It is remarkable how often I agree with Dr.
Markinson – and his last comment on this topic
is no exception. Going back to a preceptorship
model is just wrong, we do need a lot more
podiatrists, but we don’t need to train more
advanced podiatric surgeons. There is a catch-22
situation in podiatric training that isn’t
discussed much (I’m not sure why) but it is
the “elephant in the room” during every
discussion on podiatric post-graduate education.
It goes like this:
In order to get on insurance panels, you must be
on a hospital staff. In order to be on a
hospital staff, you must be board certified or
board eligible. In order to be board certified
or eligible, you must do a recognized residency
program
So in effect, in order to get paid by insurance
companies, even for non-surgical services, you
must do a surgical residency and get trained as
a surgeon. So in recent years, since the change
to the 3-year PM&S model and now Vision 2015,
all podiatric residency programs are now
surgically-oriented and there is a shortage of
them. What we need is advocacy to hospitals that
a podiatrist needn’t be a reconstructive surgeon
to be a valuable member of the medical staff.
I think that with the growth of hospital
affiliated wound care centers, they would
understand that every staff podiatrist doesn’t
need to do reconstructive surgery or
amputations. And then we need to develop the
infrastructure of podiatric medical training
programs – not because there isn’t enough
surgery, but because we need more podiatric
physicians.
Alan Sherman, DPM, Boca Raton, FL,
asherman@presentelearning.com
