06/14/2024    Rod Tomczak, DPM, MD, EdD

APMA Policy 2-24. One Board Certification in Podiatry (Allen Jacobs, DPM)

I agree with Dr. Jacobs and his views he shared
with us in the June 13th PM News. It was quite
serendipitous that I came to The Ohio State
University College of Medicine. On May 19, 1995,
one of the podiatry students who is now a faculty
member at the University of Alabama, Birmingham
called and asked me if I had seen the advertisement
for the faculty position at Ohio State. To be
honest, I hadn’t but upon inspection it looked
intriguing. I had a friend who was a pediatric
spine surgeon, Tom Kling, MD at the University of
Indiana, and I called to ask him if he knew the
chair of orthopedics at Ohio State. He said he knew
him quite well.

He said he would call him right then for me but
warned me that Shelly Simon, MD was a well-
respected foot and ankle surgeon in the orthopedic
community and warned me that it was, “Shelly’s way
or the highway,” but I would be fine. Not more
than 30 minutes later, Shelly called me and asked
if I could come the following Wednesday to be
interviewed on Thursday and Friday. He also asked
if I could get a CV to him ASAP, but not to worry
if it didn’t make it by Monday. I had six
interviews on Thursday and six more on Friday. It
was grueling. A secretary was assigned to get me on
time from one interview to the next. When I was
done with the 12 interviews I was taken back to
Shelly’s office. He told me I had the position if
I wanted it and said come back next week with my
wife to find a house.

He said he called every interviewer 15 minutes
after the scheduled interview was done to see if I
was acceptable. He asked me if I was wondering why
I had been offered the position so quickly. I said
that I was speculating and he told me that when Dr.
Kling called him, Kling offered one statement that
literally got me the job. He said, “Tomczak thinks
like an orthopedic surgeon.” By that time I had
been a podiatrist for 18 years and taught at Des
Moines for nine of them. To this day, I have no
idea what Kling meant or how Simon interpreted
that. I’m not sure what thinking like an
orthopedic surgeon entails. We have the same
anatomy, same surgical principles to go by, same
rules in the OR, same instruments and same
standards for patient care.

Perhaps this was the Johari blind spot, things
about myself I don’t recognize but others do.
Maybe it’s best described by the idea that I have
never seen myself in three dimensions while
everyone else does. Relating to podiatry, perhaps
it is the things Dr. Jacobs so eloquently describes
about the board certification processes and what
the one process should be. How can the ABMSP offer
three certifications in foot and ankle surgery
alone? Are we divided into forefoot, rearfoot and
then ankle surgeons or are we foot and ankle
surgeons, maybe just lower extremity?

We throw around a lot of reasons why we have so
many subspecialties that mean nothing and they
won’t change privileges. Some podiatrists remark
we have these levels of certification because we
are protecting the public from practitioners who
are not capable of performing more complicated
ankle surgeries. How many complicated ankle
surgeries makes one competent? How many ankle
fractures are exactly the same?

I think the reason for so many different
classification systems is that none really describe
all possible fractures. Maybe a part of thinking
like an orthopedic surgeon is not thinking with my
wallet but thinking about my competence and
confidence when seeing a patient. How may
orthopedic surgeons really want to operate on
pelvic fractures? Is there the possibility that
orthopedic surgeons see a complicated ankle
fracture and send it to a well-trained podiatrist
who has shown competence in reducing and fixating
these fractures and the podiatrist is better than
the orthopedic surgeon with such cases. The
orthopedic surgeon is not thinking with his or her
wallet but what is best for the patient and he or
she will not refer it to a podiatrist because the
podiatrist is board certified by some just sprung
up board.

Rod Tomczak, DPM, MD, EdD, Columbus, OH

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