04/16/2023    Michael M. Rosenblatt, DPM

"Discussion" with a Local Orthopedist

How far we have come as a profession sometimes
shows up on what our colleagues do NOT say: Last
December, I unfortunately fell while getting out of
bed (wearing pajamas with sewn-in slippery
slippers) and believed I might have suffered a
spinal compression fracture. I had it evaluated,
and my suspicions were verified with both a scan
and a spinal x-ray. The doctor at the ER (who had a
father who was a podiatrist) recommended a
kyphoplasty to me which would install methyl
methacrylate to stabilize the fractured vertebra. I
have a lot of allergies and was not certain I
wanted to try this out. Besides, my pain, although
disabling, was not severe enough (3.5 out of 10).

He recommended an orthopedist and this being NV, it
is difficult to get into see that doctor quickly.
But I managed to find another one and got a quick
appointment, to my surprise. We had a very nice
talk and I told him I was a podiatrist, although
retired. His main practice, (of which he was very
proud) was doing lower extremity limb lengthening
surgeries for rich people (mainly men) who wanted
to become taller. He regaled me about his
"marketing" and successful practice. And how many
"rich businessmen, politicians and even physicians"
in their 60s who had the desire to get taller. I
envision this as a very painful operation. He
tacitly agreed.

He showed me a number of x-rays. I was "interested"
and started describing how he introduces the
hardware, and where. By pure chance, I got it
right. I also described previous types, (Ilazerov
frame surgeries). I'm sure I was the only patient
he ever encountered who mentioned that device, and
how painful it is to reset the hardware.

Suddenly he stopped. No more discussion about the
surgery; and how/where he introduces the hardware.
Immediately the x-ray viewer was shut off. He
changed the subject and stopped discussing the
particulars of this operation. It became obvious
that I appeared to be a potential competitor, even
though I was a retired podiatrist. My understanding
troubled him. More recently I read that some DPM
residents are taking fellowships on this operation!
Then, it became clear to me. I don't even know if
this procedure would be covered under our
licensing. But in some states, it probably is. And
that may very well include NV.

It has been years since I did surgery. I had told
him I previously owned and operated a Medicare
Certified Surgical Center. He was "concerned." He
did not want to give any hints or "secrets" on how
he does this operation, especially to a potential
competitor. As it turns out, in NV, almost every
orthopedist group practice has at least one DPM.
This is even true of the orthopedic foot and ankle
practices! I am probably not his "first"
podiatrist. This is a very profitable operation.
There is a lot to lose.

I don't think this would have happened 15 or even
10 years ago.

Sometimes our progress is measure by the potential
"threat" we are to other professionals. My back is
fine; and I did not have the surgery. I am an old
man. This orthopedist is a very nice young man. I
am well beyond attempting anything like this. But
he had his doubts....

Michael M. Rosenblatt, DPM, Henderson, NV

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