08/26/2024    Jack Reingold, DPM

Who Decides Who is a Physician? (Rod Tomczak, DPM, MD, EdD)

I graduated from CCPM in 1979 and retired in 2023,
practicing in San Diego, CA the whole time.
Luckily, there were hospitals in the area that let
me have surgical privileges when I started. Within
15 years, all the hospitals in my area granted
podiatrists virtually full surgical privileges
(including ankle) and admitting privileges. Managed
care arrived and discovered that podiatrists
delivered excellent, cost-effective care and began
hiring them in great numbers. Kaiser Permanente
Medical Group went from none to currently 21!

Hospitalists started calling us and begging us to
take patients. Nobody seemed to care about our
degrees, caring only if we could take care of their
patients (and perhaps off their hands). The
hospitals wanted us to take positions on many
committees (of course they were none paid). I am
not even sure if all the physicians in my community
realized we had a different degree. Many of them
became patients and never even mentioned it.

In my 41 years of practice, I do not even recall a
patient asking me what degree I had or if I was a
real doctor! The biggest problem with the DPM
degree is that we are often overlooked by our
legislators regarding new laws and regulations,
which takes a lot of energy to correct.

Medicare and private insurance cannot always
identify a MD or DOs specialty and their use of
billing codes as easily as they can with a DPM
after their name. This sometimes results in unfair,
over scrutinizing of our claim. We are as
knowledgeable in our area of expertise as any other
specialty! Sure, in certain moments it would be
easier to be an MD but, I would not lose any sleep
over it.

What a great time to be a podiatrist. As I use to
tell my son, "have fun, learn something and do some
good."

Jack Reingold, DPM, Encinitas, CA

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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