02/27/2024    Robert Kornfeld, DPM

Podiatrist Published in Journal of Fungi (Allen Jacobs, DPM)

While I can neither support nor refute Dr. Roth’s
claims to a 98% success rate treating onychomycosis
without a culture, I do take offense to Dr. Jacobs’
short, off-the-cuff condemnation of those of us who
do not accept insurance. A lot was said in those
couple of sentences. First of all, in a profession
with a long history of struggles (which continue to
this day), the last thing we need is someone coming
along and dividing the profession into “them” and
“us”. This same thing happened back when I started
practice as the traditional “open” surgeons
condemned and marginalized the MIS surgeons. And
now, here we are more than 40 years later, and MIS
is not only gaining ground in podiatric surgery via
advanced technology, but it has also infiltrated
into many other surgical specialties. Second, to
denigrate himself as a “mere mortal” speaks loudly,
to me, of his resentment (and perhaps jealousy) of
those who had the self-esteem and the courage to
walk away from the exploitation and abuse of
insurance companies, which has only gotten worse in
my 42 years in practice.

Dr. Jacobs may not understand the dynamic of a
direct-pay practice, but the reality is you can
make a much better living on far fewer patients
with a lot less stress if it is done properly. And
the beauty of it is it frees up lots of time to
pursue other interests, passions and to obtain more
knowledge as it pertains to our treatment of
podiatric pathology. I can attest to the fact that
all of my advanced training in functional medicine
was afforded to me by the gift of time. We all are
free to pursue what interests us. I do not think I
am better than any other podiatrist. I am not that
haughty as Dr. Jacobs infers about direct-pay
podiatrists. However, I can definitely state,
unequivocally, after seeing the results of last
week's PM News survey that we, as a group, are far
less stressed and definitely happier practicing the
way we do than insurance-dependent doctors.

Please, Dr. Jacobs, if you want to challenge
someone, then do so. But do not extrapolate what
you are challenging into a condemnation of doctors
who you do not know and a practice model you know
nothing about.

Robert Kornfeld, DPM, NY, NY

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02/28/2024    Ivar Roth, DPM, MPH

FL Podiatrist Published in Journal of Fungi (Allen Jacobs, DPM)

Thanks Dr. Jacobs for your comments. With my
concierge practice I take the time to treat each
patient personally and follow them up very
carefully. When I say follow up for fungus nail
treatments, I include a 3 month follow-up as well
as a 12 month at no charge. Since the patients
paid significant funds, we have a high number that
return for their follow up appt. We take photos
100% of the time at each visit during the
treatment and with follow-ups. I have spent over 2
decades trying to cure fungus toenails and I can
say with great pride that I have achieved that
goal. I have successfully treated thousands of
patents now. When I say cured I mean cured. I use
a 4-step process.

The first is using a laser or lasers which I have
developed a proprietary protocol for. It took me
years to figure out what settings and times to
use. The second step is meticulous nail care where
the offending fungus nails are debrided maximally
and re shaped from sometimes as bad as horses
hoofs to perfect nails again, this is done
throughout the treatment program. All the nails
that the medical profession says cannot be cured I
cure. Look at my yelp reviews. The third step is
use of my proprietary kit which includes using a
gel I developed and that is made at a compounding
pharmacy as well as drying the nails with a hair
dryer which you earlier were critical of. The last
step is using a nail stimulant to grow the nails
quicker with a propriety combination of mini doses
of antifungals.

I am currently looking for funding to apply for a
FDA “cure” status which as you stated would be
worthy of a Nobel Prize in your estimation. I have
developed an algorithm based on the how the nails
present themselves so that if there is
noncompliance or a problem in one area you just
follow the algorithm for an alternate pathway to
success.

Dr. Jacobs, I invite you to come see the daily
miracles that I perform here at my office to see
for yourself of course with a signed NDA. I want
very much to bring this cure to our profession so
that we can add some shine to the profession of
podiatry as the experts for this problem.

Ivar E. Roth, DPM, MPH, Newport Beach, CA