When your feet hurt, it's as though everything else does, too. At least, that's how Irene Reyna, a certified podiatric medical assistant, perceives the complaints that bring patients to the podiatrist's office.
"There are so many foot deformities and other problems that people deal with every day. Feet are what carry your body and help with balance and movement," said Reyna, 33, of Southwest Podiatry in Dallas.
Demand for podiatric care is expected to rise as the population grows older and many develop foot and lower leg problems. And much of that care will be supplied by podiatric assistants.
"This is no doubt a growth industry," said Dr. David Armstrong, chairman of research and assistant dean at the Dr. William M. Scholl College of Podiatric Medicine in North Chicago, Ill. "The goal of podiatrists and their assistants is to keep America moving. As the nation ages and problems like diabetes and obesity increase, that challenge gets more and more substantial."
Although too many Americans lead sedentary lives, others routinely engage in activities that give their feet a pounding.
"I have a 74-year-old marathon runner in my practice," said Dr. Marybeth Crane at Foot & Ankle Associates of North Texas, with offices in Grapevine, Lewisville and Denton.
Patients consult podiatrists with a broad spectrum of complaints: sprains, fractures, bunions, hammertoes, skin conditions, diabetic foot complications, sports injuries and ingrown toenails.
Due to often slow and declining payments from insurance companies, "the podiatrist has to see more patients in less time to make an adequate living. The assistant then is able to do extra jobs that would free up some of his time," said Sandra Lohrentz, executive director of the American Society of Podiatric Medical Assistants.
The Chicago-area association has 1,400 members nationwide. Of those, about 750 are certified.
Podiatric medical assistants make castings, take X-rays and help podiatrists during surgery.
They "have a unique place in the pantheon of medical professionals," according to Podiatry Online. They "must have a thorough knowledge of the anatomy of the foot and the treatments and surgical procedures."
And they should possess compassion for suffering, judgment in handling clinical emergencies and common sense about managing office finances.
"A podiatric medical assistant's job is dynamic, never static," the online resource says. Professionals should dedicate themselves to constantly enhancing their knowledge and skills.
To get started in this profession, a college degree isn't necessary. But health care experience or medical-assisting vocational education is helpful, experts say.
It's an excellent career choice for jacks-of-all-trades who are interested in hands-on medicine, said Crane, who specializes in sports medicine and reconstructive foot surgery.
Before Crane hired Penny Wharton late last year, the 34-year-old assistant had worked for two orthopedists and in the physical therapy department at Harris Methodist H-E-B Hospital in Bedford, Texas.
This "gave her a great base of knowledge," Crane said. "Then we have our own on-the-job training program."
In addition, assistants who take X-rays must receive radiology certification through the Texas Podiatric Medical Association, said manager Krista Richter. The training is offered as a 20-hour continuing education course.
"Many podiatric physicians have X-ray equipment in their offices and require assistants to obtain films as directed," said Mindy Leigh Baker, 32, past president of the Texas association and office manager at Podiatry Associates of Victoria.
"Podiatrists often become involved in long-term treatment of diabetic patients for routine foot care, as well as wound care for patients with poor circulation and those with failing immune systems."
Their assistants are charged with tasks such as dispensing pre- and post-operative instructions.
"The most difficult part of my job is working with diabetic patients who have diabetic ulcers or gangrene and must have parts of their feet amputated due to bone infection," said Southwest Podiatry's Reyna.
For Wharton, "sometimes keeping up with all the responsibilities and paperwork can be quite a challenge, but a fun challenge."
Front-office duties require basic math and computer skills, including knowledge of spreadsheets and medical office management software.
Familiarity with diagnosis coding is also important, said Dr. Carl Solomon of Southwest Podiatry.
"Assistants may fulfill the role of front office, back office or be cross-trained for both," he said.
Salaries are comparable to those of other medical assistants. The lowest 10 percent earned less than $17,640, while the highest 10 percent took home more than $34,130 in 2002, the latest figures from the U.S. Bureau of Labor Statistics.
Medical assisting is projected to be the fastest-growing occupation over the 2002-12 period.
Job prospects should be best for workers with formal training or experience, particularly those with certification.
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