This category pertains to establishments of licensed practitioners having the degree of D.P. (Doctor of Podiatry) and engaged in the practice of podiatry. Establishments operating as clinics of podiatrists are included in this industry.
621391 (Offices of Podiatrists)
The podiatry industry is gaining increasing public recognition as a health profession. Podiatrists work at private or group practices, health maintenance organizations (HMOs), hospitals, public health services and departments, and podiatric schools of medicine. The majority of podiatrists work in their own private practices and set their hours of business accordingly.
Approximately 14,000 podiatrists practiced in the United States in 1997, up from 11,000 in 1996. These doctors averaged a 42.5-hour workweek, primarily occupied with patient visitation. Their income ranged from $56,000 for most inexperienced, to $138,000 for experienced doctors with over 30 years of practice. While the majority of podiatrists work in major metropolitan areas, they are not evenly distributed geographically. Since the 1970s, the northeastern United States has been the site of the highest concentration of podiatrists. Many podiatrists set up practices near the seven colleges of podiatric medicine — in California, Florida, Illinois, Iowa, New York, Pennsylvania, and Ohio. There are also two podiatric hospitals — in Pittsburgh and San Francisco. The south and southwestern portions of the United States and nonurban areas have fewer podiatrists. Less than 200 podiatrists practice in Washington State, where doctors report a saturated market.
The U.S. Bureau of Labor Statistics (BLS) maintains that podiatry is a well-paid profession, with projected growth at a par with the average growth rate for all occupations through the year 2006. In 1997, the American Podiatric Medical Association (APMA) estimated that 5 percent of the population visited podiatrists, and according to the California College of Podiatric Medicine, demand for podiatrists is projected to reach 80 million visits per year in the twenty-first century. BLS further advises that opportunities for this profession are most lucrative in group practices or within medical networks, as opposed to individual private practice.
Podiatry involves the study of movement and medical care of the foot and ankle. Doctors of podiatry diagnose and treat diseases and disorders of the foot, but they also can diagnose other maladies such as arthritis, diabetes, and heart disease because the foot is often the first part of the body to manifest the signs of serious illness. Orthopedists specialize in foot surgery, orthopedics, children's problems (podopediatrics), or foot problems of the elderly. The major focus of a podiatrist's practice, however, is the treatment of corns, bunions, calluses, ingrown toenails, and nail diseases, along with palliative care (to ease pain). Women of middle age comprise as much as 80 percent of some podiatrists' clientele, a situation attributed to the poor design of women's shoes.
The industry has experienced steady growth in the number of trained podiatrists who establish practices. Younger podiatrists, though, saddled with college-aid debt, often elect to work in partnerships to earn enough money and experience to open their own practices.
To gain admission into one of the seven colleges of podiatric medicine, prospective students must first complete at least 3 years or 90 semester hours of college credit at an accredited undergraduate institution, according to the American Podiatric Medical Association. Over 90 percent of the students entering a college of podiatric medicine have bachelor's degrees. Applicants must take the Medical College Admissions Test (MCAT). Podiatrists must be licensed to practice podiatric medicine after earning a doctor of podiatric medicine (DPM) degree from an accredited college of podiatry. Training for the DPM degree requires study in the basic and clinical sciences — anatomy, chemistry, pathology, physiology, pharmacology — and inpatient care. Graduate study entails a residency of one to three years in length after the DPM degree. All states and the District of Columbia require licensure, and another 32 require completion of an accredited residency program. Thirty-eight states require some form of continuing education in order to renew a license.
Podiatrists, like other alternative health care service providers such as chiropractors, optometrists, nurses, midwives, and acupuncturists are fighting to establish themselves in the medical community. They hope that national health care reform legislation will eventually become reality and will enable greater numbers of patients to gain access to "nontraditional" medical treatments. Medicare and private health insurance do not normally cover routine foot care. As a result, podiatric care is dependent on disposable income to a greater degree than other medical care. As the number of elderly in the U.S. population grows, demand for podiatric care also should rise, since this population has a high incidence of ailments in the leg and foot area.
Managed care also has raised serious concerns within the profession. In early 1997, an investor-owned Florida company, Consolidated Health Corporation, purchased the Podiatry Hospital of Pittsburgh, one of only two such hospitals in the United States. The hospital, which has about 70 affiliated podiatrists, had seen dwindling admissions in the era of managed care. It was converted to for-profit status, and a private management firm was hired by Consolidated. In the mid 1990s, faced with such developments, podiatrists organized the first national labor union for doctors, the First National Guild for Health Care Providers of the Lower Extremities, which will be affiliated with the AFL-CIO. Among the issues of concern to podiatrists is the change in podiatrist fee schedules associated with managed care, whereby services are reimbursed only, to the exclusion of supplies.
Freeman, Paul. "Managed Care Keeps Podiatry Population Down…." Puget Sound Business Journal, 23 May 1997.
Japsen, Bruce. "Florida Firm in Podiatry Via Deal." Modern Healthcare, 24 February 1997.
"News at Deadline Column." Modern Healthcare, 28 October 1996.
"The Rewards of Podiatric Medicine." California College of Podiatric Medicine, 2000. Available at http://www.ccpm.edu/About/rewards.html .
Schuler, Burton S., D.P.M. "Podiatry." Foot Care 4 U, 1997. Available at http://www.footcare4u.com/podiatry.html .
U.S. Bureau of Labor Statistics. Occupational Outlook Handbook, 24 February 1999. Available from http://stats.bls.gov/ .
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