Podiatric Public Health.
Others may desire a teaching position at a podiatry college or have the opportunity to engage in research projects. Podiatrists serving on hospital staffs may promote to administrative or supervisory positions.
FINDING THE JOB
Graduates should register with their college placement service before graduation and then apply directly to hospitals, podiatric groups, and civil service agencies. Another alternative is to read ads in professional journals for associate positions or opportunities to buy an established practice from a podiatrist retiring or leaving the area. Personal visits to local podiatrists can be helpful getting leads by the "grapevine."
ADDITIONAL SOURCES OF INFORMATION
California College of Podiatric Medicine 1210 Scott Street San Francisco, CA 94115 (415) 563-8070
American Podiatric Medical Association 9312 Old Georgetown Road Bethesda, MD 20814 (301) 571-9200
California Podiatric Medical Association 2430 K Street Sacramento, CA 95816 (916) 448-0248
California Board of Podiatric Medicine of the California Board of Medical Quality Assurance 1430 Howe Avenue, Suite 8 Sacramento CA 95825 (916) 263-2647
American College of Foot Surgeons 444 N. Northwest Highway, Suite 155 Park Ridge, IL 60068 (708) 292-2237
RELATED OCCUPATIONAL GUIDES
Dentists No. 377 Pharmacists No. 159 Physicians & Surgeons No. 319 Veterinarians & Veterinary Inspectors No. 282
OCCUPATIONAL CODE REFERENCES
DOT (Dictionary of Occupational Titles, 4th ed., Rev. 1)
Podiatrist 079.101-022
OES (Occupational Employment Statistics) System
Podiatrists 321110
Source: State of California, Employment Development Department,
Labor Market Information Division, Information Services Group,
(916) 262-2162.
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