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08/17/2024 Rod Tomczak, DPM, MD, EdD
Who Decides Who is a Physician?
So, are we or are we not physicians and who decides the answer? Does someone in an ivory tower get to ratify our decisionsand are the legal repercussions if we answer in the affirmative, but another group asserts we made the wrong choice? Is there some knight in the background counselling us to, “Choose wisely!”
Chiropractors call themselves chiropractic physicians in several states, perhaps over 30. It seems ludicrous to think there are chiropractic physicians and not podiatric physicians, but yet here we are, and it is happening. How can this be? I think the problem begins with which medical board holds sway over a certain discipline. Every state has a chiropractic board that more or less governs chiropractors within the framework of the state law. Where ambiguities exist, the state legislature and attorney general turn to the governing board to interpret and advise on these questions.
In many states, optometrists and chiropractors can call themselves physicians without controversy. The state seems to have the final say over whether members of a profession call themselves physicians. Every state has its own optometric and chiropractic board, and most can call themselves physicians. Now it would be nice if every podiatry graduate accepted the challenge to take MD boards and passed which would put an end to the podiatrist physician controversy. Knowing NBME and USMLE won’t allow podiatrists to take the test, foot and ankle MDs clamor for podiatrists to take the test knowing they are safe from us picking up the USMLE gauntlet and succeeding.
I seriously wonder why podiatry, in some states, is under the aegis of the state medical board when every other health care profession seems to be governed by its own board. I ponder what the advantage is to having podiatry governed by the medical board. The first response is that we are medical and maybe chiropractic or optometric isn’t. It’s not a question of diagnostic and treatment philosophies, but professional overwatch. In at least twelve states osteopathy retains its own board meaning full licensure can be granted through USMLE or COMLEX and DOs and MDs have the same unrestricted license regardless of which test is passed depending on degree granted by an accredited school.
No one ever suggested podiatry come under the watchful eye of osteopathy. Is it possible that in some states podiatrists once looked through rose- colored glasses and thought if podiatry was under the same board as MDs, we would have parity with MDs? Is it possible for podiatry to return to self-governing and decide we want to be called physicians because we know we are? Is it that simple or do others want to control us and have final say over our existential choices? Is it just to have ten MD board members for every one podiatrist deciding our name?
Rod Tomczak, DPM, MD, EdD, Columbus, OH
Other messages in this thread:
08/24/2024 Name Withheld
Who Decides Who is a Physician? (Rod Tomczak, DPM, MD, EdD)
Early this morning I had just finished my coffee and reading the latest PM News forum. Once again, we, as podiatrists, were discussing the DPM vs. MD/DO parity issue and whether or not we are physicians. As usual, many in our profession believe we are on par with the MD/DO group and should be treated as such by all and the other side believes we should remain as we are, our own profession.
I have to admit that there had been many times in my now 35 plus year career as a podiatrist that I have wished that I had gone the MD or DO route so I could be a “real doctor, a physician” but that had not been my path. I was daydreaming about what it would be like to be that “real doctor” and contemplating a second cup of coffee but my cell phone rang. It was a hospitalist standing in the ED at the local community hospital asking me to stop and see a diabetic with a foot infection that she was admitting. I agreed to do so, particularly knowing that I was headed to the hospital for surgery anyway so a consult would be easily accomplished between cases. I was tired. I had been up a good part of the night, in surgery. The ED had called about 11 PM and asked me to come in to see a 15 year old who was visiting from out of town and had fallen at a local hotel and had cut the top of her foot on a metal door. A tendon was severed and readily visible through the wound. They had already called ortho, which they typically do for trauma, but there was no bone involvement so ortho deferred to me (probably they didn’t want to go in at that time of night). I had gone in and as an on call team for the OR had just finished an appendectomy they were available to set up to repair this injury. I got home about 3:30 AM.
My day was already busy, over busy really. First to surgery, then the consult, then a stop to see the patient I had done and I & D on earlier in the week that was being discharged. Then to the office where I had two peer to peer calls to do to get MRIs approved, a call with the vascular surgeon I worked with regularly and I knew that there would obviously be calls that come in of some variety or another that would have to be dealt with, this on my afternoon “off” as no clinic patients were scheduled. Not having seen the new consult yet I had no idea if it would be a call to the OR to get some time that afternoon or evening or if it would be a “ follow” the patient with the hospitalist, non-surgically.
As usual, we had some family plans on the weekend with grandkids involved but my children knew well what I did for a living, having grown up with it and so they understood that plans sometimes were bumped or delayed, usually only by a few hours but none the less, sometimes were altered by a patient need or the hospital.
While at the hospital one of the internists stopped me in the hall and asked me to see his wife the following week for heel pain he could not resolve. Surgery went well and fortunately, the I&D from earlier in the week was going home, the patient was very gracious in praising me, “thank you doctor, for saving my leg” (those always embarrass me for some reason). The consult would be treated medically as agreed with infectious disease and the afternoon ended calmly.
Name Withheld
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