12/11/2024    Allen M. Jacobs, DPM

“I Have Built a Monument More Lasting than Bronze…” ( Rod Tomczak, DPM, MD, EdD)

Mark Twain stated “Never argue with stupid people.
They will drag you down to their level and beat
you with their experience “. With specific
reference to the question of wither podiatry,
there are realities which in my opinion are stupid
to ignore. Stupid, meaning lack of common sense.
Why is there a concerning decline in the
application pool to the colleges of podiatric
medicine? That is a reality. Those educational
facilities awarding an MD, DO, PA, NP degree are
overwhelmed with applicants. Why do all these
alternative degrees maintain a broader scope of
practice including diagnostic and therapeutic
interventions than a DPM degree maintains? The
reality is that of education. That is reality.

Those holding a DDS degree may diagnose and treat
within a limited scope of anatomy. Those holding a
DPM degree may similarly diagnose and treat within
a limited scope of anatomy. The reality is that
the education of a DDS or DPM is directed to the
goal of graduating a limited license health care
provider. Puffery suggesting that the didactic and
clinical education of a podiatrist is three or
four courses away from the more global
qualifications of an MD or DO is just that,
puffery that is accepted as realistic only by the
uninformed, I.e.,- stupid people.

Dr. Tomczak references Waiting for Godot. The two
(Estragon and Vladimir) argue in part about what
Godot will look like. As Dr. Tomczak notes, Godot
never appears. The profession must decide what it
believes will best serve the public interest. A
broadly educated health care provider practicing
podiatry or a limited license practitioner
practicing podiatry. Perhaps the former is more in
line with the reality and requirements of
tomorrow’s world, thus requiring a true change in
education. Perhaps this is the reason that the
declining applicant pool to our colleges is
analogous to the canary in the mine. Before we
continue the board certification debate, we must
answer the question: board certification for
what? Einstein noted that “Great spirits have
always encountered violent opposition from
mediocre minds “.

Are we to suffer the fate of Estragon and
Vladimir, or do we conclude this seemingly endless
debate by establishing the future definition of
podiatry and provision of an appropriate
educational experience to support that definition.
There was a time our profession moved on from the
DSC and similar degrees to the DPM degree. Is
another metamorphosis required for the future, or
do we accept the reality that we shall forever
remain a limited license practitioner?

In my opinion, the colleges do an excellent job in
providing the necessary education (together with
the residency/fellowship experience) to produce a
competent limited license practitioner. The
current goal is not to provide an education
qualifying a podiatric student to pass the USMLE.
Nor to graduate individuals misrepresenting their
education, engaged in endless puffery.

Whatever the profession determines it wishes to
be, do so and move on one way or the other. The
second act is ending, and the curtain is about to
come down. Shall we still be talking about moving,
like Estragon and Vladimir, yet never move? I do
know this; I am not stupid, and will not be
dragged down to the level of believing that I am
one gynecology and psychiatry course from being an
MD or DO and being granted a general medical
license. Thank you for the warning Mark Twain

Allen M. Jacobs, DPM, St. Louis, MO

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