Foot & Ankle Health; DO vs. MD; Interview Your New Doctor?

Ok... so I am a bit behind, but I am trying to get caught up!  The following is from the June 22, 2012 episode of Let's Talk Medical with Doctor Gigi.

Foot & Ankle Health:

Podiatrists are specialists in foot & ankle care.  They treat with medications, orthotics, bracing, & surgery.  Orthopedists care for bones & joints, so they also treat foot & ankle problems, but I have found very few who "specialize" in the area of the foot & ankle.  For this reason, I prefer to see a Podiatrist for my foot & ankle care as this is the Podiatrist's only focus, whereas most Orthopedists also treat knees, hips, shoulders, all types of fractures, & perhaps even backs.  If you have an Orthopedist who likes to treat foot & ankle issues, I am certain he will give you great care.  Just keep in mind that the Podiatrist makes 100% of his living on caring only for the foot & ankle, so they likely have more expertise in regards to these issues.

A common foot problem is plantar fasciitis, which is inflamation of the tissue which connects from the bottom of the heel to the toes.  The tissue closest to the heel can get inflamed due to your going barefoot, or perhaps due to positions such as squatting, or even due to problems with your shoes.  When you get plantar fasciitis, you are usually keenly aware of it by the classic description: "sharp pain in my heel when I take my first few steps after sleeping or sitting a while."  It is interesting to note that the pain does usually subside after you take a few steps, but it generally reoccurs every time you take your first steps after being off your feet for a little while.  This painful condition can be treated by your Primary Care doctor or a Podiatrist or an Orthopedist.  Usual care involves anti-inflamatory drugs such as Ibuprofen, Aleve, or Celebrex, along with some behavioral changes, which include: never going barefoot, using a good arch support & a soft-soled shoe, & stretching the tissue at the bottom of your foot.  Sometimes steroid injections, physical therapy, & even orthotics are needed. 

Another common foot & ankle problem is osteoarthritis, which is a stiffness or pain in 1 or more joints of the foot or ankle.  This process is usually associated with a history of trauma in the past, such as sprains, strains, or even fractures.  X-rays are generally needed to confirm the typical joint changes of arthritis, & it should be noted that Podiatrists often do their x-rays in a standing position whereas most Orthopedists & typical radiology departments often do them in a seated position.  X-rays done while the patient is standing allow for evaluation of the joint in the position it assumes while standing & walking.  Usual treatment for arthritis is anti-inflamatories, though sometimes PT, orthotics, or even surgery are needed.

Stress fractures of the feet occur when the bones of the foot get weak, generally from osteoporosis, & simply walking or standing breaks one of those bones.  These are commonly seen in older women, as these are the same people who get the most osteoporosis.  Generally they involve the bones of the forefoot, so often the lady will present to the doctor with pain & swelling in the foot between the ankle & toes (on the top, not on the bottom of the foot).  There is usually no significant history of trauma, as simply the stress of standing & walking can cause this fracture. Remember those standing x-rays done by the Podiatrist?  Those allow the weight of the body to stress & thus spread out the bones & tissues of the feet, which often can make it easier to diagnose these types of fractures.  Thankfully stress fractures usually heal well with a soft walking cast or similar brace, but it is most important to remember what this type of fracture tells us... you have osteoporosis!!!  So, if you develop a stress fracture, you must not only treat it, but you must see your doctor to treat your osteoporosis!

The feet & ankles take a beating, & when your feet hurt, every step can be misery!  If yours are painful, don't hesitate to see your Primary Care doctor, a Podiatrist, or an Orthopedist, as there are many diseases which affect these body parts, but these doctors have solutions which can make your life much less painful!

DO vs. MD, & Should I Interview My New Doctor?:

If you refer back to an earlier blog, you will find more information regarding the differences between DO physicians & MD physicians.  Basically, both go to medical school & both go to residency training after medical school to get their specialty training.  The biggest difference is that DO's learn chiropractic theory & training, whereas MD's do not.  Once medical school is completed however, many DO's never do manipulation, so they often tend to be very similar to MD's, practicing mainstream medicine with pills, advice, compassion, & surgery.  Often, these two physicians train in the same residency programs, so they are not necessarily that different from one another.  For instance, I trained at Bayfront Medical Center in a Family Practice residency program run by MD's.  Most of the residents were MD's, but at least one was a DO.  She graduated from our program & I am certain that she practices medicine very similar to the way I practice medicine.  So although we went to medical schools with different philosophies, our post-medical school training was the same, so ultimately the way we practice is the same.

So how do you know if you like & trust your new doctor?  Should you "interview" him or her?  Well, I for one do not like the idea of being interviewed, as I think that if you really want to know what kind of a physician I am, you need to let me tackle your medical concerns.  I can explain to you that I went to LSU Medical Center, then to Bayfront Medical Center's Family Practice residency program, & then started my solo family practice office.  I can inform you that I am Board Certified in Family Practice, & that I have never been sued (THANK GOD!).  But what I really can't tell you is the way I think, the fact that I love to educate, the manner in which I work with you to come to an agreeable plan for your medical concerns & future health, nor the way that I practice cost-effective medicine.  To really "interview" me (or any other physician), I believe you must present with a medical problem or concern, & watch us in action as we evaluate & treat you.  If after that you do not like your doctor, find another one.  But if you do like your new doctor after this first encounterlet that be the deciding factornot the less important issue of what credentials are hanging on the wall.

In closing, don't forget to listen to the live version of Let's Talk Medical with Doctor Gigi as we broadcast during The Skip Show on Fridays at 1-2PM Eastern time on WTAN 1340-AM in the Tampa/St. Pete area.  If you are not local, please catch us with live streaming via, where you can also find podcasts of all our previous shows so you can listen at your convenience!  As always, I welcome your medical questions or comments, & thus invite you to contact me during the live show via (727)-441-3000 or toll-free (866)-TAN-1340, or you can e-mail me at any time via

Until next time, here's to our health!

Doctor Gigi