08/02/2024    Rod Tomczak, DPM, MD, EdD

Discrimination Against DPMs (Jonathan Michael, DPM)

Jonathan, it’s a shame you can’t help your daughter
put on her white coat for the first time in public,
and, yes, I think it is a form of discrimination.
For years, MDs looked down on DOs and still do, but
it is much more subtle. They could always use the
fact that DOs took the COMLEX licensing exams
instead of USMLE and supposedly the COMLEX was
easier to pass than USMLE. Now DOs can take USMLE
so MDs don’t have the “we take a tougher licensing
exam” platform to look down from. And, there are
not enough MD graduates to fill all the residency
slots in MD hospitals, so MD hospitals have
generously condescended to accept DOs into their
residency programs.

Don’t let the MDs kid you, there are huge economic
incentives to suddenly treat DOs as academically
equal to MDs, about a 100,000 reasons per resident
per year. This becomes very important when rural
hospitals are trying to keep the doors open and it
doesn’t hurt big teaching hospitals either. Money
talks, everything else walks.

DO hospitals were the first to let DPMs train
residents in their hospitals, and there was the
same “keep the doors open incentive.” DOs once had
a rule that a DO graduate had to complete a DO PGY
1 to get hospital privileges in a DO hospital, so
this helped economically. DPMs got to work in DO
hospitals, but some DPMs thought they were the
second-class citizens. From an economic view, it
was wise to have DPMs on staff, but originally not
as voting staff. It was a superficially appearing
symbiotic relationship to the outsider, but inside
the DO hospital walls, DOs wanted to make sure DPMs
knew their place. Then MD hospitals began to see
how profitable it was to have DPMs work in the MD
hospitals, but initially not quite equal. For
example, not getting block OR time or voting. Then,
MD and DO hospitals tried to out attract each other
to incentivize DPMs to work at their hospital.
Who’d a thought?

I think there is a temptation to have someone to
look down on. If I think subconsciously I am
better than someone else, even if erroneously, and
can falsely prove it by calling you “doctor” as a
courtesy, I might feel better about myself. Hence,
you as a DPM can’t hood or white coat your DO
student daughter and this proves I am better than
you. God forbid the DO school pulls this stunt and
not let an MD hood a DO graduate relative. That
leaves the DPM on a lower rung of the ladder of
esteem.

As kind and gentle as Leonard Levy, DPM was, if you
knew what buttons to push, you could get him riled
up and he would act, sometimes shooting from the
hip. The antiquated hooding and coating policy
used to exist at the Des Moines school, and it was
the same punitive rule you are suffering under
today. The coating policy rubbed Dean Leonard Levy
the wrong way and it was one of those buttons that
could be pushed. To the DOs there appeared to be
no economic benefit in letting a DPM on stage to
hood or coat a DO student, and no appeal process at
the university. There were some hurt feelings, and
rightfully so when a DPM parent had to sit in the
audience while a son or daughter received a DO hood
or coat. Leonard’s face flushed and he stammered a
bit, but he took up the gauntlet and taking a huge
risk, invoked some Old Testament justice declaring
no MD or DO could hood or coat a DPM student unless
they also had a DPM degree. It was an enormous
gamble on his part because it could possibly
threaten the generosity of some benefactors and
filter down to Leonard personally. Hopefully,
Jonathan, it will assuage your feelings to know the
policy changed that day as the faculty sighed in
relief.

My advice is to let the DO school know you have
changed the beneficiary on that life insurance
policy you took out when your daughter started
school. Originally you named the DO school as the
sole recipient. Now, the DPM school who graduated
you will someday benefit. Money still talks…

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

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