Podiatry Management Online


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From: Greg Caringi, DPM


As I have gotten older, I put together a rock-and-roll cover band with some of the other docs in my community as a reaction to many of my high school friends joining ukulele groups and playing pickleball. I hope that future generations do not ignore the wisdom and work of those who went before them. Our parents' generation is all but gone. I still have many questions that I wish I could ask them.


Greg Caringi, DPM, Lansdale, PA

Other messages in this thread:



From: APMA Board of Trustees


Comments about APMA’s testimony presented incomplete and misleading information. APMA is the greatest advocate for this profession, driven by the expressed needs of its members. Let’s examine the facts.


After the APMA bylaws revision adopted by the House of Delegates in 2020, the Joint Committee for Recognition of Specialty Boards (JCRSB) was transferred completely to the Council on Podiatric Medical Education (CPME). CPME now has a Specialty Board Recognition Committee (SBRC) responsible for the initial and continued recognition of specialty boards. CPME documents 220 and 230 govern this activity, and an ad hoc committee of CPME is rewriting these documents. The ad hoc committee set up a listening session to solicit input from the interested stakeholders regarding these...


Editor's note: This extended-length letter can be read here.



From: Keith L. Gurnick, DPM


Those of us who did not use or offer the "Cartiva" all lost many surgical patients who first sought out our opinions for surgical treatment for stiff or swollen or painful osteoarthritic 1st metatarsal phalangeal joints  (hallux limitus, hallux rigidus).


We gave them "patient specific" and "condition specific" current surgical options available of either a cheilectomy, shortening or PF osteotomy, joint replacement with an artificial "real" implant or joint arthrodesis-fusion, only to have some of those patients end up getting a Cartiva procedure elsewhere that went on to failure. How do we know? It's because some of those patients lost confidence in their "Cartiva" surgeon and returned to our offices for help. We spoke with those patients and they told us what they were told and why they had the surgery elsewhere. Broken promises.


Patients chose this procedure because they were told that it was less joint destructive, had quicker healing, had better range of motion, was salvageable in case of failure, and that the published research papers had shown excellent results. All of this has shown to be untrue for most patients. It is a shame that patients are so easily influenced by "direct to patient marketing" from the manufacturer, and also by the foot surgeon and on their websites as well  and how the public is all too often mislead.


Keith L. Gurnick, DPM, Los Angeles, CA



From: Paul Kesselman, DPM


Kudos to Dr. Allen Jacobs for a superb essay on the issues surrounding Modern Vascular. Many of our colleagues in all fields of medicine steer their patients to facilities such as ASC where they are part owners. More recently, an orthopedic implant manufacturer was convicted of incentivizing an orthopedic surgeon by providing millions of dollars of free implants for surgeries performed out of the USA. In return, the surgeon also performed many of those same surgeries here in the U.S. using these same implants. Just today, an ENT surgeon was also found guilty of re-using sinus implants costing the tax payers millions of dollars.


I wholeheartedly agree (as we all should) with the last paragraph of Dr. Jacobs’ recent essay, that is “The decision not to act is a decision.” For those who wish to act responsibly, contacting a healthcare attorney is the responsible measure to...


Editor's note: Dr. Kesselman's extended-length letter can be read here.



From: Thomas Silver, DPM


I remember the wise words of an instructor who said, "when a patient has knee pain, our job is to determine if the pain is coming from the knee, above the knee, or below the knee. If it's coming from below the knee, then we can fix it; otherwise, refer them to the appropriate specialist who can fix it." I think the same goes for back pain. If it could be coming from the feet, then (hopefully) we can fix it. Over the years, I have found it to be a real bonus when I get patients into orthotics and they tell me that their knee, hip, and/or back pain went away too!


Thomas Silver, DPM, Golden Valley, MN



From: Bruce Smit, DPM


I too recognized the hazard of getting older as I aged. Many years ago as a young man and before my medical training, I played in a rock band in the Chicago area that played all the top 40 hits of the time. We were, thankfully, successful competing against a plethora of garage bands all who wished for "Rock and Roll success". We played record hops with the top DJs in Chicago's radio industry. We played with Herman's Hermit's and Wayne Fontana and the Mind Benders on stage at Chicago's Arie Crown Theatre in McCormick Place. We recorded a 45 rpm record at RCA Victor studios, and as it was time to release the single, The Beatles arrived! 


55 years later, I ran into the drummer by accident. He was still playing his guitar as a one-man band in the local lounges. We decided to "regroup" and with the help of two more formed a cover band. We have a regular gig at a local bar/grill and host about 75 guests at a time. What a blast we are having at age 76 years, grey hair (no pot bellies), and fortunately good health.


Bruce Smit, DPM, Frankfort, IL



From: Steven D Epstein, DPM


Name Withheld's comment about obtaining used open vials from the OR while the nurses look the other way is a direct violation of safe injection practices. This CDC document explains that multi-use vials should be dedicated to a single patient, whenever possible. 


In many states, such as Pennsylvania, where I practice, all it takes is a single anonymous complaint from a patient, employee, or other person to the department of health that you are doing something wrong and that will bring down a surprise inspection of your office, in which everything in your office is fair game for them to look at. This then can result in immediate license suspension. This is done by the health department's administrative power without due process, and without any specific regulations within the podiatry practice act having been violated. Then you have to appeal to get your license back. Many docs would be surprised at what a bunch of nurses and epidemiologists might consider substandard, such as your flooring material and the kind of products you use for office cleaning. All of these things are covered in a host of CDC and other relevant agency documents. 


It would be very easy for Name Withheld to get into trouble. An employee of the hospital who disagrees with another employee's practices could simply lodge that complaint.


Steven D Epstein, DPM, Lebanon, PA



From: Estelle Albright, DPM


You are correct in stating, "A simple scratch causing a break in the skin" could lead to consequences...particularly if it occurs in the act of drilling toenails or using a Dremel drill with sandpaper small scratch or scrape with a power tool like a Dremel causes a serious issue." Why not instead treat the underlying fungus problem: Be the physician that you are.


Nothing anyone can say will change the minds of those who insist on using this archaic way of treating patients' fungal nails. I wonder how this would stand up in court..."So, doctor, you use a woodworking tool to treat patients, is that correct, doctor?"


Estelle Albright, DPM, Indianapolis, IN



From: Gary S Smith, DPM


The issue of podiatrists obtaining parity with lesser trained medical professionals that have a broader spectrum of care than we do has come up many times. Many people would like to see this change but instead of doing anything, everybody sits back and expects podiatry "groups" that have nothing to gain and everything to lose to do it for us. If we're going to make a move, now is the time. There is a huge shortage nationwide in healthcare providers. Many places only have PAs treating patients with no MD coverage and everybody looks the other way.


I have thought about starting a dialogue with legislators in Pennsylvania about this but I have some reservations. If I was able to get it approved in some manner to where DPMs could treat...


Editor's Note: Dr. Smith's extended-length letter can be read here.



RE: Medical Marijuana and Podiatry

From: Jay Kerner, DPM


As per my previous posts regarding prescribing medical marijuana for such conditions as diabetic neuropathy, ishemic pain, and debilitating arthritis, I again wish to raise my concern that as podiatrists, we de-value our profession by not retaining parity with the other medical professions. 


As stated in Newsday last weekend, as of November 29th, nurse practitioners may certify patients for medical marijuana in New York State. Physician assistants will no doubt eventually be included, as they are already licensed to prescribe...


Editor's note: Dr. Kerner's extended-length letter can be read here



From: George Stephen Gill, DPM, MBA


Kudos to Lawrence Rubin, DPM - academic clinician extradonaire! To this day, his diagnostic radiology course  (62/63 ICPM) resonates superior every time I view a film or do a differential diagnosis of osseous pedal pathology. Thank you Larry ...just thought you and others should know!


George Stephen Gill, DPM, MBA  Denver, CO,



RE: Vasyli Medical Affiliates Program  (Eric Simmons, DPM)

From: Brandon Noble

Regarding the concern of the legality of the Orthaheel referral program and the referral bonus paid – we at Orthaheel have performed our due diligence researching law and discussing the program with governing bodies of healthcare professionals before launching the program to ensure we are providing a legal and ethical program to our valued customers. 

The goal of the Orthaheel referral program is to reward physicians for referring patients to Orthaheel with the goal of creating a great experience for both the patient and physician. If any of you have concerns or question regarding the program, we would be happy to answer them. Please feel free to contact us at for more information.

Brandon Noble, CO, LO, Director of Medical SalesVionic Group,


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