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

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