From: W. David Herbert, DPM
I have always been impressed with anything Dr. Levy has said about our profession. He is spot on today! For example, as an attorney, I have an unlimited license to practice law. However, I would not dream of getting involved in a divorce case! I have even had lawyers more knowledgeable with real estate assist me on some real estate issues.
Today's podiatrist is surely the expert in anything involving the foot or the ankle. I also think we know enough medicine to be able to refer patients to the appropriate physician specialist for our patients that present with unusual medical problems. I just heard a program about a study that showed that the average family practice physician is poorly equipped to prescribe medications to treat mental illness, but are the ones who are treating 2/3 of those with depression!
W. David Herbert, DPM, JD, Billings, MT
From: Leonard A. Levy, DPM, MPH
Name Withheld responded to this question with a statement indicating that when he/she started podiatry school, it was his understanding that the APMA Resolution "Vision 2015" was to achieve parity with MDs and DOs as physicians. He/she further stated that while much has been accomplished, we are still seen as "second-class" doctors. He/she regrets that despite "Vision 2015", podiatrists cannot sign off on diabetic shoes and are not being considered an essential provider, among other things.
I appreciate this young practitioner's frustration and disappointment. How is it possible that even though we can perform complex foot and ankle surgery without the blessing of an MD or DO or can prescribe and administer virtually any pharmaceutical agent including antibiotics and narcotics, we still need a sign off for patients whom we conclude require diabetic shoes.
While this is absolutely absurd, it further emphasizes the importance for the profession and all its components to complete the obvious task of once and for all making it the highest priority of not just achieving "parity" with the MD and DO, but becoming integrated within the broad spectrum of medicine in the same manner that all the other medical specialties are (e.g., dermatology, OB-GYN, ophthalmology, etc.). That is what we already are, that is what we must do; let's stop dancing around this issue and make its achievement the highest priority in the profession.
Leonard A. Levy, DPM, MPH, Fort Lauderdale, FL
From: Jon Purdy, DPM
I found the gap between the survey showing a majority of podiatrists are happy with their career choice, and the paucity of those who would recommend it to their child. Being a solo practitioner has to be one of the worst business models out there. My income, as well as my daily financial liability, depends solely on my showing up. That makes it one tragedy away from complete financial disaster. In addition, we are bound by reimbursements that do not align with inflation, and there is very little we can do about it. In other words, we have lost all control of our financial outcomes with the exception of working harder for less.
I’m a second generation podiatrist, and boy has medicine changed. When my father was in practice, he saw half the number of patients I see and made twice the income. Doctors were once able to use all diagnostic tools at their disposal to rapidly diagnose and treat patients. Today, patients are made to suffer for extended periods of time to meet the “requirements” of the insurance body in hopes a diagnostic modality will be approved. And, that is after the doctor spends extended time and employee wages to document and submit the necessary forms.
These are just a few of the reasons I would not recommend medicine as a career for my child.
Jon Purdy, DPM, New Iberia, LA
