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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

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