05/13/2025    Paul Kesselman, DPM

Do We Really Have a Medical Degree? (Rod Tomczak, DPM, MD, EdD)

There is no doubt that with the current class
sizes we will cause our own extinction and we must
do something about that. The question is will a DO
degree accomplish that goal? Will students going
to DO school choose podiatry as a specialty, and
or are we to continue as a profession. In the mid
‘70s , there were five schools turning out a total
of about 750 new graduates a year. Now we have
more than double that number and we graduating
nowhere near 750.

In the mid ‘70s and very early ‘80s, there were an
insufficient number of residency programs. Now we
can fill them all and some are not filled. So, we
have gone places in the past fifty years or so
since I first thought of attending podiatry school
that I never thought possible. As for the
negatives, we have no one but ourselves to blame
by continuing to bash this great profession. MD
and DO have it no better dealing with insurance
companies, decreasing RVU, heightened expectations
of the public, managed care and hospitals or
investor companies who see us as nothing but Lucy
in the chocolate factory.

Every MD DO I run into these days who is still
clinical has the same gripes as our DPM colleagues
and asks how I'm enjoying retirement. My answer is
always the same, happy to be in that space but
with it comes going to too many darn colleagues.
The problem as Dr. Tomzcak noted, is that those
who should be speaking about it are too busy to do
so. Those of us who are clinically retired or all
together retired don't necessarily have the
expertise or political connections to get this
done.

There is an expected shortfall of PCP and other
specialties in the next twenty to thirty years as
most of the baby boomer generation retires from
practice. This was not accounted for in the early
80's when an AMA study came out predicting a
physician surplus, hence a kabash on more hospital
residency slots and medical undergrad classes.
Alas not much other than some more DO schools
opening has happened to change that.

I don't profess to have any of the answers but to
suggest that all of medicine is at a critical
juncture. And we all need to put our heads
together so we can persevere! We can no longer
allow those bean counters on Wall Street or in the
Insurance industry to dictate how healthcare is
provided. We know who the wolves are guarding the
hen house and this has been tolerated far too
long. On the other hand, we need responsible
healthcare policies which cannot be abused and to
some degree rationed because we simply can't
afford to spend as we have.

Most importantly, we must stop bashing our
profession and our colleagues in these public
forums. After reading all the negative press here,
it's no wonder we are in this predicament.
Certainly alternative discussion approaches are
part of a healthy dialog, but the dismissive
holier than thou attitude needs to stop and needs
to be replaced by practical solutions. Many of us
are willing to do the hard work, but we need those
with wider vision to step up to the plate and roll
up their sleeves and get to work!

Paul Kesselman, DPM, Oceanside, NY

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