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05/18/2023
RESPONSES/COMMENTS
RE: Unequal Treatment of Ex-Patriot DPMs by ABPM
From: Jeff Carnett, DPM
There are many of us American trained DPMs working overseas who are not eligible to be board certified by either board as we did one or two-year residencies, but not three-year programs. So, how shocking to see that ABPM will certify those with bachelor degrees in podiatry from the UK, SA, Australia, Malta, and New Zealand who did not take the MCAT, have no basic medical sciences in their courses, and no residencies. These degrees are right from high school.
Doesn't that discredit anyone with the ABPM certification in the U.S.? So, we expatriate DPMs need to take a bachelor podiatry degree so we can get certified, but we can't get certified with a CPME-approved DPM degree and residency? I’m trying to understand how that helps the profession. While overseas, our work is often highly surgical, but alas that doesn't count.
Jeff Carnett, DPM. Auckland, New Zealand
Other messages in this thread:
04/20/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: It’s Time
From: Rod Tomczak, DPM, MD, EdD
If we’re going to keep podiatry just the way it is, perhaps we should find out why enrollment is decreasing. It should be on the upswing. There are so many schools you can walk to school from home, just like grade school. you can even walk home for lunch, and mom cooks dinner for the family. I think the best way to find the answers we are looking for is to use some of that APMA money and contract an extensive outside survey. Yes, that “S” word again, but in order to satisfy the general podiatry population, have some recognized professionals conduct the survey.
Professional does not mean the APMA, but a recognized consumer survey agent like the University of Michigan. Not Quinnipiac or Monmouth University that specialize in political polls, but a consumer-centered organization. I am not a big fan of U of M. As a matter of fact, on football Saturdays, my second favorite team is whoever is playing Michigan. In this realm, however, they would be reliable and valid. The APMA can’t meet those criteria. I fear they would ask questions like how many bullet holes are in the combat planes that return to base? I would expect the tough questions to be asked if we really want to learn anything. Ask DPM students in schools where DOs go to class with DPMs, why did you pick podiatry over osteopathy? Did you get rejected from...
Editor's note: Dr. Tomczak's extended-length letter appears here.
04/20/2026
RESPONSES/COMMENTS (PRACTICE MANAGEMENT TIP OF THE dAY)
From: Kenneth T. Goldstein, DPM
When I was interviewing candidates for any position, my favorite question to ask was, “What do you feel are your weaknesses”.
I always watched to see how they reacted and answered the question. A REAL RED FLAG was if they answered “none”.
Kenneth T. Goldstein, DPM (Retired), Williamsville, NY
04/17/2026
RESPONSES/COMMENTS (FROM PM's CURRENT ISSUE)
From: Allen M. Jacobs, DPM
This article suggests that many of us are unconscious racists, and that our unconscious racism results in compromised patient care. The author suggests self-assessment with the Harvard Implicit Association Test (HIAT). The Harvard Implicit Association test has been highly criticized as being scientifically invalid. This would include, among many studies, those of the Heritage Foundation and the American Psychological Association. The HIAT has been demonstrated to be devoid of reliable psychometric properties. The same person repeating the same HIAT will score differently. Furthermore, the effectiveness of the training programs suggested by the author have not been demonstrated to change behaviors or biases.
Finally, there is poor correlation between the HIAT results and actual behaviors. The HIAT has not been demonstrated to correlate with other established measures of prejudice or discrimination, and has not been shown to predict discriminatory behavior. I am from Philadelphia and hate the Dallas Cowboys. This was part of my upbringing. It was part of my environment. When I see a patient wearing a Dallas Cowboy shirt, I inherently assume they are mentally deranged and in need of help. However, I do not alter in any way the evaluation or care of that patient.
Check out the following:
1. Azar, B. Monitor on Psychology. July/August 2008 Vol 39, No. 7
2. Nagai, A. Science Policy Report. The Heritage Foundation, December 12, 2017
3. Cloud, J. Time Magazine. Oct 12, 2010
4. Jussim, L. Psychology Today. March 28,2022
Allen M. Jacobs, DPM, St. Louis, MO
04/17/2026
RESPONSES/COMMENTS (PRACTICE PEARLS)
RE: Practice Pearl: Billing Patient's Address
From: Richard A. Simmons, DPM
We have found that quite a few of our very senior patients are not listed at their addresses (some live with children, etc.) so their bills or notices are returned.
So, now we automatically create all patients' addresses beginning with c/o, then the address. Such as: c/o 1234 Main Street. This "pushes" the delivery to that address. Care of is abbreviated to c/o.
Richard A. Simmons, DPM, Rockledge, FL
04/16/2026
RESPONSES/COMMENTS (NON-CLINICAL)
From: Patrick A. DeHeer, DPM
Bob, Thank you for your thoughtful and deeply informed response. Your perspective, grounded in decades of experience across podiatry, pharmacy, and patient care, adds tremendous value to this discussion. One of the central themes of my keynote in Copenhagen was exactly what you articulated so well: the future of our profession will be shaped by how we define ourselves, what we can demonstrate through evidence, and how we lead within our respective healthcare systems.
Your work exploring prescribing authority and therapeutic access across FIP member countries highlights the very disparities that must be part of the global conversation moving forward. Scope of practice, including medication management where appropriate and evidence-based, should ultimately be driven by education, competency, patient safety, and outcomes data. I particularly appreciate your emphasis on collaborative frameworks and pragmatic pathways to close practice gaps internationally. Progress often happens step by step, and in many professions, thoughtful expansion follows proof, trust, and demonstrated responsibility.
I welcome seeing this discussion continue as we build toward Dublin in 2028. These are exactly the kinds of evidence-informed leadership conversations that move the profession forward worldwide. Thank you again for your engagement and for your longstanding commitment to advancing patient care.
Patrick A. DeHeer, DPM, President, APMA
04/16/2026
RESPONSES/COMMENTS (PODIATRISTS AND THE LAW)
From: Paul Kesselman, DPM
While this is a rare exception, this is part of the reason why we are where we are with cellular tissue products. Podiatrists and all other wound care professionals have no one to blame but themselves for this mess. How would you expect any financially responsible institution to respond to such a dramatic increase in expenditures since 2018?
This, particularly when audits are done and found there is significant abuse and outright fraud. This not only hurts the vast majority of physicians who are honest practitioners, it also cuts access to care to patients who desperately need these products; in particular as providers and facilities, curtail their use of these vital services.
There’s also abuse on the part of the Medicare contractors doing the auditing and ordering recoupments that financially crippled honest practitioners.This, mostly over picayune paperwork issues. lt is imperative that anyone providing these services understand the full implications of the current crackdown and the need to closely adhere to the required guidelines. If you are in one of the states under the auspices of the WISeR model, it is imperative to submit your claims for prior approval as opposed to pre-payment review after already providing the service.
Paul Kesselman, DPM, Oceanside, NY
04/15/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Robert Scott Steinberg, DPM
It seems to me, in my 49+ years of practice, and a million surveys that rarely effected real change, we are surveyed out! No one seems to be listening except those of us engaged on this forum. I don't enjoy reading fantasies. Students have choices: MD, DO, DVM, DDS, NP & PA. Years to completion and costs are most likely what they are thinking about.
Robert Scott Steinberg, DPM, Schaumburg, IL
04/15/2026
RESPONSES/COMMENTS (NON-CLINICAL)
RE: Podiatrists and Chiropodists Move the World with Their Best Foot Forward
From: Bob Smith, DPM, MSc, RPh
Last evening, I was reading my LinkedIn account and came across a well summarized, hopeful, and inspiring message from Dr. Patrick DeHeer, President of APMA describing his keynote speech: "From Purpose to Proof: Defining and Advancing Podiatry Worldwide". My hope is that perhaps I may someday read the transcript of his keynote address. Further, he wrote describing his belief system: “our future will be determined by how we describe ourselves. What we can prove with data and how we lead.”
I definitely concur and applaud this statement. As student, resident, podiatrist, nurse, allopath, osteopath, pharmacist, and paramedic to whom I have lectured, presented, and written in the classroom, conference, or in the field know very well, my position on medication ordering, prescribing, and dispensing that our licenses direct our scope but we are all held...
Editor's note: Dr. Smith's extended-length letter can be read here.
04/14/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: Stephen Peslar, BSc, DCh
Dr. Tomczak wrote, “I think it’s safe to say podiatry has finally made it into the tightly closed circle of the MD world.” Well, a podiatrist already made it into the serial murderer character category on TV. In the series The Practice, George Vogelman was a podiatrist who was a serial killer and a cross-dresser. He might have inspired Law and Order: Special Victims Unit, to have a character Dr. Carl Rudnick, a pathologist, who was a serial killer and a cross-dresser. So it’s good to see a podiatrist doing a consult rather than being portrayed as a cross-dressing serial killer.
But when Jay Leno was hosting The Tonight Show, he was on the UCLA campus asking university students, “what is a podiatrist?” One young lady asked if it was someone who sexually abuses children. I think podiatrists still have to educate the public about what they treat.
Stephen Peslar, BSc, DCh, Toronto, Ontario
04/14/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Rod Tomczak, DPM, MD, EdD
I was looking over the PM News survey conducted last year that gave a pretty good indication how the profession feels about the DPM degree and residency programs. The first option in the survey stated that the responder was happy with a DPM degree, a limited license, and the three-year residency that is in place now. Thirteen percent (13%) of the 690 responders agreed with that statement. As a raw number, that means only 29 of the 690 who chose option 1 agreed with that statement. That’s 13%. Extrapolated to the approximately 18,000 licensed podiatrists in the U.S., less than 2,300 are happy with the status quo. There are currently 219 CPME-approved residency institutions hosting residencies. That is not the total number of residents but reflects how many hospitals are CPME-approved facilities that have residents, and each one must have a residency director.
One would think that all 219 residency directors should like the idea of a DPM degree and a three-year residency since they are...
Editor's note: Dr. Tomczak's extended-length letter appears here.
04/13/2026
RESPONSES/COMMENTS (CALL TO ACTION)
From: Paul Kesselman, DPM
Over the past week(s) there have been many posts addressing this issue, all of which have focused on retailers allegedly providing diagnostic services to consumers without a medical license. In my humble opinion, if an untrained individual tells a consumer/patient that they have a specific issue and then they treat it with something they provide, that is both diagnosing a problem and treating it. It doesn't matter whether they dispense a cream or an arch support. But that is my opinion and not necessarily fact.
But as you will see from my explanation (from a non-attorney's perspective), the state statutes addressing this may or may not agree with...
Editor's note: Dr. Kesselman's extended-length letter appears here.
04/13/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: Podiatric Musings
From: Rod Tomczak, DPM, MD, EdD
I think it’s safe to say podiatry has finally made it into the tightly closed circle of the MD world. An obstetrician on the TV show Chicago Med asked for a podiatry consult. It seems a young pregnant woman dressed in haute couture presented with a diabetic foot that was both sickening and gangrenous. Yes, one of the stars asked for the consult by podiatry which has reached the hospital’s second floor in the Emergency Department-based medical drama.
There were no other comments about the podiatry practitioner’s non-ACGME approved residency, not passing USMLE and professional school curricula. No one called the attending aside to remind her that the podiatrist had neither an MD nor DO degree, hence, with all the accumulated evidence, not a real physician, and most of all, the consultor has no plenary license. Board certification was not part of the attendings’ conversation. No one mentioned declining admissions in spite of increased seats at 11...
Editor's note: Dr. Tomczak's extended-length letter appears here.
04/10/2026
RESPONSES/COMMENTS (CALL TO ACTION)
From: Robert Boudreau, DPM
APMA, here’s your 15-second ad:
"Would you rather be fitted for an arch support at the Good Feet store that costs $1,000 from someone who had a 1-day training session, or a custom-made orthotic from a podiatrist who has 11-12 years of training in biomechanics of the lower extremity? The choice is yours. Choose a podiatrist!
Robert Boudreau, DPM, Jacksonville, TX
04/10/2026
RESPONSES/COMMENTS (AI AND PODIATRY)
From: Bryan C. Markinson, DPM
Dr. Steinberg asks: "Then, as far as you are concerned, are striving for a plenary license and practicing podiatry mutually exclusive? Can't you see any value? What about the general public not seeing any value in attending podiatry college?"
My response is: Of course, I think a plenary license backed by the education to support it is of extreme value and as many have asserted, may be the only option soon enough. However, if anyone applying to whatever program in the future would offer this opportunity, they will find themselves sitting side-by-side with classmates taking the exact same exams, same labs, subject to the same performance measures, same board requirements prior to graduation from the "program." But the door that opens after that is the wide world of medical specialties that offer residency and...
Editor's note: Dr. Markison's extended-length letter appears here.
04/09/2026
RESPONSES/COMMENTS (CALL TO ACTION)
From: Jeffrey Klirsfeld, DPM
Regarding the Good Feet Store, I know the budget for APMA is small, but we HAVE TO ADVERTISE one way or another that we are the foot specialists and should prescribe a proper device for patients, not customers. In addition, many people are not even aware that they may be covered for custom molded devices.
Jeffrey Klirsfeld, DPM, Levittown, NY
04/09/2026
RESPONSES/COMMENTS (MIPS)
From: Michael Paris, DPM
We switched to NextGen Office EHR a few years ago, but just recently started using it for the 2025 MIPS reporting year, as we had met the threshold for MIPS exemptions for the last several years. After lots of guarantees and assurances that NextGen was the perfect podiatry-tailored EHR to meet all of our needs, including MIPS, I was shocked to find out that they left out podiatry-specific quality measures from their MIPS capabilities and dashboard. They do have "roadmaps" for other measures that are not part of the typical workflow, so coding the podiatry measures into their software would have been very doable, contrary to their statement that "NextGen Office is not able to capture or calculate these measures."
I think they are counting on the time/money/energy costs of switching to a new EHR as a deterrent to small practices actually switching away from NextGen. Hopefully, the collective voices of unhappy podiatrists will move the needle.
Michael Paris, DPM, Hanover, PA
04/09/2026
RESPONSES/COMMENTS (AI AND PODIATRY)
From: Robert Scott Steinberg, DPM
Then, as far as you are concerned, are striving for a plenary license and practicing podiatry mutually exclusive? Can't you see any value?
What about the general public not seeing any value in attending podiatry college?
Robert Scott Steinberg, DPM, Schaumburg, IL
04/08/2026
RESPONSES/COMMENTS (OBITUARIES) - PART 1
Clay was a roommate of mine in the early 1970s. He was a quiet gentleman. He was also a chef. As students, we ate very well during that time. He was willing to cook, as long as we cleaned up.
Paul Taylor, DPM
04/08/2026
RESPONSES/COMMENTS (OBITUARIES) - PART 2
I read of the passing of Hal Ornstein with tremendous sadness. Like so many in the podiatry world, Hal had a tremendous impact on my career in my early professional years. Whether it was making you feel comfortable at your first AAPPM show by a piano in the Pittsburg Airport Marriott or talking management strategy with his dog in his lap and a smile by the pool at Lago Mar, Hal possessed an innate gift for connecting people and sharing his passion for podiatry. He will forever be a pillar of the podiatry community (both for physicians and vendors alike), and his impact was immeasurable. Cheers and RIP.
Nick Turner, Co-CEO of Remy Laser
04/08/2026
RESPONSES/COMMENTS (CALL TO ACTION)
From: Lesley Wolff DPM, MS
After completing my second year at the Ohio College of Podiatric medicine, I was disillusioned by their outdated concepts of podiatric orthopedics. We took it upon ourselves, along with my close friend Dr. Richard Jaffee, to personally invite Merton Root to come and speak to the third and fourth year students in order to enlighten us on the latest concepts of biomechanics related to the foot and ankle.
I personally took Dr. Root up to the infamous Western Reserve Biomechanics Laboratory and introduced him to the director. The following year, we twice invited Dr. Tom Sgarlato to come and lecture to our third and fourth year classes. We were "hooked " on podiatric biomechanics and insisted that the orthopedic department include "Root Biomechanics" in the curriculum. Along with a fellow classmate, we were able to publish an early paper in JPMA on Triplane...
Editor's note: Dr. Wolff's extended-length letter appears here.
04/08/2026
RESPONSES/COMMENTS (MIPS)
From: Kenneth Meisler, DPM
I started with podiatry-specific EMRs in the early 1990s. I believe I have had three different ones. I was happy with all of them. I only switched when the company was bought out by another company and you had to switch to the new company's version. I was going to do the same thing about 2 years ago because my current EMR had been bought out, and again you had to switch by a certain date or it would not be supported or even run. I was prepared to do the same thing as in the past, just go with the new company that had bought it. There are four doctors in my practice and the price was going to go up dramatically per doctor.
I thought it was time to look into other programs, especially because the price for four doctors was basically four times the price of one doctor, even though it involves significantly less work for the EMR program to support one office with four doctors than four offices with one doctor. For example, we have only one billing person to call and ask questions for all four doctors vs four separate billing people to ask the same question for four one doctor offices. In the past, they always gave a multiple doctor office a discount or I was able to negotiate a discount from paying 4 times as much as four one doctor offices. This time there was absolutely no flexibility so I thought I should consider other programs and decide.
I then looked at Next Gen because 2-3 years ago, it was the "preferred EHR of the APMA" and...
Editor's note: Dr. Meisler's extended-length letter appears here.
04/08/2026
RESPONSES/COMMENTS (AI AND PODIATRY)
From: Bryan C. Markinson, DPM
The AI answer to the question of stepping up podiatry to the same level of recognition and respect as MD/DO is no surprise. The MD/DO world has stated for many years in many ways "just do what we had to do." That has always been the key to what has now reached a high level of discussion and controversy. Proclamations of equivalency from podiatry leadership has always fallen on deaf ears and frankly is not true.
I still maintain that putting a DPM student side-by-side with an MD and DO one, taking all the same tests and milestones, will create less students actually practicing podiatric medicine as their list of choices of specialty will be wide open.
Bryan C. Markinson, DPM, NY, NY
04/07/2026
RESPONSES/COMMENTS (CALL TO ACTION)
From: Jack Reingold, DPM
It is interesting to see the recent number of posts regarding the Good Foot Store. Whether what they have done over the last 44 years—since the first store was established—is good or bad, it is remarkable and perhaps points to a PR failure for podiatry. My experience with them goes back further than any other podiatrist because they opened their first store in 1992 in Solana Beach, a small coastal town in San Diego County, where I practiced. They even asked me if I would be their “Podiatry Director.” In spite of the promised riches, I turned them down.
This is the history as I know it, from first hand accounts. In those days, infomercials were big business, and the money was not in selling the products but in producing the commercial and selling the airtime. The founder was in that business and was looking for a product he could market, eventually deciding on an “innersole.” In the beginning, they cost a couple of hundred dollars and came in only one...
Editor's note: Dr. Reingold's extended-length letter appears here.
04/07/2026
RESPONSES/COMMENTS (PODIATRISTS AND BURNOUT)
From: Robert Kornfeld, DPM
Dr. Mankanjoula makes a very valid point about podiatrists being classified as "allied health professionals" and not physicians. I cannot help but raise my eyebrows and shake my head. This is exactly the issue that the "leaders" of the profession promised to fix back when I graduated NYCPM in 1980. Is it at all logical that almost 46 years later, the same issue still plagues podiatry?
At the same time, there are NPs in NYC opening up "Foot Care Clinics" and because of their plenary license, they have access to treat anything they choose. Clearly, the reason they are opening up in foot care is because there is a market out there. And what is the market they are moving in on? Non-surgical foot care. Why? Because this profession decided we should be surgeons first. And just to put this in perspective, I gave up surgery in...
Editor's note: Dr. Kornfeld's extended-length letter appears here.
04/07/2026
RESPONSES/COMMENTS (MIPS)
From: Summer R. Weary, DPM
I recently migrated to NextGen EMR based on assurances that it supports podiatry. Since implementation, I have encountered multiple issues. The company’s inadequate support for podiatrists—especially regarding the new MVP MIPS pathway—is deeply disappointing. Vendors that charge substantial annual fees, including to small practices like mine, have a responsibility to provide reliable, specialty-specific support.
Small practices already face numerous challenges in today’s healthcare environment; we need partners with the integrity and resources to back us. I agree with Dr. Brody: we should use this forum and social media to raise awareness and hold vendors accountable.
Summer R. Weary, DPM, Cookeville, TN
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