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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:
04/23/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Paul Kesselman DPM
I am not sure where Dr. Smith got his information that a family practice or hospitalist residency is one year. According to ACGME and my family physician, a 3-year residency is required before one can become board-certified in that specialty.
A hospitalist is essentially a family practice physician who has chosen their career to work in a hospital setting as a family practitioner. Bottom line is that MD and DO all have to do a minimum three-year residency. Some are even longer and require fellowship post-residency which can last two or more additional years.
Paul Kesselman, DPM, Oceanside, NY
04/23/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1B
From: H. David Gottlieb, DPM
Dr. Jacobs obviously does not constrain his journal related education to the narrowly defined podiatry titled journals. Publications such as WOUNDS [which a JAPMA is online only] and Advances in Skin & Wound Care, just to name 2, publish research and case reports by podiatrists frequently, if not almost every issue.
My experience with residents and getting them to work on posters which can then be used to create publishable papers is that they feel they have too many administrative requirements taking up their time. The too few residents that understand the importance of publishing case reports/research do an excellent effort with it. Those that don't often cite the requirements imposed by case logging as the reason they don't have the time to generate even case reports let alone results of clinical trials or perform research. I agree that while research and creating papers of a publishable quality are, I believe, still a requirement for residents it's a shame that more papers aren't published with resident input.
H. David Gottlieb, DPM, Columbia, MD
04/23/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1A
From: Amol Saxena, DPM, MPH
Dr. Jacobs brings up some interesting points. Many DPMs publish outside "podiatric" journals and those may often go unread. I was recently notified through "Researchgate" that an article from the Journal of Istanbul School of Medicine ranked the top 50 articles on Talar OCDs. They only reviewed articles cited in "high impact" factor (IF) journals, and one of mine published in the American Journal of Sports Medicine in 2007 (IF 4.5 from 2024) was ranked 15th. I published a much larger series in 2021 in the Journal of Foot & Ankle Surgery (IF 1.3) which was not ranked. This is survey bias by the researchers. Their screening would omit evaluating publications in podiatric journals, regardless of degree.
I agree with Dr. Jacobs, publishing should be a requirement for residency completion. In orthopedics, the median number of publications from their residency is three. Fellowship to the American Academy of Podiatric Sports Medicine used to require one article, though not necessarily a peer-reviewed one.
With more journals looking for articles, AI, online statistical programs etc, it should be easier to publish. Even AOFAS' Foot and Ankle International has been publishing more articles from podiatrists. Co-editor Dr. Bob Anderson has our colleague Chris Hyer and I serve as reviewers. Research and publication opens a lot of doors and often builds bridges. I see according to "pub med" Drs. Jacobs and Tomczak published an article together on wound care in 2008. Maybe they could work together to help podiatry enrollment. The profession would be grateful.
Amol Saxena, DPM, Palo Alto, CA
04/23/2026
RESPONSES/COMMENTS (PODIATRISTS IN THE NEWS)
From: Glenn C. Vitale, DPM
Thank you, Dr. Sushynski. In my 43 years of practice, during the first five years, I routinely used a medial approach when performing a plantar fascial release, also removing the spur, with a half inch resection of the plantar fascia to prevent anastomosis. After convincing myself that the spur is not the cause of pain, I stopped removing the spur and switched to a plantar half-moon approach, resulting in successful patient outcomes.
Glenn C. Vitale, DPM, West Haven, CT
04/23/2026
RESPONSES/COMMENTS (CLINICAL)
From: Conway McLean, DPM
I wanted to second the confirmation of Dr. Kesselman's post concerning radiowave matricectomies. Years ago, I used only the traditional caustic acid but was unsatisfied with the results. Radiowave technology is tremendously versatile and used by various medical specialities. I found my regrowth rate much lower, along with the obvious benefit of reduced healing time.
Conway McLean, DPM Chicago, IL
04/22/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) -PART 2
From: Gary S Smith, DPM
I can save you the expense of a survey. People don't go into podiatry because it is silly to do 4 years of medical school and 3 years of mandatory residency only to have your scope of practice limited to the feet. You could do one year of residency and go into family medicine or be a hospitalist and have a much better chance of employment and most likely get paid a lot more money. Many of us warned that this would happen with the mandatory 3 year residency.
Many students were lured by the fact they could practice with a 1 year training period, and those who excelled could go on to 3 or 4 year programs and become the premier surgeons of our profession. I like my job. I like doing what I do but I would never suggest that my children do the same. It's just not sensible to do the same training as an MD or DO and then be limited by scope and income.
Gary S Smith, DPM, Bradford, PA
04/22/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1
From:Rod Tomczak, DPM, MD, EdD
I attended the Ohio Foot and Ankle Association virtual seminar on Saturday April 18. Michael Brody, DPM gave a fantastic talk about how AI will fit into podiatry in the very near future and how it is 93% accurate as AI interprets what we tell it and that number will jump to 95% by the end of the year. I thought the presentation was very interesting and included some of the platforms he thought were accurate.
At the conclusion of the meeting, I checked my email and found a piece forwarded to me by Barry Block from “Anonymous.” Anonymous quoted some information from AI platforms about the future of podiatry and it did mention what part osteopathy plays in it. I thought I would follow up on the email with some AI platform investigating two questions, I would ask the AI platforms, “Is podiatry itself in a crisis mode?” and secondly, “Is the future of podiatric education in crisis?” So, I will report to loyal PM News what Perplexity and Chat GPT have to say about these two...
Editor's note: Dr. Tomczak's extended-length letter appears here.
04/22/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1B
From: Allen M. Jacobs, DPM
The suggestion that podiatry is underrepresented in research may not be totally accurate in general context. In fact, there are some arguments to be made that as a profession, podiatry maintains an excellent representative level of foot and ankle research.
The few published works on published foot and ankle research have a bias towards surgical topics, and as such, journals such as JFAS are examined for authorship. However, podiatrists publish in many journals in specialty areas such as wound care, diabetes care, and vascular care. Typically, it appears from a review of this subject that journals addressing topics other than surgery of foot and ankle are not included. As an example, JAPMA or Podiatry Quarterly, Podiatry Today, Podiatry Management, and other lower impact factor journals are not included in such...
Editor's note: Dr. Jacobs' extended-length letter appears here.
04/22/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1A
From: Rod Tomczak, DPM, MD, EdD
Larry, Unless you are using my postings to meet your CEU requirements, there is no reason to read them. If you are using my letters for CEUs, please answer the following question: Give an alternative reason why DPM applications are declining and first year DPM students are fewer in number than in previous years while DO applications have increased and first year DO student numbers have surged. What has happened to potential DPM students?
Thanks for continuing to read my postings. They're like watching the Indianapolis 500 for the crashes, aren't they? You can't resist.
Rod Tomczak, DPM, MD, EdD, Cleveland, OH
04/22/2026
RESPONSES/COMMENTS (PM NEWS QUICK POLLS)
From: Joel Lang, DPM
I was saddened (but not surprised) to learn in PM News' recent poll that 70% of podiatrists suffer moderate to severe stress in their practice. I felt the same way after 33 years of practice. I came home one night and told my wife that I loved my patients and hated my practice; that I was good at what I did, but I did not want to do it anymore. Her response was "so don't'. So, at age 59, I left practice for a different occupation. It has been 29 years since I treated my last patient and I never looked back in regret. Admittedly, at the beginning, I missed the personal interactions with patients, staff, colleagues, and others, but I never missed the work.
There is a whole world of things to do out there that don't cause as much stress as practice. Explore. When you are under great stress, it shows up in your work, your family relationships, and primarily your health. Podiatry is what you do; it is not who you are. If you are feeling that much stress, go back to school and learn a different field, turn a hobby into a small business, or change your practice in a way that reduces stress. You may make less money, but you will better enjoy the time you have left in better spirits and better health.
Joel Lang, DPM (retired), Cheverly, MD
04/22/2026
RESPONSES/COMMENTS (PM ARTICLES)
From: Paul Kesselman, DPM
It was wonderful to read Dr. Shapiro's first installment on duplex scanning, an invaluable diagnostic test for those providing any wound care therapy or seeing patients with a potential DVT. The loss of invaluable time, especially when dealing with patients with a possible DVT, if left not promptly diagnosed and treated, may lead to loss of life. For patients requiring vein ablations, vein mapping can be incorporated into the study. For those with venous leg ulcers, duplex venous scanning along with other non-invasive testing, can be invaluable for predicting whether conservative therapy (and which one) may be successful. For arterial ulcers and DFUs, arterial duplex scanning complements arterial Doppler, PPG, and PCR along with several other tests that offer insights into microcirculation, thus providing guidance for therapeutic interventions.
These tests can be used as part of an armamentarium to support the use of HBO, hyperoxic therapy, NPWT, and cellular tissue products. All third-party payers are currently scrutinizing several of these...
Editor's note: Dr. Kesselman's extended-length letter appears here.
04/22/2026
RESPONSES/COMMENTS (CLINICAL)
From: Paul Stepanczuk, DPM
I used radio wave matrix ablation for at least 20 years and wholeheartedly agree with Dr. Kesselman’s observations.
Paul Stepanczuk, DPM, Munster, IN
04/21/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) -PART 1A
From: Lawrence Oloff, DPM
I have enjoyed PM News over the years. Barry Block has done an amazing service for our profession. I am sure it is no simple feet (purposeful misspelling) to find contributors. As a result, some topics get discussed over and over again. The DO degree is one such topic. I enjoyed this in the beginning, and while I appreciate Dr. Tomczak’s passion for this path, maybe we can move on from this discussion? There is barely an issue that goes by without Dr. Tomczak’s gloom and doom predictions. Maybe Dr. Tomczak is right, but more likely he is wrong as podiatry has marched forward as many have posted. The profession barely resembles what it was when I was a student. He does point to a critical concern - student recruitment.
I think Dr. Tomczak’s suggestion to poll incoming students is worthwhile. Maybe this information already exists. My unofficial poll, from talking to students and residents over the past forty plus years, is that most choose podiatry because they or a family member was exposed to podiatry as a patient. I do not remember anyone saying they chose podiatry because they could not get into allopathic medical school. I am not saying that doesn’t occur, but I suspect it is...
Editor's note: Dr. Oloff's extended-length letter appears here.
04/21/2026
RESPONSES/COMMENTS (STUDENT ENROLLMENT) - PART 1B
RE: What Podiatry Can’t Afford to Do
From: Rod Tomczak, DPM, MD, EdD
While waiting impatiently for something else, I was cruising through Facebook. I came upon the section with an album of pictures of infants and dogs, sometimes puppies that make the reels even cuter. I was in a hurry which is ironic since I can’t go anywhere. Suddenly it hit me, the puppies and the infants have a quality in common that I have tried to learn a million times. Both of these characters are living in the moment, focused on each other, and not worrying about anything else. They’re not worried about their next meal, where they are going to sleep, being house- or diaper-broken. Nothing else.
Living in the moment is often envied as a large part of a spiritual life. I’m not talking about praying or going to church but keeping our minds uncluttered and open to the moment... like the dog and the infant discovering each other and instantly bonding and enjoying the moment. If we are worried about getting to Jiffy Lube before they close so we can get the oil changed, we’re going to miss our...
Editor's note: Dr. Tomszak's extended-length letter appears here.
04/21/2026
RESPONSES/COMMENTS (CLINICAL) - PART 1B
From: Paul Jones, DPM
GUESS WORK entails GUESSING you got all the matrix by applying a GUESS WORK amount of chemical or frequency, counting to a presumed, GUESS WORK amount of time. The more you GUESS right, the more you GUESS you are pretty good at it.
That’s why the sharp matrixectomy was invented. You can see exactly what is done and will stop GUESSING. Then came along the REMY Laser matrixectomy. It has the convenience and quick set-up of PnA with the accuracy of the sharp matrixectomy. I will never go back to GUESS WORK.
Paul Jones, DPM, DeSoto, TX
04/21/2026
RESPONSES/COMMENTS (CLINICAL) - PART 1A
From: Paul Kesselman DPM
While in clinical practice, someone introduced me to a 4.0 mghz radiowave unit which I used for over 30 years instead of smelly, caustic phenol. The issue with chemicals and hyfrecator is that you have little control over where the killing field is directed. With the radiowave unit, the electrode used for nail ablative procedures is plated on one side and thus insulated. Thus, the "killing field" is a flat surface and not all 360. Hence, less tissue destruction and more focus of the energy where it needs to go. There is less post-op pain, less drainage, and it's safer for immunocompromised patients, as there is less tissue death and less wound healing.
Not as important is that the ablative portion of the matrixectomy procedure is over in mere seconds as opposed to 90 seconds with phenol. It also does a great job of cauterization of any bleeders for a variety of procedures. Typically, the digital torniquet could be removed prior to dressing and there would be minimal bleeding. As for post-operative healing, since there is much less tissue destruction, the whole post-op period is far more abbreviated, there is less need for soaking, and patients may bathe normally within a few days to a week.
The electrodes and handle can be sterilized in a standard autoclave. Numerous electrodes are available in different sizes for nail and other soft tissue procedures. My unit never needed repairs and the only associated expenses were electrode replacements as needed. The handle and electrodes can be used many times, withstanding sterilization between uses, thus reducing repeat expenses.
Paul Kesselman DPM, Oceanside, NY
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 (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
04/17/2026
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
04/16/2026
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
04/16/2026
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
04/15/2026
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
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