In an email last week, Allen Jacobs, DPM sent me
several quotes that he felt depicted today’s
podiatry status. He felt the opening sentence of A
Tale of Two Cities, “It was the best of times, it
was the worst of time of times.” by Charles
Dickens depicted the “where we are today”
condition of podiatry. He also sent a few quotes
from Shakespeare. The most accurate and poignant
from Macbeth, “….so foul and fair a day I have not
seen.”
I started thinking about the elements of a tragedy
and if we personify and vivify podiatry, and use a
little imagination, we have the makings of a true
Shakespearian tragedy happening right before our
eyes. And if you remember, Hamlet, Macbeth,
Othello, Romeo and Juliet, Anthony and Cleopatra,
and Julius Caesar, they do not end well for the
tragic hero. The three witches in Macbeth make
three predictions for Banquo, a companion of
Macbeth; “He is lesser than Macbeth yet greater”
“Not so happy yet much happier” and “Although he
will never be king himself, his descendants will
be kings.”
So here are the components or elements of a
Shakespearian tragedy. Podiatry is a person, not
just a profession, calling, or degree. From
ChatGPT:
1. A tragic hero This hero must be important, from
a prosperous, renowned family and of higher rank
than a normal person, and possess exceptional
ability that the usual, ordinary individual does
not possess. The Kennedy clan is a modern example
of such a noble family dating back to Joseph and
his bootlegging fortune. His sons and daughter are
tragic heroes.
Podiatry certainly fits this criteria. We make
considerably more money than the average wage
earner, are usually well known and respected in
the community we live and practice in, possess
abilities we learned in school and residency. Then
we perfected and sharpened these dexterous
abilities through practice. We are held to a
higher standard than the average citizen. Podiatry
is a profession and we often become that
profession.
2. A fatal flaw (hamartia) A character weakness
such as ambition, jealousy, pride, or indecision
that contributes to the eventual downfall. The
Kennedys wielded power and often used it without
regard for others. They were womanizers and used
their connections to cover up these flaws. Pure
hubris.
Podiatrists often confuse what they do with who
they are. They have been known to be narcissists,
reign over less successful podiatrists using the
young podiatrists for their own gain. Thought
leaders and policy makers are quick to remind
other podiatrists of their station within the
profession. Why do we continue to layer the
profession with a board certification the excludes
most of the profession and punishes them by this
exclusion?
Often, circumstances preclude individuals from
fulfilling the criteria necessary to apply for
certification. Then there is an exam that
eliminates a higher percentage of test takers than
neurosurgery. Neurosurgeons boast a pass rate of
almost 90% of test takers. Podiatry is so
restrictive it is hesitant to publish pass rates.
This is a flaw that should haunt the profession.
3.A serious conflict The Kennedys had serious
moral and political conflicts. Bay of Pigs, Cuban
Missile Crisis, Mafia, Marilyn Monroe,
bootlegging, Chappaquiddick, etc.
Podiatry has been known for its Medicare fraud,
conflicts, undeclared cash payments, DME deceit,
harassment in the office, endorsing worthless
products, nepotism, exploiting young podiatrists,
and misleading lecture material to name a few.
Starry-eyed students and young podiatrists are
anxious to begin practice. The faculty at the
schools and universities who have established
their place tell the students what a bright future
awaits them just around the corner. Instead of
finding success, our young discover bitterness.
Who do young people want to believe?
Who can they believe? The starry-eyed become
bloodshot eyed from worry and lack of sleep.
Changes in scope and sequence offered by the
worker podiatrists, by podiatrists who are better
known in the profession than administrators or
faculty from the colleges who keep themselves
sequestered, are met with ridicule or no response.
Tell us we have an all-time high in first year
students!
4. Reversal of fortune The Kennedys have suffered
misfortune like no other family in the spot light,
but recently hordes of politicians have felt the
sting of justice.
Podiatrists have been convicted of crimes
mentioned in number three and served jail time,
been expelled from Medicare and Medicaid. Fines
have been imposed and restrictions put in place.
There is no fortune, only debt and the temptation
to compromise a high ethical standard is
overwhelming for our young podiatrists.. What does
the APMA do to help these new providers service
these loans? A thousand dollars here and there
embellished by color pictures in the latest issue
of the newsletter does nothing. This is a
political problem and APMA should be dying on the
Hill to help these young podiatrists.
Instead they are patting themselves on the back
for awarding the neophyte a bus pass to get to
work. We are not stupid. We know the once
prosperous schools can’t stay open very long with
just a few students. We know faculty will be let
go and programs cut or curtailed. What was once
flourishing is now floundering. Fortunes have
reversed and we see no explanation just
speculation.
5. Catastrophic ending The curse of the Kennedy
clan is almost over due to attrition.
This is where the misdeeds and shenanigans of
podiatry come home to roost. Do we think we are
completely guilt free for the crises facing us,
our profession today? Why is there a cohort who
are unhappy with podiatry or themselves? Why do we
have an applicant crisis? That may be the biggest
challenge facing the profession. Although the
predictions tell us that there will be an
increased need for us, for podiatry in the future,
we continue to sabotage ourselves.
Podiatrists offer possible solutions to the
paucity of students because the powers that have
shown their true colors offer no answers. The
podiatrists in the field do not want the
profession to come to a catastrophic end but are
met with disdain or disregard. We are urged to
tell the few future students we see that this is a
great profession. This advertising should be the
mission of the APMA and Dr. DeHeer street shoes
program.
Is the our podiatry tragedy self-fulfilling and
there is no hope, no escape? CPME and AACPM will
not acknowledge their present plan is not working.
Initially, the prevailing thought was that
podiatry school had been made up of students who
were not successful in gaining admission to MD
schools and the present dearth in podiatry
students was due to students attending osteopathic
schools. A look at the numbers reveals there is
not enough evidence to make this verifiable. It is
only speculation. There is just something wrong
with how we attract students. This is the fatal
flaw the hamartia, the hubris that is bringing
podiatry and our future to a catastrophic end.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
.png)
