Importance of Primary Care in Podiatry

Oftentimes patients who present to a podiatrist do not have primary care physicians.  A primary care physician is an MD or DO doctor who sees a variety of health problems and takes care of individuals in a general sense.  Examples of primary care physicians include Family Medicine, Internal Medicine, Geriatrics and Pediatrics.

Patients often tend to avoid the healthcare system altogether and instead rely on Dr. Google, then going to the urgent care clinic if something comes up.  A primary care physician may be thought of as unnecessary.

If one receives care only from urgent care, they receive treatment usually by nurse practitioners or physician’s assistants only as needed, and there is not the continuity of care.  Patients need specific tests and treatments at various stages of life, and primary care physicians can direct that care.

Podiatrists use primary care physicians also in various ways as part of a treatment team.  If a patient has no primary care physician, treatment becomes more difficult.

  1. Surgical preoperative clearance.  Prior to surgery, it is an important requirement to see a primary care physician to make sure one is healthy for surgery.  There may be conditions that may come up or need to be stabilized such as diabetes, hypertension or heart conditions.  Ongoing medications such as blood thinners may need to be bridged or dosed differently.
  2. Long-term administration of medications.  There are systemic medications affecting the feet which a primary care physician may need to administer long-term, and periodically assess the patient to make sure overall health is not affected.  Examples include oral corticosteroids, narcotic pain medications, medications for gout or other systemic arthritides.
  3. Treatment for abnormal lab values.  For example, the oral medication for nail fungus requires lab monitoring of the liver function.  If these are abnormal, a primary care physician will need to be consulted to assess and treat if necessary.
  4. Treatment for systemic conditions that involve the feet.  For example, swelling in the feet may be caused by liver, kidney or heart problems.  Burning and tingling in the feet may be caused by back problems.  A primary care physician will need to be involved to treat these problems, referring to other specialists as needed.

Dr. Hoy will refer to primary care physicians as needed as part of a treatment plan for the foot and ankle.  It is important to have this type of doctor on board to be a part of one’s overall care team.