In Texas, a legal battle ensues between orthopedists and podiatrists over who is allowed the treat the ankle.

Podiatrists are known in the medical community as having a bit of an inferiority complex. But that is not without some merit—the medical field is dominated by medical doctors. Podiatrists do not own an M.D. degree, and they are allowed to treat only a small—albeit important—part of the body. So perhaps it was that complex, or maybe the desire to branch out a bit from the foot, that became the focal point of a legal battle in Texas between orthopedists and podiatrists.

The root of the problem came when podiatrists around the state were treating individuals with ankle problems. The Texas Podiatric Medical Association (TPMA)—the board that licenses podiatrists—gave credence to the practice when it defined the ankle as part of the foot.

On March 14, however, an appeals court ruled that the board exceeded its authority, saying, in effect, that orthopedists have jurisdiction over the ankle, not podiatrists.

This is good news for the Texas Medical Association, which has been battling the TPMA over the issue for years. The TPMA plans to appeal the ruling.

Podiatrists claim that the medical community is simply trying to limit competition. In its argument before the court, TPMA stated that, “The foot includes the ankle. If you took the foot off the leg, there is nothing lying there that’s the ankle.” This is positing the quite-perplexing theory that the ankle does in fact not exist.

“If they say the ankle doesn’t exist, then why do they want to operate on it?” Dr. David Teuscher, orthopedic surgeon, asked the Austin American-Statesman. In a blatant slap at the podiatric community, he also noted that the ankle is complicated enough that treating it requires medical training. As Jerry told Elaine once in a Seinfeld episode (when he convinced her that her boyfriend, a podiatrist, was not a real doctor), “Anyone can get into podiatry school. George got into podiatry school.” While that is doubtful (George was not very bright), podiatrists do endure a rigorous education.

So what exactly is the difference in training for orthopedists and podiatrists? Orthopedists must complete four years of medical school, a one-year internship, and a four-year residency. Podiatrists, on the other hand, must go to podiatry school for four years and complete a one-year internship. So the difference, in practicality, is the residency.

If this still seems like a petty issue, consider the fact that actual livelihoods are at stake. There are currently about 900 podiatrists in Texas, and many receive specialized training beyond podiatry school. This decision could have major ramifications to podiatrists who market themselves as specialists in areas involving the ankle.

As of now, podiatrists can still keep treating the ankle until there is a final resolution in the case. The TPMA is appealing the decision to the Texas Supreme Court, and that decision could be at least a year away.