11/22/2025 Rod Tomczak, DPM, MD, EdD
De-Extinction
De-extinction is the cutting edge of science,
resurrecting vanished species using powerful gene-
editing tools. With well preserved DNA from
fossils giving us a clear blueprint of an extinct
species, extinct species resurrection is possible.
Or so says John Kennedy Philip in the most recent
issue Philosophy Now.(1) The concept is that
given the appropriate DNA a living organism can be
recreated. As of now, tabloid TV has reported
celebrities cloning pets for a mere $50,000, but
none have been extinct.
Imagine podiatry as a species. If a species does
not evolve according to the mandates of an
environment that is changing around them, there
are several possible sequels. Most of them revolve
around a decline in the health or viability of the
species (read podiatry for the word species from
now on) or even its extinction. In this article,
the author speaks to the recreation of Dire Wolves
from discovered DNA. If the recreation was not
identical, but close, would it be close enough to
call it the same species?
The podiatry we practice today is not the podiatry
we practiced in 1980, nor was it the podiatry our
fathers practiced in 1960. For NPs and PAs jumping
on board they are practicing a version of podiatry
we are familiar with but recognize as a throwback
to somewhere on the timeline of evolution. If
evolution of a species does not occur we are
risking a deterioration in the overall health of
the species or even its extinction. Whether the
last sentence was an overt or covert reason for a
three-year residency so that DPMs could declare
parity with MDs, it is not working. The new
residency graduates lack the plenary license even
though these current graduates promote themselves
as capable as a fully licensed MD or DO.
As much as we seniors declare that we did not need
a plenary license, and we didn’t, the fact that we
mandated a three-year residency on current
graduates of the colleges should weigh heavy on
our shoulders. We used the mantra of our parents
to explain the reasons why a three year residency
is required with retorts like, “We know what’s
best for you,” “Just wait to see that we are
right,” “In our experience we have come to see
it’s the best thing for you,” or in the midst of
frustration, the all inclusive, “Because I said
so.” These are all reasons we vowed as college
students to never trust anyone over 30.
If we insist on a three-year residency, at least
we should prepare the species to fight extinction
with a DO degree. Otherwise, I can see some, if
not all of the following occurring as the current
profession of podiatry, races toward the
extinction of the Dire wolf. It is better to
intervene beforehand than try to recreate the
podiatric species from DNA remnants mixed with
chains of AOFAS, PA and NP DNA.
Reduced Survival and Future Podiatrists
Insurance changes, reimbursement, more foot and
ankle orthopedists, fewer patients, and. a
changing attitude toward podiatry threaten our
species. The AMA issues a statement demeaning the
training of podiatry The APMA requests the AMA to
rescind the statement. The AMA does so, and it can
continue to do so every day. Each post by the AMA
injures our future members and patient load before
it is retracted.
Population Decline
We have witnessed fewer students enrolling in
podiatry schools meaning soon the attrition rate
of practicing podiatrists will exceed the number
of new podiatrists. Why spend seven or eight years
to attain the podiatry license our trainers spent
five years to attain and do the same work?
Extinction numbers should never exceed new members
of the pack.
Increased Competition
Orthopedic surgeons have lost the spine and hand
to other MDs. They do not want to lose the foot,
even to non-fellowship trained surgeons. We
question the Good Feet Store and its whimsical
commercials which surely the APMA could match with
its war chest but has yet to do so. We have tried
to be charitable about the NPs and PAs doing
routine care, but soon they will be performing
chemical matrixectomies under our noses. We can
not be sure they will refer more severe or complex
pathology to us instead of orthopedic surgeons.
The only possible saving grace is there will only
be a few DPMs graduating each year.
Loss of Diversity
There will also be fewer geriatric podiatrists,
fewer surgeons, fewer diabetic specialists, fewer
sports medicine specialists and fewer minimal
incision surgeons. Primary care and regenerative
podiatric medicine will also suffer because
podiatry is afraid to admit it jumped to a
solution some years ago that does not fit Gen Z or
maybe Gen Alpha’s wishes and needs. It is possible
to save these and other sub-specialties if we
place the species above our egos.
Extinction
Biologic extinction ceases to be a threat to the
podiatric ideal if most young men and women who
are entertaining a career in foot and ankle enter
DO school, complete a one year general internship
then a two-year podiatry residency. This would
prevent podiatric extinction and strengthen the
essence of our work. We do not know what the
future of podiatric education is despite all the
interest and commitment by the podiatric
community. The Dire Wolf never planned on
extinction, but climate change, competition and
megaherbivores contributed to its extinction. Pre-
emptive intervention could have prevented
extinction of the wolf, but evolutionary experts
and moralists were far and few between during that
age.
DPMs would train the DOs during the podiatry
portion of their DO residency in this plan. This
would safeguard the preservation of the podiatric
philosophy. There is no threat to the podiatry
schools unless the new program becomes so popular
it proves itself as a new species in the medical
community, one with a plenary license and leads to
the closing of remaining podiatry schools, an
unlikely outcome. Residencies would still be in
the same hospitals where today’s DPMs train
podiatrists of the future. This would ensure
podiatry lives on. The specialty will still be
called podiatry but with less chance of
extinction. Gong farmers and ether dripping
GP/anesthesiologists may have been proud of their
professions and thought the jobs would go on
unchanged forever, but new technologies ended
their dreams. Just because these laborers wanted
their careers to last forever, adapting to the
changing environment didn’t mean it would happen.
Their purity of intention and stalwart resolve
could not correct for a lack of foresight.
I think it will be easier to plan for a future
podiatry that we have some influence over than try
to retro-engineer the next generation of ankle
implant prodigies. We are all smart introspective
individuals. However, we must not let the false
pride in our accomplishments derail the
profession. We can and must change the environment
to redirect and improve the future of podiatry,
not just preserve the status quo.
Reference
1. Philip, JK. De-Extinction: Playing God,
Philosophy Now, 170, Oct/Nov 2025, 8.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
