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03/29/2023
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Jon A. Hultman, DPM, MBA
I think many of the postings concerning board certification on PM News miss an important point about our specialty. All of today’s residency programs are standardized, three-year, comprehensive programs, which include both medicine and surgery. With a few exceptions, the vast majority of those practicing in our specialty provide both surgical and non-surgical care. It seems illogical to me that a DPM today would need to choose between being board-certified in medicine or board-certified in surgery when they are trained to do both, and in practice, they do both.
Yes, some residency programs and fellowships provide more advanced types of surgical procedures, but every medical and surgical specialty has those same exceptions. It seems to me that after completing a three-year comprehensive medical/surgical residency program, there would be one certifying board that certifies DPMs as podiatric physician and surgeons.
Jon A. Hultman, DPM, MBA, Sacramento, CA
Other messages in this thread:
08/22/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Keith Gurnick, DPM
In my office, I keep a small box filled with used, worn out or broken instrument spare parts, and screws from broken tissue nippers and nail trimmers with broken springs. Often, when a spring breaks on a tissue nipper or a toenail clipper, I can easily replace the broken part quickly and simply with a similar part that I saved, and am able to locate in the box. Otherwise, the broken instrument goes into the box, or into the trash, and I will purchase new ones.
However, if you have broken two out of four new nail nippers, either the quality of the nipper is poor (Pakistani stainless steel vs. German stainless steel) or you are using too small of a clipper on too thick a toenail, or you may be heavy-handed or rushing, or you might just need a larger nail clipper, or you may need to "adjust" or "modify" your toenail clipping technique.
Keith Gurnick, DPM, Los Angeles, CA
07/30/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Rod Tomczak, DPM, MD, EdD
Dr. DiResta gets it! It's not because he mentions me or my ideas about the DO path to an unrestricted license but because of his observations concerning the DPM degree NOT being a starting point to move forward. It is a starting point to move laterally. You can have an MHA, MPH, or a PhD in healthcare, but try to aspirate a knee and see how far a master's degree gets you.
Get the DO degree, then enough ACGME-approved residency time to get an unrestricted license, followed by an APMA fellowship in podiatry from Temple, Touro, LECOM, DMU, or UTRGV. Now you can move forward from your starting point.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
05/26/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Allen M. Jacobs, DPM
Arden Smith reminds those of us from Philadelphia of his appreciation of Louis Newman and "Buzz" Forman. Both of these were also mentors of mine. When I was working in the OR at Kensington Hospital in Philadelphia, I was fascinated watching Dr. Forman teach podiatry students on clinical rounds. He went on and on questioning and educating the students. He was not a paid faculty member of the college. If I recall correctly, he was one of the first ACFAS members with a very low number on his certificate. He was devoting his time to advancing our profession with no financial award. I was very young working as a patient transporter from the room to OR and back. I remember how shocked I was watching him remove 10 toenails, thinking OMG! I watched him do forefoot surgery, always teaching. That is how you advance a profession.
Louis Newman was a dedicated surgical educator. I worked with him at Oxford Hospital and Rolling Hill Hospital in Philadelphia. He would take the students to lunch, educate us over a meal, direct and build our skills in the OR, then spend time with us after cases...
Editor's note: Dr. Jacobs' extended-length letter can be read here.
02/19/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Elliot Udell DPM)
We need to be honest with ourselves. Comparing our profession to dermatology and orthopedics to show that there is nothing wrong with teaching nurses how to practice general podiatry is unfair. Why? Every dermatologist and orthopedic surgeon knows that the overlap between what we do and what they do in their practices is small. We do not operate on knees and hips nor treat skin disorders above our anatomic ranges of practice. On the other hand, everything a podiatrist does can be duplicated by someone in the MD and DO worlds.
I suspect that Dr. DiResta's concern is that MDs and DOs choose not to practice non-surgical general podiatry. If we train nurses to do what almost all of us do most of the time, why would they send us any of their patients for foot care? They can hire a nurse to render all general foot care and profit from it. Taking it one step further, nurses and PAs can be trained to do most of the foot surgeries we do, but we probably don't have to worry about that in a few years to come.
Elliot Udell, DPM, Hicksville, NY
10/25/2024
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Lawrence Rubin, DPM
A recent post in PM News pertaining to insurance reimbursement compliance said, "Any abnormal findings on the LEAP Vitals Exam, i.e. dry and xerotic skin (L85.3) caused by sudomotor dysfunction, is a significant risk to a patient with diabetes. It therefore warrants a care plan." To prevent confusion of business names, this is not a stated opinion of the 501(c)3 not-for-profit LEAP Alliance.
Lawrence Rubin, DPM, Las Vegas, NV
09/23/2024
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Ron Werter, DPM
What I don’t understand (and maybe the lawyers among us could explain) is how does the insurance company have the legal right to charge the doctor for writing a prescription. The doctor has no financial stake in the prescription; the patient and the pharmacy are the ones who have financial benefit. Is there something in an insurance company contract that says they can do that?
Ron Werter, DPM, NY, NY
09/03/2024
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Jerry Peterson, DPM
No, you are not missing something. He should be able to assist ANY physician on ANY surgery. In Oregon, a podiatric physician can assist in general surgical procedures, Ortho, Neuro procedures, etc. They are not required to have the privileges to be able to assist. Good luck moving forward.
Jerry Peterson, DPM, West Lynn, OR
11/21/2023
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Richard M. Cowin, DPM
For a practice valuation, I highly recommend Mr. David Price at Podiatry Broker. He offers three (3) levels of service for three (3) different prices: $395.00 for a ballpark evaluation, $995 for an off-site evaluation, and $3,995 for an on-site evaluation.
Richard M. Cowin, DPM, Orlando. FL
03/30/2023
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Lloyd Smith, DPM
Jon Hultman’s experience and wisdom is apparent in his comments. Podiatry has faced similar issues now facing the board certification process. At this point, a big tent approach is needed. All representative groups must be included and a skilled facilitator is needed. All relevant issues need discussion.
Without presenting an opinion, the solutions should come from this group. Having chaired a similar process, the interactive group needs to commit time, resources, and a deep desire to find compromises. The task is not easy. The need is apparent.
Lloyd Smith, DPM, Newton, MA
07/21/2022
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Bryan C. Markinson, DPM
The USMLE or "equivalent" exam taken by podiatrists as discussed by Dr. Sherman will never materialize and if it does, who would take it and accept the limited scope of podiatry while others would have their choice of every medical specialty? Not enough to fill any podiatry school.
The AMA and NBME say simply, just go to medical school. The quoting of Frederick Douglas' reference to "injustice and wrong" as a parallel to the AMA or NBME stance on podiatrists is a bit of a stretch and may be offensive, though I am certain that none was intended.
Bryan C. Markinson, DPM, NY, NY
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