09/24/2018    Richard Bloch, JD

Podiatry’s Continuing Identity Crisis

I am responding to the editorial in the
September issue of Podiatry Management.
(“Podiatry’s Continuing Identity Crisis”). The
Maryland Podiatric Medical Association (MPMA)
had a bill introduced in this year’s legislative
session (January-April 2018) to change the term
“podiatrist” to “podiatric physician” in the
Maryland Code. Although the bill did not pass,
we will continue this effort. With this in mind,
there are several concerns regarding the
editorial.

The survey apparently did not include the term
“podiatric physician”, yet Dr. Block concludes
it “would be appropriate [to change to podiatric
physician] only with a degree change…”.

The survey results do not indicate the ages of
those that responded. The younger podiatrists in
MPMA have shown strong support for the effort by
MPMA to have Maryland change the name of the
profession to “podiatric physician”, which is
the term currently found in 23 states’ laws. 13
other states’ laws define podiatrists as a
“Physician who practices podiatric medicine” or
“Physician of the foot and leg” or “Physician of
the foot and ankle”.

There are many podiatrists that prefer not to
call themselves “surgeons”, as that implies
their practice is limited. Most podiatrists that
I am familiar with, prefer to indicate their
broad qualifications to treat the foot and
ankle, and include surgery as only one of the
services they render. That is reflected in your
survey in which almost 73% chose the broader
terms of “podiatrist” or “foot and ankle
specialist”. As Dr. Block notes, ” surgery is
only a small part of most podiatrists’
practices.” The term “podiatric physician” does
that.

MPMA sees this, not as an identity crisis, but a
continuing effort to get the allopathic and
osteopathic communities to accept the education,
qualifications and training of podiatrists, and
to acknowledge their expertise in treatment of
the foot and ankle.

Richard Bloch, JD, Executive Director and
General Counsel, Maryland Podiatric Medical
Association

Other messages in this thread:

---

09/19/2018    Alan Sherman, DPM

Podiatry’s Continuing Identity Crisis

In regard to Dr. Block’s recent editorial
“Podiatry’s Continuing Identity Crisis”, he and
I, and a large group of our peers, have
discussed the issue of the podiatrist’s
identity, our self-image and resulting issues
with our collective self-esteem for years. We
have always agreed, and to this day continue to
agree that while we all do surgery, and deserve
recognition for the training that we get, the
credentials we achieve and the fine work that we
do in that discipline, very few podiatrists are
primarily surgeons, nor should most podiatrists
primarily be surgeons. If we all were primarily
surgeons, who would do ALL THE REST of the
important work that we do in solving the worlds
foot health issues?

The volume of medical podiatry, the work we do
as physicians, not as surgeons, far exceeds the
volume of surgery needed by the public. My
reaction to the results of this interesting and
important poll is, of course most podiatrists,
when asked which of 5 terms they use to describe
their professional title, and required to choose
just one, would choose “Podiatrist” and “Foot
and Ankle Specialist”. They wouldn’t choose
“Foot and ankle surgeon”, or “Podiatric
surgeon”, because that isn’t primarily what they
do. Now, IF you had let them choose a 2nd term,
I believe many would ALSO have chosen “Foot and
ankle surgeon”, or “Podiatric surgeon because
they do identify as ALSO being foot surgeons,
and are indeed, foot surgeons. But I think what
they are telling us here, and this result is
very interesting and I believe, exaggerated, is
that only 23.17% of us think of ourselves as
primarily being surgeons.

Truth be told, my beloved colleagues, is that
less than 20% of podiatrists ARE primarily
surgeons, even though ALL podiatrists do at
least some surgery among all the treatments that
they do for their patients. And though surgery
is an advanced calling, so is the treatment of
infection, preventative medicine, the non-
surgical treatment of trauma (be that trauma
acute and forceful, or small and repetitive),
and all the other skills we possess to cure
disease and relieve suffering. Medical doctors
in medical specialties don’t feel inferior to
surgeons because they don’t do surgery.

Why do we have a hierarchy of self-esteem in
podiatry based on how much surgery we do? It’s
ridiculous, yet it persists.I believe strongly
in the 3 year model of residency training, but
wouldn’t it be great if after 2 years, residents
that show promise to be in the top 20% of
podiatric surgeons continue on to focus their
3rd year on advanced surgery to refine their
skills, while the other 80% fill that 3rd year
with everything else that podiatrists do?
They’d be spending their 3rd year getting
training that reflects that balance of work
they’ll be doing in practice. Our most talented
surgeons would go on to do one or two year
fellowships in advanced surgery, limb salvage
and trauma care. And the 80% would complete
their residency better prepared to be the best
general podiatrist they can be.

Alan Sherman, DPM, CEO, PRESENT e-Learning
Systems