03/26/2024    Joe Agostinelli, DPM

APMA Policy Proposition 2-24: One Board in Podiatric Medicine & Surgery (Bret Ribotsky, DPM)

I write this reply in support of my colleagues,
Drs. Amol Saxena and Bret Ribotsky concerning
their comments on the recent APMA HOD resolution
concerning support for “one certifying board. Drs.
Spinner and Zlotoff also have penned cogent and in
my opinion, correct observations on this subject.

My previous experiences of 23 years active duty
USAF and 13 years private practice (always as part
of a large orthopedic surgery group practice) have
colored my take on this situation. Rather than
trying to solve a problem with one certifying
board, the profession needs to do something more
radical - that is having all the podiatric medical
colleges, especially those associated with MD and
DO schools, discontinue the DPM degree and rather
have “podiatric medicine/surgery become an actual
specialty in regular medicine. We can say we are
“physicians” all we want - but we are not! The
only path to “parity/equal pay for what we do /
inclusion in legislative aspects of reimbursement
, etc “ is to have all prospective podiatric
medical students attend the same classes as
regular MD DO in colleges that grant a them the MD
/ DO degree .

Podiatric medical/surgical post-graduate residency
of 2 years for general podiatry, then an
additional 2 years surgery makes us the “lower
extremity regional specialists”. Fellowships could
follow that present CAQs is any subspecialty you
can think of. In the military for example, the
DPMs are basically in the “non-physician corps”
(Medical Services Corps for Navy/ Army, Biomedical
Sciences Corp in the USAF). This extremely
important because as “physicians” in the military
(Medical Corps) are eligible for a multitude of
physician specialty and retention pays that DPMs
are not eligible for.

After 2 years residency , you then become “board
qualified” and take one certifying board
(podiatric medicine) by case defense management .
After that with 2 additional years surgical
training (if so desired), ABFAS issues a “surgical
CAQ” . Recertification , (not self- assessment)
every 10 years follows. Grandfathering needs to
cease to be available. Since being certified in
1986 by the then ABPO (now ABPM), and in 1987 by
the ABPS (now ABFAS) lifetime certificates were
issued. Those certified prior to 1991 had to take
only a self- assessment examination every ten
years where practically you could answer choice
“A” on every question and be self-assessed
successfully every ten years. I opted to actually
recertify rather than self-assess at the
appropriate time since then the ongoing
recertification process makes more sense and
satisfies the public’s perception of competence.

I disagree with the formation of one certifying
board for all because “all are not equal “ as far
as post graduate training and experiences
Rather, the MD / DO degree with a comprehensive
podiatric post-graduate residency and fellowships
with CAQ’s is the only way to be “physicians” and
be perceived by the general public / legislatures
/ reimbursement organizations / other medical
specialties as such. I think that many of the
readers of this issue are being led to believe
that one certifying board now with grandfathering
is the answer. It is not the answer. The degree
change (promoted for many years by the PM
leadership answers all the questions! We can say
we have/are achieving parity as “ physicians “ but
saying so , does not make it so.

As Drs. Saxena and Ribotsky, I volunteer to help
in this process going forward.

Joe Agostinelli, DPM, Niceville, FL

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