05/07/2026 Allen M. Jacobs, DPM
A 40 Year Retrospective (Bret Ribotsky, DPM)
It seems to me that the majority of contributors
to PM News are of the older generation such as
Kesselman, Udell, Warsaw, Secord, Ribotsky, Oloff,
Tomczak, myself, and many others. In general,
these are individuals who have devoted a portion
of their lives to efforts at the advancement of
this profession through the participation in
educational activities. I suspect the majority of
PM readers are of the same generation, as we
seldom witness commentary from younger podiatric
physicians, as can be seen, for example, on the
podiatry student network.
As a direct consequence of decreased college
enrollment, we are now witnessing a phenomena
which was unimaginable years ago: unfilled
residency positions. It is ironic than at a time
that our profession has reached the summit of
integration and acceptance in medicine, for which
our podiatric forefathers such as Earl Kaplan and
Dalton McGlamary, Tilden Sokoloff, Arthur Helfand,
Irv Kanat, Theodore Clarke fought so hard to
attain, that interest in the profession has waned.
Thes Perhaps PM News needs to replace celebratory
declarations by the colleges that all of the
graduates placed in a residency with
congratulations to those residencies which filled
all of their positions.
If you read the commentary on the podiatry student
network, the insightful and intelligent and
informed communications indicate that today's
student is well-informed on matters podiatric.
They know which programs are providing the best
education, and as a result there will be a
Darwinian-like survival for the best residencies,
while those programs less desirable will be lost
through attrition.
Graduates in podiatric medicine, like those of
medicine in general, will more likely than not
practice in an institutionalized environment,
working for health care systems, orthopedic or
medical groups, and we will in my opinion witness
declining participation in classic models of
private practice. Perhaps, as some have suggested,
the direct pay will offer continuing private
practice opportunities.
My point is that the increased training in surgery
and limb salvage and the diminished numbers of
available podiatrists will result in a decreased
interest in the provision of so called "routine
care". Podiatry has become and will increasingly
be a surgical specialty by virtue of training and
desire. I believe that routine nail and callus
care will and should be assigned to the equivalent
of a podiatry assistant, similar to dental
assistants.
The older generation was taught by Theodore Clarke
that Earl Kaplan moved this profession "from the
nail groove to the sinus tarsi". Indeed, this
profession is involved in complex limb
reconstruction, management of foot and ankle
trauma, diabetic wound care and limb salvage,
minimal incision surgical techniques, ankle joint
arthroplasty, arthroscopic surgery, Charcot's
joint salvage, orthoplastics. We owe a significant
debt of gratitude to those who moved this
profession to its current status in the medical
community. The DPM degree is respected and
trusted.
I suspect that "routine foot care' performed by
the podiatric physician will slowly disappear as a
service generally provided personally by the
podiatric physician. The older podiatrists who are
PM News readers but who are remote from the
todays graduate cannot appreciate the advanced
education of today’s graduate when compared to the
podiatry graduate in the ‘70s and ‘80s. They are a
different breed, competent and capable. Maybe it’s
just time to let toenails and calluses go.
Allen M. Jacobs, DPM, St. Louis, MO
