The Utah Podiatry Scope of Practice Act reads (in part) as follows:
- Surgical procedures may be performed (by podiatrists) upon all bones of the foot and ankle, with the exception of the following procedures: ankle fusions, massive ankle reconstruction, reduction of trimalleolar fractures of the ankle.
- Surgical treatment of any condition of the ankle and governing and related structures of the foot above the ankle…
Years ago the podiatry scope of practice (or in other words the area of the body and what surgical procedures may be performed there) was defined by the podiatry and orthopedic community. This was a compromise made between the two groups based on the training of the podiatric surgeons at the time. Our training has improved dramatically since then but political winds have not allowed for the Utah law to be updated. Many states currently allow a podiatrist to perform surgical procedures that involve any bone, joint and soft tissue structure below the knee as long as his training has been sufficient.
Nation wide, podiatric training currently includes:
- A 4 year undergraduate degree (same as MD/DO).
- Acceptable MCAT scores (same as MD/DO).
- 4 years of Podiatry School training. The first two years are almost identical to MD/DO programs. In fact, a number of our schools share the same classroom with DO programs and take the same tests.
- 3 years minimum of foot and ankle surgical and medical residency training. Most rotations are spent shoulder to shoulder with other MD/DO residents in surgical and medical specialties.
- An optional 1-2 year foot and ankle fellowship training.
As things stand today, even though the training of a podiatrist far exceeds the difficulty of the procedures which he is currently allowed to perform, a resident that graduates today may only perform the following procedures. This list is in no way comprehensive.
Procedures and pathology managed by Podiatrists as described by the Utah Podiatry Scope of Practice Act:
- achilles tendon repair and debridement
- amputation of toes and foot for infection or traumatic reasons
- ankle fracture reduction (plates, screws etc)
- ankle sprains and strains
- arthroscopic debridement of the ankle and all other joints below the knee.
- bone tumor, mass and spur removal and treatment
- bunion correction
- Charcot foot collapse and reconstruction
- custom foot and ankle braces
- custom shoes
- flatfoot reconstruction
- fusion of all joints below the knee (ankle joint being the only exception)
- hammertoe correction
- infection management with antibiotic, surgical cleaning and amputation
- ingrowing nails
- nerve decompression, tarsal tunnel release
- neuroma removal
- pediatric complaints: club foot (surgical/casting), metatarsal adductus, vertical talus etc.
- plantar fasciitis, steroid injections, soft tissue release
- rheumatoid foot reconstruction
- skin lesions such as warts, calluses, athletes foot, skin cancer
- soft tissue tumor and mass removal including ganglion cyst, rheumatoid nodules, lipomas etc.
- tendon transfers, lengthening and repairs
- trauma to the foot and ankle
- wound care for diabetic, venous, and avascular lesions