08/06/2021    Richard A. Simmons, DPM

Why are Podiatry School Graduates Not Grasping Biomechanics (Doug Richie, DPM)

Dr. Richie, with all due respect, rather than
change the topic of the question, please offer your
opinion. I am simply offering my opinion. I believe
medical economics and billable CPT codes are
driving all aspects of medicine right now. I am 65
years old, and for the last ten years my annual
physical exam with 5 different PCPs have all
occurred with me fully clothed. I’m sure the
reason why is that the medical group had to crunch
numbers and interpret the CPT codes then determined
that reviewing my clinical lab results and reading
some snippet off of WebMD was “an annual physical
exam.”

I am old enough to remember reimbursements of $300
for matrixectomies; now, it is less than half and
barely more than a simple nail avulsion. I
performed vascular exams for more than $200 each
and simply stopped doing them because the money is
not there.

There really is not a CPT for a biomechanical exam
of the foot and ankle and we can only stretch the
current codes so far. If you’re fortunate enough to
live in a wealthy area like Long Beach, CA (Long
Beach is estimated to be 146.6% of the national
average making it one of the more expensive cities
in the US), you may be fortunate to have a patient
base who is willing to pay for services out of
pocket(my city is 98.6%). Most young podiatrists
are scrambling to get on insurance panels that
dictate pretty much everything they can do, while
at the same time are trying to figure out how to
pay back tremendous student loans.

Do “I personally” think biomechanics is important,
yes; but I also am a realist who sees that all of
medicine is being driven by money and the least
common denominator.

Richard A. Simmons, DPM, Rockledge, FL

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