It’s time for…EPIC RAP BATTLES OF MEDICINE! Podiatrist! Versus! Orthopedist! Begin! Podiatrist comes out of his corner flexing his ability to treat soft tissues, bones, skin, and joints of the foot and ankle. No doubt he’d bust some sick rhymes like expertise, disease, and diabetes.
He’d end with “I treat it all from your heel to your toe! And if you don’t know, now you know!” before dropping the mike. The orthopedist would take the mike, flex his medical degrees, insist on being called “Doctor” and boast how he treats all the bones from the hips down.
If he’s feeling petty, he might bring up the real difference between them is about $11,000. His sick rhymes would include tendinitis, osteoarthritis and plantar fasciitis “Cuz I’m the brightest!”
Unfortunately, I am not Lin Manuel Miranda or even Nice Peter, so you’ll just have to settle for some prose to explain the difference.
How They Are Alike
Orthopedists and podiatrists probably have as much similarities as differences. In most practical terms, a general orthopedic surgeon has the capability of treating all of the bones plus the soft tissues and joints of the body. Meanwhile, a podiatrist lays more focus specifically on the foot and ankle.
What’s more, an orthopedist specializing in the foot and ankle is going to cater to the aspects of the foot and ankle that apply to the bones, soft tissues and joints of the foot and ankle. It is true that a podiatric doctor fully manages all these like views, not to mention the dermatology plus biomechanics of the foot and ankle.
Podiatrists and orthopedists both are qualified health specialists. They are both required to finish a vigorous amount of schooling, with four years of undergraduate study before starting their medical training.
That’s DOCTOR Orthopedist to You!
From the view of educational background, the central difference between these two professions is that orthopedic doctors specialize in surgical and medical administration of all the bones and joints of the whole body. Meanwhile, podiatric doctors concentrate largely on the foot and ankle from the very first day of podiatric medical school and ever after in residency.
Even though both podiatric and orthopedic training is quite similar in the basis of central sciences and exposure to different medical focus in residency training, the podiatrist comes to each chapter of the planned medical school and residency training with major focus emphasizing on the foot and ankle.
It should be pointed out that podiatrists are not medical doctors. They do instead attend four years of education at a podiatric medical school and perform about another three or four years of residency training. The arc of the treatment they offer is limited solely (no pun intended) to the ankle and foot areas.
Podiatrists frequently administer to calluses, fallen arches, ingrown toenails, heel spurs and other problems resulting from abuse or injury. They may use surgical methods. They may additionally treat some underlying health issues such as diabetes on the proviso that they are connected to the foot or ankle problem.
An orthopedist, also known as an orthopedic surgeon, is a medical doctor. After graduating from an accredited medical school, an orthopedist will generally complete around five years of residency training and might see a fellowship dedicated to treating specific disorders to the end as well.
Not only do orthopedists deal with many of the same problems as podiatrists, but orthopedists also have the ability and prerogative to treat the whole body. This can be helpful in situations where foot and ankle problems have their roots in the hip or lower back areas. Distinct to ailments in the extremities, orthopedists may focus their attention on the underlying muscles, bones, ligaments, and tendons.
The majority of those who experience foot and ankle disorders usually opt to see podiatrists for their initial care. However, it’s important to first identify symptoms and the circumstances leading up to the problems before deciding which specialist is best suited: podiatrist or orthopedist.
What Can An Orthopedist Treat?
Orthopedics is the medical specialty that is entirely focused on diagnosis, treatment, prevention, and rehabilitation of injuries and maladies in the human musculoskeletal system. After postgraduate orthopedic residency training, orthopedic surgeons specializing in foot and ankle finish an extra year of training for advanced classes pertaining to the reconstruction of the foot and ankle.
The most common ailments and conditions covered by orthopedics include the following:
- Achilles tendinitis and tendinosis According to Greek myth, the warrior Achilles was dipped in a magic stream by his mother as a baby that made him invulnerable. Because she was holding him by his heel, that part didn’t get wet and stayed vulnerable. The band of tissue connecting your calf muscles to your heel is in reality very susceptible to injury.
- Broken bones, stress fractures and sprains Ah, if only Dr. Pine from Stephen King’s “Survivor Type” had been an orthopedist. Maybe he wouldn’t have ended up with his foot in his mouth! (Cackles a la the Crypt Keeper.) But, seriously, folks, there are twenty-six separate bones in the human foot. If one gets broken, someone has to put it back together.
- Osteoarthritis Ever had a flexible toy (Barbie or G.I. Joe, whatever’s your thing) that would wear out at the joints after years of play? Osteoarthritis is when that happens to a person. The flexible tissue at the end of the bone (usually the knee joint) gradually wears down. It is a very common form of arthritis that requires a medical diagnosis.
- Ligament tears Surgery is not always necessary for torn ligaments, but the anterior cruciate ligament often needs surgery to repair. Twisting the ankle or landing wrong can cause such an injury.
- Lisfranc injury This would be a midfoot injury to ligaments and bones. It can often be mistaken for a simple sprain. If the top of the foot shows bruising and the pain just gets worse, it could be Lisfranc injury. The cause is usually an impact while the foot is flexed. Improper treatment could severely damage the cartilage.
- Metatarsalgia foot pain Metatarsalgia is a ten-dollar word referring to the ball of your foot. Remember the Barbie doll analogy mentioned earlier? Well, real feet, unlike Barbie’s, are not built for high heeled shoes. Shoes that put too much pressure on the balls of the feet, as well as arthritis and high impact sports, can contribute to this pain.
- Plantar fasciitis It is also known as policeman’s heel, possibly from policemen in the old days getting stabbing pains on the bottom of their feet from walking a beat in dress shoes. (Most modern cops use a Segway and wear more practical, shock-absorbing boots. And “officer” is preferred to the antiquated word “policeman”.) Anyone over the age of forty might develop plantar fasciitis, but it’s more common in those who put stress on their feet.
- Plantar fibroma and fibromatosis This refers to benign nodules on the bottom of your foot. They look gross, but they’re fairly harmless until it makes walking or wearing shoes difficult or painful. In which case, you may need an orthopedic surgeon to cut them off.
What Can a Podiatrist Treat?
From the very start of podiatric medical school and residency, a podiatrist’s focus of the study is on the foot and ankle. Podiatrists offer treatment not only for soft tissues, bones, and joints pertaining to the foot and ankle but the dermal conditions as well plus any unusual mechanics in the lowest extremity.
The most common ailments and conditions covered by podiatrists include the following:
- Arthritis, instability, pain, joint diseases This is a general catchall for debilitating pain that requires medical attention. Anything that would affect how the foot moves as a whole would require a podiatrist to look at to determine the best course of action.
- Calluses and ingrown toenails If the ladies (they are most often ladies) at the local salon won’t touch your feet for the price of a Pedi, you may have to take your business to a professional podiatrist. When a nail’s side or corner grows into the flesh, you may need a medical professional to take care of it. Generally, calluses can be treated with a little pumice but painful or inflamed calluses may need professional help, particularly if the patient is diabetic.
- Chronic wounds associated with diabetes or other illnesses If you have a wound that is not healing on its own, particularly if you have diabetes or other illness, you should see a doctor right away. Do not forget to tell the podiatrist all of your medical history.
- Deformities of the feet This would include things such as bunions and hammertoes. Bunions that can’t be adjusted or at least eased with pads may need to be surgically altered. The same can be said of hammertoe.
- Fallen arches Remember the analogy involving G.I. Joe from earlier? The vintage twelve-inch G. I. Joe would’ve been rejected 4F for his long, flat feet. If you suffer from fallen arches, you may want to ask an orthopedist for a way to treat it or perhaps even reverse it.
- Heel pain, bone spurs, neuromas, and plantar fasciitis A podiatrist can also treat policeman’s heel. Pinched nerves, abnormal bone growths, and anything generally causing you pain in the foot can be treated by a podiatrist.
Where Can I Find a Podiatrist or Orthopedist?
Both orthopedists and podiatrists usually work in physician offices along with other medical professionals. Some may be associated with sports medicine groups or have attachments to surgical centers or hospital networks that offer patient referrals. They may even go into solo practice.
Podiatrists or orthopedists that have connections to a hospital or medical center could be on call on nights or weekends for emergency shifts. Around eighty-one percent of all U.S. hospitals have podiatric physicians as members of the staff. The bigger the hospital, the more likely it is they have people who can treat feet.
If the reason you need foot care is work-related, your employer may be able to help you find someone. If the reason is sports-related, your coach may be able to refer you to someone. If it is your child you’re concerned about, a coach, school nurse or your pediatrician may be able to refer somebody. If all else fails, you can always Google “Foot specialist near me”. A moderate-sized town will get you between a dozen and twenty results, some with Yelp reviews.
How Much Is This Going To Cost Me?
Most services provided by podiatrists are generally covered by most health insurance plans. While many podiatrists participate in health insurance plans both public and private, not all of them will accept all insurance plans. An initial consultation with a podiatrist may go for less than $300, sometimes as little as $50. A consultation with an orthopedist can run about $250, depending on location.
Medicare Part B will cover medically necessities regarding foot care such as correction for hammertoes, bunions and heel spurs. However, it will not cover routine foot maintenance such as soaking, trimming and cutting. On the whole, podiatrists usually charge twelve percent less per each service than orthopedists. However, they also tend to rate forty-three percent higher in total charges, so it may all even out in the end.
For example, let’s take a broken foot and, well, break it down. If you have health insurance, this could deduct ten to fifty percent of the total cost. On average, an X-ray of a foot costs $170. The facility and doctor fees can add up to $500. The cast may cost around $250. Add on another doctor’s fee, which could be anywhere from $90 to $200.
A realignment procedure could set you back $2,000. Surgical treatment may cost anywhere between $5,100 to $13,600. Simple crutches can cost between $15 or $40. You can get the deluxe model for $100. They are usually covered by insurance. A manual wheelchair costs around $500 and an emergency room visit can cost another $500.
There are ways to get a discount. For example, a teaching hospital connected to a medical university may treat you for reduced costs. You may be asked to be the subject of a lecture or your foot could become someone’s final exam. If you are uninsured or paying in cash, some hospitals may offer a discount.
There are health clinics that provide free or reduced-cost care if you have proof of low income. And don’t worry, hospitals do not do repossession. They won’t break your foot open and take out the pins because you missed a payment. If you are Canadian, well, aren’t you lucky?
Frequently Asked Questions about Podiatry and Orthopedics
Here are some questions you may have pertaining to these foot experts and their answers.
Q: Why do diabetics need to see a podiatrist?
A: Some diabetics may develop neuropathy, a tingling, burning or numbness in the feet. This means a diabetic may have open sores on the feet and not even know it. Diabetes can lead to a weakened immune system, increasing the risk of infection. A podiatrist can check your feet for wounds and treat any that are found. An assessment of circulation and evaluation of nerve sensation can also be performed.
Q: Do Women have more foot problems than men?
A: Gout brings the stereotype of an old, wealthy gentleman with his foot on a plush ottoman while his faithful manservant waits on him. Actually, postmenopausal women are likely victims of gout as well. On the whole, women have four times as many foot problems as men. This is not only a result of ill-fitting high heeled shoes but the fact that most “pink collar” occupations (such as teaching or nursing) require being on one’s feet for a long period of time.
Q: Will I be able to play golf with a joint replacement?
A: That depends. Could you before? (Rimshot) Actually, that depends on a number of outside factors. Ideally, a patient should be able to eventually resume all previously enjoyed recreation and exercise after the operation without limitations or pain.
Q: What are my rights as a patient?
A: You have plenty of rights. You have a right to courtesy, dignity and respect. You have the right to be fully informed. You have a right bordering on duty to ask questions about your health status. You have the right to all decisions about your healthcare or to appoint an advocate should you lose your capacity to make or express decisions. You have a right to privacy and confidentiality.
You have the right to copies and summaries of your medical record. You have the right to ask another specialist for their opinion. You have the right to be advised of any conflict of interest that may pop up. You have a right for your care to continue as long as needed.
Q: Can a podiatrist or orthopedist refuse to treat me?
A: Under federal law, services cannot be refused due to race, color, nationality, citizenship status, religion, creed, gender, disability or veteran status. If a foot problem is out of the specialist’s area of expertise (due to the patient’s age or pregnancy) then it would be prudent to refer the patient to a more suitable specialist.
State laws vary on the topic of marital status, orientation, gender identity, AIDS/HIV status, political affiliations or status as a victim of stalking, assault or domestic violence. Many such discrimination laws are currently in flux. Stay informed.
Q: What should I do if I am concerned about infection?
A: Your podiatrist should disinfect tools in a sterilizing solution. Pedicurists are not quite as meticulous. If you want to get a pedicure, try to schedule for the first appointment of the day. This is when the equipment is the cleanest. Those footbaths can be crawling with germs. Even if the technicians spray the basin down between customers, quite a few of the tubs could have drains and filters that are not cleaned often enough.
Q: Should I just get some toe separators or bunion splints?
A: This will ease the symptom, but not remove the underlying cause. You have to go to a podiatrist to get rid of hammertoe and bunions for good. There is only so much a six dollar device can do.
Q: What are some questions I should ask an orthopedic surgeon?
A: The need for surgery is so overwhelming, you may forget just how to word any questions or concerns you may have. Don’t worry. You have the right to ask anything and the right to be fully informed. You can ask why the procedure is recommended and what the success rate is.
You might want to ask about any risks involved so you can assess them against the payoff. You can ask if further surgery will be needed and how the procedure is done. You can ask about anesthesia, pain control, and recovery. Anything that would give you peace of mind would be helpful.
Q: How young is too young for a podiatrist?
A: A common misconception is that podiatrists are for elderly people. The truth is, a person can see a foot doctor as soon as they’re up and walking, sometimes as young as 8 months. (Don’t be concerned if your yet to walk infant has flat feet. The arches will develop in time.) Most adult foot problems can be prevented by taking care of the feet early in life. Keep in mind these little feet are still growing and maybe very active.
Choosing between a podiatrist and an orthopedist can be difficult. Consider what specific foot problem you have and decide from there who would be best to treat it. In the end, you are the one who knows what’s best for you. Educate yourself and go with the health care provider who seems best to you. Whatever you feel the most comfortable with will very likely be the right choice.