Part 2 — PLAN No. 1245. PODIATRY AS A VOCATION

The wise man will not come to a hurried conclusion in deciding his life work. A false start in life is frequently the undoing of an individual because misapplied ambition often eventuates in indifference. Therefore, it is well to weigh the pros and cons of so momentous a consideration, and the following is presented in the hope that it may prove of service in studying one phase of activities in that connection:

What is Podiatry?

Podiatry means the care of the human foot in health and in disease. The intelligent practice of podiatry constitutes the practitioner a specialist in this branch of medicine.

Specialists in Medicine

In recent years those educated and equipped as doctors of medicine, in many instances, particularly in the larger cities, have devoted themselves to some special branch, and so it is that we have laryngologists (throat), otologists (ear), urologists (male organs of generation), gynaecologists (female organs of generation), oculists (eye), orthopaedists (deformities), odontologists (teeth), and many others who specialize in some one particular field of medicine. Strange as it may seem, physicians, other than orthopædists, have never specialized in foot lesions, and the work of the latter in that field has been merely incidental.

The Genesis of Chiropody

In consequence, a group of non-medical practitioners, styling themselves chiropodists, assumed to care for the foot woes of the public. They claimed no scientific knowledge of the feet, but announced their ability, acquired in the school of experience, to care for the minor foot-ills of the public which were largely induced by the wearing of badly constructed foot-gear. These practitioners were primarily usually itinerants. They went about from town to town carrying their kits, which contained knives and medications which they and their predecessors had found useful in plying their craft. They flourished in England in the eighteenth and in the nineteenth centuries, and soon after our government was founded they began to appear in the larger centers of the United States.

The knowledge which they acquired was imparted to their apprentices, who were usually their offspring, and so this practice was largely handed down from father to son.

Chiropody Development

In 1895 they had grown so numerous in New York City that they organized a State Society and the State legislature chartered their organization and gave them power to license others who wished to practice similarly. Many other states gradually enacted like laws.

In 1912 the Pedic Society of the State of New York again went to the legislature and secured the passage of a law which required academic qualifications of students of chiropody and established a standard for chiropody teaching institutions.

The law also provided that no person should practice chiropody after that date, unless previously licensed, who failed to pass a state chiropody licensing examination conducted by the State Board of Medical Examiners. Since then twenty-three other commonwealths in the United States have passed similar laws.

Recently the term podiatry was made synonymous with chiropody in several states. Thus, from a trade, chiropody has been transformed into a scientific branch of medicine.

Schools and Their Curricula

The teaching schools have faculties made up of doctors of medicine, chemists and podiatrists. The outlined courses of study include instruction in the following topics: Anatomy, Histology, Chemistry, Physiology, Hygiene, Materia Medica, Therapeutics, Pharmacy, Surgery, Bacteriology, Pathology, Dermatology, The Principles of Medicine, Ethics, The History of Podiatry, Foot-Gear, Orthopedics, Massage, Electro-Therapeutics, Posture Studies and X-Ray work.

No man should take up a career in podiatry unless he is prepared to devote all of his energy to his studies because the work accomplished in the course, as it is at present carried on, crowds the equivalent of two years at a medical school into the one year of podiatry. This means unusual application because the work must be accomplished or the student fails to graduate.

Students

There are three classes of students: Regular, Special and Post-graduate.

Regular Students must have academic qualifications in keeping with the standards adopted by the various state education authorities. In most of the states two years of high school work, or its equivalent in academic counts, are pre-requisites. This standard is being advanced each year until all regular students in all schools will have to have a minimum education of graduation from a high school or its equivalent in academic counts.

Special Students are admitted to these teaching schools without academic qualifications. They may take the full course, but cannot graduate from the schools which they attend, nor can they practice in any state where laws regulating the practise of chiropody are on the Statute books. Provision has been made to educate these special students so that those contemplating practice in the states and countries where there are at present no laws governing chiropody may secure the knowledge imparted in the schools. It is fair to assume that within the next five years every state in the United States will have a law governing chiropody practice whereupon those from foreign countries only will be admitted to the course as special students.

Post-graduate Students. Practitioners of medicine or of chiropody, who have been reputably engaged as such for at least six months, and who wish to acquire the knowledge imparted to the regular students so that they may become better fitted for their vocations, are eligible as post-graduate students.

Duration of Course

In most of the established schools of chiropody the day course is of from eight to nine months’ duration. The hours are as follows: from 9 A. M. to 12, from 1 to 5 P. M., and during the last three months of the course, additionally, from 7:30 to 10 P. M.

The night course is of two years’ duration, three hours each night for eight months in each year.

Degrees

Graduates of the various schools receive titles and degrees. Some of the schools give the degree of D.S.C. (Doctor of Surgical Chiropody); others the title of M.Cp. (Master of Chiropody).

License to Practice

Before admission to practice, graduates must pass an examination conducted by the State Board of Medical Examiners in the state in which they desire to engage in practice. The conditions as to admission for licensing examination vary in the different states, as there is at present no reciprocity in chiropody licensure.

Requisites for Success

The requisites for success in podiatry study and practice are not trifling. Primarily the student should have the feeling that he is engaging in a calling in which he can be of service to his fellowman. The draft and the war itself have proved that the foot has been a very much neglected factor in the physical care of humankind. Draft statistics show a large percentage of rejections because of foot defects, and the casual lists in actual warfare are filled with the names of those who have fallen out of the ranks because of impaired locomotion.

A large part of podiatry instruction is devoted to the prevention of foot lesions, so that the child from its first step will be safeguarded against the conditions which have led to the creation of such a large percentage of foot cripples. This in itself is a humanitarian task and those contemplating entering upon a career in podiatry should be sympathetic with that particular and all-important phase of the work. Again, the podiatrist in his daily practice is called upon to relieve suffering and that aspect of his activities should be a heartening influence to the developing practitioner as it will prove a consolation to him when once he is licensed to pursue his calling.

Desirability of Mechanical Knowledge

As much of the actual practice, both preventive and curative, has to do with surgical endeavors, the prospective student should have an aptitude for mechanics.

Physical Qualifications

The practice of medicine presumes a vigorous body as well as a virile mind, and it is best for every man in every life engagement to be so equipped; but those whose physical condition is impaired so that locomotion and other normal functions are impeded can readily engage in podiatry because most of the work is carried on in the office and can be done while seated and during limited hours.

Possible Assets

Those who have studied chemistry or pharmacy or have been associated with hospital work will find themselves possessing valuable assets in the study and in the practice of podiatry.

Choice of Location

There are failures and successes in every field, professional and otherwise. It is, however, axiomatic that a podiatrist who knows his work and applies himself in the proper field will succeed as a breadwinner. The selection of a location is of the greatest importance. Graduates of the various schools, in the main, have located in the larger cities. This is frequently an error because competition with those already engaged in practice who have a standing and a following is thus inevitable and the advance of the younger practitioner is consequently curtailed.

Those graduates who have located in cities of from 25,000 to 100,000 inhabitants have invariably succeeded from the start. The most successful of these have been those who have sought out the practicing physicians and have convinced them that they are not mere “corn cutters,” but scientific practitioners of a legitimate branch of medicine.

The Income From Podiatry Practice

It is current belief that the average podiatrist enjoys a greater income than the average physician. There are no statistics available to confirm or to disprove this conclusion. In order that some idea on this point may be gained, the incomes of some of the members of the first graduating class of one of the podiatry schools of prominence are here given:

1st year 2nd year 3rd year 4th year 5th year

No. 1 $ 2,000 $ 3,000 $ 4,000 $ 4,000 $ 5,000

2 1,000 1,500 2,000 2,500 3,000

3 1,300 1,800 2,500 4,000 4,800

4 800 2,000 3,000 4,000 4,700

5 1,200 1,800 2,000 3,000 3,400

[44] 6 800 1,200 1,700 2,300 2,800

[44] 7 800 1,000 1,400 1,800 2,800

Physicians’ Co-operation

Once the co-operation of the physician is secured, success is assured. Some practitioners in towns of from 15,000 to 35,000 have in three years gained sufficient practise through the aid of medical practitioners to make their incomes from $2,000 to $5,000.

The Personal Equation

The personal equation is a great factor in this as in all other life spheres. The likeable man or woman with a modicum of other attributes will invariably succeed. When such a person possesses qualities which, when applied, prove helpful to his fellows, the limit of his earning capacity can only be measured by the hours he can serve and the population of the center in which he carries on his practice.

Podiatry is Ethical

Podiatry, as taught to-day, frowns down upon all unethical methods and disavows the charlatan. Its exponents and its loyal followers are keen as to the need for scrupulous care in the education of its students and the conduct of its practitioners. It strives to be classified as a dignified branch of medicine and fosters a literature that is strictly scientific.

Podiatry Organizations

Podiatry has a national organization whose purposes are for the benefit of the profession, based upon the good which they can accomplish in serving the public. It has a state society in almost every commonwealth in the United States, and local societies flourish in every populous city.

Professional Advancement

The scope of the podiatrists’ professional labors is continuously being enlarged by legal enactments and, where deserved, medical practitioners recommend them to their patients as foot specialists. In a number of well-known hospitals, podiatrists are attached to the medical staff, thus proving that physicians in groups are beginning to recognize the need for the services which these practitioners supply. In another year the course of study in most of the schools will be prolonged to two years and ultimately the specialist in foot lesions will be a licensed practitioner of medicine, equipped as is every other specialist in medicine.

Is There a Demand for Podiatrists?

In all of the large cities of the United States and of Europe chiropodists have been in demand for the past century. The need for foot-care is daily becoming more pronounced. Now that physicians can and do recommend their patients to chiropodists who have been scientifically trained in their calling, the need for such practitioners is rapidly growing.

The public is growing to recognize the need of both preventive care and curative treatment of the minor ills of this part of the anatomy and the properly educated, well equipped, efficient podiatrist is in great demand.

There is no scientific school for educating such practitioners in the world outside the United States.[45] In consequence, hundreds of such practitioners would also find need for their services along the lane of European travel, once it is restored. South American capitals, with large populations of foreigners, would likewise prove splendid fields for podiatrists.

How Long Does it Take to Establish a Practice?

The answer to this natural inquiry depends largely upon the place of location, the experience and the personality of the practitioner. If one locates in a city where he is the only scientifically equipped podiatrist, assuming that he is properly equipped, recognition by both medical men and by the laity should promptly be accorded and that in turn would mean success.

If a graduate locates in a metropolitan city unheralded and unsung, his advance may be exceedingly slow and like the general practitioner of medicine, similarly situated, it may take considerable time for him to make a name and a career for himself.

If the experience of the new podiatrist has been augmented by application in a clinic or in the service of an older practitioner as an assistant (and such assistants earn from $25 to $50 per week in wages), such experience is largely helpful, not only in inspiring confidence, but in securing results. If the personality of a practitioner is such as to prove repellent to his patients, his path will be a difficult one. If, on the other hand, he is of pleasing personality, he will make friends and will increase his list of patients.

Where Podiatry (Chiropody) is Regulated by Law?

The following commonwealths have passed laws regulating the practice of chiropody (podiatry) and those desiring specific information as to the details of the same in any given state should address the person whose name follows the state, as here recorded:

California—Chas. B. Pinkham, M.D., 125 Stockton St., San Francisco.

Colorado—David A. Strickley, M.D., 612 Empire Bldg., Denver.

Connecticut—Chas. A. Tuttle, M.D., New Haven.

District of Columbia—Commissioner of Education.

Illinois—C. St. Clair Drake, M.D., Springfield.

Louisiana—E. L. Leckert, M.D., 716 Macheca Bldg., New Orleans.

Maryland—J. P. McScott, M.D., Hagerstown.

Massachusetts—Walter P. Bowers, State House, Boston.

Michigan—B. D. Harrison, M.D., Detroit.

Minnesota—Thomas McDavitt, M.D., St. Paul.

Nebraska—H. B. Cummings, M.D., State Board of Health, Seward.

New Hampshire—Henry C. Morrison, M.D., Concord.

New Jersey—Alex. McAllister, Trenton.

New York—State Education Dept., Albany.

North Carolina—B. K. Hayes, M.D., Oxford.

Ohio—George H. Matson, M.D., Columbus.

Pennsylvania—N. C. Shaeffer, M.D., Harrisburg.

Rhode Island—Gardner T. Swarts, M.D., State House, Providence.

Vermont—W. Scott Nay, M.D., Underhill.

Virginia—J. N. Barney, M.D., Fredericksburg.

Washington—C. N. Suttner, M.D., Walla Walla.

West Virginia—S. L. Jeptson, M.D., Wheeling.

Wisconsin—J. M. Beffel, M.D., Milwaukee.

Podiatry Teaching Institutions

The following are the Schools of Chiropody (Podiatry), in the order of their creation:

The First Institute of Podiatry—213-17 W. 125th St., New York City.

Chiropody Dept., Temple University—18 Buttonwood St., Philadelphia, Pa.

California College of Chiropody—908 McAllister St., San Francisco.

Illinois College of Chiropody—1321 N. Clark St., Chicago, Ill.

Ohio College of Chiropody—Cleveland, O.

Chiropody Dept., University of Massachusetts—Fourth and Otis Sts., Cambridge, Mass.

Catalogs of each of the above can be had on writing to the addresses given.

The Minnesota College of Chiropody is making ready to open up its doors October next. Information as to its plans and purposes can be secured by addressing Ralph St. John Perry, M.D., Pilsbury Bldg., Minneapolis, Minn.