03/23/2026    Judd Davis, DPM

The Best of Times, The Worst of Times (Allen M. Jacobs, DPM)

Dr. Jacobs states that, "These are indeed the best
of times to be a podiatric physician. Utilizing
Medicare reported RVUs, the average podiatrist
should earn a minimum of $269,900 annually." That
may be the case for gross income, but certainly
not for net income take home pay. Chat GPT and
Gemini AI searches both state that the average net
pay is around $150K. This is the bottom of the pay
scale as far as medical specialties go. Maybe Dr.
Block can post the most recent annual survey
results for net and gross pay to help confirm
these numbers?

I have personally watched my income being eroded
away by ever increasing overhead and stagnant
unchanging reimbursement from Medicare and most
commercial insurances, even witnessing some
podiatrists being pushed right out of business for
this reason. In 1987, I had b/l matrixectomies
done and my parents paid $800 cash, and thought
wow, I can help people and make that kind of
money. Sign me up. Today, almost 40 years later
Medicare pays $245 dollars for those same two
procedures. That's some serious deflation.

No one told me about the 50% reduction for the
second procedure, and wait there's something
called a global period where the follow-up visit
is free? Of course those rules probably didn't
exist then until some brilliant insurance analysts
came up with those concepts and the medical
community was dumb enough to go along with it.
Those analysts are sitting on their own private
islands in the Bahamas right now.

The golden years, from what I read on PM News,
were apparently the 1980s when bunionectomies paid
$2,000, now its around $500, and 90 days of free
follow up visits afterwards. That doesn't pay the
bills very well. Any industry such as ours that is
completely controlled by insurance reimbursement
is in an uphill struggle and the general public is
hearing about this. I believe this is one of the
many reasons people in general don't want to go
into podiatry or medicine as a whole.

Is the DPM degree going down in flames? Probably
not. There will be a huge need for us as the
population ages more. Would an MD behind our name
elicit more respect and responsibility in the
medical community? Absolutely. How that gets
accomplished nobody knows. I must believe we are
somewhere between the best of times and worst of
times.

Judd Davis, DPM, Colorado Springs, CO

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03/19/2026    Joseph Borreggine, DPM,

The Best of Times, The Worst of Times (Allen M. Jacobs, DPM)

Two esteemed podiatrists, Drs. Amarantos and
Jacobs have dedicated their careers to advancing
the field of podiatry. Both recently have
addressed crucial topics that are essential to our
profession.

Dr. Amarantos has expressed his concerns about how
the podiatric profession has historically
overlooked a vital aspect of our practice,
biomechanics, and relegating it to a secondary
position.

As a graduate of Scholl College in 1988, after
transferring from CCPM during my freshman year, I
was fortunate to have access to Scholl’s renowned
in-house orthotic laboratory and the expertise of
Professor Oleg Petrov DPM, a former CCPM graduate
who joined the faculty in 1979. This collaboration
between podiatric expertise in sports medicine and
biomechanics became an integral part of the
educational curriculum.

Throughout my career as a podiatrist, I have
consistently utilized this knowledge to provide my
patients with numerous pairs of prescription
orthotics that effectively alleviated a wide range
of foot-related issues.

Interestingly, I never permitted my assistant to
take mold impressions of the feet, whether using
plaster or fiberglass socks. I assumed full
responsibility for the entire process of
prescribing orthotics. If any errors were made, it
was my fault, and the orthotic laboratory promptly
corrected them when necessary.

As a podiatrist well-versed in biomechanics and
skilled in taking mold impressions, during my
years at Scholl, I accepted the significant number
of castings that were destroyed in the hands of
Dr. Petrov due to incorrect impressions on my
part. However, I believe that this was an
essential part of the learning process.
Regrettably, many podiatrists today minimize this
training and education, delegating it to
assistants and dismissing it altogether. This
practice extends to various aspects of foot care,
but that is a topic for another day.

I recognize that Dr. Petrov is currently serving
as the President of the National Board of
Podiatric Medical Examiners. I hope that he will
continue to prioritize the inclusion of our
profession’s expertise in biomechanics in the exam
curriculum.

Dr. Jacobs presents a compelling and often
contentious perspective on the podiatric
profession, drawing upon historical context and
its current state. His quote from Charles Dickens’
“A Tale of Two Cities” resonates deeply with our
profession’s identity.

Regrettably, the future of medicine appears
uncertain. Several factors contribute to this
bleak outlook, including the ongoing decline in
insurance reimbursement, the displacement of
private practice by corporate entities in
hospitals, healthcare facilities, and supergroups,
and the escalating cost of medical school tuition,
which takes years to recoup.

The future trajectory of podiatry remains
uncertain. We may transition to a dual degree
program, establish foot and ankle surgery as our
primary focus (parallel to our current three-year
residency and fellowship training), or fully
embrace artificial intelligence and its potential.
These are indeed “the best of times and the worst
of times.”

Joseph Borreggine, DPM, Ft. Myers, FL