04/07/2014    Lawrence M. Rubin, DPM

How About Giving "Routine Foot Care" Some Respect?

Lyndon Baines Johnson served as the 36th President
of the United States from 1963-1969. He was
responsible for the “Great Society” legislation
that included the law that created Medicare. The
President had a foot problem that caused him to
become a “routine foot care” patient of Charles T.
Turchin, DPM, a Washington, DC, podiatrist.

"Charlie" as most of us knew him, was a great
advocate for podiatry being included in the
Medicare law. He alone convinced President Johnson
to include us in Medicare. Charlie told
podiatrists about this in the fantastic podiatric
practice management lectures he gave all over the
country.

I was once in Charlie's practice management
lecture audience when he said something like:
“...and the thing that I stressed to the President
is the fact that podiatrists are trained to
relieve pain and prevent suffering in ways such as
routine foot care that other doctors are not
trained to do.” So, yes, those of us in my "old
timers" podiatry club are proud to say that, in
great part, we are where we are today because of
yesterday's podiatrists' education and learned
skills that enabled us to provide “routine foot
care” better than any other medical profession.

Back to past history. So, Medicare included us,
and that required every insurance company that
sold Medicare supplemental insurance to begin
reimbursing podiatric physicians for all foot care
service provided by MD/DO physicians, plus the
"routine foot care" services almost exclusively
provided by podiatrists. Most other insurance
payers that were not reimbursing podiatrists for
their services followed along and began paying us.
Almost overnight, podiatry's stature and our
practices' financial potential escalated.

But Charlie did not advocate that podiatrists be
“a step above a pedicurist” by cutting corns and
callouses and ingrown toenails time after time
without any attempt to eliminate them. Charlie
had a passion for teaching podiatrists of that era
how to motivate our patients to begin “remedial
foot care treatment plans” capable of eliminating
– not just palliating – most “routine foot care”
conditions non-surgically.

So, maybe we should be putting some of Dr.
Turchin’s type of motivating, practice management
lectures back on the programs at some of our
conventions and meetings? There is something
remedial and not "routine" that we can do for
almost all of the so-called "routine foot care"
patients, especially those at risk of amputations
whose limbs we can help save.

In my humble, personal opinion, podiatry's image
and our worth to the public -- including the new
Obamacare health care reimbursement system we are
now beginning -- is enhanced when a podiatrist is
a highly qualified surgeon, but also makes him or
her self available to the foot-sore public to
relieve foot pain and suffering by all available
means.

Lawrence M. Rubin, DPM, Las Vegas, NV,
lrubindoc@aol.com

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04/08/2014    Burton J. Katzen, DPM

How About Giving "Routine Foot Care" Some Respect? ( Lawrence M. Rubin, DPM)

Thank you, Dr. Rubin, for keeping the name of Dr.
Charlie Turchin alive. I had referenced him in a
couple of my previous posts. Those of us who were
lucky enough to know "Charlie" know he was one of
a kind and what he meant to our profession. If you
were a new practitioner and one of "Charlie's
Boys", if one of his patients was from your area,
he would give them your number and tell them to go
to you.

It was said that if Charlie ever gave a med school
lecture, everyone would immediately drop out of
med school and enroll in podiatry school. Those of
us who ever heard him speak know what I mean.

There are a million Charlie stories, but I was in
his office the day President Johnson died. Luci,
who had worked at the office one summer, called
"Uncle Charlie" from the ranch crying before the
President's body had even been removed to give him
the news. It didn't hit the news wires until about
3 hours later, so when I told a couple of people
that afternoon that Lyndon Johnson had died, they
thought I had been dreaming.

I still laugh when I think about how when he would
cut somebody when reducing a corn/callus and they
would be bleeding all over the place, he would
say, "Just relieving pressure sweetheart", and
they would thank him. I will always be indebted to
Dr. T for introducing me to the profession. I was
at GWU on the typical pre-med track hoping to
follow my father's footsteps into medical school
and becoming an MD, honestly not even knowing what
podiatry was.

I spent one day in Charlie's office at the end of
August, 1967 and that was all it took. I changed
my mind and went down the next morning to tell Dr
T the news hoping to take the entrance exam and
apply the following year. He said, "Hold on for a
minute", picked up the phone, called Dr. Bates,
and said "Jim, I got a new student for you
starting next week." True story. Hopefully, I have
passed the statute of limitations for entrance
requirements.

Burton J. Katzen, DPM, Temple Hills, MD,
drburtonk@aol.com