By: William Tran, Sara Judickas, Anjali Chandra, and Kirk Metzger.

 
Podiatric medicine is a growing profession where physicians are able to combine technology, surgery, and medication to achieve the optimal outcome for each patient’s foot and ankle ailment. The profession is excelling in different dimensions, including innovative surgical techniques, high-quality research, and providing medical training to podiatric medical students yearly. However, one of the major issues that the profession as a whole experiences is the lack of awareness by the general public and how foot and ankle care impacts an individual’s daily life.

If the profession cannot voice its name farther and louder, then patients are unlikely to seek podiatrists as their primary physicians when they run into foot and ankle problems

Diving deeper into the issue, according to the United States Census Bureau, the number of people employed as podiatrists has increased by 31.1% from 6,374 people in 2017 to 8,356 people in 2018. However, looking at where podiatrists have established their practices, many gravitate towards urban areas with dense populations, including states like Texas, California, and Wisconsin. There have not been data or quantitative studies showing a strong and full coverage of podiatrists in 11 states located in the northwestern, central, and Rocky Mountain areas. This is one of the reasons why most of the general public does not know much about or has not even heard of the profession.

Despite the geographical differences or personal preferences, there is another reason preventing the public from being aware of podiatrists. According to the American Association of Colleges of Podiatric Medicine, podiatrists are defined as physicians by the federal government. In Medicare, podiatric medical services and orthotics are covered, and the program is required to pay for diabetic foot care for neuropathic patients every six months. However, under Medicaid, podiatrists are not lawfully classified as physicians; thus, those services mentioned above are defined as optional under its health policy. The conflicting classifications under different programs show the obvious inconsistency of where podiatrists stand on a federal level. If the profession cannot voice its name farther and louder, then patients are unlikely to seek podiatrists as their primary physicians when they run into foot and ankle problems.

As a special committee group, the PMA gathered its resources to help promote the awareness of podiatric medicine to the general public including 5th-12th grade students, undergraduates, and county/state government

In order to tackle these issues mentioned above, students at Des Moines University (DMU) gathered and founded a Podiatric Medicine Advocacy (PMA) group in 2014 with the hopes of being able to educate the community about the roles and values behind a podiatric medical physician. The PMA’s mission also emphasizes the idea of promoting parity among other medical specialties. Therefore, the PMA was introduced to the House of Delegates of the American Podiatric Medical Students Association meeting as a directive for all nine podiatric medical colleges. As a special committee group, the PMA gathered its resources to help promote the awareness of podiatric medicine to the general public including 5th-12th grade students, undergraduates, and county/state government.

Every fall semester, the PMA, acting as an umbrella organization, has partnered up with other podiatric clubs on campus to arrange an event called “Get Your Foot in the Door.”

Over 65 students from six middle schools and high schools participated in the event

With three different types of audiences, the PMA has developed three different detailed plans, indirectly highlighting the importance of podiatric medicine in people’s foot care routine, to induce the most efficient and robust conversations with its audience. Every fall semester, the PMA, acting as an umbrella organization, has partnered up with other podiatric clubs on campus to arrange an event called “Get Your Foot in the Door.” The event is aimed particularly at middle and high school students around the Des Moines area. From the advocating point of view, it is the most robust step that the PMA takes to strengthen the core of podiatric medicine by educating and exposing the youths to daily activities and tasks of a practicing podiatrist. In order to achieve that goal, the group has carefully planned out and teamed up with Student Chapter of the American College of Foot and Ankle Surgeons (SCACFAS) club, American Association of Women Podiatrists (AAWP) club, and American College of Foot and Ankle Orthopedic Medicine (ACFOAM) club. Over 65 students from six middle schools and high schools participated in the event, and they were divided into four groups which rotated to four different stations. At each station, students had the opportunity to learn alongside medical students and ask questions regarding imaging modalities, suturing techniques, casting processes, and sterile practices. These activities were meant to trigger students’ passion and curiosity toward the profession as well as educate them about common foot and ankle injuries.

To reach out to undergraduates at local colleges, the PMA has worked collaboratively with DMU admissions and the Dean’s office to ensure that the PMA does not act as a recruiting agency on behalf of the university. At the beginning of the spring semester, the group traveled to Central College in Pella, IA upon their invitation to talk about podiatric medicine. The panel, composed of the past, present, and future members of the PMA leadership, shared their passions and reasons as to why they chose podiatric medicine over other health professions. Surprisingly, most of the club members on the panel did not know about the profession until their senior year of college, which shows that many pre-medical students are probably not even aware of the field. Therefore, it was important to emphasize to undergraduate students the relevance of podiatric medicine and how it impacted their daily lives. To give the students an inside look at what podiatric physicians do as a part of their work, the undergraduates were shown how to operate a doppler ultrasound device. Additionally, a third-year club member demonstrated different types of surgical knot-tying techniques used in the operating room. These hands-on experiences were meant to help college students get a closer look at what they will be capable of doing if they were to choose a career in podiatric medicine.

The legislature is a unique audience to approach since they have been working to build numerous amendments and laws, which include precise facts and well-articulated logistics, on a daily basis. At the Physician Day on the Hill event, which was sponsored by Iowa Medical Society, all physicians (M.D, D.O, and D.P.M) and medical students across the state of Iowa came together and advocated for Tort reforms. The state government had a difficult time deciding on the number of dollars to cap on non-economic damages, such as pain and suffering. The bill was introduced to protect the attending and future physicians from being taken advantage by insurance companies for their malpractices. Before having a constructive conversation with both state senators and representatives, the PMA was prepared to talk about the need for podiatrists in the state and for more funding for podiatric medical education. Surprisingly, diabetes-related issues and insulin charges were among the most relevant and most debatable topics in both Iowa Chambers, which highlighted the need for podiatrists and podiatric medicine. One of the state senators acknowledged the importance of keeping podiatrists in the state of Iowa, particularly in the rural areas where access to primary care and specialties is still limited.

These are the small steps that the PMA have been taking to advocate for the profession and support its mission at the school and state levels. Podiatric medicine and podiatrists have the solid ground to stand on from an administrative perspective, but it needs to have a bigger and louder voice to spread its message and attract a larger audience so that the public becomes more aware of the profession. Until then, podiatric medical students and podiatrists across the nation should not stop advocating and fighting for the profession’s rights and privileges.

 

References

1. Becoming a Podiatric Physician. American Association of Colleges of Podiatric Medicine, https://www.aacpm.org/becoming-a-podiatric-physician/. Accessed 27 Mar. 2020.
2. Boose, Barb. DMU Podiatric Students Become Champions for Their Profession. Des Moines University- College of Podiatric Medicine and Surgery, 04 Nov. 2014, https://www.dmu.edu/news/2014/11/dmu- podiatric-students-become-champions-for-their-profession/. Accessed 27 Mar. 2020.
3. Foot care. Medicare.gov, https://www.medicare.gov/coverage/foot-care. Accessed 28 Mar. 2020.
4. Medicaid: The Definition of Podiatrist as Physician. American College of Foot and Ankle Surgeons, https://www.acfas.org/Health-Policy-and-Advocacy/Legislative-and-Regulatory-Issues/Medicaid–The- Definition-of-Podiatrist-as-Physician/. Accessed 27 Mar. 2020.
5. United States Census Bureau. Podiatrist. Public Use Microdata Sample Documentation, 2018.

By: William Tran, Sara Judickas, Anjali Chandra, and Kirk Metzger.

Student Organization: Podiatric Medical Advocacy (PMA)

School: Des Moines University College of Podiatric Medicine and Surgery

Do Podiatrists Owe Americans an Answer?

Finalist – Writing Competition 2020

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