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11/01/2019    Robert Kornfeld, DPM

The Need to Provide a Separate Medically Intensive Podiatric Medicine Residency (Leonard A Levy, DPM, MPH)

This discussion is a critically important one.
Especially because my professional path brought
me to a deep understanding of human physiology,
the foundations for health and healing and a
never-ending focus on understanding mechanisms
of pathology BEFORE symptoms are treated. I
pursued a path in functional medicine for foot
and ankle pathology because it provides a means
to heal pedal pathology AND improve the health
of the patient. This has been my path and my
passion since 1987 (I am a 1980 graduate of
NYCPM). My career has been extraordinarily
satisfying because the healing is in medicine,
not surgery. Of course there’s a place for
surgery, but without a true mechanistic approach
to healing, we correct one issue but leave our
patients open to future pathology.

Podiatry has always struggled with itself. In
our zeal to be accepted as ”real doctors”, we
focused on pushing ourselves into hospital
operating rooms. Unfortunately, that has not
aided us in achieving parity. It has caused an
unfortunate shift away from podiatric medicine
(even though our DPM degree asserts that is our
specialty). I have tried and failed on my own to
share my knowledge and expertise with this
profession. I ran self-funded seminars but was
consistently denied CME credits. I contacted
every college of podiatric medicine in years
past offering to lecture and was ignored (even
by NYCPM, my Alma Mater). And now, after more
than 30 years of intense experience in this
paradigm and having trained with many amazing
MDs and DOs, I am in the twilight of my career
(I’m now 65) and it is sad to me that this
amazing facet of podiatric medical knowledge and
experience will die with me.

Although I’m very proud to say I’m a podiatrist,
I have all but divorced myself from this
profession after my offers to help up level the
profession were disregarded. I believe the word
holistic makes many podiatrists feel like they
won’t be taken seriously as doctors (which I
believe comes from insecurity from an identity
disorder). My experience has been quite the
opposite. I eventually just gave up and have
watched podiatry flounder to find itself a
rightful place amongst physicians in this
country. I strongly believe it won’t happen
until we graduate podiatric medical doctors who
understand and apply the principles of health
and healing in addition to those who wish to
focus on foot and ankle surgery.

If I had one piece of advice for this
beleaguered profession, it would be to remember
that the foot is attached to a complex human
body that has an enormous amount of epigenetic
influences on its genome. Training needs to
focus deeply and intensively on this.

Robert Kornfeld, DPM, NY, NY

Other messages in this thread:


11/01/2019    Brent D. Haverstock, DPM

The Need to Provide a Separate Medically Intensive Podiatric Medicine Residency (Leonard A Levy, DPM, MPH)

It would seem that if podiatry were are to
become a branch of medicine (MD/DO) the APMA
would have to meet with the American Medical
Association (AMA) and the American Osteopathic
Association (AOA) to see if there is a desire to
see this happen. If there were an agreement the
schools of podiatric medicine would have to
close. The APMA and AMA/AOA along with the
Accreditation Council for Graduate Medical
Education (ACGME) would establish appropriate
training programs.

I suggest a 5-year commitment to become a
podiatric surgeon and 3-years to become a
podiatric physician. Podiatric medicine and
surgery would have a single certification board
with specialist certificates granted as either a
podiatrist or podiatric surgeons. Medical
students (MD/DO) could consider podiatry or
podiatric surgery as their career path. This is
the only way to achieve true parity.
Suggesting that podiatric medical schools grant
an MD/DO is ridiculous. What exactly will
podiatric medical students taking the USMLE
achieve? How does this begin a to address
parity? It demonstrates we have very bright
young men and women studying podiatric medicine,
but it does nothing to address a restricted
license.

Programs offering a DPM/MD or DPM/DO would not
achieve what those calling for, parity of
podiatry with medicine. Dr. Levy admitted as
much with his experience at Nova Southeastern
University College of Osteopathic Medicine. DPMs
who obtained their DO degree went on to train in
other areas of medicine leaving podiatry behind.
To achieve the parity that many so badly desire,
the entire foundation of the profession must
torn down to the ground and built back up.

I agree with Dr. Levy, this is an exciting
profession with continued opportunity for growth
and establishing ourselves as the primary
providers of foot and ankle care.

I don’t agree with the notion that we need an
MD/DO degree but rather strengthen the current
curriculum in the schools of podiatric medicine
and define appropriate tracks of post-graduate
training and practice.

Brent D. Haverstock, DPM, Birmingham, AL
ASPMA


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