Podiatrist Vs. Orthopedist
I am often asked what the difference between podiatry and orthopedics is. I always reply, it depends who’s answering. Numerous types of healthcare providers evaluate and treat conditions of the feet. These include podiatrists, orthopedic surgeons, primary care physicians, and physical therapists. The relationship between podiatrists and orthopedists is something like that of two politicians who claim to really, really respect each other, which each secretly believes in their own superiority. For most conditions, the question of which kind of doctor to see is largely a matter of whom you feel most comfortable with.
Although podiatrists and orthopedic surgeons treat many of the same conditions, their training is different. There is essentially a lot of overlap in treatments, but orthopedists point out that they are able to treat the patient as a whole, not just form the ankle down. Many patients swear by podiatrist however, believing that they are better at offering pain relief and trying conservative measures first. Current statistics show that overall, 39% of patients choose a podiatrist while only 15% choose an orthopedist. The remaining amount is treated by family doctors and others. There are more orthopedic surgeons than podiatrists but more podiatrists than foot and ankle orthopedic surgeons.
What is a Podiatrist?
A podiatrist is a Doctor of Podiatric Medicine (DPM). A podiatrist has specialized training to treat disorders of the foot and ankle. Currently, they must complete the following formal education:
- Four years of undergraduate school
- Four years at an accredited podiatric medical school
- Three to four years of only foot and ankle surgical residency training
They receive medical training plus specialized training on the foot, ankle, and lower leg. They are also extremely well trained in biomechanics and proper foot balance and therefore well equipped to fit orthotics, custom shoes, and a variety of braces. Podiatrists study medicine as it relates to feet, during the entire course of study. They spend their entire surgical residency training on the foot and ankle, often with multiple podiatric and orthopedic surgeons. Therefore, they have more years of study that is focused specifically on feet.
A podiatrist can treat only foot and ankle conditions, with a few exceptions in some remote areas. Podiatrists are able to treat disorders conservatively as well as surgically. A podiatrist is probably more inclined to try to treat conditions conservatively and would likely recommend a surgical approach only if other methods have not been successful. In fact, some podiatrists do not do surgery or are not trained in the latest surgical techniques. Others that are well trained perform complicated reconstructive surgeries. All podiatrists must pass state board examinations before they are licensed to practice.
Some podiatrists are solo practitioners while some practice in large specialty groups. Lately, more and more podiatrists are moving into practice with large healthcare clinics and primary care groups.
What is an Orthopedic Surgeon?
An orthopedic surgeon is a medical doctor (MD or DO) who treats the entire musculoskeletal system, not just the lower extremity. Orthopedics is the medical specialty devoted to the diagnosis, treatment, rehabilitation, and prevention of injuries and diseases in your musculoskeletal system. While some orthopedics practice general orthopedics, some specialize in treating the foot and ankle, hand, shoulder, spine, hip, knee, or pediatrics and sports medicine.
Some foot and ankle problems originate from your knee, hip, or lower back. Foot and ankle orthopedic surgeons are able to effectively treat complex lower extremity conditions in conjunction with the rest of your body. They specifically evaluate foot problems but can also review other orthopedic issues that may be contributing to foot and ankle pain. Currently, they must complete the following formal education:
- Four years of undergraduate school
- Four years at an accredited medical school
- Five years of generalized orthopedic surgical residency training
- Possible additional one year fellowship dedicated to treatment of foot and ankle disorders
Orthopedic surgeons have a better general medical background, but less time specifically learning about feet. All orthopedic surgeons must pass a national medical licensing examination. An orthopedic surgeon may also choose to complete one year advanced fellowship training in foot and ankle surgery. If you chose an orthopedic surgeon to take care of your feet, make sure you chose one with expertise in foot problems. Remember, an orthopedic surgeon is primarily a surgeon and their approach to foot care usually focuses on surgery.
A study by the Resident Education Committee of the American Orthopaedic Foot & Ankle Society initiated a survey of Orthopaedic Surgery Residents in the US. They found that the majority of orthopedic residents experienced an average of 12 weeks dedicated to foot and ankle training, whereas 18 of the 148 programs actually had 20-24 weeks of foot and ankle training. The majority of Orthopaedic Surgical Residencies had only one faculty member dedicated to foot and ankle training.
Regardless of whom you choose, remember, there are always differences of opinion. A surgically trained podiatrist or a foot and ankle orthopedic surgeon are both excellent choices. I obviously wound not recommend a podiatrist that has little surgical training, nor would I recommend a general orthopedic surgeon. It is always a great idea to ask your doctor about their qualifications and experience before proceeding with surgery. A well trained podiatric surgeon or a foot and ankle orthopedist is certainly a personal decision. You should be comfortable with the individual doctor and his/her demeanor, attitude, and reputation.
Dallas podiatrist Dr. Ken Legel is a board certified in foot surgery, reconstructive rearfoot and ankle surgery by the American Board of Foot and Ankle Surgery. To schedule an appointment, call our Dallas clinic at (214) 366-4600