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11/24/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: John S. Steinberg, DPM
It is a shame that a few of our own are filled with such negativity and doom. The almost daily posts to this platform seem determined to cast a dark shadow on the profession that has given almost all of us so much reward and fulfillment. How about some facts? Just about every door is open to a DPM now, we practice in every academic and group practice setting, and we dominate the field of foot and ankle surgery throughout the country. The ACFAS salary survey puts us at $446K average earnings for fellows and the APMA Marit salary survey shows $304K average earnings across the entire profession. Hardly seems like a story of doom and gloom to me!
Yes, we do have a student recruitment problem which really is a visibility, branding, and awareness issue. We are working aggressively to fix that and we will fix it.
I don’t have the time to write lengthy essays on a daily basis to counter the negativity on this platform. Rather, I fill my day with the medicine, surgery, teaching and research that fulfill me. To the naysayers, check out this recent publication from ACFAS for more facts: DPM Surgical Pathway
John S. Steinberg, DPM, Washington, DC
Other messages in this thread:
12/01/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: De-Extinction (John S. Steinberg, DPM)
From: H. David Gottlieb, DPM
Beginning with the early years of PM News, there have been naysayers lamenting the demise of the podiatric profession. At one time, I was one of them. On this Thanksgiving evening, I am thankful that all the gloom and doom has been for naught.
As Dr. John Steinberg, and others, have pointed out our graduating residents work in every practice setting there is: independent, group single-specialty, multi-specialty, as part of orthopedic practices, hospital, clinic, and others as befit their training and desired setting. They command high salaries, even those who opt for nursing home centered care. They also chair committees where they work and/or...
Editor's note: Dr. Gottlieb's extended-length letter can be read here.
11/25/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Rod Tomczak, DPM, MD, EdD
John, thank you from the bottom of my, everyone else’s, presumed dark and nefarious heart. I will shock you by telling you that we are very, very close to feeling the same way about podiatry. The profession has been wonderful to us, our families and the public, especially those facing an amputation because a wound was mismanaged or not managed at all.
I was not exuberant about private practice for the singular reason that I was alone. When an exceptional case presented and the x-rays viewed, I’d look at them and say, “Wow, look at this!” and there was no one to share my excitement with. I entered academia after less than seven years in private practice to teach at Des Moines which was one of the best decisions of my life. I looked forward to every day as I did at Ohio State and breaking a glass ceiling in Columbus and furthering the profession in unchartered...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
11/22/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Rod Tomczak, DPM, MD, EdD
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 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...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
11/06/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Rod Tomczak, DPM, MD, EdD
Dr. Secord, it sure seems like you have had more than what should be a fair share of trouble come your way down there in McAllen, TX. I wouldn’t guess there are that many orthopedic surgeons down there, and you’ve scared them off with your offer to step outside for a good ol’ Philadelphia curb stomping, if there are curbs in McAllen. Regardless, Dale Carnegie would be proud of your approach to resolving any differences between yourself and them bone doctors. I seem to recall you are also a chiropractor. Might that be a source of contention? I don’t know many orthopedic surgeons who think very highly of chiropractors. Come to think of it, even DOs think chiropractors are off the reservation, but that’s another turf war. Something about high velocity cervical manipulation to 75-year-old ladies causing paralysis.
No current podiatrist or even future podiatrist will ever be grandfathered into the DO or MD community. My treatise deals with the current decline in podiatry students matriculating in all the schools and the increase of DO seats available because of the increase in DO schools to thirty something from nine. I am theorizing that many current DPM students were not able to gain admission into allopathic or osteopathic institutions, but now they will. To maintain podiatry as a specialty, I am saying at sometime in the future, DO graduates may be able to match into a podiatry residency after a one-year general internship which would earn them a plenary medical license. None of this will happen overnight and there will be a period of overlap with both DPM and DO podiatrists.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
11/04/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: David Secord, DPM
I greatly admire the time and effort Dr. Tomczak puts into his messages to us. I'm sure that he will be remembered as a sage voice among us. As such, here's my two cents, for what it's worth:
I am of course as old as dirt and don’t really have a dog in this fight. I’m only still working because I lost everything I owned in combination with the Christus Spohn crucifixion and the 2008 banking-housing collapse given to us by the Community Reinvestment Act. Although I’ve taken the USMLE I, II, and III practice exams and passed with flying colors, we are at least a decade away from our two, divergent paths.
One will be obsolescence (brought about by Topor-induced, entrenched fiefdoms, no one will surrender); or common sense (add the classes and residency rotations to become on par with our other allopathic...
Editor's note: Dr. Secord's extended-length letter can be read here.
11/03/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: Podiatric Obfuscation
From: Rod Tomczak, DPM, MD, EdD
Obfuscation is the ability to make things obscure or unclear. A wonderful example is Mark Twain popularized the quote, “There are lies, damned lies, and statistics.” Simply put, it is obscuring the facts, and maybe even talking about statistics and probability. There are two classic ways to look at probability. One is the frequentist view which tells us that if we flip a coin 100 times, when we’re done, we will end up with a 50:50 ratio or close to it of heads and tails. The other method is called the Bayesian or belief-based method of looking at the facts that we know right now or interpreting part of the facts to influence what we are going to say. We are merely leaving out some important details. A hot topic for another posting might be, “Are podiatric seminars science-based or influencer-based experiences.” You get the idea.
An alternative way of describing Bayesian statistics is to say, “Probability probably wouldn’t exist if we had all the probable information.” So, probability gives us a way to think about things when we don’t have all the...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
10/22/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: Daniel Chaskin, DPM
It seems to me that if a podiatric resident did not eat lunch yet, this is a valid complaint. As a podiatrist in private practice, I have the right to choose not to have lunch if my patient load gets too crowded. I choose to ensure my schedule does not interfere with my lunchtime. Podiatric residents should have the right to choose to eat lunch without being criticized for being hungry.
Furthermore, they should get as much sleep as needed to maximize their ability to work without making podiatric medical mistakes. Sleep is important for anyone to function to the best of their ability. If every residency director allowed residents to get up to 8 hours of sleep when needed, enough time to eat, perhaps patient care given by podiatric residents would improve.
Daniel Chaskin, DPM, Ridgewood, NY
10/22/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: H. David Gottlieb, DPM
My experience interacting with externship over the last 20 years is that there has always been a mix of student intellect, abilities, and desire to excel. Over the last few years, I have seen a widening of the bell curve. The best students on the whole are better and the students at the bottom even worse. Additionally, the students who have been accepted to 'my' program in Baltimore have all shown either above average to exceptional intellectual ability.
Over 20 years, I have noted changes in overall attitudes towards work both from CPME requirements as well as in generational shifts. CPME is now mandating, on average, limited working hours very different from the past. The days of allowing residents to work 16 or 18 hour days are over. Do I agree with that? No. But, you know, it is what it is. I learned to deal with it (with a head shake nearly every day). I suggest others do as well. The work gets done, cases are covered.
Stop beating up on our future. Learn to adjust to reality or YOU will be the one left behind (and consider self-pay practice as was done years ago).
H. David Gottlieb, DPM, Baltimore, MD
10/21/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Ivar E. Roth, DPM, MPH
Wow, Dr. Feinman hit the nail on the head with his assessment of the quality of students rotating through his program. How sad, but according to my inside sources this is a reality.
Besides poorly qualified students being accepted into the schools, the complacency factor is a whole other matter. There needs to be a shake-up or Dr. Feinman is correct that patients will request other providers, and our reputation will take a dump as a profession.
Ivar E. Roth, DPM, MPH, Newport Beach, CA
10/20/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: We Need New Leadership and a New Direction
From: Ross B. Feinman, DPM
Unfortunately, in the last five years, the talent coming out of the podiatry schools is dismal at best! It's time that the schools either be consolidated and half of them closed, or let the MD or DO schools take them over. For far too long, these schools have been run as a business rather than a beacon of higher education. There are too many schools and the students who are coming to the hospitals and rotating are sadly not qualified to work at a sub shop. There are a few exceptions; some of the students that I have had the chance to work with have shown some aptitude, some eagerness to learn, but for the most part, they're looking at their phones the whole time waiting to get done, lack preparation before any cases, and complain that they haven't eaten lunch yet!
The profession is at a crucial time right now. If something doesn't change soon, orthopedists and PAs are going to overtake our profession. In the past, we heard all these ramblings of ortho and nurse practitioners. We weren't as concerned at the time because we were the most qualified to treat the foot and ankle, but if you take a look at the graduates coming out, I can't blame patients if they want to seek other practitioners! It's the 4th quarter and we're down a lot of points with time running out. We need new leadership and a new direction, or all the hard and innovative work of the past will crumble like a house of cards.
Ross B. Feinman, DPM, Walled Lake, MI
10/16/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Ivar E. Roth DPM, MPH
I have mentioned this before; the reason for the low student retention numbers of the matriculating classes in general is that the schools basically are allowing everyone in, and if the student can pass, they move on and, if not, they drop out. It really is that simple.
Ivar E. Roth DPM, MPH, Newport Beach, CA
10/14/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: Obituary for the DPM Degree
From: Rod Tomczak, DPM, MD, EdD
The obituary can now be completed and a necrology constructed. It’s time to sit Shiva, recite the Kaddish, and assemble the musicians for Mozart’s Requiem. The mourning is not for podiatry, it is too strong, stronger than the 70 or 80 years of Psalm 90. The mourning is for the DPM degree. Podiatry is a philosophy much stronger than three initials and will continue to be with us for a long time.
But what we have learned in the last months is that the youth opting for our profession want a plenary license, not the parochial one we have possessed and have thrived under. They want a seat at the adult medical table. How do we know this? Eighty-seven percent (87%) of the podiatrists who answered the survey in PM News stated concerning a professional degree they wanted the option of having a DO degree to practice podiatry or at least have the option of choosing podiatry as physicians with a DO degree. Only 13% said...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
09/27/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: A Short Allegory Chapter 2
From: Rod Tomczak, DPM, MD, EdD
Steve Winans was the de facto leader of the unofficial group that sat around the pot belly stoves at the seed store dropping peanuts in their Cokes or Dr. Peppers. He was up every morning before dawn and worked tirelessly all day. He found work where there wasn’t any work. He learned these characteristics from his dad who was the same way. The thing about Steve was that he had more than a touch of big city in him, something the other farmers didn’t have, and he saw things in a way the other farmers of Agronomy’s Best (AB) didn’t see them. If he hadn’t been born and raised in AB, you would have sworn he was placed in AB, Iowa by Witness Protection. He was the only guy who could tell you how to sink a large yacht in the middle of Iowa.
Greg Samsa, on the other hand, very smooth in his hand tailored suits and ostrich non-work boots was the elected chairman of the Agronomy’s Best Fine Arts Commission, (ABFAC) by the other members of the Commission. They did make all the important decisions for AB. The population of AB didn’t want to be...
Editor's note: Dr. Tomczak's extended-length letter can be read here. Chapter 1 can be read here.
09/25/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
From: Kim G. Gauntt, DPM, MS
Excellent story! How may I ask, could it have hurt, to have the APMA “leadership” actually sit down and discuss the recent query about a different path for our residencies to be legitimized than what we have now. What is it that we don’t know? Why, on such an important topic, was the membership at large not invited to discuss before a decision was made? Loss of autonomy, really?
Was it not, just the week before, that our same APMA president was publishing a rebuttal letter to the orthopedic group who sorely misrepresented podiatry and our training in a public forum?
Would it not be much more difficult to deny our training if our programs were recognized by the same body as theirs? Just asking.
Kim G. Gauntt, DPM, MS, Hillsboro, OR
09/23/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: A Short Allegory - Chapter 1
From: Rod Tomczak, DPM, MD, EdD
There is a town in Iowa called Agronomy’s Best, or AB for short. It’s called that because the soil in AB is the richest in Iowa, if not the whole USA, based on per acre production and value of the crop. Besides that, during the winter of 1954, the farmers were at the feed store sitting around the three pot-bellied stoves dropping peanuts in their soft drinks and complaining about government oversight, the cost of farm equipment, seeds, fertilizer, and low reimbursement for soy beans and corn.
The group came up with an investment idea. The town was going to purchase all the TV shows they had become fond of. They obtained the rights to the I Love Lucy Show, The Adventures of Ozzie and Harriet, a number of soap operas, a show called The 20th Century, Leave it to Beaver, and the like, and all in perpetuity. The town of AB sold rights to some other small towns to show the programs on a limited basis, and made a lot of money. Well, the town built a library, a museum, a concert center, an athletic facility with a pool for the town, subsidized the newspaper called the AB News by advertising their...
Editor's note: Dr. Tomczak' extended-length letter can be read here.
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