06/19/2015    Robert D. Phillips, DPM

Independent Practice is Dead (Joseph Borreggine, DPM)

I read with interest the comments by Dr. Joseph
Borreggine. Unfortunately, I feel that he is
equating podiatric practice with private
podiatric practice. As a teacher in the College
of Medicine at the University of Central Florida,
and also a teacher in the family practice
residency of a local hospital, I can say that the
golden age of medicine is over.

Medical students are incurring ever increasing
debt in going to school and struggling to pay off
that debt afterwards. Insurance companies have
almost totally interjected themselves in what
used to be the doctor-patient relationship –
which included both the medical relationship as
well as the financial relationship. Ever more
time is being wasted in administration of
medicine instead of learning and practicing
medicine.

More podiatric physicians seem to be interested
in the proper coding for a bunion surgery than in
selecting the right bunion surgery for the right
patient. More time is spent in filling out EMR
records than in actually laying hands on patients
and in educating patients. Anyone who interviews
medical (or podiatry) school applicants knows
that the number one answer, when asked why they
want to go into medicine (or podiatry), is
“Because I want to help people.” At the end of
the grueling debt ridden roller-coaster
schooling, the new physician is often asking
themselves, “Why did I go into medicine?”

Salaried positions are becoming ever more popular
with physicians of all specialties, to alleviate
some of the stress of the burden of the huge
debt.

With record numbers of private practice MDs and
DOs also selling their business to work for
salary for large corporate health institutions,
podiatric physicians are caught in the same bind.
This is not a fight of podiatry against big
medicine, as Dr. Borreggine would have us
believe, it is a fight for survival by all
practitioners of medicine.

The survival of podiatry as a specialty really
depends on our ability to penetrate these huge
multispecialty health institutions. Podiatry is
much more acceptable by medicine when our other
specialist colleagues have daily interaction and
are sharing patient responsibilities. It becomes
financially beneficial then to include the
podiatrist, not exclude him/her. I hope to see
many more podiatric physicians join with our MD
and DO partners in the new medical institutions
and not try to go it alone.

Robert D. Phillips, DPM, Orlando, FL

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