Training of a Podiatrist
A doctor of Podiatric Medicine (DPM) practices the medical, surgical, and biomechanical treatment of the human foot, ankle, and associated structures. Although we specialize inthe prevention, diagnosis and treatment of problems affecting the foot and ankle, Doctors of Podiatric Medicine are also highly trained health care providers. We see people of all ages and are often the first medical specialists to diagnose systemic problems that affect the feet and ankles such as diabetes, gout, hypertension, immune-deficiencies, and arthritis. Four years of medical school is typically followed by 2 or 3 years of residency that certifies these doctors to function as partners in the larger medical community. Podiatric physicians (podiatrists) are the only medical professionals who exclusively specialize in treating the foot and ankle.

What does a podiatric physician do?
• Diagnoses lower extremity pathology such as tumors, ulcers, fractures, skin and nail diseases, and congenital and acquired deformities
• Makes independent judgments, prescribes medications, utilizes x-rays, MRI, ultrasound and other laboratory tests for diagnostic purposes, and orders physical therapy
• Treats conditions such as: corns, calluses, bunion, heel spurs, plantar fascitis, ingrown nails, cysts, bone disorders, and infections of the foot
• Fits corrective inserts called orthotics that address walking patterns to improved the overall ability of effective and efficient ambulation
• Provides consultations for the patient and for referring physicians regarding prevention of podiatric problems and possible treatments
• Performs surgical correction of the foot including: hammertoes, bunions, fractures, infections, ruptured ligaments and tendons, and neuro-vascular abnormalities of the foot

Medicare Diabetic Shoe Program
Diabetes is reaching epidemic proportions in the United States. During the past decade, there has been an increase of 33% with the diabetic population currently topping 16 million people. There are many complications associated with diabetes including kidney, heart, vision, circulatory and foot problems. The good news is that many of these potential problems can be minimized as a result of life style changes, medications and other preventive care.

Amputations, or partial amputations, of the feet and legs are also growing at an alarming rate. In fact, it is the leading cause of non-traumatic amputation in the United States. Recently a task force was created by officials from Medicare, the American Podiatric Medical Association and the American Diabetes Association in order to explore ways to reduce the number of amputations in the diabetic populations. The number of these lower extremity amputations grew by 28% in just the past several years. However, it has been determined that over half of these amputations could have been prevented by timely conservation foot care.

We at Buttigheri Foot Care Center are authorized Medicare Suppliers to evaluate, prescribe and dispense high quality shoe and 3 pairs of removable protective shoe inserts per calendar year. Many diabetic patients qualify for this benefit and Medicare will pay 80% of the cost for the shoes and insoles and your supplemental insurance should pay the other 20%.

Orthotics
Orthotics are custom made devices manufactured from many types of materials. They fit inside your own shoes, and are worn on a full time basis. Orthotics help to control the way your foot functions. There are many types of orthotic devices. Advances in technology enable your podiatrist to prescribe a device specific to the activities that you participate in the most. From walking to running, or aerobics to basketball, orthotics can help you perform at peak efficiency. Professional orthotics are made from impressions of your feet. The devices are custom made for your feet only. Just as a contact lense or glasses improve vision, orthotics will help your podiatrist improve your foot functions.

Biomechanical Orthotics
Biomechanics involves the study of body in motion. Biomechanical orthotics are prescription inserts made from neutral foot position casts. The prescribing practitioner sends the casts and clinical information to a professional orthotics laboratory, where an evaluation specialist reviews the casts and prescription. A staff doctor oversees the evaluation in the form of a "second opinion." Then a production clinician takes responsibility for fabrication and quality control of the individual prescription. The fabricated orthotics are sent to the doctor to dispense with instructions to the patient. Orthotic Treatment may be combined with other forms of treatment, such as injections, medications, physical therapy or surgery.

Is There More Than One Type of Orthotic?
Because we are born with different foot types, and because we engage in different occupations and activities, there are specific types of orthotics for individual patients. Orthotics may be used with children, adults, athletes, elderly patients and, very often, with patients following surgery or injury. Orthotics may be rigid, semi-rigid or soft (flexible).

How Long will I need to Wear Orthotics and How Long do they Last?
Orthotics may require a gradual break-in period. They are worn in 95% of all walking or standing activities. You will probably need to wear orthotics indefinitely, depending upon your activities. You may need periodic changes in your prescription as your foot function changes.

Will I Need More Than One Pair of Orthotics?
There are patients who may need one pair for work and one pair for recreation. Women who wear different heel heights may require an additional pair. Your podiatrist may recommend more than one pair, depending on your individual need.