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Frequently Asked Questions about the Future of Podiatric Medicine

Podiatric Medicine in Glendale


I. Demographics Associated with Podiatric Medicine

A. Retiring Podiatrists

There are approximately 14,000 licensed podiatrists in the United States. Over the next eight to ten years, many of the "baby boomer" podiatrists will reach retirement age and leave practice. These podiatrists entered practice at a time when class sizes at the colleges of podiatric medicine were large (over 600 graduates per year). In recent years, class sizes of most programs in the country have been much smaller (the class of 2006 has 414 students — more than either the class of 2004 or 2005); therefore, as these "baby boomer" podiatrists leave practice, they will not be replaced in the pipeline by a similar number of graduating podiatrists. This will result in an overall reduction in the number of practicing podiatrists.

B. Number of Podiatrists Currently Practicing in the Southwest

The 1999 projections from the Liaison Committee of the American Podiatric Medical Association indicated that Nevada, Colorado, and New Mexico are at or below the forecast for podiatric physicians required in metropolitan areas with HMO and integrated network plans and non-metropolitan areas. Arizona is at or below the forecast of podiatric physicians required in metropolitan areas with fee-for-service plans.

C. Department of Labor Projections

In 2001, the U.S. Department of Labor projected a 10-20 percent increase in the need for new podiatrists through 2008.

D. The Competition Fallacy

Some podiatrists see their peers as competition and believe that a smaller number of podiatrists would be good for business. The recent APMA 2002 Podiatric Practice Survey clearly refutes that reasoning. Podiatrists who practice in groups earn substantially more than those practicing alone. A minimum number or "critical mass" of a profession's members is required to achieve the needed level of visibility to achieve success. This is true on both the local and the national level. To quote Jon Hultman, DPM, MBA, "If you believe that there are too many DPMs, you are neither recognizing the obvious favorable demographics which are poised to increase the future demand for podiatric medical services nor considering the untapped demand that is currently out there."

The 2000 Survey of Attitudes Toward Foot Care conducted by the APMA Department of Public Relations revealed that, not only are the most common foot problems treated at least as often by a non-podiatrist as they are by a podiatrist, but many times more patients with foot complaints see no doctor at all. Greater visibility resulting from more podiatrists and more group practices will attract those patients who do not know who to see or who have been unsuccessful with self-care.

E. Population Growth

A recent study by Health Affairs suggested that the United States will be facing a shortage of physicians. The forecast was based upon two findings. First was that previous population predictions for the United States have underestimated growth by 10 percent. Second, the number of hours worked by physicians is estimated to decline by 20 percent. Thus, the shortage of physicians will become severe, and they predict a deficit of 200,000 physicians by 2020. This same logic applies to the podiatry profession.

II. Public Need

A. Growth in Diabetes

Statistics from the United States and around the world clearly show epidemic growth of diabetes. The number of diabetic patients in the U.S. is rapidly climbing past 18,000,000. (King) In 1992 the percentage of the 65+ population in Arizona with diabetes was 7.2 percent. (U.S. Census Bureau) The incidence of foot pathology in diabetes is great. Podiatrists are critical members of the diabetes health care team. A disproportionate share of the morbidity and mortality from foot complications falls on Native Americans and Mexican Americans. (Burrows, Bennett, Carter, Hanis, Lee, Jasmanda, Will) The population of Mexican-Americans in the U.S. has increased dramatically over the past several decades. (U.S. Census Bureau) In 1999, 31.8 percent of the Arizona population were members of a minority. In 2000, 20.8 percent of Arizonans were Mexican-Americans. One-fifth of the population in Maricopa County and in the city of Glendale is of Mexican-American descent as well. (U.S. Census Bureau)

B. The "Graying" of America

As the percentage of older Americans increases steadily each year, the need for foot and ankle care will become increasingly important to maintaining a healthy lifestyle. In 1995, the percentage of Arizonans aged 65 and older was 13.7, well above the national average. The percentage growth in the Arizona population 85 and older from 1985 to 1995 was 88.9 percent, second only to Nevada (105.5 percent increase). (U.S. Census Bureau). By 2003, 20 percent of the U.S. population will be older than 65 years, up from 12.4 percent in 2000. (U.S. Department of Health and Human Services) As the large population of "baby boomers" ages, it is entering the time of life associated with greater foot care needs.

References

APMA 2002 Podiatric Practice Survey, Al Fisher Associates, Inc.; http://www.APMA.org

2000 Survey of Attitudes toward Foot Care, APMA Dept of Public Relations; http://www.APMA.org

Bennett PH, Burch TA, Miller M: Diabetes Mellitus in American (Pima) Indians. Lancet 2:125-128, 1971.

Burrows NR, Geiss LS, Engelgau MM, Acton KJ: Prevalence of diabetes among Native Americans and Alaska Natives, 1990-1997: an increasing burden. Diabetes Care 23:1786-1790, 2000.

Carter JS, Pugh JA, Monterrosa A: Non-insulin-dependent diabetes mellitus in minorities in the United States. Ann Intern. Med. 125:221-232, 1996.

Hanis CL, Ferrell RE, Baron SA, et al: Diabetes among Mexican-Americans in Starr County, Texas. Am J. Epidemiol. 118:649-672, 1983.

Hultman JA: A Strategic Look at the APMA 2002 Podiatric Practice Survey, APMA News, March 2003, pp 15-21.

Jasmanda HW, Haan MN, Liang J, et al: Diabetes as a Predictor of Change in Functional Status among Mexican Americans. Diabetes Care 26:314-319, 2003.

King H, Rewers M: Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults: WHO Ad Hoc Diabetes Reporting Group. Diabetes Care 16:157-177.

Lee ET, Howard BV, Savage PJ, et al: Diabetes and impaired glucose tolerance in three American Indian populations aged 45-74 years: the Strong Heart Study. Diabetes Care 18:599-610, 1995.

U.S. Census Bureau: Population by age, Hispanic origin, race, and sex: March 1999. Current Population Survey Internet release, March 8, 2000. Available from http://www/bls.gov/cps/home.htm/

Will JC, Strauss KF, Mendlein JM, et al: Diabetes mellitus among Navajo Indians: findings from the Navajo Health and Nutrition Survey. J. Nutr. 127 (Suppl. 10):2106S-2113S, 1997.

Cooper et al., Health Affairs, January/February, 2001.

Administration on Aging, U.S. Department of Health and Human Services. A Profile of Older Americans 2001. Available at http://aos.gov/aog.stats/profile/default/htm

Why Are Students Interested in Attending the Arizona Podiatric Medicine (AZPod) Program?

I. Student Attractions

A. Native Americans

The Glendale campus of Midwestern University is located in a state with a number of Native American tribes. In Arizona alone live 22 different tribes. One of the most widely studied groups of Native Americans, the Pima Indians, reside only 45 minutes south of the university. The Midwestern University Podiatric Medicine Program has made a commitment to reserve 10 percent of each class for qualified Native American students. Data from the AACPM reveal that only a handful of American Indian/Alaska Native students have applied for admission to podiatry school: 7 in 2000, 2 in 2001, and 2 in 2002.

Officials from both the Navajo Nation and from the Indian Health Service (IHS) have committed to assist the Podiatric Medicine Program in identifying Native American students prepared to undertake the rigorous curriculum. The Indian Health Service acknowledged the tremendous need for increasing the number of podiatrists within the IHS system and appropriated additional funding in 1999 for this purpose.

B. Geographic Location

The new Arizona Podiatric Medicine Program would be the only podiatry program located in the southwestern United States, at a site geographically remote from the existing colleges and programs of podiatric medicine. It is located in a growing, attractive suburb of the fifth-largest metropolitan area in the United States, only 15 miles from downtown Phoenix.

C. OPTI Program

Students will be attracted to the Arizona Podiatric Medicine Program at Midwestern University in part because of enhanced residency training opportunities. The University has for many years successfully operated a program of graduate medical training called the Osteopathic Postdoctoral Training Institution Program (OPTI). Where appropriate, the training opportunities that exist within the OPTI Program will be adapted to create residency programs for the MWU podiatry graduates, increasing the number of high quality podiatric residency programs.

D. Integration of Health Sciences Programs

Because of the ability to utilize existing classrooms, labs, computers, equipment, faculty, staff, and the library at Midwestern University, the Arizona Podiatric Medicine Program can take advantage of established excellence in instruction in both the basic and clinical sciences.

The integration of the podiatry program with other health care sciences programs at the university will also enhance the curriculum. Experienced teachers from the basic sciences and the clinical sciences at MWU will be instructing the podiatric medical students, who will take all of the basic science courses with the osteopathic medical students. Some clinical courses will be shared with physician assistant students and osteopathic students as well. Interacting with osteopathic students, pharmacy students, physician assistant students, and other health related disciplines will enhance the podiatric graduates' ability to function effectively in a multidisciplinary environment.

The online clinical monitoring program (MEMS) currently used by Midwestern University's other health sciences programs will help provide a superior clinical training experience for the podiatry students.

E. Lower Cost of Living/Lifestyle

In addition to the comparatively low tuition, students will be attracted to the Arizona Podiatric Medicine Program at MWU because of the relatively low cost of living in Arizona. This will help to reduce the projected student indebtedness. Existing health sciences students at MWU require less than $20,000 annually for cost of living. Affordable on-campus housing with many amenities is available for both married and single students. Additionally, modern apartments in safe, pleasant, upper middle-class neighborhoods are abundant in the immediate area surrounding the University. Free parking is plentiful on campus.

The outstanding weather in Arizona encourages an outdoor lifestyle that takes advantage of the many opportunities for hiking, cycling, swimming, and many other outdoor sports. Students are encouraged to use the on-campus fitness facilities.

F. Attractiveness of Campus

The spacious, new Glendale campus and the University's reputation for academic excellence attract students. New classroom buildings, access to computers and the latest in technology, availability of study space, library holdings, and proximity to the freeway and nearby shopping are only some of the attractive features.

G. MWU Financial Aid Program

Midwestern University has one of the best financial aid programs in the country. An exclusive institutional Signature Loan Program with SALLIE MAE provides very low interest rates for Midwestern University students. Additionally, the Financial Aid Department routinely receives excellent program audits from the Department of Education.

II. Availability of Podiatric Pathology

A. Agreements with VAs and IHS Facilities and Private Practitioners

The proximity of large teaching hospitals will support the clinical training of podiatric medical students well. The Midwestern University Podiatric Medicine Program currently has commitments from the Phoenix VAMC, the Tucson VAMC, the Phoenix Indian Medical Center, HuHuKam Memorial Hospital, the Palo Alto (CA) VAMC, the Prescott VAMC, and the Salt Lake City (UT) VAMC for the training of podiatric medical students. A large contingent of Phoenix Valley podiatrists have expressed an interest in student training as well.

B. Building of a Podiatry Clinic on Campus

The expansion of existing clinical facilities on the MWU Glendale campus will not only give the podiatric faculty a convenient place to maintain clinical skills, it will provide an on-campus facility for student training. The Podiatry Clinic will be housed with the Family Practice Center.

C. Number of Retirees/Native Americans/Mexican-Americans

The availability of podiatric pathology in the Phoenix metro area is extraordinary due to the large and growing number of retirement communities, the prevalence of diabetes among the many Native Americans and Mexican-Americans in the area, and the healthy growth of the non-geriatric population in Arizona.


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