Expands the definition of the practice of podiatry to include conditions of the ankle and all soft tissue structures of the leg below the knee anatomically affecting the foot and ankle; establishes podiatrists licensed prior to the effective date of this act need to be certified to operate on the ankle; provides for the conducting of office based surgery by podiatrists; directs the department of health to study the feasibility of a podiatrist profiling program; authorizes the calling of a physician as an expert witness in a podiatric medical malpractice cause of action.

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S3758-2011 Actions

• Jun 12, 2012: referred to higher education
• Jun 12, 2012: DELIVERED TO ASSEMBLY
• Jun 12, 2012: PASSED SENATE
• Jun 12, 2012: ORDERED TO THIRD READING CAL.1166
• Jun 12, 2012: COMMITTEE DISCHARGED AND COMMITTED TO RULES
• Mar 6, 2012: REPORTED AND COMMITTED TO FINANCE
• Jan 5, 2012: PRINT NUMBER 3758A
• Jan 5, 2012: AMEND AND RECOMMIT TO HIGHER EDUCATION
• Jan 4, 2012: REFERRED TO HIGHER EDUCATION
• Jan 4, 2012: returned to senate
• Jan 4, 2012: died in assembly
• May 24, 2011: referred to higher education
• May 24, 2011: DELIVERED TO ASSEMBLY
• May 24, 2011: PASSED SENATE
• May 16, 2011: ADVANCED TO THIRD READING
• May 11, 2011: 2ND REPORT CAL.
• May 10, 2011: 1ST REPORT CAL.593
• Mar 3, 2011: REFERRED TO HIGHER EDUCATION

S3758-2011 Calendars

Active List: May 24, 2011 , Floor Calendar: May 11, 2011 , Floor Calendar: May 16, 2011 , Floor Calendar: May 17, 2011 , Floor Calendar: May 18, 2011 , Floor Calendar: May 23, 2011 , Floor Calendar: May 24, 2011

S3758-2011 Votes

S3758-2011 Memo

BILL NUMBER:S3758

TITLE OF BILL:
An act
to amend the education law, the public health law and the civil
practice law and rules,
in relation to the
practice of podiatry

PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this bill is to expand the scope of the practice of
podiatry in New York State. Expanding the scope of podiatric practice
in New York will bring it more in line with the vast majority of
other States in the country which already allow the scope of practice
to include the treatment of the ankle and soft tissue areas
associated with the ankle, in addition to structures of the foot.

SUMMARY OF PROVISIONS:
Section 1: Amends Education Law section 7001 to expand the scope of
practice for podiatry to include, in addition to the treatment of the
foot, conditions of the ankle, and all soft tissue structures related
to the ankle that go up the leg to just below the knee cap. To limit
the scope of practice, Podiatrists may perform surgical treatments of
the rear foot and ankle, but such treatment may not extend beyond the
calf of the leg,unless it is related to the treatment of the ankle.

The bill revises Education Law section 7001(2) to update the law.
First enacted in 1996 to allow newly licensed or certified
podiatrists to prescribe narcotics related to their treatment of
patients, this provision did not allow formerly licensed podiatrists
to prescribe drugs until they had been certified. After 13 years,
this phase-in period of time between old and new podiatrists is not
needed and is therefore eliminated.

This bill section also adds a new subsection (3) to apply the expanded
scope of practice related to ankle surgery (1) to only newly licensed
podiatrists and (2) to currently licensed podiatrists who have
completed a course of study and are deemed competent by the State
Education Department to practice the new expanded scope of practice.
The bill also authorizes all podiatrists to treat soft tissue
structures related to the ankle. All podiatric schools in this
country, including the New York College of Podiatric Medicine, teach
the expanded New York scope of practice (as provided for under this
bill). In fact, by enacting this bill, New York will join at least 38
other states that now allow Podiatrists to treat areas above the foot
to include the ankle, and sometimes up to the knee cap.

Amends Public Health Law section 230-d (1) to include podiatrists of
professions (Physicians, Physician Assistants, and Specialists who
are subject to the rules regarding office based surgery.

Section 3: Amends public Health Law section 2995-d to request the
Department of Health, in cooperation with the Education Department,
to study health care practitioner data related to podiatrists and
determine if the provisions related to physician profiling should be


extended to podiatrists so that the public has additional information
on the quality of care provided by individual podiatrists.

Section 4: Amends the civil practice Laws and Rules section 3101 to
allow a physician to be called as an expert witness in a podiatric
medical malpractice action.

JUSTIFICATION:
New York State, is the home of one of the largest colleges of
podiatric Medicine in the country. Further, there are only eight
other such colleges in the country. However, New York has one of the
most restrictive scope of podiatric practice statutes in the nation
being one of only twelve States that limit the scope of podiatric
medicine to the foot. The other states being, Alabama, Indiana,
Kansas, Kentucky, Louisiana, Massachusetts, Mississippi, South
Carolina, South Dakota, Texas, and Washington.

The NYS Education Department has certified the New York College of
podiatric Medicine to offer degrees in the proposed expanded scope of
podiatric medicine (foot, ankle, and leg). This means that students
who earn degrees from this in-state college, can relocate to the
other 38 states that authorize the practice of podiatric care which
includes not only the foot, but also the ankle, and soft tissues
related to the ankle up to the knee cap.

Two disturbing trends are occurring in New York with regard to the
training and location of new podiatric physicians. First, due to New
York's very restrictive definition of podiatric scope of practice,
those graduating from podiatric medical colleges, on a national
basis, are electing to start their practices in States other than New
York. In 1999, The State Education Department provided 145 new
licenses, in 2000, 127 licenses were issued, in 2001, 69 licenses, in
2002 and in 2003, 81 licenses were issued, and in 2007, only 52
licenses were issued to new podiatrists. This decrease in the number
of new podiatrists being licensed in New York is beginning to result
in a shortage of those capable of providing podiatric care.

Second, while the number of-students who have enrolled in the New York
College of podiatric Medicine has been gradually increasing from 85
students to 92 students for class of 2010 to the class of 2013, the
number of New York residents who have elected annually to enroll in
New York's only podiatric college has decreased substantially from 55
students to 32 students. Generally, students tend to enroll in a
college in the State in which they plan to practice. With New York's
very limited scope of practice laws, prospective New York podiatric
students are electing to be trained outside of New York and then
setting up their practices outside of New York. unfortunately, this
trend indicates that in the future, there were will be even fewer
candidates who wish to apply for licensure for podiatric medicine in
New York. This will clearly exacerbate the current trends that have
reduced the number persons who have wished to become licensed to
practice podiatric medicine in New York.

Under current law, essentially, New York trains podiatrists and then
encourages them to relocate elsewhere to practice because such
graduates cannot practice the full scope of podiatric medicine that
they were taught in New York. Under current rules, students of


podiatric medicine who Intern or are Residents at the NY College of
podiatric Medicine may practice the expanded scope of podiatric
medicine, as contained in this bill, but only while being trained at
the College. After graduation, their practices must be limited to the
foot, and not include the ankle.
Therefore, under current law, podiatric students are able to practice
the expanded scope of practice as contained in this bill, but not
those who have completed their training and are licensed by the State
of New York. This bill would rectify that dichotomy.

Of the 38 states that allow podiatrists to treat the ankle and
portions of the leg above the ankle, 6 States allow Podiatrists to
treat the entire leg. Those states are Florida, Georgia, Idaho,
Nevada, New Hampshire, and Vermont. This bill merely expands the
scope of practice for podiatrists so that it more closely mirrors the
scope of practice used in at least 75 percent of all other states in
the nation.

For those who might maintain that podiatrists should not be allowed to
expand their scope of practice, because it will lead to a higher rate
of patient injury, this supposition is not true. The bill sponsor
contacted the Podiatry Insurance Company of America (PICA) and
inquired about the rate of injury by podiatrists who were limited by
their scope of practice to the foot, and those who were authorized to
treat the ankle and above. This insurer, which covers approximately
75% of all podiatrists in the nation, maintained that the loss
experience between those podiatrists who only treat the foot and
those who treat the ankle and above was the same. Hence, expanding
the scope of podiatric practice should not lead to more injuries to
patients.

The underlying goal of this bill is:

1) to ensure that the New York College of podiatric Medicine can
continue to attract a sufficient number of quality students,
particularly New York resident students, to continue to be a leading
medical college in this important area of medical care, and

2) to ensure that podiatric medical colleges in the State of New York
and around the country graduate students, who in the end will want to
choose t.O practice podiatric medicine in this State to provide this
important services to our residents.

LEGISLATIVE HISTORY:
2010: S.2992-B Passed Senate - A.2518-B Referred to Higher Education

FISCAL IMPLICATIONS:
None to the State.

EFFECTIVE DATE:
18 months after it shall have become law.

S3758-2011 Text

                      S T A T E   O F   N E W   Y O R K
  ________________________________________________________________________

                                    3758

                         2011-2012 Regular Sessions

                              I N  SENATE

                                March 3, 2011
                                 ___________

  Introduced  by  Sens. LIBOUS, KLEIN, ADAMS, MAZIARZ, OPPENHEIMER -- read
    twice and ordered printed, and when printed to  be  committed  to  the
    Committee on Higher Education

  AN  ACT  to amend the education law, the public health law and the civil
    practice law and rules, in relation to the practice of podiatry

    THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
  BLY, DO ENACT AS FOLLOWS:


    Section  1.  Section  7001 of the education law, as amended by chapter
  677 of the laws of 1996, is amended to read as follows:

    S 7001. Definition of practice of podiatry. 1.   The practice  of  the
  profession of podiatry is defined as diagnosing, treating, operating and
  prescribing for any disease, injury, deformity or other condition of the
  foot,  [and may include] ANKLE AND ALL SOFT TISSUE STRUCTURES OF THE LEG
  BELOW THE DISTAL TIBIAL TUBEROCITY.  SURGICAL  TREATMENT  OF  THE  ANKLE
  SHALL NOT EXTEND BEYOND THE TIBIAL METAPHYSEAL FLAIR; PROVIDED, HOWEVER,
  THAT  SUCH SURGICAL TREATMENT MAY EXTEND TO THE DISTAL TIBIAL TUBEROCITY
  AS NECESSARY FOR THE TREATMENT OF THE ANKLE, INCLUDING, BUT NOT  LIMITED
  TO,  THE  APPLICATION  OF EXTERNAL FIXATION; AND PROVIDED, FURTHER, THAT
  SUCH TREATMENT SHALL NOT INCLUDE PILON FRACTURES. THE PRACTICE OF PODIA-
  TRY INCLUDES performing physical evaluations in  conjunction  with  [the
  provision  of]  podiatric treatment.  Podiatrists [may] SHALL ONLY treat
  traumatic open wound fractures [only] AND PROVIDE SURGICAL MANAGEMENT OF
  COMPLICATED FRACTURES OF THE ANKLE in hospitals [,  as  defined  in]  OR
  AMBULATORY SURGERY CENTERS CERTIFIED PURSUANT TO article twenty-eight of
  the  public  health  law.    FOR  THE PURPOSES OF THIS ARTICLE, THE TERM
  "ANKLE" SHALL BE DEFINED AS THE DISTAL METAPHYSIS AND EPIPHYSIS  OF  THE
  TIBIA AND FIBULA, THE ARTICULAR CARTILAGE OF THE DISTAL TIBIA AND DISTAL
  FIBULA,  THE  LIGAMENTS THAT CONNECT THE DISTAL METAPHYSIS AND EPIPHYSIS
  OF THE TIBIA AND FIBULA AND TALUS, AND THE PORTIONS OF SKIN,  SUBCUTANE-
  OUS TISSUE, FASCIA, MUSCLES, TENDONS AND NERVES AT OR BELOW THE LEVEL OF
  THE MYOTENDINOUS JUNCTION OF THE TRICEPS SURAE.
    2.  [The  practice  of podiatry shall not include treating any part of
  the human body other than  the  foot,  nor  treating  fractures  of  the
  malleoli  or  cutting operations upon the malleoli. Podiatrists licensed

   EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                        [ ] is old law to be omitted.
                                                             LBD02760-01-1

 S. 3758                             2

  to practice, but not authorized to  prescribe  or  administer  narcotics
  prior  to  the  effective date of this subdivision, may do so only after
  certification by the department in accordance  with  the  qualifications
  established by the commissioner.] The practice of podiatry shall include
  administering only local anesthetics for therapeutic purposes as well as
  for  anesthesia  and  treatment under general anesthesia administered by
  authorized persons.
    3. PODIATRISTS LICENSED TO PRACTICE PRIOR TO  THE  EFFECTIVE  DATE  OF
  THIS  SUBDIVISION MAY PERFORM SURGICAL TREATMENT OF THE ANKLE ONLY AFTER
  CERTIFICATION BY THE DEPARTMENT IN ACCORDANCE  WITH  THE  QUALIFICATIONS
  ESTABLISHED BY THE COMMISSIONER. QUALIFICATIONS TO OPERATE ON THE ANKLE,
  PURSUANT  TO THIS SUBDIVISION, SHALL INCLUDE, BUT NOT BE LIMITED TO: THE
  SUCCESSFUL COMPLETION OF A RESIDENCY PROGRAM OR  PROGRAMS,  APPROVED  BY
  THE COUNCIL ON PODIATRIC MEDICAL EDUCATION; OR COMPLETION OF A POST-SEC-
  ONDARY  ACCREDITED  EDUCATIONAL  PROGRAM  ACCEPTABLE TO THE COMMISSIONER
  WITH DEMONSTRATED COMPETENCY IN THE SURGICAL TREATMENT OF THE REAR  FOOT
  AND  ANKLE;  OR CERTIFICATION BY THE AMERICAN BOARD OF PODIATRIC SURGERY
  OR A NATIONAL CERTIFYING BOARD HAVING CERTIFICATION STANDARDS ACCEPTABLE
  TO THE COMMISSIONER.
    S 2. Paragraph (i) of subdivision 1 of section  230-d  of  the  public
  health  law,  as added by chapter 365 of the laws of 2007, is amended to
  read as follows:

    (i) "Licensee" shall mean an individual licensed or otherwise  author-
  ized  under  [articles] ARTICLE one hundred thirty-one [or], one hundred
  thirty-one-B OR ONE HUNDRED FORTY-ONE of the education law.
    S 3. Section 2995-d of the public health law is amended  by  adding  a
  new subdivision 4-a to read as follows:

    4-A.  IN  COOPERATION WITH THE EDUCATION DEPARTMENT, STUDY HEALTH CARE
  PRACTITIONER DATA RELATING TO  PODIATRISTS.  SUCH  STUDY  SHALL  INCLUDE
  CONSIDERATION  OF  WHETHER  AN  INDIVIDUAL  PODIATRIST PROFILING PROGRAM
  SHOULD BE ESTABLISHED AND OUTLINE AN APPROPRIATE METHOD TO  DEVELOP  AND
  IMPLEMENT  SUCH  A  PROFILING PROGRAM IF SUCH A PROGRAM IS DETERMINED BY
  THE DEPARTMENT TO BE IN THE PUBLIC INTEREST. SUCH PROGRAM AND  RECOMMEN-
  DATIONS MAY BE SIMILAR TO THE PHYSICIAN PROFILES ESTABLISHED PURSUANT TO
  SECTION TWENTY-NINE HUNDRED NINETY-FIVE-A OF THIS TITLE. SUCH A PROPOSED
  PODIATRIST  PROFILING  PROGRAM,  IF  SUCH A PROGRAM IS DETERMINED BY THE
  DEPARTMENT TO BE IN THE PUBLIC INTEREST, SHOULD BE CAPABLE  OF  PRESENT-
  ING, IN A COST EFFECTIVE MANNER, RELEVANT MEDICAL AND TREATMENT INFORMA-
  TION  IN A FORMAT THAT IS EASILY UNDERSTOOD BY AND MADE AVAILABLE TO THE
  GENERAL PUBLIC.  SUCH STUDY AND ITS FINDINGS SHALL BE SUBMITTED  TO  THE
  GOVERNOR,  THE  TEMPORARY  PRESIDENT  OF  THE SENATE, THE SPEAKER OF THE
  ASSEMBLY, THE MINORITY LEADER OF THE SENATE AND THE MINORITY  LEADER  OF
  THE ASSEMBLY ON OR BEFORE JUNE FIRST, TWO THOUSAND SEVENTEEN;
    S 4. Paragraph 1 of subdivision (d) of section 3101 of the civil prac-
  tice  law and rules is amended by adding a new subparagraph (iv) to read
  as follows:

    (IV) IN AN ACTION FOR PODIATRIC MEDICAL MALPRACTICE, A  PHYSICIAN  MAY
  BE CALLED AS AN EXPERT WITNESS AT TRIAL.
    S 5. This act shall take effect 18 months after it shall have become a
  law; provided, however, that effective immediately, the addition, amend-
  ment and/or repeal of any rule or regulation necessary for the implemen-
  tation  of  the provisions of this act on its effective date are author-
  ized and directed to be made and completed on or before  such  effective
  date.