WWW.IBISWORLD.

COM Podiatrists in the USAugust 2016 1

Step by step: Despite competition, the aging

population will provide a larger customer base
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IBISWorld Industry Report 62139a

Podiatrists in the US
August 2016 Kelsey Oliver

2 About this Industry 17 International Trade 29 Key Statistics

2 Industry Definition
2 Main Activities
2 Similar Industries
3 Additional Resources
4 Industry at a Glance
5 Industry Performance
5 Executive Summary
5 Key External Drivers
7 Current Performance
10 Industry Outlook
12 Industry Life Cycle
14 Products & Markets
14 Supply Chains
14 Products & Services
15 Demand Determinants
16 Major Markets
18 Business Locations 29 Industry Data
29 Annual Change
20 Competitive Landscape 29 Key Ratios
20 Market Share Concentration 30 Industry Financial Ratios
20 Key Success Factors
20 Cost Structure Benchmarks 31 Jargon & Glossary
22 Basis of Competition
22 Barriers to Entry
23 Industry Globalization
24 Major Companies
25 Operating Conditions
25 Capital Intensity
26 Technology & Systems
26 Revenue Volatility
27 Regulation & Policy
28 Industry Assistance

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WWW.IBISWORLD.COM Podiatrists in the USAugust 2016 2

About this Industry

Industry Definition This industry includes establishments of
health practitioners who have the degree
of DPM (Doctor of Podiatric Medicine)
and are primarily engaged in the
independent practice of podiatry. These
practitioners diagnose and treat diseases
and deformities of the foot and operate
private or group practices in their own
offices or in the facilities of others, such
as hospitals or other medical centers.

Main Activities The primary activities of this industry are

Operating doctors of podiatry (DPs) offices (e.g. centers and clinics)
Operating foot specialist (podiatry) offices (e.g. centers and clinics)
Operating podopediatrician offices (e.g. centers and clinics)

The major products and services in this industry are

Circulatory system diseases
Endocrine, nutritional and metabolic diseases
Infectious and parasitic diseases
Merchandise sales
Musculoskeletal system and connective tissue diseases
Nervous system and sense organ diseases
Skin and subcutaneous tissue diseases
Other

Similar Industries 62111a Primary Care Doctors in the US

Primary care doctor practices are based on a broad understanding of all illnesses. Many individuals with foot
ailments visit their primary care doctor prior to a podiatrist.

62111b Specialist Doctors in the US

Specialist doctors include all medical doctors except doctors of family and general medicine and doctors of
podiatry

62131 Chiropractors in the US

Chiropractors are primarily engaged in diagnosing and treating patients based upon the concept that the
nervous system coordinates all of the bodys functions.

62139b Alternative Healthcare Providers in the US

Alternative healthcare includes meditation, yoga and massage, among other services.

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WWW.IBISWORLD.COM Podiatrists in the USAugust 2016 3

About this Industry

Additional Resources For additional information on this industry

www.aacpm.org
American Association of Colleges of Podiatric Medicine
www.apma.org
American Podiatric Medical Association
www.census.gov
US Census Bureau

IBISWorld writes over 700 US

industry reports, which are updated
up to four times a year. To see all
reports, go towww.ibisworld.com

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WWW.IBISWORLD.COM Podiatrists in the US August 2016 4

Industry at a Glance
Podiatrists in 2016

Key Statistics Revenue Annual Growth 11-16 Annual Growth 16-21

Snapshot
$5.4bn 1.9% 3.9%
Profit Wages Businesses

$817.1m $1.9bn 12,092

Revenue vs. employment growth Federal funding for medicare and medicaid
Market Share
There are no major 6 16
players in this 12
4
industry
8
2
% change

% change
4
0
0
-2 -4

-4 -8
Year 08 10 12 14 16 18 20 22 Year 10 12 14 16 18 20 22
Revenue Employment
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p. 24
Products and services segmentation (2016)
2.6%
Key External Drivers Nervous system and
sense organ diseases
Federal funding for 5.2% 5.1%
Medicare and Medicaid Merchandise sales Circulatory system diseases

Total health expenditure 7.1%

Endocrine, nutritional
Median age of population
Number of physician visits
and metabolic diseases
37.4%
Musculoskeletal system
7.7% and connective tissue diseases
Per capita disposable Infectious and
parasitic diseases
income

14.6%
Other

p. 5 20.3%
Skin and subcutaneous
tissue diseases SOURCE:
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Industry Structure Life Cycle Stage Mature Regulation Level Heavy

Revenue Volatility Low Technology Change Medium
Capital Intensity Low Barriers to Entry Low
Industry Assistance Low Industry Globalization Low
Concentration Level Low Competition Level High

FOR ADDITIONAL STATISTICS AND TIME SERIES SEE THE APPENDIX ON PAGE 29

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Industry Performance
Executive Summary | Key External Drivers | Current Performance
Industry Outlook | Life Cycle Stage
Executive Over the past five years, the Podiatrists
Summary industry stepped in the right direction
thanks to the aging population and the
rising prevalence of diabetes, which has
caused more individuals to require foot
care. Furthermore, about 75.0% of
Americans have experienced foot health
problems, according to the Illinois
Podiatric Medical Association (IPMA),
which has stimulated demand for
podiatry services. Additionally, many
healthcare insurance providers have
recognized how vital preventive podiatry
care is to lower diabetic patients
Healthcareinsurance providers recognized
how vital preventive podiatry care is to lower
diabetic patients healthcare costs
healthcare costs. For example, according
to the latest study by the American
Podiatric Medical Association and
Thomson Reuters, podiatrists that treat
diabetic patients can save the US
healthcare system billions of dollars
annually due to providing preventive care
and thus limiting diabetic individuals
foot-related ailments. For instance,
diabetic individuals may have peripheral
arterial disease (PAD), which lowers
blood flow to the feet, as well as nerve
disease, which lowers patients sensation
in their feet.
Key External Drivers Federal funding for Medicare
and Medicaid
Medicare is the second-largest payer for
industry services. Federal funding of
Medicare, coupled with the federally
determined terms of access to these
programs, affects demand for podiatry
services and the prices charged for these
services. If coverage increases for
Medicare, more beneficiaries will likely
visit podiatrists. Federal funding for
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Podiatrists in the USAugust 2016 5
Due to these diabetes-related ailments,
which increase a diabetic patients risk to
have a diabetic foot ulcer (DFU), the
patient may receive an amputation.
Nevertheless, much of these healthcare
costs can be mitigated by diabetic
patients visiting podiatrists and
implementing foot care regimens.
However, podiatrists still compete with
general practitioners for patients. This
trend is evidenced by an IPMA survey,
which has indicated that podiatrists
provide treatment for 82.0% of total
patients that have corn and callus
problems, toenail problems (65.0%),
bunions (63.0%), flat feet or fallen arches
(46.0%) and toe or joint deformities
(43.0%). Nevertheless, over the five years
to 2016, industry revenue is anticipated
to grow at an annualized rate of 1.9% to
$5.4 billion, including 4.5% revenue
growth in 2016. Profit is anticipated to
increase from 14.0% of industry revenue
in 2011 to 15.4% in 2016, as many
podiatrists join larger group practices or
partnerships, thus bolstering profitability.
In the five years to 2021, industry
revenue is forecast to grow at an
annualized rate of 3.9% to $6.5 billion.
While Americans have typically
overlooked feet as an essential
component in health and well-being, this
trend is expected to change in line with
more healthcare providers stressing
preventive care, including podiatry.
Medicare and Medicaid is expected to
increase in 2016.
Total health expenditure
Total health expenditure is driven by the
aging domestic population, rising
spending on healthcare per person and
the Patient Protection and Affordable
Care Act (PPACA). Consequently, with
increasing health expenditure and
expanded coverage for patients, demand
WWW.IBISWORLD.COM Podiatrists in the USAugust 2016 6

Industry Performance

Key External Drivers for podiatrists is likely to increase.
continued Health expenditure is expected to
increase in 2016.
Median age of population
As people age, they are more likely to
develop physical conditions that
podiatrists can treat, including arthritis
and diabetes. Consequently, as the
median age of the population rises, the
market for podiatrist services is likely to
increase. The median age of the
population is expected to slowly grow in
2016, representing an opportunity for
the industry.
Number of physician visits
Podiatrists struggle to compete against
primary care physicians for foot ailments.
As the number of physician visits
increases, competition from this source
will increase even further. With more
accessible healthcare due to the
Affordable Care Act, the number of
physician visits is expected to increase in
2016, representing a potential threat to
the industry.
Per capita disposable income
Out-of-pocket payments make up a
significant portion of revenue for the
industry. Any increase in household
disposable income will generally make
podiatry services more affordable and
increase the likelihood of people having
private health insurance. Per capita
disposable income is expected to increase
over 2016.

Federal funding for Medicare and Medicaid Total health expenditure

16 7

12
6
8
% change

% change

4 5

0
4
-4

-8 3
Year 10 12 14 16 18 20 22 Year 09 11 13 15 17 19 21

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WWW.IBISWORLD.COM
Industry Performance
Current Over the past five years, the Podiatrists
industry has put its best foot forward. The
Performance burgeoning elderly population, coupled
with the rising prevalence of diabetes, has
stimulated demand for podiatry services
to address foot-related ailments, thus
bolstering industry revenue. Nevertheless,
the industry has contended with high
competition from primary care
physicians, which has hampered industry
revenue as many patients have visited
physicians to amend their foot conditions
rather than podiatrists.
However, the industry has benefited
from the estimated 75.0% of Americans
that have experienced foot health
problems, according to the Illinois
Podiatric Medical Association, which has
spurred demand for industry services. In
the five years to 2016, industry revenue is
expected to grow at an annualized rate of
1.9% to $5.4 billion, including a 4.5% rise
Diabetes and As chronic disease has become more
demographics prevalent, demand for podiatry services
has increased. For example, leg- and
foot-related ailments are the most
common symptoms for diabetic
individuals to be hospitalized, with
diabetes being a leading cause for
patients to receive amputation in the
lower leg and foot. However, regular
podiatrist visits, which include
examinations and vascular testing, are an
integral component in diagnosing
inadequate blood flow in patients legs
and feet. Diabetes has grown rapidly in
the United States, with the disease
afflicting an estimated 29.1 million US
adults or 9.3% of the population in 2012,
Gaining a foothold Despite favorable demographic shifts in
the past five years, podiatrists, similar to
other alternative healthcare service
providers like chiropractors and
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Podiatrists in the USAugust 2016 7
Industry revenue
6
4
2
% change
0
-2
-4
Year 08 10 12 14 16 18 20 22
SOURCE: WWW.IBISWORLD.COM
in 2016. Profit is anticipated to increase
from 14.0% of industry revenue in 2011
to 15.4% in 2016 due to many podiatrists
forming group practices or partnerships
rather than solo practices, which enables
them to share fixed costs.
which has grown from 25.8 million
diabetic individuals in 2010, according to
the latest data available from the Centers
for Disease Control and Prevention.
The incidence of foot pathology in
diabetes is significant. A disproportionate
share of the morbidity and mortality
from foot complications is particularly
prevalent among some patient
demographics, such as the elderly,
African Americans, American Indians
and Hispanics. Furthermore, as the
burgeoning elderly population has
implemented an increasingly active
lifestyle, demand for foot and ankle care
has increased due to this demographic
being highly prone to injury.
optometrists, have been fighting to
establish themselves in the medical
community. Medicare, Medicaid and
private health insurance do not cover
WWW.IBISWORLD.COM
Industry Performance
Gaining a foothold routine foot care to the same degree that
continued coverage is provided for visiting a
primary care physician. As a result,
podiatry services depend more on
patients out-of-pocket expenditures
compared with other medical care.
Despite podiatrists generating about
14.0% of their revenue from patients
out-of-pocket expenditures, private
insurers still account for the largest share
of industry revenue, with about 41.6%. As
healthcare reform has expanded the
number of insured individuals, this has
had mixed effects on the industry. On one
hand, the Patient Protection and
Affordable Care Act excludes podiatry
from its essential health benefits,
meaning that states can decide whether
or not to include podiatry in their
essential benefits for Medicaid recipients.
In total, eight states exclude podiatry
under Medicaid services. At the same
time, some insurers have expanded their
podiatry coverage to lower costs by
bolstering their preventive care coverage,
such as covering diabetic patients visits
to the podiatrist to lower the incidence of
foot ulcers.
Additionally, a considerable
percentage of those seeking foot care visit
a general physician rather than, or prior
Consolidation and Due to rising competition, coupled
with relatively low patient awareness
wages
of the merits of podiatry, the industry
has moved away from solo practices.
While solo practices still account for
the majority of podiatrist practices,
with an estimated 49.0% according to
the Podiatric Economics survey, many
practices have formed larger, group
practices. In particular, many
podiatrists have joined multi-specialty
groups, such as orthopedic groups,
diabetes treatment groups and multi-
specialty orthopedic surgical groups.
As a result, the number of industry
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Podiatrists in the USAugust 2016 8
to, a podiatrist, which has curbed
industry revenue growth. Nevertheless,
according to the Illinois Podiatric
Medical Association (IPMA), podiatric
physicians are less likely to use high-cost,
inpatient services, compared with other
physicians, which has stimulated
consumer demand for industry services.
In response to high competition from
general practitioners, the Podiatrists
industry has made efforts to garner
greater visibility. For example, many
podiatrists have formed joint group
practices, rather than individually owned
practices, to have the resources necessary
to invest in marketing. Additionally,
podiatrists have worked to generate
patient awareness pertaining to the
importance of foot care in overall health
and wellness by working with lobby
groups and medical associations. Still,
many foot issues remain unknown to
potential patients. For example,
according to the IPMA, an estimated
5.0% of the US population visits their
podiatrist each year, with 82.0% of total
corn and callus problems being
addressed by podiatrists, followed by
toenail problems (65.0%), bunions
(63.0%), flat feet or fallen arches (46.0%)
and toe or joint deformities (43.0%).
Dueto rising competition,
the industry has moved
away from solo practices
enterprises is expected to grow at an
annualized rate of 0.7% to 12,092 in
the five years to 2016, in line with
larger, multi-specialty groups
collaborating with solo practices to
provide more in-house services. In the
same period, wages are anticipated to
slightly increase at an annualized 2.1%
to $1.9 billion.
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Industry Performance
Consolidation and Further exacerbating the movement
wages continued toward joint podiatry practices,
managed care organizations seek
doctors that can provide services in a
timely manner, which is easier to
provide in a multi-specialty, group
setting. Also, according to data from the
US Department of Labor, podiatrists
that practice in groups earn
substantially more than those practicing
alone. This is owing to increased
marketing expenditure capacity that can
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Podiatrists in the USAugust 2016 9
result in greater outreach and,
consequently, greater patient expansion
and establishment growth, according to
the Podiatric Economics Survey. Joint
practices can also include doctors with
different specialties, so that any specific
foot or ankle issue can be treated
accordingly. Furthermore, the advent of
new technologies, such as electronic
health records, has positioned joint
practices favorably to spread this
operational cost among several doctors.
WWW.IBISWORLD.COM
Industry Performance
Industry Over the next five years, the Podiatrists
industry will stand on its own two feet,
Outlook benefiting from the rising incidence of
diabetes bolstering patient volumes.
Nevertheless, while the aging population,
coupled with the high prevalence of
foot-related health ailments, will provide a
larger customer base for the industry, this
trend will be offset by rising competition
from primary care physicians. Further
exacerbating this trend, many patients will
still be unaware of the role that foot care
places in their wellness and overall health.
In response to relatively low visibility,
Vision 2015, established by the American
Podiatric Medical Association (APMA), has
created a plan to achieve recognition of
podiatrists as physicians. For example, the
association is working with podiatrists to
collect the data necessary to prove the
industrys comparability to the allopathic
and osteopathic communities. The APMA
Demographic trends Over the next five years, the incidence of
may lead to shortages diabetes is expected to continue an upward
trend. As a result, more diabetic individuals
will require podiatrists to address their
foot-related ailments. For example,
according to the American Podiatric
Medical Association (APMA), an estimated
15.0% of diabetic patients have foot ulcers,
which are open sores or wounds, with 6.0%
of these individuals requiring
hospitalization due to infection or ulcer-
related complications. As a result, many
diabetic patients will require podiatrists to
provide treatment and establish foot care
regimens. Furthermore, the burgeoning
elderly population, which typically suffers
from foot conditions pertaining to dry skin,
fallen arches and varicose veins, will also
stimulate demand for industry services.
Patient demand for industry services is
expected to rise significantly. According to
data from the National Center for Health
Workforce Analysis, which operates under
the US Department of Health and Human
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Podiatrists in the USAugust 2016 10
also focuses on legislative issues on state
and federal levels, such as the recently
introduced the Helping Ensure Life- and
Limb-Saving Access to Podiatric Physicians
(HELLP) Act, which, in addition to
recognizing podiatrists as physicians under
Medicaid, also seeks to strengthen state
podiatric care programs such as the
Diabetic Shoe Program. In the five years to
2021, industry revenue is forecast to grow
at an annualized rate of 3.9% to $6.5
billion. Profit is expected to rise from 15.4%
of industry revenue in 2016 to 16.7% in
2021, which can be attributed to many
podiatrists forming large, group practices
to enhance their specialized service
offering. As a result, larger group practices
will enable podiatrists to negotiate with
managed care organizations to be included
in their provider network. Industry-
relevant revenue is expected to grow 3.1%
over 2017.
Overthe next five years,
the incidence of diabetes
is expected to continue an
upward trend
Services, demand for podiatrists is
projected to grow 22.2% from 2012 to
2025. At the same time, the number of
podiatrists will likely exceed demand.
According to the APMA, the number of
podiatry graduates has exceeded the
number of residency positions. In
response, the APMA has urged podiatrists
to demonstrate the importance of podiatry
to hospitals and other healthcare
organizations. In addition, the APMA is
lobbying to remove the cap on graduate
medical education (GME) funding for
residency programs, which would enable
more podiatry graduates to obtain
residency positions.
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Industry Performance
Healthcare reform The Patient Protection and Affordable
Care Act of 2010 is expected to continue
affecting the Podiatrists industry in a
multitude of ways. According to data
from the Kaiser Family Foundation,
Medicaid covers podiatry services in
most states, with only eight states
excluding podiatry coverage from their
Medicaid funding. Some states limit
Medicaid beneficiaries for podiatry
services to individuals that suffer from
systemic conditions, including diabetes.
Additionally, Medicare provides
beneficiaries with medically necessary
and reasonable foot care, which
excludes treatment of flat foot, routine
foot care and supportive foot devices.
Nevertheless, the industry will benefit
from more individuals having
healthcare insurance.
For example, private health insurance
is the main method of payment for
industry services, making up 41.6% of
industry revenue, and is anticipated to
comprise a larger market share over the
next five years. Subsidies will continue to
help those with low incomes gain
coverage, while the rise in the number of
insured will bolster demand. Patients
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Podiatrists in the USAugust 2016 11
Private
health insurance
is the main method of
payment for industry
services
who deferred treatment for their foot and
ankle conditions due to high out-of-
pocket expenses will be able obtain
treatment under their insurance plan.
Over the next five years, the industry
will continue to move toward larger,
group podiatry practices. Larger
podiatry practices will have more
resources to allocate for marketing
expenditures and negotiating with
managed care organizations to be
included in their provider network. In
the five years to 2021, the number of
podiatry enterprises is expected to
increase at an annualized rate of 1.6% to
13,116, in line with more group and solo
practices emerging. Over the same
period, employment is anticipated to
grow at an annualized rate of 2.9% to
51,561 due to more multispecialty
podiatrists entering the market.
WWW.IBISWORLD.COM Podiatrists in the USAugust 2016 12

Industry Performance
Life Cycle Stage The value that the industry adds to the economy
is growing at a similar rate as GDP, however
this can be attributed to consolidation
The aging population and rising incidence
of diabetes is boosting demand
Consolidation efforts are helping support profitability

20 Maturity Quality Growth

% Growth in share of economy

Key Features of a Mature Industry

Company High growth in economic
consolidation; importance; weaker companies Revenue grows at same pace as economy
level of economic close down; developed Company numbers stabilize; M&A stage
importance stable technology and markets Established technology & processes
Total market acceptance of product & brand
15 Rationalization of low margin products & brands

10

Quantity Growth
Many new companies;
minor growth in economic
importance; substantial
5 technology change

Brand Name Pharmaceutical Manufacturing

Primary Care Doctors
Hospitals
0 Specialist Doctors
Podiatrists

Health & Medical Insurance

-5 Decline
Shrinking economic
importance

-10
-10 -5 0 5 10 15 20
% Growth in number of establishments
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Industry Performance
Industry Life Cycle The Podiatrists industry is in the mature
stage of its life cycle. Over the 10 years
to 2021, industry value added, which
Thisindustry measures the industrys contribution to
is M
 ature the overall economy, is expected to grow
at an annualized rate of 3.4%.
Comparatively, GDP is expected to
increase at an annualized rate of 2.1%
during the 10-year period. The industry
is growing at a slower pace, compared
with the overall economy, which is
indicative of an industry in the mature
life cycle stage.
Furthermore, the industry is moving
toward larger, group practices to realize
the cost saving benefits of operating with
other podiatrists or healthcare providers.
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Podiatrists in the USAugust 2016 13
Also, more podiatrists are offering
specialized services, such as foot care for
diabetic patients, which has indicated the
industrys maturation in line with more
podiatrists attempting to differentiate
their product portfolio. In addition, the
industry will benefit from the aging US
population and the growing number of
diabetic individuals. Improving
awareness of podiatry services will
stimulate demand for industry services,
as more individuals are aware of the
importance of foot care for their health
and well-being. However, the industry
lacks new technological innovation,
which is indicative of an industry in the
mature life cycle stage.
WWW.IBISWORLD.COM Podiatrists in the USAugust 2016 14

Products & Markets

Supply Chain | Products & Services | Demand Determinants
Major Markets | International Trade | Business Locations

Supply Chain KEY BUYING INDUSTRIES

52411b Health & Medical Insurance in the US
Insurers can include coverage for podiatry.
62111a Primary Care Doctors in the US
Doctors are a source of referrals to podiatrists.
62111b Specialist Doctors in the US
Doctors are a source of referrals to podiatrists.
62211 Hospitals in the US
Hospitals can be a source of referral. They may also engage podiatrists on a contractual basis.
9901 Consumers in the US
Podiatrists treat individuals, although sometimes other payers can limit individuals choice of
practitioner.

KEY SELLING INDUSTRIES

32541a Brand Name Pharmaceutical Manufacturing in the US
This industry supplies pharmaceuticals to podiatrists.
32541b Generic Pharmaceutical Manufacturing in the US
This industry supplies pharmaceuticals to podiatrists.
33911a Medical Instrument & Supply Manufacturing in the US
This industry supplies treatment tables and other treatment and diagnostic equipment.

Products & Services Products and services segmentation (2016)

2.6%
Nervous system and
sense organ diseases
5.1%
7.1% Circulatory system diseases
Endocrine, nutritional
and metabolic diseases 5.2%
Merchandise sales

7.7%
Infectious and parasitic diseases
37.4%
Musculoskeletal system
and connective tissue diseases
14.6%
Other

20.3%
Skin and subcutaneous
Total $5.4bn tissue diseases
SOURCE: WWW.IBISWORLD.COM

Musculoskeletal system and necessitating care from podiatrists.

connective tissue diseases
In 2016, musculoskeletal system and
connective tissue diseases make up an
estimated 37.4% of total revenue.
Patients that have musculoskeletal
system diseases may have arthritis, or
may be more prone to fractures, thus
Overall, this segment refers to patients
that have disorders of bone density and
structure (e.g. osteoporosis), joint
disorders (i.e. other disorders not related
to bone density and structure issues), soft
tissue disorders and disorders pertaining
to the synovium (the tissue between the

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WWW.IBISWORLD.COM
Products & Markets
Products & Services joint capsule and cavity of synovial
continued joints) and tendon.
However, providing treatment related
to musculoskeletal system and connective
tissue diseases is subject to significant
competition from orthopedic surgeons,
due to orthopedic physicians being
specialized in the diagnosis, treatment,
rehabilitation and prevention of
musculoskeletal system diseases. Still,
this market segment is expected to have
grown over the past five years.
Skin and subcutaneous tissue diseases
Skin and subcutaneous tissue diseases
comprise about 20.3% of total revenue.
This market segment typically refers to
patients that have infections of the skin
and subcutaneous tissue or diseases of
the skin appendage. Additionally, foot
ulcers are included in this product
segment. Diabetic patients have a fairly
high prevalence of foot ulcers, which
spurs demand for care from podiatrists.
Overall, patients may have foot ulcers
due to neuropathic (the loss of sensation
in the feet), arterial (limited blood flow
circulation), venous (compromised veins)
and decubitus reasons (ulcers which
occur due to long-term pressure, which
may occur due to patients being on bed
rest). Over the past five years, the rising
diabetic population has bolstered
demand for this product segment.
Infectious and parasitic diseases
Infectious and parasitic diseases generate
about 7.7% of total revenue. This product
segment primarily includes Athletes foot
and other fungal infections. Some
patients may not be proactive about
Demand Demand for podiatry services is
Determinants influenced by the age profile of the
population; the rates of obesity and
diabetes in the population; public
awareness of the nature and benefits of
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Podiatrists in the USAugust 2016 15
receiving care from podiatrists for
infectious and parasitic diseases,
constraining demand for this product
segment. However, as the prevalence of
diabetics and patients with chronic
conditions (which results in these
patients having weakened immune
systems, thus making them more prone
to infections) rises over the next five
years, demand for podiatry services will
also rise from patients that have
infectious and parasitic diseases.
Endocrine, nutritional and
metabolic diseases
Endocrine, nutritional and metabolic
diseases account for about 7.1% of total
revenue. This product segment includes
providing routine, preventive care to
diabetics. Moreover, vitamin
deficiencies, which are included in the
nutritional diseases category, may result
in foot issues. For example, patients that
have calcium deficiencies may have
stress fractures more frequently.
Overall, this market segment is expected
to remain stable.
Circulatory system diseases
Circulatory system diseases are expected
to make up 5.1% of total revenue.
Patients that have hypertension and
coronary artery disease, among other
circulatory system diseases, may require
podiatry services. For example,
individuals that have Raynauds disease,
which causes some areas of the body to
have limited blood circulation, may
require podiatry services. Over the past
five years, this product segment is
expected to have remained stable.
industry services; and the out-of-pocket
cost and affordability of services. An
increasing percentage of the US
population is likely to suffer from chronic
health conditions (and their concurrent
WWW.IBISWORLD.COM
Products & Markets
Demand complications) due to both an aging of
Determinants the population and more sedentary
lifestyle choices. Obese individuals are at
continued
risk of long-term foot, leg, back and other
chronic health problems, including type 2
diabetes and high blood pressure.
Additionally, obesity can put extra
pressure on the joints in the foot, leading
to problems in foot alignment. Diabetic
individuals have many health ailments,
including damaged blood vessels and
nerves, reduced blood flow to the feet,
lowered foot sensation and increased risk
of developing foot ulcers and infection.
Public awareness of the nature and
benefits of the services this industry
offers can affect demand for those
services. There is already significant
awareness of podiatry in the community.
The American Podiatric Associations
Consumer Survey found that about
90.0% of respondents were aware what
part of the body podiatrists specialized
in, which increased in line with
respondents age (almost all respondents
aged 51 to 60 knew what podiatrists did).
Health insurance can reduce the direct
cost of services to patients and boost
overall demand. Government health
Major Markets Private insurers
Private insurers make up the largest
share of revenue, with an estimated
41.6% of total revenue. Over the past five
years, healthcare reform has incited
many previously uninsured individuals to
purchase coverage, thus spurring
demand for various healthcare services,
including podiatry. As a result, this
market segment has grown over the past
five years.
Medicare and Medicaid reimbursements
In 2016, Medicare and Medicaid
reimbursements comprise about 36.1%
of total revenue. Over the past five
years, the number of individuals aged
Provided to: OHIONET (212223369) | 16 March 2017
Podiatrists in the USAugust 2016 16
policy (including the level of government
funding) can also affect the price for and
quality of services. People with higher
incomes tend to spend more on
healthcare, and they are more likely to
have private health insurance.
According to the American Podiatric
Association, people with foot ailments
choose from a number of service
providers to address their ailments
(including podiatrists, primary
physicians, orthopedists and
dermatologists), utilize over-the-counter
products or do nothing. Respondents to
the survey were asked what they did
most to address their foot ailments, and
they indicated that purchasing over-the-
counter medications was their main
course of action (accounting for 28.0%
of female respondents and 36.0% of
male respondents), followed by doing
nothing (27.0% of female respondents
and 23.0% of male respondents),
followed by seeing a podiatrist
(accounting for 25.0% of female
respondents and 24.0% of male
respondents), followed by seeing a
primary physician (12.0% of female and
male respondents).
65 and older with diabetes has
increased, with about 25.9% of
individuals in this age demographic
having diabetes, according to data from
the Center for Disease Control and
Prevention (CDC). Due to many of
these individuals also being eligible for
Medicare, this trend has been a key
driver for podiatry care over the five-
year period. Moreover, healthcare
reform has stressed preventive care,
including emphasizing how diabetic
patients should take preventive care to
prevent diabetic foot ulcers. As a result,
podiatrists have seen an uptick in
Medicare patients, thus causing this
market segment to grow.
WWW.IBISWORLD.COM Podiatrists in the USAugust 2016 17

Products & Markets

Major Markets Major market segmentation (2016)

continued
0.3%
Contributions, 0.7%
gifts and grants Investment and 1.0%
property income Other nonpatient
14.6% care revenue
Patients' out-of-pocket payments 5.7%
Other patient care revenue

41.6%
Private insurers
36.1%
Medicare and
Medicaid reimbursements

Total $5.4bn SOURCE: WWW.IBISWORLD.COM

Patients out-of-pocket payments patients demand for industry services

Patients out-of-pocket payments
generate about 14.6% of total revenue.
According to data from Podiatry
Managements Podiatry Economics
survey, the increase in patient cost
sharing initiatives (i.e. patients incur
higher deductibles or out-of-pocket costs)
has limited some patients ability to incur
higher out-of-pocket costs. Moreover,
according to the survey, many podiatry
procedures increased their prices for
particular services in 2014, curbing some
financed via out-of-pocket payments.
Other patient care revenue
Other patient care revenue accounts for
5.7% of total revenue. This market
segment includes ancillary patient-care
related revenue, such as revenue from
selling medical equipment and other
goods to patients. Overall, this market
segment is characterized by cost sharing
payments, such as payments made via
out-of-pocket and reimbursements.

International Trade This industry primarily services the intervention, generally focus on
domestic US market. Industry services, rehabilitation and do not treat life-
which involve a high level of manual threatening illnesses.

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 WWW.IBISWORLD.COM Podiatrists in the USAugust 2016 18

Products & Markets

Business Locations 2016

West
AK
0.3 New
England
ME
Mid- 0.5

Great Atlantic 1 2
Lakes NY 3
WA MT ND 8.6
5 4
4.2 0.1 MN
Rocky
0.5 1.3
WI
OR Mountains SD
0.2
Plains 1.3 MI
2.5
PA
3.6
7
6

2.5 ID IA OH 9 8
0.6 WY 3.0
0.2
NE
0.7
IL IN WV VA
4.2 1.6 1.8

West NV
0.5 0.3
KY
UT MO
1.1 NC
0.8
1.2 CO KS 1.4 2.1
3.6 0.9 TN
SC
Southeast
1.7
CA 0.9
10.8
OK AR GA
1.0 0.6 AL 2.6
AZ MS 0.8
2.8 NM
0.8 Southwest 0.8

TX LA
1.2 FL
6.2 10.3

West
HI
0.3 Additional States (as marked on map) Establishments (%)

1 VT 2 NH 3 MA 4 RI Less than 3%
0.2 0.4 1.8 0.4 3% to less than 10%
10% to less than 20%
5 CT 6 NJ 7 DE 8 MD 9 DC
1.1 3.2 0.2 1.9 0.2
20% or more

SOURCE: WWW.IBISWORLD.COM

Provided to: OHIONET (212223369) | 16 March 2017

WWW.IBISWORLD.COM
Products & Markets
Business Locations The location of the nations podiatry
schools plays a role in the state in which
podiatrists choose to practice. More
relevant to practice growth, however, is
the location of prospective patients.
While overall population numbers from
the US Census Bureau put the top three
states for industry practices among the
most populated in the United States, the
states with the highest number of
residents age 65 and older (a targeted
patient group) are California, Florida,
New York, Texas and Pennsylvania. The
distribution of industry establishments
reflects this metric. California, New York
and Texas account for 10.8%, 8.6% and
6.2% of industry establishments,
respectively. Further illustrating this
connection is Florida, which according to
the US Census Bureau is the state with
the highest percentage of the population
age 65 and older. Florida accounts for
10.3% of industry establishments. Of
additional importance to practice growth
is the changing makeup of the patient
base. For instance, the percentage of the
US population that is Hispanic or Latino
(of any race) has been increasing during
the past five years. New Mexico,
California, Texas and Arizona have the
highest percentage of Hispanics of all
states, and this proportion is expected
to grow over the next five years. To
continue to attract patients for whom
English is a second language, especially
in the states mentioned, practitioners
can hire bilingual staff members and
use such items as bilingual forms,
brochures and reception room videos.
Also, understanding cultural
differences will help practitioners
attract and keep these patients.
Industry services are utilized more in
large capital cities, and podiatrists largely
practice in these areas. According to the
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Podiatrists in the USAugust 2016 19
Distribution of establishments vs. population
30
20
%
10
0
West
Great Lakes
Mid-Atlantic
New England
Plains
Rocky Mountains
Southeast
Southwest
Establishments
Population
SOURCE: WWW.IBISWORLD.COM
2016 Podiatry Managements Podiatric
Economics survey, about 26.0% of
podiatrists surveyed were located in a
metropolis (i.e. cities with a population
greater than 500,000), compared with
27.0% locating in a large city (i.e. cities
with a population from 100,000 to
500,000), 31.0% locating in a small city
(i.e. cities with a population from 25,000
to 100,000) and 16.0% locating in a rural
area (i.e. cities with a population less
than 25,000). Small cities have been
luring more podiatrists in during the past
five years. These cities provide a major
infrastructure and adequate population
density to support practices; yet, they
often offer lower crime rates and business
costs compared to more densely
populated cities. In some areas, small
cities are newer, so small businesses will
find updated construction and high-tech
office amenities. In older areas, small
cities are getting infrastructure facelifts
to improve their image and attract new
residents and businesses.
WWW.IBISWORLD.COM
Competitive Landscape
Market Share Concentration | Key Success Factors | Cost Structure Benchmarks
Basis of Competition | Barriers to Entry | Industry Globalization
Market Share The Podiatrist industry has a low level of
Concentration market share concentration. In 2016,
each podiatry practice is expected to
account for less than 5.0% of total
Level
revenue. Several small establishments,
Concentration in particularly solo or self-employed
this industry is L ow podiatry practices, which account for the
largest share of industry practices,
characterize the industry. Nevertheless,
over the next five years, as more
Key Success Factors Development of a symbiotic
relationship with another industry
Association or co-location with a
IBISWorld identifies physician, sports clinic or paramedical
250 Key Success group can increase referrals to podiatrists.
Factors for a
business. The most Having a good reputation
Establishing a reputation for consistent
important for this
and sound results with the patient
industry are: community and with local physicians
and allied health professionals can
increase demand.
Proximity to key markets
Practitioners should locate in areas that
are close to other healthcare practitioners
Cost Structure Profit
Benchmarks In 2016, profit, measured as earnings
before taxes and interest, is expected to
account for 15.4% of industry revenue.
According to data from Podiatry
Managements Podiatric Economics
survey, solo, self-employed podiatry
practices have become less common over
the past five years, whereas group
practices have become more pronounced.
Thus, industry profitability grew in line
with this trend, as group practices tend to
be more profitable.
Wages
Wages are the largest expense category for
the industry. Podiatry practices are labor
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Podiatrists in the US August 2016 20
podiatrists join group partnerships or
practices, the industrys market share
concentration is expected to rise. As more
podiatrists have either single- or multi-
specialty practices, some podiatry
practices will be able to provide more
varied expertise. As a result, these larger
practices will likely develop a strong
customer base, thus securing a larger
share of total industry revenue.
in order to gain more referrals of
patients. In addition, podiatrists should
locate in proximity to large populations
of patients.
Effective product promotion
Industry operators must work to increase
awareness of the importance of foot care
in order to attract patients.
Ensuring pricing policy is appropriate
A significant portion of payments are
made out of pocket, so setting fees at a
level which maximizes profitability
while remaining attractive to customers
is essential.
intense and depend on personal interaction
with patients in order to achieve success.
Podiatrists are also compensated well.
According to the latest annual Podiatric
Economics survey by Podiatry
Management, solo practitioners generated
$227,500 on average in gross income.
However, the average industry wage is
lower due to part-tie office staff and
receptionists. Podiatrists in partnerships
tend to earn higher incomes than those in
solo practices, due to partnership practices
being able to expand their service offering
and provide more expertise, which may
increases their number of patients.
For employer firms, principals and
directors of these firms may receive
WWW.IBISWORLD.COM Podiatrists in the US August 2016 21

Competitive Landscape

Cost Structure remuneration in ways other than
Benchmarks through the receipt of payroll, such as
through profit distributions or
continued
dividends. A large percentage of firms
in this industry comprise sole
practitioners and partner practitioners
who may receive payment in the form
of profit distributions (i.e. nonpayroll-
related income).
Purchases
Purchases, which include medical
supplies, make up about 9.3% of total
revenue. Podiatrists may dispense
over-the-counter pharmaceuticals to
patients, as well as administer bandages,
adhesives and splints. In addition,
podiatrists may have to purchase
disposable medical supplies, non-medical
supplies, plaster and other commodities
to create individually tailored casts to
make orthotics.
Other
Other major expenses of employer firms
include rent and lease payments, the cost
of utilities and communications services,
cleaning and office maintenance
expenses, the cost of advertising and
promotion, depreciation and
amortization, insurance costs (e.g.
malpractice insurance) and taxes and
license fees. Also, professional dues, such
as membership with the American
Podiatric Medical Association and the
American Academy of Podiatric Practice
Management, are included as well.
Additionally, many podiatrists have
educational expenses related to keeping
up with their clinical education.

Sector vs. Industry Costs

Average Costs of
all Industries in Industry Costs
sector (2016) (2016)
100 n Profit
11.7 15.2 n Wages
n Purchases
80 n Depreciation
n Marketing
n Rent & Utilities
41.1 35.7 n Other
Percentage of revenue

60

9.3
40 14.4 1.5 1.4
3.2 7.3
4.4 0.5
20

24.1 29.6

0
SOURCE: WWW.IBISWORLD.COM

Provided to: OHIONET (212223369) | 16 March 2017

WWW.IBISWORLD.COM
Competitive Landscape
Basis of Competition Internal competition
The Podiatry industry has a high level of
Level & Trend competition. Podiatrists typically
compete on the basis of price and service
 ompetition
C in this differentiation. They seek to differentiate
industry is H
 ighand their services from competitors (usually
the trend is S teady within their area of specialization) in
order to attract and retain customers and
to obtain a price premium for services.
Podiatrists in private practice can
differentiate their services by developing
rapport with patients to create customer
loyalty and referrals, and by conveying a
professional approach to win referrals. A
reputation for quality care and favorable
results among both the general
community and the medical community
(who may refer patients) can be
important. Specialization may elevate
perceptions of quality and provide some
competitive advantages.
Marketing decisions and activities can
promote competitiveness. Some areas of
importance include the location of the
Barriers to Entry The Podiatrists industry is characterized
by low barriers to entry. According to
Level & Trend Podiatry Managements Podiatric
Economics survey, about 37.0% of
 arriers to Entry
B podiatry practices surveyed were solo
in this industry are practices, with an additional 12.0% of
Lowand I ncreasing practices operating as solo practices
under a corporation. While the number
of group practices are growing, which
adds to barriers to entry for industry
entrants, about 49.0% of podiatrists
operate as solo practices, keeping
barriers to entry relatively low.
Furthermore, podiatrists do not have
to make significant investments in
medical equipment. Potential industry
entrants can also lease equipment and
buildings, which lowers their capital
outlay. Over the past five years, many
single - and multi-specialty practices
have emerged, which will enable
potential industry entrants to lower their
Provided to: OHIONET (212223369) | 16 March 2017
Podiatrists in the US August 2016 22
practice, effective advertising and other
media campaigns that generate awareness
in the local press and in publications (such
as publications for the elderly),
involvement in the local community (such
as in sporting clubs and clubs that cater to
elderly individuals) and presentations to
local organizations (such as local health
and medical practitioners). Co-locating
practices with other health and medical
practitioners may improve opportunities
and may increase awareness.
External competition
While patients typically have need-based
demand for podiatry services, which
limits the extent of external competition,
the industry is still prone to external
competitors. For example, patients with
foot-related ailments may purchase
industry products from pharmacies, such
as foot and ankle braces, or over-the-
counter products to self-treat fungal
infections and warts.
Barriers to Entry checklist
Competition High
Concentration Low
Life Cycle Stage Mature
Capital Intensity Low
Technology Change Medium
Regulation & Policy Heavy
Industry Assistance Low
SOURCE: WWW.IBISWORLD.COM
operational costs by spreading fixed costs
across numerous podiatrists.
Nevertheless, a major barrier to entry
includes the length of training required
to practice. Podiatrists need a state
license that requires the completion of at
least 90 semester hours of undergraduate
study, the completion of a four-year
program at a college of podiatric
medicine, and, in most states, a
WWW.IBISWORLD.COM
Competitive Landscape
Barriers to Entry postdoctoral residency program which is
continued typically two and three years in duration.
However, some states, like Ohio, Hawaii
and Pennsylvania have lenient
regulations and merely require
podiatrists to pass national board and
state exams. The availability of colleges
or training in a particular area, as well as
intake levels at training institutions, can
also represent barrier to potential
industry entrants.
There are some economies of scale
available in this industry, and new solo
practices may be at some cost
disadvantage. For example, group
podiatry practices can offer a team of
podiatrists to provide different areas of
Industry There is no known offshore investment in
Globalization this industry, either within the United
States by overseas-based firms or outside
Level & Trend the United States by US-based firms. The
importance of professionalism and
 lobalization
G in this
industry is L owand
the trend is S  teady
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Podiatrists in the US August 2016 23
expertise, which diversifies a teams
product portfolio. They can contract
rates with insurance companies under a
single tax identification number (and
these rates can be over 10.0% higher
compared to rates that solo practitioners
obtain). Group practices are more likely
to afford and adopt state-of-the-art
computer systems with an electronic
medical record system integrated into
the billing system. In addition, larger
practices are more likely to employ
more administrative and management
staff, resulting in practitioners having
more time and energy to devote to
patient care, thus enhancing the level of
patient satisfaction.
motivation of practitioners, together with
the need for practitioners to quickly
generate rapport with clients, makes it
difficult to build a large practice,
particularly across international borders.
WWW.IBISWORLD.COM
Major Companies
There are no Major Players in this industry | Other Companies
Other Companies Podiatrist offices are mainly small
establishments, with fewer than four
employees on average. Most podiatrists
operate as solo practitioners. However,
more podiatrists are entering partnerships
with other podiatrists and other health
practitioners, according to the US Bureau
of Labor Statistics. An increasing
percentage of employer establishments in
this industry are corporations. The main
reasons for incorporation of a practice are
asset protection, tax considerations and
succession planning.
Village Podiatry Centers
Estimated market share: less than 1.0%
Village Podiatry Centers is the largest
foot and ankle practice in the United
States, with more than 37 physicians in
30 locations. Village Podiatry Centers
provide care for children and adult
patients in metro Atlanta and the middle-
Provided to: OHIONET (212223369) | 16 March 2017
Podiatrists in the USAugust 2016 24
Georgia region. Every physician at Village
Podiatry Centers is a board-certified or
board-qualified podiatrist. Advanced
treatment and surgery is provided for
more than 100,000 patients annually.
The companys services include surgical
treatments, pediatric and diabetic foot
care, diagnostics, work injury treatments
and clinical trials. In 2016, Atlanta
Business Chronicle selected Village
Podiatry Centers as one of the top 25
Atlanta Physician Group Practices.
Distinguished as the only physician
group award recipient, Village Podiatry
was recognized for revenue and employee
growth. This illustrates the potential for
growth among larger industry practices.
Due to the company being privately-held,
financial information is not available.
However, IBISWorld expects that the
company accounts for less than 1.0% of
total revenue.
WWW.IBISWORLD.COM Podiatrists in the USAugust 2016 25

Operating Conditions
Capital Intensity | Technology & Systems | Revenue Volatility
Regulation & Policy | Industry Assistance

Capital Intensity The Podiatrists industry has a low level

of capital intensity. In 2016, for every Capital intensity
Capital units per labor unit
dollars spent on wages, the industry
Level
incurs an estimated $0.04 in capital 0.5
The levelof capital expenditures. Overall, the industry is
intensity is L ow labor intensive, due to patients 0.4

typically requiring specialized 0.3

podiatrists to address their foot
ailments. Additionally, wages account 0.2

for the largest share of industry 0.1

revenue, comprising about 35.7% of
total industry revenue. Comparatively, 0.0
Economy Healthcare and Podiatrists
while purchase costs account for an Social
Assistance
estimated 9.3% of total industry Dotted line shows a high level of capital intensity
revenue, many podiatrists have formed SOURCE: WWW.IBISWORLD.COM

partnerships or group practices, which

has enabled them to spread fixed costs mitigate the high cost of depreciable
across larger practices. As a result, the assets, such as x-ray units and
industry has been able to slightly ultrasound devices.

Tools of the Trade: Growth Strategies for Success

New Age Economy Investment Economy

Recreation, Personal Services, Information, Communications,
Health and Education. Firms Mining, Finance and Real
benefit from personal wealth so Estate. To increase revenue
stable macroeconomic conditions firms need superior debt
are imperative. Brand awareness management, a stable
and niche labor skills are key to macroeconomic environment
product differentiation. and a sound investment plan.

Capital Intensive
Labor Intensive

Podiatrists
Hospitals
Primary Care Doctors Brand Name Pharmaceutical Manufacturing
Traditional Service Economy Specialist Doctors Old Economy
Wholesale and Retail. Reliant Health & Medical Insurance Agriculture and Manufacturing.
on labor rather than capital to Traded goods can be produced
sell goods. Functions cannot using cheap labor abroad.
be outsourced therefore firms To expand firms must merge
must use new technology or acquire others to exploit
or improve staff training to economies of scale, or specialize
increase revenue growth. in niche, high-value products.

Change in Share of the Economy SOURCE: WWW.IBISWORLD.COM

Provided to: OHIONET (212223369) | 16 March 2017

WWW.IBISWORLD.COM Podiatrists in the USAugust 2016 26

Operating Conditions

Technology & Systems There is generally a moderate but diabetes. Technological innovations have
increasing level of technology in this also assisted with operations for
Level industry. To diagnose a foot problem, common conditions. For example,
podiatrists often utilize imaging or conditions such as plantar fasciitis or
The level
of laboratory tests. Examples of technology neuromas are treated with an endoscope,
Technology Change used include extracorporeal shock wave an optical instrument that allows
is M
 edium treatment (ESWT) and pulsed dye laser podiatrists to create precise incisions,
therapy. ESWT is a procedure used to which results in a faster healing process.
treat plantar fasciitis and heel spur There are a number of technologies
syndrome; the technology is similar to involved in foot and ankle surgery, with
Lithotripsy technology, which is used to laser surgery being a relatively new
break up kidney stones without surgery. technology. A surgical laser beam can cut
Pulsed dye laser therapy removes warts or vaporize tissue almost
and utilizes a machine that shines a laser instantaneously; and the laser beam
light on a wart to remove the blood sterilizes and seals blood vessels as it
supply from a wart. cuts, so there is generally less bleeding,
Also, negative pressure wound therapy less post-operative pain and less chance
(NPWT) can heal post-operative foot of post-operative infection than with
wounds and ulcers among patients with conventional surgical instruments.

Revenue Volatility The Podiatrist industry has a low level of industry services. Furthermore,
revenue volatility. Podiatrist services are according to a 2011 study by the
typically demanded by patients to American Podiatric Medical Association
Level
address diabetes-related foot ailments, and Thomson Reuters, podiatrists that
The level of which has increased over the past five treat diabetic patients can save the US
Volatility is L ow years in line with the burgeoning elderly healthcare system an estimated $3.5
population having chronic illnesses, billion per year.
including diabetes. As a result, the As a result, over the next five years,
industrys revenue volatility has been many health insurance companies may
mitigated by growing demand for provide incentives for diabetic

A higher level of revenue Volatility vs Growth

volatility implies greater
industry risk. Volatility can 1000 Hazardous Rollercoaster
negatively affect long-term
Revenue volatility* (%)

strategic decisions, such as 100

the time frame for capital
investment.
10
When a firm makes poor
investment decisions it Podiatrists
may face underutilized 1
capacity if demand
suddenly falls, or capacity 0.1 Stagnant Blue Chip
constraints if it rises 30 10 10 30 50 70
quickly. Five-year annualized revenue growth (%)
* Axis is in logarithmic scale
SOURCE: WWW.IBISWORLD.COM

Provided to: OHIONET (212223369) | 16 March 2017

WWW.IBISWORLD.COM
Operating Conditions
Revenue Volatility individuals within their network to visit
continued podiatrists, thus lowering the industrys
revenue volatility. Furthermore, as more
individuals have health insurance
Regulation & Policy In the United States, licensed podiatrists
practice podiatric medicine and surgery.
Podiatrists need a state license that
Level & Trend requires the completion of undergraduate
 he level of
T study, the completion of a four-year
Regulation is program at a college of podiatric
Heavyand the medicine, and a postdoctoral residency
program usually of two to three years in
trend is S
 teady
duration, however license regulations
vary by state. Each state allows or limits
the practice of podiatric medicine to the
foot, ankle, and, in many states, portions
of the leg or related leg structures. Also,
some states have less stringent
regulations; for example, Connecticut,
Hawaii, Kentucky, Ohio and
Pennsylvania do not require post
graduate education. Some states, like
Georgia and Oklahoma, require
podiatrists to pass written or oral exams.
While some states are subject to
additional state-specific exams, many
states require podiatrists to pass national
boards to obtain a license. Many states
require podiatrists to pass the American
Podiatric Medical Licensing
Examination, which consists of three
components. The first component tests a
candidates knowledge after their second
year of study, the second component is
taken after their final year of study and
the last test determines whether a
candidates knowledge and clinical skills
are safe for unsupervised practice.
Podiatrists can achieve board
certification in orthopedics, primary
medicine or surgery.
The American Podiatric Medical
Association (APMA) represents about
80.0% of all doctors of podiatric
medicine in the United States. APMAs
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Podiatrists in the USAugust 2016 27
coverage, which lowers their out-of-
pocket healthcare expenses, demand for
podiatrist services will likely rise, thus
lowering industry revenue volatility.
Council on Podiatric Medical Education
is the body designated by the US
Department of Education to accredit the
nations podiatric medical schools. In
addition, the council has the
responsibility to accredit residency
programs and continuing medical
education programs.
HIPAA and kickbacks
Federal anti-kickback laws prohibit the
offer, payment, solicitation or receipt of
any form of remuneration to induce, or in
return for, the referral of Medicare or
other government health program
patients or patient care opportunities, or
in return for the purchase, lease or order
of items or services that are covered by
Medicare or other government health
programs. The Health Insurance
Portability and Accountability Act 1996
(HIPAA) effectively broadened the
applicability of the Anti-Kickback Statute.
HIPAA requires the adoption of
standards for the exchange of health
information in an effort to encourage the
overall administrative simplification and
to enhance the effectiveness and efficiency
of the healthcare industry. In addition to
requirements under HIPAA, there are
numerous other federal and state laws and
regulations that regulate the privacy of an
individuals health information.
The federal Stark laws prohibit
physicians from referring patients to
designated health services in which the
physician has an ownership interest.
Many states have also enacted laws
similar in scope and purpose to the
Anti-Kick Back Statute and the Stark laws
to apply to state health programs.
WWW.IBISWORLD.COM
Operating Conditions
Regulation & Policy Healthcare reform
continued Since 2010, the Patient Protection and
Affordable Care Act has been in place.
The overhaul of the healthcare system
provided coverage to about 32 million
people who were previously uninsured,
according to the Congressional Budget
Office. Individuals have gained access to
private insurance through insurance
exchanges, Medicare and Medicaid,
which was expanded to cover individuals
with income up to 133.0% of the poverty
line. However, Medicaid coverage for
podiatry services is still determined on a
state level. In total, all but eight states
cover podiatry services under Medicaid,
Industry Assistance Tariffs do not apply to this industry.
Generally, Americans provide podiatry
services to other Americans within the
Level & Trend United States.
 he level of
T Podiatry is covered by Medicare and,
Industry Assistance to the extent authorized by state law, by
is L owand the Medicaid. Medicare Part B coverage of
podiatry is currently limited to services
trend is S teady
that are deemed to be medically
necessary. Such services can include
treatment for chronic conditions, such as
bunion deformities and heel or toe spurs.
Medicare Part B does not cover routine
foot care that is not medically necessary.
Provided to: OHIONET (212223369) | 16 March 2017
Podiatrists in the USAugust 2016 28
according to the American Podiatric
Medical Association. States that include
podiatry services under Medicare but not
Medicaid include California, Nevada,
Arizona, Alaska, Wyoming, Kansas,
Alabama and South Carolina, according
to the latest data available. Moreover,
Medicaid and Medicare reimbursements
will likely become increasingly stringent,
thus resulting in podiatrists increasingly
needing to demonstrate favorable patient
outcomes to receive reimbursements. At
the same time, healthcare reform has
increased the number of insured
individuals, likely bolstering the number
of patient volumes for podiatrists.
The American Podiatric Medical
Association (APMA) is the leading
resource for foot and ankle health
information. Currently, the organization
represents a vast majority of the
podiatrists in the country. APMAs staff is
dedicated to promoting foot and ankle
health, member service and professional
excellence. Looking toward the future, the
APMA will continue to advance the
growth and stability of podiatric medicine
by increasing nationwide awareness of
foot and ankle health through public
education and legislative advocacy.
WWW.IBISWORLD.COM Podiatrists in the US August 2016 29

Key Statistics
Industry Data Number of people
Industry with private
Revenue Value Added Establish- Wages Domestic health insurance
($m) ($m) ments Enterprises Employment Exports Imports ($m) Demand (Mils)
2008 4,695.2 2,347.1 12,399 11,861 40,615 -- -- 1,671.0 N/A 202.6
2009 4,754.2 2,333.3 12,305 11,755 40,119 -- -- 1,715.2 N/A 196.3
2010 4,831.3 2,333.6 12,233 11,671 40,078 -- -- 1,720.0 N/A 196.2
2011 4,884.6 2,488.2 12,236 11,669 40,441 -- -- 1,736.0 N/A 197.3
2012 5,000.3 2,615.2 12,430 11,788 41,661 -- -- 1,780.2 N/A 198.8
2013 4,902.7 2,567.3 12,194 11,559 41,283 -- -- 1,743.6 N/A 201.1
2014 4,868.5 2,615.6 12,271 11,627 41,553 -- -- 1,763.6 N/A 208.6
2015 5,143.0 2,701.6 12,553 11,868 43,154 -- -- 1,847.8 N/A 218.2
2016 5,375.8 2,834.0 12,812 12,092 44,680 -- -- 1,925.2 N/A 220.5
2017 5,542.8 2,924.8 12,971 12,226 45,614 -- -- 1,975.3 N/A 222.6
2018 5,697.8 3,014.0 13,166 12,397 46,700 -- -- 2,029.5 N/A 224.8
2019 5,972.2 3,164.9 13,427 12,617 48,294 -- -- 2,114.2 N/A 226.9
2020 6,223.8 3,313.1 13,717 12,871 49,885 -- -- 2,196.7 N/A 228.8
2021 6,501.2 3,470.1 14,001 13,116 51,561 -- -- 2,285.1 N/A 231.0
2022 6,858.3 3,680.3 14,412 13,475 53,782 -- -- 2,401.5 N/A 231.0
Sector Rank 32/34 31/34 24/34 22/34 32/34 N/A N/A 31/34 N/A N/A
Economy Rank 868/1546 683/1546 394/1546 372/1546 632/1546 N/A N/A 630/1546 N/A N/A

Annual Change Number of people

Industry Establish- Domestic with private
Revenue Value Added ments Enterprises Employment Exports Imports Wages Demand health insurance
(%) (%) (%) (%) (%) (%) (%) (%) (%) (%)
2009 1.3 -0.6 -0.8 -0.9 -1.2 N/A N/A 2.6 N/A -3.1
2010 1.6 0.0 -0.6 -0.7 -0.1 N/A N/A 0.3 N/A -0.1
2011 1.1 6.6 0.0 0.0 0.9 N/A N/A 0.9 N/A 0.6
2012 2.4 5.1 1.6 1.0 3.0 N/A N/A 2.5 N/A 0.8
2013 -2.0 -1.8 -1.9 -1.9 -0.9 N/A N/A -2.1 N/A 1.1
2014 -0.7 1.9 0.6 0.6 0.7 N/A N/A 1.1 N/A 3.7
2015 5.6 3.3 2.3 2.1 3.9 N/A N/A 4.8 N/A 4.6
2016 4.5 4.9 2.1 1.9 3.5 N/A N/A 4.2 N/A 1.1
2017 3.1 3.2 1.2 1.1 2.1 N/A N/A 2.6 N/A 0.9
2018 2.8 3.0 1.5 1.4 2.4 N/A N/A 2.7 N/A 1.0
2019 4.8 5.0 2.0 1.8 3.4 N/A N/A 4.2 N/A 0.9
2020 4.2 4.7 2.2 2.0 3.3 N/A N/A 3.9 N/A 0.8
2021 4.5 4.7 2.1 1.9 3.4 N/A N/A 4.0 N/A 1.0
2022 5.5 6.1 2.9 2.7 4.3 N/A N/A 5.1 N/A 0.0
Sector Rank 12/34 15/34 26/34 28/34 20/34 N/A N/A 14/34 N/A N/A
Economy Rank 529/1546 537/1546 756/1546 752/1546 611/1546 N/A N/A 594/1546 N/A N/A

Key Ratios Imports/ Exports/ Revenue per Share of the

IVA/Revenue Demand Revenue Employee Wages/Revenue Employees Average Wage Economy
(%) (%) (%) ($000) (%) per Est. ($) (%)
2008 49.99 N/A N/A 115.60 35.59 3.28 41,142.44 0.02
2009 49.08 N/A N/A 118.50 36.08 3.26 42,752.81 0.02
2010 48.30 N/A N/A 120.55 35.60 3.28 42,916.31 0.02
2011 50.94 N/A N/A 120.78 35.54 3.31 42,926.73 0.02
2012 52.30 N/A N/A 120.02 35.60 3.35 42,730.61 0.02
2013 52.37 N/A N/A 118.76 35.56 3.39 42,235.30 0.02
2014 53.72 N/A N/A 117.16 36.22 3.39 42,442.18 0.02
2015 52.53 N/A N/A 119.18 35.93 3.44 42,818.74 0.02
2016 52.72 N/A N/A 120.32 35.81 3.49 43,088.63 0.02
2017 52.77 N/A N/A 121.52 35.64 3.52 43,304.69 0.02
2018 52.90 N/A N/A 122.01 35.62 3.55 43,458.24 0.02
2019 52.99 N/A N/A 123.66 35.40 3.60 43,777.69 0.02
2020 53.23 N/A N/A 124.76 35.30 3.64 44,035.28 0.02
2021 53.38 N/A N/A 126.09 35.15 3.68 44,318.38 0.02
2022 53.66 N/A N/A 127.52 35.02 3.73 44,652.49 0.02
Sector Rank 21/34 N/A N/A 10/34 26/34 30/34 10/34 31/34
Economy Rank 240/1546 N/A N/A 1201/1546 235/1546 1235/1546 953/1546 683/1546

Figures are in inflation-adjusted 2016 dollars. Rank refers to 2016 data. SOURCE: WWW.IBISWORLD.COM

Provided to: OHIONET (212223369) | 16 March 2017

WWW.IBISWORLD.COM Podiatrists in the US August 2016 30

Industry Financial Ratios

Apr 2015 - Mar 2016 by company revenue
Apr 2012 - Apr 2013 - Apr 2014 - Apr 2015 - Small Medium Large
Mar 2013 Mar 2014 Mar 2015 Mar 2016 (<$10m) ($10-50m) (>$50m)

Liquidity Ratios
Current Ratio 1.2 1.2 1.4 1.6 1.4 2.0 1.7
Quick Ratio 1.0 1.1 1.3 1.4 1.2 2.0 1.6
Sales / Receivables (Trade Receivables
Turnover) n/c n/c n/c n/c n/c 16.5 12.6
Days Receivables 0.4 0.4 0.4 n/a n/a 22.1 29.0
Cost of Sales / Inventory (Inventory Turnover) n/a n/a n/a n/a n/a n/a n/a
Days Inventory n/a n/a n/a n/a n/a n/a n/a
Cost of Sales / Payables (Payables Turnover) n/a n/a n/a n/a n/a n/a n/a
Days Payables n/a n/a n/a n/a n/a n/a n/a
Sales / Working Capital 76.9 91.0 43.4 43.9 69.2 11.3 10.6

Coverage Ratios
Earnings Before Interest & Taxes (EBIT) /
Interest 10.9 7.6 16.2 14.0 15.3 14.5 5.8
Net Profit + Dep., Depletion, Amort. / Current
Maturities LT Debt n/a 5.0 2.6 3.8 n/a n/a n/a

Leverage Ratios
Fixed Assets / Net Worth 1.0 1.2 0.9 0.8 0.8 0.8 1.0
Debt / Net Worth 2.4 2.0 1.9 1.4 1.7 1.0 1.4
Tangible Net Worth 11.0 13.3 16.0 24.6 21.7 38.7 25.0

Operating Ratios
Profit before Taxes / Net Worth, % 82.6 56.8 68.9 52.2 68.7 19.5 14.7
Profit before Taxes / Total Assets, % 28.0 17.0 23.7 16.7 23.5 10.6 4.2
Sales / Net Fixed Assets 26.5 18.0 18.3 19.6 23.1 15.1 6.0
Sales / Total Assets (Asset Turnover) 4.6 4.1 3.7 3.7 3.9 2.2 2.2

Cash Flow & Debt Service Ratios (% of sales)

Cash from Trading n/a n/a n/a n/a n/a n/a n/a
Cash after Operations 9.4 12.0 13.8 9.7 11.5 7.8 9.9
Net Cash after Operations 9.5 12.0 12.8 9.0 11.5 7.9 10.0
Cash after Debt Amortization 2.2 1.4 1.3 1.5 1.1 2.6 3.4
Debt Service P&I Coverage 5.5 3.5 6.8 6.2 5.9 6.5 6.2
Interest Coverage (Operating Cash) 15.0 7.9 18.0 14.9 14.0 16.1 13.4

Assets, %
Cash & Equivalents 28.7 30.0 32.0 30.1 31.0 29.6 21.7
Trade Receivables (net) 12.7 10.1 11.7 10.1 7.9 19.1 13.9
Inventory 0.8 0.9 0.5 0.8 0.8 0.8 1.1
All Other Current Assets 4.1 4.5 3.5 4.0 3.7 5.6 4.4
Total Current Assets 46.3 45.4 47.7 45.0 43.4 54.9 41.1
Fixed Assets (net) 31.2 37.6 34.2 32.9 32.4 31.5 41.5
Intangibles (net) 8.1 4.6 6.5 7.3 8.0 3.6 8.2
All Other Non-Current Assets 14.3 12.4 11.6 14.8 16.3 9.9 9.3
Total Assets 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Total Assets ($m) 1,319.9 1,709.2 1,158.4 2,288.9 263.3 579.8 1,445.9

Liabilities, %
Notes Payable-Short Term 19.8 17.9 15.8 13.6 16.0 4.6 7.6
Current Maturities L/T/D 5.8 5.0 5.6 4.6 5.1 3.1 2.1
Trade Payables 4.5 4.2 3.0 2.6 1.9 5.3 4.5
Income Taxes Payable 0.1 0.4 0.2 n/a n/a 0.1 0.3
All Other Current Liabilities 20.2 21.1 17.9 18.0 17.6 21.7 14.7
Total Current Liabilities 50.4 48.7 42.5 39.0 40.7 34.8 29.2
Long Term Debt 22.8 25.0 28.1 21.7 22.4 17.6 22.8
Deferred Taxes n/a 0.1 0.1 0.1 n/a 0.2 0.4
All Other Non-Current Liabilities 7.8 8.2 6.9 7.4 7.2 5.2 14.4
Net Worth 19.1 17.9 22.5 31.9 29.7 42.3 33.2
Total Liabilities & Net Worth ($m) 1,319.9 1,709.2 1,158.4 2,288.9 263.3 579.8 1,445.9

Maximum Number of Statements Used 254 238 239 298 231 46 21

Source: RMA Annual Statement Studies, rmahq.org. RMA data for all industries is derived directly from more
than 260,000 statements of member financial institutions borrowers and prospects.
Note: For a full description of the ratios refer to the Key Statistics chapter online.

Provided to: OHIONET (212223369) | 16 March 2017

WWW.IBISWORLD.COM
Jargon & Glossary
Industry Jargon DIABETES MELLITUSA polygenic disease
characterized by abnormally high glucose levels in the
blood; any of several metabolic disorders marked by
excessive urination and persistent thirst.
HEALTH MAINTENANCE ORGANIZATIONS (HMO)A
form of health insurance that combines a range of
coverage plans on a group basis.
OBESITYA medical condition in which excess body fat
has accumulated to the extent that it may have an
adverse effect on health, leading to reduced life
expectancy and increased health problems.
IBISWorld Glossary BARRIERS TO ENTRYHigh barriers to entry mean that
new companies struggle to enter an industry, while low
barriers mean it is easy for new companies to enter an
industry.
CAPITAL INTENSITY Compares the amount of money
spent on capital (plant, machinery and equipment) with
that spent on labor. IBISWorld uses the ratio of
depreciation to wages as a proxy for capital intensity.
High capital intensity is more than $0.333 of capital to
$1 of labor; medium is $0.125 to $0.333 of capital to $1
of labor; low is less than $0.125 of capital for every $1 of
labor.
CONSTANT PRICESThe dollar figures in the Key
Statistics table, including forecasts, are adjusted for
inflation using the current year (i.e. year published) as
the base year. This removes the impact of changes in
the purchasing power of the dollar, leaving only the
real growth or decline in industry metrics. The inflation
adjustments in IBISWorlds reports are made using the
US Bureau of Economic Analysis implicit GDP price
deflator.
DOMESTIC DEMANDSpending on industry goods and
services within the United States, regardless of their
country of origin. It is derived by adding imports to
industry revenue, and then subtracting exports.
EMPLOYMENTThe number of permanent, part-time,
temporary and seasonal employees, working proprietors,
partners, managers and executives within the industry.
ENTERPRISE A division that is separately managed
and keeps management accounts. Each enterprise
consists of one or more establishments that are under
common ownership or control.
ESTABLISHMENTThe smallest type of accounting unit
within an enterprise, an establishment is a single
physical location where business is conducted or where
services or industrial operations are performed. Multiple
establishments under common control make up an
enterprise.
EXPORTSTotal value of industry goods and services sold
by US companies to customers abroad.
Provided to: OHIONET (212223369) | 16 March 2017
Podiatrists in the USAugust 2016 31
ORTHOTICSShoe inserts that are intended to correct
an abnormal or irregular walking pattern.
POPOPEDIATRICIANA physician that treats childrens
foot diseases.
PREFERRED PROVIDER ORGANIZATIONS (PPO)
Comprises physicians, hospitals or other providers that
offer healthcare services at a reduced fee.
IMPORTS Total value of industry goods and services
brought in from foreign countries to be sold in the
United States.
INDUSTRY CONCENTRATIONAn indicator of the
dominance of the top four players in an industry.
Concentration is considered high if the top players
account for more than 70% of industry revenue.
Medium is 40% to 70% of industry revenue. Low is less
than 40%.
INDUSTRY REVENUEThe total sales of industry goods
and services (exclusive of excise and sales tax); subsidies
on production; all other operating income from outside
the firm (such as commission income, repair and service
income, and rent, leasing and hiring income); and
capital work done by rental or lease. Receipts from
interest royalties, dividends and the sale of fixed
tangible assets are excluded.
INDUSTRY VALUE ADDED (IVA)The market value of
goods and services produced by the industry minus the
cost of goods and services used in production. IVA is
also described as the industrys contribution to GDP, or
profit plus wages and depreciation.
INTERNATIONAL TRADEThe level of international
trade is determined by ratios of exports to revenue and
imports to domestic demand. For exports/revenue: low is
less than 5%, medium is 5% to 20%, and high is more
than 20%. Imports/domestic demand: low is less than
5%, medium is 5% to 35%, and high is more than
35%.
LIFE CYCLEAll industries go through periods of growth,
maturity and decline. IBISWorld determines an
industrys life cycle by considering its growth rate
(measured by IVA) compared with GDP; the growth rate
of the number of establishments; the amount of change
the industrys products are undergoing; the rate of
technological change; and the level of customer
acceptance of industry products and services.
WWW.IBISWORLD.COM Podiatrists in the USAugust 2016 32

Jargon & Glossary

IBISWorld Glossary NONEMPLOYING ESTABLISHMENT Businesses with WAGESThe gross total wages and salaries of all
no paid employment or payroll, also known as employees in the industry. The cost of benefits is also
continued nonemployers. These are mostly set up by self-employed included in this figure.
individuals.
PROFITIBISWorld uses earnings before interest and tax
(EBIT) as an indicator of a companys profitability. It is
calculated as revenue minus expenses, excluding
interest and tax.
VOLATILITYThe level of volatility is determined by
averaging the absolute change in revenue in each of the
past five years. Volatility levels: very high is more than
20%; high volatility is 10% to 20%; moderate
volatility is 3% to 10%; and low volatility is less than
3%.

Provided to: OHIONET (212223369) | 16 March 2017

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