Most Marylanders are not aware of the shortage of one type medical specialists that will affect health care availability for decades: Podiatrists. Podiatry is the medical specialty that deals with foot and ankle injuries and disease. Don't laugh. This is serious business.
With the aging of our population and the explosion in diabetes, we're likely to see more diabetic foot conditions. Left untreated or undertreated, this disease can progress to chronic infections and lower limb amputations, resulting in disabling and life-changing consequences. The Centers for Disease Control and Prevention estimates that 24 million Americans have diabetes, and 86,000 undergo amputations each year.
But major studies have substantiated the beneficial effects and economic efficiencies of having podiatrists as part of the treatment team. They show that podiatrists provide preventive treatment and reduce the amputation rate. This avoids costly care. Estimates show that savings could be $3.5 billion per year in the U.S. More importantly, people can continue to walk, work and enjoy their lives.
As a medical doctor, one of us regularly calls on his podiatric colleagues to consult and manage a wide range of problems: everything from deep foot lacerations and embedded foreign bodies to foot bone fractures and diabetic foot maladies. Here too, as part of the health care team with physicians, nurses, and pharmacists, podiatrists play a key role.
Podiatric medical school education and training mirrors that of physicians. College graduation is followed by four years of podiatric medical school. After passing national board exams, the podiatrist completes a three-year residency training program involving both medical and surgical care before entering the community to practice.
Maryland is a center for training health care professionals in all fields, and our state taught podiatrists at such highly regarded institutions as the University of Maryland, Good Samaritan Hospital, Greater Baltimore Medical Center, Franklin Square and Mercy Hospital.
But no longer. Due complex budgetary and regulatory changes, the last non-federally funded podiatric residency training program closed in 2005. The Veterans Administration program was to be closed this year but has gained a one-year reprieve and will most likely close next year.
Many Maryland podiatrists are now approaching retirement age. According the State Board of Podiatry, there were 467 podiatrists in Maryland in 2008, but that's down to 436 in 2013. At the same time our state's population has grown and aged, making the access disparity worse. Because doctors often stay to practice in the region where they were trained, a new local program is essential. Without one, the number of Maryland podiatrists will continue to dwindle.
We call on our health care system administrators and regulators to find a way to fund new podiatric residency training programs, perhaps at one of our excellent academic centers. To control start-up costs, one could begin with as few as three podiatrists per year in a three-year training program. Eventually, the program would be graduating these specialists so that they can enter Maryland's health care work force. But even if a program were to start as early as 2014, the new residency graduates would not be available until at least 2017. That's why action is needed now.
We Marylanders are rightly proud of our health care system, and all the providers who work in it are needed. We can't overlook any one essential part. Standing up for podiatry and taking the initiative to ensure our state has enough of this essential provider group is a key first step. We cannot slip up and leave our citizens without the care that is — and will be — required.
Del. Dan K. Morhaim (firstname.lastname@example.org), a physician, represents District 11 in Baltimore County. Sen. Catherine Pugh (email@example.com) represents District 40 in Baltimore City. Both are Democrats. Enzo J. Leone is president of the Maryland Podiatric Medical Association.