Key Milestones in Podiatry: Scope of Practice & VA Advancements

South Carolina.  On May 17, 2018, South Carolina signed into law H 3622, an updated podiatry scope-of-practice act to allow doctors of podiatric medicine to medically and surgically treat the ankle, and gain greater amputation privileges as well. The podiatry scope-of-practice statute was last updated in 1976.  This scope of practice victory was achieved through extensive grass roots efforts and will help to offer the citizens of South Carolina increased availability of expert foot and ankle care.  South Carolina became the 47th state to allow podiatrists to treat the ankle. Now only three states remain that limit podiatry scope of practice to the foot: Massachusetts, Alabama and Mississippi. Massachusetts DPMs are engaged in similar efforts right now and prospects look good, but nothing is a certainty in legislative politics. There is no DPM scope legislation pending in Alabama or Mississippi.

Quick Answer

Recent milestones in podiatric medicine include South Carolina's updated scope-of-practice act, signed into law on May 17, 2018, which expanded podiatrists' ability to medically and surgically treat the ankle and gain greater amputation privileges. This legislative change made South Carolina the 47th state to allow podiatrists to treat the ankle, significantly increasing the availability of expert foot and ankle care for its residents. Another key milestone is the U.S. Senate's passage of the VA MISSION Act on May 23, 2018, which reclassified podiatrists as podiatric surgeons within the VA Health Administration. This landmark legislation, the first specific to podiatry passed by the United States Congress since 1976, ensures veterans receive high-quality foot and ankle care by addressing recruitment challenges and achieving pay parity for podiatrists.

Department of Veterans Affairs.  On May 23, 2018 the United States Senate passed S 2372, the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018, or MISSION Act. The legislation provides comprehensive reforms to the Department of Veterans Affairs (VA) health-care system and includes language from APMA’s VA Provider Equity Act. The bill passed the House last week and will now go to the U. S. President, who is expected to sign it immediately.

The VA Provider Equity Act reclassifies podiatrists as podiatric surgeons within the VA Health Administration (VHA), placing them in the same pay band as their allopathic and osteopathic peers. This update to decades-old regulations will go far in addressing the dire recruitment and retention issues in the VHA and ensure our veterans receive the best possible foot and ankle care.

The passage of this legislation represents the largest advancement for federally employed podiatrists since 1976, and is the first bill specific to podiatry passed by the United States Congress.

The VA Provider Equity Act was introduced by Rep. Brad Wenstrup, DPM (R-OH), in the House and Sen. Bill Cassidy, MD (R-LA), in the Senate.

The significance of this legislation cannot be overstated. While it’s immediate affect is contained within the Veterans Health Administration, the ripple effect on the profession of podiatry with respect to parity will reach far and wide.

“This bill reflects significant advancement in the education, training, and licensure requirements for podiatric physicians over the past 40 years,” said Dr. Steve Goldman. “Podiatrists deserve parity within the VHA, and our patients deserve the proven benefits of the best-trained experts in lower extremity care as part of their health care team.”. Dr. Goldman was one of several physicians asked to speak on behalf of podiatrists. Others included: Jeffrey Robbins, DPM, Director of the Veterans Health Administration Headquarters Podiatry Services and Chief of the Podiatry Section at the Louis Stokes Cleveland VA Medical Center, and Seth Rubenstein, DPM, APMA treasurer.

The elevation of podiatrists within the VA will bolster APMA efforts to pass the Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians (HELLPP) Act, which seeks to appropriately recognize podiatrists for their care of Medicaid patients.

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Frequently Asked Questions

1 How do recent legislative changes expand the scope of care podiatrists can provide, especially for ankle issues?

Recent legislative changes, such as the 2018 South Carolina law, expanded the podiatry scope of practice to allow doctors of podiatric medicine to medically and surgically treat the ankle. This means podiatrists in most states are now able to offer comprehensive foot and ankle care, increasing the availability of expert treatment.

2 What impact do these milestones have on foot and ankle care for veterans?

The VA MISSION Act, passed in 2018, reclassified podiatrists as podiatric surgeons within the VA Health Administration. This update aims to address recruitment and retention issues for specialists, ensuring veterans receive the best possible foot and ankle care.

3 Do these advancements in podiatric medicine affect the types of complex foot conditions, like those requiring limb preservation, that podiatrists can treat?

Yes, some legislative updates, such as the South Carolina law, granted podiatrists greater amputation privileges. This, combined with an expanded scope of practice to include the ankle, enhances a podiatrist's ability to manage complex foot conditions and provide comprehensive limb-preserving care.