01/28/2016    David Secord, DPM

The Only Way is By Getting an MD Degree (Alireza Khosroabadi, DPM)

I think it is interesting to try and follow the
logic on the page with Dr. Khosroabadi’s
monograph. In terms of an Aristotelean syllogism:
I’m doing well. I have a DPM degree. All DPMs can
do well because I’m doing well.

Whether this is fallacious reasoning or not
misses the point that there is a sea change in
our world and that is what Dr. Klein is
addressing. It has always been the case that not
a single thing we do can’t be done by some other
specialty (unlike dentistry, which has a virtual
lock on what they do). Those other professions
are likely to perform the task at a lesser level
of competency, but perform it none the less.

In the current healthcare arena, it is the bottom
line and not performance which counts (regardless
of the rhetoric coming from the federal
government). If a nurse practitioner can perform
the tasks that the podiatrist performs and will
do it for less, the LPN or RN gets the contract.
We’ve seen this in our own profession, as the
individual is willing to sign a contract for less
than you and he/she gets the patients, possibly
at a rate of reimbursement which isn’t even zero
sum. The providers are willing to cut each other
off at the knees and the insurers are willing to
sit back and watch.

As the scope of the LPN keeps expanding in each
State, I believe that we will eventually see
osseous work approved in their scope as well and
the your ability to do a bunion will mean very
little if someone else can and will do it for
less. The way out is the Robert Kornfeld school
of the concierge practice (if you can pull it
off).

The attainment of the MD degree not only follows
the natural progression of growth and maturity in
the profession, mirroring the maturation of the
DO degree, but overcomes the real, codified
rating of the DPM as 3rd-class citizen compared
to the MD and DO crowd. We’ve been fighting the
Title 19 standing in Medicaid for years and it
would be a moot point if we simply realized that
we could be foot and ankle specialists AND be on
parity with our other allopathic peers if we step
up and let nature take its course.

I see the slow and inexorable death of the
profession if we wallow in our complaints of
exclusion and wallow in our torpor as well. The
progression to the MD degree is necessary,
inevitable and productive if we would like to be
viewed and paid as equals.

David Secord, DPM, Corpus Christi, TX

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01/28/2016    William Deutsch, DPM

Parity: The Only Way is By Getting an MD Degree (Alireza Khosroabadi, DPM)

The point of a license change for podiatry isn't
to feel important or even to gain self respect.
It's to establish professional parity among
medical doctors performing the same tasks but
as podiatrists being paid differently.

Dr Khosroabadi's post is inspiring but it misses
the point entirely. Not all podiatrists seek the
type of niche he's carved out for himself.
combining MIS and open procedures isn't re-
inventing the wheel but it works for him and
that's great. What about everyone else?

Most don't possess the personality or charisma
needed to establish a practice such as his and
probably most don't seek the fame and notoriety
that accompanies it.

But most do want to be able to practice without
the restrictions insurance companies, government,
hospitals and other physicians place on the
profession.

It's not that podiatrists suffer from delusions
or paranoia or professional insecurity. There's a
reality which can't be imagined away by self
help tapes or emulating more successful
practitioners.

Will a degree change become a reality? Will the
powers that drive podiatry give a degree change a
fair chance?

William Deutsch, DPM, Valley Stream, NY