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Information for Consumers
Doctors of Podiatric Medicine (DPMs) are specialists in the foot and ankle. Some specialize in conservative care while others practice mostly as surgeons. They are unmatched in their understanding of the foot's biomechanics. The value of podiatry," UCSF Center for the Health Professions Executive Director Edward H. O'Neil, PhD wrote in 1996, "is manifested in the intense knowledge and expertise in care of the foot, something no other profession can avow."
Many DPMs specialize in care and preservation of the diabetic foot. DPMs also assist other doctors in non-podiatric surgeries, because of their special skills and doctor-patient relationships. The Board of Podiatric Medicine (BPM) is the Medical Board unit that administers their licensing under the Medical Practice Act.
DPMs are the only medical specialty limited to its area of expertise by the license itself, which enhances patient protection. They also are the only California doctors required to do two-years of postgraduate training prior to licensure, another higher standard. Then, at each two-year license renewal, DPMs must meet peer-reviewed continuing competence requirements, over and above continuing medical education. These higher standards help to prevent patient harm. Together with strong BPM enforcement, they are reducing complaints to the Board, while complaints about other provider groups continue increasing. BPM's licensees support this effort by paying higher biennial licensing fees ($900) than other doctors and health care providers.
DPMs graduate from one of nine podiatric medical schools, which are specialized four-year medical schools affiliated with larger health science teaching centers. While providing general medical training, they concentrate on the eventual specialty and other areas of medicine most related. Each of the schools and subsequent graduate medical education programs (2-3 years duration) required thereafter must be approved by the Council on Podiatric Medical Education (CPME), which is recognized by the U.S. Department of Education for accrediting the schools.
Prior to initial licensure, DPMs also must pass Parts I, II and III of the exams administered by the Educational Testing Service for the National Board of Podiatric Medical Examiners. On the recommendation of the profession's state association, California requires a Part III passing score higher than the national passing score as an added measure of quality for Californians.
Many individuals provide foot care, but only licensed doctors (MDs, DPMs, or DOs) may diagnose, treat, and prescribe for medical conditions. Among doctors, none receive more intensive foot and ankle training or meet higher licensure and renewal requirements than DPMs. But every group has some who may practice below professional standards. The BPM is here to protect you.
- Check with Medical Board Verifications through our website [http://bpm.ca.gov/] or directly at:www2.dca.ca.gov/pls/wllpub/wllquery$.startup or call 916/263-2382 to make sure your doctor is licensed and to check on malpractice, State Accusations or discipline history.
- BPM wants you to know if it has referred a Doctor to the Attorney General for prosecution, even if a formal Accusation has not yet been prepared. This is public information you are entitled to know: http://bpm.ca.gov/consgde/agreferrals.shtml
- Ask doctors about their foot and ankle training and if they are certified by an approved medical specialty board certifying for podiatric expertise. For DPMs, California has approved: American Board of Podiatric Surgery, American Board of Podiatric Orthopedics and Primary Podiatric Medicine, and the American Board of Multiple Specialties in Podiatry. If you are seeing a non-podiatric doctor for podiatric care, ask about their training specific to foot and ankle. In 1995, the ACGME (the equivalent of CPME) approved standards for 12-month Residency Education in Foot and Ankle Orthopedics programs that a few non-podiatric doctors have undertaken. ACGME reports that nationwide, in 2004-05, there are five foot and ankle orthopedic programs with a combined total of eight residents. Programs of less duration or not approved by CPME, ACGME, or the Medical Board may be questionable.
- Call 1-800-FOOT-CARE, the Foot Care Information Center sponsored by the American Podiatric Medical Association. It has free brochures answering many questions. Its state affiliate, the California Podiatric Medical Association, can be reached at 1-800-794-8988. CPMA, 2430 K Street, Suite 200, Sacramento, CA 95816. Or visit its website: http://www.calpma.org
- Call the American College of Foot and Ankle Surgeons toll-free at 1-888-THE FEET (1-888-843-3338) for information about surgery. http://www.acfas.org/
- Ask your primary care physician to recommend a DPM.
- Obtain second opinions before surgery. Ask the surgeon to explain the risks, possible complications, and alternative methods of treatment. Ask how often they perform any recommended surgical procedure, and what the results have been. Costs should be fully disclosed before treatment.
- Except in emergencies, beware of rushed surgeries without attempts at conservative care. Be wary of multiple surgeries, claims about laser surgery (lasers do not cut bone), promises of "painless surgery," "miracle cures," "discount coupons," and the like.
- Don't choose doctors by the size of their advertisements!
Patient Rights - Hospitals must post a policy. If you don't see it, ask for a copy.
Fraud Hotlines - Call the Federal Inspector General (1-800-447-8477, that is HHS-TIPS) if you suspect anyone is cheating our tax-supported Medi-Cal or Medicare programs. The State Attorney General's Medi-Cal Fraud unit can be reached through 1-800-722-0432.
Insurance Issues – Call 1-888-HMO-2219 or 1-800-400-0815 (State Department of Managed Health Care) to complain about a health maintenance organization. Seniors in Medicare can call 1-800-638-6833. To file a complaint about an insurance provider or to report suspected insurance fraud, call the Department of Insurance at 1-800-927-4357 or visit their web site at http://www.insurance.ca.gov.
FILING COMPLAINTS ABOUT DOCTORS--Call 1-800-MED-BDCA (1-800-633-2322) for information or to file a complaint. Address written complaints to: Central Complaints, Medical Board of California, 2005 Evergreen Street, Suite 1200, Sacramento, CA 95815. Central Complaints can also advise about Better Business Bureau arbitration, Small Claims Court, filing with the profession's peer review program, or other options.
- How to file a complaint: http://www.mbc.ca.gov/Consumers/Complaints/
- Consumer Complaint Form: http://www.dca.ca.gov/online_services/complaints/complain_bpm.shtml
- Consumer information from BPM: http://www.bpm.ca.gov/consgde/index.shtml
- Links to consumer, government and professional organizations: http://www.bpm.ca.gov/about_us/links.shtml