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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:
02/16/2026
RESPONSES/COMMENTS (OBITUARIES)
RE: The Passing of Michael Lee Simons, DPM
It is with heartfelt sadness that I share the loss of a beloved colleague on Sept. 28, 2025. Dr. Michael Simons, a graduate of the California College of Podiatric Medicine, practiced in Orange County, California for over 50 years. He was a mentor to many and a friend to all. He was considered by many to be the godfather of podiatry in Orange County due to his hospital and podiatry political activism.
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Dr.. Michael Simons |
He was a man of great character and wit who was loved and respected by his patients. He is survived by his wife, Judy Simons, children and grandchildren. His legacy lives on in the lives he touched and he will be missed by all who knew him. May his memory be a blessing.
Richard Jaffe, DPM
02/13/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: Andrew Carver, DPM
The directive of adding an MD to the rear of our names may not lift up our profession to a level much greater than it already is. What about improving the "product" to our present four years study, the student, in ALL eleven podiatric colleges. Developing a student "product" that can compete intellectually AMONG our MD Associates.
What about the idea of sending teaching teams of the best of our educators, nationally, to teach electronically into all schools for a large portion of the lecture yearly material? Individuals like: E. Dalton McGlamry DPM, Lowell Scott Weil Sr, DPM, John Ruch, DPM, John Schuberth, DPM, Harvey Lamont, DPM, Allen Jacobs, DPM, John Steven Steinberg, DPM, David G Armstrong, DPM, MD, Lawrence Harkless, DPM, etc. These great minds and instructors in the profession would function directly with electronic student interactive teaching for a large segment of podiatric education. This might lift the profession higher than adding two nice letters following the DPM.
Andrew Carver, DPM, Ko Olina, HI
Editor's note: This topic is temporarily closed.
02/13/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Amol Saxena, DPM, MPH
I have been reading the responses to Dr. Hrywnak's recent letter. I thought about what got me to "achieve" what I have, and it makes me sad that many of our younger members, despite apparently better training, will not achieve RRA credentials (required by Operation Footprint) and be blocked from working within the governing bodies of many Olympic sports (US Track & Field says specifically they will not take podiatrists on the medical team. They will take psychologists: only one brain, and we can treat at least two feet!).
My classmate Joe Borreggine wrote a very cogent analysis of Dr. Hrywnak's concerns. Both are SCPM/ICPM grads, which is within a medical institution with no orthopedic department. Joe was in the audience when I gave the lecture at the 2023 Midwest Conference on "Podiatry, Prejudice & Possible Solutions". He concurred with my findings as did many of my classmates who are not RRA certified and/or no longer perform surgery. Drs. Tomczak and DiResta continue to point out reasons to change. PM News polls, albeit not scientific, give signs the profession wants to change.
Amol Saxena, DPM, MPH, Palo Alto, CA
02/13/2026
RESPONSES/COMMENTS (PODIATRY AND AI)
From: David Laurino, DPM
The largest merger in history just happened. And it has everything to do with how you'll run your medical practice in 2026. Two days ago, SpaceX acquired xAI for $1.25 trillion. Most people see a valuation story. I see a playbook:
• Vertical integration (own the infrastructure, don't rent it)
• Cost collapse (do it cheaper than everyone else)
• Market dominance (move faster than regulators can respond)
Here's what just combined:
• SpaceX (90% of global payload to orbit)
• xAI (200K+ GPUs, largest AI cluster on Earth)
• Starlink (9M subscribers, global satellite coverage)
• X (billions of data points training Grok AI)
Now connect the dots for healthcare: When Starlink's direct-to-cell V3 satellites deploy, Grok will be...
Editor's note: Dr. Laurino's extended-length letter can be read here.
02/13/2026
RESPONSES/COMMENTS (IN THE COURTS)
From: Michael S. Nirenberg, DPM
I am writing to provide an update on a ruling in Maine that involved my forensic podiatry testimony. This ruling is limited to Maine, is non-binding everywhere else, and does not reflect the standing of forensic podiatry as a discipline. In State v. Brackett (2026 ME 9), the Maine Supreme Judicial Court vacated a murder conviction, ruling that my testimony regarding sock-clad footprint comparison should not have been admitted. In brief, I testified to "moderate" evidential support using a recognized forensic verbal scale. I never called it a "match." Those words were the prosecutor's, not mine. I was not consulted during the appeal, so these distinctions were never presented to the justices.
The court's suggestion that forensic podiatry lacks recognition is incorrect. The discipline is recognized by the International Association for Identification—the world's largest forensic organization—along with other forensic bodies and scientific publications. Moreover, the UK's Forensic Podology Code of Practice, developed with the UK Forensic Science Regulator, mandates the methodology I employed. I drafted a Petition for Rehearing refuting every point in the ruling, however, as a non-party expert witness, I am unable to file it with the court.
In a Wisconsin homicide case, also involving bloody sock-clad footprints, the defense raised the same challenges. In this case, the conviction was affirmed on appeal, with the Court of Appeals finding the forensic podiatry testimony "relevant and the product of reliable principles and methods" and concluding that challenging its admission "would be wholly frivolous." As President of the American Society of Forensic Podiatry, I remain committed to growing this field through research, education, and training. This ruling reinforces why this work matters.
Michael S. Nirenberg, DPM, Crown Point, IN
02/13/2026
RESPONSES/COMMENTS (FINANCIAL TIP OF THE DAY)
From: Steven Finer, DPM
That’s correct. Never do your own taxes. First of all, you increase your chance of being audited. An audit is an uncomfortable situation and a tremendous time waster. Gathering those receipts will take hours for most. Secondly, your CPA will find some deductions that will cover the costs of the tax preparation.
Steven Finer, DPM, Philadelphia, PA
02/12/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: Rod Tomczak, DPM, MD, EdD
Larry, let me thank you again for again sharing your impressive CV with me and the other 21,000 readers of PM News. The thing is, Larry, not many of us have a resume as long or inspiring as yours. When we graduated, many graduates did not match to a residency. Even those who matched were not assured of a surgical program and only a few attained a PSR 24+, a real rarity. Very few podiatrists eventually secured an academic appointment, a full professorship, and yet enjoyed the thrills of private practice. A limited number became residency directors, fewer podiatrists regularly published, and a smaller minority became lecturers. Yes, Larry, we were the lucky soldiers of the 1980s and ‘90s and were truly fulfilled in our profession, but we were the far and few between podiatrists. I hear from classmates who are now hanging up their Dremels and nail nippers with the catch phrase, “If I knew then what I know now, I would have done it differently and not gone into podiatry.”
Just because every current graduate gets a three-year residency does not mean they all finish training with...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
02/12/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: James DiResta, DPM
It is beyond frustrating in reading recent comments regarding a plenary license for podiatrists. Dr. Olaf remarks how far we have come as a profession and we should be satisfied. He states the reality is orthopedists and others never pick up a stethoscope and frankly they know, like most specialists, to stay in their lane. I would agree but as time has gone on, we in completing our single track medical education have found ourselves stuck in our own lane; but it is not a lane in the same bowling alley as other medical and surgical specialists as we are left inferior to our peers and unable to play on the same field. The big picture has left us not being a full member as we lack a full general medical education before pursuing residency.
Trying to make this deficit up during our post-graduate time to get us to play on the same field as the big boys and girls is not working as no organization or licensing board will grant us an equal plenary license. We need to fix this issue and time is of the essence and the DO route as proposed by Dr. Tomczak is the most doable I have heard to date!
James DiResta, DPM, Newbury, MA
02/12/2026
RESPONSES/COMMENTS (FINANCIAL TIP OF THE DAY)
From: Joel Lang, DPM
I hope no one is taking the recurring tax advice to heart and doing their taxes themselves. I think you would mostly all agree that foot problems should be left to the experts; namely DPMs. You similarly should leave tax filings to the experts as well; namely CPAs.
Even after I completed my (CFP) financial planning course, which included an entire section on taxes, I knew that I would never do taxes either for myself or any clients. The system is too complex and the rules change all the time with changing deductibles, new tables, different minimums and maximums, etc. Being in practice makes your tax return infinitely more complicated than the simple 1040 form. So do family issues such as divorce, child support, alimony and financial issues such as long and short term capital gains and losses, depreciation tables, purchases and sales of property, etc.
I personally have never done my own taxes, even though I was "theoretically" trained. Only persons who do taxes full-time should be entrusted with your return. Then, if there is a subsequent question or problem, you have someone to rely upon. The cost of having someone else do taxes is about what you might charge for one or two office visits. Why would you spend hours doing your own taxes when you would not spend hours with a patient for that same amount of money? Better to let an accountant do it and spend that time with your family.
Joel Lang, DPM, Retired, Cheverly, MD
02/11/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1C
From: Lawrence Oloff, DPM
Having healthy dialogues is always worthwhile, as long as it is done in a respectful manner. I appreciate the posts by Drs. Hrywnak and Tomczak about a plenary degree. I respect their comments but I do not agree with them. I used to agree with these thoughts early in my career. However, I feel such thoughts are no longer in the best interests of our profession. I am in the tail end of my professional life. I have been blessed by the many positions that fell my way. I have been on podiatry faculty at a college, Academic Dean, managed a podiatry program in a top tier medical university, member/partner in a prominent orthopedic sports medicine group, podiatry residency director, and now my last job as full-time faculty in a medical school. Equally important is that I have been a private practitioner. I feel qualified to a give an opinion on these issues.
First a few facts. Podiatry now is not what I first started in. Those days were fighting tooth and nail for...
Editor's note: Dr. Oloff's extended-length letter can be read here.
02/11/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Jon Purdy, DPM
For anyone that can see the writing on the wall, Dr. Hrywnak has spelled out exactly what needs to happen to keep podiatric practices viable. Being small in number, the podiatric profession does not have the political clout to fight battles on its own. Larger medical entities such as nurse practitioners and physician assistants do, and that is the reason they are able to do more than a podiatrist with less than half the training. We cannot employ ancillary healthcare workers without MD/DO oversight. We can’t even prescribe a cream for dermatitis on an arm.
What doesn’t hold water are the statements concerning “run away” practices. Could an orthopedist perform brain surgery or an internist perform sinus surgery? Technically with full scope they could, but why don’t they? Could a podiatrist with full scope do this?
Jon Purdy, DPM, Iberia, LA
02/11/2026
RESPONSES/COMMENTS (PM'S ANNUAL SURVEY)
RE: PM’s 43rd Annual Survey 2026, Oral Analgesic Responses
From: Robert G. Smith DPM, MSc, RPh
As I read, studied, and performed comparative analyses on the responses provided by the 504 participants of the Podiatry Management’s (PM’s) 43rd Annual Survey 2026, I noticed an interesting discovery. I began this process in 2010 and continued over these years comparing and analyzing the presenting data with known published references as well as foundational citations. My initial acknowledge is that over the years a few readers of PM News have offered criticism that the annual data is not as robust statistically as portrayed in meta-analysis studies as well as citing bias that may creep into data interpretation.
I do respectfully disagree and believe valuable data is found in PM’s Annual Survey. Of course, every investigator would love data that would withstand rigorous scrutiny, to include myself. From 2009 to the present, I have collected the prescribing and dispensing data from PM’s 43rd Annual Survey and performed arithmetic and comparative analysis on...
Editor's note: Dr. Smith's extended-length letter can be read here.
02/11/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: Evan Meltzer, DPM
I have been following the discussion of the possibility of granting a plenary degree for podiatrists. This has caused me to think about a number of issues. A podiatry program director might ask a third-year podiatry resident if they feel that they have enough extra time in their three years to also study internal medicine, family medicine, etc. And if not, how many more years of residency do they think it would take to become proficient in an additional medical specialty? What might the MD/DO program directors of these specialties think?
Another major issue is how each state would handle the licensing process. New York State was one of the last states to expand the current scope of practice to include ankle surgery. I can’t imagine how many years it would take New York, for example, to approve a plenary scope of practice for podiatrists.
Evan Meltzer, DPM (retired), Rio Rancho, NM
02/10/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: Robert Scott Steinberg, DPM
I have been in practice for nearly 50 years, and in all that time, I have never heard anyone say that if we became MDs or DOs, we would leave podiatry behind. MDs and DOs have plenary licenses, and then choose specialties. We have MDs who are now focusing on the narrow field of foot surgery. If you do not think they have a distinct advantage over us, you are very out of touch.
Dr. Udell, Dr. Hrywnak's arguments were very well presented. You did not make any specific comments about any of his arguments. You are completely ignoring the disparity we face, as DPMs by insurance companies and other healthcare professionals. Shoe store salespeople present themselves as experts, as do DCs, PTs, and NPs. I am sure you're not alone in your opinions, as they seem to be pervasive in the APMA, as well.
I want to thank Dr. Hrywnak for his clear insights into the reality we face.
Robert Scott Steinberg, DPM, Schaumburg, IL
02/10/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Joseph Borreggine, DPM
Dr. Hrywnak has presented a compelling case, substantiated by incontrovertible facts. The podiatric medical profession must address its shortcomings in the educational path it has pursued for years. Podiatry has undergone significant evolution over the decades, surpassing the expectations of its practitioners. However, this advancement has not yet resulted in the parity that podiatrists rightfully deserve as physicians. The debate surrounding MD/DPM has persisted for years, yet it has remained unaddressed. The reasons for this stagnation are unclear. Is it the podiatry schools, the Council on Podiatric Medical Education (CPME), or the American Podiatric Medical Association (APMA)? Or is it a combination of all three?
Dr. Hrywnak’s unwavering dedication to advocating for full licensure in our profession over the past decade has faced significant challenges, seemingly impeded by podiatry schools and the American Podiatric Medical Association (APMA). Given the current low admission pool for all eleven podiatry schools, it is reasonable to assume that there is a disconnect between the number of college graduates interested in entering the profession and the demand for podiatrists.
Dr. Hrywnak’s assertions appear to be accurate, but the APMA’s response has been lacking regarding his opinion on the matter. The future of our profession may be uncertain due to the inability to obtain full licensure, but the contrary view that the future of podiatric practice is promising contradicts reality. The future direction of our profession will be determined by the prevailing winds, and it is crucial that we address the challenges we face to ensure its continued success.
Joseph Borreggine, DPM, Fort Myers, FL
02/10/2026
RESPONSES/COMMENTS (PODIATRIC MEDICAL EDUCATION)
RE: And ACGME Said, “Be Not Afraid!”
From: Rod Tomczak, DPM, MD, EdD
For the life of me, I’ve been trying to think why any residency director would be afraid to have ACGME visit their program. I would want to know where I stand among others, “Am I good?” “Do I need improvement?” “How is my program compared to other residency programs?” “Where can I improve?” The answer to these questions is exactly why the football game on Sunday evening keeps score and will not end in a boring tie.
There will be those podiatric educators and residency directors who will fire their Derringer, reminding us that these outside, MD, ACGME evaluators are not podiatric content experts. These evaluators are not assessing what gets taught; we have our psychometrician constructed In-Training Exams to do that. Every ACGME residency program already offers that feature so residency faculty can appraise their own educational program for that parameter because they are the content experts, at least on paper.
And if I’m a podiatrist in private practice, I am even more interested in how the residency education process is progressing. Everybody out here in the real world is either thinking about selling their practice, adding an associate, or buying multiple practices. At least 99.9% are curious, so they do have an interest in how things are evolving in those hospitals where residents spend three years. I like to think of myself as an ethical and truthful person, so you can trust me when I tell you ACGME will not be sending evaluators named Pestilence, War, Famine, or Death. More likely they will be Michael, Gabriel, Raphael, and Uriel.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
02/09/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: Narmo L. Ortiz, Jr., DPM
I am compelled to again comment on this issue because, with all due respect to Dr. Hrywnak's well-versed and possibly well-intended post, to me, it falls into the category of isolationism and not of inclusive parity.
If I may quote from one of his post's paragraphs, "Future-proofing the profession: the line between specialties is blurring. By expanding licensure, podiatrists can respond to emerging needs without outsourcing to other specialists..."
In other words, a plenary license will allow a podiatrist to diagnose, manage, and treat anything and everything ailing the patient that presents to their office or hospital's ER with a diabetic foot ulcer (which is the example given in his post). So many hats to choose from, right? In reality, "blurring" would be presenting to the public that the podiatry profession's members can be primary care, internal medicine, cardiology, and foot and ankle surgeons. Respectfully, I think only a fool would engage in such a practice without engaging in a team approach when treating a metabolically complicated patient.
Narmo L. Ortiz, Jr., DPM, Davenport, FL
02/09/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Elliot Udell DPM
The subject of "unlimiting" podiatrists' limited licensure has been debated ever since I opened my first office more than 35 years ago. The old argument was to give podiatrists MD and DO degrees and allow them to choose whether to treat feet or go into some other medical specialty and leave the treatment of feet behind. Dr. Hyrwnak's approach is to broaden the DPM degree, just as DOs can do everything an MD can do, Dr. Hyrwnak's approach would seem to allow a person with a DPM degree to treat the entire body. If I am reading this line of thinking correctly, theoretically, a person with an unlimited DPM degree could do a GI fellowship, orthopedic residency, psychiatry, etc.
The problem is how many doctors with expanded licensure would decide to treat people with foot problems, and doesn't "John J Public" deserve access to a doctor who will treat people with foot problems in a scenario where the majority of graduates might turn their backs on good old foot care? The only fair way for Dr. Hyrwnak's proposal to work would be to moderately but not fully expand the scope of a DPM and monitor each stage carefully before proceeding further.
Elliot Udell, DPM, Hicksville, NY
02/06/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Sev Hrywnak, DPM, MD
Podiatry has historically focused on foot and ankle pathology, but the evolving healthcare landscape demands a wholesale shift in how this profession prepares its graduates. A limited license that restricts practice to foot and ankle care constrains the potential impact podiatrists can have on population health, collaboration, and cost-effective care delivery. Here are key reasons for pursuing planetary/full licensure and broader scope:
Competitive relevance in a crowded market: Healthcare professions are expanding scope to meet comorbidity management and aging populations. Licenses that affirm competency in a wider set of musculoskeletal and systemic health issues differentiate practitioners and attract patients seeking comprehensive foot-to-knee care in a single...
Editor's comment: Dr. Hrywnak's extended-length letter can be read here.
02/06/2026
RESPONSES/COMMENTS (PM NEWS QUICK POLLS)
From: Steven Finer, DPM
I provided my cell phone number and most patients used it properly. They contacted me for emergencies and I met them in the office or the hospital.
There were a few who thought they were my friend, calling with non-podiatric questions. I explained the situation and most understood.
Steven Finer, DPM, Philadelphia, PA
02/06/2026
RESPONSES/COMMENTS (CLINICAL)
From: Gary Smith, DPM
I agree with Dr. Jacobs. I would add that the edema may also be caused by lumbar mediated neuropathy. It is not a bad idea to order an EMG of the lower extremity and maybe even a lumbar MRI. A history of lower back pain is not necessary in these cases. Sometimes the edema or lower leg issues are the first symptoms. I would consider this diagnosis if the neuropathy or edema is different from leg to leg. Difficulty walking is also an indication of lumbar disease, especially if one leg is weaker than the other.
Gary S Smith, DPM, Bradford, PA
02/05/2026
RESPONSES/COMMENTS (PODIATRIC PRODUCTS IN THE NEWS)
From: Paul Taylor, DPM
Many, many years ago, I was the committee chair for the initial Seal of Acceptance. The criteria was fairly simple. We would evaluate the product for quality, that it was safe and would perform as advertised. We did not grade similar products against each other. One company wanted us to state that their product was the best one. We would not agree because that was not the objective for the seal.
Many companies have obtained the seal. Apparently, they feel the seal is valuable for their marketing and trusted by the customer. I feel that it has also been positive for podiatry. I don't think the evaluation for the seal is a secret and the process should be available from APMA.
Paul Taylor, DPM, Silver Spring, MD
02/05/2026
RESPONSES/COMMENTS (PM NEWS QUICK POLLS)
From: Ivar E. Roth, DPM, MPH, Elliot Udell, DPM
Every podiatrist practicing today should read Dr. Lang’s sage advice. As an expert forensic podiatrist, too often I see patients undergoing surgery with no definitive pre-operative visit. They just show up for surgery and supposedly have their pre-operative consult and sign the consent minutes before their surgical procedure. I see this habit causing many malpractice cases to be filed. Please do yourself and the patient justice and follow Dr. Lang’s protocol and you will save you and your patients many headaches.
Ivar E. Roth, DPM, MPH, Newport Beach, CA
In general, I prefer that patients reach me on my office landline. On occasion, some patients prefer to call me on my cell phone, even to make appointments. Today, when I was driving home from the office, a patient called and wanted me to fit her into my schedule tomorrow. In the past, when I scheduled this and other patients' appointments without consulting my appointment calendar, it caused problems. The patients were double-booked and got angry when they had to wait. The way I handled it today was to thank the patient for calling and to request that she call back in the morning to speak with my office manager, who will determine when to fit her in.
Elliot Udell, DPM, Hicksville, NY
02/05/2026
RESPONSES/COMMENTS (CLINICAL)
RE: Edema in the Diabetic Patient
From: Allen Jacobs, DPM
Edema in the diabetic patient, particularly in the patient with sensory neuropathy, is a seldom discussed risk factor for ulceration. Edema may reflect the status of concurrent renal, cardiac, or pulmonary disorders seen with increased frequency in these diabetic patients. The potential for medication effects should be similarly considered.
Another potential etiology for lower extremity edema in these diabetic patients is neuropathic edema, a subject that I have discussed for many years. Neuropathic edema is caused by autonomic neuropathy with venodilation due to loss of sympathetic innervation of the tunica media. It may be associated with orthostatic hypotension or other manifestations of autonomic neuropathy. Compression therapy in such patients is appropriate. Simple efforts to reverse manifestation of autonomic neuropathy, such as supplant therapy with cyanocobalamin and active forms of folic acid have been demonstrated as helpful for some patients, with low associated risks of adverse sequela.
Screening for, and treatment or referral for treatment of edema in the patient with diabetes is important. It is one more potential contributor to skin breakdown, dermatitis, or ulceration. From a practice management standpoint, with appropriate supportive documentation, it is yet another qualifying problem for billing an E/M visit, with or without “at-risk” foot care, using the -25 modifier, when appropriate.
Allen Jacobs, DPM, St. Louis, MO
02/04/2026
RESPONSES/COMMENTS (PODIATRIC PRODUCTS IN THE NEWS)
From: Allen M. Jacobs, DPM
Dr. Steinberg has raised questions regarding the basis upon which a particular shoe was “awarded” the APMA Seal of Acceptance.
The eclectic list of products listed as having the APMA Seal of Acceptance is readily available to any concerned podiatry healthcare provider, the public, and other interested healthcare providers.
The APMA repeatedly has asked for our support and confidence. Yet, when it comes to the Seal of Acceptance, the basis upon which a determination of the product efficacy, safety, and superiority was made has been kept as a secret similar to the security surrounding the development of the atomic bomb in...
Editor's note: Dr. Jacobs' extended-length letter can be read here.
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