From: Evan Meltzer, DPM
In the various letters regarding the low applicant numbers and the educational requirements, there is one important characteristic of the podiatry profession that hasn’t been addressed. Podiatry is a compassionate profession. How many times have you seen a patient who has been complaining of pain for days, weeks, or months; and after your treatment they walk out of your office pain-free? Even if their pain is relieved only for the duration of what you injected.
How many other medical professions can provide this compassionate service? Perhaps this reality can be mentioned to pre-medical students who are considering their future direction.
Evan Meltzer, DPM (retired), Rio Rancho, NM
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
