03/05/2020    Joseph Borreggine, DPM

Knowledge Level of Nurse Practitioners (Steven Finer, DPM)

Who are we kidding in this profession about the
education, training, and experience of a
podiatrist (not a foot and ankle surgeon who is a
podiatrist) versus a nurse practitioner (NP)
Well, we all know the answer. So, I will leave it
there. But, what we are not getting is that the
NP is fighting to obtain a full and unlimited
license comparable to an MD or a DO. Here is the
proof: https://www.nurse.com/blog/2019/09/10/np-
shares-insight-full-practice-authority-laws/ and
we are not.

Moreover, podiatric physicians are not even
considering this as a potential and viable
possibility for the profession. Yes, we have the
plenary license stature in California as a
"physician and surgeon", expanded areas of
practice on the lower extremity in Florida for
soft tissue et al., and finally we are now
compensated equal to the MDs and DOs in the VA
System, but I think that is about it.

Oh yeah, less I be remiss in saying there has
been talk in recent years at the APMA HOD and
resolutions in words only to look into possibly
do so, but it looks like this is going nowhere
fast. Talk is cheap. Action speaks louder than
words. So, are we now, as a profession, going to
try and convince the AACPM and the podiatry
school deans that the full and unlimited license
as a DPM is our future or not? Or is opening
another podiatry school the best way to handle
this problem in light of the current admission
roles for the 9 podiatry schools as of Jan 2020
only being 500 applicants. Anyone want to chime
in and tell me why I am wrong, then I would love
to her your opinion as to why I am wrong?

Joseph S. Borreggine, DPM, Port Charlotte, FL

Other messages in this thread:

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03/11/2020    Gary S Smith, DPM

RE: Knowledge Level of Nurse Practitioners (Steven Finer, DPM)

The issue of podiatrists obtaining parity with
lesser trained medical professionals that have a
broader spectrum of care than we do has come up
many times. Many people would like to see this
change but instead of doing anything everybody
sits back and expects podiatry "groups" that have
nothing to gain and everything to lose to do it
for us. If we're going to make a move, now is the
time. There is a huge shortage nationwide in
healthcare providers. Many places only have PAs
treating patients with no MD coverage and
everybody looks the other way.

I have thought about starting a dialogue with
legislators in Pennsylvania about this but I have
some reservations. If I was able to get it
approved in some manner to where DPMs could treat
medical issues, most likely with an additional
training and exam scenario it may lead to more
problems than solutions. DPMs from around the
country would flock to PA until other states
caught up. The three year residency crowd would
try to make medical care an exclusive right to
them and large medical conglomerates would try in
raise the cost of compliance so high that only
their employees could afford to comply.

The biggest way it would help our bottom line
would be to allow us more job opportunities as a
healthcare employee. The biggest reason to make
the move even though it may not be the best for
most of us in the short term is that podiatry
could become obsolete. The three year mandatory
residency requirement is killing our profession
and as we become less influential insurance
carriers will care less about us. They could
eliminate nail care reimbursement or even
coverage for podiatric services entirely. Some
insurances have already done this and I expect
any "Medicare for all" programs to make that
their first priority.

Gary S Smith, DPM, Bradford, PA