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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:
01/17/2026
RESPONSES/COMMENTS (OBTUARIES)
From: Ian S Goldbaum, DPM
I recently learned of the passing of one of my earliest mentors, Dr. Howard Reznick of Ypsilanti and Chelsea, Michigan. I was fortunate to train in his program in 1984–85—an experience that gave me the foundation for building and running a high-end podiatric practice. Dr. Reznick and his partner, Dr. Paul Tai, generously shared the practical “secrets” of surgical practice and the art of managing podiatric patients in everyday encounters. Their office was not only a learning environment, but a genuinely enjoyable place to be. Dr. Reznick’s humor, good nature, and quick wit made even the busiest clinic days memorable.
One holiday season at the Chelsea office, a patient arrived carrying an unexpectedly large live pig. Without hesitation, Dr. Reznick handed me a dog leash and, recognizing neither of us wanted livestock in our sports cars, gave me the afternoon off to escort the pig to the town butcher. As I walked down Main Street, townspeople called out, “Hi Doc—nice pig!” Years later, when Doc Hollywood was released—with Michael J. Fox leading a pig down the street—I couldn’t help but smile at the resemblance.
I remain grateful to Dr. Reznick for his guidance, example, humor, and generosity. His impact on me—and on countless podiatrists who trained under him—lives on in every patient we treat and every practice he helped shape. May his memory be a blessing.
Ian S Goldbaum, DPM
01/17/2026
RESPONSES/COMMENTS (NON-CLINICAL) - PART 2
From: Allen M. Jacobs, DPM
Dr. Kornfeld has asked to open a discussion on functional medicine. The basic tenet of functional medicine is to address the etiology of a disorder rather than address only the symptoms. It is a holistic approach. This is a principle that generally is appropriate in our daily practice. No reasonable person can reasonably argue a contrary position. It calls for individually unique programs for each patient.
Many practitioners of functional or integrative medicine are direct pay. As a result, a significant portion of the population may not be able to avail themselves of functional medicine benefits due to the cost of some therapies such as supplement therapies or testing protocols which are out-of-pocket. There are often high expenses associated with functional medicine, as many of these services are not covered by insurance. In addition, there is a distinct lack of...
Editor’s note: Dr. Jacobs' extended-length letter can be read here
01/17/2026
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1
RE: Know Your Worth
From: Cynthia Correa-Cedeño, DPM
It’s 2026, and I’m still shocked that when I talk to the general public—and even MDs and DOs—people think podiatrists only deal with warts, calluses, and nails. Being a podiatrist means being a specialist of an entire lower extremity region of the body. We treat the foundation of the human body. When the feet aren’t functioning properly, it creates a cascade of issues up the kinetic chain—knee pain, hip pain, back pain, shoulder pain, even headaches. We study the nervous system, vasculature, muscles, tendons, ligaments, biomechanics, immunology, genetics, and homeostasis. We think like engineers. We perform surgeries that take patients from barely walking to living fully again. We correct deformities, restore function, and change lives.
Yet somehow, we’ve been reduced to glorified nail clippers. Yes, there are elite podiatrists doing incredible, complex work—but that doesn’t make the other 90% insignificant. We prescribe medications that affect the entire body. We diagnose systemic disease from foot exams. We detect early diabetes, identify cancer, and help women navigating menopause-related inflammation and pain.
So why do so many podiatrists feel undervalued and boxed in? We are not just treating feet—we are treating people. Our communities need us. Every podiatrist who understands their worth and continues to level up their skills expands the impact of this profession. You didn’t go through podiatric medical school and residency to shrink yourself. Don’t let others define your value. This profession is noble, intelligent, and essential. Know your worth—and don’t let anyone put you in a box.
Cynthia Correa-Cedeño, DPM, Orlando, FL
01/17/2026
RESPONSES/COMMENTS (DME)
RE: CMS and Cellular Tissue Products
From: Paul Kesselman, DPM
CMS’s recent decision to sharply reduce reimbursement for all cellular tissue products (CTPs) and to eliminate payment for wastage is, paradoxically, both commendable and deserving of strong criticism.
The explosive growth in CTP utilization over the past five years was clearly unsustainable. CMS had little choice but to take decisive action. Left unchecked, CTP expenditures could have significantly strained the Medicare Trust Fund and potentially jeopardized CMS’s ability to fund other critical, life-saving treatments—including those for cancer, cardiovascular disease, and countless other conditions affecting our families and communities.
That said, as is often the case, the pendulum may have swung too far. These sweeping cuts now risk...
Editor’s note: Dr. Kesselman’s extended-length letter can be read here.
01/15/2026
RESPONSES/COMMENTS (SOLE PURPOSE BY SAVANNAH SANTIAGO, DPM) -PART 1C
From: Mark Wolpa, DPM
After reading Dr. Zlotoff's memorable experience, I was reminded of mine that I have not thought about in many years, but still break out in a cold sweat re-living it.
As a first-year residents at the California Podiatry Hospital in San Francisco, we were required to take call and stay overnight at the hospital. Back in the days when dinosaurs roamed the streets, patients having surgery checked into the hospital the night before and we would work them up before their surgery the next day. My surgery schedule had me in the operating room with an attending who was very generous with residents. If the case was B/L, the resident was guaranteed to do a foot. The case I would be scrubbing was a B/L bunionectomy. This was at the beginning of my program and I was very excited to add to my very limited case numbers.
The night before the surgery I was called in the middle of the night to deal with a patient...
Editor’s note: Dr. Wolpa’s extended-length letter can be read here.
01/15/2026
RESPONSES/COMMENTS (SOLE PURPOSE BY SAVANNAH SANTIAGO, DPM) -PART 1B
From: Allen M. Jacobs, DPM
The commentary regarding the preparation of a resident for surgery is important. However, there is the other side of the equation: the role of the attending. Ultimately, the goal is to graduate a resident that will have the confidence to perform surgery independently. We have a responsibility to the resident as they have to the attending. I have devoted my life to the education of students and residents and would like to share some thoughts.
A pre-operative discussion is critical. What factors did the attending consider in making the decision to proceed with surgery? What are the intended goals of the surgery? In what manner is the surgery planned to be performed? What are the intended goals of the resident for the case? Are you prepared to offer constructive...
Editor’s note: Dr. Jacobs’ extended-length letter can be read here.
01/15/2026
RESPONSES/COMMENTS (SOLE PURPOSE BY SAVANNAH SANTIAGO, DPM) -PART 1A
From: Tom Silver, DPM
As a student, I was on a rotation at a hospital and excited to observe one of my first forefoot cases. I asked a supervising nurse which OR the podiatry case was in. She told me, then said something to the effect "you work with feet...oh how disgusting!" On my way to the OR, I passed by another OR and saw several doctors and nurses working between the legs of an extremely obese patient. I then walked into the OR where I was about to observe, I saw a nicely scrubbed, very clean, exposed forefoot. Lesson learned: There are a lot worse things to be working with than feet!
Tom Silver, DPM, Minneapolis, MN
01/15/2026
RESPONSES/COMMENTS (NON-CLINICAL)
From: James Huish, DPM
I am very satisfied with Inteliscribe. The pricing is very reasonable, significantly more affordable than several other AI platforms I have used, while still delivering excellent performance. Both the mobile app and desktop interfaces are intuitive, clean, and easy to use. The quality and accuracy of dictation capture across all components of my clinical documentation, combined with the speed of transcription, are outstanding. From a workflow perspective, I have seen clear improvements in efficiency, particularly in billing and coding, due to the additional features built into the system. Overall, Inteliscribe has delivered exceptional value to my practice, with strong security and practical tools that extend well beyond transcription alone. I highly recommend it.
James Huish, DPM, Safford, AZ
01/14/2026
RESPONSES/COMMENTS (NON-CLINICAL)
RE: The Quest for Non-Covered Services
From: Robert Kornfeld, DPM
Many podiatrists are working hard to find as many non-covered services as possible to add into their practice to improve income over the abysmal insurance payments. And I completely understand that. Surviving on what insurance is willing to pay is a huge challenge. To that end, we have lasers, shockwave, regenerative medicine injection procedures, peptides, and supplements to name a few that have become very popular as an adjunct to covered services. And there is no doubt that all of these modalities can be extremely helpful when used on the right patient at the right time.
The trap many are falling into is recommending these treatments without fully understanding the mechanism of action. Again, I have no problem with improving your practice’s bottom line. This is how we make a living and we all have a right to make a really good one. But we have an obligation to our patients to recommend treatments in a...
Editor’s note: Dr. Kornfeld’s extended-length letter can be read here.
01/14/2026
RESPONSES/COMMENTS (MEDICARE ADVANTAGE)
RE: UHC Used "Aggressive" Tactics To Falsely Report Patient Data to CMS
From: Paul Kesselman, DPM
In today's Becker's HealthCare, there is a report that UHC used aggressive tactics to bloat and inflate UHC data in order to up the risk assessment of patients. While stopping short of accusing UHC of illegal action, Chuck Grassey, US Senator from Iowa, stated, "Bloated federal spending to UnitedHealth Group is not only hurting the Medicare Advantage program, it’s harming the American taxpayer."
In plain simple terms, the status quo of how CMS pays Medicare Advantage (MA) plans is simply obsolete and must go the way of the Pony Express. It clearly continues to invite fraud and abuse without any signs of let up. There needs to be a better way to compensate for these plans and show them the door and/or a view from behind bars. On a similar note: A few weeks ago, Horizon Blue Cross pleaded guilty to committing $100M worth of fraud by violating the New Jersey False Claims Act. If medical providers committed the amount of fraud and abuse that many of the insurers have committed, they would have had their billing privileges restricted/removed and/or seen how well an orange jumpsuit fits.
In conversations with every medical specialist encountered, we all agree that it's time that the same level of justice be meted out to the insurance industry and their MBAs in the executive suite, who commit fraud.
Paul Kesselman, DPM, Oceanside, NY
01/12/2026
RESPONSES/COMMENTS (CREDENTIALING)
From: Paul Kesselman, DPM
Dr. Crawford brings up an issue which, while interesting, is insignificant for most physicians (MD/DO/DPM) who provide DME to their own patients. Space in this forum only allows me to touch on the highlights of this issue and there is much more than what is presented below.
Let me set the record straight so that most if not all DPMs reading this DO NOT PANIC and understand they are NOT required to undergo Facility Accreditation by an accreditation organization unless they voluntarily want to. Most other DME providers, including but not limited to pedorthists, wound care suppliers, and your local neighborhood DME brick and inventory store, require facility accreditation by an accredited organization.
Let me repeat, physicians are exempt and do not require facility accreditation when providing DME as an ancillary service to their OWN patients. Those last two words are key. If you are...
Editor’s note: Dr. Kesselman’s extended-length letter can be read here.
01/10/2026
RESPONSES/COMMENTS (PM NEWQUICK POLLS)
From: H. David Gottlieb, DPM
This is a topic which comes up here every few years. When I started out in practice, I wore slacks, button down shirt, tie, and white coat. After many years, I went to wearing scrubs for my own comfort while telling myself that it told patients I was a surgeon. When I went to work at the VA, I continued to wear scrubs. After a while, I noted the Chief of General Surgery almost always came to work well dressed - nice shoes, slacks, shirt, tie, even sports jacket.
I eventually came to the conclusion that what I wore was a matter of respect - not for patients to respect me but for me to show respect to the most important person - the patients sitting in my chair. I could wear scrubs like the custodial staff do or wear professional attire [slacks, shirt, tie]. I chose to respect my patients and did not regret it.
H. David Gottlieb, DPM, Baltimore, MD
01/08/2026
RESPONSES/COMMENTS (PODIATRISTS AND SPORTS MEDICINE) - PART 2
From: Joel Feder, DPM
In response to Dr. Hoffman’s opinions on barefoot running, I consider that advice nutritious. My family ate much better from the fees I earned by treating barefoot runners.
Joel Feder, DPM (Retired), Sarasota, FL
01/08/2026
RESPONSES/COMMENTS (PODIATRISTS AND SPORTS MEDICINE) - PART 1
From: Keith L. Gurnick, DPM
I was a competitive distance runner in track and cross country in high school and continued to train and run and race for many years after. The protective benefits of training and running in appropriate, well designed and properly fitted running shoes outweighs barefoot running. Even with the tremendous improvements in shoes, injuries including overuse, acute traumas, repetitive trauma will always occur. That is the nature of the running sport and how athletes do their best to get in shape, stay in shape or try to improve and excel, in all genders and all age groups.
Every year, over 300 million pairs of athletic shoes are sold worldwide, and every year many brands come out with new colors and updates that do not meaningfully change the shoe but do promote consumption. Nike is the most popular sneaker brand among U.S. consumers, with two thirds of respondents who know the brand actually liking it. Adidas also enjoys a significant preference but lags behind Nike. Converse, New Balance, and Sketchers follow some way behind.
Keith L. Gurnick, DPM, Los Angeles, CA
01/08/2026
RESPONSES/COMMENTS (MEDICAL-LEGAL)
From: Elliot Udell DPM
The best way to cover yourself is to give a copy of the report to the patient's primary care physician. Give him or her a couple of days to digest the report and then call the doctor, discuss the matter, and document the conversation in the patient's notes.
Since we do not treat autoimmune diseases, we need to document that we made a proper and timely referral. With the "ball in the court" of the patient's primary care physician, he or she might opt to do nothing or refer the patient to an immunologist. In either case you are covered.
Elliot Udell, DPM, Hicksville, NY
01/06/2026
RESPONSES/COMMENTS (MEDICARE AUDITS)
RE: Modifier -25 Derangement Syndrome
From: Allen M. Jacobs, DPM
Though the courtesy of the ARCHE healthcare amputation prevention program, I had the December 25 OIG office of Audit Services report. I do not profess to be a practice management expert, nor an expert at statistical analysis. With that stated, I believe the paranoia infecting the primary care podiatry healthcare providers is not justified. It is a -25 derangement syndrome.
The "study" examined the ICD-10 and CPT codes for essentially what is callus or nail care by paring, cutting, or debridement. The appropriateness for the utilization of the -25 modifier, i.e.-the concurrent billing of an E/M code for a significant and distinct pathology unrelated to the routine care code was also examined.
To begin with, the sampling frame consisted of 155, 811 claims paid to podiatrists, of which ONLY...
Editor's note: Dr. Jacobs' extended-length letter can be read here.
01/02/2026
RESPONSES/COMMENTS (NON-CLINICAL)
From: Elliot Udell, DPM
Dr. Kesselman, as usual, started a fascinating discussion. To what extent are podiatrists trained in general medical issues and to what extent are we allowed to share this information with patients? Many times in our practices, patients might ask for general medical advice, having nothing to do with the foot. To what extent are we legally allowed to give such advice even though the knowledge is correct and the advice is sound? If we give non-podiatric advice and something goes wrong, can we be sued, and will our insurance companies accuse us of practicing out of scope? One way out is to give the advice but let the patients know that they must confirm it with their MD, DO specialist before acting on the advice.
Yesterday, I saw a patient with severe gout. I wanted to prescribe a short course of an NSAID, but the patient has severe systemic GI and cardiac issues. I called and got clearance from the gastroenterologist. Still, when I asked him if there were any cardiac issues to be concerned about, he was quick to tell me that he is a GI doctor and even though he is boarded in internal medicine, I must run that question past his primary care doctor or cardiologist. I did and all was okay and I felt that I covered all potential medical legal bases.
Elliot Udell, DPM, Hicksville, NY
01/02/2026
RESPONSES/COMMENTS (MEDICAL-LEGAL)
From: Rod Tomczak, DPM, MD, EdD
Two things happened this week that have led me to pen this letter to PM News. One was Dr. David Gottlieb’s December 31, 2025 letter to PM News and the conclusion that national advertising leads everyone to believe that podiatrists are universally considered physicians. The second is the rediscovery of the August 12, 2021 letter from Dr. Eric Stamps, then Dean of Samuel Merritt, representing AACPM to the APMA and ACFAS, stating the majority of podiatric deans did not support DPM graduates sitting for USMLE as part of the process of becoming recognized as physicians by the MD and DO professions.
To summarize Dr. Gottlieb’s letter, he states that because a retired New York podiatrist is featured in a national advertisement endorsing an OTC peripheral nerve medication and the advertisement erroneously calls the podiatrist a retired physician implies our profession has reached...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
01/01/2026
RESPONSES/COMMENTS (NON-CLINICAL)
From: Paul Kesselman, DPM
Last night, toward the end of a zumba class, the young instructor began to feel weak and said she could not safely continue the class as she was not feeling well. Later, the other regulars in the class told me she had a myriad of medical issues. After the class, the instructor admitted she had been suffering from hypokalemia for years, but her doctors were not sure why. One of my neighbors then told her I was a doctor, but not of the whole body, rather of the foot and ankle. Totally deflecting those remarks, a conversation proceeded with the instructor with many questions. Her answers and some follow-up questions, especially about various prescription potassium supplements, were shocking to this nosey neighbor. Despite not having those two magical letters after my name, the conversation which took place left my neighbor speechless. Then came the quote of the evening from the instructor, “See, he understands what I am talking about,” especially when we discussed potential cardiac events, one of which she admitted she had a few years ago.
It was only later that evening when having a private conversation with my neighbor, one question asked of her: If you were undergoing the simplest of foot/ankle surgery or had blood work ordered by a “foot and ankle” doctor, wouldn’t you want them to understand the implications and...
Editor's Note: Dr. Kesselman's extended-length letter can be read here.
01/01/2026
RESPONSES/COMMENTS (MEDICAL-LEGAL) - PART 2
From: Lawrence Rubin, DPM
In previous posts, there has been some uncertainty about Medicare considering podiatrists to be physicians. Here is the actual rule announced in 1965: Section 1861(r) of the Social Security Act which defines a "Physician" for Medicare purposes, generally a doctor of medicine or osteopathy, but also extending to dentists, podiatrists, optometrists, and chiropractors for specific services.
Here's a breakdown of the definition:
Core Definition: A doctor of medicine (MD) or osteopathy (DO) legally authorized to practice medicine and surgery in the state where they work.
"Physician" includes:
Dentists: When acting within their license for dental care.
Podiatrists: For specific foot-related services (e.g., in sections 1814(a), 1832(a)(2)(F)(ii), 1835).
Optometrists: For certain vision-related services (e.g., eye exams).
Chiropractors: Licensed chiropractors for spinal adjustments.
Interns/Residents-in-Training: Under approved medical education programs.
Lawrence Rubin, DPM, Las Vegas, NV
Editor's note: This definition applies ONLY for federal programs such as Medicare. Podiatry licenses and scopes of practice are state-mandated functions as per the 10th Amendment.
01/01/2026
RESPONSES/COMMENTS (MEDICAL-LEGAL) - PART 1
RE: Asking Medicare About Your Billing Profile
From: Name Withheld
I remember reading a query on PM News about providers requesting their billing profile information from local Medicare carriers. This information consists of the providers' patient billings to Medicare as compared to those of their fellow peers. I am not offering advice about requesting this. I am only sharing my experience with Medicare after I requested this information.
Several years ago, I was involved in a statewide audit in Florida from First Coast Medicare relating to codes billed for painful corns and calluses. I had a very busy Medicare practice and used these codes frequently when my patients' symptoms and criteria reflected the use of these codes. The audit involved several hundred podiatrists in Florida. While Medicare always advises providers to follow the published LCD requirements to justify billing a particular code, they literally changed the....
Editor's note: This extended-length letter can be read here.
12/31/2025
RESPONSES/COMMENTS (MEDICAL-LEGAL)
RE: Who thinks podiatrists are physicians? National Advertising, That's Who
From: H. David Gottlieb, DPM
The commercials for the neuritis supplement Nervive feature (according to the manufacturer) the retired physician Dr. Samuel Ruggiero. Purely on a hunch, I did a Google search. It turns out that the retired physician, as promoted on national advertising, is a retired podiatrist. Referencing the court room scene in the movie Miracle on 34th Street when the preponderance of the nation calls something to be true, as in this case, it can be considered as a true reflection of national belief.
When a national marketing campaign calls a retired member of our profession a 'retired physician', I think it's safe to say that we are considered physicians by the majority of the American public. Should one think otherwise, it betrays their lack of confidence in their own worth. Don't put your insecurities and inferiority complex on me. "Woe is me" is a cry for pity, not action.
H. David Gottlieb, DPM, Baltimore, MD
Editor's comment: Dr. Samuel Ruggiero is a retired New York podiatrist. In New York podiatrists are not legally permitted to call themselves physicians. Hopefully, this will eventually change.
12/30/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: Cherry Picking
From: Rod Tomczak, DPM, MD, EdD
On December 19, 2025, I received a publication titled “The Wonderful Mind of a Med Student” by Haroon Tariq. This particular issue literally scared the hell out of me. Over the past year, I have been criticized and condemned by my podiatric confreres who have interpreted my submissions as calls for the demise of podiatry. In reality, they have been just the opposite, but many short-sighted podiatrists have neglected the long-term ramifications of the almost quadratic growth in osteopathic schools where we can grow while sustaining our heritage, belief system, and philosophy as DO podiatrists.
My postings have been met with responses that flaunt the economic status of some podiatrists, the financial stability of the profession, and the responses of debt-free, well established, familial practices that push the seven figure mark while neglecting the young podiatrist who cannot partake in...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
12/30/2025
RESPONSES/COMMENTS (ROUTINE FOOT CARE)
from: Allen M. Jacobs, DPM
A very common example of the pathology in the diabetic patient requiring evaluation and treatment of a podiatric healthcare provider is that of neuropathy. We are all aware of the fact that neuropathy and ulceration associated with neuropathy are responsible for up to 80% of overall amputations. The most significant manifestations of neuropathy are the result of non-painful neuropathy, such as Charcot's joint disease, ulceration, and infection. Painful neuropathy is associated with decreased quality of life.
With reference to non-painful neuropathy, it has been my experience that unless a patient has profound sensory deficit of which the patient is aware, or has a frank sensory ataxia, many patients are not aware that indeed neuropathy is affecting them. With reference to painful neuropathy, there are many standard protocols which can be followed utilizing various...
Editor's note: Dr. Jacobs' extended-length letter can be read here.
12/30/2025
RESPONSES/COMMENTS (NEWS STORIES)
From Ron Werter DPM
Everybody knows that the purpose of the pinky toe is to make sure your furniture is in the right place.
Ron Werter, DPM, NY, NY
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