Patients are often stuck between deciding to see a podiatrist versus an orthopedic surgeon for their foot and ankle care. Not many are familiar with podiatry since it is still a new field of medicine, so why choose podiatry over orthopedics or vice versa? What are the differences in skills and education between the two specialties? What are some everyday things that a podiatrist versus an orthopedist treats? Are outcomes generally better between one profession over the other? Are risks higher when treated by a podiatrist versus an orthopedist? This article hopes to serve the purpose of answering these questions and to compare and contrast the two specialties to help assist patients in their decision making.
An orthopod or an orthopedic surgeon who specializes in foot and ankle goes to a U.S. M.D. or D.O. school for four years, matches into a residency in orthopedic surgery for five years, then a two years fellowship in foot and ankle surgery. Even with a specialty in foot and ankle, they could still treat the whole body without any licensing restrictions. Orthopedic surgeons work in hospitals, clinics in the same specialty practice, or a multispecialty group. They often treat conditions related to bone injuries and malformation, muscle and joint pain, or musculoskeletal conditions. Some common procedures orthopedic surgeons perform include Achilles’ tendon repair, ankle replacement, and ankle arthroscopy. Due to the nature of their unrestricted license, they can also do knee replacement, carpal tunnel release, and hip replacement.
On the other hand, a podiatrist or a podiatric surgeon goes to a U.S. Podiatric medical school for four years, then an additional three years of podiatric residency. There are an additional 1-2 years of fellowships for those who wish to further their education. Radiology, dermatology, wound care, sports medicine, and orthopedic care through footwear, orthotics or prosthetic devices are some of the subspecialties for podiatry. Podiatrists are specialized since day 1 of school and are restricted to treat only the foot and ankle. However, license restrictions are varied between states. Similar to orthopedic surgeons, podiatrists can work in hospitals, multispecialty groups, or open their own practice. Podiatrists do a plethora of procedures: ranging from lower extremity reconstructive surgery, various lower extremity wound care, diabetic foot care to ingrown toenail avulsion and callus debridement.
Several studies were done to assess surgical outcomes when performed by an orthopedic surgeon versus a podiatrist. One study on 11,115 patients performed by an orthopedic surgeon and 630 patients performed by a podiatrist showed no significant difference (p<.05) for the rate of post-op complication following an ankle fracture fixation (Chen et al.). Another study on 3674 patients for total ankle arthroplasty and 4980 patients for ankle arthrodesis showed no significant difference in the outcome, post-op complication, infection, or duration of hospital stay when performed by a podiatrist versus an orthopedic surgeon (Chan et al.). It is down to the patient’s preference to decide whether or not they want to see an orthopedic surgeon or a podiatrist for their foot and ankle care.
Sources:
Chan JY, Truntzer JN, Gardner MJ, Bishop JA. Lower complication rate following ankle fracture fixation by orthopaedic surgeons versus podiatrists. Journal of American Academy of Orthopedic Surgery. 2019; 27(16): 607-612.
Chan JJ, Chan JC, Poeran J, Zubizarreta N, Mazumdar M, Vulcano E. Surgeon type and outcomes after inpatient ankle arthrodesis and total ankle arthrosplasty: a retrospective cohort study using the nationwide premier healthcare claims database. The Journal of Bone and Joint Surgery. 2019; 101(2): 127-135
Foot problems and the podiatrist. National Health Service. 2018.
Levrio J. Podiatric medicine: a current assessment. Journal of American Podiatric Medical Association. 2009; 99(1): 65-72.
What is an orthopedic doctor? University of Utah. 2020.