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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:
11/08/2025
RESPONSES/COMMENTS (OBITUARIES)
RE: The Passing of Althea Belinda Finley
I am saddened to hear of the passing of Althea Finley, 64. Althea worked for the California Podiatric Medical Association (CPMA) for over 32 years. As past President of the Harbor and Los Angeles County Podiatric Medical Associations as well as heading the Insurance and Patient Relations South for CPMA, I had many opportunities to interact with her.
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Althea Finley |
I looked forward to her beautiful smile and warm greeting at the Western. Rest in Peace Althea.
Ira Cohen, DPM
11/08/2025
RESPONSES/COMMENTS (APMA NEWS)
From: Ron Freireich, DPM
I think one of the many problems that our profession is facing is that APMA considers this a "Win". Let me remind some of our younger colleagues what happened in 2013. The Medicare Sequestration happened. The Medicare Sequestration is a budget control measure that reduces Medicare payments to providers by a set percentage, currently 2% under the Budget Control Act.
Starting in 2026 (yes, the same year as our Medicare fee schedule "Win"), this reduction may increase to 6% due to an additional 4% cut under Statutory PAYGO rules, unless Congress intervenes. So now, if one does the complicated math, 4.5% ("Win") minus 6% sequestration reduction equals -1.5%. A negative number doesn't sound much like a "Win" to me. And let me remind everyone that the 2.5% payment increase for 2026 is temporary and sunsets at the end of that year, but the sequestration reduction has been ongoing for the last 12 years.
Ron Freireich, DPM Cleveland, OH
11/06/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Rod Tomczak, DPM, MD, EdD
Dr. Secord, it sure seems like you have had more than what should be a fair share of trouble come your way down there in McAllen, TX. I wouldn’t guess there are that many orthopedic surgeons down there, and you’ve scared them off with your offer to step outside for a good ol’ Philadelphia curb stomping, if there are curbs in McAllen. Regardless, Dale Carnegie would be proud of your approach to resolving any differences between yourself and them bone doctors. I seem to recall you are also a chiropractor. Might that be a source of contention? I don’t know many orthopedic surgeons who think very highly of chiropractors. Come to think of it, even DOs think chiropractors are off the reservation, but that’s another turf war. Something about high velocity cervical manipulation to 75-year-old ladies causing paralysis.
No current podiatrist or even future podiatrist will ever be grandfathered into the DO or MD community. My treatise deals with the current decline in podiatry students matriculating in all the schools and the increase of DO seats available because of the increase in DO schools to thirty something from nine. I am theorizing that many current DPM students were not able to gain admission into allopathic or osteopathic institutions, but now they will. To maintain podiatry as a specialty, I am saying at sometime in the future, DO graduates may be able to match into a podiatry residency after a one-year general internship which would earn them a plenary medical license. None of this will happen overnight and there will be a period of overlap with both DPM and DO podiatrists.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
11/06/2025
RESPONSES/COMMENTS (PODIATRIC EDUCATION)
RE: Education Beyond the Foot and Ankle
From: Steven Finer, DPM
When I attended PCPM (1972-1976), we had many classes devoted to neurology, dermatology, psychiatry, and traumatology.
I did a one-year residency, most of it was non-podiatric. I was permitted to do anesthesia, CPR, and casting all limbs. Through my years in practice, I have read medical books on all subjects. I still do Medscape courses and was able to complete many subjects far from podiatry. So let the students today know that, we don’t only see a foot.
Steven Finer, DPM, Philadelphia, PA
11/06/2025
RESPONSES/COMMENTS (OBITUARIES)
From: George F. Jacobson, DPM
It's an honor to remember our professors, colleagues, and classmates. They are scattered throughout the country and many times we would not know or honor them. Although sad at times, thank you for keeping us informed. I'm sure if PM News had a survey on whether to continue this tradition, it would be overwhelmingly affirmative.
George F. Jacobson, DPM
11/05/2025
RESPONSES/COMMENTS (OBITUARIES) - PART 1C
From: Howard Zlotoff, DPM
I’m so glad to see your response to the podiatrist questioning the need to post obituaries in PM News. First of all, I give you credit for taking the high road in your explanation. I’m not sure I’d have that “self-control” if it were me responding!
Our profession is comprised of many who are friends, colleagues, fellow classmates, and residents living around the world. While we may not be in contact with them on a regular basis, it is an appreciated service of PM News to share the passing of our fellow podiatrists so that we might reach out to family and offer our condolences.
While we may be professionals to our community, we are all human beings who deserve recognition of our accomplishments in our lives and our passing at the end of life. I sincerely hope this newsletter continues to do both. Celebrate the accomplishments of our fellow podiatrists and give them a final farewell from all who knew them and cared for them.
Howard Zlotoff, DPM
11/05/2025
RESPONSES/COMMENTS (OBITUARIES) - PART 1B
From: Ira Cohen, DPM, Rod Tomczak, DPM, MD, EdD
I respectfully disagree with Dr. Robert Gottlieb's characterization of the reporting as an obsession and a regularly reported headline. As a retiree, I find it informative to find out about the passing of colleagues whom otherwise I would not have known about. Occasionally, there is a classmate or someone I trained with or I trained. On a few occasions, I was able to send condolences to the family. Thank you and continue to post these.
Ira Cohen, DPM
Thank you, Dr. Block for printing obituaries sent to you. Unless passings are in the same city, there is little chance of learning that someone we knew in school or residency has passed on. The schools are not in the business of informing alumni of deaths.
It’s a wonderful tradition and a fine service to the profession. We easily lose contact with those podiatrists we swore we would stay in touch with when we graduated. It gives readers an opportunity and excuse to call members of a study group or fraternity to touch base again after all these years. And then we promise to stay in touch again until we read another familiar obituary. Maybe Dr. Gottlieb hasn’t been through many of those Schadenfreude moments. I’m grateful to you for printing the obituaries and the thoughtful podiatrists around the country who are kind enough to take the minute needed to send the notice to PM News.
Rod Tomczak, DPM, MD, EdD
11/05/2025
RESPONSES/COMMENTS (OBITUARIES) - PART 1A
From: Bruce Blank, DPM, Jerry Peterson, DPM, Ivar E. Roth, DPM, MPH
I absolutely agree with Dr. Barry Block. Publishing obituaries of DPMs in PM News is important for all the reasons cited by Dr. Block. It is also a sign of respect and appreciation for those who are part of our special family and for those who have fought many of the battles on behalf of our profession.
Bruce Blank, DPM
I agree with PM News. Keep reporting the obits. Every so often, it is a classmate like Don Grim who I knew from school at ICPM and from practicing in the northwest like me. It is always nice to recognize their life and contributions to podiatric medicine.
Jerry Peterson, DPM
I would like to commend Dr. Barry Block for including the obituary information about our brother podiatrists in the PM News. First, it is in homage to each and every one who practices in our profession and Barry is correct - what is written in responses is very telling. I read each one of them carefully and reminisce on what that person contributed in their lifetime. Again, keep up the great work Barry.
Ivar E. Roth, DPM, MPH
11/04/2025
RESPONSES/COMMENTS (OBITUARIES)
RE: Obituaries in PM News
From: Robert Gottlieb, DPM
There seems to be an obsession with reporting the passing away of a podiatrist in just about every issue. With nearly 20,000 practitioners, doctors passing away will be a regular event. Does death really have to be a reported headline article regularly? I think not. I think this type of routine coverage of obituaries is way overdone. Perhaps just publish all those passing away on a monthly basis, in a separate writing.
Robert Gottlieb, DPM, Oyster Bay, NY
Editor's Comment: PM News believes that the every podiatrist's memory needs to be recognized. This 31-year tradition informs classmates, colleagues, and the entire podiatric community of our collective loss. PM News readers often respond with insights about the descendant that would otherwise go untold.
11/04/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: David Secord, DPM
I greatly admire the time and effort Dr. Tomczak puts into his messages to us. I'm sure that he will be remembered as a sage voice among us. As such, here's my two cents, for what it's worth:
I am of course as old as dirt and don’t really have a dog in this fight. I’m only still working because I lost everything I owned in combination with the Christus Spohn crucifixion and the 2008 banking-housing collapse given to us by the Community Reinvestment Act. Although I’ve taken the USMLE I, II, and III practice exams and passed with flying colors, we are at least a decade away from our two, divergent paths.
One will be obsolescence (brought about by Topor-induced, entrenched fiefdoms, no one will surrender); or common sense (add the classes and residency rotations to become on par with our other allopathic...
Editor's note: Dr. Secord's extended-length letter can be read here.
11/03/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: Podiatric Obfuscation
From: Rod Tomczak, DPM, MD, EdD
Obfuscation is the ability to make things obscure or unclear. A wonderful example is Mark Twain popularized the quote, “There are lies, damned lies, and statistics.” Simply put, it is obscuring the facts, and maybe even talking about statistics and probability. There are two classic ways to look at probability. One is the frequentist view which tells us that if we flip a coin 100 times, when we’re done, we will end up with a 50:50 ratio or close to it of heads and tails. The other method is called the Bayesian or belief-based method of looking at the facts that we know right now or interpreting part of the facts to influence what we are going to say. We are merely leaving out some important details. A hot topic for another posting might be, “Are podiatric seminars science-based or influencer-based experiences.” You get the idea.
An alternative way of describing Bayesian statistics is to say, “Probability probably wouldn’t exist if we had all the probable information.” So, probability gives us a way to think about things when we don’t have all the...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
10/30/2025
RESPONSES/COMMENTS (OBITUARIES)
I am so sorry to hear about Irwin (Irv) Mann's death. Dr. Mann (Irv) was an attending at Northlake Community Hospital when I was a resident in 1970. He left a permanent impact on me with his infectious smile and willingness to help the residents in any way he could. When asked how he was doing, he always responded with "PERFECT", a response I admit to this day, I stole from him.
I only learned later that his life was anything but "perfect". He just didn't want to burden anyone else with his problems. He practiced near me in the '70s in the Chicago Western suburbs and we became close friends. He was an inspiration to me and others and will be sorely missed. RIP, Irv.
Rich Polisner, DPM, MJ, Ponte Vedra Beach, Fl.
10/29/2025
RESPONSES/COMMENTS (THE FUURE OF PODIATRY)
RE: Podiatry and Manifest Destiny
From: Rod Tomczak, DPM, MD, EdD
Is the practice of podiatry exclusively our turf? After seven, maybe eight long years, should everything about the diagnosis and treatment of foot pathology belong to podiatrists? Orthopedic surgeons spend a year fellowship learning about the foot pathology, mostly trauma or maybe deformities and lay claim to a right of first refusal for all things foot. If the pathology is “clean” and they have hospital administration in their pocket, there’s a good chance patients coming through the emergency department will never see a podiatrist. Ulcerated, infected, malodorous feet may see an NP in the orthopedic surgeon’s office, but the orthopedic surgeon doesn’t want to contaminate and infect a clean patient by seeing the diabetic on the verge of becoming a non-infected amputee. But podiatrists have fought for care of the global foot here in the United States and have slowly managed to gain entrance to the complete spectrum of foot care. This includes forefoot, rearfoot and ankle, walk-in or trauma, infected or clean. After all, as Carly Simon sang, “Nobody Does it Better.” Or don’t we?
To be fair, let’s examine what’s happened to orthopedic surgery. Little by little the...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
10/29/2025
RESPONSES/COMMENTS (RVUs)
RE: Explanation of RVUs and Proper Payment (Joseph Borreggine, DPM)
I think our problem is multifactorial.
1. Our payor mix is probably slightly worse as we get more under/uninsured patients as we tend to be the limb salvage teams at most large medical centers; compared to some Ortho specialties like sports/joints with almost 100% elective paid for surgeries.
2. There are DPMs willing to accept much lower rates for a job at a medical facility. No podiatrist should accept less than high 40s to low 50s/RVUs now. We unfortunately have guys willingly accepting mid 30s per RVU, which drives down the averages.
3. I believe there are likely a lot of providers working part time, (or fresh out of residency) who are factored into the MGMA calculations with an already low (n) which really drives down the averages. This gives administration (who need to make their money) a reason to not pay us what we rightfully earned.
At our current facility, podiatry makes roughly 10-15$ per RVU less and is comparable to other medical providers in the mid 40-mid 50$/RVU range with orthopedic surgery making well into the high 60s per RVU. I find it discriminatory but seeing how every specialty is provided different dollar per RVU amounts, I’m not sure there is much we can do. The RVU system at its core is supposed to equilibrate the work from one specialist to another. Unfortunately, administrators have decided that there needs to be more discrepancy and have varying RVU rates, which defeats the purpose of the RVU system.
Name Withheld
10/29/2025
RESPONSES/COMMENTS (OBITUARIES) - PART 1B
RE: The Passing of Irwin Mann, DPM
I am very sorry to hear of the passing of Irwin Mann, DPM. He was the residency director at Kern Hospital during my time there as a resident in the 1970s. I will never forget the time they staged a simulated "code blue" in the middle of the night. I happened to be the junior resident on call.
I had a hollow feeling in the pit of my stomach, heart racing, and a cold sweat on my forehead when I ran into the patient room, only to find Dr. Mann and a couple others standing there waiting to grill me on what to do to save the patient's life. That moment was the first time I ever felt like a real doctor.
Rest in peace Dr. Mann.
Stefan Feldman, Spring Hill, TN
10/29/2025
RESPONSES/COMMENTS (OBITUARIES) - PART 1A
RE: The Passing of Irwin Mann, DPM
Dr. Irwin Mann was an old friend who helped promote podiatry and teach foot surgery as a past resident of Kern Hospital and its residency program in the early 1960-1980s. The profession can only thank him and the early podiatrists who went out of their way to teach foot surgery. He will be missed.
Steven J Berlin, DPM
I am deeply saddened at the loss of Irwin Mann. He was a mentor to dozens of us and strongly influenced me to apply for a residency at Civic Hospital.
He was a force for good in podiatry. May his memory be a blessing.
Joel Feder, DPM, (Retired), Sarasota FL
10/28/2025
RESPONSES/COMMENTS (RVUs)
RE: Explanation of RVUs and Proper Payment
From: Joseph Borreggine, DPM
This is a very interesting article. APMA is working with Marit to get salary information. According to this site, the average RVU value in dollars equals $49.00 for podiatry, with the average podiatrist usually generating around 5,000 [billable encounters or procedures] per year. Therefore, the average DPM should make no less than 250K a year on average.
Joseph Borreggine, DPM, Sarasota, FL
10/28/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 2
From: Howard Dinowitz, DPM
I received the exact billing scam scenario last Thursday. I had no clue who an e-mail was from, so I did not open the attachment. Then this individual was literally yelling at the front desk that she experienced credit problems, IRS letters, etc. from bills sent to her from an office visit from 03/21. It hit me almost immediately that this was likely a scam. She left a "name and number" which I Googled with no success. Clearly a scam... beware!
Howard Dinowitz, DPM, Brooklyn, NY
10/28/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1
From: Ivar E. Roth, DPM, MPH
I totally agree with Dr Kornfield. There is an imbalance occurring in training of our current residents, and it starts at the schools. Newly minted podiatrists are becoming what differentiated us from the orthopods. The orthopedists have little to no training in podiatric medicine and examination skills. They are, as they should be, surgeons who are great at fixing broken bones but that finesse on how to figure out between capsulitis and a neuroma is missing. It's the same with palliative care. The local new podiatric residency grads either do not know how to do a good job or refuse to do this; many patients who find me were told to go to a nail salon for their callus concerns.
I do not know what the answer is, but this nonchalance attitude seems to be perpetuated and gaining steam. I think one cause is that instead of the new grads going into private practice, they are joining hospital groups and HMOs where there is little amplitude and time to exam patients and the algorithms for practice are set for them to follow with no ability to think or act out of the practice guidelines they are given.
I had a patient a while back who saw multiple pods at Kaiser. They missed a simple sesamoid fracture by not doing a lateral oblique x-ray and they were going to do a fusion on a very young patient due to his continuing severe pain in his foot after 5 years of being seen at Kaiser. After examining him, I took a lateral oblique in my office thinking he had a sesamoid problem and it was a very obvious fracture. He healed and has since begun to enjoy his life again.
Ivar E. Roth, DPM, MPH, Newport Beach, CA
10/27/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 3
From: Robert Kornfeld, DPM
I believe Dr. Tomczak has hit more than one nail on the head here. While a trauma-based fellowship may make sense for some, and I do believe it is something that is needed, I do not think it would be the draw for many and shouldn't be something that we push our graduates into. One of the things I have witnessed in my more than 40-year career is the loss of podiatric medicine from our residencies. Don't get me wrong. I do believe we need to be good surgeons. I did thousands of procedures in my career.
But just look at how things have evolved in our profession. The better the surgical training for our residents became and the more we were pushing well-trained, surgically-oriented podiatrists into society, insurance companies lost their respect for surgeons and slashed fees to the point of absurdity. And if that is how a podiatrist is expecting to earn his or her living, it is going to be a...
Editor's note: Dr. Kornfeld's extended-length letter can be read here.
10/27/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 2
From: Scott Kochenower, DPM
I have had the same concerns. I am paid much less than my orthopedic colleagues in the wRVU. They do the exact same procedure and make a lot more with the value of the wRVU. In my opinion, we are definitely discriminated against. I think there should be a value to the CPT code regardless of who does the procedure. I have asked APMA about the MGMA data and pay scale multiple times, and I have been told they don't have any answers for me. I think we should be able to fight for comparable compensation for what we do.
I brought this to the attention of my hospital and they have helped, but they stated that they follow MGMA guidelines on wRVU-based pay. When will podiatry stand up for itself and get the pay we deserve?
Scott Kochenower, DPM, Lawton, OK
10/27/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1
RE: New Billing Scam
The office got a call today from a person who said she got a bill from us and she doesn’t know us and never used us. The bill had our correct doctor and contact info but the link to make the payment was not ours. She said it looked official.
We looked her up in our EMR and confirmed we never saw her. Someone is mailing bills out randomly hoping people just pay them.
Name Withheld
10/27/2025
RESPONSES/COMMENTS (INTERNATIONAL PODIATRISTS IN THE COMMUNITY)
From: Jeffrey Trantalis, DPM
Providing healthcare to the homeless is not easy to process. The Chicago school was located in downtown Chicago near a park frequented by the homeless. One day in my young career, a homeless patient sat down and proceeded to remove his shoes. However, upon removing one of his shoes, he left three of his toes in his shoe due to frostbite. That was a learning lesson you do not receive from a book.
Jeffrey Trantalis, DPM (retired), Delray Beach, FL
10/24/2025
RESPONSES/COMMENTS (STUDENT RECRUITMENT)
RE: Student Recruitment
From: Stephen Doms, DPM
Yesterday at my physical therapist's office, there was a student DPT assisting. I asked him if he considered other professions before starting PT school. He told me that he shadowed PAs, DPMs, and PTs. The two podiatrists he shadowed discouraged him from podiatry. One DPM said that he had wished he had gone to medical school and became a dermatologist. The other DPM said that he should have gone into engineering instead of podiatry. As Walt Kelly said in his Pogo comic strip, "We have met the enemy, and he is us."
Stephen Doms, DPM (retired), Hopkins, MN
10/24/2025
RESPONSES/COMMENTS (PODIATRIC MEDICAL EDUCATION)
From: Robert Scott Steinberg, DPM
Dr. Oloff... Rod Tomczak, DPM, MD, EdD's comments filled the vacuum created by the APMA's knee-jerk reaction to a very friendly offer from the Accreditation Council for Graduate Medical Education (ACGME) to sit down and talk. You attacked the messenger.
The only reason for this appears to be people wanting to "protect their turf from the unknown." Does anyone actually think podiatric residency directors would no longer be necessary if we sat down with ACGME and talked?
Dr. Tomczak's insights are always enlightening and spot-on, even when painful to some. Thank you, Dr. Tomczak.
Robert Scott Steinberg, DPM, Chicago, IL
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