|
|
|
|
|
Search
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:
04/13/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: Podiatric Musings
From: Rod Tomczak, DPM, MD, EdD
I think it’s safe to say podiatry has finally made it into the tightly closed circle of the MD world. An obstetrician on the TV show Chicago Med asked for a podiatry consult. It seems a young pregnant woman dressed in haute couture presented with a diabetic foot that was both sickening and gangrenous. Yes, one of the stars asked for the consult by podiatry which has reached the hospital’s second floor in the Emergency Department-based medical drama.
There were no other comments about the podiatry practitioner’s non-ACGME approved residency, not passing USMLE and professional school curricula. No one called the attending aside to remind her that the podiatrist had neither an MD nor DO degree, hence, with all the accumulated evidence, not a real physician, and most of all, the consultor has no plenary license. Board certification was not part of the attendings’ conversation. No one mentioned declining admissions in spite of increased seats at 11...
Editor's note: Dr. Tomczak's extended-length letter appears here.
04/13/2026
RESPONSES/COMMENTS (CALL TO ACTION)
From: Paul Kesselman, DPM
Over the past week(s) there have been many posts addressing this issue, all of which have focused on retailers allegedly providing diagnostic services to consumers without a medical license. In my humble opinion, if an untrained individual tells a consumer/patient that they have a specific issue and then they treat it with something they provide, that is both diagnosing problem and treating it. It doesn't matter whether they dispense a cream or an arch support. But that is my opinion and not necessarily fact.
But as you will see from my explanation (from a non-attorney's perspective) is that the state statutes addressing this may or may not agree with...
Editor's note: Dr. Kesselman's extended-length letter appears here.
04/10/2026
RESPONSES/COMMENTS (CALL TO ACTION)
From: Robert Boudreau, DPM
APMA, here’s your 15-second ad:
"Would you rather be fitted for an arch support at the Good Feet store that costs $1,000 from someone who had a 1-day training session, or a custom-made orthotic from a podiatrist who has 11-12 years of training in biomechanics of the lower extremity? The choice is yours. Choose a podiatrist!
Robert Boudreau, DPM, Jacksonville, TX
04/10/2026
RESPONSES/COMMENTS (AI AND PODIATRY)
From: Bryan C. Markinson, DPM
Dr. Steinberg asks: "Then, as far as you are concerned, are striving for a plenary license and practicing podiatry mutually exclusive? Can't you see any value? What about the general public not seeing any value in attending podiatry college?"
My response is: Of course, I think a plenary license backed by the education to support it is of extreme value and as many have asserted, may be the only option soon enough. However, if anyone applying to whatever program in the future would offer this opportunity, they will find themselves sitting side-by-side with classmates taking the exact same exams, same labs, subject to the same performance measures, same board requirements prior to graduation from the "program." But the door that opens after that is the wide world of medical specialties that offer residency and...
Editor's note: Dr. Markison's extended-length letter appears here.
04/09/2026
RESPONSES/COMMENTS (MIPS)
From: Michael Paris, DPM
We switched to NextGen Office EHR a few years ago, but just recently started using it for the 2025 MIPS reporting year, as we had met the threshold for MIPS exemptions for the last several years. After lots of guarantees and assurances that NextGen was the perfect podiatry-tailored EHR to meet all of our needs, including MIPS, I was shocked to find out that they left out podiatry-specific quality measures from their MIPS capabilities and dashboard. They do have "roadmaps" for other measures that are not part of the typical workflow, so coding the podiatry measures into their software would have been very doable, contrary to their statement that "NextGen Office is not able to capture or calculate these measures."
I think they are counting on the time/money/energy costs of switching to a new EHR as a deterrent to small practices actually switching away from NextGen. Hopefully, the collective voices of unhappy podiatrists will move the needle.
Michael Paris, DPM, Hanover, PA
04/09/2026
RESPONSES/COMMENTS (CALL TO ACTION)
From: Jeffrey Klirsfeld, DPM
Regarding the Good Feet Store, I know the budget for APMA is small, but we HAVE TO ADVERTISE one way or another that we are the foot specialists and should prescribe a proper device for patients, not customers. In addition, many people are not even aware that they may be covered for custom molded devices.
Jeffrey Klirsfeld, DPM, Levittown, NY
04/09/2026
RESPONSES/COMMENTS (AI AND PODIATRY)
From: Robert Scott Steinberg, DPM
Then, as far as you are concerned, are striving for a plenary license and practicing podiatry mutually exclusive? Can't you see any value?
What about the general public not seeing any value in attending podiatry college?
Robert Scott Steinberg, DPM, Schaumburg, IL
04/08/2026
RESPONSES/COMMENTS (OBITUARIES) - PART 2
I read of the passing of Hal Ornstein with tremendous sadness. Like so many in the podiatry world, Hal had a tremendous impact on my career in my early professional years. Whether it was making you feel comfortable at your first AAPPM show by a piano in the Pittsburg Airport Marriott or talking management strategy with his dog in his lap and a smile by the pool at Lago Mar, Hal possessed an innate gift for connecting people and sharing his passion for podiatry. He will forever be a pillar of the podiatry community (both for physicians and vendors alike), and his impact was immeasurable. Cheers and RIP.
Nick Turner, Co-CEO of Remy Laser
04/08/2026
RESPONSES/COMMENTS (OBITUARIES) - PART 1
Clay was a roommate of mine in the early 1970s. He was a quiet gentleman. He was also a chef. As students, we ate very well during that time. He was willing to cook, as long as we cleaned up.
Paul Taylor, DPM
04/08/2026
RESPONSES/COMMENTS (MIPS)
From: Kenneth Meisler, DPM
I started with podiatry-specific EMRs in the early 1990s. I believe I have had three different ones. I was happy with all of them. I only switched when the company was bought out by another company and you had to switch to the new company's version. I was going to do the same thing about 2 years ago because my current EMR had been bought out, and again you had to switch by a certain date or it would not be supported or even run. I was prepared to do the same thing as in the past, just go with the new company that had bought it. There are four doctors in my practice and the price was going to go up dramatically per doctor.
I thought it was time to look into other programs, especially because the price for four doctors was basically four times the price of one doctor, even though it involves significantly less work for the EMR program to support one office with four doctors than four offices with one doctor. For example, we have only one billing person to call and ask questions for all four doctors vs four separate billing people to ask the same question for four one doctor offices. In the past, they always gave a multiple doctor office a discount or I was able to negotiate a discount from paying 4 times as much as four one doctor offices. This time there was absolutely no flexibility so I thought I should consider other programs and decide.
I then looked at Next Gen because 2-3 years ago, it was the "preferred EHR of the APMA" and...
Editor's note: Dr. Meisler's extended-length letter appears here.
04/08/2026
RESPONSES/COMMENTS (AI AND PODIATRY)
From: Bryan C. Markinson, DPM
The AI answer to the question of stepping up podiatry to the same level of recognition and respect as MD/DO is no surprise. The MD/DO world has stated for many years in many ways "just do what we had to do." That has always been the key to what has now reached a high level of discussion and controversy. Proclamations of equivalency from podiatry leadership has always fallen on deaf ears and frankly is not true.
I still maintain that putting a DPM student side-by-side with an MD and DO one, taking all the same tests and milestones, will create less students actually practicing podiatric medicine as their list of choices of specialty will be wide open.
Bryan C. Markinson, DPM, NY, NY
04/08/2026
RESPONSES/COMMENTS (CALL TO ACTION)
From: Lesley Wolff DPM, MS
After completing my second year at the Ohio College of Podiatric medicine, I was disillusioned by their outdated concepts of podiatric orthopedics. We took it upon ourselves, along with my close friend Dr. Richard Jaffee, to personally invite Merton Root to come and speak to the third and fourth year students in order to enlighten us on the latest concepts of biomechanics related to the foot and ankle.
I personally took Dr. Root up to the infamous Western Reserve Biomechanics Laboratory and introduced him to the director. The following year, we twice invited Dr. Tom Sgarlato to come and lecture to our third and fourth year classes. We were "hooked " on podiatric biomechanics and insisted that the orthopedic department include "Root Biomechanics" in the curriculum. Along with a fellow classmate, we were able to publish an early paper in JPMA on Triplane...
Editor's note: Dr. Wolff's extended-length letter appears here.
04/07/2026
RESPONSES/COMMENTS (PODIATRISTS AND BURNOUT)
From: Robert Kornfeld, DPM
Dr. Mankanjoula makes a very valid point about podiatrists being classified as "allied health professionals" and not physicians. I cannot help but raise my eyebrows and shake my head. This is exactly the issue that the "leaders" of the profession promised to fix back when I graduated NYCPM in 1980. Is it at all logical that almost 46 years later, the same issue still plagues podiatry?
At the same time, there are NPs in NYC opening up "Foot Care Clinics" and because of their plenary license, they have access to treat anything they choose. Clearly, the reason they are opening up in foot care is because there is a market out there. And what is the market they are moving in on? Non-surgical foot care. Why? Because this profession decided we should be surgeons first. And just to put this in perspective, I gave up surgery in...
Editor's note: Dr. Kornfeld's extended-length letter appears here.
04/07/2026
RESPONSES/COMMENTS (MIPS)
From: Summer R. Weary, DPM
I recently migrated to NextGen EMR based on assurances that it supports podiatry. Since implementation, I have encountered multiple issues. The company’s inadequate support for podiatrists—especially regarding the new MVP MIPS pathway—is deeply disappointing. Vendors that charge substantial annual fees, including to small practices like mine, have a responsibility to provide reliable, specialty-specific support.
Small practices already face numerous challenges in today’s healthcare environment; we need partners with the integrity and resources to back us. I agree with Dr. Brody: we should use this forum and social media to raise awareness and hold vendors accountable.
Summer R. Weary, DPM, Cookeville, TN
04/07/2026
RESPONSES/COMMENTS (CALL TO ACTION)
From: Jack Reingold, DPM
It is interesting to see the recent number of posts regarding the Good Foot Store. Whether what they have done over the last 44 years—since the first store was established—is good or bad, it is remarkable and perhaps points to a PR failure for podiatry. My experience with them goes back further than any other podiatrist because they opened their first store in 1992 in Solana Beach, a small coastal town in San Diego County, where I practiced. They even asked me if I would be their “Podiatry Director.” In spite of the promised riches, I turned them down.
This is the history as I know it, from first hand accounts. In those days, infomercials were big business, and the money was not in selling the products but in producing the commercial and selling the airtime. The founder was in that business and was looking for a product he could market, eventually deciding on an “innersole.” In the beginning, they cost a couple of hundred dollars and came in only one...
Editor's note: Dr. Reingold's extended-length letter appears here.
04/07/2026
(RESPONSES/COMMENTS (AI AND PODIATRY)
RE: AI and Podiatry
From: Allen M. Jacobs, DPM
There was an old toy you may recall, the magic eight ball. You would ask a question then shake the ball. An answer would then float into a window (e.g.: yes, no, or try again). I feel as though the questions I ask AI regarding the future of podiatry are a recreation of the magic eight ball. Within seconds I am given an answer. It creates in me the very same feeling-certainly more scientific but nevertheless the very same feeling.
I posed the question to AI: how do we elevate the DPM degree to the same level of respect as an MD or DO degree? Click here to read the proposed answer.
Allen M. Jacobs, DPM, St. Louis, MO
04/06/2026
RESPONSES/COMMENTS (PODIATRISTS AND BURNOUT)
From: Samuel Makanjuola, DPM
I find some things interesting after seeing the projected shortages for podiatrists by the National Center for Health Workforce Analysis. First and foremost, their projection for 2026 right now is that there is a 2000+ podiatrist shortage. Surprising seeing how many grads are having trouble finding jobs where they are located.
Secondly, and more importantly, did anyone notice it said as part of "wider allied health shortages"? I did. So I double-checked the source. The MSN "article", if it can be called that, was AI-generated and has no link to the actual NCHWA information. No issue, I can just go directly to them. Upon doing so, I found that while they specify many different types of "physicians" in their analysis, they do not include podiatry in their physician category but rather as...
Editor's note. Dr. Makanjuola's extended-length letter can be read here.
04/06/2026
RESPONSES/COMMENTS (AI)
RE: AI In Your Future?
From: Paul Kesselman, DPM
In a recent Becker's Spine Review, there is an interesting quote which should cause concern. "AI is coming fast and being widely employed before it has been refined. AI slop is going to be a big problem. Patients are being guided by an AI agent that generates unrealistic expectations and creates confusion. The surgeon will have to find a way to get ahead of the conversation, but this will be challenging. AI billing agents are communicating with each other (from the practice and from the insurance companies). The result will be a drive to over-simplification, delay, and inaccurate reimbursement."
As one can see, while we as providers think we have the upper hand by using AI to ensure our charting and documentation adheres to the third-party payer policy, the insurance carrier is doing the same thing. Their systems may be more robust than ours, but perhaps not. The AI chatting going back and forth will no doubt, as the article states, create significant delays, inaccurate payments, and outright denials, even for clean claims.
Paul Kesselman, DPM, Oceanside, NY
04/03/2026
RESPONSES/COMMENTS (MIPS)
RE: Podiatry and MIPS in 2026
From: Michael Brody, DPM
The reporting period for the MIPS for 2025 is now over and it is time to look at MIPS for 2026. One of the biggest changes in MIPS for podiatry is the new podiatry MIPS Value Pathway (MVP). Kudos to the APMA for working with CMS to have this pathway created.
With the Podiatry MVP, there is a short list of measures that are relevant to the practice of podiatry. When a podiatrist elects to participate in the MVP, they are only required to report four (4) measures rather than the six (6) required for traditional MIPS. This change alone reduces the burden of reporting by...
04/03/2026
RESPONSES/COMMENTS (CAREERS IN PODIATRY)
From: Jeffrey Kass, DPM
Dr. Ribotsky’s point is well taken, but his post failed to mention that many provider contracts have a built-in clause that doesn’t allow for a practitioner the ability to bill for a service without first billing the insurance company. This includes services one may think is “non-covered”. A colleague recently billed a patient for a wart treatment with a microwave machine. The insurance company expelled the doctor from the plan because he did not first bill the insurance company and hence the doctor did not know whether the service would be paid for or not.
I have a different take on the matter. I agree fee reductions are not keeping pace with the cost of inflation. Ancillary services are one way of bringing in extra income to a practice. The other is being reimbursed at a fair rate. This is the real problem. I don’t understand why the medical profession runs away from the etiology. As podiatrists, we are always taught to treat the root cause of the problem. This scenario should be no different.
Doctors need to break the shackles of “you’re not allowed to strike”. Nurses make headlines every couple of years and they always end up with better deals than they had. Every profession strikes and then they compromise and come out better. If striking is illegal, we need to find a way to make it legal or have the law changed. This is the real solution. Everything else doesn’t “solve the root cause of the problem”.
Jeffrey Kass, DPM, Forest Hills, NY
04/03/2026
RESPONSES/COMMENTS (CALL TO ACTION) - PART 1B
From: Allen M. Jacobs, DPM
Just for the record Dr. Oloff. Not only does the Good Feet Store chain have orthopedic consultants, they also have paid podiatry consultants. I must admit that I was taken back by this realization when a DPM consultant spoke on their behalf at a dinner meeting associated with a state meeting.
My former billing supervisor was on a recent cruise. The cruise ship advertised a free screening by the Good Feet Store for undiagnosed foot problems. She attended to see what they do and to inform me. They diagnosed her with “pronation” and attempted to sell her over $1000 of pre-made...
04/03/2026
RESPONSES/COMMENTS (CALL TO ACTION) - PART 1A
From: Philip Radovic, DPM, Robert Scott Steinberg, DPM
Philip Radovic, DPM, San Clemente, CA
I never use the word "custom." I dispense prescription corrective, i.e. posted functional foot orthotics. I use plaster because DCs, PTs, CPeds, shoe stores cannot or won't take the time, and don't have the training or experience.
Robert Scott Steinberg, DPM, Schaumburg, IL
04/03/2026
RESPONSES/COMMENTS (SUBSTANCE ABUSE & ADDICTIONS)
From: Joel Lang, DPM
What incredible courage to share this with so many. Best wishes and thanks for your contribution to the profession, your community, and the world.
Joel Lang, DPM (retired), Cheverly, MD
04/02/2026
RESPONSES/COMMENTS (SUBSTANCE ABUSE & ADDICTIONS)
RE: Everyone Has a Drug of Choice
From: Rod Tomczak, DPM, MD, EdD
I wasn’t sure how to start this letter, then I decided to begin the way I’ve started thousands of other meetings, with a stammer in my voice and say, “My name is Rod Tomczak (I choose to use my last name) and I’m an addict and an alcoholic and I last used 20 years ago.” Verbalizing the self-diagnosis gets easier after the first five years or so.
Everyone, and I mean everyone, has a drug of choice. For some people it’s not alcohol or a controlled substance. It might be gambling, plastic surgery, shopping, golf, eating, sex, money, work, power, working out, the Internet, or watching TV. It’s something that too much throws your life out of balance. For the longest time, I told people my drug was Absolut. I was absolutely wrong, but I did put it before my family.
In August of 1999, I broke out in....
Editor's note: Dr. Tomczak's extended-length letter appears here.
04/02/2026
RESPONSES/COMMENTS (PRIOR AUTHORIZATION)
RE: Mandated Publication of Prior Authorization Rates
From: Paul Kesselman, DPM
Yesterday's Becker Payer has a story related to mandated public posting of prior authorization issues for Medicaid, Managed Medicaid and Medicare, and CHIP plans. This includes denials rates, how often they are processed, and how often denials are overturned on appeal. The first reports are due today, March 31 under a rule finalized by Medicare in 2024. The only metric not subject to such posting are pharmaceutical denials. That means diagnostic and therapeutic tests and procedures, DME, etc.; all must have those metrics noted posted for publication.
Additionally, these carriers must process standard prior authorizations within 7 calendar days (currently 14) and urgent requests within 72 hours. Payers must provide specific reasons for the denials and communicate through their portals, faxes, email, mail, or phone. As was posted the other day, communication via fax and mail will be discontinued over the next year or so.
Paul Kesselman, DPM, Oceanside, NY
|
| |
|
|
|
