Understanding Patient Preference of Providers to Treat Foot and Ankle Disorders

Objective: The purpose of this study is to evaluate patients' knowledge of the professional training between doctors of podiatric medicine (DPM) and orthopedic surgery doctors (MD or DO), patients' confidence in understanding these differences, and factors that are important to patients when selecting a provider. Design: A 28-question survey was administered to new patients who were referred to the foot and ankle service in an orthopedic department. Survey questions included data on patient demographics, patient opinion, and knowledge of differences between podiatrists and orthopedic surgeons. Setting: Patient surveys were administered at Froedtert Memorial Lutheran Hospital in Wauwatosa, Wisconsin USA and Mayo Clinic in Jacksonville, Florida USA. Participants: 186 patients completed the survey. Methods: Study population characteristics and survey results were analyzed with variance (ANOVA), Fisher's Exact test, binomial tests, and chi-square tests. Results: Of the 186 patients who completed the entire survey, 108 chose "orthopedic surgeon" as their provider of preference for any foot or ankle injury. Patients preferred an orthopedic surgeon over a DPM for ankle (65.7% vs. 9.6%, P<0.01) and knee injuries (86.0% vs. 5.0%, P<0.01), while they preferred a DPM for toe pain (29.4% vs. 42.2%, N0.03). 80.8% of patients thought orthopaedic surgeons and podiatrists undergo the same professional training. Conclusions: Patients have poor understanding of the different provider training between a DPM and orthopedic surgeon. Patients showed a preference based on anatomic location with podiatrist favored for conditions affecting the toes.Those patients that demonstrate a higher level of knowledge of the specialties were more likely to prefer an orthopaedic surgeon. Other factors, such as physician interpersonal skills and provider availability, may be more important for patients than training backgrounds.