DATA ON NATIONAL HEALTH RESOURCES

Trends in the

PodiatricProfession

A Comparative Study of

1970 and 1974 Survey Data

Information on all licensed podiatrists was collected in 1970 and

1974 through mailed questionnaires. The two questionnaires addressed essentially identical data elements and were coded and tabulated in comparable ways. Trends in the podiatric profession are

discussed in this report by dealing with issues that impact on the

general demographic characteristics of podiatrists, the characteristics of their clinical practice and the volume and nature of patient

care administered during the week preceding the survey.

DHEW Publication No, (PHS) 79-1816

Series 14

Number 21

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Public Health Service

Office of the Assistant Secretary for Health

National Center for Health Statistics

Hyattsville, Md. November 1978
Library of Congress Cataloging in Publication Data

Greenberg, Leonard.

Trends in the Podiatric Profession

A Comparative Study of 1970 and 1974 Survey Data.

(Vk.al and health statistics: Series 14, Data from the National Health Survey, Data cm

national health resources, manpower, and facilities; no. 21) (DHEW publication; (PHS)

79-1816)

Includes bibliographical references.

1. Podiatrists-United States–Statistics. 2. Podiatry-United States–Statistics, I. Title.

II. Series: United States. National Center for Health Statistics. Vital and health statistics:

Series 14, Data on national health resources, manpower, and facilities; no. 21.111. Series:

United States. Dept. of Health, Education, and Welfare. DHEW publication; (PHS) 79-1816.

RD563.G73 362.1’9’75850973 79-606161

ISBN 0-8406-0139-5
NATIONAL CENTER FOR HEALTH STATISTICS

DOROTHY P. RICE, Director

ROBERT A. ISRAEL, Depz.@ Director

JACOB J. FELDMAN, Ph.D., Associate Director for Ana~ysis

GAIL F. FISHER, Ph. D., Associate Director for the Cooperative Heakh Statistics System

ELIJAH L. WHITE, Associate Director for Data Systems

JAMES T. BAIRD, JR., Ph.D., Associate Directorfor International Statistics

ROBERT C. HUBER, Associate Director for Management

MONROE G. SIRKEN, Ph. D., Associate Director for Mathematical Statistics

PETER L. HURLEY, Associate Director for Operations

JAMES M. ROBEY, ph.D., Associate Director for Program Development

PAUL E. LEAVERTON, Ph.D., Associate Director for Research

.4L1CE HAYWOOD, Information Officer

DIVISION OF HEALTH MANPOWER AND FACILITIES STATISTICS

GLORIA KAPANTAIS, Director

SHELDON STARR, Deputy Director

EVELYN MATHIS, ChieJ Health Facilities Statistics Branch

JOSEPH BARBANO, Chief Health Manpower Statistics Branch

CHARLES M. CRONER, Ph.D., Chiej ~echnical Services Branch

Vital and Health Statistics-Series 14-No. 21

DHEW Publication No. (PHS) 79-1816

Library of Congress Catalog Card Number 78-606161
CONTENTS

Introduction ................................................................................................................................o........o. ~

Data Sources and Issues Treated ............................................................................................................. 1

Summary of Findings .............................................................................................................................

Age Distribution ...............................................................................................................................

Podiatrist-Population Ratios .............................................................................................................

Sex Distribution ................................................................................................................................

Years Active in Podiatry ...................................................................................................................

Principal Form of Employment ........................................................................................................

Use of Assistants ...............................................................................................................................

Primary Clinical Activity ...................................................................................................................

Types of Patient services Rendered ..................................................................................................

Hours Worked ...................................................................................................................................

Patient Vkits .....................................................................................................................................

Treatment Setting .............................................................................................................................

Age of Patient ...................................................................................................................................

2

2

2

2

2

2

3

3

3

;

4

4

General Profiie ......................................................................................................................................- h

Age Distribution ............................................................................................................................... 4

Po&atnst.Poptiation Ratios ............................................................................................................. 6

Sex Distribution ................................................................................................................................ 7

Years Active in Potia~ ................................................................................................................... 7

Chmcteristics of~iticd Pmctice .......................................................................................................... 8

prineipd Fom of Employment ........................................................................................................ 8

Use of Assistants ...............................................................................................................................

Primary Clinical Activity

8

................................................................................................................... 10

Types of Patient Services Rendered .................................................................................................. 10

Volume and Nature of Patient Care ........................................................................................................ 10

Hours Worked ...................................................................................................................................

Patient Vkits

10

..................................................................................................................................... 11

Treatment Setting ............................................................................................................................. 13

Age of Patient ................................................................................................................................... 14

References .............................................................................................................................................. 15

List of Detailed Tables ........................................................................................................................... 16

Appendixes

I. Description of Survey Methodology .......................................................................................... 27

II. Definitions ................................................................................................................................ 30

III. Productivity as Related to Use of Auxiliary Persomel, Various Age Groups 32

N. Facsimiles of Survey Questionnaires ......................................................................................... 36

.............................

LIST OF FIGURES

1. Number of podiatrists providing patient care, by age of podiatrist: United States, 1970 and

1974 ........................................................................................................................................ .... 4

...

m
LIST OF TEXT TABLES

A. Percent of podiatrists in the outer age brackets (under 35 years or 65 years or over) providing

patient care and ratio of podiatrists between 35 and 65 years of age to those in the outer age

brackets, by year of survey: United States, 1970 and 1974 .........................................................

B. Percent of podiatrists under 35 years and 65 years or over providing patient care and replacement

rate, by geographic region and year of survey: United States, 1970 and 1974 .............................

C. Number of pod~trists between 35 and 44 years of age providing patient care, with change

between 1970 and 1974, by geographic region and year of survey: United States, 1970 and

1974 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................

D. Ratio of podiatrists under 45 years of age to those 65 years or over providing patient care, by

geographic area: United States, 1970 and 1974 ...........................................................................

E. Number and percent distribution of podiatrists providiig patient care, by years active in podiatry:

United States, 1970 and 1974 .....................................................................................................

F. Number of podiatrists providing patient care, by number of years active in podiatry and year of

survey: United States, 1970 and 1974 .........................................................................................

G. Percent of podiatrists providing patient care engaged in partnerships or group practice with

change between 1970 and 1974, by age of podiatrist and year of survey: United States, 1970

and 1974 .....................................................................................................................................

1% Percent distribution of podiatrists providing patient care by principal form of employment,

according to geographic region and year of survey: United States, 1970 and 1974 ......................

J. Percent of podiitxists providing patient care and using 1 assistant or more, with change between

1970 and 1974, by principal form of employment: United States, 1970 and 1974 .....................

K Percent of podiatrists providing patient care and using 1 assistant or more, with change between

1970 and 1974, by age of podiatrist and year of survey: United States, 1970 and 1974 .............

L Percent of podiatrists providing patient care, with change between 1970 and 1974, by age of

podiatrist, primary clinical practice, and year of survey: United States, 1970 and 1974 ..............

M. Percent of podiatrists who devoted 35 houm or more to patient care, with change between 1970

and 1974, by geographic region and year of survey: United States, 1970 and 1974 ....................

N. Percent of podiatrists who devoted 35 hours or more to patient care during the preceding week,

with change between 1970 and 1974, by age of podiatrist and year of survey: United States,

1970 and 1974 ............................................................................................................................

0. Percent of podiatrists who devoted 35 hours or more to patient care dining preceding week,

with change between 1970 and 1974, by principal form of employment and year of survey:

United States, 1970 and 1974 .....................................................................................................

P. Median number of patient visits per week, with change between 1970 and 1974, by geographic

region and year of survey: United States, 1970 and 1974 ...........................................................

Q. Median number of patient Vi&s per week, with change between 1970 and 1974, by age of

podiatrist providing patient care and year of survey: United States, 1970 and 1974 ...................

R Median number of patient visits per week, with change between 1970 and 1974, by principal

form of employment of podiatrist providing patient we and year of survey: United States,

1970 and 1974 ............................................................................................................................

S. Median number of patient visits per week, with change between 1970 and 1974, by number of

full- and part-time assistants to podiatrists providing patient care and year of suwey: United

States, 1970 and 1974 .............................................................................. .............. ...................

T. Percent of podmtrists providing patient care with 100 patient visits or more during preceding

week, with change between 1970 and 1974, by selected characteristics of podiatrist and year of

survey: United States, 1970 and 1974 .........................................................................................

5

5

6

6

7

7

!3

9

9

9

10

11

11

11

12

12

12

12

12

iv
U. Percent distribution of patients, with change between 1970 and 1974, by treatment setting and

year of survey: United States, 1970 and 1974 ............................................................................. 13

W. Percent of podiatrists providing patient care, with change between 1970 and 1974, by treatment

setting and year of sorvey: United States, 1970 and 1974 ........................................................... 13

X. Median age of podiatrists providhg patient care, with change between 1970 and 1974, by treatment setting and year of survey: United States, 1970 and 1974 .................................................. 14

Y. Number and percent distribution of patients treated during week preceding survey, by age of

patient and year of survey: United States, 1970 and 1974 .......................................................... 14

SYMBOLS

Data not available ----------------------------------- ---

Category not applicable ----------------------------- . . .

Quantity zero-–--—--–---------–------—--- -

Quantity more than Obut less than 0.05-— 0.0

Figure does not meet standards of

reliability or precision -----------------------

*
TRENDS IN THE PODIATRIC PROFESSION:

A COMPARATIVE STUDY

OF 1970 AND 1974 SURVEY DATA

Leonard Greenberg, Formerly with Division of Health Manpower and Facilities Statistics

INTRODUCTION

During the period from October through

December 1974, the National Center for Health

Statistics (NCHS) conducted a survey of the

Nation’s podiatrists in cooperation with the

American Podiatry Association. Of the 8,261

licensed podiatrists to whom self-administered

questionnaires were mailed, valid responses were

received from 7,253, a response rate of 88 percent. The results of the survey dkclosed that

7,085 podiatrists were actively engaged in

administering patient care during this period. 1-s

The methodology employed in conducting the

survey and in analyzing its results is described in

appendix I; the questionnaires employed are

shown in appendix IV.

In this publication the reported results of

the 1974 survey are compared with those obtained during an earlier survey, similar in scope,

conducted in 1970.4-6 Trends, to the extent discernible from the published data, are highlighted

and their implications in terms of manpower

planning and other policy considerations are

dealt with at some length.

DATA SOURCES AND

ISSUES TREATED

The data sources employed in producing this

report include detailed tables covering the 1974

surveyl’3 and the survey conducted in 1970.4-6

Additional use was made of special tabulations

produced by NCHS in support of an earlier project conducted by the author. T

It should be noted that the questionnaires

employed in the two surveys differed in several

respects. The major differences were:

. The 1974 questionnaire addressed the

issue of the podiatrist’s race/ethnicit y; the

1970 questionnaire did not.

. The 1970 questionnaire asked the podiatrist to estimate the sex distribution of

patients; the 1974 questionnaire did not.

Apart from these differences, however, the

two questionnaires addressed essentially identical data elements, subsequently encoded and

tabulated in comparable ways. The specific

issues selected for treatment in this report are as

follows:

1. Issues that deal with the general profile

of podiatrists

. their age distribution

. their sex &tribution

. their number of years active in

podiatry

In addition to these issues, which are

based on direct questionnaire responses, a

special section of this report is devoted to

the derived measure, podiatrist-population

ratios.

1
2. Issues that deal with the characteristics of

clinical practice

. principal form of employment

. number of assistants

@ primary clinical activity

. types of patient services rendered

3. Issues that deal with the volume and

nature of patient care administered

during the week preceding the survey

●

●

●

●

hours worked

number of patient visits

treatment setting

age of patients seen

SUMMARY OF FINDINGS

Highlighted in this summary of findings are

the major observations derived through a comparison of the 1970 and 1974 data.

Age Distribution

Although the median age of podiatrists has

remained the same (51 years), there were in

1974 a greater percentage of older (65 or over)

and younger (under 35) podiatrists than in

1970. In both years, the age distribution showed

a distinct unevenness in the middle, with many

more podiatrists between ages 45 and 54 than

between 35 and 44. Morever, the numerical disparity between these two age groups has

widened materially since 1970.

Nationwide, the ranks of podiatrists under

age 35 are growing at almost twice the rate as

those over 65. However, when one considers the

total number of podiatrists under age 45, compared to those over 65, that ratio declined from

3.3 in 1970 to 2.8 in 1974. Moreover, in certain

geographic divisions–specifically, the New England and West North Central Divisions–the

ratio went from substantially greater than to

substantially less than 2.0, a development that

warrants special attention.

Podiatrist-Population Ratios

The ratio of podiatrists per 100,000 population who provide patient care dipped slightly,

from 3.5 in 1970 to 3.4 in 1974. Five of the

nine geographic divisions showed declines; the

largest decline occurred in New England where

the podiatrist-population ratio dropped from 5.9

to 5.1 per 100,000. Gains were noted only in

the South Atlantic and Pacific Divisions, whose

podiatrist-population ratios (2. 1 and 3.2, respectively) nonetheless remained well below the

national average. The Nation’s least well supplied areas, from the standpoint of podiatric

manpower, remain the East South Central and

West South Central Divisions, with ratios of 0.9

and 1.5, respectively; neither of these divisions

showed an increase.

Sex Distribution

The number of female podiatrists declined

substantially, from 315 in 1970 to 271 in 1974.

The age disparities noted earlier for the podiatric

community as a whole are accentuated for

women: In 1970, 59 percent of the Nation’s

female podiatrists were 55 years or older; by

1974, that proportion had increased to 64 percent, with no clear evidence of meaningful replacement at the younger age levels. Less than 1

percent of the Nation’s podiatrists under age 35

were women.

Years Active in Podiatry

In 1970, podiatrists with 20 or more years

of prior activity were a bare majority (52.6 percent). By 1974, that proportion had climbed to

over 60 percent, indicating that the increased

infusion of younger podiatrists in the early

1970’s had not yet–as of 1974–made a material

numerical impact.

Principal Form of Employment

The percent of podiatrists engaged in solo

practice declined from 86 to 81 percent between

1970 and 1974 and the percent engaged in partnerships and group practice went from 8 to 16

percent. Most of the latter increase took place

among podiatrists under age 45, although shifts

toward partnerships and group practice were

noted among older podiatrists as well. Comparable shifts in mode of employment were noted in

all four geographic regions, with the South and

2
West registering slightly greater increases than

did the Northeast and North Central Regions.

Use of Assistants

At all age levels, in all geographic regions,

and within all forms of employment, there has

been a marked increase in the use of assistants,

both medical and nonmedical.

Nationwide, the percent of podiatrists with

one or more assistants rose from 62 percent in

1970 to 73 percent in 1974. Almost all of that

increase is attributable to the rise in percent of

podiatrists with part-time assistants; the percent

with one or more full-time assistants has remained virtually unchanged, indicating that

those employing assistants for the first time are

tending toward the employment of part-time

help. Significantly, however, the percent of

podiatrists with two or more full-time assistants

has risen sharply (from 13 to 23 percent), reflecting an increased tendency among those who

already employ full-time assistants to employ

them in greater numbers.

Primary Clinical Activity

A marked shift was noted toward the reporting of surgery as one’s primary clinical activity.

The percent of podiatrists who reported general

practice as their primary activity dropped from

90 to 84 percent, and the percent who reported

surgery rose from 6 to 11 percent. The bulk of

the latter increase took place among younger

podiatrists, although some increase was noted

among older podiatrists as well.

Types of Patient Services Rendered

Little change took place in the types of

patient services rendered. Palliative and orthopedic services continued to be performed by

over 90 percent of the Nation’s podiatrists, and

the prescription of drugs was close behind.

Hospital surgery was on the rise, however. Only

30 percent reported it in 1970 as compared with

39 percent in 1974, by far the largest increase

noted for any single form of service. Among

podiatrists under age 35, a substantial majority

reported hospital surgery as a “usual” service, as

against approximately 30 percent of those aged

55 or older.

Hours Worked

Despite the slight reduction in podiatristpopulation ratio, there has seemingly been no

corresponding increase in number of hours

worked. The median number of hours devoted

to patient care during the week preceding the

survey dipped from 38.2 in 1970 to 37.4 in

1974, and the percent of podiatrists who devoted 35 hours or more each week to patient

care declined from 70 to 68 percent.

The apparent tendency toward a shorter

workweek was most evident among older podiatrists and among those who are self-employed.

Salaried podiatrists and those under age 35

showed an increased number of hours devoted

to patient care. To what extent these fluctuations can be attributed to seasonal factors (considering the different times of year at which the

1970 and 1974 surveys were conducted) is unknown.

Patient Visits

Notwithstanding the reduction in workweek,

podiatrist productivity (measured in number of

patient visits per week) increased sharply. The

median number of patient visits rose from 71 to

77 and the percent of podiatrists who administered 100 patient visits or more during the preceding week went from 24 to 34 percent.

Gains in productivity were chiefly evident

among younger podiatrists and among those engaged in partnerships and group practice. There

is strong inferential evidence that these gains can

be attributed almost exclusively to the increased

use of both full- and part-time assistants.

From a geographic standpoint, the greatest

gains were registered in the Northeast and North

Central Re@ons, although the South remained

the region with the highest unit productivity.

The median number of patient visits per week in

the South was 83 in 1974 (up from 80 in 1970),

followed in order by the North Central (79),

Northeast (76), and West (72). All of these figures represent gains since 1970, but the largest

single increase was noted in the North Central

3
Region, which in 1970 had a median productivity of only 69.

Treatment Setting

As with the types of services rendered, the

distribution of treatment settings remained fundamentally unchanged. Roughly 5 out of every

6 patients (84 percent) continued to be treated

in the podiatrist’s office and an additional 6 percent were treated in nursing homes. The remaining 10 percent of patients were treated in

hospitals (5.4 percent), clinics (2.9 percent), and

in the patient’s home or other setting (1.6 percent ). Home visits were only about half as frequent as in 1970, and clinic visits were slightly

more common. The numbers involved, however,

were quite small compared to the total universe

of patient visits.

The median age of podiatrists involved in

hospital and clinic treatment settings tended to

be lower–both in 1970 and 1974–than that of

those who treated patients in the office, the

patient’s home, or in nursing homes.

Age of Patient

Although podiatrists have traditionally

treated a higher percent of older patients than

young ones, the ratio of old-to-young has risen

somewhat since 1970. In 1970, that ratio stood

at 2.6 (31 percent old vs. 12 percent young); by

1974, it had reached 3.5 (35 percent old vs. 10

percent young).a

GENERAL PROF

Age Distribution

LE

The numbers presented in this and the ensuing sections pertain only to podiatrists who

provide patient care. There were 7,078 such

podiatrists in 1970 and 7,085 in 1974. The distribution of podiatrists, by age and geographic

area, is shown in table 1.

Although the median age of podiatrists–51

years-remained fundamentally unchanged bea“Old” is defhed

is 16 years or under.

tween 1970 and 1974, the shape of the distribution showed signs of revision. By 1974, the number of podiatrists at the outer age extremes had

increased and the ranks of those within the inner

age brackets had declined (see figure 1). One of

the striking features of the age distribution-in

1974 as in 1970–is its unevenness. In both

years, there were substantially fewer podiatrists

between ages 35 and 44 than in either of the

10-year cohorts immediately ahead.

Two specific aspects of the age distribution

stand out. The first is that the gap (between

those aged 35 to 44 years and those immediately

older) has widened. The second is that the ranks

of all three age groups (35-44 years, 45-54 years,

55-64 years) combined has decreased by almost

10 percent–from 5,415 in 1970 to 4,920 in

1974.

On a gross nationwide basis, from the standpoint of sheer numbers, the declines within

these inner age brackets have been compensated

2,100

1,900

1,700

2 1,500 9

K

$

=

2 1,300

u.

0

K

Lu

~

3 1,100

z

900

700

0

1,296

2.030 El “7°

Under 35.44 45.54 55-64

35 years

65 vears

years years years m m-r

AGE

as age 65 years or older; “young” Figure 1. Number of podiatrists providing patient care, by age

of podiatrist: United States, 1970 and 1974

4
for by corresponding increases at the extremes.

As a consequence, the total number of podiatrists engaged in patient care has remained fundamentally unchanged as has their median age.

The increased concentration of podiatrists at the

outer extremes has led, however, to a profession

in which almost 1 podiatrist in 3 is either under

age 35 or over 64. This is a marked shift from

1970, in which the corresponding ratio was less

than 1 in 4 (see table A).

On the positive side, these figures indicate

that the ranks of the younger podiatrists are

growing twice as fast as the ranks of those

approaching retirement age, thereby assuring an

increasing supply over the next few years. This

situation, however, does not hold true across the

Nation. As shown in table B, older podiatrists

are only barely being replaced in the Northeast,

and the North Central Region is only slightly

better off.

Compounding the issue of geographic disparity, the regions with the lowest replacement

rates as shown in table B are also characterized

by the greatest decline in number of podiatrists

between the ages of 35 and 44 (see table C).

As a result of the factors just cited, the age

profile of podiatrists in the Northeast and North

Central Regions has taken an upward turn. The

ratio of podiatrists of less than middle age (i.e.,

under 45 years) to those approaching retirement

(65 years or over) has dropped substantially in

both of these regions, as well as in each of their

Table A. Percent of podiatrists in the outer age brackets (under 35 years or 65 years or over) providing patient care and ratio of

podiatrists between 35 and 65 years of age to those in the outer age brackets, by year of survey: United States, 1970 and 1974

Outer age brackets Ratio of podiatrists

Year of survey

between 35 and 65

Both groups Under 35 65 years years to those in

combined years or ovar outer age brackets

Percent of podiatrists

1970 ........................................................................................................... 23.5 13.3

1974

10.2 3.26 to 1

........................................................................................................... 30.6 18.3 12.3 2.27 to 1

Change, 1970-74 ........................................................................................ +7.1 +5.0 +2.1 . . .

Table B. Percent of podiatrists under 35 years and 65 years or over providing patient care and replacement rate, by geographic region

and year of survey: United States, 1970 and 1974

Geographic region and year of survey

Northaast:

1970 ..............,....................................................................................................

1974 !..................................................................................................................

North Central:

1970 ...................................................................................................................

1974 ...................................................................................................................

South:

1970 ...................................................................................................................

1974 ...................................................................................................................

West:

1970 ...................................................................................................................

1974 0,,., .,, ...........................................................................................................

Percant of

podiatrists

under 35 years

(A)

9.9

14.7

13.6

16.9

17.7

26.3

18.6

21.9

Percent of

podiatrists

65 years or over

(B)

10.1

14.3

11.1

13.6

8.4

6.9

10.0

10.1

Replacement

rate

(A) - (B)

-0.2

+0.4

+2.5

+3.3

+9.3

+19.4

+8.6

+11.8

5
Table C. Number of podiatrists between 35 and 44 years of age

providing patient care, with change between 1970 and

1974, by geographic region and year of survey: Unitad

States, 1970 and 1974

1 #

Geographic region

H ‘:;::i

I

Number

United States ...................... 1,460 1,156 -304

Northeast ....................................... 533 356 -177

North Central ................................ 463 336 -127

South ............................................. 239 230 -9

West ............................................... 225 233 +8

NOTE: Numbers may not add to totals due to rounding.

component divisions separately. In New England, for example, the ratio of less-than-middleage to retirement-age podiatrists has been

halved in 4 years–from 2.2 in 1970 to 1.1 in

1974. By way of contrast, that ratio has climbed

from 6.4 to 9.0 in the South Atlantic Division

and from 3.0 to 5.4 in the Mountain Division.

The relevant figures, broken down by geographic

region and division, are presented in table 2.

Nationwide, the ratio of less-than-middle-age

to retirement-age podiatrists declined from 3.3

in 1970 to 2.8 in 1974. Regions and divisions

with greater- and less-than-average ratios in each

of those years are shown in table D. As noted,

the Mountain Region, originally below the

nationwide average, is now above; the East

North Central Region, originally above average,

is now below.

Podiatrist-Population Ratios

Since the number of podiatrists who provide

patient care has increased by only a tenth of a

percent in 4 years, during which time the total

population has climbed by almost 4 percent, the

number of podiatrists per 100,000 population

has declined slightly–from 3.5 per 100,000

population in 1970 to 3.4 in 1974.

Not surprisingly, the decline has been greatest in those geographic areas that show the greatest upward turn in age profile—the Northeast

and North Central Regions and their component

divisions. All other regions and divisions have

remained essentially stable, except for the South

Atlantic Division in which there has been some ‘

modest growth (see table 3).

The decline in the podiatrist-population

ratios in the Northeast Region (and in the New

England and MiddIe Atlantic Divisions) might be

regarded as the first step toward a more uniform

nationwide distribution, and not necessarily as a

cause for concern. The decline in the North Central Region, however–and particularly in the

Table D. Ratio of podiatrists under 45 years of age to those 65 years or over rxovidina ~atient care, by geographic area: United Statas,

1970” and 1974 -

Ratio

Ragions:

Greater-than-average ........................................................................................................

Lass-than -avarage .............................................................................................................

Divisions:

Greatar.than.average ............................................................................ ............................

Less.than.average .............................................................................................................

1970

South

Wast

Northeast

North Central

East North Central

South Atlantic

West South Central

Pacific

New England

Middle Atlantic

West North Central

East South Central

Mountain

1974

Unchanged

Unchanged

South Atlantic

Wast South Central

Mountainl

Pacific

New England

Middle Atlantic

East North Central 1

West North Central

lDenotes change.

6
West North Central Division–does constitute

cause for concern because these units were, in

1974, at or below the national average. Whether

or not increased enrollment in the schools of

podiatric medicine, spurred by Public Law

94-484, will serve to reverse these trends (and to

stimulate growth in other areas) remains to be

seen.

Sex Distribution

A second major area of change with respect

to the universe of podiatrists is that of sex. In

1970, there were 315 female podiatrists administering patient care; by 1974, that figure had

dropped to 271, a decline of 14 percent.

The reason for the decline is evident from an

examination of the age distribution of female

podiatrists. As shown in table 4, they are chiefly

to be found in the upper age brackets. In 1970,

for example, females accounted for only 1.0 percent of podiatrists under the age of 35 but 1,0

percent of those age 65 or over; by 1974, both

of these percents had declined.

Women, clearly, are retiring from the profession at a much higher rate than they are being

replaced. Again, whether this trend will be reversed through increased enrollment of female

students remains to be seen.

Years Active in Podiatry

A further characteristic of podiatrists, for

which comparison is permitted by the 1970 and

1974 data, is “years active in podiatry. ” The

relevant figures are presented in table E.

As with age, the distribution of years of

activity is highly uneven. In 1970, those with 10

to 19 years of activity heavily outnumbered

the cohort immediately behind (28.8 to 18.6

percent). In 1974, a similarphenomenon (shifted

slightly due to the passage of time) is noted with

respect to those with 20 to 29 years of activity.

In both years, well over 50 percent of the podiatrists engaged in patient care have had more than

20 years of prior activity-52.6 percent in 1970,

increasing to 60.2 percent in 1974. These figures

indicate an aging process that can only be reversed through an increased infusion of new

podiatrists.

Table E. Number and percent distribution of podiatrists providin~ patient care, by years active in podiatry and year of

survey: United States, 1970 and 1974

Years active in

podiatry

Total ............

0-9 years .................

10-19 years .............

20-29 years .............

30 years or more .....

1970 I 1974

Number Percent Number Percent

7,078 100.0 7,085 100.0

1,314 18.6 1,529 21.6

2,040 28.8 1,289 18.2

1,542 21.8 2,122 30.0

2,182 30.8 2,143 30.2

NOTE: Numbers may not add to totals due to rounding.

The 1974 data on years of activity, unlike

those reported in 1970, were subdivided into 5-

rather than 10-year intervals. A useful byproduct of this feature is that it permits the two

sets of data to be checked for mutual consistency. Making use of the fact that the two

surveys were conducted essentially 5 years apart

(January-March 1970 vs. October-December

1974), the data were compared to see if the

number of podiatrists who, in 1970, reported x

years of prior activity equaled the number who,

in 1974, reported x + 5 years of prior activity.

The comparison in question is shown in table F.

Table F. Number of podiatrists providing patient care, ”by number of years active in podiatry and year of survey: United States, 1970

and 1974

I

Number of years active in podiatry

Yaar of survey

o-9 10-19 20-29 30 or 5-14 15-24 25-34 35 or

more more

I

Number of podiatrists

1970 .......................................................................................... 1,314 2,040

1974

1,542 2,182

,.,,,,,,.,,,,.,...,,,,,,.,.,,,,. .......................................................... . . . . . . . . . . . . 1,325 2,041” 1,333 1,5+8

7
For the two youngest cohorts, the comparative

figures are remarkably close–1,3 14 versus 1,325

and 2,040 versus 2,041. The closeness of these

figures reinforces the credibility of the data and

indicates that the 5-year attrition for these two

groups was undoubtedly very small.

For those with greater numbers of years of

experience, the differences are larger, but in the

right direction and of reasonable magnitude.

Moreover, they provide some measure of the

attrition levels characteristic of the profession:

Of the 1,542 podiatrists who reported 20 to 29

years of prior activity in 1970, some 200 were

apparently no longer active in 1974, and of the

2,182 who reported 30 years or more of prior

activity, some 600 were no longer active. Both

of these levels of attrition seem reasonable.

CHARACTERISTICS OF

CLINICAL PRACTICE

Principal Form of

Employment

Although solo practice remains the most

common form of employment–particularly

among older podiatrists—the percent engaged in

partnerships and group practice has risen

markedly since 1970. The increase is evident at

all age levels but particularly among younger

podiatrists (see table G).

Changes in employment among podiatrists

35 years or older are largely attributable to deTable G. Percent of podiatrists providing patient care engaged

in partnerships or group practice, with change between

1970 and 1974, by age of podiatrist and year of survey:

United States, 1970 and 1974

Age of podiatrist

H“’’”

All ages .................................

Under 35 years ................................

35-44 years ......................................

45-54 years ......................................

55-64 years ......................................

65 years or over ...............................

Percent of

podiatrists I

T

8.3 15.8 +7.5

16.9 32.6 +1 5.7

9.2 21.0 +11.8

7.2 11.3 +4.1

5.5 9.7 +4.2

5.4 6.9 +1.5

clines in solo practice. Within the youngest age

group, however, the change is chiefly in the

“salaried and other” category, as shown in table

5.

Another way of viewing changes in mode of

employment among younger podiatrists is as follows: In 1970, only 78.4 percent of those under

age 35 were self-employed; by 1974, that figure

had risen to 92.7 percent.

Nationwide, the percent of podiatrists engaged in solo practice declined from 85.7 to

80.7 percent, and the percent of salaried and

other practitioners declined from 6.1 to 3.5 percent. The combined drop of 7.6 percent equals

(except for rounding error) the gain in partnerships and group practice noted earlier.

Increases in the percent of podiatrists engaged in partnerships and group practice were

fairly uniform among the four geographic

regions. The smallest increase (5.9 percent) was

in the North Central Region; the largest (10.9

percent) took place in the South (see table H).

Declines in the “salaried and other” category

ranged from a low of 2.0 percent in the South to

a high of 3.4 percent in the West. The nationwide average drop, not ed earlier, was 2.6 percent.

Declines in solo practice ranged from a low

of 2.7 percent in the North Central Region to a

high of 9.0 percent in the South. The nationwide average drop was 5.0 percent.

Use of Assistants

The use of office assistants, both medical

and nonmedical, has increased. In 1970, about

62 percent of all podiatrists engaged in patient

care employed one or more assistants; by 1974,

that percent had increased to 73 percent.

Undoubtedly, the greater use of assistants is

associated with the greater tendency toward

partnerships and group practice. However, even

solo practitioners are making greater use of

assistants, as shown in table J.

The increased use of assistants is greatest

among those age groups that showed the greatest

trend toward partnerships and group practice.

The relevant figures are shown in table K. Two

aspects of this increased use of assistants are of

particular note. The first is that the increase is

almost wholly attributable to the greater use of

part-time, rather than full-time, personnel. Spe8
Table H. Percent distribution of podiatrists providing patient care by principal form of employment, according to geographic region

and year of survey: United States, 1970 and 1974

Geographic region and year of survey

Northeast:

1970 .......................................................................................................................

1974 ........................................................................................................................

North Central:

1970 .......................................................................................................................

1974 .......................................................................................................................

South :

1970 .......................................................................................................................

1974 .......................................................................................................................

West:

1970 .......................................................................................................................

1974 .......................................................................................................................

Table J. Percent of podiatrists providing patient care and using 1

assistantl or more, with change between 1970 and 1974,

by principal form of employment: United States, 1970 and

1974

Principal form of employment

All forms ...............................

Solo practice ....................................

Partnership ......................................

Group practice .................................

Year of survey

1970 I 1974

Change,

1970-74

Percent of

podiatrists

61.8

60.6

86.8

89.0

72.8

68.8

94.6

91.0

+11.0

+8.2

+7.8

+2.0

lInc]ude5 both medical and nonmedical 8SSkttUIk

Table K, Percent of podiatrists providing patiant care and using

1 assistantl or more, with change between 1970 and 1974,

by aga of podiatrist and year of survey: United States,

1970 and 1974

Age of podiatrist

M “;’”

Under 35 years ................................

35-44 years ......................................

45-54 years ......................................

55-64 years ......................................

65 years or over ,, ..,, .,, ,, .,....., ............

Percant of

podiatrists

73.4

77.1

66.8

50.4

32,3

91.6

90.7

75.6

61.5

38.9

+18.2

+13.6

+8.8

+11 .1

+6.6

solo Partnership or

Total

Salaried

practice group practice and other

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Percent distribution

87.6 7.0

83.8 13.6

84.6 8.5

81.9 14.4

82.9 11.0

73.9 21.9

83.2 8.8

77.7 17.6

5.4

2.6

6.9

3.8

6.1

4.1

8.0

4.6

cifically, the percentage of podiatrists with parttime a~sistan{s has ri~en o~er 11 percent ~ince

1970 (from 32.4 to 43.5 percent); the figure

associated with full-time assistants has barely

changed (48.3 percent vs. 47.5 percent). (See

table 6.)

On the other hand, despite the relatively

small increase in percent of podiatrists with one

or more full-time assistants, the percent with

two or more has almost doubled–from 13.0 to

23.4 percent–indicating that those podiatrists

who did employ full-time assistants tended to

employ them in greater numbers.

Age of podiatrist. –Podiatrists of all age

levels showed both of the tendencies just noted:

the greater use of part-time assistants and the

greater prevalence of two or more full-time

assistants. Only podiatrists under age 45, however, showed a tendency to hire full-time assistants where none previously worked.

Geographic req.on.–All four regions are

fairly uniform in the degree of change noted.

Regional differences are essentially in terms of

level–that is, podiatrists in the South and West

were more apt to use full-time assistants than

were those in the Northeast and North Central

Regions-rather than in terms of change.

PrskciDal form of em~lovment.–lnterestingly, aii three

showed a decrease

with one or more

fo~ms ;f “self-employment

in the percent of podiatrists

full-time assistants. Only the

9
Table L. Percant of podiatrists providing patient care, with change between 1970 and 1974, by age of podiatrist, primary clinical

activity, and year of survey: United States, 1970 and 1974

General practice

Age of podiatrist

All ages ...............................................................................................

Under 35 years ...................................................................................................

35-44 years .............................................. ...........................................................

45-54 years .........................................................................................................

55-64 years .........................................................................................................

65 years or over ..................................................................................................

Percent of

podiatrists

89.9 I 83.8

86.1 76.6

92.9 87.2

95.0 91.4

94.3 92.3

increased tendency toward partnerships and

group practice has kept the nationwide percent

from declining. Again, these figures confirm that

the use of part-time assistants is finding greater

favor and that podiatrists–regardless of their

mode of employment—are more likely to take

on a full-time assistant if they already have one

on staff.

Primary Clinical Activity

The percent of podiatrists who reported that

their primary clinical activity was “general practice” declined from 89.9 percent in 1970 to

83.8 percent in 1974. Corresponding to that decline, the percent whose reported primary activity was “surgery “ increased from 5.7 to 11.0

percent. This shift toward greater emphasis upon

surgery was manifest at all age levels, but was

predominant among younger podiatrists as

shown in table L.

Types of Patient Services

Rendered

The types of patient services i-endered by

podiatrists, in 1970 and 1974, are shown in

table 7.

Except for hospital surgery, the percent

changes are generally small and the order is fundamentally unchanged. Palliative services remained the most common form of treatment

with orthopedic services and the prescription of

drugs following closely behind. Low-voltage

treatment and diathermy, which were among the

Ieast common types of services in 1970, have become less common. In addition to hospital

Change,

1970-74

-6.1

-7.3

-9.5

-5.7

–3.6

-2.0

Surgery

Percent of

podiatrists

5.7

17.9

8.7

3.7

1.5

1.1

11.0

26.0

18.5

7.3

3.2

3.0

Change,

1970-74

+5,3

+8.1

+9.8

+3.6

+1.7

+1,9

surgery, ultrasonic treatment, office surgery, and

X-ray services have become more comm;n;

Insight as to the relative frequency with

which certain services are performed by various

age groups may be gained from table 8. In that

table, services are grouped into four categories

according to the percent of podiatrists who performed them: almost all (more than 90 percent),

most (60 to 90 percent), many (30 to 60 percent), and some (less than 30 percent).

Viewed from that standpoint, there are six

services which almost all podiatrists under the

age of 45 performed: palliative services, office

surgery, prescription of drugs, physical therapy,

orthopedic services, and X-ray services, but only

one service which almost all podiatrists 55 years

or older performed—palliative services. That pattern, evident in 1970, remained unchanged in

1974.

Hospital surgery, office surgery, physical

therapy treatment, and X-ray services became

less common as the age of the podiatrist increased. Diathermy, low-voltage treatment,

ultraviolet lamp treatment, and the fitting of

special shoes are seen to be essentially invariant

with age. Apart from hospital surgery, no major

changes were noted between 1970 and 1974.

VOLUME AND NATURE

u: ,JATILNT CARE

Hours Worked

The median number of hours per week

devoted to patient care showed a slight

10
decline–from 38.2 in 1970 to 37.4 in 1974.

Along with that decline, the percent of podiatrists who reported having devoted 35 hours or

more to patient care during the preceding week

dipped from 70 to 68 percent.

The South remained the region in which the

greatest percent of podiatrists provided at least

3.5 hours of patient care per week. In all four

regions, however, that percent showed some degree of decline (see table M).

Not all age groups followed the nationwide

trend, however. Those in the youngest age

brackets, perhaps because of their increasing involvement in partnerships and group practice,

showed a distinct tendency toward an increased

number of hours of patient care per week, as

shown in table N.

About 3 in every 4 podiatrists engaged in

partnership or group practice devoted at least 35

Table M. Percent of podiatrists who devoted 35 hours or more

to patient care, with change between 1970 and 1974, by

geographic region and year of survey: United States, 1970

and 1974

Geographic region

H“’’’”

United States ........................

Northeast..,...,.., ...............................

North Central ....................,, ,.,, ,., .....

South ...............................................

West ,!,,,.,...,.,.,.,., ,,, ,,, ,, .,,,,,,..,.,,...,,,,,,

Percent of

podiatrists

69,9 I 68:1

69.5

73.8

68.8

66.9

71.3

64.6

-1;8

-0.2

-2,6

-2.5

-4.2

Table N. Percent of podiatrists who devoted 35 hours or more

to patient care during the pracading waek, with change

batwaen 1970 and 1974, by age of podiatrist and year of

survey: United Statas, 1970 and 1974

Age of podiatrist

Under 35 years ................................

35-44 years ......................................

45.54 years ,,, .,, ,.,, ,,, ,,, .,! .,, .,, ,., .!, ,., ..0,

65-64 years .,, ...................................

65 yeers or over .,, ., ..........................

Yaar of survay

==’l=

Percent of

podiatrists

69.0

74.4

74.7

71.1

45.4

75.0

72.1

72.9

68.6

41.4

Change,

1970-74

hours per week to patient care, as opposed to 2

of every 3 solo practitioners. Except for those

engaged in partnerships, these figures represent a

substantial decline since 1970. Among salaried

and other podiatrists, however, the comparable

percent has gone up–from 40 percent in 1970

to 68 percent in 1974. The figures in question

are shown in table O. Table 9 summarizes these

data on hours worked in 1970 and 1974.

Patient Visits

Table 10 shows the median number of

patient visits per week, by selected characteristics, for 1970 and 1974.

Despite the noted decline in number of

hours devoted to patient care, the median number of patient zJisits per week increased by

almost 10 percent–from 71 in 1970 to 77 in

1974. The South remained the re@on with the

highest weekly median number of patient visits,

but the Northeast and North Central Regions

made great strides, as shown in table P.

The greatest gains in productivity were

noted among those podiatrists under age 55.

Podiatrists in the 35-44-year age bracket remained the most productive, but those under

age 35 and between 45 and 54 years also showed

gains (see table Q).

Some portion of these gains is undoubtedly

attributable to changes in principal form of

employment—toward partnerships and group

practice. The latter forms of employment are by

far the most productive, outstripping solo practice by an even greater margin than they did in

1970 (see table R).

Tabla O. Percent of podiatrists who devoted 35 hours or more

to patient care during preceding week with change between

1970 and 1974, by principal form of employment and Year

of survey: United’ States,” 1970 and 1974

Principal form of

employment

+6.0

-2.3

-1.8

-2.5

-4.0

Self employed:

Solo practice ..............................

Partnership .................................

Group practice ...........................

Salaried and other ............................

Year of survay

EE

Percent of

podiatrists

70.0 66.8

74.6 74.7

80.5 74.2

39.7 67.9

Change,

1970-74

–3.2

+0.1

-6.3

+28.2

11
Table P. Median number of patient visits per waek, with change

between 1970 and 1974, by geographic region and year of

practices with a fixed number of assistants; that

is to say, podiatrists with a given number of

assistants in 1974 were no more productive than

those with the same number in 1970, leading

one to conclude that any increase in productivity could only be associated with an increased number of assistants. As shown in table

S, productivity is a strong function of the

number of assistants employed, but the numerical relationship has not changed fundamentally

since 1970.

survay: United States, 1970 and 1974 -

Change,

1970-74

Year of survey

Geographic region

1970 I 1974

number of

patient visits

United States ........................

Northeast .........................................

North Central ..................................

South ...............................................

Wast .................................................

71 i 77 +6

+6

+10

-I-3 T +1

70 76

69 79

80 83

71 72

Table S. Median number of patient visits per week, with change

between 1970 and 1974, by number of full- and part.time

assistants to podiatrists Drovidina oatient care and vear of

survey: United States, 19“70 and {974

..—

Table Q. Median number of patient visits per week, with change

betwaen 1970 and 1974, by aga of Podiatrist Drovidina

Number of assistants

Year of survey

EE

Median

number of

patient visits

46 49

73 72

94 94

120 117

Change,

1970-74 patient care and year of survey; United States, 1970 anj

1974

Age of podiatrist

Year of survey Change,

1970-74

+13

+16

+11

+2

+2

m!_Lu

Median

number of

patient visits

71 I 84

None ................................................

One ..................................................

Two .................................................

Threa or more ..................................

+3

-1

0

-3

Under 35 vaars ................................

lIncl~des both medical and nonmedical a?sktmts 3544 yea& ...................................... 84 100

45-54 years ...................................... 78 89

55-64 years ...................................... 66 68

65 years and oar . ............................ 40 42

Table T. Percent of podiatrists providing patient care with 100

patient visits or mora during preceding week, with chenge

between 1970 and 1974, by selected characteristics of

podiatrist and year of survey: United States, 1970 and

Table R. Median number of patient visits per week, with changa

betwean 1970 and 1974, by principal form of employment

of podiatrist providing patient cara and year of

1974

Yaar of surva} survey: United Statesr 1970 and 1974 Change,

1970-74 Selected characteristic

Principal form of

employment

Year of survey

EE

Median

number of

patiant visits

70 73

84 103

89 103

Changa,

1970-74

1970 I 1974

Parcent of

podiatrists

United Statas ........................ 24.1

~

22.4

22.7

32.8

23.4

22.4

36.2

40.7

33,6

33.0

34.8

38.1

28.7

29.5

51.7

52.7

+’9.5

+1 0.6

+1 2.1

+5.3

+5.3

+7.1

+1 5.5

+1 2,0

Geographic region

Solo practice ....................................

Partnership ......................................

Group practice .................................

+3

+19

+19

Northeast .........................................

North Central ..................................

South ...............................................

Wast .................................................

Principal form of

employment It is clear, however. that the maior contrib-

.

uting factor toward the noted increase in productivity is the increased use of assistants. The

importance of this factor is evident from the

fact that no rise in productivity was noted for

12

Solo practice ....................................

Partnership ......................................

Group practice .................................
Due no doubt to the increased use of assistants, weekly productivity in excess of 100

patient visits per week has become increasingly

common. In 1970, less than 1 podiatrist in 4

administered as many as 100 visits per week; by

1974, that ratio had reached 1 in 3. Substantial

gains in productivity were registered in all

regions and among those forms of employment

shown in table T.

Because of its impact upon local and regional manpower planning, the issue of productivity takes on special significance. Realistic

estimates are required not only of the produ-ctivity podiatrists have achieved in the past but

also of the levels that they can reasonably reach

in the face of anticipated future demand.

Appendix III examines this issue in further

detail, making use of special runs conducted on

unpublished data from the 1974 survey.y In that

appendix, it is shown that average productivities

well in excess of 100 patient visits per week have

been achieved by podiatrists of virtually all ages,

given a sufficient number of assistants.Generally

speaking, older podiatrists with n + 1 assistants

are seen to be essentially as productive as

younger ones with n assistants. This finding has

strong implications in terms of future projections of manpower need.

Treatment Setting

In 1970, the Nation’s

administered patient care

7,078 podiatrists who

treated-a weekly total

of 459,285 patients. Of these, 82.7 percent were

treated in the podiatrist’s office, 6.3 percent in

nursing homes, and the remaining 10 percent in

hospitals and other settings.

In 1974, with only a handful of additional

podiatrists involved in patient care (7,085 as

opposed to 7,078), and with a generally shorter

workweek, podiatrists managed to treat an

appreciably greater volume of patients–536,732

as against 459,285.b The distribution of treatment settings, however, remained fundamentally

bThesenumbers pertain to patients seen during the

week immediately preceding the survey. It is possible,

therefore, that the noted increase may be due—at least in

part-to seasonal factors, since the 1970 survey took

place in the first calendar quarter and the 1974 survey in

the last.

unchanged: Roughly 5 out of every 6 patients

continued to be treated in the podiatrist’s office

and an additional 6 percent in nursing homes.

The major change of consequence was a reduction in percent of patients treated at home and

an increase in the percent treated in clinics. The

relevant figures are shown in table U.

In 1974, well over 90 percent of all podiatrists provided treatment in their private offices;

about a third treated patients in nursing homes.

These figures have not changed substantially

since 197 O—however, home visits have declined

and, to a lesser extent, visits conducted in clinics

and on inpatients in hospitals have shown some

increase (see table W).

Table U. Percent distribution of patients, with change between

1970 and 1974, by treatment setting and year of surveY: United States, 1970 and 1974

Treatment setting

Total ...................................

Podiatrist’s office ...........................

Hospital (inpatient) .......................

Hospital (outpatient) .....................

Clinic (other than hospital) ............

Nursing home ................................

Patient’s home ...............................

Other .............................................

Year of survey

EE

Percent

distribution

I

100.0 100.0

82.7 84.2

3.3 3.1

2.8 2.3

1.9 2.9

6.3 5.9

2.2 1.0

1.0 0.6

Change,

1970-74

. . .

+1.5

-0.2

-0.5

+1.0

-0.4

-1.2

-0.4

NOTE: Numbers may not add to totals due to rounding.

lPercentages for 1974 are based on patient visits rather than

patients seen.

Table W. Parcent of podiatrists providing patient care, with

chanrre between 1970 and 1974, bv treatment setting and

year ;f survey: United States, 1970 and 1974

Traatment setting

Podiatrist’s office .............................

Hospital (inpatient) .........................

Hospital (outpatient) .......................

Clinic (other than hospital) ..............

Nursing home ..................................

Patient’s home .................................

Year of survey

G

Parcent of

podiatrists

93.4 95.2

23.1 27.1

9.7 9.9

3.6 6.7

33.3 34.1

35.2 24.2

Change,

1970-74

+1.8

+4.0

+0.2

+3.1

+0.8

-11.0

13
Table X. Median age of podiatrists providing patient care, with

change betwaen 1970 and 1974, by treatmant setting and

yaar of survey: United States, 1970 and 1974

Table Y. Number and percent distribution of patients traated

during week preceding survey, by age of patient and year of

survey: United States, 1970 and 1974

Treatment setting

Podiatrist’s office .............................

Hospital (inpatient) .........................

Hospital (outpatient) .......................

Clinic (other than hospital) ..............

Nursing home ..................................

Patient’s home .................................

Median

age of

podiatrists

50.6

45.9

45.0

41.2

49.3

50.3

50.7

44.6

46.2

39.7

49.5

51.8

+0.1

-1.3

+1.2

-1.5

+0.2

+1.5

Treatment administered in hospitals (both

in- and outpatient) and in clinics tended to be

administered by podiatrists who were generally

younger. The median age of podiatrists involved

in each of the various treatment settings is

shown in table X; again, little change is noted

between 1970 and 1974.

I

Year of survey

Age of patient 1970

I

1974

Number

diR%’tlon ‘umber dtstributlon ‘ercen:

All ages........ 459,285 100.0 536,732 100.0

16 years or under ... 54,207 11.8 55,889 10.4

17-64 years ............ 264.287 57.5 292,847 54.6

65 years or over ..... I 140;791 I 30.7 1187;996 I 35.0

Age of Patient

Patients treated in 1974 tended to be older

than patients treated in 1970. The relevant figures are shown in table Y.

The increased treatment of the elderly population may be associated with the expansion,

since 1970, of podiatric benefits under Medicare.

000

14
REFERENCES

lNational Center for Health Statistics: Preliminary

data from the Survey of Podiatrists: United States,

1974. Monthly Vital Statistics Report. VOL 24, N0. 7.

SUpp. DHEW Pub. No. (HRA) 76-1120. Health Resources Administration. Rockville, Md., Oct. 24, 1975.

2National Center for Health Statistics: Podiatry

manpower: A general profile, United States, 1974, by

Kenneth Stant and Aaron Handler. Vital and Health

Statistics. Series 14-No. 18. DHEW Pub. No. (PHS) 78-

1813. Public Health Service., Washington. U.S. Government Printing Office, Oct. 1978.

3Nation~ Center for Health Statistics: podiatry

workforce: Chmacteristics of the provision of patient

care, United States, 1974, by P. Hannah Davis Zytnick

and Kenneth Stant. Vital and Health Statistics. Series

14-No. 22. Public Health Service. Washington. U.S. Government Printing Office. In preparation.

4Nation~ Center for Health statistics: podiatry

manpower: A general profiie, United States, 1970, by

Hugo K. Koch and Hazel M. Phillips. Vital and Health

Statistics. Series 14-No. 10. DHEW Pub. No. (HRA)

74-1805. Health Resources Administration. Washington.

U.S. Government Printing Office, Aug. 1973.

5National Center for Health Statistics: Podiatry manpower: Characteristics of clinical practice, United States,

1970, by Hugo K. Koch and Hazel M. Phillips. Vital and

Health Statistics. Series 14-No. 11. DHEW Pub. No.

(HRA) 74-1806. Health Resources Administration.

Washington. U.S. Government Printing Office, Mar.

1974.

6National Center for Health Statistics: Characteristics

of patients treated by podiatrists, United States, 1970,

by Hugo K. Koch and Hazel M. Phillips. Vital and Health

Statistics. Series 14-No. 14. DHEW Pub. No. (HRA) 75-

1809. Health Resources Administration. Washington.

U.S. Government Printing Office, Aug. 1974.

7Greenberg, L.: A Proposed Demand-Productivity

Model for the Designation of Podiati-c Manpower Shortage Areas. Prepared for the Bureau of Health Manpower,

Health Resources Administration, Washington, D.C.,

Jan. 1977.

15
LIST OF DETAILED TABLES

1. Number of podiatrists providing patient care, by age of podiatrist and geographic area of practice: United States, 1970 and

1974 ............................................................................................................................................ ............................ .................

2. Number of podiatrists under 45 years and 65 years and over providing patient care and ratio between the two age groups, by

geographic area of practice and year of survey: United States, 1970 and 1974 ........................................................................

3. Number of podiatrists providing patient care per 100,000 population and change in ratio between 1970 and 1974, by geographic area of practice and year of survey: United States, 1970 and 1974 .................................................................. ............

4. Number and percent of female podiatrists and percent of all podiatrists providing patient care, by age of podiatrist and yeer

of survey: United States, 1970 and 1974 ............... ....................................................................................... .......................... .

5. Percent distribution of podiatrists providing patient care, by principal form of employment, age of podiatrist, and year of

survey: United States, 1970 and 1974 ..................................................................................... ...................... ..................... ......

6. Percent of podiatrists providing patient care who employ full-or part-time assistants, by selected characteristics of podiatrist,

year of survey, and number of assistants: United Statesr 1970 and 1974 ....................................................... ...........................

7. Number and parcent of podiatrists providing patient care, with change between 1970 and 1974, by selacted patient services:

United States, 1970 and 1974 ................................................................................................................................ ...................

8. Percent of podiatrists providing patient care, by age of podiatrist, year of survey, and selected services provided: United

States, 1970 and 1974 ....................... ..................................................................................................................... ..................

9. Percent of podiatrists who devoted 35 hours or more to patient care during preceding week, with change between 1970 and

1974, by selected characteristics of podiatrist: United States, 1970 and 1974 ..........................................................................

10. Median number of patient visits per week, with change between 1970 and 1974, by selected characteristics of the podiatrists

providing patient care and year of survey: United States, 1970 and 1974 .................................................................................

17

18

19

19

20

21

22

23

24

25

16
Table 1. Number of podiatrists providing patient care, by age of podiatrist and geographic area of practice: Unitad States, 1970 and 1974

Geographic area of

practice

United States ....

Geographic region

Northeast ................ ...... .. ..

North Central ...................

South ................................

West ..................................

GeorsraDhic division

New England ............ ........

Middle Atlantic .................

East North Central ..... .......

Wast North Central ........ ...

South Atlantic ..................

East South Central .... ........

West South Central ...........

Mountain ..........................

Pacific ...............................

1970 1974

Under 3544 45-54 55-64 65 Under

Total 35 Total 35

3544 45-54 55-64 65

years years years

years

years years years

years

years or over years or over

Number of podiatrists

7,078

2,991

2,059

989

1,038

697

2,295

1,698

361

588

115

286

207

831

944

296

279

175

193

33

263

247

33

106

11

58

34

159

1,460

533

463

239

225

133

400

383

80

151

15

73

50

175

2,030

894

572

299

265

213

681

465

107

171

48

79

46

219

1,925

967

515

192

251

242

725

420

95

120

22

51

49

202

718

301

230

83

104

76

226

183

47

40

19

24

28

76

7,085

2,876

1,968

1,135

1,105

621

2,255

1,636

333

701

119

315

228

877

1,296

423

332

298

242

51

372

296

36

196

27

75

59

183

1,156

356

336

230

233

61

295

282

55

146

15

69

50

183

1,897

737

604

297

259

172

564

497

107

174

35

88

51

209

1,867

949

428

232

258

237

713

345

83

147

26

59

48

210

411

268

78

112

100

311

216

52

38

15

24

20

92

NOTE: Numbers may not add to totals due to rounding.

17
Table 2. Number of podiatrists under 45 years and 65 years and over providing patient care and ratio between the two age croups, by

geographic area of practice and year of survey: Uni{ed States, 1970 and 1974

Geographic area of practice and year of survey

Geographic region

Northeast:

1970 .................................................................................................................................

North Central:

1970 .................................................................................................................................

1974 .................................................................................................................................

South :

1970 ....#...........................................................! ................................................................

1974 .................................................................................................................................

West:

1970 ........ ..................................................................................................................#......

1974 .................................................................................................................................

Geographic division

New England:

1970 .................................................................................................................................

1974 .................................................................................................................................

Middle Atlantic:

1970 .................................................................................................................................

7974 .................................................................................................................................

East North Central:

1970 .................................................................................................................................

1974 .................................................................................................................................

West North Central:

1974 .................................................................................................................................

South Atlantic:

1974 .................................................................................................................................

East South Central:

1970 .................................................................................................................................

1974 .................................................................................................................................

West South Central:

1970 .................................................................................................................................

1974 .................................................................................................................................

Mountain:

1970 .................................................................................................................................

1974 ............................................. ....................................................................................

Pacific:

1970 .................................................................................................................................

1974 .................................................................................................................................

Number of

podiatrists

under

45 years

(A)

829

779

742

668

414

528

418

475

166

112

663

667

630

578

113

91

257

342

26

42

131

144

84

109

334

366

Number of

podiatrists

65 years

or over

(B)

301

411

230

268

83

78

104

112

76

100

226

311

183

216

47

52

40

38

19

15

24

24

28

20

76

92

Ratio of

(A) to (B)

2.8

1,9

3.2

2.5

5.0

6.8

4.0

4.2

2.2

1,1

2.9

2.1

3.4

2.7

2.4

1.7

6.4

9.0

1.4

2.8

5.5

6.0

3.0

5.4

4.4

4.0

18
Table3. Number of podiatrists providing patient care per 100,000 population and change in ratio between 1970 and 1974, by

geographic area of practice andyear of survey: United States, 1970 and 1974

Geographic area of practice

United States ...................................................................................................................................

Geographic region

Northeast ............................................ .............................................................................................................

North Central .......................................... ........................................................................................................

South ............................................................................................................................................ .............. .....

West .................................................................................. ........................................................................ .......

Geographic division

New England ...................................................................... .............................................................................

Middle Atlantic .............................................................................................................................. ..................

East North Central ...........................................................................................................................................

West North Central ..........................................................................................................................................

South Atlantic ............................................................. ....................................................................................

East South Central ......................................................................... ..................................................................

West South Central ..........................................................................................................................................

Mountain .........................................................................................................................................................

Year of survey

R-Lx

Number of

podiatrists

3.5

6.1

3.7

1.6

3.0

5.9

6.2

4.2

2.2

1.9

0.9

1.5

2.5

3.1

3.4

5.8

3.4

1.7

3.0

5.1

6.0

4.0

2.0

2.1

0.9

1.5

2.4

3.2

Change,

1970-74

-0.1

–0.3

–0.3

+0.1

0.0

-0.8

-0.2

-0.2

-0.2

+0.2

0.0

0.0

-0.1

+0.1

Table 4. Number and percent of female podiatrists and parcent of all podiatrists providing patient care, by age of podiatrist and year of

survey: United States, 1970 and 1974

Age of podiatrist and year of survey

Under 35 years:

1970 .......................................... ..................................................................................

1974 ............................................................................................................................

3544 years:

1970 ......... ...... ................ ...... .... .. ........ ................ ...................... ........ ...........................

1974 ............................................................................................................................

45.54years:

1970 .............................................................................................. ..............................

1974 .............. ..............................................................................................................

55-64 years:

1970 ............................................................................................................................

1974 ............................................................................................................................

65 years or over:

1970 ............................................................................................................................

1974 ............................................................................................................................

Number of

female

podiatrists

9

12

31

11

90

75

113

105

72

68

Percent of

all female

podiatrists

2.9

4.4

10.0

4.1

28.6

27.7

35.9

38.7

22.9

25.1

Percent of

all podiatrists

(male Plus

female)

1.0

0.9

2.1

0.9

4.4

4.0

5.9

5.6

10.0

7.8

19
Table 5. Percant distribution of podiatrists providing patient care, by principal form of employment, age of podiatrist, and year of

surveY: United States, 1970 end 1974

Age of podiatrist and year of survey

Under 35 years:

1970 ......................................................................................#................................

1974 .......................................................................................................................

35-44 years:

1974 .......................................................................................................................

45-54 vears:

"1970 .......................................................................................................................

1974 ... ................................................................................ ...................... ..............

55-64 years:

1970 .......................................................................................................................

1974 .......................................................................................................................

65 years or over:

1970 ........................ ...............................................................................................

1974 .......................................................................................................................

I

Total

solo

practice

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Partnership Salaried

and group

practice

and other

61.5

60.1

86.5

75.9

88.1

85.8

91.2

87.9

92.0

91.2

16.9

32.6

9.2

21.0

7.2

11.3

5.5

9.7

5.4

6.9

21,6

7.3

4.2

3.1

4.8

3.0

3.3

2.3

2.6

1.8

20
Table 6. Percent of podiatrists providing patient care who employ full-or part-time assistants,l by selected characteristics of podiatrist,

year of survey, and number of assistants: United States, 1970 and 1974

Selected characteristic and year of survey

United States:

1970 ......................... .... .. .......................... .......................................c.....oooo.c.+..oo.. e..........oc@.o

1974 ....................................................................................................................................

Aqe of Podiatrist

Under 35 years:

1970 ....................................................................................................................................

1974 ....................................................................................................................................

35-44 years:

1970 ....................................................................................................................................

1974 ................................................................................................................................ ....

45-54 years:

1970 ....................................................................................................................................

1974 ................................................................................................... .................................

55-64 years:

1970 ................................................................................................................................ ....

1974 ,., ............................................................................................................................. ....

65 years or over:

1970 ....................................................................................................................................

1974 .............................................................................................................................. ......

Geographic region

Northeast:

1970 ....................................................................................................................................

1974 ....................................................................................................................................

North Central:

South :

1970 ................................................................................................................................ ....

1974 .............................................................................................................................. ......

West:

1970 ....................................................................................................................................

1974 ........................................................ ........................................................................ ....

Principal form of employment

Solo practice:

1970 .............................. .......................... ............................................................................

1974 ....................................................................................................................................

Partnership:

1970 ....................................................................................................................................

1974 ....................................................................................................................................

Group practice:

1970 ....................................................................................................................................

1974 ....................................................................................................................................

Number of assistants

EEEzzEE

Percent of podiatrists

47.5

48.3

55.1

65.0

60.5

64.4

51.5

51.5

39.0

37.4

22.4

18.6

33.9

34.0

51.2

51.0

68.9

67.7

58.9

61.1

45.1

42.4

78.8

77.4

83.0

75.4

32.4

43.5

40.4

56.4

45.7

56.4

34.9

44.2

22.3

35.1

14.6

23.8

29.2

42.5

35.3

45.4

32.4

43.2

35.8

43.2

31.5

41.4

51.4

57.5

47.2

50.1

13.0

23.4

18.5

34.0

20.2

37.3

13.9

24.7

7.5

14.2

3.9

6.2

12.4

13.9

24.6

27.0

37.6

15.2

30.5

10.0

16.2

39.7

59.1

44.2

52.7

lIncludes both medical and nonmedical assistants.

21
Table 7. Number and percent of podiatrists providing patient care, with change between 1970 and 1974, by salected patient services: United States, 1970 and 1974

Patient service

Palliative services ..................................................................................................

Orthopedic services ..............................................................................................

Prescription of drugs ..................................... .......................................................

Physical therapy treatment ...................................................................................

X-ray services .......................................................................................................

Office surgery .......................................................................................................

Whirlpool baths ....................................................................................................

Ultrasonic treatment ............................................................................................

Fitting special shoes ...... .......................................................................................

Low-voltage treatment ........................................................ .................................

Hospital surgery ...................................................................................................

Ultraviolet lamp treatment ...................................................................................

Diathermy ............................................................................................................

1970

Numbar

6$21

6,386

6,187

5,686

5593

5,437

4$76

4,524

3,703

2/584

2,148

2,123

2,046

Percent

97.8

90.2

87.4

80.3

79.0

76.8

70.3

63.9

52.3

36.5

30.3

30.0

28.9

1974

Number

6,925

6,484

6,361

5,840

5,848

5,719

5,075

4)325

3,687

2,323

2,788

2,124

1,779

Percent

97.8

91.5

89.8

82.4

82.7

80.7

71.6

88.1

52.0

32.8

39.4

30.0

25.1

Change,

1970-74

0

+1.3

+2.4

+2.1

+3.6

+3.9

+1.3

+4.2

-0.3

-3,7

+9.1

o

-3.8

22
Table 8. Percent of podiatrists providing patient care, by age of podiatrist, year of survey, and selected services provided: United States,

-1970 and 1974

Age of podiatrist and

year of survey

Under 35 years:

1970 .....................

1974 .....................

35-44 years:

1970 .....................

1974,..,,,, ..............

45-54 years:

1970 .....................

1974,.,,,.,.., ...........

65-64 years:

1970 .....................

1974 .....................

65 years or over:

1970 ,....................

1974 .....................

Percent of podiatrists

ALMOST ALL MOST MANY SOME

(More than 90 percant) (60-90 percent) (30-60 parcent) (Less than 30 parcant)

Services provided

Pall iative services Hospital surgery Fitting special shoes Diathermy

Office survery Whirlpool baths Low-voltage treatmant

Prescription of drugs Ultrasonic treatment Ultraviolet lamp treatmant

Physical therapy treatment

Orthopedic services

X-ray services

As above, except “hospital surgary” went from MOST to MANY.

Palliative services Whirlpool baths Fitting special shoes Diathermy

Office surgery Ultrasonic treatment Hospital surgery Low-voltage treatment

Prescription of drugs Ultraviolet lamp treatment

Physical therapy treatment

Orthopedic servicas

X-ray services

As above, excapt “low-voltage treatment” went from SOM E to MAN Y.

Palliative services

Prescription of drugs

Orthopedic services

Office surgery

Physical tharapy treatment

X-ray services

I

Whirlpool bath

Ultrasonic treatment

Fitting special shoes Diathermy

Hospital surgary

Ultraviolet lamp treatment

Low-voltage treatment

As above, except “hospital surgery” went from MANY to SOME.

Palliative services Office surgery Fitting special shoes Diathermy

Prescription of drugs Ultraviolet lamp treatment Hospital surgery

Physical therapy treatment Low-voltage treatment

Orthopedic services Ultrasonic treatment

Whirlpool baths

X-ray services

As above, except “ultraviolet lamp treatment” went from MANY to SOME, and

“diathermy” went from SOME to MANY.

Palliative services Prescription of drugs Fitting special shoes Diathermy

Orthopedic services Ultrasonic treatment Hospital surgery

Office surgery Ultraviolet lamp traatment

Physical therapy treatment Low-voltage treatment

Whirlpool baths

X-ray services

As above, except “prescription of drugs” went from MOST to MANY.

23
Table 9, Percent of podiatrists who devoted 35 hours or more to patient care during precadirm week, with charme between 1970 and

1974, by selected characteristics of podiatrist: United St;tes, 1970_&d 1974

Selected characteristic

United States ...... .......................................................................................................................... ...

Geographic region

Northeast ...................................... ...................................................................................................................

North Central .......................................................................................... ...................................... ..................

South ................................................................................................................................ ...............................

West ................................................................................................................................ ................................ .

Aae

Under 35 years ................................................................................................................................ ................

35-44 years ................................................................................................................................ ......................

45-54 years ................................................................................................................................ ......................

55-64 years ......... ................................................................................................................................... ..........

65 years or over ................................................................................................................................ ...............

Principal form of employment

Solo practice ................................................................................................................................ ....................

Partnership ......................................................................................................................... ....... ......................

Group practice ............................................................................................................................................ .....

Salaried and other ................................................................................................................................ ............

P

Percent of

podiatrists

69.9

69.3

69.5

73.8

68.8

69.0

74.4

74.7

71.1

45.4

70.0

74.6

80.5

39.7

68.1

69.1

66.9

71.3

64.6

75.0

72.1

72.9

68.6

41.4

66.8

74.7

74.2

67.9

Change,

1970-74

-1.8

-0.2

-2.6

-2.5

-4.2

+6.0

-2.3

-1.8

-2.5

-4.0

-3.2

+(),1

-6.3

+28.2

24
Table 10. Median number of patient visits per week, with change between 1970 and 1974, by selected characteristics of the podiatrist

providing patient care and year of survey: United States, 1970 and 1974

Selected characteristic

United States ...................................................................................................................................

Geographic region

Northeast ............................................................................. ............................................................................

North Central .............................................................................................................................. ....................

South ................................................................................................................................ ...............................

West ................................................................................................................................ ................................ .

Age —

Under 35 years ......... .......... ................ ......................................................................................................... ....

35-44 years ......................................................................................................................................................

45-54 years ......................... .............................................................................................................................

55-64 years ............................................................................................................................................ ..........

65 years or over .......................................... .....................................................................................................

Principal form of employment

Solo practice ........................................................................ ........................................................................ ....

Partnership .................................................... ............................................................................ ......................

Group practice .............. ...................................................................................................................................

Year of survey

EIE

Median

number of

patient visits

71

70

69

80

71

71

84

78

66

40

70

84

89

77

76

79

83

72

84

100

89

68

42

73

103

103

Change,

1970-74

+6

+6

+1 o

+3

+1

+13

+16

+11

+2

+2

+3

+19

+19

25
APPENDIXES

CONTENTS

I. Description of Survey Methodology ............................................................................................ ...

Background: 1974 Survey of Licensed Podiatrists ...................................................................

Data Collection .........................................................................................................................

Weighting Factors .....................................................................................................................

II. Definitions .....................................................................................................................................

III. Produditity as Related to Useof AuxWq Persomel, for Vtious Age Groups ............................

IV. Fa=imfies of Smey Questiomaires .......................................................................................... .....

1970 Survey Questionnaire .......................................................................................................

1974 Survey Questionnaire .......................................................................................................

LIST OF APPENDIX TABLES

L Number and percent distribution of the podiatric population surveyed, by type of response:

United States, 1974 .......................................................................................................... ...........

IL Dktribution by State of responding podiatrists and application of inflation factor: United States,

1974 ................................................................................................................................... ..........

III. Item nonresponse rates experienced in 1974 Survey of Licensed Podiatrists ........................ ..........

F/. Average number of patient visits per week, standard deviation, and number of podiatrists providing patient care, by number of full- and part-time assistants employed and age of podlatnst:

United States, 1974 .....................................................................................................................

V. Average number of patient visits per week, standard deviation, and number of podiatrists providing patient care, by number of full-time assistants employed and age of podiatrist: United

States, 1974 ....................................................................................................................... ..........

VI. Average number of patient visits per week, by age of podiatrist and assistants employed: United

States, 1974 .................................................................................................................................

27

27

27

27

30

32

36

36

40

27

28

29

33

34

35

26
APPENDIX I

DESCRIPTION OF SURVEY METHODOLOGY

Background: 1974 Survey

of Licensed Podiatrists

The 1974 Survey of Licensed Podiatrists was

conducted from October through December

1974 by NCHS in cooperation with the American Podiatry Association. Informatics, Inc., of

Rockville, Md., was responsible for the collection, editing, processing, and tabulating of data

obtained from the survey. A similar survey of

the Nation’s licensed podiatrists was conducted

by NCHS in 1970. Informatics developed,

tested, and implemented procedures to computer print onto the 1974 survey questionnaires

responses to five questions reported by the respondent during the previous 1970 Survey of

Podiatrists. Although all analyses in this report

stem from the data collected by the contractor,

all analyses were performed by the author.

A self-administered questionnaire was mailed

in autumn of 1974 to all licensed podiatrists in

the United States, The 1974 survey’s mailing list

was derived from the 1970 survey’s mailing list

with the addition of graduates of podiatry colleges between 1970 and 1973. This mailing list

was then updated by the deletion of podiatrists

kncswn to have died as well as any duplicate listings of podiatrists.

Data Collection

The initial mailing list consisted of 8,763

podiatrists. A total of 8,261 podiatrists remained after eliminating names of the deceased;

the duplicates discovered after mailing; and a

few potential subjects who were out of scope of

the survey because they were no longer licensed,

had left the United States, or had been mistakenly assumed to be podiatrists. A further

elimination of refusals, postmaster returns, and

other nonresponses reduced the usable universe

to 7,253 “good” responses (table I).

Weighting Factors

In order to duplicate the total universe of

podiatrists as it would have appeared had there

been no refusals, postmaster returns, or other

nonresponses, a weighting or “inflation” factor

was established for each State from the ratio of

total podiatrists in that State (excluding deceased and those out of scope of the survey) to

the number of usable (good) responses obtained

(see table II). Within each State the computerized record for each “good-response” podiatrist

received the same weight. When all the weighted

good-response records were cumulated, they

yielded after rounding, a weighted national

figure of 8,261 for total active and inactive podiatrists. In a similar manner, an estimate of 7,120

was derived for podiatrists who were active in

their profession in 1974. Of the 7,120 goodresponse podiatrists, 7,085 reported that they

Table 1. Number and percent distribution of the podiatric

population surveyed, by type of rasponse: United States,

1974

Percent

Type of response Number distribution

All podiatrists surveyed excluding

those deceased and out of scope... 8,261 100.0

Response ................................................... 7,253 87.8

Refusal ...................................................... 133 1.6

Postmaster return ...................................... 334 4.1

Nonrasponse .............................................. 541 6.5

27
Table 11. Distribution by State of responding podiatrists and application of inf Iation factor: United States, 1974

State

United States.............................................................................................................

Alabama ................................................................................................................................ ....

Alaska ................................................................................................................................ .......

Arizona ................................................................................................................................ .....

Arkansas................................................................................................................................. ...

California ................................................................................................................................ ..

Colorado ................................................................................................................................ ...

Connecticut ...............................................................................................................................

Delaware ...................................................................................................................................

District of Columbia ..................................................................................................................

Florida ......................................................................................................................................

Georgia........................................... ..........................................................................................

Hawaii .......................................................................................................................................

Illinois ................................................................................................................................ .......

Indiana ................................................................................................................................ ......

Kansas................................................................................................................................ .......

Kentucky ................................................................................................................................ ..

Louisiana................................................................................................................................ ...

Maine ................................................................................................................................ ........

Maryland ...................................................................................................................................

Massachusetts............................................................................................................................

Michigan ................................................................................................................................ ....

Minnesota ..................................................................................................................................

Mississippi................................................................................................................................ .

Missouri................................................................................................................................ .....

Montana ................................................................................................................................ ....

Nebraska ...................................................................................................................................

Nevada ................................................................................................................................ ......

New Hampshire .........................................................................................................................

New Jersey ................................................................................................................................

New Mexico ..............................................................................................................................

New York ..................................................................................................................................

North Carolina ..........................................................................................................................

North Dakota ............................................................. ...............................................................

Ohio ................................................................................................................................ ..........

Oklahoma ................................................................................................................................ ..

Oregon ......................................................................................................................................

Pennsylvania ..............................................................................................................................

Rhode Island ................................................................................................... ..........................

South Carolina ..........................................................................................................................

South Dakota ............................................................................................................................

Tennessee..................................................................................................................................

Texas ................................................................................................................................ .........

Utah ................................................................................................................................. .........

Vermont ....................................................................................................................................

Virginia ................................................................................................................................ .....

Washington................................................................................................................................

West Virginia .............................................................................................................................

Wisconsin. ................................................................................................................................ .

Wyoming ...................................................................................................................................

Number of

responding

podiatrists

7,253

20

1

74

21

815

67

181

19

42

331

69

5

17

583

140

87

48

63

35

19

120

380

289

78

9

85

13

39

16

26

365

24

1,159

54

5

489

45

42

668

53

14

14

41

205

32

7

81

74

41

140

8

Weighting

factor

1.14

1.35

3.00

1.05

1.05

1.14

.21

.11

.05

.29

.10

.17

.60

.06

.17

.06

.11

.08

.06

.14

.11

.18

.16

.11

.03

.22

,13

.08

Weighted

number of

podiatrists

8,261

27

3

78

22

929

81

201

20

54

364

81

8

18

662

148

97

52

67

40

21

142

441

321

80

;:

14

1.05 41

1.06 17

1.15 30

1.12 409

1.29 31

1.18 1,368

1.06 57

1.00 5

1.15 562

1.18 53

1.02 43

1.14 762

1.13 60

1.29 18

1.00 14

1.10 45

1.18 242

1.06 34

1.14 8

1.07 87

1.04 77

1.10 45

1.06 148

1.13 9

usually spent 1 hour or more a week in patient ently rounded and may not add to totals. Percare. This fi~re is the statistical base for the cents also have been inde~endentlv rounded and

tables and tie textual commentary that appear may not always add to 160.0. Per;ents and rates

in this report. were calculated on the basis of original, unNumbers in this report have been independ- rounded figures and will not necessarily agree

28
Table I I1. Item nonresponse rates experienced in 1974 Survey of Licensed Podiatrists

Question number and subject

1.

2.

3a.

3b.

4.

5.

6.

7.

8.

9.

10.

Ila.

Ilb.

12.

13a.

13b,

14.

15.

16a.

16b.

16c.

16d.

16e.

17a.

17b.

17C.

18a.

18b.

Year of birth ................................................................................................................

Sex .....................................................................................................................o...o....

School of graduation ...................................................................................................

Yeer of graduation .......................................................................................................

Race ............................................................................................................................

Origin or dascent .........................................................................................................

years active in podiatry ...............................................................................................

Numbar of weeks active in 1973 ..................................................................................

Current activity status .................................................................................................

Hours per week in all podiatric activities .................................................................m...

Usual activity in patient care .......................................................................................

Primary activity ...........................................................................................................

Secondary activity .......................................................................................................

Services usually provided .............................................................................................

Location of primary place of work ..............................................................................

Years at location of primary place of work ..................................................................

Principal form of employment ...................................................................................

Numbar and type of assistants.....................................................................................

Hours providing patient care last weak ........................................................................

Patients seen last week .................................................<..................................o............

Age of patients seen last week .....................................................................................

Patient visits last week .................................................................................................

Type of setting for patient visits last week .................................................................

Hospital residency program .........................................................................................

Clinic residency program .............................................................................................

Preceptorship program .................................................................................................

Hospital privileges........................................................................................................

Clinic privileges............................................................................................................

with the percents and rates calculated from

rounded data.

In order to compensate for partial nonresponse within the questionnaire, that is, leaving

individual items unanswered, a second type of

adjustment was applied to the data as received.

In such cases, omitted items were randomly

“o

Number of

respondents

to whom

question

applied

7,253

6,248

6,217

6,248

Number of

podiatrists

not

responding

2

1

4

7

114

876

155

18

.

152

—

14

35

38

9

26

7

346

29

87

43

81

34

95

118

132

70

323

Item

nonresponse

rate

(percent)

0.03

0.01

0.06

0.10

1.57

12.08

2.14

0.25

0.00

2.43

0.00

0.23

0.56

0.61

0.14

0.42

0.11

5.57

0.46

1.39

0.69

1.30

0.54

1.52

1.89

2.11

1.12

5.17

assigned the response obtained from respondents

with similar characteristics, and the total figure

for the item was adjusted to include this “impupation.” As may be seen in table III, the need

For this kind of adjustment was minimal. The

item nonresponse rate was less than 2 percent

for all except six items on the questionnaire.

00

29
APPENDIX II

DEFINITIONS

Age.–Age refers to the respondent’s age in

1970 and 1974. In all cases, age is calculated as

the difference between 1970 or 1974 and the

respondent’s year of birth.

Active and inactive podiatrists.– For the purposes of the 1974 Survey of Licensed Podiatrists, practitioners who spent 1 hour or more

each week in providing patient care or were en’-

gaged in another podiatric activity such as teaching and podiatric research were considered to be

active podiatrists. Also included in the group of

active podiatrists were practitioners who were

temporan”ly not active at the time of the survey

owing to short-term illness or injury, vacation,

and so forth. Inactive podiatrists were defined as

those practitioners who failed to meet the

criteria for either of the above categories (see

appendix IV, question 8 of 1974 questionnaire).

Principal form of employ ment.–Two general

categories of employment may be identified

from the survey data: self-employed and salaried. In addition, severzd specific types of

employment may be identified within each of

the two major categories.

A self-employed podiatrist may also be categorized according to one of the following types

of self-emplo yment:

A solo practitioner is a podiatrist working

with or without assistants but not in conjunction with another health professional

who can independently treat patients for

podiatric or nonpodiatric ailments.

A partnership practitioner is one of two or

more podiatrists who conjointly provide

podiatric services only.

A group practitioner is a podiatrist conjointly working with at least one person in

another health profession who can independently treat patients for nonpodiatric

ailments.

Salaried podiatrists could check 1 of 7

sources of their salary (see questionnaire). Because only a small number of podiatrists completed this section, for the purpose of this report

they were grouped together.

For explanatory notes regarding the various

principal types of employment, see question 14

of the 1974 questionnaire in appendix IV.

Geo~aphic area.–For the purpose of reporting the data yielded by the 1974 podiatry

survey, the United States (the 50 States and the

District of Columbia) is divided into the geographic regions and divisions used by the U.S.

Bureau of the Census and into 10 Standard

Federal Administrative Re@ons.

Geographic re~”on and

division States included

Northeast

New England ........... Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut

Middle Atlantic ........ New York, New Jersey, Pennsylvania

North Central

East North Central ... Ohio, Indiana, Illinois,

Michigan, Wisconsin

West North Central .. Minnesota, Iowa, Missouri, North Dakota,

South Dakota, Nebraska, Kansas

30
South

South Atlantic ......... Delaware. Marvland,

District of Col;mbia,

Virginia, West Virginia, North Carolina, South Carolina,

Georgia, Florida

East South Central..

West South Central .,

West

Mountain ................

Pacific .....................

Standard Federal

A dma’ru’stration

Reg”on with headquarters city

Kentucky, Tennessee,

Alabama, Mississippi

Arkansas, Louisiana,

Oklahoma, Texas

Montana, Idaho, Wyoming, Colorado,

New Mexico, Arizona,

Utah, Nevada

Washington, Oregon,

Alaska, California,

Hawaii

States included

Region I (Boston) .......Connecticut. Maine, Massachusetts, New Hampshire, Rhode Island, Vermont

Region II (New

York) .....................New York, New Jersey

Region III (Philadelphia) ..................District of Columbia, Delaware, Maryland, Pennsylvania, ,Virginia, West

Virginia

Region IV (Atlanta) ...Alabama. Florida, Georgia, Kentucky, Mississippi,

North Carolina, South

Carolina, Tennessee

Region V (Chicago) ....Illinois. Indiana, Minnesota, Michigan, Ohio, Wisconsin

Region VI (DallasFort Worth) ............Arkansas. Louisiana, New

Mexico, Oklahoma, Texas

Region VII (Kansas

City) .......................Iowa, Kansas, Missouri,

Nebraska

Region VIII (Denver) .........................blorado. Montana, North

Dakota, South Dakota,

Utah, Wyoming

Re@on IX (San Francisco) ......................Arizona. California, HaRegion X (Seattle)

waii, Nevada

......Alaska. Idaho,

Washington

Oregon,

000

31
PRODUCT

APPENDIX Ill

VITY AS RELATED TO USE OF AUXILIARY PERSONNEL,

FOR VARIOUS AGE GROUPS

Data from the 1974 Survey of Licensed

Podiatrists were subjected to special computer

runs in which the mean productivity of podiatrists of various age groups, employing varying

numbers of assistants,was calculated.

The following cell intervals were defined for

the two independent variables:

Age:

Under 35 years

35-44 years

45-54 years

55-64 years

65 years or over

Number of assistants:

None

One

Two

Three or more

For each cell, the dependent variable “mean

productivity” was defined as the average number

of patient visits conducted during the preceding

week by podiatrists with the specified cell

characteristics.

The results of these calculations are shown

in table IV for the case of full- and part-time

assistants combined, and in table V for full-time

assistants only. The cells in both tables contain

the following entries:

P = The mean productivity characteristic

of podiatrists within that cell.

OP= The standard deviation of P.

N= The number of podiatrists (nationwide)

included within each cell.

NOTE: A list of references follows the text.

Tables IV and V confirm that productivity

varied sharply with both the age of the podiatrist and the number of assistants employed.

Several additional features of these tables, however, are particularly noteworthy:

1.

2.

Despite the clearcut relevance of age,

categories of older podiatrists with a

given number of assistants are generally

seen to be more productive than podiatrists in up to 3 age categories younger

with just one assistantless. Several examples (see table VI), culled from table V,

serve to illustrate thk point. It would

appear, therefore, that age is not an insurmountable barrier to high productivity.

Given adequate demand, podiatrists

could, if they chose, close the productivity gap simply by hiring an additional

assistant.c

A second feature that warrants comment

is that productivity is highly variable,

cThis statement contains two important qualifiers:

“given adequate demand” and “if they chose.” The fiist

qualifier denotes simply that productivity can be pushed

no further than local demand will carry it. The second

qualifier implies that not all podiatrists (or other providers for that matter) are necessarily motivated to

match that demand. Certainly, among older practitioners, the economic incentive characteristic of younger

persons may be expected to have tapered off; this, perhaps more than anything else, may account for the drop

in productivity noted among self-employed podiatrists

starting at age 55, whereas those who are salaried are

seen to maintain high productivity through age 64.

32
Table IV. Avarage number of patient visits per waak, standard daviation, and number of podiatrists providing patient care, by numbar

of full-and part-time assistants employed and age of podiatrist: United States, 1974

Age of podiatrist and descriptive statistics

All ages combined:

P ........................................................................................................................

Up ,.,,.. ..............!.................................................................................................

N ........................................................................................................................

Under 35 years:

P ........................................................................................................................

‘P """"'"'`"""""""''"""""""`"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""

N ........................................................................................................................

3544 years:

P ...............................................................................................4........................

*P "'"""""""`"''""'""""""""""""''"""""""""""""""""""""""""""""""""""""'""""""""""'"""""""""""""""""""""""""""""""""""""""

N ........................................................................................................................

45-54 years:

P ...............................0........................................................................................

up ......................................................................................................................

N .........!...... ..........................................................................................!..... ........

55-64 years:

P ........................................................................................................................

‘P "'s""'`"""""''""""""""""'`""""""""""'`"'""""""""""""""'"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""

N ........!....,,. ,,.,.,,..,,,,.,, ........................................................................................

65 years or over:

P ........................................................................................................................

VP '.".""""""`"""""""""'"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""

N .................................................................................................................0...,..

1~nclu~e~ both ~~ijical and nonmedical assistants.

Number of assistants employed

o

50.7

36.3

1927

68.1

62.1

109

67.7

36.2

108

59.5

37.8

462

51.6

31.6

718

34.8

26.1

531

1

74.2

38.7

2,045

66.8

40.9

357

81.4

45.3

284

82.4

37.6

549

73.3

33.6

632

59.7

34.6

224

2

93.5

43.2

1,420

84.3

38.5

327

101.2

49.2

298

99.2

41.6

436

93.1

41.9

287

71.3

34.3

73

3 or more

123.3

68.4

1,692

115.4

66.1

503

128.0

60.8

466

132.2

57.1

450

119.6

71.6

230

86.0

54.5

42

All

podiatrists

combhecf

83.4

54.3

7,085

90.2

58.5

1,296

104,0

57.3

1,156

92.5

52.5

1,897

73.7

47.8

1,867

46.8

35.6

869

NOTES: P = mean number of patient visits per week.

– standard deviation of P, for podiatrists within the cell in question.

%=_number of podiatrists (nationwide) included within that cell.

Numbers may not add to totals due to rounding.

even among podiatrists of like character- especially true at the county level, since

istics. Of the 20 interior cells (i.e., those 96 percent of the counties that have

which do not display row or column

totals) in tabIe V ftiy half show standard

deviations greater than 50.d Standard

deviations this high hamper one’s ability

to make meaningful manpower projections for limited geographic areas. Thk is

‘Standard deviations based (as these are) on 1 week’s

data can be misleading, since an otherwise active podiatrist on vacation or attending a professional meeting

during the week in question will create the illusion of

higher variability than would be noted over an extended

period of time. There is no way of judging the magnitude of thisphenomenonbut its likelypresenceshould

be noted.

podi~trists at all, have less than 10 podiatrists. Since the precision of a sample

varies with the square root of the sample

size, it follows that given a standard

deviation of (say) 50 and a sample size of

9, the standard error of the resulting productivity estimate is

50

— = 16.7 visits per week.

<9

This means that for 85 percent of the

counties in the United States, any estimate of productivity based on the age

distribution of the podiatrists who prac33
--

Table V. Averaae number of ~atient visits Der week, standard deviation, and number of podiatrists providing patient care, by number of

full-time ass;stantsl employed and age of podiatrist: United States, 1974

Age of podiatrist and descriptive statistics

All ages combined:

P ........................................................................................................................

UP """""""""""""""""""""""""""'""""""""'"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""`"""`""""`""""""""

N ........................................................................................................................

Under 35 years:

P ........................................................................................................................

UP ......................................................................................................................

N ........................................................................................................................

35-44 years:

P ........................................................................................................................

up .....................................................................................................................%

N ........................................................................................................................

46-54 years:

P ........................................................................................................................

‘JP......................................................................................................................

N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years:

up."."".".."."`.".."""`.a..m.."`."" "..".".."`....""."..."""""..."""."``""'""...".""."".."."..'.""...'".."."""...""."""..

N ........................................................................................................................

6S yaars or over:

P ........................................................................................................................

N........................................................................................................................

1Includes both medical and rtonmedical assistants.

NOTES: P = mean number of patient visits per week.

u - standard deviation of P, for podiatrists within the cell in question.

#:number of podiatrists (nationwide) included within that cell.

Numbers may not add to totals due to rotmding.

dumber of full-time assistants employe(

o

64.2

43.4

3,660

75.8

51.4

453

85.8

51.7

412

73.5

43.8

920

60.3

35.8

1,169

38.6

27.3

707

1

89.4

45.2

1,766

84.9

50.9

401

99.2

53.2

313

94.3

39.4

509

83.8

38.0

434

76.9

40.6

108

2

109.3

48.5

888

99.4

46.9

214

118.5

54.1

215

114.3

46.8

263

105.9

43,7

167

89.0

33.3

29

3 or more

130.9

76.7

771

119.5

75.2

228

131.2

60.1

216

145.3

66.5

205

134.6

52.0

97

99.7

67.9

25

All

podiatrists

combined

83,4

54.3

7,085

90.2

58.5

1,296

104.0

57.3

1,156

92.5

52.5

1,897

73.7

47.8

1,867

46.8

35.9

869

tice in that county, and the number of

assistants they employ, is characterized

by a 2-standard deviation (95 percent)

confidence interval of at least k33 visits

per week, or about 1,500 per year. For

counties with less than 9 podiatrists, the

width of the confidence interval is correspondingly greater.

34
Table V1. Averaae number of visits Dar week. .,O bv age of podiatrist and assistants employed: United States, 1974

Example and age of podiatrist

Exampla I

Younger podiatrists with no full-time assistants:

Under 35 years ......................................... ................................................................................................... ............

35-44 years ................................................................................................................................................ ..............

45-54 years am.,.,...,,,.,,. ................................................................................................................................ ..............

Older podiatrists with one full-time assistant:

55.64 years ............................................................................................................................................ ..................

65 years or older ................................................................................................................................................ .....

Example 2

Younger podiatrists with one full-time assistant:

Under 35 years ,, .,,,,,,....,,. ........................................................................................................................................

35-44 years ...............................................................................................................$..............................................

45.54 years ..............................................................................................................................................................

Older podiatrists with two full-time assistants:

55-64 years ,,, ,,, ,,, ..,,.,, ....................................... ......................................................................................... ..............

65 years or oldar ............................................................................................................................................ .........

Example 3

Younger podiatrists with two full-time assistants:

Under 35 years ............................................................................................................................................ ............

35-44 years ............................................................................................................................................ ..................

45-54 years ............................................................................................................................................ ..................

Older podiatrists with three full-time assistants:

55-64 years ......................................... ................................................................................................... ..................

65 years or older ........................... ................................................................................................................. .........

Average number

of patient visits

per week

75.8

85.8

73.5

83.8

76.9

84.9

99.2

94.3

105.9

89.0

99.4

118.5

114.3

1121.7

1117.7

1These “Um hers ~i]l not be found in table v because the coiumn heading in that table pertains to three or more (rather than exactlY

thrtc) assistants. The numbers in question are derived from the original computer printout on which table V was based.

000

35
APPENDIX IV

FACSIMILES OF SURVEY QUESTIONNAIRES

1970 Survey Questionnaire

....”.?4... or

HEALTH, EDUCAT,ON, AND WELFARE

HCALT” SE*”,.,, ..0

MENTAL . . ...” .0!4(?4, s,,.,,.!4

N.’r, oNA. c,”,,. .=0. HCALTH STATISTIC,

CONFIDENTIAL: AN ,.lorm.ti.n whwh permits

the tdenziftc.tio. of the individ..l will be held

.Cricdy confid.mi.1, will be used solely by

P-... ..m.d i., and ..!Y for the PWP.SeS of

the swv.y .nd will not be disclosed ., cel..s.d

w other Person% o, for any other PLUF. OS,.

SURVEY OF PODIATRISTS

Form ADwo.cd HSM.353

Suds,, H“,,.. No. 68.S69W3 ,2-6,

Aww.v.l EXF.,,CSMatch >1, 1970

1. Is your nom. corr..t, and is ih. .ddross akve your PRIMARY PLACE OF PRACTICE?

, ❑ Yes

I

ZCINO

If no, please enter the correct i“fonnarion below

Name:

>,.s1 Af,ddle Last

Prim*cy pl.ce of pr.ctice:

himber street

~, w SI.1* Z,) Code

2. In what y..r w.,. you born? I’..,

3. Whcr* were you born?

stole 0. p,etgn Co”* fry

4. Ara you a citlzcn of the United States? (Please check appropriate L-ax)

t ❑ Yes, Native born

z ❑ Yes, Naturalized

a~No

5. S*K I I-J Male

a ❑ Female

6. A. From which COII*OC of podiatry did you graduate?

time. / co!letr

b

B. Wfmn did you Waduate?

Ye., gr.du.fcd

7. What d.grcos have you ●arned OTH ER THAN your dagr.* in podfotry? Kheck ~ch ~X thOf Gpplies)

~ Doctorate (Ph. D.. Ed. D.. etc.] u B.$helor’s m Other (Sp<CI{y : )

❑ Master’s ❑ Associate ❑ Non.

36
f,. f! which Stotss do you ew, wrtiy hold a lic~nso 10 practico padiatry?

9,

10.

11.

12.

13.

HOWmany years how you bcon active In podiatry? (Include patient care, teaching, reseorch, and administration.

Exclude years spent in non.podiatric activities or retirement.)

Number o/ years

Are you CURRENTLY ACTIVE in podiatry? (Include potient care, teaching, research, and administration)

10

i

Yes, Full-time an

I

No, Not active in podiatry but not retired

*“ Na, Retired

‘“Ge 4 ‘–

STOP I If you arc not currantly activ. in podiatry,

romoindw of questionnaire does not apply. Pleosa

return quostionnairo in tho wwelepo providod.

Which of the fallowlng categories best describes your PRINCIPAL form af ●mployment? (Check one) —

I ❑ Self-employed - Solo practice

z ❑ Self-emplayed - Partnership practice

s o Self. employed - Group practice

4 ❑ Emplayed by - Military

s ❑ Emplayed by - Federal government (rron.milihmy)

s (g Employed by - Stste or local government

7 ❑ Employed by - Non-government organization or institution

s R Employed by - Other podiatrist

o ❑ Other (S@ci/y: )

HOW many WEEKS were you active in podiatry during calendar year 1969?

(Include patient care, teoching, research, and administration. Do not count vacations os weeks worked. )

Weeks per year

APPROXIMATELY haw many hours per week do you usually spend in each of the following podiatric activities?

hrs. Patient care (Include o//ice work connected with the care of your patients)

bra. Teaching in a college of podiatry

bra. Podiatry research

bra, Administration (Podiatry associations. colIege administration, etc.)

bra. Other podiatric activity

,-, Total houre per week

14. DO you spend any hours per week in the category “Patient care” in question 130, above?

fo 1

Yes, 1 spend same hours z ❑

\

No, I spend g hours

in patient care. in patient care.

m STOP I If no hours ars spent in patient coro,

~ndor of questionnaire doss not apply. Ploaso r*-

turn questionnaire In tho wrwlopo providod.

37
15. ‘When providing pctient care, which of the services below are rendered to your patients by you or under your direction?

(Check all that apply)

❑ Palliative services

❑ Hospital surgery

❑ Office surgery

❑ Prescription of &ugs

❑ Physical therapy treatment

❑ Orthopedic services

❑ Whirlpool baths

❑ Fitting of special shoes

❑ X-ray services

❑ Ultrasonic treatment

❑ Diathermy

❑ Low-voltage trearment

❑ Ultra-violet lamp treatment

❑ Other (Speci/y: )

16. In your principal form of ●mployment, do you emplay office assistants ather then podiatrists to assist you? (Include

receptionists, secretaries, technical assistants, nurses, etc. )

P/ease irrdicrrte the NUMBER of fu//-time ond port- time office ossistorrts emp/eyed by you,

a. Number of FULL-TIME assistants —

(3s hours or more per ueek)

b. Number of PART-TIME assistants _

(Less than .?5 hours per ueek)

17. During your hours spent in patient care, what do you cansidcr ta be

A. PRIMARY activity: (Check one)

t ❑ General practice

2 D Surgery

s u Podogeriatrics

4 ❑ Podopediatrics

s u Podiatric dermatology

e ❑ Roentgenology

7 ❑ Foot orthopedics

IJ CI Other (Speci/y: )

18. In your PODIATRY PRACTICE,

———

1

2

3

4

5

6

7

8

9

your PRIMARY, and your SECONDARY activity?

B. SECONDARY activity: (Check one)

❑ General practice

❑ Surgery

❑ Podogeriarrics

❑ Podopediatrics

❑ Podiatric dermatology

u Roentgenology

❑ Foot orthopedics

❑ Orher (Speci/y )

❑ None

how many hours did you spend in patient care LAST week?
19. APPROXIMATELY how mony PATIENT VISITS did you have LAST w-k? (Include office visits and visits in

other settings.)

Approximate number of visl ts last week

20. APPROXIMATELY hew many different PATIENTS daes this represent? (Patients with multiple visits should be

cm.mted only once.)

Appmm”mate number of patients last week

A. Of these PATIENTS, what is the APPROXIMATE NUMBER in the following age rsnd sex categories?

MALE PATIENTS FE.MALE PATIENTS

LAST WEEK: LAST WEEK:

Number 16 years old or under:

Number from 17 to 64 years old:

Number 65 years old or over:

B, Of these PATIENTS, what is the APPROXIMATE NUMBER treated in the following settings?

Number in private office

Number in hospital (Inp(lflcnt)

Number in hospital (OI1t/r(/f/c77f)

Number in clinic ( ,YfJt (ls.sr]ctc{tcd I( It}> (I hIJspitcI[)

Number in nursing home ( IIOWC,for tht,cigI.,/, (f(m)! c III CirY, C.IC. )

Number in patient’s home

Number in other setting ( \pc~.//y: 1

COMMENTS - General comments are invited os well as camments on specific items:

1

PLEASE RETl)i2t4 QljESTloN)JAIF/E IN “rHE f+TAMp~D ENVELOpE ~ROvlDED. j

——. .—.—.-— —.. —--- ..- - .—c —... ______

39
1974 Survey Questionnaire

,

DEPARTMENT DF HEALTH, EDUCATION, ANO WELFARE

I

HRA-T2 PUBLIC HEALTH SERvlcE O.M.B. NO: 6SS-731213

REV. 1.74

HEALTH RESOURCES ADM1N1STRATION APPROVAL EXPIRES DECEMBER 31, 1974

NATIONAL CENTER FOR HEALTH STATISTICS

5600 Fshers Lane Rcckw!!e, Maryland 20852

IN COLLABORATION WITH

❑UREAU OF HEALTH RESOURCES DEVELOPMENT

1974 SURVEY OF PERSONS TRAINED [N PODIATRIC MEDICINE

r 1 Dats W.

Please correct your name and!or madmg address

as appropriate

completsd I

ttis questionnaire I

!

INSTRUCTIONS FOR QUESTIONS 1, 2, and 3. If the 1970 responses are incorrect or blank, I

please provide the correct information under the “correct response” column.

1970 RESPONSE CORRECT RESPONSE

1. Year of birth 2. Sex 1. Year of birth 2. Sex

❑ MALE ❑ FEMALE ❑ MALE u FEMALE

3. From which SCHOOLOF PODIATRY and in what YEAR 3. From which SCHOOLOF PODIATRYand in what YEAR

did you graduate? did you graduate?

School School

1 Stats or foreign country I State orforeign.countW I

Year graduated Year graduated

4. Color or Race (Check one box only)

I

1 ❑ WHITE 2 ❑ NEGRO OR BLACK 3 ❑ INOIAN (AMER.) ‘ESKIMO/ALEUT

4 ❑ CHINESE/JAPANESE 5 ❑ FILIPiNO~HAWAllAN, KOREAN 6 ❑ OTI-IERRACE (sPcci/Y: —————_)

5. Is your origin or descent fckk me box OdY)

1/J MEXICAN OR CHICANO 2 ❑ PUERTO RICAN OR BORICUA 3 ❑ CUBAN

4 ❑ CENTRAL OR SOUTH AMERICAN 5 ❑ OTHER SPANISH 6 G NO, NONE OF THESE

6. Years active in rsodiatw (ROUND TO NEAREST YEAR)

(Podiatric activiti& inclu~e: patient care, teaching podiatric related course(s), pod[atric research, program or institution adminlstratiol?,

residency, in podiatric training after receiving podiatric degree, and other podiatric related activities. Include ttme on vacatton from pod.

atric activities.)

7. During the year 1973, how many WEEKS were you in each of the following categories?

ACTIVE IN PODIATRY

_ WEEKS ACTIVE IN POOIATRY (Includes weeks in which 1 or more hours were spent in any

of the following patient care, teaching podlatrlc related course(s), podmtric m.

search, program 01 institution administration, residency, m pod!atnc traning, and

WHERE

other podlatnc related actwities)

_ WEEKS ON VACATION, MOVING, OR TEMPORARILY INACTIVE FOR OTHER REASON(S)

NONE, NOT ACTIVE IN PODIATRY

WRITE _ WEEKS RETIREO FROM POOIATRY ANO/’OR ACTIVE IN ANOTHER OCCUPATION

o _ WEEKS ILL OR INJURED

(ZERO) _ WEEKS UNEMPLOYED. LOOKING FOR WORK

— WEEKS OTHER REASON(S) (srmi~y : J

52 WEEKS = TOTAL WEEKS IN 1973

8. Are you CURRENTLY ACTIVE IN PODIATRY? (Check .ms box only)

1 ❑ 1 yES. CURRENTLYSPENO 1 OR MORE HOURS PER WEEK 3 D 1 No, CURRENTLY RETIREO FROM PODIATRY

1

IN ANY OF THE FOLLOWING PATlENT CARE, TEACHING

POOIATRIC RELATEO COURSE, POOIATRIC RESEARCH,

PROGRAM OR INSTITUTION AOMINISTRATION, RESIOENCY,

IN PODIATRIC TRAINING, OR OTHER POOIATRIC RELATED

ACTIVITY.

2H YES, BUT CURRENTLY ON VACATION, HAVE SHORT.TERM

ILLNESS OR INJURY, MOVING OR TEMPORARILY INACTIVE

FOR OTHER REASON(S)

PLEASE CONTINUE

4D

/

NO, NOT RETIREO FROM POOIATRY, ACTIVE IN

ANOTHER OCCUPATION

5D

(.Spocij} OCCUPATION: )

NO, HAVE OISABLING ILLNFSS OR INJURY

6D NO, UNEMPLOYED, LOOKING FOR WORK

7D NO, OTHER REASON(S) FOR CURRENT INACTIVITY

fSp-ci/j REASON(S): )

STOP! If you are not currsntly active in podiatry, remainder of

questionnaire doea not apply. Please return this queationneirs in

the prapaid return envelops provided. Thsnk you for your psr’ticipation.

40
9. How many HOURS PER WEEK do you USUALLY spend in each of the following podiatric activities?

HRS. PATIENT CARE (Include also residencyand administrative work related to patient

care regardless of the setting.)

HRS. TEACHING FODIATRIC RELATED COURSE(S)

WHERE HRS. PODIATRIC RESEARCH

NONE,

HRS. PROGRAM OR INSTITUTION ADMINISTRATION (Associations, licensing boards, schools, hospitals, etc.)

WRITE

HRS. OTHER PODIATRIC ACTIVITIES (e.g., training received after podiatric degree, etc.)

o

(ZERO) (Speci\y:

HRS. = TOTAL PER WEEK USUALLY SPENT IN ALL poDIATR IC ACTIVITIES

10. Did you report in question 9 above that you USUALLY spend 1 OR MORE HOURS PER WEEK IN PATIENT CARE?

In

,1

YES, I USUALLY SPEND 1 OR MORE 20

,1

NO. I DO NOT USUALLY SPEND ANY

HOURS PER WEEK IN PATIENT CARE HOURS PER WEEK IN PATlENT CARE

PLEASECONTINUE I

SKIP TO QUESTION16s,

INSTRUCTIONS FOR QUESTION 11. If the 1970 data do not reflect your current primary or

secondary activity, mark the box under the “Current Activity” column that applies now.

11. During your hours spent in patient care, what do you consider to be your PR IMARY and your SECONDARY ACTIVITY?

197ccw~ARY

1 ❑ GENERAL PRACTICE 10 In

2 ❑ SURGERY 2U 2n

3 ❑ FOOT ORTHOPEDICS, OR 3D 3D

BIOMECHANICS

4 ❑ PODOGERIATRICS 4D 4D

5 ❑ OTHER ACTIVITY 5U 5D

6D

1970A; f~Ot#ARY “ CURREPJ&:;~ONDARY

NO SECONDARY ACTIVllY In

SURGERY 2D

FOOT ORTHOPEDICS, OR 3D

BIOMECHANICS

PODOGERIATRICS 4U

GENERAL PRACTICE 5D

OTHER ACTIVITY 60

I INSTRUCTIONS FOR QUESTION 12, I

IF: a) 197Q data do not reflect all services you currently provide or,

b) Since 1970 you have stopped providing a service previously indicated,

THEN: Mark ALL BOXES under the “Current Services” columns that indicate

all services you provide now.

12, When providing patient care, which of the services below are usuallv rendered by you or under your direction?

1970

SERVICES

❑ PALLIATIVE SERVICES

❑ HOSPITAL SURGERY

❑ OFFICE SURGERY

❑ PRESCRIPTION OF DRUGS

❑ PHYSICAL THERAPY TREATMENT

~ CIRTHOPEOIC OR BIOMECHANICS

❑ WHIRLPOOL TREATMENT

EEl

CURRENT

SERVICES

1970

SERVICES

❑ FllTING SPECIAL SHOES

❑ X-RAY SERVICES

❑ ULTRASONIC HEAT

❑ DIATHERMY HEAT

❑ LOW-VOLTAGE TREATMENT

❑ ULTRAVIOLET LAMP TREATMENT

❑ OTHER SERVICE(S)

CURRENT

SERVICES

PLEASE GO TO PAGE 3 ON THE REVERSE OF THIS PAGE.

J

41
13a. Where is your primary place of podiatric practice or employment located?

STATE COUNTY CITY. TOWN. UNINCORPORATED OR RURAL AREA ZIP CODE

13b. For how many YEARS have You been active in podiatry in the locations You specified in item 13a above?

YEARS ACTIVE IN STATE fSpcriJicd dorr)

EEzl

YEARS ACTIVE IN COUNTY fSprci/icd Arrc)

YEARS ACTIVE IN CITY, TOWN, UNINCORPORATED OR RURAL AREA /Spccilirrf (thrrr)

14. Which category below best describes your current PRINCIPAL FORM OF PODIATRIC EMPLOYMENT?

SELF.EMPLOYED; (Check only mw . . . the one usually

•1

SOLO PRACTICE worked most hours per tceek)

Partnership Practice (Partnership includes two or more podiatrists

conjointly providing podiatric services only)

NUMBER OF PODIATRISTS IN

PARTNERSHIP, INCLUDING YOURSELF

GROUP PRACTICE (Group includes at least one podiatrist conjointly

working with at least one person in another

health profession, who can independently

J

NUMBER OF PODIATRISTS IN

treat patients for nonpodiatric ailments) GROUP, INCLUDING YOURSELF

Number of other health professionals in above

group who can independently treat patients WHERE

GENERAL OR FAMILY PRACTICE (M.D. or D.O.) . . . . . . NONE,

ORTHOPEDIC SURGEON (M.D. or D.O.) . . . . . . . .

WRITE

INTERNAL MEDICINE (M.D. or D.O.) . . . . . . . .

OTHER HEALTH PROFESSIONALS (Speci/y: . . 0

).. (ZERO)

---------- ------------------------------------------------------------------------------------------------------------- -------

EMPLOYEE OF:

❑ FEDERAL GOVERNMENT (Nonmilitary, includes V.A. hospitals, and Public Health Service, etc.)

❑ MILITARY SERVICE (ARMED SERVICES personnel only)

fJ STATE OR LOCAL GOVERNMENT (Includes clinics, health departments, hospitals, ,nursing homes, schools, etc.)

❑ PREPAID GROUP HEALTH PLAN

lJ NON PREPAID GROUP HEALTH PLAN

U NONGOVERNMENTAL ORGANIZATION OR INSTITUTION (Includes private hospitals, clinics, nursing homes, schools, etc.)

I_J OTHER PODIATRIST

. . . . . . ..- . . --------- ------- ------------------------------------ -------------------------------------------------- . . . . . . . . . . . . .

OTHER FORM OF EMPLOYMENT:

jJ fSpeci/fi )

15. Indicate the NUMBER and TYPE OF ASSISTANTS whose services you use in your PRINCIPAL FORM OF EMPLOYMENT —

EXCLUDE persons who can independently treat patients — INCLUDE assistants who are temporarily absent due to illness,

injury, training, or vacation, etc.

REPORT NUMBER NOT SHARED by you with any other person

WHERE NONE, WRITE () (ZERO)

SHARED by You with 1 or more persons

who can Independently treat patients who can independently treat patients

MEDICAL OCCUPATIONS USUALLY WORK USUALLY WORK USUALLY WORK USUALLY WORK

(Includes persons trained as follows even if 1 TO 34 HOURS 35 HOURS OR 1 TO 34 HOURS 35 HOURS OR

they are spending some time performing nofr- PER WEEK MORE PER WEEK PER WEEK MORE PER WEEK

medical functions) (Part Time) (Full Time) (Part Time) (Full Time)

PODIATRY ASSISTANTS

(Trained formally or on-the-job)

REGISTERED NURSES

OTHER MEDICAL OCCUPATIONS

(Speci/y: .—— — .—— — ——— — ——— —

) —.— — —.— — —— _— —_— —

NON.MEDICAL OCCUPATIONS

(includes receptionists, secretaries, typists,

clerical., and other assistants who

perform only non-medical functions.

42
16a, How many HOURS did you spend providing PATlENT CARE LAST WEEK?

(Inclttde also re$idency and administrative work related to pment care regardless o/ the setting)

NUMBER OF HOURS (If none, write O (ZERO) and skip question 17)

16b. How many DIFFERENT PATIENTS did YOU 16c. What PERCENTAGES of all the DIFFERENT PATIENTS seen by you LAST

see LAST WEEK, regardless of the setting? WEEK were in the AGE categories specified?

Count each “DIFFERENT PATIENT” only once, regardless of the

number of times seen or the setting.

NUMBER OF DIFFERENT PATIENTS WHERE % PERCENTAGE 16 YRS. OR LESS

(If none, write O (ZERO)) NONE, % PERCENTAGE 17 TO 64 YRS.

WRITE

o

% PERCENTAGE 65 YRS. OR MORE

(ZERO) Iooyo ‘ALL DIFFERENT PATIENTS SEEN LAST WEEK

16d. Of the patients seen by you LAST WEEK, I

16e. What PERCENTAGES of your PATlENT VISITS LAST WEEK were in each

how many PATlENT VISITS do these of the SETTINGS specified?

represent?

The number of “PATlENT VISITS” is the total number of times

you saw patients last week. Include each separate patient visit,

even if the same patient was seen more than once.

NUMBER OF PATlENT VISITS % PERCENTAGE IN PRIVATE OFFICE

(If none, write O (ZERO)) % PERCENTAGE IN HOSPITAL, INPATIENT

WHERE ‘% PERCENTAGE IN HOSPITAL, OUTPATIENT

NONE, % PERCENTAGE IN. CLINIC (Nonhospital clinic)

WRITE 0~ PERCENTAGE’IN NURSING HOME (Home for the aged, extended

o

care facility, domiclhary, rest home, convalescent home, etc.)

(ZERO)

% PERCENTAGE IN RESIDENT FACILITY OR SCHOOL FOR THE

HANDICAPPED

% PERCENTAGE IN PATIENT’S HOME

% PERCENTAGE IN OTHER SETTING(S)

100% = ALL PATlENT VISITS LAST WEEK

17. Are you currently in a: YES

n

1) HOSPITAL RESIDENCY PROGRAM? 10 2N;

2) CLINIC RESIDENCY PROGRAM? 10 2D

3) PRECEPTORSHIP PROGRAM? In 2D

18. Do you currently hawx

YES NO

m

1) HOSPITAL PRIVILEGES? lD 2D

2) CLINIC PRIVILEGES? lo 2D

Comments and Suggestion=

HRA.T2 (PAGE 4)

REV. 1.74 Thank you for your participation. Please return this completed

questionnaire using the prepaid return envelopa provided.

43
VITAL AND HEALTH STATISTICS Series

S,’ri(x 1. Pro~vams and Collection Procedures. –Reports which describe the general programs of the National

Cemtcr for Health Statistics and its offices and divisions and data collection methods used and include

definitions and other material necessary for understanding the data.

St4rirs 2, Data Evaluation and Methods Research. –Studies of new statistical methodology including experimental tests of new survey methods, studies of vital statistics collection methods, new analytical

techniques, objective evaluations of reliability of collected data, and contributions to statistical theory.

Siv%’s 3. Analytical Studies. –Reports presenting analytical or interpretive studies based on vital and heaIth

statistics, carrying the analysis further than the expository types of reports in the other series.

Series 4. Documents and Committee Reports. –Final reports of major committees concerned with vital and

health statistics and documents such as recommended model vital registration laws and revised birth

and death certificates.

Si’rim 10. Data From the Health Interview Survey. —Statistics on illness, accidental injuries, disability, use of

hospital, medical, dental, and other services, and other health-related topics, all based on data collected

in u continuing national household interview survey.

S,rit,.t 11. Data From the Health Examination Survey and the Health and Nutrition Examination Survey .–Data

from direct examination, testing, and measurement of national samples of the civilian noninstituticm.dized population provide the basis for two types of reports: (1) estimates of the medically defined

prevalence of specific diseases in the United States and the distributions of the population with respect

to physical, physiological, and psychological characteristics and (2) analysis of relationships among the

various measurements without reference to an explicit finite universe of persons.

SIYi(x 12. Data From the Institutionalized Population Survey s.–Discontinued effective 1975. Future reports from

these surveys will be in Series 13.

S(”rim 13. Data on Health Resources Utilization. –Statistics on the utilization of health manpower and facilities

providing long-term care, ambulatory care, hospital care, and family planning services.

Smit w 14. Data o n Health Resources: Manpower and Facilities. –Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other health

occupations, hospitals, nursing homes, and outpatient facilities.

Smies 20. Data on Mortality. –Various statistics on mortality other than as included in regular annual or monthly

reports. Special analyses by cause of death, age, and other demographic variables; geographic and time

series analyses; and statistics on characteristics of deaths not available from the vital records based on

sample surveys of those records.

Series 21. Data on Natality, Marriage, and Divorce. –Various statistics on natality, marriage, and divorce other

than as included in regular annual or monthly reports. Special analyses by demographic variables;

geographic and time series analyses; studies of fertility; and statistics on characteristics of births not

wm.ilable from the vital records based on sample surveys of those records.

Series 22. Data Fro m the National Mortality and Natality Surveys. —Discon tinued ef feet ive 1975. Future reports

from these sample surveys based on vital records will be included in Series 20 and 21, respectively.

Srrim 23. Data From the National Survey of Family Growth. –Statistics on fertility, family formation and dissolution, family planning, and related maternal and infant health topics derived from a biennial survey

of a nationwide probability sample of ever-married women 15-44 years of age.

For a list of titles of reports published in these series, write to: Scientific and Technical Information Branch

National Center for Health Statistics

Public Health Service

Hyattsville, Md. 20782
. I

For publications in tbc

Vital and Health Statistics

Series call 301-H6-NCHS. I

II