Removing Barriers To More DPMs Contributing To Published Podiatric Research

Hi, my name is Patrick and I have a problem. I am a digital article hoarder and my condition is getting worse. I have access to many journals through a large hospital system and I subscribe to several journals on my own. I recently joined the International Society of Biomechanics because it is a good organization but also so I could subscribe to Clinical Biomechanics, Gait and Posture and The Journal of Biomechanics. I was like a kid at Christmas as I claimed my online subscriptions. Giddy almost.

Like I said, I have a problem and I have no intention of fixing it. In fact, it will probably get worse as I have several articles I am in the process of writing and research projects I am working on or would like to start.

One article that is near submission and a research project I am about to start have led me to the conclusion that podiatry is lacking in published and cited peer-reviewed literature in comparison to our colleagues in orthopedics. When you critically examine citation indices regarding lower extremity orthopedics, podiatric articles lag behind orthopedic articles substantially.

There are several reasons for this. One reason is that orthopedic literature does not cite podiatric literature nearly as often as podiatric literature cites orthopedic literature. Prior to recent changes in podiatric employment models, most podiatric physicians have functioned as clinicians rather than researchers. There has been a welcome change in this paradigm with a growing number of podiatric physicians being employed by large universities and orthopedic groups. Finally, there is a growing interest and priority for evidence-based, high quality research in podiatric medicine.

I had to recently submit for an institutional review board (IRB) approval for the aforementioned research project. I have no experience in this process and I had to research how to do a research project. I received word that my research proposal was approved so apparently I did it correctly. This is an intimidating process for anyone without experience. There is also a substantial cost involved in the IRB application process.

Both of these factors are deterrents for the clinician trying to do research outside of a university setting. I believe there is a wealth of talent amongst my podiatric colleagues who have much to offer the world of orthopedic lower extremity research and peer-reviewed published articles, but we need to clear this path to bring this to fruition.

The American Podiatric Medical Association (APMA) has stepped to the forefront of this matter with the Dartmouth Institute (TDI) by establishing the APMA/TDI Public Health Fellowship with research positions at each of the podiatry schools for unmatched graduates and potential funding for research upon review by the APMA's Clinical Practice Review Committee. There have been many individuals who have led podiatric medicine into the field of research. Additionally, there is more emphasis from schools and residency programs on research.

Progress is happening but what I think is missing is a research resource with an affordable IRB process. This could potentially remove the deterrents that prevent many from contributing to the knowledge base. The question is who provides this for podiatric physicians? Would it be the APMA, the American Society of Podiatric Surgeons, the American College of Foot and Ankle Orthopedics and Medicine, or the American College of Foot and Ankle Surgeons? I do not know the answer but there should be one sooner rather than later.