Learning To Love Orthopods

By John McCord, DPM

Learning to trust and even like orthopedic surgeons was tough for me. I spent four years in podiatry school being warned that orthopods stay awake at night plotting the demise of podiatry. At the very least, I could expect a clever orthopod would ruin my career the first time I slipped up.
My experience with orthopedic surgeons in my residency training created a greater fear and dislike for the specialty. The gruff and ornery old Dr. Borman was Chief of Orthopedics in the hospital where I trained. He chewed me out in front of a young extern one day because my hair was too long. He told me I could not scrub on his ankle case the next morning unless I got it cut. The extern was shocked and told me I didn’t need to take that kind of harassment. I got a haircut that afternoon. I’d rather be abused than not used.
I had a rotation at the children’s hospital in pediatric orthopedics. The chief of pediatric orthopedics was mean as a snake and didn’t like podiatrists. None of the orthopedic residents liked to work with him so I would be berated while I assisted him with clubfoot surgery.
By the time I finished with training and was ready to enter practice, I had a plan for the first orthopod I encountered. I would dehorn him, scrape off his scales, cut off his tail and boil him alive.
I expected the worst 27 years ago from the two orthopedists who had just opened a clinic in the small town where I started my practice. They were two young guys fresh out of residency who immediately had a full practice. A few weeks after opening my office, I got a call from Larry, one of the orthopedic surgeons. He welcomed me to the community and invited me to visit. He also welcomed me to consult with him on any interesting cases since he too liked feet. I didn’t trust him. He seemed too friendly and too slick.
I met him and guess what? No horns, no scales and no tail. For the past 27 years, Larry and I have been conferring with each other and sharing difficult cases.
Larry helped me through my difficult first few years as the first podiatrist in my community. Many of my patients would ask him for a second opinion on procedures I proposed. A frequent question was, “Should an orthopedic surgeon operate on this bunion?” Larry would explain he was as qualified as I to operate but not more qualified. I can’t recall Larry stealing a single case from me over the years.
Larry’s practice expanded to six orthopedic surgeons. They have let me use their surgical center and have invited me several times to join the practice. Since I like being self-employed, I declined. Today they have a well-trained young DPM as part of their group. It hasn’t hurt my practice a bit. I recently took in a young associate and we’re all busy with quality foot and ankle care.
The irrational fear and mistrust we have of orthopedic surgeons is a waste of time and does not benefit our patients. Many of my colleagues will not seek an orthopedic consultation on difficult cases or postoperative complications. I have asked my orthopedic friends for help many times over the years with bone infections, delayed union fractures and difficult ankle problems that are not clearly podiatric cases. They are skillful and well-trained. Our combined talents usually benefit the patients.
The orthopedists have used me as a consultant. They readily defer to my biomechanical skills and my experience with forefoot surgical procedures. During my first few years of practice, the majority of my physician referrals came from the orthopedic clinic.
It’s one thing for them to say they respect podiatry. Larry had a unique way of showing his respect. He showed up in my clinic one day with a list of his own foot problems. He was a runner and wanted a pair of orthotics. He also wanted a deformed nail permanently removed. He was a little difficult as a patient and demanded I do it all in one visit because he didn’t plan any follow-up visits. He showed me his toe multiple times over the next year, usually in the OR dressing room where he loudly proclaimed his satisfaction with my work on his nail removal and the orthotics.
Think about getting an orthopedic consult the next time you’re clobbered with an osteotomy that fails and then develops MRSA. We owe our patients access to all medical resources.

Dr. McCord (pictured) is a Diplomate wtih the American Board of Podiatric Surgery. He practices at the Centralia Medical Center in Centralia, Wash.

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