Scope Of Practice Update: Where Things Stand

Start Page: 26
Rachel L. MacAulay, Contributing Editor

Will The Profession Establish A Uniform Scope of Practice?

With four years left in the APMA’s Vision 2015 timeline, the pieces are falling into place to ensure reforms to the scope of practice will happen. The ideas of flexibility on a professional level and understanding on a personal level are slowly getting around.

   “A scope of practice should represent a range of care, not a baseline of care,” according to Glenn B. Gastwirth, DPM, the Executive Director of the APMA. “Not every physician in every specialty will have the requisite education and training to deliver medical and surgical care at the highest end of their scope of practice even if it is an ‘unlimited scope.’ Can or should any thoracic surgeon be allowed to perform organ transplant surgery?”

   Dr. Gastwirth believes that the podiatric scope of practice should be commensurate with the highest level of care for which a podiatrist receives training. He says the highest end of the profession’s scope must be dynamic and subject to change with the advancement in education and training.

   “These few remaining restrictive state statute scope barriers will fall in due course as there is no justification in so much as the training and credentialing standards, and practices of institutions now mandate appropriate training for all surgeons practicing medicine and surgery of the foot, ankle and leg regardless of medical degree or specialty,” comments Dr. Vogler. “This is a uniform standard that all physicians and surgeons must meet.”

   Rachel L. MacAulay is a freelance writer who lives in Matawan, N.J.

image description image description

robert bijak,dpmsays: December 1, 2011 at 10:09 pm

Look at all the effort, expense and animus with the MDs we expend by trying to legislate our license instead of earn it. We would have the support of the MDs, increase our scope and, once and for all, end ALL podiatry's problems by changing our schools to have exactly the same 4-year curriculum and rotations, and announce our desire to offer the MD instead of keeping us apart with the disdained DPM.

It is time to drop the sentimentality of our chiropodal past and return to allopathy where we originated from. Even if the MDs acquiesce to "giving us the ankle," there's still the rest of the body and a majority of diseases we will be considered too inferior to treat. For the next 100 years, podiatrists will sue to creep up the leg. It IS possible to change pod schools to MD offering institutions but there are still too many frightened and lazy podiatrists who don't want the increased responsibility.

Podiatric politicians must be bold and brave at this stage, and scuttle the incrementalism associated with project 2015, which does not guarantee any increase in scope in and of itself. It will only provide grounds for another series of suits.

Reply to this comment »
Dr Jose A Mattei-Diazsays: December 3, 2011 at 8:49 am

Dear colleague Dr. Bijak,

We are a specialist medical profession full of hardworking, intelligent, well educated professionals who need to explore and expand our limits. Yes, we need to prepare better. We all do.

Nevertheless, we as a profession specialized in an anatomical area need to do as other specialties do, allow the alpha dogs to cause that change and, as always, the time is now.

José A Mattei, MD, DPM
Chief of Medical Staff
Hosp Metropolitano Dr. Susoni
Arecibo, PR

Reply to this comment »
anonymoussays: December 20, 2011 at 10:21 pm

According to the proposed law, the ankle means the skin. You mean since I did not complete a residency back in 1985, I cannot even cut the skin around the ankle to obtain a wound culture? And someone who completed a non-surgical podiatric approved residency in 1985 can be licensed to cut the ankle bones? How does this relate to current competence? Shouldn't proposed laws relate to current competence? Why not open it up equally for all podiatrists?

Furthermore, board certification by a nonsurgical podiatric board is not written as accepted in the law and the health commissioner may turn around and decide not to accept
a non-surgical board regarding cutting skin around the ankle to be able to get a culture and sensitivity of ankle ulcers. I should send my patients to another podiatrist who performed
a non-surgical podiatric residency program for treating and culturing ankle ulcers. How does this make me look in the eyes of my patients? Why should this law even be passed as written? There are other podiatrists in the same situation as me.

Disclaimer: The above comments are only my opinions.

Reply to this comment »

Post new comment

  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

More information about formatting options

Enter the characters shown in the image.