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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:
06/22/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1C
From: James Sang, DPM
I applaud Dr. Jacobs for proposing a potential solution for the current student recruitment crisis. Since all of the podiatry schools are now part of a university system, the proposed model of direct entry into the podiatric medical school without a bachelor's degree (similar to the British education model) may pose a challenge. This is due to significant curricular changes, which require approval from the university governing structure, certain state education boards, other regulatory/certification bodies, and modification of the current CPME accreditation requirements.
An alternative approach would be to mirror the current 6 years or 7 years direct entry programs for MD, DO, DPT, and PharmD programs, where the admitted students would get awarded a bachelor’s degree (after so many years of schooling) and professional degree (MD, DO, DPT, or PharmD) at the end of 6 or 7 years, depending on the program. This does NOT eliminate the bachelor's degree requirement for the DPM program, but allows for the student to complete both degrees in a short time frame. There are very few 6 years bachelors/MD or DO programs out there since many medical school direct entry programs favor the 7 years or 8 years model. Currently, Howard University and University of Missouri - Kansas City offer 6 years bachelor's/MD direct entry and LECOM offers 6 years bachelor's/DO direct entry programs. If podiatric medical schools were to experiment with this accelerated direct entry model, LECOM and Western (which currently offers a 7 years bachelor's/DO direct entry program) should trial this since those universities are already doing this.
James Sang, DPM, Boston, MA
06/22/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1B
From: James J. DiResta, DPM, MPH
Dr. Jacobs presents a novel idea/solution for our profession's dilemma in our student recruitment problem. Ironically, I spent this past week writing a discussion board paper comparing the healthcare system of a Scandinavian country, in my case Sweden, with that of the U.S., and to try to understand once again why their medical outcomes are better, cost of healthcare less, life expectancy longer, and their student medical education either free or of low cost. Student medical education in Sweden and in Norway is free for permanent residents. They follow the 6-year model that Dr. Jacobs described. In my work as an admissions reviewer for graduate work in public health and research I come across many applicant physicians who have followed this model and their cand.med degree (Norway and Sweden) is equivalent to our MD degree in the states as is the MBBS degree awarded in countries like India and the UK.
As we can envision politics, power and money will drive the opposition. Watching how our leadership responded to the ACGME fiasco, I think this new proposed hurdle would be difficult if not impossible to overcome. But as the saying goes, Never Say Never. I like Dr. Jacobs’ idea of "out-of-the-box thinking" and would propose that in developing this "new" curriculum for podiatry that it mirrors that of the cand.med. and MBBS curriculum with the caveat of additional podiatry-specific courses and clerkships. Perhaps one or two of our colleges can arrange a partnership for a pilot program with a western European or Asian medical school so as to award the cand.med. or MBBS degree to our graduates. This would force state medical boards to award these podiatry graduates MD status and put all the foolishness of allopathic and osteopathic discrimination against podiatry to rest, once and for all!
James J. DiResta, DPM, MPH, Newburyport, MA
06/22/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1A
From: Thomas A. Graziano, DPM, MD, Erik L Kenyon, DPM
Dr. Jacobs is correct when stating that the rest of the world has a direct entry program from high school to medical school. This typically takes 6 years to accomplish. I think it's a great idea for all the reasons Dr. Jacobs stated in his post. The only issue I can see with this program in the U.S. is that the rest of allopathic/osteopathic medical education here does not universally embrace that model. We've always been unnecessarily under the microscope when it comes to our current model of education and this would provide more ammunition or fuel for our detractors. It may attract more applicants but at the same time be a step backward in the parity the profession fought hard to reach over the years. I'm interested in what others have to say about the idea.
Thomas A. Graziano, DPM, MD, Clifton, NJ
How many of those countries allow admission and surgery of the provider to a hospital? Not a co-admit or limited to forefoot surgery only? It may be a quicker line to a degree, but the current candidates don’t need anything faster, but something more robust and much more selective. Graduating more, less qualified people should never be a solution. Unfortunately, the residents today aren’t the same as 20 years ago. A few are, but only a select few.
Erik L Kenyon, DPM, Modesto, CA
06/22/2026
RESPONSES/COMMENTS (MEDICARE FRAUD)
From: Bret M. Ribotsky, DPM
Yes — and my experience may resonate with many PM News readers. In 2015, following a significant injury while volunteering with the United States Coast Guard, I began what would become a multi-years-long odyssey of Medicare and insurance fraud perpetrated in my name. The scheme followed me through every phase of my coverage.
It began with Blue Cross Blue Shield, through which fraudulent claims were submitted for wheelchairs and home health devices — including compression devices, TENS units, and other durable medical equipment — that I never received. As my coverage transitioned to federal workers’ compensation, the fraudulent billing continued, with additional wheelchairs billed to that program as well. When I was ultimately placed on Medicare, two more wheelchair claims appeared — again, for equipment I never received.
The bitter irony is this: I did use a wheelchair — for approximately the first four months following my injury. It was a rental. I paid for it out of pocket. My insurer, despite having been reimbursed, never paid me back a dime. I reported the fraud to Medicare, to my insurers, to the Florida State Attorney’s office, and to my local congressman. The collective response was, in a word, indifference. No meaningful investigation that I was ever made aware of. No restitution. No accountability. Yes, this happens systematically, it followed me across three separate coverage programs, and the safeguards designed to catch it failed at every level. I suspect I am far from alone.
Bret M. Ribotsky, DPM, Fort Lauderdale, FL
06/22/2026
RESPONSES/COMMENTS (AI)
From: Peter Sorensen, DPM
The bigger shift is that we now have more than one free, NPI-gated AI built for clinicians. OpenEvidence is one; OpenAI's own ChatGPT for Clinicians launched in April. It's also free, also NPI-verified, with cited literature answers, a deep-research mode, and CME on eligible reviews. "Designed for physicians" doesn't mean "safe for PHI." Both are fine for general questions with no identifiers, and both need a signed BAA before any patient data goes in — OpenEvidence markets full HIPAA/SOC 2 with a free org-level BAA, while ChatGPT for Clinicians treats HIPAA support as optional (no PHI without one). It's not automatically HIPAA-compliant with the advanced features unless a BAA is signed, which usually happens at the institutional level. The tool you pick matters less than the habits around it.
Peter Sorensen, DPM, Indianapolis, IN
06/22/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1D
From: Rod Tomczak, DPM, MD, EdD
“Some places will never let progress interfere with 100 years of tradition.” So said Dr. Battinelli of Northwell/Hofstra School of Medicine. I have been advocating change in podiatry schools since 1986. Faculty and administration, including CPME, wanted to see Problem-based Learning fail at Des Moines so I would cease to be a threat and would go away. It didn’t and I didn’t.
Personally, I have a certain disdain for any most podiatric school curricula. I don’t think they are structured correctly, taught efficiently, or learned favorably, but I am but one voice crying out in the wilderness of the medical school experience. It took six years to earn a doctorate in education from Drake and I never missed a class, nights after a full day at DMU or all day Saturday and Sunday. I cannot say the same for my attendance at...
Editor's note: Dr. Tomczak's extended-length letter appears here.
06/19/2026
RESPONSES/COMMENTS (SUPPLY CHAIN ISSUES)
From: Medline Industries
On June 11, 2026, a fire occurred at Medline's Tracy, California distribution facility. All personnel were safely evacuated with no injuries reported. To ensure continuity of care for your patients, Medline is actively fulfilling orders through its national distribution network. Podiatric practices in affected regions should be aware of the following:
• Continue placing orders through your normal channels.
• Some deliveries may arrive 24–48 hours later than usual.
• Order early, especially for time-sensitive or overnight needs.
• A limited number of products with high Tracy inventory concentration may require substitutions — your Medline representative will communicate any impacts directly.
Medline remains fully committed to ensuring that podiatric practices experience minimal disruption to patient care during this recovery period.
Medline Industries
06/19/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT)
RE: A Potential Solution to the Student Recruitment Crisis
From: Allen M. Jacobs, DPM
I would like to offer a potential solution for the current podiatry college "recruitment crisis". The solution requires out-of-the-box thinking and a dramatic change in the education of our future podiatric physicians. Change is always difficult.
My proposal is that the podiatry colleges, at least one or two as an initial program, institute a direct admission program for the DPM degree. That is to say, admitting students directly from high school into the colleges of podiatry for a five or six year combined DPM and bachelor of arts or bachelor of science degree.
Before you react, keep in mind that with the exception of the United States and Canada, the rest of this world has direct admission of students from high school into medical school. This includes European countries, the United Kingdom, Australia, Asia, South America, and...
Editor's note: Dr. Jacobs' extended-length letter appears here.
06/19/2026
RESPONSES/COMMENTS (AI)
From: George Jacobson, DPM
Why not use the AI designed for Physicians? ChatGPT says, "Open Evidence states that it is HIPAA compliant and will sign a Business Associate Agreement (BAA) for covered entities. Open Evidence announced HIPAA compliance in April 2025 and states that it complies with HIPAA Privacy, Security, and Breach Notification Rules."
I mentioned this AI before. It is for physicians; you must have an NPI number.
George Jacobson, DPM, Hollywood, FL
06/19/2026
RESPONSES/COMMENTS (MEDICARE FRAUD)
From: Gary S Smith DPM
I am a Medicare fraud victim too. Recently Medicare demanded repayment for claims they "over paid" three years ago. There was no explanation and no details. It was for about 10 patients' normal visits. I thought I would just bill the patients and let them deal with Medicare over it but, by some extradentary coincidence, they are all deceased. This has happened a few times over the last 6 years. Every time there is no explanation and always some coincidence like the staff forgot to have them sign an ABN so I could not bill them.
PICA provides legal help with these things. I contacted them the first time and they set me up with a lawyer in Utah that had no office, just a cell phone. He was worthless and my PICA insurance has gone up 50% since then. Every time I hear about Medicare fraud now, I take it with a grain of salt.
Gary S Smith, DPM, Bradford, PA
06/18/2026
RESPONSES/COMMENTS (MEDICARE FRAUD)
RE: I am a Medicare Fraud Victim
From: Paul Kesselman, DPM
For the third time in the last year, my Medicare number was billed for DME equipment I did not order, was not prescribed, had no use for, and NEVER RECEIVED! Twice last year, I was billed for continuous glucose monitors, despite the fact that I am not diabetic. One CGM provider was paid, the other was nailed with a same or similar denial and not paid. I reported that to Medicare and In December 2025, my account was billed for approximately $4,000 in upper extremity and back braces. I have since changed my Medicare number and so far, so good.
As physicians, we have several obligations; at the very least to provide the best care we can in the most ethical manner possible. One other obligation is to ensure that the way that care is paid for is preserved for future generations. In my opinion, these are both...
Editor's note: Dr. Kesselman's extended-length letter can be read here.
06/18/2026
RESPONSES/COMMENTS (AI)
From: Brian Kiel, DPM
Dr. Chaskin misunderstood my method for using Chat GPT. I speak into my phone which is blue-toothed to my laptop into Chat GPT. I do not use a patient's name. Chat GPT then formats it into a SOAP note which I copy and paste into the note part of the patient’s chart. The info is not identified nor does it leave Chat GPT except to go to the individual patient’s chart. This takes very little time and it gives me excellent notes.
Brian Kiel, DPM, Memphis, TN
06/18/2026
RESPONSES/COMMENTS (NON-CLINICAL)
From: Ira Kraus, DPM
Talar medical has access to and has been provided dehydrated alcohol for podiatric practices to be able to provide sclerosing injection therapy to their patients.
Ira Kraus, DPM, President Talar Medical
06/17/2026
RESPONSES/COMMENTS (MEDICAL ECONOMICS)
RE: Financial Strain of Medical Education - 53% of Doctors Say It’s Not Worth It
From: Paul Kesselman, DPM
Everyone with an eye to the future must heed the call of this most recent article in Medical Economics entitled "53% of doctor’s aren’t sure medicine is worth it." This needs to be a wake-up call not just for the entirety of the medical profession, but more importantly to our politicians and all of society in general.
This article raises these interesting questions: 1) Can society afford to continue to allow newly minted physicians to be saddled with debt they can’t fully pay back until shortly before they retire?
2) How can young physicians garner the ability to save money and build a nest egg for themselves and their families, if they are primarily working to pay...
Editor's note: Dr. Kesselman's extended-length letter can be read here.
06/16/2026
RESPONSES/COMMENTS (SUPPLY CHAIN ISSUES)
RE: Medline Warehouse Fire in Tracy, CA Facility
From: Keith Gurnick, DPM
This fire destroyed 20% of their overall inventory or about two months of their total sales nationwide. Hospitals may be impacted more than individual doctors, but this will have a supply chain impact.
Keith Gurnick, DPM, Los Angeles, CA
06/16/2026
RESPONSES/COMMENTS (NPDB)
RE: NPDB Personal Accounts Are Now Available for Healthcare Professionals
From: Richard Willner, DPM
On May 8, 2026, the National Practitioner Data Bank (NPDB) launched personal accounts for healthcare professionals. Personal accounts provide a centralized, secure way to access NPDB Self-Query and Report services from a single sign-in page.
What Is an NPDB Personal Account?
A free personal account allows healthcare professionals to:
• Search the NPDB for reports that match the information they provide and view the results
• Manage their personal and contact information
• Get notified by email and text message if any future reports are submitted to the...
Editor's note: Dr. Willner's extended-length letter appears here.
06/15/2026
RESPONSES/COMMENTS (DME]
RE: WISeR Model Days May be Numbered
From: Paul Kesselman, DPM
Rumblings are growing in Washington that threaten any further funding of the WISeR program. For those unfamiliar, the WISeR program was set up as a pilot program to perform prior authorization (P/A) in a few states for a few medical policies. For podiatrists, WISeR has since earlier this year been conducting P/A for cellular tissue products (CTP) primarily in New Jersey, Ohio, Oklahoma, and Texas.
The U.S. House Appropriations Committee has moved forward with an amendment blocking further funding during a June 9 vote on their 2027 spending bill. Under the provisions of this proposal, none of the funds could be allocated to WISeR or any similar...
Editor's note: Dr. Kesselman's extended-length letter can be read here.
06/15/2026
RESPONSES/COMMENTS (DIABETIC FOOT EXAMS)
From: Lawrence Rubin, DPM
Dr. Hardiman, thanks for bringing up this incredibly important topic. Your sensed frustration is completely understandable, given how crucial the diabetic foot exam is for preventing severe lower extremity complications.
I actually have some direct updates on this. Through regular communications via the Lower Extremity Amputation Prevention (LEAP) Alliance, I have been in personal contact with current NCQA administrators. They shared the exact present published status of where things stand regarding the integration of the diabetic foot exam. To the best of my knowledge, here is the substance of the HEDIS status information points as they have been published to date by...
Editor's note: Dr. Rubin's extended-length letter appears here.
06/15/2026
RESPONSES/COMMENTS (CME)
From: Chris Seuferling, DPM
Two words: PRESENT Podiatry. I have been using them for years. Well worth the fee when you weigh out the alternative methods of obtaining CME. Tons of lectures. You can select your topic. I’ve been diving deep into diabetic wound care. I listen to them on the way to and from work and before I know it I’ve met my state’s requirements. Alan Sherman (co-owner) is great too!
Disclosure: I am not affiliated nor receive any proceeds from PRESENT Podiatry.
Chris Seuferling, DPM, Portland, OR
06/12/2026
RESPONSES/COMMENTS (CODING & BILLING Q&As FROM CODINGHELPLINE.COM) - PART 1B
From: Steven Finer, DPM
When I read the question about the refusal to pay $28 I am sad. Here is the way a dental practice handles their billing. My wife needed oral surgery. When making the appointment, the receptionist informed us the fee would be $700. We have dental insurance, so we were told to bring $189.The balance was paid within 3 days electronically. Smooth as a baby’s derrière.
Steven Finer, DPM, Philadelphia, PA
06/12/2026
RESPONSES/COMMENTS (CODING & BILLING Q&As FROM CODINGHELPLINE.COM) - PART 1A
From: Howard R. Fox, DPM
I have successfully sued Magnacare in small claims court when they refused to send me a check, but rather an image of a merchant's account card. Since I don't take credit cards, I had no way of depositing their "payment." I sued them for my entire regular fee, not their allowable amount. Their lawyer called me promptly after they were served and mailed me a check the next day (and paid the full amount).
It happened again 10 years later as a secondary payer to Medicare. I called the lawyer (who still worked there), and he fixed the problem and marked my account "paper check only" and I haven't had a problem with them since. Requiring two patients' claims before they will process it is ridiculous and probably violates CMS rules. Suing them will preserve your relationship with the patient and likely be more successful. You'll find it very gratifying.
Howard R. Fox, DPM, Staten Island, NY
06/10/2026
RESPONSES/COMMENTS (INSURANCE COMPANY FRAUD)
RE: Reports on More Fraud by Contractors
From: Paul Kesselman, DPM
Two recent reports continue to illustrate the significant amount of fraud and abuse at the level of contractors, NOT physicians or suppliers. The first is the State of Massachusetts is suing UHC over alleged $100M in fraudulent Medicaid payments. Having read the summary of the complaint, it appears that for over the last decade, UHC has been involved in data mining and billing CMS for higher levels of care than were actually provided. The full story can be found here.
The second is a report from the OIG entitled: “CMS Potentially Overpaid Medicare Advantage Organizations $462 Million Based on Certain Unsupported Acute Stroke Diagnosis Codes”. The OIG Found the following:
• For all 97 sampled enrollees,...
Editor's note: Dr. Kesselman's extended-length letter appears here.
06/09/2026
RESPONSES/COMMENTS (THE ROAD TO PARITY)
RE: Maintenance of Certification (MOC) Through the National Board of Physicians and Surgeons (NBPAS)
From: Rod Tomczak, DPM, MD, EdD
MDs and DOs have another method for maintenance of certification or recertification that caught my attention. Someone sent me the article and addresses for five additional articles that explain the complete process through the National Board of Physicians and Surgeons (nbpas.org). In a nutshell, this board requires initial certification after completing an ACGME residency, an active license, and at least 50 hours of continuing medical education over a two-year period. This ACGME requirement would definitely tell us why APMA and Patrick DeHeer, DPM have tabled the offer by ACGME to visit some podiatry residency programs. The only thing podiatry would need to fulfil the stipulations set up by NBPAS for recertification is the initial certification of residency programs by ACGME. But remember, NBPAS is a maintenance of certification program for now, but things change.
One of the roads APMA and ABFAS uses to seek parity is testing podiatrists to death. Test results for first time RRA certification test takers are not released by ABFAS but...
Editor's note: Dr. Tomczak's extended-length letter appears here.
06/09/2026
RESPONSES/COMMENTS (STATE PODIATRY NEWS)
From: Erwin J. Juda, DPM, Gene Sherwood, DPM
Congratulations to John Boyle, DPM chosen as Vice President of the State Medical Board of Ohio. There is no one more deserving than him to fulfill that position. I first met John as a 4th year student during an externship at Lindell Hospital in St. Louis, Mo. back in 1981. He is an ethical and responsible decision-maker, rendering him an excellent choice to uphold the necessary standards of care issues that he will face.
Erwin J. Juda, DPM, RPh, Wilmington, DE
Congratulations to Dr. John Boyle on becoming Vice President of the State Medical Board of Ohio. He was a classmate of mine at OCPM 1982. I'm glad to see his accomplishment.
Gene Sherwood, DPM (retired)
06/09/2026
RESPONSES/COMMENTS (AI)
From: Daniel Chaskin, DPM
Running Large Language Models (LLMs) locally through Ollama or LM Studio have become the gold standard approach for independent clinics, hospitals, and medical software developers building clinical charting and billing tools.
Because medical data is governed by strict privacy laws like HIPAA, sending patient data to a third-party cloud API (like OpenAI or Anthropic) introduces significant legal, security, and compliance liabilities. Running models locally via Ollama or LM Studio completely eliminates this risk by processing patient notes entirely on-premise, with zero data leaving the clinic's local network.
Daniel Chaskin, DPM, North Bellmore, NY
Editor’s comment: PM News does not provide legal advice. Using the free or plus versions of ChatGPT does not ensure HIPAA compliance because it does not allow for Business Associate Agreements (BAA). The Enterprise and Developer Tools (ChatGPT Enterprise/API) version does allow for BAAs.
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