To the Editor: Shortages of physicians will be escalating rapidly because of a growing population of people over age 65, implementation of the Affordable Care Act, a marked increase in physician retirement, and an aging baby-boomer generation.1 This problem could be eased if doctors of podiatric medicine (DPMs) could become licensed physicians.
Such a change seems logical. The education of DPMs compares in most important ways to that of other physicians, both doctors of medicine (MDs) and doctors of osteopathic medicine (DOs). Prerequisites to podiatric medical school are the same as those for U.S. MD- and DO-granting medical schools, followed by a four-year curriculum with preclinical and clinical studies virtually identical to those of MD-granting schools. In fact, one podiatric medical school provided a new accredited osteopathic medical school with almost its entire preclinical curriculum (i.e., basic sciences) before that school moved to its own campus, receiving accreditation for its curriculum by the American Osteopathic Association’s accrediting body. In the required three-year residency clinical rotations for DPMs (e.g., internal medicine), residents provide medical care as part of the health care team with MDs and DOs. During such experiences it is hard to differentiate MD or DO residents from DPM residents.
There are approximately 13,000 members in the profession now; that number is expected to increase 20% by 2020.2 DPMs provide medical and surgical care for people with foot, ankle, and lower leg problems; they focus on prevention, perform physical examinations in their offices and hospitals, employ imaging studies, order laboratory tests, preform biopsies, prescribe topical, oral, and parenteral medications, and give medical and surgical care for conditions affecting the foot and ankle. The pedal extremity, a mirror of systemic disease, results in DPMs’ often being the first practitioners identifying undiagnosed diabetes, neurological conditions, generalized cardiovascular disease, and other general health problems, referring such patients to other specialists often early in their history.
The guidelines of the Joint Commission on the Accreditation of Health Care Organizations permit DPMs to perform admitting histories and physical examinations on podiatric medical patients, and the American College of Surgeons and American Medical Association recognize that they can have practice privileges based on education, training, and experience.
A task force of the California Orthopedic Association, California Medical Association, and California Podiatric Medical Association was formed in 2011 to find a way for podiatric medical schools to meet accreditation standards of the Liaison Committee on Medical Education. The outcome could be the first step for California DPMs to become licensed physicians and surgeons.3
Leonard A. Levy, DPM, MPH
Associate dean for education, planning, and research, and professor of family medicine/public health/biomedical informatics, Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, Florida; firstname.lastname@example.org.