Perioperative medical assessment of the podiatric surgical patient

Patients undergoing podiatric surgery should receive a thorough perioperative evaluation. Medical "clearance" is no longer sufficient; rather, formal risk assessment should be performed and risk-reducing strategies provided. A collaborative, multidisciplinary approach involving practitioners in internal medicine, anesthesiology, and podiatry is generally most appropriate. Unfortunately, expertise and training in this critical dimension of clinical practice are variable. Thus podiatric physicians should develop independent competence in perioperative evaluation in order to ensure optimal care for their patients. A general systematic approach is described that can be readily incorporated into clinical practice.