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Podiatrist or Orthopedic Surgeon?

Posted by on Friday, March 30th, 2012

There you are, running on a bright clear spring day. You feel good, no you feel GREAT! You’re almost home. There’s a flight of steps leading out of the park, stairs you’ve run down a million times. This time, though, you miss a step and take an awkward spill. Oww. You hurt your ankle. I’m sorry–that’s a terrible thing to have happen on your lovely spring day of running. The missed step. It happens to the best of us.

Wait, it gets worse. You hobble home, put some ice on it, and wait for the pain to subside. Nope, sorry, it’s still there. You begin to suspect that you have more than a sprain. Actually, you’re now pretty sure you fractured it (at least according to Wikipedia!). You know you need to see someone about it, and you wonder if you might even need surgery. So now what? Should you see a podiatrist or an orthopedic surgeon?

(I know, as if you don’t have enough stress from a Wikipedia-diagnosed broken ankle, now you have to make this kind of huge decision!)

Here’s the common misconception: “Podiatrists just treat things like toenail issues, corns, or prescribe orthotics, so if you need surgery,  you should see an orthopedic surgeon.”

Au contraire, my little foot-curious reader. That’s not the case at all. Let’s take a closer look at these two options and figure out what to do for our broken ankle friend.

How are podiatrists and orthopedic surgeons trained? Yes, let’s clear this one up right away. An orthopedic surgeon first trains as a medical doctor, then follows that with training in orthopedic surgery. Then they can pursue additional training in a specialty like foot or ankle surgery.

Podiatrists first go through a four year doctoral training program at a college of podiatric medicine, where they study all aspects and conditions of the foot and ankle. Then they do a two year residency, one year of which must be a surgical residency. A two year residency will make them eligible for board certification in foot surgery; a third year of residency will make them eligible for board certification in foot and ankle surgery (for more information on their training, see the American Board of Podiatric Surgeons or the American Podiatric Medicine Association)

Okay, well, they’re both trained in surgery, so what should I do? How do I decide? In some cases, the decision might be made for you, unfortunately. What if you’re in the emergency room because you’ve suffered a foot or ankle injury that requires surgery right away? In a situation like that, the hospital is likely just going to get you the most qualified surgeon in the building at the time. This may be a regular orthopedic surgeon, or if you’re lucky an orthopedic surgeon who specializes in foot and ankle surgery. If you’re really, really lucky, the hospital may also have a podiatric surgeon on their staff, at which point they’ll decide whether you should have your surgery done by the podiatrist or orthopedist.

But let’s go back our friend with the broken ankle, described initially with the elusive second person you but who I will now refer to as she, because I am a she and tend to think that way. She is at home, coherent, and the one who will be making the decision podiatrist or orthopedist decision. Let’s assume that she doesn’t have any friends who have recently seen one or the other and is full of helpful information or referrals. No, she’s just on her own, looking at lists of doctors online.

Here’s the broadest way to think of it–an orthopedist who specializes in foot and ankle surgery has learned a lot about surgery, and then tagged on training for the foot and ankle. A podiatrist has learned everything about the foot, and then added training in surgery.

So assuming they both are competent surgeons, the podiatrist would seem to have the edge because he or she knows the mechanics of the foot inside out and may be able to apply that knowledge in a way that will make the surgery easier or more productive. The podiatrist’s knowledge may even be able to think of alternatives to surgery or have ideas about rehab for a foot or ankle injury that the orthopedist might not naturally think about.

There are other factors to consider that may make you feel more comfortable with one doctor or another. If you’re an athlete, you may want to look for a practice on either side that also specializes in sports injuries, such as The Center for Podiatric Care and Sports Medicine (212.996.1900). If you’re a runner, you may want to seek a doctor who’s also a runner and will really understand your injuries and mindset. You may even find a practice that has both a podiatric surgeon and an orthopedist, and they will then be able to decide who is best for your particular injury.

If it was me, I’d rather go with someone who knows everything about feet and is also a surgeon than a surgeon who also knows something about feet. But that’s me. If you’re not sure what to do, you can contact us at The Center for Podiatric Care and Sports Medicine to ask the questions that will help get you started. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine LaiDr. Nadia Levy, and Dr. Ryan Minara have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.

One Response to “Podiatrist or Orthopedic Surgeon?”

  1. Angelica Jordan says:

    A small toe injured 49 yrs ago when I was hit by a car has separated from other toes causing much pain and discomfort. Am scheduled for surgery by an orthopedist Aug 31. Dr. Says I will need a pin to straighten toe and bring it back to alignment. Should I cancel see a podiatrist who most likely come to the same conclusion?

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