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05/10/2021
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: Bret Ribotsky, DPM
I just read an email from APMA containing a copy of a white paper agreement between the MD world and the DPM world. In essence, it says that if a DPM takes and passes the United States Medical Licensure Examinations (USMLE) and all of our “training programs” meet the MD/DO Standards, they will recognize us at physicians with limited licenses. WOW - what incredible negotiations that our leadership engaged in. It's crystal clear that if we jump through all the requirements and rules of any foreign medical school graduate, we would still be a DPM with limited license with additional recognition from the big boys in medicine, while foreign medical students who pass the same criteria would be licensed as MDs. What did the orthopedic surgeons give up during this negotiation? We validated that we are NOT physicians at this time.
After reading this white paper, why are we still trying the keep the DPM degree? If this proposal goes through at the AMA meeting, and we clearly MATCH the training of MDs, we will still be subservient to the MDs.
Bret Ribotsky, DPM, Boca Raton, FL
Other messages in this thread:
07/16/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: Robert Scott Steinberg, DPM, Daniel Chaskin, DPM
What is missing from this conversation is how the public and others in healthcare perceive us. At least once a month, a patient asks me, do you do surgery? Orthos are not referred to as orthopedic doctors, are they?
At Humboldt Park Health (formerly Norwegian American Hospital), our department, which used to be a section of surgery, is now called the Department of Podiatric Medicine and Surgery and has been for over 12 years. The Illinois Podiatric Medical Association has been renamed the Illinois Association of Podiatric Medicine and Surgery. I support the APMA's recommended change.
Robert Scott Steinberg, DPM, Schaumburg, IL
The APMA has finally succeeded in proposing a definition that would increase our scope of practice by including the treatment of systemic diseases as part of podiatric care. The APMA likely agrees that we are part of an honorable profession and our integrity will provide public safety. Podiatrists as well as other healthcare professionals understand even if they are licensed, a license is not a granting permission to give treatment for which a healthcare practitioner is not currently competent at performing.
This is one more reason why podiatrists should consider joining the APMA and our state societies.
Daniel Chaskin, DPM, Ridgewood, NY
07/15/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: James DiResta, DPM, MPH
I read with great interest the recent comments concerning the revised definition of podiatry, specifically as to the removal of the "treatment of the local manifestation of systemic disease". Elimination of this phrase is absolutely paramount for the survival of podiatry. Increasing our scope by inching our way proximal from the tibial tuberosity is not the answer.
If we have increased our level of education to that of a true single track medical school which provides us an equal foundation to our allopathic and osteopathic colleagues during our 1st and 2nd years curriculum in the anatomical sciences and body systems course of study, and we then provide a carefully planned and more focused series of clerkships and classes during our 3rd and 4th years that emphasizes the diagnosis and treatment of systemic illnesses in addition to surgery and...
Editor's note: Dr. DiResta's extended-length letter can be read here.
07/12/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: Brian Kiel, DPM
I just received a request to vote to change the definition of podiatry. Why is the treatment of the leg added to our definition. Exactly how many states allow us to treat, much less operate on, the leg. It is my understanding that there are states that still don’t allow surgical treatment of the ankle. Whose idea was this and what is its purpose? If the purpose is to elevate our status to “MD”, adding the word leg sure is not going to do it. I vote no!!
Brian Kiel, DPM, Memphis, TN
07/03/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: Allen Jacobs, DPM
Quite some years ago, I served as the scientific chairman, assisted by Ray Esper, DPM for the APMA scientific meeting for three years (Disney, California, Las Vegas, and Boston). At that time, the scientific meeting was held concurrently with the House of Delegates. At the Las Vegas meeting, I had invited a number of nationally respected medical school faculty members to lecture. I was rather upset at the fact that it seemed to me that the House of Delegates was receiving priority over my needs for the academic faculty. Although I did not voice my concern, I was indeed upset about this.
James Ganley was one of the individuals I had invited to speak. With his usual insight, he sensed that I was upset. He asked me to take a walk with him through the exhibit hall. He asked me, “Allen, you any good at politics?” I told Dr. Ganley absolutely not. I have an inability to negotiate if I feel someone is wrong and willfully misrepresenting facts or willfully distorting facts. Dr. Ganley looked at me and said "neither am I." He then said, “you know, neither one of us is good at politics. But we do need politicians. We need them to move the profession forward and...
Editor's note: Dr. Jacobs' extended-length letter can be read here.
07/02/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: Allen Jacobs, DPM
There is an old joke that goes something like this: what is the difference between an internist, a surgeon, a psychiatrist, and a pathologist? The answer: an internist knows everything but does nothing, a surgeon does everything but knows nothing, a psychiatrist knows nothing and does nothing, and a pathologist knows everything and does everything, but it is too late.
It is difficult to believe that the AMA position statement, obviously driven by AOFAS, will have any significant impact on your practice. Your medical colleagues who refer to you regularly are well aware that you are not an MD. They are well aware that you did not go to medical school. By virtue of referrals of patients and trusting you with the care of their patients, by action, they respect your diagnostic and therapeutic abilities. Otherwise, they would not refer their patients to you. This suggestion that we pursue legal action in my opinion is unfounded and likely not...
Editor's note: Dr. Jacobs' extended-length letter can be read here.
07/01/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: Ivar E. Roth DPM, MPH
I agree that removing the offensive post is not enough; a retraction with appropriate language is what is needed. The damage is done without the retraction quote. Otherwise, SUE. I would ask nicely for a retraction and if they do not respond, threaten a suit. The AMA are not our friends, as shown with this physician’s issue. The AMA needs to be dealt with appropriately until they give us the correct due respect. Just like in war, use deterrence with strength; cowering to them gets us nowhere.
Ivar E. Roth DPM, MPH, Newport Beach, CA
06/28/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: Robert Scott Steinberg, DPM
What I want to know is what has my many thousands of dollars paid to the APMA done to put money in my pocket. It's time to shed the milk-toast attitude and get mad.
Robert Scott Steinberg, DPM, Schumburg, IL
05/17/2021
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: Clifford Wolf, DPM
American Medical Association House of Delegates Resolution Resolution: 303 (JUN-21) Introduced by: American Orthopaedic Foot & Ankle Society American Academy of Orthopaedic Surgeons Subject: Improving the Standardization Process for Assessment of Podiatric Medical Students and Residents by Initiating a Process Enabling Them to Take the USMLE Referred to: Reference Committee C.
I talked with all concerned parties and confirmed our CPME was never involved in the Joint Task Force and did not have any part in the white paper or resolution. I was very concerned that this paper, generated over the last two years by the ACFAS and APMA, was without input from CPME, AACPM, NBPME and other stakeholders. I recommend withdrawing the Resolution, pull back, rethink this strategy, and formulate a resolution (or not), more representative of our profession.
Clifford Wolf, DPM, Oceanside, CA
Editor's note: Having allowed a balanced debate on this issue, we are temporarily closing this topic.
05/13/2021
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: Douglas Richie, DPM
Doctor Jacobs' observations about the AMA resolution are spot on. In reading the white paper produced by the Joint Task Force of Orthopaedic and Podiatric Surgeons, it is clearly stated three times that currently, DPMs do NOT meet the common standard established by MDs to provide medical and surgical care.
In fact, this paper infers that patients as well as referring healthcare professionals do not have the "same high degree of confidence" that DPMs have met this common standard and DPMs will now need to pass all 3 parts of the USMLE in order to gain that confidence. How this document could have been endorsed by the APMA and ACFAS is confounding.
Douglas Richie, DPM, Long Beach, CA
05/12/2021
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: James R. Christina, DPM, Patrick (PJ) Andrus, CAE
The longest journey begins with a single step. The announcement by the Orthopaedic and Podiatric Surgeons Joint Task Force of the AMA resolution and the white paper was the first step on a long journey. It took the task force three years to get to this point. If the resolution is approved, it will certainly take several more years until we will even know if NBME will grant podiatrists access to take the USMLE. If and when we gain access to the USMLE, we don’t know for sure what direction the process will take. But as it stands today, there are varying definitions of the term “physician,” and at this point we have a map to gain recognition as “physicians” (as defined by the AMA) by AOFAS and AAOS and then hopefully by AMA and AOA.
How this recognition could eventually affect podiatrists and their licensure is unknown at this point. For now and the foreseeable future, the podiatry licensing boards will be the only ones licensing podiatrists for practice, and any change to the exam used (APMLE from the NBPME) would have to go through...
Editor's note: This extended-length letter can be read here.
05/11/2021
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: John Lanthier, DPM
In response to Dr. Ribotsky's observation of "why are we trying to keep the DPM degree if the USMLE proposal is approved?", I'm in full agreement with this statement. As gold is seen as a "barbarous relic" of the past in the age of Bitcoin, so the analogy can be extended to the DPM degree as a barbarous relic from the past that should be upgraded to MD.
I see how advanced the training is now for the new graduates and their level of skill and knowledge and I appreciate that I stand on the shoulders of giants, but even I am selling some gold to buy Bitcoin now.
John Lanthier, DPM, Sudbury, ON, Canada
03/16/2020
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: Joseph Borreggine, DPM
Since there are so many “unknowns” out there regarding the novel coronavirus, I would like to applaud Dr. Rubinstein and the APMA for making the diligent decision to protect all those who would have been attending.
There are so many conflicting reports out there regarding this virus, but the truth is that science and the experts in this field will eventually have an answer. All we need to do is wait. Yes, we all want answers and to live our normal lives, but this is going to take time. And I know, time is money. When the answer finally arrives that we are waiting for, and only then, we will have certainty and normalcy back into our lives. Until then, all we can do is wait and see what happens. This is a scary time. We all want this to go away. It is not.
However, making adjustments and changing what we do as a whole as instructed by the powers that be will have undesired consequence. But, to allow others to make statements of ignorance about this new virus that is fueled by ulterior motives and agendas is unfortunate. This does nothing more than to create complacency which may cause undesirable effects to the population at risk. With that said, every decision that seems extreme in nature such as what the APMA has decided may indirectly and directly save lives. Everyone be safe.
Joseph Borreggine, DPM, Port Charlotte, FL
03/13/2020
RESPONSES/COMMENTS (APMA NEWS) - PART 1B
From: Stephen Schmid, DPM
With all due respect to Dr. Purdy, his comments are a bit short sighted. I have previously worked with the APMA Board of Trustees as the Young Physician Liaison and I can assure you that they did not come to this decision lightly. Their actions are also in line with numerous other organizations including the cancellation of the World Congress of Cardiology, the American Academy of Orthopedic Surgeon’s annual meeting, and even a conference on COVID-19, to name a few.
I have spoken with some of my colleagues in Northern Italy. Their clinics are essentially on hold and there are no surgeries being scheduled except for emergency situations. Their hospitals are currently overrun with COVID-19 patients, many of whom require ventilators.
Make no mistake, this will continue to spread. It is, in part, up to us to help reduce the rate of transmission as to not overrun our healthcare system. As a delegate, I look forward to the HOD every year, but I’m proud that the APMA and the Board of Trustees were able to make the difficult decision.
Stephen Schmid, DPM, Fergus Falls, MN
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