05/11/2026    Samuel Makanjuola, DPM, MEd

The Case for a Plenary License

I know this was brought up before, but I think we
as a profession have to address it. Scope of
practice is all over the place for different
states; this isn't unheard of even in other MD/DO
specialties. That being said, the limited scope
really does significantly affect practice. More
importantly it affects patients and the care they
receive.

A few examples come to mind. Recently, I had
someone come see me for "gout" - this is something
I could technically treat; but can I? If I give
colchicine for the acute phase, I think most would
agree that that's the correct course of treatment.
This patient however had gout of the wrist, and
didn't realize he scheduled with a podiatrist. Now
the location doesn't change the pathology and,
again, technically I could prescribe colchicine
for said acute phase. But isn't this now outside
of my scope? Furthermore, if he needed long term
management and I put him on allopurinol would that
be within scope? Even if his gout was never in his
lower extremity?

Or take the case of the pediatric patient I just
saw. Warts, everywhere - except his foot. The
worst ones were on his hands. Technically, in my
state we have "superficial hand privileges" yet no
one has really specified what that means. Should I
treat his hand warts? With what? Should I treat
his hand warts yet send him out for the arm warts
and the trunk warts? Now make no mistake I'm not
necessarily saying I want to treat upper extremity
pathology, not at all tbh. But my first thought
went to cimetidine and h2 antagonists that help
with warts of this nature. But can I prescribe
cimetidine? Especially for warts that are again,
elsewhere other than the foot?

I remember reading that many podiatrists didn't
feel comfortable prescribing and managing even
gabapentin, despite the fact that peripheral
neuropathy is mostly in the legs and feet! So at
this point we have to ask, as someone pointed out
before: did we do ourselves a disservice by not
focusing just as much on the medicine as the
surgery and more importantly by not pushing for
that to be enshrined in scope of practice laws?

Would a plenary license solve these issues where I
was taught what would help, I know how to help, I
could help, but I don't want any legal problems?
For the record I don't think tying the DPM degree
to an MD/DO degree would be the right way to
accomplish this. I'm frankly astonished that in
this day and age, especially with the chaos at all
levels of government, that we can't pass a bill
solidifying our scope and granting plenary
privileges.

Do better podiatry. Do better. Plenary license.
Standardized scope. Equal pay for equal work from
insurances. These are floor level requirements I
was promised almost 10 years ago when starting
this journey that never materialized. Then y'all
have the nerve to ask why people don't want to go
into podiatry.

Samuel Makanjuola, DPM, MEd, Columbus, OH

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05/12/2026    Robert Kornfeld, DPM

The Case for a Plenary License (Samuel Makanjuola, DPM, MEd)

Dr. Samuel Makanjuola brings up a decades old
issue. It’s not just the 10 years he has been in
practice. It’s the almost 46 years since I
graduated NYCPM. But here is what is interesting
about podiatry. When we prescribe NSAIDs, are we
treating the foot? No we are not. We are treating
the immune system. Same when we prescribe
steroids. When we prescribe narcotic analgesics,
are we treating the foot? No we are not. We are
treating the CNS. I can site many more examples.
Of course, we can only do these things in relation
to podiatric pathology, but we are absolutely
allowed, on a legal level, to treat systemically
in order to address the pathology we are licensed
to treat.

We’ve been halfway there for decades. Yet, the
people we have appointed for all of these years as
the spokespersons of this profession seem to have
only been able to keep us stuck. So I took a
different track. If I’m licensed to suppress the
CNS, the immune system, alter the microbiome with
antibiotics, and all the other ways we’re licensed
to treat systemically, then I am also licensed to
support the immune system, the CNS, the
microbiome, etc. as long as I do it to treat
podiatric pathology.

My point is that you cannot separate the foot from
the human body. It is an integral part of all the
systems that keep us alive and functional.
Podiatry made a GRAVE error by focusing on
surgery. I knew it then. Time has proven me right.
We have become technicians of the surgical
approach to foot and ankle pathology. As such, the
argument for a plenary license becomes moot. Our
residents should be, need to be, learning all the
systems of the human body and how they affect
immune function when out of balance because that
is why people cross the morbidity threshold and
become our patients.

We need to go back and reassess how we train our
young, aspiring podiatrists. The mistake we have
to address is definitely fixable. But in order to
fix it, we have to confront the pink elephant in
the room. This profession has lacked pride for as
long as I have practiced. Many podiatrists refuse
to call themselves podiatrists. They are “foot and
ankle surgeons”. They have shame about who they
are. They don’t really know medicine in the way
they need to know it. But yes, they are highly
trained and very skilled surgeons.

Despite this, we are still called upon to practice
podiatric MEDICINE. And unless your patients can
drop off their feet on Tuesday, leave them for
repairs and pick them up on Wednesday, we will be
treating whole persons, not feet.

Specializing should NOT mean ignoring the patient
and the systemic underlying mechanisms those feet
are attached to. Come on podiatry. It’s time.
Start by learning functional medicine. Optimize
your patient so you can heal, not just treat,
their pathology. You are physicians. Let’s get
trained like physicians.

Let’s reassess our approach to training our
residents. When we train like physicians, the path
to a plenary license will become way more inviting
and far more attainable.
Robert Kornfeld, DPM, NY, NY