Diplomacy in foot and ankle surgery, a systematic review of divisive literature within the field.

Foot and ankle pathology is most often managed by orthopedic surgeons and podiatric surgeons. Over time, podiatric surgery has been privy to literature criticizing its influence on patient outcomes, hospital systems, and the orthopedic community. To better understand where this literature is coming from, the authors performed a literature search through PubMed, Google Scholar, and Cochrane Database using the following search terms: "surgeon type, podiatric surgeon, orthopedic surgeon, foot and ankle, podiatry, and doctors of podiatric medicine." Included studies were assessed for study characteristics and outcomes. Article categories included: journal, year of publication, level of evidence, degree of primary author, presence of a podiatric surgeon (DPM) on author panel, discussion of training discrepancies, and outcome variable utilized. We identified seventeen thousand two hundred twenty-nine articles through our search method. Seventeen studies met inclusion and exclusion criteria. Reviewers were blinded to authorship and asked to state whether or not training discrepancies were mentioned in the papers between DPM and orthopedic surgery. Eight (47 %) studies were found to discuss training discrepancies. Seven (87.5 %) of these articles discussing training discrepancy were found to be primarily authored by orthopedic surgeons. The authors concluded that, published articles which question professional work of a differing medical degree tends to support the degree of the primary author. More attention is needed to create a collaborative interprofessional relationship among these two societies. A stronger podiatric surgery research effort is necessary to support its influence on the community, hospitals, and surgical literature. Level of Evidence: Level 4.