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01/29/2016
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: John Martucci, BS
A new program (DPM-MD) or attaining or changing to an MD degree should not be a goal for podiatrists. Training has evolved greatly in the past decades, and while some federal and state laws can't keep up, podiatry should continue to progress. The profession should recognize and be proud of the strides podiatric medical training has made and continues to make. While an "MD" degree may look impressive on a resume, it does not ensure a level of expertise, training, and passion. I’m not convinced that this would lead to parity, but am confident that it would create a divide in a profession known for great unity. Proven expertise and training by podiatry's best should serve as examples to all medical practitioners and lawmakers, that the letters "DPM" are not representative of an archaic practice any longer, but a group of experts on the forefront of modern medicine.
As a current student, I study the same basic medical courses and will complete similar clinical rotations as my MD counterparts. In my opinion, there is no need to re-train and re-invest in another degree, and no future DPM student should have to do so. The foundation is here and is being built to best prepare and educate today’s DPMs for modern medicine. With the addition of DPM-MDs and more dual-degrees (DPM, MD), podiatry will be further complicated. Why devalue and desert a degree that alone is gaining great value and recognition each day?
John Martucci, BS, Podiatric Medical Student, Philadelphia, PA
Other messages in this thread:
07/02/2021
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: Robert Scott Steinberg, DPM, Bryan C. Markinson, DPM
I think some of my colleagues are being quite naïve, or their egos have gotten the better of them! There was a time when DPMs owned orthotics.
If you don't respect our specialty, find another profession.
Robert Scott Steinberg, DPM, Schaumburg, IL
I need to point out some wrong conclusions by Dr. Ribotsky. Firstly, prior to coming to Mount Sinai, I ran a private solo community practice for 16 years, and taught anyone and everyone who asked anything they wanted to learn, believing in that ethic long before I came to Mount Sinai. It brought me more patients, never less. I do agree that academic center practice is different from community practice. Still, I cannot imagine ever that teaching a nurse practitioner or a PA coming back to hurt me by losing patient volume...and in his last statement, about nurse practitioners replacing us.
I know Bret for many years, and when he was actively practicing podiatry, I know for a fact that he never worried about that, as I do not. As the nurse practitioner or similar professionals get more and more into podiatric care, it has nothing to do whatsoever with what podiatrists are teaching them, but rather what practice enhancing opportunities exist that podiatrists continue to trivialize or downright ignore.
Bryan C. Markinson, DPM, NY, NY
07/01/2021
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: Kathleen Satterfield, DPM
I was surprised to hear my friend Bret Ribotsky’s take on educating other healthcare providers as to the ways of podiatric care. My experience has been the opposite. In the early 2000s, I wrote a BHPR grant that called for cross-training between family practice physicians and podiatric residents at UT Health Science Center in San Antonio and it was generously funded. Our residents learned how to recognize common health problems they could treat as did FP residents learn how to take care of basic foot problems and more importantly when to refer to us for more complicated care.
It had exactly the opposite effect than what Dr. Ribotsky said. The Podiatric Service got more referrals as did the FP department but both were more accurate and useful. Unfortunately I left UTHSCSA before I had an opportunity to write up the study results but anecdotally they were positive. An internist may know how to perform an ingrown nail avulsion but that does not necessarily mean they are prepared to do it, comfortable to do it, or even want to do it.
I respect my colleague Dr. Ribotsky very much but my experience does not mirror his. In my experience, if interprofessional education teaches my colleagues to do what I do, it may instead make them respect my skills and say “You are the expert here. Please go ahead and do what you do best.”
Kathleen Satterfield, DPM, Pomona, CA
03/18/2021
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: Ben Pearl, DPM
Regarding my recent Interview with Golden Harper, there was a question by Dr. Steinberg as to his degree so I feel obliged to respond. Sometimes people get caught up in life and adventure and do not update various profiles publicly available such as Linkedin. It is best to check more than one source as vigorous journalistic and scientific principles demand. In a 2015 article, Y Magazine, off the Brigham Young website, Golden Harper is listed as a BS (2009) in exercise physiology.
I was particularly impressed with Golden’s search for knowledge irrespective of what a study might say about the benefits of a particular concept related to his commercial interest of selling a running shoe.
The study of biomechanics continues to be at times an elusive and controversial area due to the inherent problems of isolating a particular variable, capturing longitudinal data, and repeating trials. One of the things I learned at NIH and from my father, who was a grant administrator there, was to line up your ducks before you cleared your potential grant applicant lest you both end up with egg on your hands.
Ben Pearl, DPM, Arlington, VA
03/02/2021
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: James R. Hanna, DPM
Dr. Morelli expressed displeasure about the way our profession was portrayed in a recent article from MSN Money Talks News. I will not comment on the content of that article; however, I take strong issue with his characterization of how local and national leadership represents the profession. Before becoming president of the New York State Podiatric Medical Association, I served on the Board of Trustees for many years. During that time, one of the committees that I co-chaired was the Public & Population Health Task force. This task force has been working hard for several years gathering data on how podiatry plays a significant role in major public health areas such as diabetes mellitus, obesity, the opioid crisis, and falls prevention. We are currently conducting a pilot program in falls prevention at Lenox Hill Hospital. This is an initiative in which the CMS has expressed great interest. This hard data will be used to demonstrate to anyone interested the absolutely vital role that podiatry plays in these areas.
Charles, I can state that throughout all my years in promoting and discussing the role of podiatry with high-level stakeholders at the local, state, and national level, I have not, nor have any of my colleagues, brought up the topic of “flip-flops are bad for your feet”. Charles, I have known you for many years. If you truly do not know what NYSPMA and APMA do for you and our profession, please reach out to me. I assure you that I can talk your ear off on these matters as I have made them a cornerstone of my time in office.
James R. Hanna, DPM, President-New York State Podiatric Medical Association
09/14/2018
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: Ronnie Lepow, DPM
Teacher, mentor, consummate physician, colleague, and visionary. It is rare to find someone who fits this description but that is how I would describe my old friend Lowell Weil. When I was a student, Lowell was one of my most respected instructors, and his work had a profound effect on my professional career both as a practitioner and as a politician in our profession.
Over the years and especially during the 1990s as we both led our respective podiatric medical organizations, my interactions with Lowell were always cordial, professional, and productive. I look back at those years with fond memories. To our younger generation of doctors, I highly recommend that you review the history, academic work, and accomplishments of this great pillar of our podiatric profession.
Retirement? How can that be? If you must, my most hardy congrats, warm wishes, and best of luck in your future endeavors. You certainly spent your life paying it forward for all of us, and so Dr. Weil, you deserve the best retirement ever.
Ronnie Lepow, DPM, Houston, TX
06/22/2018
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: Joseph Borreggine, DPM
The “new” bunion procedure that is called the lapiplasty which was brought to fruition by Dr. Paul Dayton, et al. and his team certainly has “changed” the way we look at the biomechanics of a bunion deformity, let alone, how to correct it. But, the question I pose to the PM News readers and to my podiatric colleagues: is this bunion procedure the pinnacle of podiatric surgical success because of its continual outcome of “reproducible” results along with reduction in bunion deformity re-occurrence?
Or is this procedure driven like most of our profession’s innovations by the vendor dollars created by performing said procedure? Or is this procedure’s ability to stay in the limelight of surgical success fueled by the...
Editor's note: Dr. Borreggine's extended-length letter can be read here.
06/29/2017
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: Steven J. Kanidakis, DPM
Bret, likely you are among the growing number of DPMs reading about the uncertainty of rendering the various podiatry-type procedures. It is not about asking for "cash". Even taking cash, performing the procedure "free", or not getting paid does not mean you are free from guilt. I give the podiatrist in question much more credit than to stoop to the answer of taking "cash" as the answer to our problems. (Yes, our problems, since all these problems are not just his.) If any podiatrist currently in practice, or ever in practice, thinks he has never broken one rule or law, then stand up. Or else, sit down.
Steven J. Kanidakis, DPM. Saint Petersburg, FL
09/15/2014
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: Kevin A. Kirby
Thanks to Drs. Kiel and Solomon for their replies on this interesting subject. I base my initial response that continued application of external force to a body part over time has the potential to deform that body part; such as the chronic wearing of pointy-toed dress shoes that are too short, on the known biomechanical property of all human tissues known as viscoelasticity.
Ligaments, tendons, cartilage, skin, and even bone are all viscoelastic structures which means that they exhibit time-dependent load versus deformation characteristics over time. Two of the most commonly accepted load vs. deformation behaviors of our body’s tissues are creep-response where a given magnitude of load is applied to a tissue over time and that tissue is seen to deform; and stress-relaxation where a tissue is elongated or compressed a certain amount and, then over time, the stress within the tissue decreases.
Because of this known time-dependent load vs. deformation characteristic of all the structural components of the human body, chronic application of abnormal magnitudes of forces have the potential to cause permanent deformation of those tissues, especially if the loads applied cause plastic deformation of those tissues. Whether or not a shoe produces permanent deformation of the foot is likely related to how much force is applied, how long that force is applied, and the internal structural ability of the foot to resist such change, along with other factors such as other activities, trauma, joint inflammation, etc. that may predispose the joint to such changes.
09/13/2014
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: Brian Kiel, DPM
I do not want to get into an extended discussion of this issue but I felt I did need to respond. Neither of the responses answered the question that if it is true that environmental factors such as shoes can cause hallux valgus, then why are so many bunions unilateral and what explains the presence of juvenile hallux valgus? By the way, Chinese foot binding was applied to girls from infancy 24 hours a day 7 days a week. That is not a fair comparison.
06/07/2014
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: Robert Scott Steinberg, DPM
The Illinois Podiatric Medical Association testified in the Illinois capital, when the cut was first proposed. Originally, it was proposd to cut all podiatric services. That was changed to allow podiatrists to treat Medicaid recipients with diabetes, and children under 21. To make things worse, back in '92 or '94, the state did the same thing and it cost them far more. You'd think the elected officials in Illinois would have studied a little history.
03/03/2014
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: Robert C Chelin, DPM
Barry, congratulations on this milestone. Your up-to-date information not just of North American podiatry happenings, but on news on global podiatry has been both informative and enlightening. You have been a global thinker, and by doing so, you have expanded the knowledge of international podiatry. Far too often, we get comfortable in our own environment, but you have been able to think outside the box and reach out to podiatrists everywhere. You have made them feel inclusive, more knowledgeable, and have sparked great debate about our profession.
Robert C Chelin, DPM, CEO, International Federation of Podiatrists (FIP)
Editor's note: We would like to thank all those who have sent congratulatory letters. To read some of the additional letters, click here.
01/25/2014
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B
From: Joel A Feder, DPM, Ivar E. Roth DPM,MPH
I totally agree with Dr. Feder about the certificate replacement for ABPS. We both go back to the days that our first executive, John Bennett, worked for gratis because the organization could not afford his salary. Now there is plenty of income to support Dr. Feder's recommendation.
I agree with Dr. Feder. The ABPS charges outrageous fees for their re-certification, something close to $1,000 for a 100 or so question test at a computer testing center. I do not think they thought this one through as we are not replacing a lost certificate. We must get the certificate re-framed/laminated, etc. which is another cost. Possibly due to the sheer volume of certificates to be issued, they might engage a company to offer the certificates with lamination at a great price as an incentive to getting the new document. I would like to get the business to laminate 10,000 certificates @$100 each - that is a million dollars.
03/18/2013
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B (CLOSED)
RE: PA Podiatrist Among Highest Paid by Big Pharma
From: Hartley Miltchin, DPM, Robert E. Kuvent, RPh, DPM
Dr. Joseph is an asset to our profession as he presents information via his presentations in a concise, factual, and easy-to-understand manner. I have listened to Dr. Joseph lecture numerous times, and his passion about the information and his ability to deliver it is quite evident in his presentations. Who and how Dr. Joseph gets paid is really irrelevan., He is entitled to receive payment for time out of his office, expenses, as well as a loss of valuable family time. I would commend Dr. Joseph for teaching his colleagues on relevant topics that apply to all of our practices. I would prefer to see podiatrists paid for presentations rather than being paid for being malpractice expert witnesses for plaintiffs.
Hartley Miltchin, DPM, Toronto, Canada, doctortoe@aol.com
I don't know why Dr. Joseph should have to defend himself, or in any way be vilified for making an honest buck. I say more power to him, and I hope he earns twice that much this year. He has taught us all a lot and saved many lives and limbs. Think of the relative value to society of Dr. Joseph vs. some supermodel or star athlete who nobody questions.
Robert E. Kuvent, RPh, DPM, Chandler, AZ, ftfixr@gmail.com
Editor's note: This topic is now closed.
03/18/2013
RESPONSES/COMMENTS (NEWS STORIES) - PART 2B (CLOSED)
RE: PA Podiatrist Among Highest Paid by Big Pharma
From: Paul J Maglione, DPM, Vinny Giacalone, DPM
We all respect Dr. Joseph as an educator and a fellow podiatrist. However, it is indeed a slippery slope when you deal with Pharma sponsors and the number he has dealt with in past years.
Paul J Maglione, DPM, Ossining, NY, drmaglione@aol.com
If you have ever attended a Dr. Warren Joseph lecture, then you understand that he is a consummate professional who is objective, truthful, and not influenced by the name on his honorarium check. We as a profession should not be ashamed of the fact that one of our own has risen to such a prestigious level. A simple Internet search will astound you with the amount of money that is given to politicians through their PACs, from the pharmaceutical and healthcare industry. This list not only includes large corporations such as Blue Cross Blue Shield, Aetna, Pfizer, Merck, and Johnson and Johnson, but small start-ups, generic manufacturers, and Biotech companies that also donate millions to our nation’s leaders. The tens of millions of dollars donated to our politicians, on both sides of the aisle, is staggering. So, I ask these rhetorical questions: why is this money donated in the first place and what are the politicians doing to earn their money?
Dr. Joseph is reading, working, researching, developing lectures, traveling, spending time away from his family and patients in order to provide the medical community with useful and clinically appropriate knowledge.
Vinny Giacalone, DPM, Emerson, NJ, VinnGiacalo@aol.com
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