|
|
|
|
|
Search
09/21/2016
RESPONSES/COMMENTS (NON-CLINICAL)
RE: Board Recertification
From: Name Withheld
I first became board certified by ABPS in 1987. I was recertified in 1997 and 2007 (now ABFAS). I subsequently applied for membership in ACFAS. I'm certainly proud of my membership in both organizations.
I got a notice that moving forward, I would have to take an exam which gives me another 10 years of "board certification". I am in a situation where I hope to practice 1-2 more years, slow down, and/or retire. I'm not sure yet. I don't like the idea of studying and sitting for an exam, paying $675 to take the exam, etc. I did not read that there is any special dispensation for seniors or members like myself, who have 30 years’ experience and have trained more than one ACFAS and ABFAS president. I'd like to hear some PM News readers weigh in on this topic.
Name Withheld
Other messages in this thread:
08/11/2025
RESPONSES/COMMENTS (NON-CLINICAL)
RE: How About Three Cheers for Podiatry?
From: Lawrence Rubin, DPM
Let's start patting ourselves on the back for choosing the profession of podiatry. What physician other than the podiatric physician has the opportunity virtually every day of clinical practice to use simple fishing line-type calibrated nylon filaments to check for undiagnosed and untreated diabetic peripheral neuropathy -- and by doing so, potentially prevent a limb from being amputated, and by this, increase that patient's life expectancy?
Three cheers for podiatry, please!
Lawrence Rubin, DPM, Las Vegas, NV
08/08/2025
RESPONSES/COMMENTS (NON-CLINICAL)
RE: Beware of Insurance Phishing Scam
From: Howard Dinowitz, DPM
i wanted to alert PM News to an issue I found in my email. I had it verified that it was a phishing scam. The letter statied that they need verification of a check from an insurance company with a stated amount and a bonafide insurance company that I have submitted claims to in the past.
It had the date of service, my TIN number, but it was lacking the patient's name. They wanted me to fill out the questionnaire to get a check sent to me. After searching through my EMR for 3 years of service, I discovered there was no such claim with that insurance company. The thought process was that this very well could have been from the Change healthcare fiasco. Let this serve as a warning to those receiving similar emails. It looked too good and it was.
Howard Dinowitz, DPM, Brooklyn, NY
08/06/2025
RESPONSES/COMMENTS (NON-CLINICAL)
RE: DPM, Nurse Practitioner
From: Daniel Chaskin, DPM
Instead of getting an off-shore MD degree, why not work out an agreement with nursing schools so that a DPM might have advanced standing to get that NP degree in less time than a normal nursing student. This way, an unlimited license can be obtained with an NP degree without worrying about getting a residency match with a U.S. medical residency program.
With the DPM degree and NP degree, one can then apply for a podiatric residency program and treat all foot and leg problems without worrying about getting an ankle permit. After all, an NP is licensed to treat the entire body. My question is how many podiatrists obtained NP degrees or nursing degrees?
Daniel Chaskin, DPM, Ridgewood, NY
07/31/2025
RESPONSES/COMMENTS (NON-CLINICAL)
From: Paul Kesselman, DPM
Thank you, Dr. DiResta, for pointing out the fact that APMA discontinued their sponsorship of the Dartmouth MPH program. I was totally unaware of that, but the fact remains that when it was in place, it provided graduates who went onto non-clinical careers or it simply improved those individual's status in whatever clinical programs they were involved with. Now that Becker's has published the story I wrote about where both MD and DO programs are offering dual programs for medicine and MPH or MBA, perhaps it is time that APMA reassess its importance. Perhaps APMA, if it cannot afford to sponsor this program itself, can partner with other private enterprises which have profited from podiatry well over the years to offer such scholarships to individuals interested in one of these programs.
I have been made aware for some time that APMA has serious financial issues. Having been a member of various committees over the years as well as...
Editor's note: Dr. Kesselman's extended-length letter can be read here.
07/30/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1B
From: William Wayne Egelston, DPM
I too enjoy the posts in PM News. Whether one agrees with the authors or not, doesn't detract from their insightfulness. I appreciate the dialogue presented by Drs. Kesselman and DiResta and others on this topic. Considering how things are evolving for podiatrists with diminishing numbers of qualified (academically prepared) applicants, likelihood of schools (some or all) closing and increasing number of MD/DO schools on the horizon. It would seem to me a likely scenario might be that future applicants matriculate to MD/DO schools (domestic/foreign), complete orthopedic residencies and foot and ankle fellowships (or others), then train physician extenders (LVN, RN, NP, PA, etc.) in C&C, nail care, and primary podiatry. I see this as a more plausible pathway than watching our decline and obsolescence.
I see this as I, along with other DPMs at Kaiser (California), functioned in...
Editor's note: Dr. Egelston's extended-length letter can be read here.
07/30/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Rod Tomczak, DPM, MD, EdD
Dr. DiResta gets it! It's not because he mentions me or my ideas about the DO path to an unrestricted license but because of his observations concerning the DPM degree NOT being a starting point to move forward. It is a starting point to move laterally. You can have an MHA, MPH, or a PhD in healthcare, but try to aspirate a knee and see how far a master's degree gets you.
Get the DO degree, then enough ACGME-approved residency time to get an unrestricted license, followed by an APMA fellowship in podiatry from Temple, Touro, LECOM, DMU, or UTRGV. Now you can move forward from your starting point.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
07/29/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 2
RE: AOFAS and Podiatry
From: Jeffrey Trantalis, DPM
The American Orthopaedic Foot & Ankle Society (AOFAS) was started in Chicago in 1969. The organization officially added “Ankle” to its name in 1983 to reflect a broader clinical and surgical focus. I was practicing in The State of Washington during this time. One of their goals was to put podiatrists out of business. The irony and sad part of all this is that some of the orthopedists were trained by a podiatrist at Harborview Hospital. Now they have their own institution teaching our profession to orthopedists. The bottle has been opened and now we are paying for it.
Jeffrey Trantalis, DPM, (Retired), Delray Beach, FL
07/29/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1
From: James DiResta, DPM, MPH
I normally enjoy comments from Dr. Kesselman on the blog, but I do believe he has missed the mark on his recent entry regarding the DPM degree. I can also speak to his comment on the fellowship program at Dartmouth which had been a positive initiative for the profession, but it is simply not true that this is just getting started in the world of allopathic medicine. I completed the program at Dartmouth from 2002 thru 2004 in the initial MPH class and was taught by several MD/MPH faculty. I chose Dartmouth because of their initiative to change the business of what we knew as healthcare delivery and, for both good and bad, they were influential in forming the Affordable Care Act (Obamacare) and the development of what we know today as an Accountable Care Organization (ACO). They continue to be a leader in healthcare delivery innovation.
What I don't think Paul realized is that with present financial constraints on APMA, they have chosen to place their priorities elsewhere and discontinued funding for this fellowship program. This program provided the opportunity for fellows like...
Editor's note: Dr. DiResta's extended-length letter can be read here.
07/28/2025
RESPONSES/COMMENTS (NON-CLINICAL)
RE: DPM is NOT a Dead-End Degree; It Is Just a Starting Point
From: Paul Kesselman, DPM
Over the last few years, there has been an increase in the "bashing" of the DPM degree by many of my colleagues. Fortunately, there have been many of my colleagues who have called for this eternal bashing to stop. The reasons for those who are not happy with their current lot vary as do those who are satisfied with their careers. But I suspect there are many in the MD/DO, JD, accounting, and other fields who are also not happy with their current career path.
I am not an occupational sociologist or psychologist and cannot get into the mindset of those who constantly bash this profession or specialty (that too seems to be debatable). The purpose of this letter is to demonstrate that there are many individuals who have taken their DPM and used it as a springboard to go...
Editor's note: Dr. Kesselman's extended-length letter can be read here.
07/21/2025
RESPONSES/COMMENTS (NON-CLINICAL)
RE: STAND+ Shoes (Jack Ressler, DPM)
From: H. David Gottlieb, DPM, Robert Scott Steinberg, DPM
First, I have no relationship with STAND+ Shoes. I received a pair of these shoes for evaluation after a meeting in DC last year. I was told they were meant for standing in all day, hence the name. Also, they were heat moldable/adjustable with a hair dryer, as well as non-absorbent and machine washable. They sat in the box for a couple of months before I tried them on.
They are now my favorite shoes and all of the claims made by the company are true. I highly recommend them for anyone. I am not associated with STAND+ nor do l have any financial inducement to recommend their shoes.
H. David Gottlieb, DPM, Baltimore, MD
How does the APMA determine who is eligible to receive its Seal of Approval? Do the companies whose products are endorsed by the APMA advertise with the APMA?
Robert Scott Steinberg, DPM, Schaumburg, IL
Editor’s comment: The APMA Seal of Acceptance and Seal of Approval are granted by the APMA to products that promote good foot health. The Seal of Acceptance is awarded to footwear, insoles, and materials, while the Seal of Approval is given to therapeutic products like lotions and medicines. These seals indicate that a product has been reviewed by podiatrists and found to be beneficial for foot health, safety, and quality. Source: APMA
07/15/2025
RESPONSES/COMMENTS (NON-CLINICAL)
RE: DPMs as Foot Experts?
From: Jay Grife, DPM, JD
As a former practicing podiatrist, I appreciate the comments extorting the population to accept podiatry as the leader in foot care and treatment. I also have noted from learned persons such as Dr. Tomczak whom I admire for his honesty and devotion, the devolution of podiatry. What I read as quoted below displays that podiatrists are omitted from a topic they see daily and likely treat more often than other healthcare providers. Lest we listen and react to Dr. Tomczak’s prescient explanation, I fear he might be right.
From Health: “Toenail fungus can begin as a minor cosmetic issue, but if left untreated, it may become painful and harder to treat. ‘The signs of toenail fungus are thickened nails that are hard to clip, might appear yellow or white, and can sometimes crumble,’ explains Jeffrey M. Cohen, MD, a board-certified dermatologist and Director of the Psoriasis Treatment Program at Yale School of Medicine.
After consulting with two dermatologists for their expert recommendations, we tested six toenail fungus treatments ourselves. A dermatologist from our Medical Expert Board also reviewed this article for medical and scientific accuracy.”
Jay Grife, DPM, JD, Jacksonville, FL
06/30/2025
RESPONSES/COMMENTS (NON-CLINICAL)
From: Steven Finer, DPM
I agree with Dr. Lai. Unless your initials say MD or DO, we will always be placed with that other group. Look what the DOs have accomplished since the 1970s.
Steven Finer, DPM, Philadelphia, PA
06/27/2025
RESPONSES/COMMENTS (NON-CLINICAL)
RE: Degree, Not Training: The Parity Gap Facing Podiatrists
From: Jengyu Lai, DPM
I joined the American College of Lifestyle Medicine (ACLM) ten years ago, excited to be part of a growing movement focused on evidence-based, whole-person care. When ACLM began working toward official specialty recognition, I was excited—but then surprised to learn that podiatrists would not be recognized as physicians within the specialty but instead classified as allied health providers. This decision was not based on differences in clinical training, residency, or capability, but solely on the degree—DPM rather than MD or DO.
Many ACLM members voiced support for including podiatrists as physicians, but the final determination rested with the American Medical Association. When lifestyle medicine was officially recognized as a specialty in 2019, DPMs were excluded from physician designation. I initially refused to pursue board certification. However, after meaningful discussions with a friend and ACLM board leader, I eventually completed the exam. I am now a diplomate of the American College of Lifestyle Medicine—not the American Board of Lifestyle Medicine—and classified alongside NPs, PAs, nurses, dietitians, and therapists.
This experience highlights an ongoing issue: the lack of parity for podiatrists stems not from training or expertise, but from degree classification. As healthcare continues to evolve and new specialties emerge, such as wound management, this degree-based disparity may persist—potentially sidelining podiatrists despite our central role and qualifications in those fields.
Jengyu Lai, DPM, Rochester, MN
06/26/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: James DiResta, DPM, MPH
While I don't disagree with the need for podiatry to visit more colleges to gain more exposure to potential applicants, I am more concerned about the watering down of our applicants' strength to schools of podiatric medicine. The problem as we have stated over and over is how can we possibly get enough qualified students is this diminishing pool. Schools of osteopathic medicine are growing exponentially. For example, have you ever heard of Debusk College of Osteopathic Medicine? It has two schools in Tennessee now and a third opening in Florida in 2026. Did you know MSU has three campuses now of osteopathic medical students. How about Meritus School of Osteopathic Medicine in Maryland? How about The Edward Via College of Osteopathic Medicine (VCOM) now in four campuses!
There are 43 osteopathic schools listed but in reality there are presently 69 campuses and many more coming. The mean MCAT of all their schools for 2024 is 502.43 and falling. Several of the schools are below...
Editor's note: Dr. DiResta's extended-length letter can be read here.
06/26/2025
RESPONSES/COMMENTS (NON-CLINICAL) -PART 1B
From: Ivar E. Roth, DPM, MPH
Kudos to Drs. Tomczak and now Saxena. I have written this in PM News before without any evidence, but as told to me from my son who recently graduated. He said a good number of students in his class should never have been allowed to be accepted in the first place. A fair number dropped out after the first and second year, but he felt that there were many in his class that just graduated who were barely hanging on and probably should have been weeded out.
Ivar E. Roth, DPM, MPH, Newport Beach, CA
06/24/2025
RESPONSES/COMMENTS (NON-CLINICAL) -PART 1
From: Amol Saxena, DPM, MPH
Mic drop for Dr. Tomczak! Makes me think of the Jack Nicholson line, "You can’t handle the truth." Promoting podiatry is one thing and lowering standards to fill seats is another. Kudos to him for doing the research and pointing out the current data available.
Amol Saxena, DPM, MPH, Palo Alo, CA
06/23/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1
RE: Other Non-MD, Non-DO Doctor Healthcare Providers
From: Rod Tomczak, DPM, MD, EdD
I thought it might be interesting to look at the data surrounding other non-physicians, but in a non-judgmental view, of course. Draw your own conclusions but be sure to refrain from rash judging anyone blowing their own horn about how hard they work and the good they do. A lot of the following data had large ranges, so I used the Jethro Bodine average technique. For those who aren’t familiar with Jethro, it went something like; “Cipher, carry, naught, naught, carry, cipher, etc…”
Doctors of Chiropractic
There are 18 accredited chiropractic colleges in the U.S. with 2,800 first year students right now. In 2023, approximately 2,700 students were awarded a Doctor of Chiropractic degree. Tuition per year averages about $30,000 and the average income is $89,000 per year. Average admission GPA is 3.38 and a school can suffer loss of accreditation if they admit anyone with a GPA below 3.0. Most accredited chiropractic schools offer...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
06/16/2025
RESPONSES/COMMENTS (NON-CLINICAL)
From: Thomas A. Graziano, DPM, MD
I agree with Dr. Sherman. There is nothing wrong with advanced training, and the decision to mandate a 3-year residency was well intended. However, a mandatory 3-year "surgical" residency should be reserved for those who have a desire to specialize in surgery. A number of podiatry students are better suited and more comfortable with practicing as a general podiatrist.
No matter how you slice it (no pun intended), there is something wrong when there are only 400 applicants over 11 accredited podiatric medical schools in the U.S. It's time to face the facts and come up with another answer for this profession. If not, based on the diminished number of applicants, we're headed for a downward spiral into the abyss in the very near future.
Thomas A. Graziano, DPM, MD, Clifton, NJ
06/13/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 2
From: Alan Sherman, DPM
It is gratifying to see the last two messages from Drs. Pressman and Tomczak supporting the need for some kind of dual track 3-year residency training program to best meet the training needs of both predominantly surgical and medically oriented podiatrists. We are all proud of what our profession has accomplished in the development of the standardized 3-year surgical residency model. It seems to be producing excellent foot surgeons that are well respected in medical delivery systems, well employed, and well rewarded financially. But these two individuals seem to agree with me that it is time to catch our breath and assess whether these training programs are the best that we can do in training ALL the podiatrists that the U.S. population needs to provide for their foot care needs in the decades ahead.
My main concern is that a resident’s time is well spent training in the work that they will be doing after their 3 years are up. Believe me, I know that restructuring what was years in the making will be difficult. But perhaps some programs are already well suited to offer more clinic-based outpatient training for residents heading for more medically oriented office-based practice? And where does wound care, which occupies so much of podiatry practice, fall in this dual track system? I’d like to hear opinions of other PM News readers.
Alan Sherman, DPM, Boca Raton, FL
06/13/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1
RE: Compensating for Podiatric Surgeons Who are Not Trained In General Podiatry
From Elliot Udell, DPM
There has been a great deal of discussion on how to compensate for a lack of training in general podiatry at some of our 3-year residency programs. The issue is that many who complete these programs are masters in foot and ankle surgery but are not trained in how to manage patients with "corns, calluses, warts, ingrown toenails, and other "bread & butter" pathologies.
When I did my residency many years ago, we treated patients at a hospital-based general podiatry clinic several days a week, managed all foot emergencies in the ER, and assisted podiatric surgeons and orthopedic surgeons in the operating room. Many programs today, as has been well pointed out, are strong in surgical training but lacking in general podiatry training. The root of the problem may be that these programs may not have standing general podiatry clinics. If that is the case, these programs can work with general podiatrists and have residents rotate through their offices in order to master the non-surgical aspects of our profession.
Elliot Udell, DPM, Hicksville, NY
06/12/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1B
From: Martin M Pressman, DPM
Thank you, Dr. Tomzack for not burying me. I do remember my trip to Ohio State to review your program. Things have indeed changed and evolution continues in spite of the inertia. In the last PM News, there was an interesting article by Jarrod Shapiro, DPM about surgical vs non-surgical podiatry. The article is apropos to the issue at hand. As I see it, the unified 3-year residency has brought podiatry to parity with medicine with respect to post-graduate training hours. Of course this is not the solution to all issues with respect to the profession's duality (medicine vs surgery). Medicine struggled with this issue when GI docs started endoscopy and cardiologists and radiologists became interventionalists.
Somehow they solved the issues between cardiac surgeons, vascular surgeons, and general surgeons and their respective medical colleagues. Disparate training algorithms, yet somehow they work together. I saw that at Yale for 25 years. I do not have a solution for this profession's problems, but I am sure that solutions exist. Perhaps the 3-year training model can have a medical model leading to an optional approved foot surgery fellowship for those PM trained DPMs who want or need to do surgery. The surgery done in the podiatric medical model plus a one year fellowship perhaps could lead to ABFAS foot surgery certification. There is an answer that could satisfy all parties involved. This probably will not stop the turf battles that seem incurable within medicine and podiatry. The answer is NOT to allow our medicine board to certify in surgery!
Martin M Pressman, DPM, Summerville, SC
06/12/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Martin M Pressman, DPM
Dr. Kesselman asks why podiatry was “not even listed” in the AMA article on scope creep of lesser trained (post graduate hours/residency) providers. The article does not mention podiatry for good reasons. Our training hours are consistent with most MD and DO post-graduate programs. I have been part of the “parity movement” for all of my 50-year professional career. I have seen the AMA/Orthopedic partnership fight every advance podiatry has made and call it the derogatory term “scope creep”. This article was based on measuring competence and patient safety on hours of post-graduate training. (Pedagogically sound?) In all comparisons, the article stresses the lack of training hours for the professions listed. The fact that podiatry was not on the list is simply because our training has reached “parity”.
Of course, the AMA article does say one must go to an MD/DO medical school to be a physician. I am also fairly certain no orthopedic input was sought by the author or we would have somehow been number one on the list. In the end, not being on this list or even mentioned in an AMA article on scope creep is, in my view, a reluctant acceptance of our training model.
Martin M Pressman, DPM, Summerville, SC
06/11/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1B
From: Rod Tomczak. DPM, MD, EdD
I would like to comment on the letter by Martin Pressman, DPM. In the spirit of true transparency which I insist upon, Dr. Pressman was one of my trainers at Metropolitan Hospital in Philadelphia where I completed a two-year residency beginning in 1977. I am neither afraid to bury or praise podiatrists who have influenced my life.
When I arrived at Ohio State University from Des Moines CPM in 1995, there were two foot and ankle care givers for the 35,000 faculty and staff plus their families who were self-insured by the University’s prime care, 55,000 students and outside patients. The two foot and ankle physicians were the chair of the department, Sheldon Simon, MD and myself. I asked him if I could start a surgical residency program shortly after arriving. He told me...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
06/11/2025
RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Paul Kessleman, DPM
I hope Dr. Pressman can answer a question or two about the reference AMA article. I agree that the three-year 4/4/3 model may have helped elevate us to the point where podiatry is no longer negatively noted in this interesting article. Unless I am missing something, however, I failed to see in the reference article any mention of podiatrists at all. The physicians who were listed were MDs, DOs, even optometrists and naturopathic physicians.
I guess the good news is that nothing was noted negatively about DPMs, but where does that leave us if we are not even listed? I am sure those of us who read the AMA article would appreciate some interpretative explanation for this. Or if I missed something, please let me know.
Paul Kesselman, DPM, Oceanside, NY
06/10/2025
RESPONSES/COMMENTS (NON-CLINICAL)
From: Paul Kesselman, DPM
Regarding totally free Medicare verification websites, I cannot stress enough signing up for your local MAC and all four DME MAC portals. To reiterate, these are totally free and provide way more than just verification. They provide the old Social Security based number to the current National Medicare Beneficiary Identifier (NMBI), deductible status for the majority of patients, same or similar for many DME items, and financial information. Most also provide a way for you to submit appeals (which in the very near future will be the only way to submit them), and even in some cases claim submission.
While consolidated billing information is also found on these portals, it is not 100% reliable as it is dependent on the information received from Social Security and that is often a month or so lagging behind. Also, the patient's enrollment into Medicare Advantage plans also does show up, but again especially at the beginning of the year, or for patients who are new to the area in which you practice. They may have switched from either traditional fee-for-service to a MCR Part C plan and that may not be up to date, especially if it was very recent.
To state for the third time is not overstating it to all readers. Enroll in both your local MCR Part B carrier and all four DME MAC portals. These are free!
Paul Kesselman, DPM, Oceanside, NY
|
| |
|
|
|
