03/28/2023    David Secord, DPM

Board Certification Summit (John Hultman, DPM, MBA)

Once upon a time, there was a podiatrist of some
note who originally hailed from Michigan. After
being mentioned in one of Lee Iacocca’s books
(when he was at Ford Motor), this podiatrist
(unfortunately) moved to the Corpus Christi area.
Mr. Iacocca overheard this podiatrist sitting
behind him, talking to his partner about
capitalizing upon the UAW provision in their
contract which allowed for 6 weeks of paid
convalescent care after foot surgery and how they
would use this to do a digital procedure on a UAW
member. When they were about to go back to work,
another digit would be done and then, another and
so on.

With the extended time off, a number of these UAW
members would actually have other jobs during the
convalescent period and collect two pay checks.
Mr. Iacocca got off the plane, met with the UAW
and wrote podiatry out of the upcoming contract.
My understanding is that a number of people in our
profession lost their practices in the Detroit
area with the loss of UAW coverage.

This same podiatrist then decided to start his own
board (the rather long and tortured name escapes
me.) Due to many actions which are too lengthy to
mention here, this doctor sued the ABFAS, a long
and expensive legal battle ensued, all of us
received a letter informing us of the financial
plight and were asked to consider a donation.
ABFAS won the lawsuit and shortly thereafter, the
doctor who started all of this closed his practice
without notice and was never heard from again.
Auspicious, to say the least.

Those of us who remember this battle remember the
hard feelings and professional debris left on the
side of the road with this internecine battle to
have everyone “board certified” by someone. It was
expensive, accomplished nothing except clogging
the courts and employing attorneys and left us
wondering how long it might be before something
similar occurred. Here we are.

The threatened lawsuit from those who never did a
residency lead to a dilution of the worth of board
certification by the “grandfathering” action.
Anyone outside the profession who wasn’t already
confused became such after hearing that a person
who only did a preceptorship had the same board
certification as a multiple-year, hospital-
trained, multi-specialty rotation resident (and
perhaps, fellowship trained) individual.

At this point, it is a fair guess that the
preponderance of the “grandfathered” board
certified have reached retirement age and are not
an issue anymore. On the horizon is yet another
maelstrom to threaten the board certification
status.

Moving to a three-year basis for residency and a
multi-year minimum training standard was made (as
far as I can divine) to bring us up to par with
primary care standards. Eventually moving to a
five-year residency standard is likely to occur in
our future to bring us up to standard with other
allopathic practitioners in the surgical arts.
Adoption of the USMLE is inextricably in our
future in pursuit of parity and a plenary license.
If you’ve never viewed a sample of the USMLE phase
I, II and III exams, I would encourage you to do
so. Sobering, to say the least. Break out the
Harrison’s!

What do we do with the elephant in the room? The
phase of training which was less than two-year
minimum in surgery and—before that—included non-
surgical residencies of different acronyms corrals
a not inconsiderable cadre of our peers. How is a
fair administration of privileges and insurance
panel participation assured when the standard for
adequate training in surgery is now set at three
years? How are these individuals not orphaned by
the progression of the whole?

Heady issues worthy of debate. I’m overwhelmingly
glad that I’m not the one who has to figure this
out, as the Paul Kruszka, DPM debacle was
memorable, damaging to the profession, expensive,
and embarrassing.

David Secord, DPM, McAllen, TX

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