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07/12/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Kathleen Neuhoff, DPM
I read the APMA’s new proposed referendum defining "podiatrist", with a little bit of concern. I am sure the purpose was to increase our scope of practice. However, eliminating the phrase, “local manifestations of systemic disease” actually limits our practice.
I frequently prescribe medications for gout, and diabetic neuropathy. According to the new definition, I would be operating outside of my defined role as podiatrist. I suggest a return of this phraseology to the definition.
Kathleen Neuhoff, DPM, South Bend, IN
Other messages in this thread:
07/16/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Jon Purdy, DPM
It’s a little laughable that our own national association has difficulty in defining who and what we are. I’m a podiatrist and I’m confused by this statement. Our state medical boards restrict us in different ways. Our training limits us to certain structures of the foot above and beyond state scope of practice.
The lumbar spine at minimum is a governing and related structure. We treat global manifestations of systemic conditions such as neuropathy, allergic reactions, and bloodborne conditions, to name a few. So we treat the leg below the tibial tuberosity but specialize in the foot and ankle? So now we are an orthopedic sub-specialty that further sub-specializes?
Our profession is archaic and continually trying to define itself. No other “physician” by definition has such issues. The MD and DO specialties are well defined, not restricted by scope, and perform within their specialty, secondary to agreement between the local healthcare entities and the physician’s level of training. It seems most of our discussions, be it professional practice, medical, surgical, or political, point us in the direction of achieving parity through inclusion in MD or DO modern medical practices.
Jon Purdy, DPM, New Iberia, LA
07/15/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: H. David Gottlieb, DPM, Joel Feder, DPM, William Egelston, DPM
Many of the responses on PM News regarding the APMA survey on the Revised Definition of Podiatry are off the mark in my opinion. The APMA's opinion on this is their opinion. It does not carry any legal weight in any state or territory. The 'role as a podiatrist' is the scope of practice granted to you by the legal entity of the state or territory which awarded you your license to practice podiatric surgery and medicine. However aspirational or inspirational the APMA's definition may be, it does not change one iota the legal scope of practice that you currently have.
If you want a broader scope, fight for it in your state. If you don't, then enjoy what you have.
H. David Gottlieb, DPM, Baltimore, MD
Why change the "broader and working" definition of our profession to a more limiting one? The newer definition is ill conceived.
Joel Feder, DPM, Sarasota, FL
I think a less cumbersome and cogent definition might be:
Podiatry is an allopathic medical specialty addressing conditions of the lower extremity.
William Egelston, DPM, Modesto, CA
07/03/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Lawrence A. Santi, DPM
Dr. Steinberg asks what our APMA has done to put money back in members’ pockets. In addition to defending our members’ reputations from scurrilous attacks that could have a legitimate impact on their patient volume, our APMA is the leading organization protecting members from fee cuts, onerous payer policies, and more, all of which affect your bottom line.
Following advocacy by our APMA and others to change office and other outpatient E&M level selection methodology and advocacy to increase payment associated with those services, in 2022, podiatrists submitted approximately 530,000 more Level 4 and 5 office and other outpatient E/M services than in 2018, resulting in approximately $76.8 million more paid to podiatric...
Editor's note: Dr. Santi's extended-length letter can be read here.
07/02/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Keith L. Gurnick, DPM
When will our national and state associations bring us real victories? I preface this post as a 42 year dues paying member of the APMA, California Podiatric Medical Association, and Los Angeles County Podiatry Association. It is always good news when our associations fight for us and win the battles to right the wrongs. Quick action to eliminate the AMA's irresponsible, inaccurate, and defamatory social media hit piece against our profession should be commended.
The CPMA recently was victorious against Blue Shield who was planning to cut allowable payment by 50% for an E/M or consultation when billed at the same encounter (same date of service) as a minor procedure. These are two recent actions successfully undertaken where we prevailed. But is not losing the same as winning? We all know...
Editor's note: Dr. Gurnick's extended-length letter can be read here.
07/01/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Jon Purdy, DPM
The fact of the matter is, a DO does additional training above that of the MD, yet the AMA tries to minimize their degree and strong arm them out of competition. They instill this thinking into their graduates. I remember touring a potential MD school I was considering attending. We were given a tour by an MD resident. I asked if she ever considered DO school. Her reply was, “I didn’t consider it. After all this training, I want to be respected.” I tried to keep from laughing.
We are on a path of stepping stones as DPMs, with the hopeful outcome of obtaining an MD or DO degree in addition to DPM. It may not sit well with some, but the reality is, medicine continues to change. The DO degree only has to deal with disrespect. DPMs have to deal with disrespect, lack of full scope licensure, and a small political presence.
Jon Purdy, DPM, New Iberia, LA
06/28/2024
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Bret Ribotsky, DPM
Is this really a victory? It seems that a real victory would be a make good by the American Medical Association to jointly produce a “product” that demonstrates the incredible value that podiatric medicine provides to society and what integral members of the healthcare team podiatrists are.
It seems that at least yearly, there’s a direct attack from organized medicine made upon the podiatric profession. And leadership in our profession seem to be content with just a retraction. I want more! Tort laws in our country allow for recovery of intentional, misleading damages placed upon a person or party. It seems like organized podiatry always threatens to sue somebody unless they remove the offensive post, video, campaign. But that’s clearly not a deterrent until there are significant ramifications for even beginning these actions.
APMA, please share with all of us what benefit has been obtained as a result of your educating AMA to take down their tortuous action; and, while you’re doing this, maybe comment on creating a cancer registry for all of us.
Bret Ribotsky, DPM, Fort Lauderdale, FL
05/17/2021
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Bob Sage, DPM
I just had the opportunity to watch our current APMA President Jeff DeSantis talk about the resolution coming from the Joint Task Force that is up for discussion at the AMA House of Delegates.
This video really hit home for me as I remember the APMA House of Delegates and all the discussions leading to the formation of the concept of VISION 2015 to achieve parity with our MD and DO colleagues... not just parity because we said so, but true parity with our colleagues that we work shoulder to shoulder with every day. I remember the decision to go to the 2-year standardized residencies away from the multitude of different residency types that were in place when I graduated. Then there was the decision to go to the 3-year standardized surgical residencies, and the changes that took place in our colleges of podiatric medicine and the changes that took place in our residency programs as well.
I am proud of the changes that we have accomplished and that the rest of the medical community is taking note. I look forward to finding out what happens at the AMA HOD. I know that whatever the outcome, we will continue on the path that will lead to true parity and that someday in the not so distant future, our podiatric medical students will not be able to fathom the fact that we were not always able to take the USMLE and didn’t always have a 3-year surgical residency.
Bob Sage, DPM, Beloit, WI
05/13/2021
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: David G. Armstrong, DPM, MD, PhD
I read with some interest the AMA resolution regarding a path to a plenary DPM license. While I empathize with those that might have frustrations in the past regarding the evolution of our specialty and our degree, I disagree with those that have impugned the outcome of this draft resolution. I see this as the next logical step in our evolution. The fact of the matter is this: Our degree should define us (our training, our background, our area of specialty), but it should not confine us. In other words, the silly things that have stood in our way over the past two or three generations that my father and many of our collective mentors fought for will yield fruit that my oldest daughter, now a rising third year podiatric medical student, will not even have to think about. That is progress.
David G. Armstrong, DPM, MD, PhD, Los Angeles, CA
05/12/2021
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Allen Jacobs, DPM
Everyone with an interest in this “step toward equality” is obligated to read this document, the related motions to the AMA house, and other related documents not specifically referenced in the white paper. Should you do so, I believe you shall find yourself anything but enthusiastic regarding the prospect of equity. Personally, I am shocked that the APMA and ACFAS would have signed off on this document. State delegates to the APMA HOD should be urged by you not to consider any approval of this document as presently constructed. It is a complete and total repudiation of your education and degree.
There are four major components to this proposal. It is not a simple matter of allowing a podiatric...
Editor's note: Dr. Jacobs' extended-length letter can be read here
05/11/2021
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Allen Sherman, DPM
I read the announcement by the APMA and reporting by PM News with great interest regarding the joint effort of the APMA, ACFAS, AOFAS, and the AAOS (Joint Task Force of Orthopaedic Surgeons and Podiatric Surgeons) to petition the American Medical Association and the National Board of Medical Examiners to allow podiatrists to prove that they ”demonstrate(s) the core competencies to practice medicine” by taking and passing the USMLE exam. I have long felt that merely stating that our education was equivalent and demanding an MD degree was a pointless, sophomoric exercise. Power and exclusivity are never ceded voluntarily. Rights to so valuable a commodity as a professional degree is always only achieved by proof, and that proof is testing by our peers.
If we are asking for an MD degree, it’s always been a foregone conclusion that we must pass our...
Editor's note: Dr. Sherman's extended-length letter can be read here
05/10/2021
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Adam Howard, DPM, John Chisholm, DPM
Congratulations and kudos to APMA, ACFAS, AAOS, and AOFAS and their Joint Task Force for the recent announcement of a white paper and AMA resolution whose goal is to outline a pathway by which podiatric surgeons can be defined as physicians within their scope of practice. The passage of their resolution by AMA and the subsequent ability of graduates of podiatric medical school to take and pass the USMLE will enable state podiatric associations to begin the process of having DPMs granted an unrestricted, plenary license.
For more than a decade, the California Podiatric Medical Association has been working tirelessly for true parity between DPMs and our MD and DO colleagues. Our own Task Force established a similar pathway for a plenary license with our orthopedic and medical colleagues in California. This announcement is another step towards the goal of changing our DPM license to a plenary license while allowing us to keep our unique perspective and identity as podiatrists. We are now one step closer to making DPM=MD=DO a reality. CPMA calls on all APMA members and our schools of podiatric medicine to support this effort.
Adam Howard, DPM, President, CPMA, John Chisholm, DPM, Past President, CPMA
03/16/2020
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Ted Hull, Ben Pearl, DPM
In light of the growing concerns related to COVID-19, we applaud the difficult decision made by APMA leadership to cancel the APMA House of Delegates, and also commend the other podiatry organizations who have cancelled their events. The phrase “we’re all in this together” holds true now more than ever. The health and safety of physician attendees, staff, our employees, and the patients we all serve comes first. Our sincere congratulations to Dr. Seth Rubinstein on his quiet inauguration as APMA President. We look forward to celebrating in the near future, hopefully in July at the APMA National.
Ted Hull, CEO, Bako Diagnostics
Being from Virginia, I have had a chance to see how thorough Seth Rubenstein, DPM is in his approach to state issues. I am sure he will be recognized in the proper fashion. There are two sides to every coin and an argument with pros and cons for each. One of the main concerns for more rapid transmission is that the healthcare system will be overwhelmed with real cases or people that think they have the coronavirus. I think we can make choices as individuals. Organizations also have to make choices based on the perceived risk that they have reviewed involving everything with flight travel, etc. involved with bringing people to meetings in the current ever-changing landscape.
Ben Pearl, DPM, Arlington, VA
03/13/2020
RESPONSES/COMMENTS (APMA NEWS) - PART 1A
From: Corey Fox, DPM
Congratulations to the incoming leaders of the APMA. It was a wise decision to cancel the HOD meeting. Just curious about Dr. Purdy's reply. What medical facts is he basing his opinion on? The facts are that we don't know too much about this novel virus strain. The facts are that the number of cases is doubling every two or three days, just like it did in China, Korea, Italy, and Spain. The facts are that the entire human population is not immune and that the only way to contain and mitigate its spread is by social distancing. You will likely get exposed to the virus. You are unlikely to get sick or show symptoms. But you can be an unintentional vector and unwittingly spread it. These are the facts.
Corey Fox, DPM, Massapequa, NY
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