03/22/2023    ABPM Board of Directors

APMA Board Certification Summit

The American Podiatric Medical Association hosted
a board certification summit on March 20, 2023.
Approximately 120 leaders attended the daylong
meeting, which was held in Washington, DC. The
American Board of Podiatric Medicine was
represented in person by President Lee C. Rogers,
DPM, Vice-President Melissa J. Lockwood, DPM,
Past-President William E. Chagares, DPM, Board
member Priya Parthasarathy, DPM, Exam Chair Gina
M. Painter, DPM, and Executive Director Phill E.
Ward, DPM. Multiple other ABPM Board of Directors
and staff listened to a live feed of the event.
Approximately 100 total individuals tuned in for
the remote broadcast.

Open and frank discussion addressed whether
podiatrists are having trouble getting hospital
privileges and/or trouble being admitted onto
insurance panels based on their board
certification status or lack thereof. The group
reached the conclusion that there were significant
and valid concerns related to board certification
and its relationship to insurance paneling and
hospital privileging and credentialing which
adversely affects podiatrists of all age and
experience levels.

A discussion of possible solutions to these
concerns then ensued. Consensus was reached that
some type of single certification board in
podiatry was needed to rectify the challenges
incumbent to the existence of two separate
certifying boards. The actual design, processes,
and implementation of such a board will be further
discussed amongst stakeholders at a future date,
likely later this year, and will require the
cooperation and collaboration of existing
certifying boards to become a reality. Multiple
stakeholders were also in attendance including
representatives from the American Board of Lower
Extremity Surgery (ABLES) and the American Board
of Multiple Specialties in Podiatry (ABMSP) who
advocated for an equal opportunity for all DPMs to
achieve certification. The consensus at the summit
was that future discussion be inclusive of all
boards.

ABPM wishes to thank APMA for organizing and
facilitating this important day of discussion.
ABPM pledges to be involved with any future dialog
regarding this issue and maintains its current
commitment to the vision of a single certifying
board, serving all podiatrists. ABPM is committed
to moving Podiatry Forward and being an active
stakeholder in all discussions in the future.

ABPM Board of Directors

Other messages in this thread:

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04/24/2023    Michael M. Rosenblatt, DPM

APMA Board Certification Summit (Bilal Shamsi, DPM)

Bilal Shamsi, DPM recently published a letter to PM
News decrying the alleged "excessive number of
podiatrists" graduating DPM schools. Medscape
recently published a warning of the high number of
physician retirements coming on board recently,
which is expected to get much worse.

Of course, those described are MDs. Even in my
community, I do not see a high number of
podiatrists treating our expanding elderly
population here in NV. I do see dentists on almost
every block. There is nothing approaching THOSE
numbers of DPMs here. A family friend here (who was
complaining of a worsening Haglund's deformity)
stated that he did not find it "easy" to find a
DPM.

I assume that Dr. Shamsi comes from an area with a
lot of podiatrists. I like to try to keep an open
mind when I read such claims. I wonder if Dr.
Shamsi can provide us with hard data to match his
opinion? Here in NV, we have a number of 3-year
residency trained DPMs associated with MD
orthopedic group practices. I have to admit that I
was surprised by this. But it is what I see
locally. It is what it is.

When we lived in CA, a DPM became the director of
the ambulatory surgical center at the Kaiser
Hospital where I received my care. That was over 10
years ago. We still see DPMs working at that Kaiser
office and their numbers has not decreased. I did
not recognize their names. The "old cadre" has
apparently retired. I assume the demand for their
services continues.

When I practiced, over 25 years ago, I was allowed
as a DPM to accredit my own Medicare Certified
Surgical Center by the State of Washington. My
professional licensure was not an "issue" in this
regard.

Of course, I could be incorrect. I look forward to
seeing data backing his claim. Our population is
aging, and we are not "replenishing" it with
younger people. We have an epidemic of obesity and
higher numbers of diabetics than ever before.
Orthodontists, by comparison, are no longer seeing
a widening number of children and are now required
to concentrate on adults. Onychomycosis, a commonly
seen attribute of aging is not showing any signs of
diminishing.

Michael M. Rosenblatt, DPM, Henderson, NV

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04/24/2023    Michael M. Rosenblatt, DPM

APMA Board Certification Summit (Bilal Shamsi, DPM)

Bilal Shamsi, DPM recently published a letter to PM
News decrying the alleged "excessive number of
podiatrists" graduating DPM schools. Medscape
recently published a warning of the high number of
physician retirements coming on board recently,
which is expected to get much worse.

Of course, those described are MDs. Even in my
community, I do not see a high number of
podiatrists treating our expanding elderly
population here in NV. I do see dentists on almost
every block. There is nothing approaching THOSE
numbers of DPMs here. A family friend here (who was
complaining of a worsening Haglund's deformity)
stated that he did not find it "easy" to find a
DPM.

I assume that Dr. Shamsi comes from an area with a
lot of podiatrists. I like to try to keep an open
mind when I read such claims. I wonder if Dr.
Shamsi can provide us with hard data to match his
opinion? Here in NV, we have a number of 3-year
residency trained DPMs associated with MD
orthopedic group practices. I have to admit that I
was surprised by this. But it is what I see
locally. It is what it is.

When we lived in CA, a DPM became the director of
the ambulatory surgical center at the Kaiser
Hospital where I received my care. That was over 10
years ago. We still see DPMs working at that Kaiser
office and their numbers has not decreased. I did
not recognize their names. The "old cadre" has
apparently retired. I assume the demand for their
services continues.

When I practiced, over 25 years ago, I was allowed
as a DPM to accredit my own Medicare Certified
Surgical Center by the State of Washington. My
professional licensure was not an "issue" in this
regard.

Of course, I could be incorrect. I look forward to
seeing data backing his claim. Our population is
aging, and we are not "replenishing" it with
younger people. We have an epidemic of obesity and
higher numbers of diabetics than ever before.
Orthodontists, by comparison, are no longer seeing
a widening number of children and are now required
to concentrate on adults. Onychomycosis, a commonly
seen attribute of aging is not showing any signs of
diminishing.

Michael M. Rosenblatt, DPM, Henderson, NV

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04/24/2023    Bret Ribotsky, DPM

APMA Board Certification Summit (Bilal Shamsi, DPM)

I feel that Dr. Shamsi has misinterpreted my
concept of a third board. The current issue facing
graduates, and those in practice is that insurance
companies and hospitals are requiring board
certification in order to practice. Many are
unable, through practice experience (lack of
diversified procedures) or allowing eligibility to
expire. This was the purpose of the summit last
month. When I first started practicing TUSPM class
of 1988, all that was needed was passing the
national boards and obtaining a state license in
order to begin working as a podiatrist. Today, that
is not the case.

I worked very hard (did a POR and a PSR-24
residency) to become board certified in: surgery,
orthopedics, wound care and medicine; I collected
all the initials available. These accomplishments
should be preserved and protected for all who have
them. But the world has changed, and now it seems
the survival of our profession teeters on ending
the infighting and cohesively synergistically
working together, to raise the quality and the
respect of the care we provide to the public.
APMA’s email to the membership regarding sharing
our dirty laundry in open forums on 4/20/23
demonstrates that if we cannot work together, our
future is in jeopardy.

If the starting salary out of residency was
comparable to that of a hand, surgeon or a
dermatologist, we would have zero problems with
recruiting the finest candidates for our schools.
But since that is not the case today, we must be
cognizant of lowering the bar and diluting the
talent pool entering our profession. Each of the
schools is a business, and the primary tenant of
business is to remain in business, so they
essentially may lower the benchmark of whom they
accept. And once those are accepted, the pressure
not to fail out sub-par students along the way and
lose significant revenue during years two, three
and four is a pressure we all should be aware of.

The American Board of Podiatry in conception is
being offered as the first steps to the future that
might save our profession. As I stated publicly at
the summit, I believe the best for our profession
is an amalgamation of the two boards to a more
simple name and process, so that the rest of
organize medicine looks at podiatry no different
than other medical specialties.

As I’ve received dozens of emails, privately
sharing my ideas. I think it’s time for everyone in
practice to become involved (through this forum)
and to contact leadership, or replace them, as
change is needed for our success.

Bret Ribotsky, DPM, Ft. Lauderdale, FL

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03/24/2023    Rich Hofacker, DPM

APMA Board Certification Summit (Rod Tomczak, DPM, MD, EdD)

In the late 1980s, I became board eligible.
However, I never had quite enough cases to sit for
certification. I was very fortunate to be
grandfathered into my area hospitals to enable me
to practice what I was trained to do. When I had
the appropriate number of cases, I was told by (at
that time) ABPS, that I could no longer sit for
certification examination, which never made sense
to me.

Now we have a battle between ABFAS (the old ABPS)
and ABPM, which has divided our profession and
made us a laughing stock in the medical world. No
one wins in litigation. What is needed is
negotiation, but both sides have to be willing to
come to the table and negotiate in good faith. We
need to one board that can be agreed on by all.
Perhaps, ABFAS (ABPS) needs to look into the
mirror. How can ABFAS be proud of the fact that
the pass rate for the rear foot boards in our
third year podiatric residents is about 30%? This
is diabolical.

Today's Podiatric residents are highly trained,
intelligent physicians. However, when some test
questions are ambiguous, this is not acceptable.
How can the some of the correct answers be
dependent on the part of the country from which
you obtained your training? When the orthopedic
residents have an examination pass rate of about
90%, perhaps the Orthopedists have come to
conclusion that the more Orthopods that are board
certified and that are on hospital staffs, only
gives them more influence and power in the medical
world.

The podiatric profession is apparently too busy
with internal strife to realize that we are only
destroying the future of our own profession. So,
many areas of our country are begging for
podiatrists and yet the podiatry colleges are
dealing with a declining enrollment. This is a sad
time for our good and noble profession.

Rich Hofacker, DPM, Akron, OH

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03/21/2023    Rod Tomczak, DPM, MD, EdD

APMA Board Certification Summit (ABPM Board of Directors)

"Those who cannot remember the past are condemned
to repeat it." George Santayana wrote the above in
1905. Podiatry is approaching the board
certification intersection controversy once again
and it may serve the profession well to review the
history of ABPS.

ABPS was founded in 1978 when I was a first year
resident. The orthopedic surgeons in Philadelphia
immediately told us we had a weak board and
becoming board certified in podiatric surgery was
about as difficult as getting a library card.
When I finished my second year I was considered
board eligible by the ABPS. One very prominent
podiatrist told me the best way to get hospital
privileges was to get a part time job as a scrub
tech and show surgeons I knew what I was doing in
the operating room and some

how back door my way into surgical privileges.
Another podiatrist, one of the fathers of
podiatric surgery told me we would walk into a
staff meeting where I was going to give a
presentation on bunion surgery and open my
resident surgical logs for all to see. We did the
latter.

I became board certified in foot and ankle surgery
the quickest I could according to the rules of
ABPS, in 1981. In a year or two all ABPS members
were hit by a surcharge to pay legal fees in our
defense of a lawsuit filed against ABPS by minimal
incision podiatric surgeons who wanted the same
certification I had. This lawsuit was settled and
minimal incision surgeons were granted
certification by ABPS under a separate subsection.

I reviewed cases submitted by applicants and had
to reject some because of substandard care. We
had a mentor to talk to when we suspected a denial
was in order so denial of a case was not a
solitary decision.

Next was the committees and then oral examiner.
For awhile oral exams were monitored by an
experienced examiner to ensure new examiners were
capable to examine. Then exam sessions were tape
recorded. Examiners could not examine candidates
they knew and exam takers could eliminate
examiners they felt like rejecting. Supposedly,
the only reason for rejecting an examiner was a
personal relationship, but reputations often came
into play. Examiners were to remain anonymous,
but it's a small profession.

Like many boards, ABPS evolved. Psychiatry and
neurology which had been a single board, split
into separate boards and ABPS introduced forefoot
and rear foot sections allowing podiatrists who
had not done enough rear foot and ankle cases to
become board certified giving them access to
hospital privileges and insurance panels under the
aegis and auspices of ABPS. ABPS underwent a name
change to American Board of Foot and Ankle
Surgery. Regardless of the limitation, forefoot
or rear foot and ankle, the certifying board was
still the ABFAS. It could be argued, to the
casual credentialer at an insurance company or
hospital, the podiatrist was board certified in
podiatric surgery and was placed on a panel or
granted privileges.

I would really like to think the ABFAS board exam
is very difficult. I would hate to think a
nonchalant orthopedic surgeon could sit for the
ABFAS boards and ace it. Young MD/DO physicians
study before taking their respective boards. Some
have study groups that meet once a week during the
first year of practice in preparation. I wonder
how foot and ankle orthopedic surgeons would score
on our LEAD program. I'd like to think they score
in the same ball park as we do.

We do not want to be accused again of having weak
boards and we don't want to return to the days of
lawsuits and intra-professional animosity.

Rod Tomczak, DPM, MD, EdD