08/11/2016     Robert Kornfeld, DPM

Are You Proud to be a Podiatrist? (Michael. Z. Metzger, DPM)

A few years ago, I was lecturing to over 200
attendees. I asked the podiatrists present to
raise their hand if they love the practice of
podiatry. Two doctors raised their hand. That
spoke volumes to me. As Dr. Udell proudly
states, we help a lot of people. And no doubt
we all feel a great sense of pride in that. But
that is no longer what the practice of podiatry
is. So let me answer this question - Am I proud
to be a podiatrist in 2016? The answer is no.

No, because a podiatrist (like all other
physicians) has become nothing more than a pawn
of the insurance companies and Medicare. No
because in our desperation to find parity, we
dove into this insurance game demanding that we
be included in ALL provider panels. The end
result is that podiatrists are no longer
dealing with patients as specific encounters
regarding their pathology. What's done depends
on the insurance coverage, how many patients
are falling off the rafters in the waiting
room, what level of administrative and clinical
burn-out the doctor is feeling in the moment,
the attitude of the patient being treated and
most importantly, what are the guidelines that
must be followed to render care for that
patient and expect to be reimbursed.

No, because patients are no longer going to
doctors based on glowing recommendations from
other patients (as it was when I first went
into practice) but rather who accepts their
insurance. I've been a podiatrist since 1980
and I can honestly say that over the course of
these many years, I have experienced the
erosion of the doctor/patient relationship
brought about by "patient entitlement". Your
patients believe that you are not worthy of
anything more than the co-pay (which many pay
grudgingly) because they "pay" for their
insurance. Interesting, isn't it? They pay for
everything in their lives except their doctors.

I still find it amazing how the public became
conditioned to medical entitlement and doctors
became conditioned to thinking (believing) that
their services are worth nothing. So even
though I run a cash only practice and no longer
deal with all of this nonsense, I can
unhesitatingly state that I am NOT proud of
being a podiatrist. Our podiatric forefathers
had many reasons to be proud. I'd say that the
greater majority of DPMs currently in practice,
if given another chance, would choose a
different profession.

Robert Kornfeld, DPM, Port Washington, NY

Other messages in this thread:

---

08/17/2016    Roody Samimi, DPM

Are You Proud to be a Podiatrist? (Michael. Z. Metzger, DPM)

When I decided on this profession, I was told
it was a requirement to shadow a podiatrist.
And going back to earlier postings, yes --
having patients walk out feeling better is that
motivation and satisfaction in this profession.
As I told my classmates as a podiatry student,
don't get involved in the politics.

But, you may say, you have to make money. I
didn't go into podiatry strictly to make money,
though I can see how frustrating it is for
currently practicing podiatrists, especially
those in practice since 1980, have seen the
historical downfall of all medical professions
(via insurance companies, from a money-making
standpoint) which hit podiatry pretty hard as
well, as I cannot deny there are parity issues.

In return, there are podiatrists like me who
have hope and are positive. So many times while
on this rocky road, I've been questioned by
less positive folks in the profession -- have
you ever considered leaving the profession?
Coming from an athletic and long distance
running background since very young, I don't
give up. I see a lot of negative posts on this
forum, so I thought I'd post a positive one.
There is so much that current and prior
podiatrists have done to bring podiatry this
far, making a difference is really what it
comes down to. Of course, the problem is that
you don't see that difference immediately, as
it takes time.
To the young practitioners just budding I would
say, find your niche in podiatry and if you
don't want to deal with insurance companies,
you do have the option to work in a hospital
setting, the VA and the Kaiser system, to name
a few. If you are currently in business and
are frustrated with insurance companies,
consider making the switch. If you don't have
someone hired to deal with insurance companies
and you are very established in your practice,
attend a practice management seminar-- I have
not yet attended a practice management seminar
and regretted it. I went to one as part of pre-
ACFAS in 2011, and most conferences I have
attended have it, and of course there's the
podiatric practice management national
association.

Anyhow, when I was looking to practice in
Winston-Salem, I found that small private
practices were being bought by the hospital
(Novant)-- which is a large corporation in
North Carolina. However the practice still had
its autonomy, but I was salaried with
incentive. Especially to younger
practitioners, I say-- please don't just throw
your hands in the air, particularly when you've
devoted (for me, 13 years) of your life to the
profession. For me it started with running,
then biomechanics in residency, then I added
dermatology and finally some wound care, all
across the country: from school in Philly, then
Cali, some practice in Cincinnati, a year in
NYC, Allentown, and just was in the Denver V.A.
system. I'd have to say there was definitely
some negativity at the latter, but as any
positive person does, as Andy Meyr, DPM
lectured to our class, as his class was our big
brother/big sister class, take every advice
with a grain of salt. With that, you do what
you need to do to be happy.

Roody Samimi, DPM Denver, CO

---

08/12/2016    Neal Houslanger, DPM

Are You Proud to be a Podiatrist? (Michael. Z. Metzger, DPM)

I am proud to be a podiatrist! But I have
suffered a bit of an identity crisis for years.
In 1976 upon receiving my DPM degree (as did
our esteemed editor of PM News), when people
asked me what I did, I proudly said I was a
podiatrist. However their response was "do you
treat children", or "is that like a
chiropodist". So, I eventually answered that I
was a physician and surgeon of the foot. As
time went on, that was too confusing and wordy
so I then became a foot surgeon. That garnered
some respect, but people confused that with an
orthopedic surgeon.

As our profession became more recognized
through the efforts of our local and state
associations as well as the APMA. And the many
efforts of all of us promoting the profession
through gaining greater knowledge, healing and
educating our patients, podiatry had become
more well-known and recognized by the public.
Flying from California to New York a number of
years ago I was sitting next to a beautiful
blonde and an elderly gentleman in first class.
She was very nice and friendly while he was a
bit standoffish to me, when I asked what he
does, he pompously replied "I make films". He
was Joel Schumacher a famous director (he
directed a couple of the Batman movies and many
others) and she was Kristen Chenoweth a famous
actress of screen and stage.

When he asked what I do, I replied "I'm a
podiatrist". He suddenly treated me with a
great deal of respect and acted very friendly.
We all enjoyed the rest of the flight
conversing on many subjects. I will continue
to be proud of our profession and will always
answer the question of what do you do with "I
am happy and proud to be podiatrist".

Neal Houslanger, DPM, Patchogue, NY