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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:
12/15/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Robert G. Smith DPM, MSc, RPh
As a daily reader and consumer of the news, advertisements, and fascinating accounts of accomplishments reported in PM News, even before my graduation from a podiatric medical college, I have enjoyed the content and witness that as a profession ideas, opinions, and point of views can be translated and defined as a geometric area of a circle (360 degrees) over time ever expanding in size but consistently a circle. Thank you, Dr. Block, for a great account, these many years.
The year 2025 has ushered in some previous views and introduced some new ones that have given this reader cause for pause as 2026 begins to peak over the horizon. The changes to the healthcare arena will be paramount as they will change for patients, care givers, and all providers uniformly. Over the years, I have held the belief that a podiatrist, podiatric physician, and podiatric physician and surgeon with head held high embodies parity with all those who...
Editor's note: Dr. Smith's extended-length letter can be read here.
12/15/2025
RESPONSES/COMMENTS (PODIATRIC EDUCATION)
RE: What Does the Undergraduate Pre-med Major Think?
From: Rod Tomczak, DPM, MD, EdD
It doesn’t matter much to the undergraduate pre-med major in Tuna Fish, Wyoming if a podiatrist father and his scion are making $600,000 per annum. The Wyomingite is interested in multiple specialties, not just podiatry. They could be attracted to podiatric sub-specialties like limb salvage, vascular work, plastic surgery as applied to the lower extremity, trauma, etc. This is best achieved by becoming a DO rather than a DPM, where matching into a DPM residency offers him or her a low potential of fulfilling dreams if the residency match doesn’t meet their wishes at that time.
Fellowships are, well, not approved.
If we want to keep podiatry alive, we had better start listening to students’ wants and needs rather than pontificating over their choices by telling them how we listened to what we were told by our elders and how lucrative DPM podiatry has been to us and our families. Undergraduate pre-med advisors will be alerting pre-med students to the multipotential aspect of increased DO seats. If we need to provide attainable podiatry options within...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
12/15/2025
RESPONSES/COMMENTS (HEALTH INSURANCE)
RE: Private Practice Management and Health Insurance 2026 (Keith Gurnick, DPM)
From: Chaim (Ira) Cohen, DPM
I read Dr. Gurnick’s article and agree with what he has to say but in the same breath I say, "What a tragedy that in 2026 especially after Obamacare and EMR touted sharing of information that an office essentially needs one or more full-time employees to verify benefits.” What a waste of time and money. I retired five years ago. What was even more disconcerting was that managed care would send authorizations for patients who weren't enrolled. The disclaimer at the bottom that "authorization does not guarantee payment" is despicable. My heart goes out to those still having to deal with this insanity.
Chaim (Ira) Cohen, DPM, Brooklyn, NY
12/13/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Rod Tomczak, DPM, MD, EdD
The question is not, “Who are we?,” but should be, “Whom do we want to become? “Who we are is too much of what we used to be, practitioners who could only use a scalpel parallel to the skin, then experts in soft tissue surgery followed by forefoot bone surgery, then a Kirschner wire. Being a podiatrist was like landing on Iwo Jima and fighting for every inch of the foot. ACGME has now asked us, not we asked them, if ACGME would like to look at our post-graduate training to see if we are on par with MD and DO residencies.
They are asking us; something we never thought would happen. There is a chance ACGME learns something from us and vice versa. What we cannot do is shun them by rejecting that once in maybe a lifetime offer because we have become complacent in our own apathy. It’s no time to reminisce about how much we made last year or how happy we were because we were elected secretary of the hospital staff because we got an MPH at the same time we earned a DPM degree and because...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
12/13/2025
RESPONSES/COMMENTS (PODIATRISTS AND DIABETES)
RE: -25 Modifier and RFC
From: Allen M. Jacobs, DPM
The -25 modifier appended to “routine care“ visits is a subject about which I am now passionate. For the last several years, Michael Warsaw and I have spoken on this subject in detail at the St. Louis Podiatry Seminar and will do so again this year.
Why? My job as a podiatrist is in no small part the evaluation of the diabetic patient for risk factors which increase the likelihood of skin breakdown, infection, ulceration, and ischemia. When such risk factors are present, my job is to either treat or refer, or both. My job is also to improve the patient’s quality of life.
As a profession, we have accepted the role of diabetic foot care. This is wide-reaching. Yes, Charcot’s joint reconstruction and stabilization...
Editor's note: Dr. Jacobs' extended-length letter can be read here.
12/13/2025
RESPONSES/COMMENTS (HEALTH INSURANCE)
RE: Private Practice Management and Health Insurance 2026
From: Keith Gurnick, DPM
Health insurance should be verified on each new patient and each returning patient on every visit. It is not enough to ask the patient, "is your insurance still the same? Asking such a broad and general question may make the office staff feel they have done their job of checking insurance in a kind and non-confrontational way, but this is not focused enough. Patients need to be asked to show their current member I.D. insurance card which they almost always carry in their wallet or purse, or they can also easily produce virtually on their cell phone. A simple request from office staff, "Can I please see your current health insurance card, or cards?" is a polite way to check for insurance changes such as a new I.D. card or different insurance altogether, policy or group # changes, or plan coverage and benefit changes including office visit co-pays. Assuming nothing has changed is a way of the past.
Although time-consuming up front, doing it this way is much more efficient than assuming the patient's insurance has not...
Editor's note: Dr. Gurnick's extended-length letter can be read here.
12/11/2025
RESPONSES/COMMENTS (MEDICARE NEWS)
From: Farshid Nejad, DPM
Minnesota has been identified with $70M in healthcare fraud. Grafts being billed by the billions: Medicare Advantage programs are stealing money by the millions. Vascular surgeons billing millions by unbundling endovascular procedures. And I am sure there are billions more in fraud. But the OIG is worried about $4M in overpaid RFC billing. Where are their priorities?
Farshid Nejad, DPM, Beverly Hills, CA
12/11/2025
RESPONSES/COMMENTS (MEDICAL-LEGAL)
From: Lawrence Kosova, DPM
I wouldn't upload any patient chart, especially with the information you stated, into Chat GPT or any open AI system. You are just opening yourself up to lawsuits that the lawyers can now use the entire Internet against you. Also Sam Altman, who invented Chat GPT states in many recent articles that it is not even close for that yet. If you use Chat GPT vs Dax Copilot (Microsoft) vs Google Gemini, you will notice the accuracy and detail is different for the same questions/inquiries. Also, the way you phrase the question and the detail given will change what you wish to discover.
I am an advisor for Heidi Health AI. We are beta testing a research mode that the hospitals/clinicians are asking for. It will do what you are looking for but in a closed system. The LLM is specific to medicine also. This will aid in evidenced-based medicine protocols and even give citations etc. Imagine using this type of information for research but also for fighting with insurance companies to get paid properly. I would in fact go right to your malpractice carrier and ask these questions. They probably won't know the answer since everything is developing so quickly, but rest assured they won't want you to upload items about patients to the web via an AI model. Closed systems de-identify the patient; name, age, where they live, location, etc. needs to be stripped off what you are uploading.
I totally understand what you are doing and my answers are so others can learn as well. Please reach out to me if you would like to go further in this and I should be able to put you in touch with people that can possibly help.
Lawrence Kosova, DPM, Naperville IL
12/11/2025
RESPONSES/COMMENTS (PODIATRISTS AND SPORTS MEDICINE) - PART 1C
From: Robert Scott Steinberg, DPM
As to Dr. Smith's assertions regarding statins and Achilles injuries, the science is not that solid. Here is what a Google AI result states: "Yes, there's a noted link between statin use and Achilles tendon problems (tendinopathy/rupture), with case reports highlighting severe issues, though large population studies show mixed results, some finding a slight increased risk, while others finding no causal link, suggesting other factors like age, diabetes, or combined meds play a role. Tendon issues often resolve when statins are stopped, and symptoms usually appear early in treatment, prompting physicians to monitor patients for pain or weakness."
Since we all know there are multiple factors that can lead to Achilles injuries, like age, health, weight, and body conditioning, I am not sure how these were figured into the suggestion that statins are a significant risk.
Robert Scott Steinberg, DPM, Schaumburg, IL
12/11/2025
RESPONSES/COMMENTS (PODIATRISTS AND SPORTS MEDICINE) - PART 1B
From: Ron Werter, DPM
I wonder where Dr. Smith gets his data from that he claims that statins cause diabetes and lowers testosterone and estrogen. According to most cardiologists, the data shows a 5% increase in muscular pain at higher doses. Nothing in legitimate peer-reviewed journals speaks about statins causing diabetes or hormonal disturbances. Most articles speak about statins reducing vascular inflammation and reducing cardiovascular pathology.
As a cardiologist friend of mine said many years ago when asked about the early thought that lipitor causes cataracts, it’s easier to treat cataracts than to treat death.
Ron Werter, DPM, NY, NY
12/11/2025
RESPONSES/COMMENTS (PODIATRISTS AND SPORTS MEDICINE) - PART 1A
From: Carl Solomon, DPM
Dr. Smith, thank you for sounding the alarm. As testimony to your comments, I can describe my own very recent experience. For over 6 months, I've had increasing connective tissue pain unrelated to overuse, stiffness, rotator cuff problems, a hamstrings strain from simply drying off after a shower, then a biceps tendon rupture. There was an obvious predisposition to these injuries due to something systemic. I reviewed my meds with my internist and we decided to do a 3-month holiday from rosuvastatin. My symptoms gradually subsided to the point I was pain-free after only 3 weeks. The biceps rupture us healing on its own.
If you do a PubMed search for keywords "statin", "tendonopathy", "rotator cuff", "rupture", etc., you'll find a wealth of articles in well-respected peer-reviewed the journals that describe this.
Carl Solomon, DPM, Dallas, TX
12/10/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1C
From: Carl Solomon, DPM
Regarding determining where to open a practice, it's easy. Get on the phone and sample some practices in the areas of interest. Ask each of them how soon you can get an appointment for (take your pick)...a painful bump behind the big toe, a recurrent corn on a crooked toe, a non-infected recurring ingrown nail, whatever. If they're eager to get you right in, that's not where you want to open up. If they're booked up for the next week or two, you've found your spot.
Carl Solomon, DPM, (Retired) Dallas, TX
12/10/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: Stephen Peslar, BSc, DCh
Many years ago, I was watching Jay Leno. He was on campus at UCLA and asked the university students, "What is a podiatrist?" One student answered, “Is it someone who sexually abuses children?” None of the university students were able to correctly answer Leno’s question, “What is a podiatrist?”
During one episode of The Brian Keith Show, Dr. Sean Jamison (played by Brian Keith), a pediatrician was running a free clinic for children in Hawaii. A senior comes to Dr. Jamison’s free clinic with foot problems. Dr. Jamison explains that the senior should be going to a podiatrist, not a pediatrician. The senior tells him that he’s a pedestrian and that pediatricians should be treating pedestrians. It's obvious that podiatrists must do more PR to educate the public about their specialty and scope of practice.
Stephen Peslar, BSc, DCh, Toronto, Ontario, Canada
12/10/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Denis Leblang, DPM
The first day we were in general podiatry clinic in 1977, Monte Tuchman, DPM told us the definition of a podiatrist. He said that we are physicians and surgeons of the foot. This is what I told my patients and to anyone who asked me what a podiatrist does. End of story. This is what we do. Now, it extends to physicians and surgeons of the foot and ankle.
Denis Leblang, DPM, Congers, NY
12/10/2025
RESPONSES/COMMENTS (PODIATRISTS AND SPORTS MEDICINE)
From: Gary S Smith, DPM
I have noticed a large increase in the incidence of Achilles tendon injuries, rotator cuff, and anterior and posterior tibial ruptures in people on statins.
I think the incidence of tendon injuries has risen with the prescriptions of statins. They are given out like candy now as if they have no side-effects. Stains cause diabetes, low testosterone/estrogen, and have been linked to dementia. You should keep a mental note of your patients who get these tendon ruptures while on statins. If you do an MRI, you see all their tendons will be inflamed.
Gary S Smith, DPM, Bradford, PA
12/09/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: Robert Kornfeld, DPM
I graduated NYCPM in 1980. Back then, podiatry wasn’t at all happy with what it was but also had no clear plan to make things different. I won’t go into what didn’t happen over the past 45 years. Suffice it to say there is a large number of podiatrists today (way too many) who are loathe to identify themselves as podiatrists. They are “foot and ankle surgeons”. That says a lot about the morale of this profession and how our colleagues feel about their status among MDs and DOs.
Now there’s talk about the DO degree as if that will solve all the problems our profession faces. I’m not going to say it’s a bad idea. In fact, I think it would be a good one. But it won’t change things for many years to come and does not address our challenges now. We have an obligation to every DPM practicing in the U.S. today to do something now. Something that will change things for the better. I opine we have wasted decades worrying...
Editor's note: Dr. Kornfeld's extended-length letter can be read here.
12/09/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Elliot Udell, DPM
Dr. Kesselman brought back fond memories of when I first started my podiatry practices. I had asked the former owner of what is now Henry Schein, where to open up. "Should I open up in an area where there are no podiatrists or in an area that may have many podiatrists?" He strongly advised me to open my first office in an area with many podiatrists, for the very reasons Dr. Kesselman stated. If there are no podiatrists, the community does not know what a podiatrist is. But in a community with many podiatrists, there might be some competition, yet the community is at least aware of how a podiatrist can address their foot problems.
I opened in three locations. I opened two where I was the only "kid on the block" and one where there were lots of colleagues. The adviser was right: I did better in the podiatry-busy area and had to wait many years to build a practice in the two areas where I was the only podiatrist.
Elliot Udell, DPM, Hicksville, NY
12/09/2025
RESPONSES/COMMENTS (PODIATRISTS AND SPORTS MEDICINE)
From: Lancing Malusky, DPM
I can heartily agree with Dr. Parthasarathy. My wife, at age 64, suffered an Achilles rupture during an indoor school gymnasium pickleball game!.
Lancing Malusky, DPM, Lancing Malusky, DPM
12/08/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: Who Are We?
From: Paul Kesselman, DPM
Recently, I came across an old You Bet Your Life TV show with probably the best comedian ever to live. This show aired from 1950-1961. Groucho Marx asked the contestants what a podiatrist was? The contestants were confused and had no idea, finally muttering something akin to a pediatrician. Today, while most lay people may say they know what a podiatrist is, and may say a foot doctor, they still may not know what we do. When I was in practice, there was not a day that didn't go by, especially back in the good old 1980s when patients would say, "I didn't know podiatrists did......" Is that still true? Perhaps it is.
Today, we appear to also be faced with a barrage of internal questions, where we ourselves can't agree on how to define ourselves. If we cannot make peace with ourselves, then what can we expect from others? We need some cool heads to come together and face this head on and resolve this. No name calling.
We need real solutions from across the spectrum of podiatric practice. If we are not unified, we will destroy ourselves. We won't need the insurance industry or the medical community to do it for us.
Paul Kesselman, DPM, Oceanside, NY
12/08/2025
RESPONSES/COMMENTS (PM NEWS QUICK POLLS)
From: Chris Robertozzi, DPM, Allen Warren, DPM
Dr. Smith, you are absolutely correct. Parity is all about perception. That is what we are attempting to change; how the podiatric profession is perceived. The osteopathic profession started their perception change about 50 years ago. Now they are considered equals as a profession to their allopathic colleagues, both by the public and MDs. They made significant changes to achieve that, including allowing ACGME to accredit their residency programs.
They had to make changes in their residency programs. In the end, it made them better physicians. Having ACGME accredit our residency programs in the multi-decade journey is another step on the way to achieve parity, just as it did for the osteopathic profession.
Chris Robertozzi, DPM, Newton, NJ, Allen Warren, DPM, Chester, NJ
12/08/2025
RESPONSES/COMMENTS (PM ARTICLES)
From: David Secord, DPM
I thought that I’d offer a correction in the published “Implications of Cannabis Use on Diabetes and Diabetic Ulcers It’s important to understand its use in wound healing,” by Zanib Cheena, DPM, MS and Stephanie Wu, DPM, MSC.
In that article, they state that “According to the Center for Disease Control (CDC), cannabis is the most commonly used federally illegal drug in the United States as it is currently legal in 24 states for recreational use and in 40 states for medical use.” Marijuana is still a Schedule I narcotic and is not legal in any State of the Union. It has been decriminalized in these states, but it is still a felony to grow, process, sell, and distribute or possess this...
Editor's note: Dr. Secord's extended-length letter can be read here.
12/05/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Amol Saxena, DPM, MPH
Great letter Dr. Diresta.
In summary, limiting the future is not a good way of preserving the past.
Amol Saxena, DPM, MPH, Palo Alto, CA
12/04/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: James DiResta, DPM, MPH
I believe a large majority of podiatrists are concerned about our survival as a profession if we fail to make a move to a plenary license. Our effort to bring the DPM to parity with MD/DO degree colleagues has run its course. The obstacles that have been placed in front of that effort are insurmountable. The recent postings concerning the need for podiatry to move from our DPM degree to a DO degree is well received and it does not come at the expense of stripping our identity as podiatrists. It simply moves us to our rightful place at the table. There are many well trained and successful podiatrists who oppose this transition as they fear they will be excluded from obtaining this level of parity for themselves and that the newly ordained podiatrists will have a level of training and degree that is superior to theirs.
The answer to this concern is obvious. You're correct but there is a big BUT here as the transition will take...
Editor's note: Dr. DiResta's extended-length letter can be read here.
12/03/2025
RESPONSES/COMMENTS (MEDICAL-LEGAL)
From: Paul Kesselman, DPM
Dr. Chaskin brings up an excellent question of who is responsible for clawbacks when any healthcare provider works as an employee. There is no one fits all answer to this question and one must explore a number of common possibilities. Their legality is beyond my paygrade.
#1: Many physicians who work for facilities, hospital groups, etc. are W2 employees and hence do not directly bill for their services. The claim form may have them as the rendering physician with their NPI and name but the billing information (to whom the funds will go) will be that of the facility, hospital, etc.
An example here familiar to Dr. Chaskin in NY is NYU Langone or Northwell Hospital, which owns many physician groups. Rest assured, the individual physician (or possibly even the group) is NOT the billing entity but they may be...
Editor's note: Dr. Kesselman's extended-length letter can be read here.
12/02/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Rod Tomczak, DPM, MD, EdD
About 50 years ago, I was asked to speak to the state medical board of Ohio. I think I was a second year student at OCPM and the purpose of my address was to help convince the medical board that podiatry should be under the aegis of the medical board and that the podiatry board subsequently be disbanded. One of the members of the medical board asked me why podiatry should be under the medical board. I replied that our education was not equal to an MD's education and oversight by the medical board would help us attain credibility in the eyes of the public. By being under the guidance of the medical board, I was saying we want to be held to the same standards as MDs. I could have just as easily said that podiatric education is different than an MD’s education and the profession should remain under a podiatric board because it would make more sense to be judged by a peer who had navigated the same education and training, but we knew we would never be equal. Naturally, I had been coached up on what to say and the podiatry board was disbanded and podiatry was under the all-seeing eye of the medical board.
Twenty-five years later, I was asked to give my opinion to the medical board on whether or not the practice of podiatry should include ankle surgery. This was...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
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