Podiatric surgery is surgery performed by a "foot doctor". Unlike other specialists, a Doctor of Podiatric Medicine (D.P.M.) is a separate degree from that of a Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.). M.D.s and D.O.s differ in their approach to patient care. In all states in the U.S. they both have the same rights and privileges, although this has not always been the case. All M.D.'s and all D.O.'s have the same basic education respectively. Some then obtain further education and clincal time to become a specialist. A podiatrist is not an M.D. or D.O. that has obtained specialization. In the U.S. podiatric medicine is regulated by each state. Podiatrists treat diseases, injuries and congenital problems of the foot, ankle and lower leg. Podiatrists are often paid less for the same surgery or treatment than an M.D. or D.O. Insurance companies say this is due to a lesser degree of education, but this is very often not the case.