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09/18/2019    Dale Feinberg, DPM

Welcome to the Future of Podiatry (Joseph Borreggine, DPM

Dr. Borreggine’s excellent analysis of the future
of podiatry hit the nail right on the head. He
had been prognosticating that the demise of
private practice was coming and now he has put
out the word that private practice is dead,

I started reading the tea leaves about seven
years ago when the implementation of Obamacare
started affecting my practice. Denial of payment
for the medically necessary diabetic shoes was
the opening shot in the war with Big Brother that
we have unfortunately lost. Things have continued
to go downhill every day and has now culminated
with 90% of podiatrists feeling some level of
burnout. I am not burned out, I’m bummed out!

I love our profession, but it is becoming harder
and harder to stay afloat and I feel that I’m
paying out-of-pocket to enjoy my hobby. Yes, a
few of us are transitioning to newer models of
employment but you’ll never know the level of
freedom and joy that self employment brings.

I have recently been telling patients that when I
retire my much needed podiatry skills would
become a lost art. I recently had a patient
present to my office for a new set of custom
orthotics. When I inquired why he didn’t have
these made back home he told me that no one makes
them anymore. Another patient was so happy that I
removed a painful callous as she had difficulty
finding a Podiatrist to do it. A neighbor in
California asked me to remove his painful heloma
molle as his podiatrist had retired and it took
six months to get a foot appointment at his
health plan. Don’t even get me started on
dystrophic mycotic nails. If you are in the front
lines of private practice you know these things
to be true. Supergroups and orthotic lab support
at meetings will not save us.

In closing I am reminded of an op-ed article Dr.
Bret Ribotsky wrote ten years ago comparing the
reported average yearly DPM income to that of a
school teacher. He made the argument that the two
incomes were in fact equal when you took into
account years of deferred income, educational
costs, cost of loan repayment, malpractice
insurance, and practice costs let alone no funded
retirement, paid days off and a summer off from

I am counting the days until I get Medicare. My
house is paid for and I have no kids in college.
I will ride my Harley into the sunset and I wish
you all the best of luck.

Dale Feinberg, DPM, Yuma, AZ

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