02/22/2016    Ira Baum, DPM

Podiatrists Joining Orthopedic Groups (William Deutsch, DPM)

Dr. Deutsch's point is well taken- basic podiatry
does not include only C&C, but if the lion's
share of non-surgical podiatry is relegated to
PAs, nurses, techs, etc., and if foot and ankle
surgery done by podiatrists is not reimbursed
equally with foot and ankle orthopedics, it will
not only will be a disincentive to operate, but
place the risk/benefit equation well against the
podiatric surgeon, then what is left for
podiatry?

Parity, don't hold your breath. Foot and ankle
orthopedist will fight against it. Why? Because
it most likely will result in reduce fees for
their procedures, not an increase in
reimbursement for podiatric surgeons. So, there
it is. Parity in reimbursement will most likely
result in one of two ways: 1. Lawsuits. 2.
Assimilation into allopathy and osteopathy.

Legal action is costly and complicated. On the
surface it appears a slam dunk. The same pay for
the same service, right? For private third-party
payers the trump card is simple, their position
is they have a contract with a podiatrist.
Therefore, since the podiatrists accepted the
arrangement with a fee schedule part of the
agreement, the insurance company should not be
compelled to "equal pay for equal service."

Of cours,e contracts can be contested and in this
case should be, but does podiatry have the will
and resources to do it? The fight will be on at
least two fronts, the AMA and the private
insurance companies. Both have deep pockets.

Assimilation into allopathy and osteopathy, the
second option is also complex. Podiatrists are
polarized on this approach. Some are for it and
some are against it. From previous posts on this
issue, the podiatrists against it appears to be
emotionally or economically-based.

On a personal note, I love podiatry. I loved my
career, but during the last 30 years healthcare
has changed. My allegiance is to individuals who
love to care for the foot and ankle and to ensure
they have a satisfying career no matter what form
it takes.

Institutions representing podiatry should be
aware of the difficulty facing podiatric students
and future students and either develop a
practical solution, in which concrete result can
be measured or if they are not part of the
solution, they should get out of the way.

Ira Baum, DPM, Miami, FL

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