I’m A Podiatrist, Not Just A Foot And Ankle Surgeon

There is a continuing trend in our profession, especially among our newest members, to try to consider ourselves as equals to orthopedic foot and ankle surgeons. In many hospital systems, our two specialties do not have an amicable relationship so there are continuing efforts to make our training equal to theirs. I do agree we should take every opportunity to better ourselves in regard to surgical techniques and knowledge. However, we need to remember what we really are: podiatrists.

I love being in the operating room just as much as the next surgeon but that is not all we are trained to do. We have a knowledge and skill set without equal in the clinic. We are experts at many things that other specialties do not treat. Our extensive clinical knowledge combined with our surgical skills is what makes us podiatrists.

I have seen far too many students, residents and attendings try to masquerade themselves as orthopedic surgeons, or simply as foot and ankle surgeons. There is an overwhelming notion that podiatrists are inferior and that the only respectable aspect of our training is our surgical skills. This is an insult to our training and our profession.

From the beginning of our education, people look down on nail care. However, for those high-risk patients with diabetes, those with debilitating back pain and those with severe mycotic disease, this service is extremely important. Every patient with diabetes who comes in for nail care is there for more than just nail care. Although we may not be billing for it, we are still performing a diabetic foot exam. Though the majority of patients are stable and do simply need nail care, we have all seen patients who have developed wounds since their last appointments and have neglected to make an appointment. We also have the ability to ensure proper foot gear and identify any risk factors for wounds to develop.

Yes, we trim toenails but that appointment is far more important that “just toenails.” As a personal note, I have had more people thank me and even hug me after performing nail care than any other service I perform. That to me demonstrates how important this aspect is to our patients.

Ingrown toenails are one of the most common acute issues we treat. Patients get referrals to us from primary care and even the emergency room for treatment. For the younger population, ingrown toenails are painful and activity restricting but for the diabetic population, an ingrown toenail can be limb-threatening. Whether it is a temporary or permanent procedure, the fact that this procedure is a standard treatment for us should make us proud. We have the ability to provide an instant solution and relief to our patients. Not all specialties can say that.

We are not just office experts though. We are exceptionally well trained in surgery. We are capable of handling bunion surgery, flatfoot reconstruction, trauma or fracture fixation all in the same day. We have a large array of skills and knowledge, which makes us versatile as well as subject matter experts. There is a wide variety of pathologies from soft tissue pathologies to osseous issues that we have the surgical skills to repair. What gives us the edge is our biomechanical knowledge of the foot and ankle. We are able to make surgical assessments not just in the scope of “if it’s broken, fix it,” but we are able to ensure we choose an appropriate procedure and fixation to ensure adequate ambulation and biomechanics after surgery.

From plantar fasciitis to dermatological issues to flat feet, we can do it all. And the best part? We get to do the surgery too. I love my time in the OR. Any chance to operate is an amazing experience. However, I’m not just an orthopedic foot and ankle surgeon. I’m a podiatrist.