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02/09/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Elliot Udell DPM
The subject of "unlimiting" podiatrists' limited licensure has been debated ever since I opened my first office more than 35 years ago. The old argument was to give podiatrists MD and DO degrees and allow them to choose whether to treat feet or go into some other medical specialty and leave the treatment of feet behind. Dr. Hyrwnak's approach is to broaden the DPM degree, just as DOs can do everything an MD can do, Dr. Hyrwnak's approach would seem to allow a person with a DPM degree to treat the entire body. If I am reading this line of thinking correctly, theoretically, a person with an unlimited DPM degree could do a GI fellowship, orthopedic residency, psychiatry, etc.
The problem is how many doctors with expanded licensure would decide to treat people with foot problems, and doesn't "John J Public" deserve access to a doctor who will treat people with foot problems in a scenario where the majority of graduates might turn their backs on good old foot care? The only fair way for Dr. Hyrwnak's proposal to work would be to moderately but not fully expand the scope of a DPM and monitor each stage carefully before proceeding further.
Elliot Udell, DPM, Hicksville, NY
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02/13/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Amol Saxena, DPM, MPH
I have been reading the responses to Dr. Hrywnak's recent letter. I thought about what got me to "achieve" what I have, and it makes me sad that many of our younger members, despite apparently better training, will not achieve RRA credentials (required by Operation Footprint) and be blocked from working within the governing bodies of many Olympic sports (US Track & Field says specifically they will not take podiatrists on the medical team. They will take psychologists: only one brain, and we can treat at least two feet!).
My classmate Joe Borreggine wrote a very cogent analysis of Dr. Hrywnak's concerns. Both are SCPM/ICPM grads, which is within a medical institution with no orthopedic department. Joe was in the audience when I gave the lecture at the 2023 Midwest Conference on "Podiatry, Prejudice & Possible Solutions". He concurred with my findings as did many of my classmates who are not RRA certified and/or no longer perform surgery. Drs. Tomczak and DiResta continue to point out reasons to change. PM News polls, albeit not scientific, give signs the profession wants to change.
Amol Saxena, DPM, MPH, Palo Alto, CA
02/12/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: James DiResta, DPM
It is beyond frustrating in reading recent comments regarding a plenary license for podiatrists. Dr. Olaf remarks how far we have come as a profession and we should be satisfied. He states the reality is orthopedists and others never pick up a stethoscope and frankly they know, like most specialists, to stay in their lane. I would agree but as time has gone on, we in completing our single track medical education have found ourselves stuck in our own lane; but it is not a lane in the same bowling alley as other medical and surgical specialists as we are left inferior to our peers and unable to play on the same field. The big picture has left us not being a full member as we lack a full general medical education before pursuing residency.
Trying to make this deficit up during our post-graduate time to get us to play on the same field as the big boys and girls is not working as no organization or licensing board will grant us an equal plenary license. We need to fix this issue and time is of the essence and the DO route as proposed by Dr. Tomczak is the most doable I have heard to date!
James DiResta, DPM, Newbury, MA
02/11/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Jon Purdy, DPM
For anyone that can see the writing on the wall, Dr. Hrywnak has spelled out exactly what needs to happen to keep podiatric practices viable. Being small in number, the podiatric profession does not have the political clout to fight battles on its own. Larger medical entities such as nurse practitioners and physician assistants do, and that is the reason they are able to do more than a podiatrist with less than half the training. We cannot employ ancillary healthcare workers without MD/DO oversight. We can’t even prescribe a cream for dermatitis on an arm.
What doesn’t hold water are the statements concerning “run away” practices. Could an orthopedist perform brain surgery or an internist perform sinus surgery? Technically with full scope they could, but why don’t they? Could a podiatrist with full scope do this?
Jon Purdy, DPM, Iberia, LA
02/10/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Joseph Borreggine, DPM
Dr. Hrywnak has presented a compelling case, substantiated by incontrovertible facts. The podiatric medical profession must address its shortcomings in the educational path it has pursued for years. Podiatry has undergone significant evolution over the decades, surpassing the expectations of its practitioners. However, this advancement has not yet resulted in the parity that podiatrists rightfully deserve as physicians. The debate surrounding MD/DPM has persisted for years, yet it has remained unaddressed. The reasons for this stagnation are unclear. Is it the podiatry schools, the Council on Podiatric Medical Education (CPME), or the American Podiatric Medical Association (APMA)? Or is it a combination of all three?
Dr. Hrywnak’s unwavering dedication to advocating for full licensure in our profession over the past decade has faced significant challenges, seemingly impeded by podiatry schools and the American Podiatric Medical Association (APMA). Given the current low admission pool for all eleven podiatry schools, it is reasonable to assume that there is a disconnect between the number of college graduates interested in entering the profession and the demand for podiatrists.
Dr. Hrywnak’s assertions appear to be accurate, but the APMA’s response has been lacking regarding his opinion on the matter. The future of our profession may be uncertain due to the inability to obtain full licensure, but the contrary view that the future of podiatric practice is promising contradicts reality. The future direction of our profession will be determined by the prevailing winds, and it is crucial that we address the challenges we face to ensure its continued success.
Joseph Borreggine, DPM, Fort Myers, FL
12/10/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Denis Leblang, DPM
The first day we were in general podiatry clinic in 1977, Monte Tuchman, DPM told us the definition of a podiatrist. He said that we are physicians and surgeons of the foot. This is what I told my patients and to anyone who asked me what a podiatrist does. End of story. This is what we do. Now, it extends to physicians and surgeons of the foot and ankle.
Denis Leblang, DPM, Congers, NY
12/09/2025
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Elliot Udell, DPM
Dr. Kesselman brought back fond memories of when I first started my podiatry practices. I had asked the former owner of what is now Henry Schein, where to open up. "Should I open up in an area where there are no podiatrists or in an area that may have many podiatrists?" He strongly advised me to open my first office in an area with many podiatrists, for the very reasons Dr. Kesselman stated. If there are no podiatrists, the community does not know what a podiatrist is. But in a community with many podiatrists, there might be some competition, yet the community is at least aware of how a podiatrist can address their foot problems.
I opened in three locations. I opened two where I was the only "kid on the block" and one where there were lots of colleagues. The adviser was right: I did better in the podiatry-busy area and had to wait many years to build a practice in the two areas where I was the only podiatrist.
Elliot Udell, DPM, Hicksville, NY
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