Podiatrists enjoy very high earnings.
Americans spend a great deal of time on their feet. As the
Nation becomes more active across all age groups, the need
for foot care will become increasingly important to maintaining
a healthy lifestyle.
The human foot is a complex structure. It contains 26 bones—plus
muscles, nerves, ligaments, and blood vessels—and is designed
for balance and mobility. The 52 bones in the feet make up
about one-fourth of all the bones in the human body. Podiatrists,
also known as doctors of podiatric medicine (DPMs),
diagnose and treat disorders, diseases, and injuries of the
foot and lower leg.
Podiatrists treat corns, calluses, ingrown toenails, bunions,
heel spurs, and arch problems; ankle and foot injuries, deformities,
and infections; and foot complaints associated with diseases
such as diabetes. To treat these problems, podiatrists prescribe
drugs, order physical therapy, set fractures, and perform
surgery. They also fit corrective inserts called orthotics,
design plaster casts and strappings to correct deformities,
and design custom-made shoes. Podiatrists may use a force
plate or scanner to help design the orthotics: patients walk
across a plate connected to a computer that “reads” their
feet, picking up pressure points and weight distribution.
From the computer readout, podiatrists order the correct design
or recommend another kind of treatment.
To diagnose a foot problem, podiatrists also order x rays
and laboratory tests. The foot may be the first area to show
signs of serious conditions such as arthritis, diabetes, and
heart disease. For example, patients with diabetes are prone
to foot ulcers and infections due to poor circulation. Podiatrists
consult with and refer patients to other health practitioners
when they detect symptoms of these disorders.
Most podiatrists have a solo practice, although more are
forming group practices with other podiatrists or health practitioners.
Some specialize in surgery, orthopedics, primary care, or
public health. Besides these board-certified specialties,
podiatrists may practice other specialties, such as sports
medicine, pediatrics, dermatology, radiology, geriatrics,
or diabetic foot care.
Podiatrists who are in private practice are responsible for
running a small business. They may hire employees, order supplies,
and keep records, among other tasks. In addition, some educate
the community on the benefits of foot care through speaking
engagements and advertising.
Podiatrists usually work in their own offices. They also
may spend time visiting patients in nursing homes or performing
surgery at hospitals or ambulatory surgical centers, but usually
have fewer afterhours emergencies than other doctors have.
Those with private practices set their own hours, but may
work evenings and weekends to accommodate their patients.
|Training, Other Qualifications, and Advancement
All States and the District of Columbia require a license
for the practice of podiatric medicine. Each State defines
its own licensing requirements, although many States grant
reciprocity to podiatrists who are licensed in another State.
Applicants for licensure must be graduates of an accredited
college of podiatric medicine and must pass written and oral
examinations. Some States permit applicants to substitute
the examination of the National Board of Podiatric Medical
Examiners, given in the second and fourth years of podiatric
medical college, for part or all of the written State examination.
Most States also require the completion of a postdoctoral
residency program of at least 2 years and continuing education
for license renewal.
Prerequisites for admission to a college of podiatric medicine
include the completion of at least 90 semester hours of undergraduate
study, an acceptable grade point average, and suitable scores
on the Medical College Admission Test (some colleges also
may accept the Dental Admission Test or the Graduate Record
Exam). All of the colleges require 8 semester hours each of
biology, inorganic chemistry, organic chemistry, and physics,
as well as 6 hours of English. The science courses should
be those designed for premedical students. Potential podiatric
medical students also are evaluated on the basis of extracurricular
and community activities, personal interviews, and letters
of recommendation. About 95 percent of podiatric students
have at least a bachelor’s degree.
In 2005, there were seven colleges of podiatric medicine
accredited by the Council on Podiatric Medical Education.
Colleges of podiatric medicine offer a 4-year program whose
core curriculum is similar to that in other schools of medicine.
During the first 2 years, students receive classroom instruction
in basic sciences, including anatomy, chemistry, pathology,
and pharmacology. Third- and fourth-year students have clinical
rotations in private practices, hospitals, and clinics. During
these rotations, they learn how to take general and podiatric
histories, perform routine physical examinations, interpret
tests and findings, make diagnoses, and perform therapeutic
procedures. Graduates receive the degree of Doctor of Podiatric
Most graduates complete a hospital-based residency program
after receiving a DPM. Residency programs last from 2 to 4
years. Residents receive advanced training in podiatric medicine
and surgery and serve clinical rotations in anesthesiology,
internal medicine, pathology, radiology, emergency medicine,
and orthopedic and general surgery. Residencies lasting more
than 1 year provide more extensive training in specialty areas.
There are a number of certifying boards for the podiatric
specialties of orthopedics, primary medicine, and surgery.
Certification means that the DPM meets higher standards than
those required for licensure. Each board requires advanced
training, the completion of written and oral examinations,
and experience as a practicing podiatrist. Most managed-care
organizations prefer board-certified podiatrists.
People planning a career in podiatry should have scientific
aptitude, manual dexterity, interpersonal skills, and good
Podiatrists may advance to become professors at colleges
of podiatric medicine, department chiefs in hospitals, or
general health administrators.
Podiatrists held about 10,000 jobs in 2004. About 23 percent
of podiatrists are self-employed. Most podiatrists were solo
practitioners, although more are entering group practices
with other podiatrists or other health practitioners. Solo
practitioners primarily were unincorporated self-employed
workers, although some also were incorporated wage and salary
workers in offices of other health practitioners. Other podiatrists
are employed in hospitals and by the Federal Government.
Employment of podiatrists is expected to grow about as fast
as average for all occupations through 2014. More people will
turn to podiatrists for foot care because of the rising number
of injuries sustained by a more active and increasingly older
population. Additional job openings will result from podiatrists
who retire from the occupation, particularly members of the
baby-boom generation. However, relatively few job openings
from this source are expected because the occupation is small
and most podiatrists remain in it until they retire.
Medicare and most private health insurance programs cover
acute medical and surgical foot services, as well as diagnostic
x rays and leg braces. Details of such coverage vary among
plans. However, routine foot care, including the removal of
corns and calluses, ordinarily is not covered unless the patient
has a systemic condition that has resulted in severe circulatory
problems or areas of desensitization in the legs or feet.
Like dental services, podiatric care is often discretionary
and, therefore, more dependent on disposable income than some
other medical services.
Employment of podiatrists would grow even faster were it
not for continued emphasis on controlling the costs of specialty
health care. Insurers will balance the cost of sending patients
to podiatrists against the cost and availability of substitute
practitioners, such as physicians and
physical therapists. Opportunities will be better for board-certified
podiatrists, because many managed-care organizations require
board certification. Opportunities for newly trained podiatrists
will be better in group medical practices, clinics, and health
networks than in traditional solo practices. Establishing a
practice will be most difficult in the areas surrounding colleges
of podiatric medicine, where podiatrists are concentrated.
Podiatrists enjoy very high earnings. Median annual earnings
of salaried podiatrists were $94,400 in 2004. Additionally,
a survey by Podiatry Management Magazine reported median
net income of $113,000 in 2004. Podiatrists in partnerships
tended to earn higher net incomes than those in solo practice.
Self-employed podiatrists must provide for their own health
insurance and retirement.
Other workers who apply
medical knowledge to prevent, diagnose, and treat lower body
muscle and bone disorders and injuries include athletic trainers,
chiropractors, massage therapists, occupational therapists,
physical therapists, and physicians and surgeons. Workers who
specialize in developing orthopedic shoe inserts, braces, and
prosthetic limbs are orthotists and prosthetists.
|Sources of Additional Information
For information on a career in podiatric medicine, contact:
- American Podiatric Medical Association, 9312 Old Georgetown
Rd., Bethesda, MD 20814-1621. Internet: http://www.apma.org/
Information on the colleges of podiatric medicine and their
entrance requirements, curricula, and student financial aid
is available from:
- American Association of Colleges of Podiatric Medicine,
15850 Crabbs Branch Way, Suite 320, Rockville, MD 20855-2622.
- Source: Bureau of Labor Statistics,
U.S. Department of Labor, Occupational Outlook Handbook,