07/01/2015    Alan Sherman, DPM

Gone With the Wind (Dale Feinberg DPM, CPed)

Dale Feinberg, DPM wrote a nostalgic message
entitled “Gone With the Wind” about the demise of
podiatry as we knew it, and compared the demise
with the recent criticism of the confederate flag
that we’ve all seen in the news. His thesis is
that there was something virtuous in each
institution and we are “letting” them wither away.
Dr. Feinberg and I were roommates freshman year at
CCPM in 1978, and shared a few important life
experiences together. I think his feelings are
sentimental and yes, I can be sentimental at times
as well. But fundamentally, I have believed for 20
years that the private practice fee for service
model that we all enjoyed during these years was
doomed to be replaced by a system with much
different payment dynamics.

Frankly, I hated billing insurance companies for
services. I never felt empowered in that
situation, and always felt like I was going to Dad
for money, only to have him judge whether my
“claim” was worthy to be paid. I felt I had done
the correct service for the patient, but that’s
not what got me paid. Submitting the “claim”
properly is what got me paid. And it was totally
out of my control as far as how much I was paid.
Again there, Dad decided what the “claim” was
worth. Even the term “claim” is demeaning. Why
should I have to proves my “claim” that I treated
the patient correctly? This isn’t the way a doctor
should be paid.

I have long felt that we as physicians should be
paid a salary, negotiated with an employer, so
that we do not need to “claim” payment for each
individual service that we perform. I have been
quite entrepreneurial in my life, having built two
businesses and sold one, but looking back, I think
I would have been much happier, and certainly
would have spent more time caring for patients, if
I had been on salary. The business people who own
the delivery system should deal with getting paid.
The doctors should deal exclusively with treating
the patients. I know this is a kick in the balls
for those of us who have run practices for
decades, but I believe it.

As far as the confederate flag, unfortunately, it
has come to mean different things to different
people, and what was a symbol of the genteel
culture of the south, and their rebellion against
the northern Yankees has been adopted by white
supremacist groups to symbolize their freedom to
hate people different from themselves. That isn’t
freedom for the people they hate..it’s terrorism.
That flag will persist as a meaningful personal
symbol for those people, but I agree that it
should no longer be flying from any public
buildings in this country.

Alan Sherman, DPM, CCMEP, Boca Raton, FL

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