FOOT AND ANKLE ORTHO OR PODIATRISTPosted by QUINCY on 12/13/03 at 10:25 (139917)
WHO HAS TO ENDURE MORE SCHOOLING AND TRAINING, WHWN IT COMES TO THESE DOCTORS?????????????
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. Z on 12/13/03 at 13:02 (139939)
A podiatrist goes to podiatry school for four years. He or she takes course in basic science for two years and then the last two years he or she concentrates on Foot Sciences and Clinical Applications. After graduating he or she will continue anywhere from one to four years of additional training in foot and ankle surgery and other types of foot related fellowships.
I really have no idea the state of education for a foot and ankle orthopedic doctor. Some will take six months to one year of foot surgery after completing a three general surgery course
Re: FOOT AND ANKLE ORTHO OR PODIATRISTPauline on 12/13/03 at 15:27 (139948)
The physician who specializes in orthopedic surgery is called an orthopedic surgeon, or sometimes, simply, an orthopedist. Orthopedists are educated in the workings of the musculoskeletal system, which includes (but is not limited to) diagnosing a condition or disorder, identifying and treating an injury, providing rehabilitation to an affected area or function, and establishing prevention protocol to inhibit further damage to a diseased area or component of the musculoskeletal system.
Upon graduation from high school, Othopedic Surgeons must complete up to 14 years of formal education; 4 years in College, 4 years in Medical School, 5 years in Orthopedic Residency and an optional year of speciality education
After becoming licensed to practice medicine, the orthopedic surgeon may become board-certified by passing both oral and written examinations given by the American Board of Orthopedic Surgery.
Many orthopedic surgeons choose to practice general orthopedics, while others specialize in certain areas of the body (i.e., foot, hand, shoulder, spine, hip, or knee), or in a specialized area of orthopedic care (i.e., sports medicine, trauma medicine).
This information and more can be found at the library,on the internet or through any accredited Medical School in your state.
Hope this answers your question.
Re: thank you paulineQUINCY on 12/14/03 at 06:53 (139968)
thanks for the info. it seems orthos are more qualified than pods
Re: thank you paulineDr. Z on 12/14/03 at 11:30 (139975)
The key is how much training does each one have in the foot. A podiatrist has much more training in the foot. If you are talking about plantar fasciitis you best bet is a podiatrist.
IF you don't a have a way for someone to recommend either type of physician ask your family doctor for a name of someone who can help you.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. David S. Wander on 12/14/03 at 12:05 (139976)
After high school, a podiatrist may complete up to 12 years of formal education, 4 years in college, 4 years in podiatric medical school and up to 4 years in residency training. Additionally, many podiatrists also serve a fellowship in sports medicine or other subspecialties. During hospital rotations as a student and resident, significant time is spent on rotations through medicine, emergency medicine, general surgery, plastic surgery, orthopedic surgery, etc., although naturally the majority of the emphasis is on surgery of the foot and ankle.
Pauline's personal preference seems to favor orthopedic surgeons based on her past experience. If you survey the readers on this site, you'll probably get a pretty good amount favoring podiatrists, and a good amount favoring orthopedists. My recommendation would be to find a doctor that you are comfortable with that treats your condition on a frequent basis. Most orthopedic surgeons are also treating backs, shoulders, elbows, hips, wrists, hands, knees, etc. Podiatrists and foot/ankle orthopedists dedicate their practices to treating the foot and ankle.
I believe that if you see a podiatrist or orthopedist specializing in foot/ankle, you will be making a wise choice.
Re: thank you paulinePauline on 12/14/03 at 12:29 (139978)
No one here will ever settle the on going discussion about 'Who is best' to treat a foot condition, an Orthopedist who specilizes in Foot and Ankle or Sports Medicine or a Podiatrist. This decision is best left up to the individual seeking the treatment because 'Who is best' is really arbitrary subject to individual judgement.
More often than not many people begin with one doctor and seek a second or even a third opinion until they are comfortable with the doctor and the treatment suggested.
You now know the difference in educational levels for each type of doctor and this is important because many people think they are the same.
As you can see it's not true.
I think the important thing for you to remember is that you always have a choice whether it's in foot care or your heart. Begin with a doctor of your own choosing and if you are not comfortable seek opinions from others until you find that perfect match. Education matters, so does experience,technique and the procedures being performed.
The 'best' doctors are out there, but its up to each of us to find who we consider the 'best'.
Re: thank you paulineDr. Z on 12/14/03 at 13:06 (139982)
This one just came to mind. Dr. Dellon, Johns Hopkins Medical School is considered by many to be the best in the surgical treatment for TTS. He is neither a Podiatrist and or Foot Orthopedist. He is a plastic surgeon by education.
Again if we are talking about plantar fasciitis you want to go to a physician who treats alot of plantar fasciitis.
As for the educational level of a podiatrist and an orthopedic surgeon that two depends on the residency program that the foot orthopedist and or podiatrist went to .
So again ask you family physician who she/He would use if you had such and such a foot problem.
What kind of foot problem do you have Quincy ??
Re: FOOT AND ANKLE ORTHO OR PODIATRISTPauline on 12/14/03 at 13:30 (139984)
I think it's important to point out to become a licensed practicing Orthopedic Surgeon each physician MUST have complete all the educational and residency requirements I mentioned earlier.
The words 'must complete' a five year residency to become a Licensed Orthopedic surgeon is quite clear in it's meaning and different from the use of the words 'may complete' and 'up to' when speaking about a Podiatry License Requirement. Many of your colleagues in the 'Foot Talk' forum often complained about podiatry graduates not being able to get into residency programs and are tired of providing this missing part of their education in their offices. Unfortunate but true this is where 'up to' and 'may' become very defining and significant words when speaking about education.
In addition, I don't know one M.D or D.O. who, by the very nature of the education being provided by the various medical school, has not spent significant time in all medical rotations. It's just part and parcel of the program. This is how most confirm their area of specialization, be it Internal Medicine, ENT, Orthopediacs or another branch of medicine.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. Z on 12/14/03 at 14:25 (139986)
Don't you think that quality is just as important as duration of training Any general orthopedic surgeon that completes a five year program and is all readdy to repair the trauma and fractures during is ER call, but his traing with the foot is near zero. The foot and ankle training that a podiatric physician undergoes is must more in depth that a general orthopedic surgeon. The quality of podiatric education is just far superior.
If we used your logic of duration of training being of more value then quality of education then the next time you need a dentist better go you see an orthopedic surgeon.
Your research is excellent but one must have the experience of working with both orthopedic and podiatric physician. There are both good, bad and ulgy but to evaluate someone on their education in a specific field is just so misleading. If we use your standard Dr. Dellon shouldn't be doing TTS surgery it should only be done by a neuro-surgeon who went 10 years to
school. I hope you understand my point,which is to choose a doctor ask your physician, ask someone who has a similiar problem that you have
and most of all education yoursself about YOUR health so that you can understand what is wrong with you and what the options are, but DON't CHOSE your doctor only on his length of education.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTPauline on 12/14/03 at 14:34 (139989)
I think you forgot to mention that Dr. Dellon is a professor of neruosurgery at J.H. too.
He is no run of the mill plastic surgeon. Part of his bio.
Dr. A. Lee Dellon, M.D. graduated from Johns Hopkins University in 1966 and from the Johns Hopkins School of Medicine in 1970. He then completed eight years of additional training, including two years of research at the National Cancer Institute, Surgery Branch, of the National Institutes of Health. He completed a Plastic Surgery Residency at the Johns Hopkins Hospital and a Hand Surgery Fellowship at the Raymond M. Curtis Hand Center. Dr. Dellon has received the Certificate of Added Qualifications in Hand Surgery and is Board Certified in Plastic Surgery. He is currently a Professor of Plastic Surgery and a Professor of Neurosurgery at the Johns Hopkins University School of Medicine. He is also Professor of Plastic Surgery and Neurosurgery at the University of Arizona.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTPauline on 12/14/03 at 14:57 (139991)
I agree educating yourself is important and WE all should strive to do it.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. Z on 12/14/03 at 15:11 (139992)
Does he even do Plastic Surgeon? Where is his fellowship in foot and ankle surgeon. I don't think he even did a neuro-surgical fellowship BUT he is still tops in TTS and neuropathy treatments .
With your advice there are many people who JUST look at the bio's etc and never even research their condition and or ask the correct questions.
I sure wish you understood the point I am trying to make.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. David S. Wander on 12/14/03 at 15:21 (139994)
Pauline, I'm sorry, but I just completely miss the point you're attempting to make. My point was that many podiatrists undergo vigorous training, which includes other aspects of medicine. It is obvious that the MD/DO residency programs also contain these rotations. I was attempting to educate everyone that during podiatric training, there is exposure to much more than foot and ankle pathology. The decision to see a podiatrist vs. an orthopedic surgeon is a personal preference. I believe that I was being very diplomatic when I stated that if you saw a podiatrist or foot/ankle orthopedist you will probably have better results than a general orthopedist.
Once again, it seems obvious from your postings over the years that your preference is for orthopedic surgeons, and I'm sure you have reasons for your preference. But there are excellent podiatrists and horrible podiatrists, just as there are excellent orthopedists and horrible orthopedists. Treating plantar fasciitis is not rocket science. If you see an orthopedist or podiatrist that care about his/her patients and treats the condition often, your results will be superior.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. Z on 12/14/03 at 17:08 (139995)
I think the better question should be who has more experience treating plantar fasciitis an orthopedic foot and ankle or a podiatrist.
The answer is podiatrist
Re: FOOT AND ANKLE ORTHO OR PODIATRISTPauline on 12/14/03 at 19:02 (139998)
I think Dr. Wander said it best in his last post. 'there are excellent podiatrists and horrible podiatrists, just as there are excellent orthopedists and horrible orthopedists. Treating plantar fasciitis is not rocket science. If you see an orthopedist or podiatrist that care about his/her patients and treats the condition often, your results will be superior'.
BTW if you want to know more about Dr. Dellon's credentials just him, he will gladly provide the information to you. I think you'll find they are more than adequate and greater than your expectation.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. Z on 12/14/03 at 19:35 (140003)
Thanks I have much respect for Dr. Dellon and his work and it is all based on his present work. If he graduated from Johns Hopkins Community College if wouldn't matter because he has contributed much to the science of feet
As far as Dr. Wanders comment that treating pf isn't rocket science I don't think that Dr. Wander was down playing the complexity of the foot and the work it takes to cure plantar fasciitis
One of the problems that I see with simple plantar fasciitis turning into chronic pain, fasciosis and sometimes even RSD is the lack of understanding in both the podiatric and orthopedic community of just how bad pf can turn into. Just look at the pf diseaster we see on this board
There is an art to treating Plantar fasciitis and that art has to be refined each and every day. You must keep up with all treatments out there .For example I am now educating myself and investigating the treatment of chronic pf that is atypical in presentation . I think that RFL may be an answer. I love ESWT but I am not closing my mind to other treatments. Another example is the use of the most recent pf stretch that we first heard about on this site. That has become another part of treating pf in my practice and it has made alot of difference in the reduction of pain.
We must not just look at the foot as just a foot. It is complex and any physician treating pf must take even one day pf very seriously.
I take pf very seriously and maybe there should be an extrea in school explaining just what can happen if you don't listen to your patient and treat your patient just you would any family member. IT is very important to beable to listen and learn from your patients
Re: thank you paulineAly on 12/15/03 at 07:21 (140017)
I went to an orthopedist and he looked at me blankly and asked why I hadn't gone to a podiatrist...I guess some may be well schooled in the foot, but don't assume that they really know feet going in - just depends on the doc, i guess...
Re: thank you paulinePauline on 12/15/03 at 07:46 (140018)
One doc, one response. Your absolutely right it depends on the doctor you see.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTRichard, C.Ped on 12/15/03 at 11:12 (140025)
One suggestion is to find a couple C.Peds in your area and ask their advice. I personally have my opinion of the good docs vs the less than docs on either side (pods or orthopedic). I hear when patients tell me what they think of the doctor they saw. Per my patients (and my personal meetings with the doctors), only one podiatry group and two orthopedic groups here in Columbia are trusted. This is based on knowledge of their condition, office staff and bedside manor.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. G on 12/15/03 at 15:02 (140032)
Podiatric physicians are the only doctors exclusively trained in the treatment of foot and ankle conditions. It is an area that other doctors dabble in but the sole specialty of the podiatric physician. No doctor spends more hours studying the foot and ankle than a podiatric physician.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTPauline on 12/15/03 at 16:46 (140037)
Tell me how does one argue against Podiatrists who post they are the best? Impossible! Do you really expect one to say otherwise?
I'd like you to tell someone like Dr. Arthur Manoli M.D., to his face, he is insuffiently trained and only a dabbler in his field. Do you really think he cares what you or I think or would even enter in this conversation? I doubt it. He has no need to prove anything to anyone---patients go, because they know.
It's very easy to post and boast in the shadows of this website, and anyone subscribing to Foot Talk understands why there is a need for Pods constant reasurance of worth. You must admit hardly a quarter goes by without one of your colleagues speaking to this issue of self worth.
Let's ask a Nike Manufacturer which Running Shoes are best, Nike or New Balance and see what he say. My guess, he'd say Nike stating his workers in China are better trained and New Balance is only dabbling in making running shoes:*
Re: FOOT AND ANKLE ORTHO OR PODIATRISTPauline on 12/15/03 at 16:49 (140038)
Is a RX always needed to have custom orthotics made or is it only for insurance reasons?
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. Z on 12/15/03 at 16:55 (140039)
Here is what is interesting thing about who is the best. I believe that there are certain procedures that podiatrists are better at and there are certain procedures that orthopedic foot and ankle surgeons are better at. The experience in training and in private practice has alot to be with what each individual doctor is best at.
I will gave you an example. I bet that Dr. Z is better then Dr. Manoli in the treatment of ingrown toe nails. I know that Dr.Manoli is better than Dr. Z in the surgical treatment of flat feet.
Now what makes a doctor even better is working with all doctors and making sure that the patient gets the best treatment period. Now that is the best doctor
Re: FOOT AND ANKLE ORTHO OR PODIATRISTPauline on 12/15/03 at 17:28 (140040)
I think we've finally come to some agreement. I like your answer.
At least you and I can now move on.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. Z on 12/15/03 at 17:38 (140042)
So what else can we talk about ? I will think of a new topic.It been some time since I pick a topic for discussion
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. G on 12/15/03 at 17:48 (140043)
I never made a statement that 'I was the best.' I simply made a statement of fact concerning the training of podiatrists. I will be happy to make the same statement to your Dr. Manoli. I don't see him posting here, only podiatrists. Tell me Pauline, assuming this is your website which I am guessing it is based on your behavior, why do you not have any orthopedic surgeons answering questions here?
Yes, most orthopedic surgeons dabble in the treatment of feet. A subset of orthopedic surgeon, known as foot and ankle orthopods have more foot specific training but that comes from a fellowship, many as little as 6 months. Don't run from the facts.
Re: To Dr. Z FOOT AND ANKLE ORTHO OR PODIATRISTPauline on 12/15/03 at 17:54 (140044)
Talk to your friend.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTRACHAEL T. on 12/15/03 at 17:56 (140045)
What is 'FOOT TALK' - referenced in this thread by I believe Pauline....I'd like to know - is it online mag. or what?
Re: To Dr. Z FOOT AND ANKLE ORTHO OR PODIATRISTDr. Z on 12/15/03 at 19:49 (140049)
I have no idea who this friend is. Hey friend you are barking up the wrong tree. So long as the physician does what he knows best and refers the rest he is a good doctor whether he is a ortho or pod doctor
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. David S. Wander on 12/15/03 at 20:22 (140050)
Pauline, as you know I'm a podiatrist and I believe I was very objective with my response and recommended a podiatrist or foot/ankle orthopedist vs a general orthopedist.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTPauline on 12/15/03 at 21:24 (140054)
Have at it.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTPauline on 12/15/03 at 21:36 (140057)
A bit more explanatory. Have at it Dr. Z. Pick a topic, but perhaps we better move it to the Social Board.
I just found out that Mayo is using the older model lithotripsy machine, the water bath type for kidney stones. A bit unconventional when newer models are out there that allow patients to have less anesthesia and lay on a water pillow.
Their reason behind this is that it's a more powerful machine and because of this their success rate is close to 100%.
I guess sometimes a 'new model' isn't always better, but then you still must weigh in the heavy anesthesia that is required with the older machine as a factor too.
Re: To Dr. Z FOOT AND ANKLE ORTHO OR PODIATRISTDr. G on 12/15/03 at 22:47 (140061)
I think it is good that you and Pauline have reached a level of agreement.
That hardly changed the fact that she had taken it upon herself to convince Quincy to her point of view as you can see from Quincy's response above. It is not clear to me to what extent Pauline runs this site as her posts seem to dominate much of the site but her attitude is certainly not an open invitation for new podiatric physicians to join in.
What is the official policy of this site in this matter and do her repsonses reflect the official policies of this site?
My query is that if this is a board where doctors are here to answer questions, is it appropriate for others to jump in and try to debate the doctors on matters of fact. What are Pauline's qualifications? It appears that only podiatric physicians are participating here and deserve some consideration for that fact. It is okay to debate the validity and advantages of one treatment over another. It is another thing to provide misinformation concerning the credentials and training of an entire profession. I think that answers to some of these questions may determine the motivation of new posters from the professional community.
Re: To Dr. Z FOOT AND ANKLE ORTHO OR PODIATRISTDr. Z on 12/15/03 at 23:46 (140062)
We always welcome any posters especially podiatrists. You make some very good points. Pauline is a long time poster who has very strong opinions and is very good at expressing her point of view. Pauline's Dr. Z's or any one else's view point don't reflect the official policy of heelspurs.com. Scott Roberts is the owner of this site. The most important policy that he has is to be nice and only talk about feet.
Most of the posters on this board go to podiatric physicians. I have found the level of what a podiatric physician is and that they treat most of the plantar fasciitis is reflected among the posters on this board.
Every once in a blue moon we get this type of question that in my opinion was a poor question to begin with
I have come to just say what was written yesterday was yesterday and what we discuss today is what is important. Please stick around i am sure that you can contribute alot to this board
I appreciate your expression of how you feel and hope that you stay and give this board more time. I have been on this board since 1999 and for some reason it has become a part of my life . I hope it will become a part of yours
Re: FOOT AND ANKLE ORTHO OR PODIATRISTQUINCY on 12/16/03 at 07:24 (140065)
WOW I DID'T EXPECT TO START A THREAD LIKE THIS.............
Re: To Dr. Z FOOT AND ANKLE ORTHO OR PODIATRISTAly on 12/16/03 at 07:50 (140068)
Hi Dr. G,
Speaking as patient and follower of this message board - it would be great to have more doctors such as yourself take part. There are so many of us here who just can't seem to find the treatment they need, or learn why they've been in pain for years from a condition that is supposed to be treatable. We need as much diversity of medical opinion as we can get! I hope you'll stick around.
Re: Pauline...RX answerRichard, C.Ped on 12/16/03 at 10:16 (140075)
I never like to make an orthosis without an RX. If that is done, basically the C.Ped or whoever is making the orthosis, is diagnosing the problem themselves....thats not good. Of course, I am talking about casting for an orthosis...not directly formed to the patients foot. Having the script also allows us to file insurance.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTRichard, C.Ped on 12/16/03 at 10:21 (140077)
I'm the best C.Ped. If you don't believe me...just ask me. hahahahaha
Sorry....just wanted to add a little comedy relief. :)
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. Z on 12/16/03 at 10:28 (140079)
Never know what a few words can do to stir up a conservation. I hope that you understand my point that the LENGTH of training is only one facet of your evaluation when chosing a physician whether it be an orthopedic and or podicatric physician.
I will state one fact that if you are researching who to see for plantar fasciitis a podiatrist in most cases will have more experience and training for this specific foot condition. Most podiatrists will see anywhere from 5-10 cases of pf weekly in their office. Taking this information and then applying some help from either your medical doctor, your local pharmacist, your orthotist you should be able to make a good decision on who to see.
By the way I have an opening tommorrow at 8am just joking.
Re: FOOT AND ANKLE ORTHO OR PODIATRISTDr. Z on 12/16/03 at 11:43 (140081)
Know I am the best C. Ped. It you don't believe me just take a look at my casts. HA ha
Re: FOOT AND ANKLE ORTHO OR PODIATRISTRichard, C.Ped on 12/16/03 at 13:03 (140082)
Re: this siteDr. G on 12/16/03 at 17:58 (140108)
Poor guy. I hope you got an answer to your question. I would listen to Dr. Z as he makes a lot of sense. You have to give him a lot of credit for trying to give people good answers among all the 'noise' here. He is a better man than most to put up with what appears to go on here. There are a bunch of sites out there but few with the volume of information you will find here. The Heel Pain Book has a lot of good information but be very selective about what you see on the chat boards.