12/03/2013    Ira Baum, DPM

Ankle Surgery in NY (George Vito, DPM)

With respect for Dr. Vito, if you drill down his
clear, yet complex combination of solutions, I
think the issue becomes transparent. The problem
is the convoluted certification classification
system of the ABPS (or if name changed ABPFAS).
The classification system appears to have its
origin from podiatrists confronting obstacles to
perform surgeries that they were trained to
perform, in bona fide podiatric surgical residency
programs.

The podiatrist were unfairly scrutinized primarily
by orthopedic surgeons and subsequently hospital
administrations and they negotiated solutions
based not on rational evaluation of the surgeons
certification and experience. Podiatrist "work
around", and possibly the only way to satisfy the
unjust position of the orthopedic surgeons and
hospitals, proposed the problem to the APBS and
the multiple classes of certification was born and
flourished.

Like most negotiations that result in unwise
solutions, the process continues producing issues
as is noted in NY's "Ankle Law" that has excluded
well qualified, experienced and knowledgeable
podiatric surgeons who have been performing ankle
surgery successfully for years. As I have
previously pointed out, many of these podiatrist
have trained residents who have gone on to
complete 3 year programs to perform ankle surgery.
The purpose of this response to Dr. Vito's post is
to make clear the issue facing podiatrists is not
only regarding ankle surgery in NY, but to
understand the process of confronting orthopedic
surgeons that are "hell bent" on limiting
podiatrists privileges will do so when ever they
can.

For those of you who do not think this is true,
count the number of foot and ankle orthopedic
surgical fellow that have completed their training
in the last 5 years. Their interest is provide
foot and ankle care and even though all of us have
good friends that are orthopedic surgeons, this is
a turf war and our current strategy to have
focused certifications, to present the principle
that well trained podiatrist provide quality care
is ill founded.

The solution is for the board to have an ad hoc
committee composed of a spectrum of respected
podiatric surgeons from several generations and
come up with a single board certification the same
as the orthopedic surgeons. For those who desire
to specialize, develop post residency fellowship
programs that can be scrutinized by those groups
trying to limit privileges including not only
hospitals, but legislators as well.

Ira Baum, DPM Miami, FL, ibaumdpm@bellsouth.net

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