03/14/2024    Meghan M. Arnold, DPM

APMA Proposition 2-24

We need to as a profession eliminate the foot/rear
foot separation within the board credentialing.
Orthopods are laughing at us behind our backs
because of this. You don't see the orthopedic board
saying, well you didn't do a hand fellowship, so no
hand surgery for you. We have literally shot
ourselves in the foot as a profession with the
limitation of privileges at hospitals and with
state boards with this restriction of rear foot or
foot certification. This also tracks back to our
board certification as a whole it is ludicrous that
we separate medicine and surgery into two separate
boards. And then within the surgery board, separate
the foot and ankle into two separate
certifications.

We are already a subspecialty fighting for our
lives. We need to be more cohesive as a profession
with no restriction based on training and board
certification. Truly the board certification should
be much more the width and breadth of Podiatry.
Anyone who states that we are doing this to protect
podiatry as a profession are protecting their own
turf, they see younger practitioners as a threat,
why else would you limit someone's possible
privileges based on the fact they haven't yet
reached a board certification.

With the state of affairs being as it is in the
next 10 years the rear foot ankle certified people
who are not grandfathered in will be minimal and
the expansion of podiatric privileges will flounder
due to people who are not board-certified unable to
perform ankle and rear foot procedures. The APMA,
the American Board of Podiatric Medicine, and the
American Board of Foot and Ankle Surgeons need to
look at themselves and fix this problem.

The main problem in podiatry in that we are too
busy fighting with each other and protecting our
turf instead of advancing the profession. We can't
even agree on one board but have numerous boards
the primary medicine board, the surgery board, the
multi-specialty board, wound care board. If
podiatry wishes to succeed and thrive in the future
many people's personal and political agendas must
be set aside. As a profession we must band together
as a whole repeal the restrictive State boarding
laws, hospital privileges, and reorganize into one
podiatric board. Only then can we face the rest of
the medical community and truly be the experts of
the foot and ankle. We need to get our own house in
order so that we may stand together as one.

Meghan M. Arnold, DPM, St. Louis, MO

Other messages in this thread:

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03/15/2024    Philip Radovic, DPM

APMA Proposition 2-24 (Meghan M. Arnold, DPM)

While the call for unity within our profession is
understandable. When it comes to a single board
certification, it's important to consider the
perspectives and needs of all stakeholders
involved. When it comes to consolidating foot
surgery and reconstructive rearfoot/ankle surgery,
here are some points to consider:

1. Protecting the Public: Board certification
serves as an important measure to ensure that we
have met specific standards of competence and
expertise in our specialty. It provides reassurance
to patients that their podiatrist has undergone
rigorous training and assessment, thus safeguarding
their health and well-being.

2. Credentialing for Medical/Surgery Centers and
Hospitals: Most hospitals and medical centers rely
on board certification to evaluate the
qualifications of all healthcare providers. By
delineating specialized areas such as foot and
ankle surgery, it enables these institutions to
help ensure quality care.

3. Evaluating Competencies and Skills: Disparities
in training among podiatric residents and fellows
are a legitimate concern and can impact patient
outcomes. Despite all programs now being
standardized, there is a broad variation of
competencies coming out of them. Board
certification helps to standardize the assessment
of competencies and skills, providing a benchmark
for proficiency across different areas of practice.
We should take pride in that we separate
competencies in Reconstructive Rearfoot and Ankle
surgeries from Foot Surgery certification. It’s
what separates us from general bone doctors. We
don’t need to emulate orthopedic standards. We can
do better.

4. Addressing Disparity in Training: Recognizing
the variations in training experiences among
podiatric residents/fellows, and the focused sub-
specializations of many seasoned podiatrists, there
could be merit in exploring the implementation of
additional certificates of competence from A Single
Board. These certificates could reflect specialized
training/competence in areas such as podiatric
sports medicine, podiatric surgery, and
biomechanics, allowing practitioners to demonstrate
proficiency in their skill set while the gateway
certification can be reasonably obtained.

5. Promoting Cohesion and Collaboration: While
advocating for reform within the profession, it's
crucial to foster collaboration and unity among our
colleagues. By engaging in constructive dialogue
and working towards common goals, we can
collectively advance the profession as a whole.
“Limiting someone's possible privileges based on
the fact they haven't yet reached a board
certification” (assuming they are qualified), is
not a board issue as much as it is the facility
that allows this restraint.

I think it's important to balance the need for
standards of competence with the imperative of
promoting inclusivity within the profession
(however, unlike children’s sports, not everyone
deserves a trophy). Exploring avenues for enhancing
training, addressing disparities, and adapting a
single pathway certification process to reflect
specialized competencies can contribute to the
overall advancement of podiatric care and better
serve the needs of both podiatrists and patients.

Philip Radovic, DPM, San Clemente, CA