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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:
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 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.
11/13/2025
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.
11/12/2025
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 (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 (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 (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
11/11/2025
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
11/10/2025
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 (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
11/10/2025
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
11/08/2025
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
11/08/2025
RESPONSES/COMMENTS (APMA NEWS)
From: Ron Freireich, DPM
I think one of the many problems that our profession is facing is that APMA considers this a "Win". Let me remind some of our younger colleagues what happened in 2013. The Medicare Sequestration happened. The Medicare Sequestration is a budget control measure that reduces Medicare payments to providers by a set percentage, currently 2% under the Budget Control Act.
Starting in 2026 (yes, the same year as our Medicare fee schedule "Win"), this reduction may increase to 6% due to an additional 4% cut under Statutory PAYGO rules, unless Congress intervenes. So now, if one does the complicated math, 4.5% ("Win") minus 6% sequestration reduction equals -1.5%. A negative number doesn't sound much like a "Win" to me. And let me remind everyone that the 2.5% payment increase for 2026 is temporary and sunsets at the end of that year, but the sequestration reduction has been ongoing for the last 12 years.
Ron Freireich, DPM Cleveland, OH
11/06/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Rod Tomczak, DPM, MD, EdD
Dr. Secord, it sure seems like you have had more than what should be a fair share of trouble come your way down there in McAllen, TX. I wouldn’t guess there are that many orthopedic surgeons down there, and you’ve scared them off with your offer to step outside for a good ol’ Philadelphia curb stomping, if there are curbs in McAllen. Regardless, Dale Carnegie would be proud of your approach to resolving any differences between yourself and them bone doctors. I seem to recall you are also a chiropractor. Might that be a source of contention? I don’t know many orthopedic surgeons who think very highly of chiropractors. Come to think of it, even DOs think chiropractors are off the reservation, but that’s another turf war. Something about high velocity cervical manipulation to 75-year-old ladies causing paralysis.
No current podiatrist or even future podiatrist will ever be grandfathered into the DO or MD community. My treatise deals with the current decline in podiatry students matriculating in all the schools and the increase of DO seats available because of the increase in DO schools to thirty something from nine. I am theorizing that many current DPM students were not able to gain admission into allopathic or osteopathic institutions, but now they will. To maintain podiatry as a specialty, I am saying at sometime in the future, DO graduates may be able to match into a podiatry residency after a one-year general internship which would earn them a plenary medical license. None of this will happen overnight and there will be a period of overlap with both DPM and DO podiatrists.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
11/06/2025
RESPONSES/COMMENTS (OBITUARIES)
From: George F. Jacobson, DPM
It's an honor to remember our professors, colleagues, and classmates. They are scattered throughout the country and many times we would not know or honor them. Although sad at times, thank you for keeping us informed. I'm sure if PM News had a survey on whether to continue this tradition, it would be overwhelmingly affirmative.
George F. Jacobson, DPM
11/06/2025
RESPONSES/COMMENTS (PODIATRIC EDUCATION)
RE: Education Beyond the Foot and Ankle
From: Steven Finer, DPM
When I attended PCPM (1972-1976), we had many classes devoted to neurology, dermatology, psychiatry, and traumatology.
I did a one-year residency, most of it was non-podiatric. I was permitted to do anesthesia, CPR, and casting all limbs. Through my years in practice, I have read medical books on all subjects. I still do Medscape courses and was able to complete many subjects far from podiatry. So let the students today know that, we don’t only see a foot.
Steven Finer, DPM, Philadelphia, PA
11/05/2025
RESPONSES/COMMENTS (OBITUARIES) - PART 1A
From: Bruce Blank, DPM, Jerry Peterson, DPM, Ivar E. Roth, DPM, MPH
I absolutely agree with Dr. Barry Block. Publishing obituaries of DPMs in PM News is important for all the reasons cited by Dr. Block. It is also a sign of respect and appreciation for those who are part of our special family and for those who have fought many of the battles on behalf of our profession.
Bruce Blank, DPM
I agree with PM News. Keep reporting the obits. Every so often, it is a classmate like Don Grim who I knew from school at ICPM and from practicing in the northwest like me. It is always nice to recognize their life and contributions to podiatric medicine.
Jerry Peterson, DPM
I would like to commend Dr. Barry Block for including the obituary information about our brother podiatrists in the PM News. First, it is in homage to each and every one who practices in our profession and Barry is correct - what is written in responses is very telling. I read each one of them carefully and reminisce on what that person contributed in their lifetime. Again, keep up the great work Barry.
Ivar E. Roth, DPM, MPH
11/05/2025
RESPONSES/COMMENTS (OBITUARIES) - PART 1B
From: Ira Cohen, DPM, Rod Tomczak, DPM, MD, EdD
I respectfully disagree with Dr. Robert Gottlieb's characterization of the reporting as an obsession and a regularly reported headline. As a retiree, I find it informative to find out about the passing of colleagues whom otherwise I would not have known about. Occasionally, there is a classmate or someone I trained with or I trained. On a few occasions, I was able to send condolences to the family. Thank you and continue to post these.
Ira Cohen, DPM
Thank you, Dr. Block for printing obituaries sent to you. Unless passings are in the same city, there is little chance of learning that someone we knew in school or residency has passed on. The schools are not in the business of informing alumni of deaths.
It’s a wonderful tradition and a fine service to the profession. We easily lose contact with those podiatrists we swore we would stay in touch with when we graduated. It gives readers an opportunity and excuse to call members of a study group or fraternity to touch base again after all these years. And then we promise to stay in touch again until we read another familiar obituary. Maybe Dr. Gottlieb hasn’t been through many of those Schadenfreude moments. I’m grateful to you for printing the obituaries and the thoughtful podiatrists around the country who are kind enough to take the minute needed to send the notice to PM News.
Rod Tomczak, DPM, MD, EdD
11/05/2025
RESPONSES/COMMENTS (OBITUARIES) - PART 1C
From: Howard Zlotoff, DPM
I’m so glad to see your response to the podiatrist questioning the need to post obituaries in PM News. First of all, I give you credit for taking the high road in your explanation. I’m not sure I’d have that “self-control” if it were me responding!
Our profession is comprised of many who are friends, colleagues, fellow classmates, and residents living around the world. While we may not be in contact with them on a regular basis, it is an appreciated service of PM News to share the passing of our fellow podiatrists so that we might reach out to family and offer our condolences.
While we may be professionals to our community, we are all human beings who deserve recognition of our accomplishments in our lives and our passing at the end of life. I sincerely hope this newsletter continues to do both. Celebrate the accomplishments of our fellow podiatrists and give them a final farewell from all who knew them and cared for them.
Howard Zlotoff, DPM
11/04/2025
RESPONSES/COMMENTS (OBITUARIES)
RE: Obituaries in PM News
From: Robert Gottlieb, DPM
There seems to be an obsession with reporting the passing away of a podiatrist in just about every issue. With nearly 20,000 practitioners, doctors passing away will be a regular event. Does death really have to be a reported headline article regularly? I think not. I think this type of routine coverage of obituaries is way overdone. Perhaps just publish all those passing away on a monthly basis, in a separate writing.
Robert Gottlieb, DPM, Oyster Bay, NY
Editor's Comment: PM News believes that the every podiatrist's memory needs to be recognized. This 31-year tradition informs classmates, colleagues, and the entire podiatric community of our collective loss. PM News readers often respond with insights about the descendant that would otherwise go untold.
11/04/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: David Secord, DPM
I greatly admire the time and effort Dr. Tomczak puts into his messages to us. I'm sure that he will be remembered as a sage voice among us. As such, here's my two cents, for what it's worth:
I am of course as old as dirt and don’t really have a dog in this fight. I’m only still working because I lost everything I owned in combination with the Christus Spohn crucifixion and the 2008 banking-housing collapse given to us by the Community Reinvestment Act. Although I’ve taken the USMLE I, II, and III practice exams and passed with flying colors, we are at least a decade away from our two, divergent paths.
One will be obsolescence (brought about by Topor-induced, entrenched fiefdoms, no one will surrender); or common sense (add the classes and residency rotations to become on par with our other allopathic...
Editor's note: Dr. Secord's extended-length letter can be read here.
11/03/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: Podiatric Obfuscation
From: Rod Tomczak, DPM, MD, EdD
Obfuscation is the ability to make things obscure or unclear. A wonderful example is Mark Twain popularized the quote, “There are lies, damned lies, and statistics.” Simply put, it is obscuring the facts, and maybe even talking about statistics and probability. There are two classic ways to look at probability. One is the frequentist view which tells us that if we flip a coin 100 times, when we’re done, we will end up with a 50:50 ratio or close to it of heads and tails. The other method is called the Bayesian or belief-based method of looking at the facts that we know right now or interpreting part of the facts to influence what we are going to say. We are merely leaving out some important details. A hot topic for another posting might be, “Are podiatric seminars science-based or influencer-based experiences.” You get the idea.
An alternative way of describing Bayesian statistics is to say, “Probability probably wouldn’t exist if we had all the probable information.” So, probability gives us a way to think about things when we don’t have all the...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
10/30/2025
RESPONSES/COMMENTS (OBITUARIES)
I am so sorry to hear about Irwin (Irv) Mann's death. Dr. Mann (Irv) was an attending at Northlake Community Hospital when I was a resident in 1970. He left a permanent impact on me with his infectious smile and willingness to help the residents in any way he could. When asked how he was doing, he always responded with "PERFECT", a response I admit to this day, I stole from him.
I only learned later that his life was anything but "perfect". He just didn't want to burden anyone else with his problems. He practiced near me in the '70s in the Chicago Western suburbs and we became close friends. He was an inspiration to me and others and will be sorely missed. RIP, Irv.
Rich Polisner, DPM, MJ, Ponte Vedra Beach, Fl.
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