03/17/2026    Allen M. Jacobs, DPM

Is Podiatry Aboard the Pequod?

Mark Twain famously proclaimed, “the reports of my
death have been greatly exaggerated”. Do we
maintain a profession whose anticipated demise has
been greatly exaggerated? Reading PM News, one
feels like Queegueg in Moby Dick, who rolls the
bones and says “build me a coffin”. Is podiatry
aboard the Pequod? The Titanic? The Edmund
Fitzgerald?

PM News recently noted the death of Terry Gamche.
He was a quiet dedicated podiatrist. He cared for
his patients and made them comfortable. He hurt no
one. He helped many. He did little or no surgery,
and made a modest living. He was a generation of
podiatrists past. He was a respected and trusted
member of the health are community. I emphasize
the words respected and trusted.

Podiatry graduates today are recruited by
orthopedic groups, hospitals, and healthcare
institutions. I suspect that we will not witness
an NP or PA performing a TAR, Charcot’s joint
reconstruction, or a bunionectomy. Will they care
for lesser foot pathology, possibly.

Podiatry graduates are recruited by the VA, the
armed forces, the Indian Health services. Podiatry
services flourish in major teaching institutions
often with affiliated residency programs. Private
equity groups continue to show interest in
podiatry.
The DPM is intimately linked to evaluation and
care of the patient with diabetes.

The training of podiatrists, without ACGME
accreditation, has advanced to a three-year
experience which prepares the podiatry college
graduate to evaluate and treat disorders of the
foot and ankle. Many if not most podiatrists make
an excellent living, are respected and trusted
members of the medical community and community at
large, and have a happy and satisfying life.

Are there problems which need to be addressed for
the future? Of course. Has the APMA failed the
profession? I believe so, but to look back offers
no solutions for the future. Podiatry today is the
ACFAS, not the APMA. Podiatry today is a 3-year
residency and optional fellowship, not a
preceptorship.

Will the NP or PA replace the podiatrist? Has
optometry replaced ophthalmology? Will podiatry
lose toenails and minor foot problems. Maybe.
Maybe not.

Our profession must always examine the changing
health care system and consider and effect needed
changes. However, the constant negative tones
without recognition of our professions
accomplishments and advances are unbalanced and
unfair.

Is podiatry aboard the Pequod? Call me Ishmael.
Allen M. Jacobs, DPM, St. Louis, MO

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