11/22/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Rod Tomczak, DPM, MD, EdD
De-extinction is the cutting edge of science, resurrecting vanished species using powerful gene-editing tools. With well preserved DNA from fossils giving us a clear blueprint of an extinct species, extinct species resurrection is possible. Or so says John Kennedy Philip in the most recent issue Philosophy Now.(1) The concept is that given the appropriate DNA, a living organism can be recreated. As of now, tabloid TV has reported celebrities cloning pets for a mere $50,000, but none have been extinct.
Imagine podiatry as a species. If a species does not evolve according to the mandates of an environment that is changing around them, there are several possible sequels. Most of them revolve around a decline in the health or viability of the species (read podiatry for the word species from now on) or even its extinction. In this article, the author speaks to the recreation of Dire Wolves from discovered DNA. If the recreation was not identical, but close, would it be close enough to call it the same species?
The podiatry we practice today is not the podiatry we practiced in 1980, nor was it the podiatry our fathers practiced in in 1960. For NPs and PAs jumping on board, they are practicing a version of podiatry we are familiar with but recognize as a throwback to...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
11/22/2025
RESPONSES/COMMENTS (INTERESTING PODIATRY BASED STORIES IN THE NEWS)
From: Wenjay Sung, DPM
Every podiatry school in America should be offering him a scholarship, ready for him when he’s done with football. For publicity, for clicks, for aura, or whatever it’s called now, put it out to the press because there will be a huge positivity swing for the profession that comes from this.
Wenjay Sung, DPM, Arcadia CA
11/22/2025
RESPONSES/COMMENTS (ACGME ACCREDITATION)
RE: ACGME Recognition – A Small Step to Parity
From: Christian Robertozzi, DPM
Being under the ACGME umbrella by itself will not give us parity. However, it is a step in that direction, the same way that mandating a three-year podiatric residency program was a step in that direction. Medicine is a team sport. Podiatry must be able to bring something of value to the table and demonstrate its worth.
When I applied to my local hospital, there were no podiatrists who had OR privileges. At my interview, I was told to apply to the other local hospital 15 miles away. They initially granted me bedside privileges. For three years, I appealed it until I finally got OR privileges. When I went to do my first case, the chief of anesthesia greeted me with a 10-minute lecture why podiatry doesn’t belong in an OR. He ended his oration with, “We don’t want your kind...
Editor's note: Dr. Robertozzi's extended-length letter can be read here.
11/22/2025
RESPONSES/COMMENTS (MEDICARE ADVANTAGE)
From: Joe Boylan, DPM
After the laughs and giggles and John’s informative overview of Medicare Advantage (MA), John never addressed why MA is popular with patients. I am personally a proponent of traditional Medicare and private supplement insurance; for all the obvious reasons. In NJ and Florida, I ask people on MA plans why they chose their plan. Some of these Medicare-eligible people are low income but MANY are not.
I learned that if you have a plan C MA plan, you do not have the plan B premium deducted from your SSI monthly payment. The 2026 Plan B premium will be $ 202 per month. You do not pay for a supplement plan which can range from $ 200-$400 per month depending on age. Some MA patients do choose a PPO-style plan and do have some additional costs. You do not pay for a drug plan which may be $100 per month. Some people do choose a higher tier MA drug plan and do pay additional costs.
Some of these MA patients are getting monthly debit cards for food and monthly debit cards to cover OTC items. Some provide social meeting areas where breakfast is offered and other services like haircuts. It seems the MA business plan is to get the highest amount of federal money available and pay low physician fee schedules, and at the same time drive down the cost to the patients and provide other amenities.
Joe Boylan, DPM, Ridgewood, NJ
11/21/2025
RESPONSES/COMMENTS (SOCIAL MEDIA)
From: Ivar E. Roth, DPM, MPH
I had a patient tell me yesterday that the wait to see a specialist doctor on referral in her health plan was on average 6 months. This is really terrible. That is why my concierge practice continues to grow and thrive and I am sure will be exceptional when my son takes over in a few years.
Ivar E. Roth, DPM, MPH, Newport Beach, CA
11/19/2025
RESPONSES/COMMENTS (SOCIAL MEDIA)
From: Elliot Udell, DPM
Thank you, Dr. Beaton, for bringing this online support group to our attention. We should all visit it. Many healthcare professionals are upset when laypersons give medical advice on internet support groups. One reason why these support groups have gained popularity is that many doctors fail to communicate effectively with their patients, and the busier they are, the worse this problem becomes. I have chronic medical issues.
Recently, I was prescribed a medication. The paperwork that came with the drug indicated that there might be contraindications with other meds I was taking, as well as untoward side-effects. The nurse at the drug company told me not to take the medication until I discuss it with my doctor. I called to speak with the specialist and was told that I would have to make an appointment to talk with either the doctor or his NP, which would amount to a three-month wait. I realized that the days are gone when all doctors promptly returned telephone calls. I visited a Facebook group on that drug and read how others handled the problem and acted accordingly. Welcome to the practice of medicine 2025.
Elliot Udell, DPM, Hicksville, NY
11/19/2025
RESPONSES/COMMENTS (INSURANCE ISSUES)
RE: Horizon BCBS New Jersey to Pay $100M Over False Claims Allegations
From: Paul Kesselman, DPM
In a recent Becker’s Payer Issues there is an incredible story about Horizon BC BS, which has paid $100M in fines over allegations of violations of the False Claims Act. This is the same company which has ruthlessly conducted post-payment audits on podiatrists for orthotic and other claims. Horizon is also notorious for denying payment on clean claims for all healthcare providers in the State of NJ.
The very same allegations (lack of appropriate documentation and/or misleading billing practices) which Horizon accused many DPMs and other physicians of perpetrating in the State of NJ, Horizon BC has admitted to. it appears that Horizon fraudulently induced the state (or its employees) to award them a multibillion-dollar contract and then overcharged the state throughout the contract’s duration. According to the NJ Attorney General, this fraudulent action represents the state’s largest ever non-Medicaid False Claims recovery. Hopefully, the future impact will result in:
1) Horizon BC making whole any provider who was wrongly persecuted by Horizon BC, who turn out to be crooks in their own right.
2) There is foundation for contract termination, and the State of NJ will have the temerity and grounds to terminate its relationship with the State of NJ.
3) Other state OIG and Attorney Generals acting more vigorously at reviewing health insurance carriers’ business dealings. This is likely not an isolated issue and each state and the Federal Govenment needs to do a better job at watching over the wolf which is watching the henhouse.
Paul Kesselman, DPM, Oceanside, NY
11/18/2025
RESPONSES/COMMENTS (SOCIAL MEDIA)
RE: Plantar Fasciitis Talk and Tips Support Group on Facebook
From: William Beaton, DPM
I have been following the Plantar Fasciitis Talk and Tips Support Group on Facebook for quite some time and have been amazed as to just how much confusion there is around the treatment of the symptoms of plantar fasciitis. It seems as though most of the posters are self-treating with what they can find on Google either before seeing a podiatrist or after failed treatment by a podiatrist or other provider. When the underlying biomechanical malalignment is not addressed, the symptoms will continue to recur as confirmed by the many posts and many of these are less than complementary about podiatrists and their care.
If you are not following this group, I suggest that you do in order to get a feeling of the patient frustration and attitude toward podiatry regarding the treatments and results of our professional care.
William Beaton, DPM, Saint Petersburg, FL
11/18/2025
RESPONSES/COMMENTS (OBITUARIES)
While Dr. Denno was stationed at Ft. Sill in Oklahoma, he called me to come up and see an x-ray he had just taken. I drove the hour north. We were both at a loss to explain what we saw. The radiograph was an AP of both feet showing SEVEN metatarsals at each foot.
Gordy was a kind, dedicated, and excellent podiatric physician. He will be greatly missed.
Peter Harvey, DPM
11/18/2025
RESPONSES/COMMENTS (MEDICARE ADVANTAGE)
From: Alan Sherman, DPM, Connie Lee Bills, DPM
Oh my goodness, the John Oliver segment about Medicare Advantage Plans that Paul Kesselman, DPM shared was just precious. Thank you for sharing one of the best pieces of satirical journalism I have seen in years. Every doctor should have this piece playing in their waiting room as a valuable service for their patients. Sometimes, humor is the best medicine and this one was certainly that. In the words of P.T. Barnum, there is certainly a sucker born every minute.
Alan Sherman, DPM, Boca Raton , FL
I agree what an amazing and informative piece! I learned something from it.
Connie Lee Bills, DPM, Mount Pleasant MI
11/17/2025
RESPONSES/COMMENTS (NON-CLINICAL)
RE: A Call for Unity and Constructive Action
From: Lawrence Rubin, DPM
I have been a proud member of the podiatry profession since 1958, and it is with both deep concern and affection that I observe the current heated discussions on this platform. The frustrations regarding residency competitiveness, our professional standing, and slights by MDs and DOs are real and valid concerns that have, in various forms, been with us throughout the decades.
However, the current tone of the conversation—pitting colleague against colleague in argumentative threads—serves only to diminish our collective strength and distracts us from the very real, practical solutions we need to pursue. We are one profession with a shared goal: to provide excellent lower extremity care and achieve the full recognition we deserve. Instead of reiterating our argumentative positions, I respectfully suggest that we pivot our valuable time and energy toward recommending concrete, remedial solutions for the existing problems. Let us channel our passion into proactive measures.
Lawrence Rubin, DPM, Las Vegas, NV
11/14/2025
RESPONSES/COMMENTS (PODIATRIC MEDICAL EDUCATION) - PART 1B
From: Charles M. Lombardi, DPM
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Email to the Editor on Tuesday, November 11, 2025 |
Editor's response: We appreciate reader feedback, but our publication will not be strong-armed or intimidated. This is hardly the first time — and won’t be the last — that someone has threatened to use their influence to dictate who can express their opinions about podiatry. We remain committed to open dialogue and the free exchange of ideas. Our readers are invited to view the full discussion and come to their own conclusions.
This topic is now closed.
11/14/2025
RESPONSES/COMMENTS (N0N-CLINICAL)
RE: Graphic Cards with Thunderbolt Port
From: Daniel Chaskin, DPM
How many podiatrists make use of desktop graphic cards linked to their laptops with a thunderbolt port to use local language models of offline artificial intelligence? There are medical local language models out there. Perhaps the APMA might consider creating a podiatric local language model geared to podiatry.
This way podiatrists with the proper graphic cards might run such a podiatric language model on their encrypted computer so as to attempt to provide complete privacy regarding patients. An encrypted computer should be used.
Daniel Chaskin, DPM, Ridgewood, NY
11/13/2025
RESPONSES/COMMENTS (PODIATRIC MEDICAL EDUCATION) - PART 1B
From: Steven Spinner, DPM
Parity or Parody…A little boy is standing outside a sandbox where the big kids are playing. He is distressed and wants to play with the big kids but they have not been paying attention to him for a very long time. He thinks that if only they would let him in the sandbox that he will become one of the gang. As we all know, probably not true. He will never become one of the “big kids”….and if he should happen to be invited in, most likely he will be assigned to the corner of the sand box.
At some point, after a lot of whining about his predicament, he turns around and sees a really nice sandbox where all of his friends are having a grand old time. Maybe if he stopped whining about wanting to be in the big kids' sandbox, he would have gained an appreciation for what he already had and found a new appreciation for his...
Editor's note: Dr. Spinner's extended-length letter can be read here.
11/13/2025
RESPONSES/COMMENTS (PODIATRIC MEDICAL EDUCATION) - PART 1A
From: Charles M. Lombardi, DPM
I am writing to address the recent disparaging comments made by Dr. Rod Tomczak regarding me. His experience in podiatry is outdated, as he has not practiced in over 40 years and lost his license due to “personal issues”. One must ask what his relevance is. One must also ask if he has ulterior motives like working for a non-designated board in the hopes of making them become more relevant.
It is clear that Dr. Tomczak is out of touch with the current state of podiatry, a field that has evolved significantly in recent years. He lists his MD degree like it means something when in fact he cannot use it to see patients. His comments do not reflect the advances and practices that podiatrists are actively engaged in. We as a profession have become independent with our own institutions that are...
Editor's note: Dr. Lombardi's extended-length letter can be read here.
11/12/2025
RESPONSES/COMMENTS (PRACTICE MANAGEMENT TIP OF THE DAY)
From: Sam Bell, DPM
Smile and say the patient’s name two times was one of the lessons that Dr. Leonard Hynes taught us back in the ‘60s. We always had a smiley face sticker on the phone.
Sam Bell, DPM, Niskayuna, NY
11/12/2025
RESPONSES/COMMENTS (PODIATRIC MEDICAL EDUCATION)
RE: Do Real Stakeholders Exist?
From: Rod Tomczak, DPM, MD, EdD
Every few years for the last 30 years or so, the idea of an MD or DO podiatrist has popped up in the profession. There was considerable talk each time pining about how wonderful that would be. Barry Block, DPM has penned editorials in favor of the change, and the profession has mostly voiced the opinion that it would be a great accomplishment, but it is a fictitious aspiration never to be realized. That’s because no one will pull the trigger. So let’s be satisfied wallowing in our mire, complaining and wishing the status quo wasn’t.
And here we are again, same location, but this time we’re staring at a fulminating pneumonitis of fervor by the APMA membership. However, the leadership of APMA, Brooke Bisbee, DPM is worried the “stakeholders” need to be consulted about an offer by ACGME to look at our residencies. ACGME has no authority over podiatry residencies at this point. If anything, they are doing us a favor by...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
11/12/2025
RESPONSES/COMMENTS (MEDICARE) - PART 2
From: Paul Kesselman, DPM
While CMS has announced the “Final Rule” for the Physician’s Fee Schedule, things are far from finalized from CMS for 2026. There are many more final rules which CMS has yet to release. These no doubt will also affect all physicians, either directly or indirectly. They include the Medicare Outpatient Prospective Payment System and home health final rules as well as those impacting DME suppliers. Late October and early November are always a bumpy road for these final rules.
As for Dr. Smith’s comments on Medicare Part D, the insurance companies are constantly changing their formularies and in so far as I understand, they are the ones who decide which drugs are to be covered, not CMS. Thus, the variability in drug formularies between companies changes from year to year. Some Part D drugs move to Part B which means the physician administering the medication may now bill Medicare for it. On the other hand, some drugs move from the Part B arena to Part D, in which case the patient’s pharmaceutical plans cover the medications.
With the myriads of medications and pharmaceutical plans and coverages, it behooves one to use an insurance broker who can work off a survey of your medications and provide you with choices from which to pick. Some plans have a high deductible and high co-pay but low premiums. Others have higher monthly premiums but lower or no deductible and lower co-pays. Which medications and whether they are generic vs. brand name and which tier they are in are all basic questions to be answered by someone knowledgeable about Part D Medicare. It is incumbent to work with a broker who can provide you with a detailed prospective for you to make an intelligent decision based on what is best for you and NOT what is best for the broker’s commission.
Paul Kesselman, DPM, Oceanside, NY
11/12/2025
RESPONSES/COMMENTS (MEDICARE) - PART 1
From: George Jacobson, DPM
By lowering the out-of-pocket costs, you perpetually now have a higher part D premium to make up for it, whether you have cheaper generics or no medications. People went from low or no premium to $100 per month (Aetna/CVS) to pay for the lower cap. My part D is now higher than my part B supplement. There is still one part D plan in my area with $0 premium which I’ll change to, but they’ll probably catch on next year to increase their cost too.
George Jacobson, DPM, Hollywood, FL
11/11/2025
RESPONSES/COMMENTS (MEDICARE)
RE: Medicare Part D
From: Lloyd Smith, DPM
The changes to Medicare and the implementation of Part D were promulgated under the George Bush administration. Part D, in particular, benefits insurers and pharma. The limits on Part B are shared by all providers and were designed to prevent a Medicare bankruptcy.
The $2,000 cap for Part D is a step in the right direction. Allowing Medicare to negotiate drug prices is long overdue. Only Congress can alter the Part B formula.
Lloyd Smith, DPM, Newton, MA
11/11/2025
RESPONSES/COMMENTS (SALARIES)
From: Ivar E. Roth DPM, MPH
First, Dr. Rappaport is correct. ACFAS should either prohibit ads for MD foot and ankle Orthos, or ACFAS should contact the equivalent of ACFAS in the MD world and tell them either establish a quid pro quo or no more ads will be allowed.
The solution for your unequal pay is simple. Start your own practice and make as much as you want from your own efforts. Depending on others never really works out anyway.
Ivar E. Roth DPM, MPH, Newport Beach, CA
11/10/2025
RESPONSES/COMMENTS (SALARIES)
RE: Unequal Salaries
From: Chad Rappaport, DPM
I am constantly perusing the different job boards (Hospital employers, private practices, multi-specialty groups, etc.) just to keep a finger on my pulse regarding what’s happening out there. It just seems as time goes on, there are way more employers specifically looking for fellowship- trained orthopedic foot and ankle surgeons and not even considering podiatrists. I have worked for North Orthopedic group for 20 years and it has been great for me. I thought 10 years ago that positions for podiatrists as providers of foot ankle surgery within orthopedic groups would become increasingly more popular, but quite the opposite is what I have found. The starting salaries for our graduates compared to their graduates is not even comparable.
I realize that these folks will be taking general orthopedic call, which is not something that our new grads can do for an employer, but the disparity between salaries is embarrassing. What I’m also seeing now way more often is that Nguyen, a large employer like a hospital system or large multi-specialty group, looks to hire a podiatrist, it’s stated right from the outset that it will be a non-operative position. It just seems like the future for a new Ortho foot and ankle grad is so much brighter than for a DPM grad. With that said, the real issue is why are we making it easier for them and harder for us. Why would the American College of Foot and Ankle Surgeons allow employers to post on our website when they clearly state that they will not even entertain hiring a DPM. It just seems and looks ridiculous that whoever pulls the levers over at access would allow that.
Chad Rappaport, DPM, Westwood, NJ
11/10/2025
RESPONSES/COMMENTS (NON-CLINICAL)
From: Chris Seuferling, DPM
Thanks for the tip. I didn’t know such an attachment existed. I might try it myself. I imagine the exact part you’re having trouble finding is the plastic Dremel VAC attachment itself, because the other parts in the picture (Dremel, air hose, and shop vac) are readily available online or at local hardware store.
Here is what I found on Etsy (key search words “Dremel shop vac attachment”) Just purchase the attachment and then connect it to your Dremel 3000 or 4000. Then connect to shop vac….and presto you’re all set. Fungal dust be gone!
Chris Seuferling, DPM, Portland, OR
11/10/2025
RESPONSES/COMMENTS (APMA NEWS)
From: Gary S Smith, DPM
I think Dr. Freireich brings up a great point. I think it is important to add a little more history. In 1998 as the result of a bipartisan attack on healthcare, the Govt. cancelled the cost of living annual increase in Medicare. They also exempted commercial healthcare insurance from anti-trust laws and protected them from civil lawsuits. This allowed them to fix prices and commit previously illegal activities like denying coverage for covered benefits without cause. This allowed commercial insurances to monopolize areas and cut how much they paid doctors and hospitals for procedures by 75%. They have not raised it since. We are getting paid for procedures and surgeries 75% less than we did in 1996. The government decided farmers need help in the 1970s and all their help ended up in the small family farm becoming extinct. The same is happening to private practice healthcare providers.
Gary S Smith, DPM, Bradford, PA
11/08/2025
RESPONSES/COMMENTS (OBITUARIES)
RE: The Passing of Althea Belinda Finley
I am saddened to hear of the passing of Althea Finley, 64. Althea worked for the California Podiatric Medical Association (CPMA) for over 32 years. As past President of the Harbor and Los Angeles County Podiatric Medical Associations as well as heading the Insurance and Patient Relations South for CPMA, I had many opportunities to interact with her.
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Althea Finley |
I looked forward to her beautiful smile and warm greeting at the Western. Rest in Peace Althea.
Ira Cohen, DPM
