July 1, 2012

We are continuing our discussion of a podiatrist who is facing nine lawsuits right now. Eight of the suits are for medical malpractice; one is for wrongful death. He does not practice in Oregon, but his story offers us an opportunity to discuss an interesting tension that exists between podiatry and orthopedics.

According to the Oregon Medical Board, podiatrists “diagnose and perform medical, physical or surgical treatments related to the human foot, ankle and tendons directly attached to and governing the function of the foot and ankle.” A podiatrist must complete four years of college and four years of medical school; additional training is optional and can last anywhere between two and four years.

The educational requirements are more extensive for orthopedic foot and ankle surgeons: four years of college, four years of medical school, five years in an orthopedic residency, and a one-year fellowship devoted to the study of foot and ankle diseases, disorders and injuries.

The difference in training has fostered a kind of rivalry in which orthopedists feel more qualified to treat feet and ankles. Podiatrists have been the scrappy underdogs, whittling away at orthopedics’ piece of the pie.

For a long time, the medical community did not consider the ankle to be a part of the foot. As a result, podiatric practice was limited to the foot. No broken ankles or ankle replacements at all.

Podiatrists changed that, but questions about surgical skill when it comes to the ankle have persisted. State medical boards and legislatures have responded by finding some middle ground. In Oregon, for example, podiatrists must go through additional ankle-specific training before they can be “endorsed” to perform ankle surgery. Oregon statute specifically states that only those podiatrists whose licenses have been endorsed by the board may perform ankle surgery.

Several of the claims against the podiatrist we’re talking about are related to ankle surgeries. When ankle surgery goes wrong, the results can be life-changing: Below-the-knee amputation was the only option left to at least two patients. One patient wears a permanent ankle brace to prevent amputation.

Perhaps the key to this podiatrist’s legal troubles is the ankle? We’ll examine that twist in our next post.

Source: The Columbus Dispatch, “Hilliard podiatrist facing 8 malpractice lawsuits,” Courtney Hergesheimer, July 9, 2012


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