Achieving A Common Ground Between DPMs And Orthopedists

There was a great moment during the first International Foot and Ankle Congress (IFAC) meeting in New Orleans, where podiatrists and orthopedic surgeons convened to share their knowledge and experience. During his lecture on performing an FHL tendon transfer, Pascal Rippstein, MD, discussed the difficulty of trying to pass a tendon through a drill hole. Using motion photography, Dr. Rippstein, an orthopedic surgeon from Zurich, Switzerland, went back and forth with the images to convey the frustration of this experience. There was a roar of laughter from the audience and applause. It was in recognition of the fact that, as one podiatric surgeon put it, “We’ve all been there.” Achieving this kind of common ground between podiatrists and orthopedic surgeons is significant given the turbulent nature of the relationship between the two professions in the past. One prominent leader in the profession recalls a time when podiatrists were not allowed to attend the American Academy of Orthopedic Surgeons’ (AAOS) Annual Meeting. When he was just starting out, he recalls sneaking into the meeting for five years and “hiding in the projection booth” in order to hear lectures. Another podiatrist recalls a similar experience, noting that he once attended the AAOS meeting as an exercise physiologist. There was an uneasy sensitivity even 10 years ago. Back then, one of my colleagues here used to work in sales for an orthopedic journal. He recalls telling a potential advertiser that the journal also went to some podiatrists. The advertiser told him that wasn’t a fact that he should emphasize in future sales pitches. However, recent developments in the last couple of years seem to indicate that the negativity of the past is starting to fade away in the rear view mirror. In regard to the current relationship between orthopedists and podiatrists, one DPM tells me “it’s more interactive than it’s ever been.” A veteran podiatric educator concurs, emphasizing that “it is much more common” for general orthopedists to refer cases to podiatrists than when he began his career. It’s a personal thing as well, according to another DPM, who says once you get to know them and they get to know you, you can have a truly symbiotic relationship. He says he has worked closely with five orthopedic surgeons over the past three to four years. They have helped him with things such as obtaining iliac crest grafts and he notes that they collaborate on complex ankle or lower extremity cases, and team up on medical mission trips as well. He adds that multidisciplinary efforts in treating the diabetic foot and its associated pathologies have also helped in forging relationships between the two professions. The increasing emphasis on multidisciplinary collaboration has also been fueled by the podiatric profession’s focus on bolstering and elevating residency standards. While previous resentments were partially fueled by the notion that podiatrists were “under-schooled” in comparison to orthopedists, more and more podiatry residents spend time in orthopedic rotations with orthopedic residents. Several DPMs says this greatly facilitates future collaboration as they have trained together in the same settings. Perhaps the scene from the IFAC meeting is a positive harbinger of things to come. The lecture hall was standing room only. I truly can’t recall this level of rapt attention at any other podiatry conference. Overall, there does seem to be an emerging consensus that as the podiatric residencies continue to excel and the podiatric research and conferences continue to improve, the relationship between orthopedists and podiatrists will continue to bloom and prosper.