01/29/2021    Joe Agostinelli, DPM

Volunteer to be a Vaccinator (Tilden Sokoloff, DPM)

I have followed this topic last several days and
I keep returning to a position I have taken for
many years - “it’s the degree!” You can talk
about “state licensing” which requires
legislation, which is at a snail’s pace - or you
can go to regular medical school, earn your MD/DO
degree and vaccinate to your heart’s content
because your degree allows it! For years, we have
been told we are “physicians” when we really are
not! i.e. DME diabetic shoes have to have a
physician’s co-signature despite the fact that
Medicare lists us as physicians! There is also
inequality in payment for similar services -
because of our degree.

Many of our successes are personal, not
professional successes. For example, we never had
a DPM in the military as an orthopedic department
chairperson until 1991, only because I outranked
all the other doctors. In 1994, I was able to
perform independent physicals on pre- surgical
patients because of being on the hospital
executive committee for credentials. These are
not to just “compliment “myself but to illustrate
that “who you know” is still a factor in our
successes!

Interestingly after leaving the USAF active duty
as a DPM, where I was able to be credentialed to
perform any surgery whereby I could show
residency training or personal experiences, with
full medical staff privileges and benefits as
MD/DO colleagues, in 2004 I was confronted with
the realities of private practice . Our local
hospitals had DPMs as auxiliary / ancillary /
podiatry staff unable to vote but required to
attend the meetings!

Luckily, with my working for an orthopedic
surgery group as their DPM, we were able to
obtain full medical staff status and vastly more
performance based privileging for all of our
local DPMs. Fortunately , when it became time to
obtain physical examination for pre - surgical
cases , the letter I received many years earlier
in the military for these privileges, only
allowed such to happen. In 36 years working daily
with orthopedic surgeons in clinics and large/
small hospitals, in my opinion, until the degree
is changed, there can be no parity. What we think
we can do and what we are able to do without the
credential to back it up is otherwise
meaningless.

Still, as in the past, I have strong beliefs that
we need the MD/DO degree, an internal medicine
internship then 3 or 4 years “Podiatric medical/
surgical residencies” for those that want to
practice as a “regional lower extremity
specialist”. Otherwise, we will still be
lamenting the need to co-sign a form for a
diabetic show or be unable to give a deltoid
muscle vaccination injection!

Joe Agostinelli, DPM, Niceville, FL

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