06/09/2022    Eddie Davis, DPM

"Who Wants to Be a Podiatrist?"

Dr. Block asks, “Who wants to be a podiatrist?”
Dr. Fellner discusses how non-professionals appear
to charge more for routine foot care than
podiatrists.

Dr. Block notes that the applicant pool for
podiatric medical schools is too small. That is
interesting considering the fact that the applicant
pool for medical schools is hitting record highs:
https://www.aamc.org/news-insights/medical-school-
applicants-and-enrollments-hit-record-highs-
underrepresented-minorities-lead-surge. This
demonstrates that the lack of sufficient applicant
numbers is a podiatry issue.

We can encourage prospect students and tell them
about the wonderful services we provide as
podiatrists but have to be honest about the
challenges we face. APMA has operated under the
assumption that the way to elevate podiatry was by
emulation of the MD/allopathic education model. If
we are just like them, we will be better accepted.
Our educational system was modified with expansion
of our residencies to 3 years after graduation from
podiatric medical school.

So, 4 years of college, 4 years of podiatry school
and 3 years of residency for a total of 11 years
gives new podiatrists what? It creates
practitioners with a limited license without parity
in reimbursements, limited employment opportunities
which require most to go into more debt to be in
private practice. The numbers just do not add up!
The dental profession got it right as Dr. Fellner
realizes.

Dentistry has a limited scope but defends the right
to be fairly reimbursed and has vigorously enforced
state dental practice acts that limit the ability
of non-dentists to provide dental care. Dentistry
is well respected and did not need to emulate
allopathic medicine to survive and thrive.
A career in podiatry need make financial sense to
prospective students. Podiatry requires more
education/training than any medical specialty
relative to scope of practice.

Despite that, we seem to struggle to assert that we
are the premier providers of the foot and ankle.
That does not just mean assertion of that fact to
the public but to government and payors. We
deserve, based on our training, to be paid more,
not less for similar procedures. At the very least,
we should have parity.

My state organization, the Texas Podiatric Medical
Association, had the opportunity to promote
legislation providing parity in reimbursements but
declined to do so. I have seen no coherent national
plan from the APMA to achieve reimbursement parity.
Adjusted for inflation, I have insurance plans
paying about twenty cents on the dollar for
procedures I performed after I graduated from TUSPM
in 1983.

Yes, I hear that we can negotiate better rates and
drop poorly reimbursing health plans. Sorry, but
small and solo practitioners have little ability to
obtain better rates. Insurance plans often expand
market share by cutting rates to employers. Those
plans then obtain a large local market share, for a
period of a few years, and underpay providers.
That challenge in dropping such plans is just that,
they have a large local market share.

So with a failure to fight for fair
reimbursement/reimbursement parity and requiring
too much of a student financial commitment relative
to scope and earning potential our leadership has a
hard sell.

Eddie Davis, DPM, San Antonio, TX

There are no more messages in this thread.