Podiatrist vs. Orthopedist for Bunions

What is the difference between orthopedic surgery and podiatry for the condition of bunions?  Both are medical and surgical specialties, and its practitioners attended medical school and residency, and go through a licensure and board certification process.  Orthopedic surgeons and podiatrists work side by side in hospitals and in the same group practices.

The main difference lies in the body systems they treat.  Orthopedic surgeons are concerned with bones, muscles, ligaments and joints throughout the body.  They are bone and joint surgeons.  Podiatrists are foot and ankle doctors and surgeons.  As such, there are overlaps between the two.  Both are concerned with bones, muscles, ligaments and joints in the foot.

Outside of this, orthopedic surgeons are concerned with other areas of the body, including knees, hips, spine.  Podiatrists go into their field knowing from day one that they will be physicians and surgeons of the foot and ankle.  Their curriculum and course of study is geared toward that end.  So even though an orthopedic surgeon may have some experience or training in the foot and ankle, it does not compare in terms of commitment and depth of training in the foot and ankle, all systems, that a podiatrist receives over many years of schooling, residency and fellowship.

This is true in the diagnosis and treatment of bunions. Bunions are a very common condition we treat.  There is a bump at the base of the big toe, which is an increase in the angle between the 1st and 2nd metatarsals.  The condition is caused by pressure against the great toe, pushing it at an angle towards the second toe.  It can often result in a callus on the side of the big toe.  Bunions are common in the case of ballet dancers, or with pronated feet, a genetic condition which causes one to walk on the inside of the foot.  There can be pain in the bump or bunion itself, or there can be pain in the big toe joint.

Bunions are treated with orthotics, wider shoes, and surgery if the condition affects one’s lifestyle. There are over 100 surgeries for bunions.  Podiatrists learn, perform, and are tested on them in the board certification process.  To be board certified, a podiatrist must take and pass a written test. Then, within a short timeframe, they must perform a diversity of cases, that is, different types of bunion procedures. They must then submit a portfolio of case studies to be accepted for oral board certification testing.  There is no such intense certification process for foot surgery cases for orthopedic surgeons.

A surgeon must also have an understanding of the biomechanics of the condition to keep the condition from progressing and recurring.  Podiatrists receive instruction on biomechanics throughout schooling, residency and fellowship.  Orthopedists do not generally make custom functional foot orthotics, which are the eyeglasses for the feet that ensure proper biomechanics.  They are used to reduce pain, prevent the need for surgery, and keep the bunion from coming back after surgery.

Podiatric surgeons, therefore, are more specialized and detailed in the treatment of bunions, as the foot and ankle are their specialty.

“He was welcoming and listened well to the concerns I presented. I especially liked that I was able to write down my problem before I came in and he addressed them efficiently. I was diagnosed with a much different problem than I had been given before, and Dr. Hoy explained his simple, methodical method for his diagnosis as we went. I felt extremely cared for and like I will be able to make progress on my problem before I see him again. Definitely see Dr. Hoy if you’ve had problems seeing a general practitioner or orthopedist with no luck. It may be that you need a more specialized opinion.” -Samuel S.