Testimony in Opposition to H.2450/S.1260, An Act Relative to The Definition of Podiatry, Before the Committee on Public Health

The Massachusetts Medical Society wishes to be recorded in opposition to H.2450/S.1260, identical bills that would allow podiatrists to expand their surgical scope of practice from the foot to the ankle and lower leg. The bill would allow health care facilities to determine what is “allowable surgical treatment” for a podiatrist in that facility.

This is an unfortunate example of podiatrists seeking to equate the practice of podiatry with that of a foot and ankle orthopedist, without having to undergo the education and training requirements demanded of all medical doctors nor the surgical residencies of orthopedic surgeons.  Moreover, the MMS believes that it is the role of the Massachusetts State Legislature to define allowable surgical practice for podiatrists.  Charging health care facilities to determine such will result in a patchwork of practice standards for podiatrists and will likely confuse patients and jeopardize quality patient care.

Podiatrists are not medical school graduates nor are they licensed by the Board of Registration in Medicine; instead, they are graduates of schools of podiatric medicine licensed by the Board of Registration in Podiatry. They have a completely different educational process, postgraduate training and licensing system from medical doctors, yet they seek to expand their practice by legislation into treatment of systemic disease, the leg and ankle.  By contrast, orthopedic surgeons are medical school graduates who go through general surgery residency programs and follow that with orthopedic residency training.  Five to six years of surgical training is typical for physicians before they obtain full orthopedic privileges at a hospital and begin to work independently.  Podiatry is a completely different profession and the training, while including hospital based surgical training on the foot is far from equivalent. This legislation specifies no new minimum standards of education and training for podiatrists, except those to be set by the profession itself.

The amazing successes of highly skilled orthopedic surgeons in Massachusetts in recent years should not imply that ankle surgery is a simple matter or that a medical degree and residency in orthopedic surgery are superfluous minimum qualifications to engage in such work.  The fact that the foot is close to the ankle and the lower leg does not make the qualifications of a podiatrist close to those of an orthopedic surgeon.

The Massachusetts Medical Society urges the Committee on Public Health to reject H.2450/S.1260 and to report the bill out of Committee “ought not to pass.”

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