From: Allen M. Jacobs, DPM
Respondents and contributors to PM News have proposed various theories to explain the serious decline in applications to podiatry colleges. Perhaps PM News readers should look at the obvious. How many state societies have changed their names to "foot and ankle society" when they were previously a state podiatry or podiatric society? We have, of course, board certification by the American Board of Foot and Ankle Surgery. We have the American College of Foot and Ankle Surgeons. We have podiatrists essentially denying the fact that they are podiatrists walking about with the prefix Dr. on their jackets. The problem is just that simple. No one uses the term podiatry.
PM News recently published a story regarding an award given by the North Carolina Foot and Ankle Society... not by the North Carolina Podiatry Society. We have the Ohio Foot and Ankle Society conducting a meeting. Physicians and other healthcare providers know that we are podiatrists. For example, when I receive a consultation in the hospital for an infected diabetic foot, the residents and the attending in medicine will state, "infectious disease and podiatry have been consulted." Patients frequently do not understand that the "foot and ankle surgeon" they are seeing is in fact a podiatrist. This is to a large extent, in my opinion, the reason that as of the time I am preparing this for PM News, I believe there are less than 300 applicants total for all the colleges of podiatry. You reap what you sow.
Allen M. Jacobs, DPM, St. Louis, MO
From: James Wilton, DPM
I read with some interest Dr. Allen Jacobs’ comments regarding "AENS surgeons operating on diabetic peripheral neuropathy with nerve decompressions". As a member of that society and director of the basic peripheral nerve surgery course, this is as far from the truth as can be stated. The surgeons that take our course for training have a much broader background in diagnosing, and conservatively and also interventionally treating peripheral nerve disorders. We do not advocate on any level the use of PSSD testing for the evaluation for peripheral nerve pathologies. We specialize in developing skills for our surgeon students in giving a complete neurologic extremity "hands-on" examination.
As the first DPM surgeon admitted to the American Society for Peripheral Nerve, it has been eye-opening seeing the difference in training between allopathic peripheral nerve surgeons and what is being taught in traditional podiatric residencies. I had excellent medical and surgical training through Dr. James Ganley, however peripheral nerve injuries and syndromes were not a part of my training. In having taught podiatric surgeons and international plastic surgeons over the past 20 years peripheral nerve surgery techniques and also diagnostic evaluation of patients, the current podiatric residency model falls way short of the allopathic model for plastic surgeons in these fields. It is through advanced training that the AENS offers, that podiatric physicians can become better diagnosticians and surgeons
James Wilton, DPM, Claremont, NH
From: Lancing Malusky, DPM
I started my Ohio practice in 1974. From the start, all kinds of podiatric procedures were in my purview: Warts, ingrown corrections, fractures, hammertoes, etc. Naturally, routine foot care (CNC) was a major component of my practice. I used staff to set up and finish the patient. In those days, Medicare would pay a little for a whirlpool. Patients would be finished with lotion and a foot massage. As the practice matured, I became ABPS board certified and practiced more foot surgery. But, C&C was always there and profitable.
I retired in 2016. The major factor I considered, beyond the current insurance and management hassles, was/is degenerative arthritis in my dominant hand. My hand orthopod stated he never saw so much DJD in a hand. I've had episodes of Dupuytren's and digital spurs treated in that hand since retirement. If I had worked any longer, I would not have been able to enjoy retirement. In later years of practice, I still did all the C&C, and I had a medical assistant finish the mycotic nails with a Dremel drill and central vacuum. If I would have had access to an ancillary nail person, I would have readily accepted that and stayed in practice longer. I do believe that supervision and adequate training would be necessary for such a person to be in the practice and billing "ancillary" C&C.
Lancing Malusky, DPM, Dayton, OH
