PRACTICE OF PODIATRIC MED. & SURGERY S.B. 901 (S-1):
ANALYSIS AS PASSED BY THE SENATE
Senate Bill 901 (Substitute S-1 as passed by the Senate)
RATIONALE
Podiatrists are physicians and surgeons who specialize in the diagnosis, treatment, and prevention of conditions affecting the foot, ankle, and related structures of the leg. In Michigan, an individual who wishes to become licensed as a podiatrist must possess a four-year undergraduate degree, graduate from an approved school of podiatric medicine accredited by the Council on Podiatric Medical Education of the American Podiatric Medical Association, and either complete one year of a Board of Podiatric Medicine and Surgery-approved postgraduate residency or one year of training in a Board-approved preceptorship. In addition, applicants must pass the American Podiatric Medical Licensing Examination, administered by the National Board of Podiatric Medical Examiners. Individuals also may apply for licensure by endorsement (verification of licensure in another state), or for an educational limited license.
Scope of practice refers to the services a healthcare professional is permitted to provide under the terms of his or her professional license, registration, or certification. In most jurisdictions, a provider's scope of practice is determined by that jurisdiction's laws, regulations, and licensing bodies. Evidently, the scope of practice for podiatric medicine and surgery, which is defined in the Public Health Code, has not been updated since it was written in 1978. It has been suggested that the scope of practice be revised to accurately reflect how podiatrists in Michigan currently practice.
CONTENT
The bill would amend Part 180 (Podiatric Medicine and Surgery) of the Public Health Code to modify the definition of "practice of podiatric medicine and surgery" and revise the exclusion of certain procedures.
Under Part 180, a person may not engage in the practice of podiatric medicine and surgery or practice as a physician's assistance unless licensed or otherwise authorized by Article 15 (Occupations).
The Code defines "practice of podiatric medicine and surgery" as the examination, diagnosis, and treatment of abnormal nails, superficial excrescences occurring on the human hands and feet, including corns, warts, callosities, and bunions, and arch troubles or the treatment medically, surgically, mechanically, or by physiotherapy of ailments of human feet or ankles as they affect the condition of the feet.
The bill, instead, would define "practice of podiatric medicine and surgery" as either of the following:
-- The treatment of ulcerations below the tibial tuberosity and of human nail diseases, callosities, and verruca.
-- The evaluation, diagnosis, management, and prevention of conditions of the lower extremities, including local manifestations of systemic diseases in the human foot and ankle, by attending
-- to and advising patients and through the use of devices, diagnostic tests, drugs and biologicals, surgical procedures, or other means.
The evaluation, diagnosis, management, and prevention of conditions of the lower extremities could include osseous and soft tissue procedures that address the pathology of the foot, ankle, and the contiguous attachments below the tibial tuberosity.
Currently, the term does not include amputation of human feet, or the use or administration of anesthetics other than local. Under the bill, it would not include amputations proximal to the tibiotalar joint, proximal osseous procedures that did not involve the tibiotalar joint, or the administration of intravenous sedation or general anesthesia.
The bill would take effect 90 days after its enactment.
ARGUMENTS
(Please note: The arguments contained in this analysis originate from sources outside the Senate Fiscal Agency. The Senate Fiscal Agency neither supports nor opposes legislation.)
Supporting Argument
The scope of practice for podiatric medicine and surgery was written in 1978, and does not accurately reflect how podiatrists currently are practicing in the State. Medicine is constantly changing, and the practice of podiatry has evolved substantially in the last 40 years. The current scope of practice limits podiatrists to the treatment of conditions affecting the foot and ankle. However, podiatry is not limited to treating fungi, calluses, and nails. It also includes treating chronic conditions such as diabetes, vascular disease, and arthritis, and performing reconstructive surgeries for bunions, club feet, and ankle fractures, which could require placing external fixation and stabilization hardware above the ankle. The bill would not expand what podiatrists are allowed to do, but would ensure that their scope of practice accurately reflects what they do currently.
Legislative Analyst: Stephen Jackson
FISCAL IMPACT
The bill would have no fiscal impact on State or local government.
Fiscal Analyst: Elizabeth Raczkowski
This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.