Something Interesting for APMSA Delegates to look into

[dpmgrad]

I got this in the email today from ACFAS (ACFAS E-Update). Perhaps, APMSA Delegates and current Podiatry students may want to take a look into this as well.

July 10, 2006

On June 27, 2006, HR 5688, the Healthcare Truth and Transparency Act of 2006 was introduced in the U.S. Congress by Rep. John Sullivan (R-OK). This bill is a blatant attack on any provider other than those who hold a degree in medicine (MD), osteopathic medicine (DO), or dentistry (DDS). The College [ACFAS] strongly agrees with the APMA that this bill is a direct attack on the integrity, training, and practice of all our members.

It is imperative that all ACFAS members send a strong, quick message that any legislation of this type will be vigorously attacked by the groups affected. ACFAS members are being called upon to urge their U.S. representative to oppose this bill, which is nothing more than a turf battle between the medical professions. Send an e-mail message to your member of Congress and follow up with a phone call to the congressman’s district and Washington offices.

HR 5688 is a destructive bill that, among other things, calls for sanctions by the Federal Trade Commission against any non-MD/DO/DDS for “making deceptive or misleading statements” to the public and attempts to prohibit anyone other than an MD, DO, or DDS from calling himself a “doctor.”

Some important things to remember:

Podiatrists are defined as physicians in the Social Security Act, Section 1861(r)(3).

According to the Physician Payment Review Commission (now MedPAC) as early as 1991, podiatrists were found to provide medical and surgical care of the foot equivalent to that of MDs and DOs.

Podiatrists provide the majority of medical and surgical foot care to Medicare and Medicaid beneficiaries.

Urge Congress not to involve itself further in this turf war and your Congressman not to support this bill. The level of concern created for the legislators must be deeply intensified in order to make them think twice about becoming involved in legislation of this type in the future. The time for action on this issue is now.

To view a copy of HR 5688 click on the following link: http://www.govtrack.us/data/us/bills.text/109/h5688.pdf

[Dr_Feelgood]

Wow this guy is an idiot. I'll be watching to see who supports this bill. It will definitely make my political discussion watch list.

[Dr_Feelgood]

I contacted Rep Sullivan and I would suggest everyone do the same. Also the co-sponsors of the bill are Mr. Gene Green, Mr. Charles F. Bass, Mr. Joe J H “Joe” Schwarz, Mr. Michael C. Burgess, Mr. Michael Bilirakis, and Mr. Pete Sessions.

I'm attaching a copy of what I emailed them. Feel free to adapt it for your use.

I understand the confusion that is everywhere in our health care system. With all of the advertisements for drugs, information on the Internet, and different medical specialties, it makes for a confusing system. But your "Healthcare Truth and Transparency Act" seems uninformed. I'm sure you looked at podiatrists training before excluding them from this bill, right? You ignored the fact that they work in hospitals with full privileges and dispense medications without limits. You ignored the fact that they are the only other specialty that requires a post-graduate residency where you work shoulder to shoulder with DOs and MDs. You ignored the fact that with the growing epidemic of diabetes and obesity, the need for podiatric care is at an all time high. You ignored the fact that they receive more training in foot and ankle surgical procedures than any other medical profession including MDs and DOs.

I hope as a fellow Republican that you ignored those facts and did not make an uninformed decision. Especially when you list dentists, who are not required to do a post-graduate residency and have as limited scope as podiatrists.

I hope that you do the right thing and clarify that doctors of podiatric medicine and surgery are indeed physicians.

[AZPOD Rocks]

WHOA, BOY! SLOW DOWN EVERYONE!

I understand the alarm everyone is having/going to have as a result of this legislation but I think you ought to read it for yourselves. It does NOT attack podiatry or any healthcare field.

The legislation is very clear in its mission: make sure those who are not MD's, DO's, DDS's, and DMD's do make the patient think they are MD's, DO's, DDS's, and DMD's. This legislation makes it illegal, federally, for anyone to claim such degrees when they do not have the degrees themselves.

As DPM's, podiatrists do not claim to be MD's, DO's, DDS's, or DMD's. They claim to be DPM's.

The one and only part of this legislation that is an area of concern is the restriction on claiming one "has the same or equivalent education, skills, or training" as MD's, DO's, DDS's, or DMD's. I believe many, but not all, podiatrists may claim to have an equivalent education with impunity, especially those who graduated from 2 and 3 year residency positions.

AZPOD Rocks

[AZPOD Rocks]

Sorry to break it to the ACFAS emailers... but their letter is unneccessary and unduly alarming in its claims. The legislation does not purport that someone is "making deceptive or misleading statements” to the public by representing themselves as a doctor of podiatric medicine (only if one attempts to trick the patient into believing one's degree is a MD, DO, DDS, or DMD degree). It does NOT "attempt to prohibit anyone other than an MD, DO, or DDS from calling himself a “doctor.'"

These claims are bogus!

AZPOD Rocks

[Dr_Feelgood]

Maybe I did not read the same bill b/c it is definitely open to negative interpretation.

For example:
Findings
(2) consumers believe that complex medical issues, surgeries, procedures, and prescribing medications should be performed by medical doctors

Prohibited
(1) It shall be unlawful for any person who is a licensed health care service provider but who is not a medical doctor, doctor of osteopathic medicine, doctor of dental surgery, or doctor of dental medicine to make any deceptive or misleading statement,
or engage in any deceptive or misleading act, that deceives or misleads the public or a prospective or current patient that such person is a medical doctor, doctor of osteopathic medicine, doctor of dental surgery, or doctor of dental medicine or has the same or equivalent education, skills, or training.

These statements are very inflammatory and this is where I find fault. If our patients only desire to receive care from medical doctors and we can present ourselves as a doctor or as qualified as an orthopod. How can we survive?

I am more than okay with them saying if you are a DPM you cannot tell patients that you are an MD or a DDS. By the same right can a MD claim the same training as a DPM? They should not be able to but this is not listed in this bill. It has be repeatedly stated (by myself) that in The Journal of Bone and Joint Surgery, that orthopedic foot and ankle fellows are under-trained when compared to DPMs to operate on the foot and ankle. We receive a long and more intense training in that SPECIFIC AREA (an attempt to stop the trolls). So for a F&A fellow to claim he is better qualified than a DPM is not protected under this bill. But reverse that claim and it is a direct violation? That does not seem logical.

[scpod]

Originally Posted by Dr_Feelgood

(1) It shall be unlawful for any person who is a licensed health care service provider but who is not a medical doctor, doctor of osteopathic medicine, doctor of dental surgery, or doctor of dental medicine to make any deceptive or misleading statement...

It all stems from the fact that MOST people in the US still don't know what a DPM is, or does. There are only 8 DPM schools in the whole country. Yes, I know that DPMs are probably more qualified than orthopods, and have probably been a part of a lot more (thousands of, in fact) foot/ankle surgeries than most orthopods, but the general public doesn't know that. Nor does Congress or the Senate and THEY make the laws in this country. Some states seem to have done a pretty good job because the scope of practice is pretty good, but some are just piss poor. It's really up to those of you who are just now entering the profession to become activists, since you can't count on the "old guys" to give you a lot of help. I'm a HUGE fan of all things podiatric. I hope that I can help at some point in time. I think that you guys are probably better "people" than a whole lot of pre-meds that I have known. I STILL wonder sometimes if I have made the wrong decision as to my future, but I would never hesitate to defer to most of you when the foot/ankle is on the line-- except for maybe Whiskers...I don't know if he showed up for the "old tests" that day or not.

[mrfeet]

Originally Posted by AZPOD Rocks

WHOA, BOY! SLOW DOWN EVERYONE!

I understand the alarm everyone is having/going to have as a result of this legislation but I think you ought to read it for yourselves. It does NOT attack podiatry or any healthcare field.

The legislation is very clear in its mission: make sure those who are not MD's, DO's, DDS's, and DMD's do make the patient think they are MD's, DO's, DDS's, and DMD's. This legislation makes it illegal, federally, for anyone to claim such degrees when they do not have the degrees themselves.

As DPM's, podiatrists do not claim to be MD's, DO's, DDS's, or DMD's. They claim to be DPM's.

The one and only part of this legislation that is an area of concern is the restriction on claiming one "has the same or equivalent education, skills, or training" as MD's, DO's, DDS's, or DMD's. I believe many, but not all, podiatrists may claim to have an equivalent education with impunity, especially those who graduated from 2 and 3 year residency positions.

AZPOD Rocks

Guys, I have to agree with AZPod Rocks on this one. This bill in no way attacks podiatric medicine or the future of our profession. The bill simply prohibits people who are not MD/DO/DDS from presenting themselves as such. Let me explain to you why this legislation has been brought forth.

There is a great problem in the U.S. today with alternative medicine practitioners passing themselves off as doctors. Specifically, Naturopathic Doctors (N.D.'s) and other practitioners of things such as Oriental Medicine, have (in some cases) presented themselves as doctors of medicine and have committed fraud against the public. Several states, such as Arizona and Montana allow N.D.'s to present themselves as "doctors" and practice medicine. However, many states, such as my home state of North Carolina, specifically prohibit N.D.'s from calling themselves "doctors" or practicing medicine.

Also, I believe that this could be an attack on some chiropractors. Though I personally have respect for D.C.'s (as one of my good friends is one), some chiropractors are starting to call themselves "chiropractic physicians." Also, many have been granted very liberal privileges by the military. Even going so far as to give a bulk of the musculoskeletal cases to chiros and taking this work away from DO's and MD's who have better training.

I think that the Congressman is targeting such persons as these. You have to also consider that Optometrists and Pharmacists are not mentioned in this legislation. This is certainly not an attack against these vocations, as they are very important, especially pharmacists.

Everyone take a deep breath and really think about this one! You'll see that it is not an attack against DPM's. I think that some of you are just upset that DPM's aren't mentioned in the legislation.

[AZPOD Rocks]

Originally Posted by mrfeet

Guys, I have to agree with AZPod Rocks on this one. This bill in no way attacks podiatric medicine or the future of our profession. The bill simply prohibits people who are not MD/DO/DDS from presenting themselves as such. Let me explain to you why this legislation has been brought forth.

There is a great problem in the U.S. today with alternative medicine practitioners passing themselves off as doctors. Specifically, Naturopathic Doctors (N.D.'s) and other practitioners of things such as Oriental Medicine, have (in some cases) presented themselves as doctors of medicine and have committed fraud against the public. Several states, such as Arizona and Montana allow N.D.'s to present themselves as "doctors" and practice medicine. However, many states, such as my home state of North Carolina, specifically prohibit N.D.'s from calling themselves "doctors" or practicing medicine.

Also, I believe that this could be an attack on some chiropractors. Though I personally have respect for D.C.'s (as one of my good friends is one), some chiropractors are starting to call themselves "chiropractic physicians." Also, many have been granted very liberal privileges by the military. Even going so far as to give a bulk of the musculoskeletal cases to chiros and taking this work away from DO's and MD's who have better training.

I think that the Congressman is targeting such persons as these. You have to also consider that Optometrists and Pharmacists are not mentioned in this legislation. This is certainly not an attack against these vocations, as they are very important, especially pharmacists.

Everyone take a deep breath and really think about this one! You'll see that it is not an attack against DPM's. I think that some of you are just upset that DPM's aren't mentioned in the legislation.

Your reasoning is completely along the lines of what I was thinking! The naturopath deal is, as you mentioned, quite interesting here in Arizona. Here, they can call themselves N-MD, which makes it seem as though they are certified to practice far beyond the scope they should have and to the unknowing eye appears to be some kind of specialty in the MD world. Their students have clinical rotations here in AZ and can write scripts for the homeless in homeless clinics (nothing like faceless guinea pigs, huh ).

To prove this point (about people thinking N-MD's are MD's), I cite a personal example. My mother-in-law recently was seeking help for a metabolic disorder (thyroid issues) and someone suggested Dr. so-and-so. After a month or two, I found out and asked what the Dr's specialty was. She said, "I don't know, but she is an MD." So, next visit to the in-laws, I saw a book this "Dr." had written and noticed the N-MD. I was alarmed and let my mother-in-law know about this and she said, "I know, I just found out." She seemed to be embarrassed that she had been "taken" into thinking this woman was something she is not.

Great Post!

AZPOD Rocks

[IlizaRob]

My only question is who is trying to pass themselves off as dentists when they are not? The dental assistants? Im still confused as to why they were included.

[Dr_Feelgood]

My thought is why do we need more laws??? This is a Republican doing a Democratic thing. The foundation of the Republican party is less government. Do we really need a law to accomplish this??? Instead if you pass yourself off as something you are not, they should go in front of the state medical board. Which is what happens already; use the damn system that is in place.

Once again, the law is open for interpretation. That is where my problem lies. If you read the law, it can and probably in the future will be used against podiatrist. If you go for full privileges at a hospital, they could say you are breaking the law b/c at this hospital, only MDs and DOs practice, therefore you are presenting yourself as a MD/DO.

The question in my mind is: "Is this necessary?" With all of the problems in health care what does this accomplish? Two, "Can this lead to a restriction on podiatrist is the future?" Of course, do you think that the First Amendment was meant to protect "artists" from taking a dump in public on the flag, then calling it art? This is the danger of ambiguous laws.

[Dr_Feelgood]

Let me clarify something. I do not want to be an MD nor do I want to present myself as one. But in the same breath, I do see myself as an equal to any foot and ankle orthopedic fellow. Any law that separates MDs and DOs from the rest of the pack is bad in my mind. We are fighting to become their equals (on our chosen area) but by the definition of this law we cannot be. The catch 22 is not a defective chromosome 22 that leads to cardiac and thymus abnormalities (sorry damn boards), it is the wording "such person has.... the same or equivalent education, skills or training." I firmly believe that we meet and exceed the training of any MD and DO in the area of the foot and ankle.

[AZPOD Rocks]

Originally Posted by Dr_Feelgood

Let me clarify something. I do not want to be an MD nor do I want to present myself as one. But in the same breath, I do see myself as an equal to any foot and ankle orthopedic fellow. Any law that separates MDs and DOs from the rest of the pack is bad in my mind. We are fighting to become their equals (on our chosen area) but by the definition of this law we cannot be. The catch 22 is not a defective chromosome 22 that leads to cardiac and thymus abnormalities (sorry damn boards), it is the wording "such person has.... the same or equivalent education, skills or training." I firmly believe that we meet and exceed the training of any MD and DO in the area of the foot and ankle.

Like I posted before, this bolded portion of your quote is the only area of the proposed legislation I mistrust and believe could potentially be cause for alarm. I don't like the wording but I have personally HEARD naturopath students claim their education is "the same as MD's." So, I can see why they included it, but wish they would include DPM's among their safe list.

AZPOD Rocks

[jefguth]

Originally Posted by IlizaRob

My only question is who is trying to pass themselves off as dentists when they are not? The dental assistants? Im still confused as to why they were included.

Greeting current future DPM's! Current OD student here with some observations.

First, I have to disagree with the posters who say this legislation is not a threat to our respective professions. While yes, the bill as it is written does not sound all that unagreeable, I would caution others to be concerned about the section that prohibits no MD, DO, DDS/DMD's from making claims of equivalent education and training. The fact remains, on a daily basis providers such as yourselves, DPM's, OD's, a few others DO provide equivalent and possibly superior care. To allow a restriction such as this would be a major blow.

Furthermore, if you look at press releases from the supporters of this bill you will find just a few of the bill's targets: Podiatry, Optometry, Chiropractic, Psycology, etc. while the supporters are the medical specialists that provide complementary care- the orthopedic surgeons, opthalmologists, shrinks...

The supporting coalitions, which includes the American Academy of Orthopedic Surgeons, claims (http://www.magnetmail.net/images/cli...oalitionPR.pdf) that Americans are confused about the credials of their providers and lists the results of a survey revealing that 72% believe podiatrists are MD's, 70% believe optometrists are MD's...etc. In fact the bill includes language that implies that non-MD/DO and non-DDS/DMD providers are actively decieving the public. How can we allow the AMA to slander our professions with the help of Congress?

I strongly suggest raising this issue with your representive in congress in a very respectful manner.

Regards.

[dpmgrad]

Originally Posted by jefguth

Greeting current future DPM's! Current OD student here with some observations.

First, I have to disagree with the posters who say this legislation is not a threat to our respective professions. While yes, the bill as it is written does not sound all that unagreeable, I would caution others to be concerned about the section that prohibits no MD, DO, DDS/DMD's from making claims of equivalent education and training. The fact remains, on a daily basis providers such as yourselves, DPM's, OD's, a few others DO provide equivalent and possibly superior care. To allow a restriction such as this would be a major blow.

Furthermore, if you look at press releases from the supporters of this bill you will find just a few of the bill's targets: Podiatry, Optometry, Chiropractic, Psycology, etc. while the supporters are the medical specialists that provide complementary care- the orthopedic surgeons, opthalmologists, shrinks...

The supporting coalitions, which includes the American Academy of Orthopedic Surgeons, claims (http://www.magnetmail.net/images/cli...oalitionPR.pdf) that Americans are confused about the credials of their providers and lists the results of a survey revealing that 72% believe podiatrists are MD's, 70% believe optometrists are MD's...etc. In fact the bill includes language that implies that non-MD/DO and non-DDS/DMD providers are actively decieving the public. How can we allow the AMA to slander our professions with the help of Congress?

I strongly suggest raising this issue with your representive in congress in a very respectful manner.

Regards.

Thanks for sharing that press release about the new Physician and Dental Coalition for Healthcare Accountability, Responsibility and Transparency's support for the bill.

[jefguth]

Originally Posted by IlizaRob

My only question is who is trying to pass themselves off as dentists when they are not? The dental assistants? Im still confused as to why they were included.

I believe the dentists are on board with this bill mainly b/c they are concerned about hygentists pushing for legislation that would allow them to offer stand-alone dental hygene clinics without the supervision of a dentist.

[krabmas]

Originally Posted by jefguth

Greeting current future DPM's! Current OD student here with some observations.

First, I have to disagree with the posters who say this legislation is not a threat to our respective professions. While yes, the bill as it is written does not sound all that unagreeable, I would caution others to be concerned about the section that prohibits no MD, DO, DDS/DMD's from making claims of equivalent education and training. The fact remains, on a daily basis providers such as yourselves, DPM's, OD's, a few others DO provide equivalent and possibly superior care. To allow a restriction such as this would be a major blow.

Furthermore, if you look at press releases from the supporters of this bill you will find just a few of the bill's targets: Podiatry, Optometry, Chiropractic, Psycology, etc. while the supporters are the medical specialists that provide complementary care- the orthopedic surgeons, opthalmologists, shrinks...

The supporting coalitions, which includes the American Academy of Orthopedic Surgeons, claims (http://www.magnetmail.net/images/cli...oalitionPR.pdf) that Americans are confused about the credials of their providers and lists the results of a survey revealing that 72% believe podiatrists are MD's, 70% believe optometrists are MD's...etc. In fact the bill includes language that implies that non-MD/DO and non-DDS/DMD providers are actively decieving the public. How can we allow the AMA to slander our professions with the help of Congress?

I strongly suggest raising this issue with your representive in congress in a very respectful manner.

Regards.

just a comment/observation about the scared MD/DO's out there.

is it our fault that the american public is generally uneducated and un informed?

why doesn't the AMA instead of wating money on lobbying to pass legislation just give the APMA money to start doing TV commercials as an education campaign to educate the general public about the education and training and skills of podiatrist?

I think this would be a great idea.

they can also give money to all the other medical specialties because clearly the AMA has money to waste.

[jefguth]

Originally Posted by dpmgrad

Thanks for sharing that press release about the new Physician and Dental Coalition for Healthcare Accountability, Responsibility and Transparency's support for the bill.

No problem,

thought you might also like to see Rep. Sullivan's press release also: http://www.magnetmail1.net/ls.cfm?r=...essRelease.pdf

[Dr_Feelgood]

I definitely see this bill as more of tactic to continue controlling medicine by MD/DO/DDS than a bill that helps little old ladies find competent care.

I hope hygienist get more training and are allowed to work w/o dentist. The same thing has happened to medicine with PAs and NPs.

[jefguth]

An interesting point was raised in the optometry forum - that such offensive motions on the part of organized medicine are designed not necessarily to be successful but rather to put the other professions on the defensive, to pre-occupy their organizations, and to force them to spend their political funds fighting garbage bills such as this one so they cannot afford to push for reforms and enhanced scopes of practice in the legislatures.

[mrfeet]

I'll be honest, this blowhole Okie Representative doesn't scare me one bit, nor does his two-bit legislation! The bottom line is, podiatrists have been in this country for nearly 100 years and the general public know who we are. They know, foot problem-go see a podiatrist.

If some of you in school or about to enter school are thinking that the passage of such legislation as this could ruin your future, DON'T! MD's tried to attack DO's, and look what happened. MD's tried to attack chiropractors, and look what happened. Years ago insurance companies wouldn't equally pay DMD's for dental work, because they didn't hold the DDS degree. Now, they have equal pay and equal rights.

There will always be the old guard who try to hold on to their dying empire, and the walls still come tumbling down!

[Podman]

Originally Posted by jefguth

An interesting point was raised in the optometry forum - that such offensive motions on the part of organized medicine are designed not necessarily to be successful but rather to put the other professions on the defensive, to pre-occupy their organizations, and to force them to spend their political funds fighting garbage bills such as this one so they cannot afford to push for reforms and enhanced scopes of practice in the legislatures.

thats actually a very possible motive but nevertheless, this is a bill that needs to be stopped because if passed, it can definately slow down our progress...

i was just wondering if anyone has heard anything new about that bill?

[Dr_Feelgood]

I haven't heard anything. I'm sure that it is something that will die on the committee floor.

[blazenmadison]

Originally Posted by Dr_Feelgood

I haven't heard anything. I'm sure that it is something that will die on the committee floor.

Here is the status of the bill:
http://thomas.loc.gov/cgi-bin/bdquer...9:HR05688:@@@P
and the folllowing contacts for the subcomittee:
http://energycommerce.house.gov/108/...on_Members.htm

the bill is in subcommittee chaired by Cliff stearns, endorsed by MDs/OMDs. it might be tough to get it killed.

[Dr_Feelgood]

If you'd like a letter to cut and paste to your congressman, I'm including an updated and more universal letter.

Congressman _____,

I am writing on the topic of HR 5688, the Healthcare Truth and Transparency Act of 2006. As a podiatric medical student, I understand the confusion that is everywhere in our health care system. With all of the advertisements for drugs, information on the Internet, and different medical specialties, it makes for a confusing system. But the "Healthcare Truth and Transparency Act" seems uninformed and unnecessary. One such flaw is the exclusion of podiatric medical care. By passing this bill, it makes it more confusing for consumers. For example in the area Findings section 2:

"Consumers believe that complex medical issues, surgeries, procedures, and prescribing medications should be performed by medical doctors."

I completely agree with this statement, but when medical doctors are defined in the bill they are DOs, MDs, and DDS. This amazes me b/c while I understand the DOs and MDs; why is a DDS consider a medical doctors and not DPM? Let’s look at the facts: 1) All podiatric medical colleges are associated w/ MD/DO programs, and two of the colleges have fully integrated curriculum. Dental schools operate under completely separate bodies. 2) Podiatrist are required to participate in a 2-3 year post-graduate residency training; dentist are not. 3) Podiatrists work in hospitals with full privileges. Once again this is not true for dentists. 4) Podiatrist work hand in hand with DOs and MDs including areas of general medicine, diabetes and surgical care.

My concern is that if this law passes the way it is written that podiatrists will suffer at the hands of political ignorance. As stated in the prohibited area, section 1:

"It shall be unlawful for any person who is a licensed health care service provider but who is not a medical doctor, doctor of osteopathic medicine, doctor of dental surgery, or doctor of dental medicine to make any deceptive or misleading statement,
or engage in any deceptive or misleading act, that deceives or misleads the public or a prospective or current patient that such person is a medical doctor, doctor of osteopathic medicine, doctor of dental surgery, or doctor of dental medicine or has the same or equivalent education, skills, or training."

This states that even though podiatrists have equal if not superior training to a MD, DO or DDS in the area of foot and ankle pathologies, I cannot legal state that fact. This could led to an increase in consumer confusion and a decrease in the services that DPMs are able to offer.

I hope that I can count on you to clarify that doctors of podiatric medicine and surgery are indeed medical doctors. If that is an impossible task, I hope that you are able to stop this bill before I creates more confusion than it is trying to prevent.

[molldoll2010dpm]

Originally Posted by Dr_Feelgood

If you'd like a letter to cut and paste to your congressman, I'm including an updated and more universal letter.

Congressman _____,

I am writing on the topic of HR 5688, the Healthcare Truth and Transparency Act of 2006. As a podiatric medical student, I understand the confusion that is everywhere in our health care system. With all of the advertisements for drugs, information on the Internet, and different medical specialties, it makes for a confusing system. But the "Healthcare Truth and Transparency Act" seems uninformed and unnecessary. One such flaw is the exclusion of podiatric medical care. By passing this bill, it makes it more confusing for consumers. For example in the area Findings section 2:

"Consumers believe that complex medical issues, surgeries, procedures, and prescribing medications should be performed by medical doctors."

I completely agree with this statement, but when medical doctors are defined in the bill they are DOs, MDs, and DDS. This amazes me b/c while I understand the DOs and MDs; why is a DDS consider a medical doctors and not DPM? Let’s look at the facts: 1) All podiatric medical colleges are associated w/ MD/DO programs, and two of the colleges have fully integrated curriculum. Dental schools operate under completely separate bodies. 2) Podiatrist are required to participate in a 2-3 year post-graduate residency training; dentist are not. 3) Podiatrists work in hospitals with full privileges. Once again this is not true for dentists. 4) Podiatrist work hand in hand with DOs and MDs including areas of general medicine, diabetes and surgical care.

My concern is that if this law passes the way it is written that podiatrists will suffer at the hands of political ignorance. As stated in the prohibited area, section 1:

"It shall be unlawful for any person who is a licensed health care service provider but who is not a medical doctor, doctor of osteopathic medicine, doctor of dental surgery, or doctor of dental medicine to make any deceptive or misleading statement,
or engage in any deceptive or misleading act, that deceives or misleads the public or a prospective or current patient that such person is a medical doctor, doctor of osteopathic medicine, doctor of dental surgery, or doctor of dental medicine or has the same or equivalent education, skills, or training."

This states that even though podiatrists have equal if not superior training to a MD, DO or DDS in the area of foot and ankle pathologies, I cannot legal state that fact. This could led to an increase in consumer confusion and a decrease in the services that DPMs are able to offer.

I hope that I can count on you to clarify that doctors of podiatric medicine and surgery are indeed medical doctors. If that is an impossible task, I hope that you are able to stop this bill before I creates more confusion than it is trying to prevent.

Nice Job!!!

[Dr_Feelgood]

Originally Posted by molldoll2010dpm

Nice Job!!!

Thanks, now all when need is 1000 of our closes friends to cut and paste it on an email to their congressmen and women.

[Podman]

Originally Posted by Dr_Feelgood

Thanks, now all when need is 1000 of our closes friends to cut and paste it on an email to their congressmen and women.

Feelgood, would you mind if I send a copy of this letter to the rest of my class?

[Dr_Feelgood]

Not at all. I would love to see the template flood the inboxes of the idiots that are considering this bill

[jefguth]

List of campaign contributions to the house representatives <link> sponsoring and co-sponsoring bill H.R. 5688 from CHART constituent organizations:

John Sullivan:
American Academy of Otolaryngology $10,000
American Academy of Ophthalmology $7,500
TOTAL: $17,500

Michael Burgess:
American Assn of Orthopaedic Surgeons $8,900
American Society of Anesthesiologists $7,000
American Dental Assn $5,000
American Medical Assn $5,000
TOTAL: $25,900

Barbara Cubin:
American Academy of Ophthalmology $6,000
American Dental Assn $5,000
American Association of Orthopaedic Surgeons $2,000
TOTAL: $13,000

Jim McDermott:
American Academy of Ophthalmology $5,000

Joseph R. Pitts:
American Medical Assn $3,000

Ted Poe:
American Assn of Orthopaedic Surgeons $1,000
American Dental Assn $3,500
American Medical Assn $2,000
American Society of Anesthesiologists $1,000
TOTAL: $7,500

Joe Schwarz, MD:
American Academy of Ophthalmology $10,000
American Assn of Orthopaedic Surgeons $7,500
American Academy of Otolaryngology $10,000
American Dental Assn $6,000
American Medical Assn $5,000
American Osteopathic Assn $3,000
American Society of Anesthesiologists $6,000
TOTAL: $47,500

John Sullivan:
American Academy of Otolaryngology $10,000
American Academy of Ophthalmology $7,500
TOTAL" $17,500

Pete Sessions:
American Assn of Orthopaedic Surgeons $5,000
American Academy of Ophthalmology $3,500
American Dental Assn $3,000
American Medical Assn $2,000
American Osteopathic Assn $1,000
American Society of Anesthesiologists $6,000
TOTAL: $20,500

And the Grand Total donated to HR5688 supporters: $157,400.

[Podman]

thanks for the info jefguth.

[peapod]

In my opinion, this bill does not attack podiatrists. I think it just bruises the egos of a couple of students/podiatrists bc we are not included. But think about it, what podiatrist ever puts an MD after his name when he/she is a DPM. They do not have to do so because majority of the footcare done in the US is by podiatrists. When we advertise that we are foot doctors or podiatric physicians we are not misleading the public bc we are those titles. Podiatrists are doctors and are considered legally a physician so I believe this bill just attacks anyone who claims they are an MD, DO or DDS. We do what we do bc we love it and probably for some because of the huge incomes podiatrists make. I think it would be huge for APMA to adopt this bill bc, honestly, it would make the US safer bc i sure as hell dont want to send my kids to a person who claims he is a MD when he is not. Podiatry is a small profession and is not well known and i doubt there are many more people who claim they are MDs than DPMs or even DOs, DDSs.

The truth is no matter what you do someone is going to try to bring you down. I personally know someone from UMDNJ and he is constantly telling me about the UPenn Med students that constantly look down on him. As long as DPMs remain good at what they do they do not have to worry about anything.

[Dr_Feelgood]

Originally Posted by peapod

In my opinion, this bill does not attack podiatrists. I think it just bruises the egos of a couple of students/podiatrists bc we are not included. But think about it, what podiatrist ever puts an MD after his name when he/she is a DPM. They do not have to do so because majority of the footcare done in the US is by podiatrists. When we advertise that we are foot doctors or podiatric physicians we are not misleading the public bc we are those titles. Podiatrists are doctors and are considered legally a physician so I believe this bill just attacks anyone who claims they are an MD, DO or DDS. We do what we do bc we love it and probably for some because of the huge incomes podiatrists make. I think it would be huge for APMA to adopt this bill bc, honestly, it would make the US safer bc i sure as hell dont want to send my kids to a person who claims he is a MD when he is not. Podiatry is a small profession and is not well known and i doubt there are many more people who claim they are MDs than DPMs or even DOs, DDSs.

The truth is no matter what you do someone is going to try to bring you down. I personally know someone from UMDNJ and he is constantly telling me about the UPenn Med students that constantly look down on him. As long as DPMs remain good at what they do they do not have to worry about anything.

As I have stated before, I do not disagree that a DPM should not present him/herself as a MD or DO. My thought is does this happen often? I would guess no. Does anyone claim to be a MD and they are not? Again, I would guess no. We have laws against this already, it is called fraud. This bill states that you are not able to claim that you are as qualified as an MD or DO. I don't know about you but in the area of the foot and ankle we are better qualified.

I could care less about egos; I care about being able to tell people I know my sh*t and I certainly don't want a F&A Orthopod to have another weapon to eliminate the local podiatric competition. This is not a personal attack, but I think your view is short sighted and naive. Many unnecessary laws are used against business everyday. Heck, you can't fly into the Dallas airport unless you get federal permission b/c American Airlines pushed a similar bill throw congress. This gave them almost exclusive rights and is being fought tooth and nail still today.

[Flobber]

Originally Posted by Dr_Feelgood

I hope hygienist get more training and are allowed to work w/o dentist. The same thing has happened to medicine with PAs and NPs.

Why would you hope for that? You are revealing yourself to be quite bitter at MD's and DDS's alike.

[AZPOD Rocks]

Originally Posted by peapod

In my opinion, this bill does not attack podiatrists. I think it just bruises the egos of a couple of students/podiatrists bc we are not included. But think about it, what podiatrist ever puts an MD after his name when he/she is a DPM. They do not have to do so because majority of the footcare done in the US is by podiatrists. When we advertise that we are foot doctors or podiatric physicians we are not misleading the public bc we are those titles. Podiatrists are doctors and are considered legally a physician so I believe this bill just attacks anyone who claims they are an MD, DO or DDS. We do what we do bc we love it and probably for some because of the huge incomes podiatrists make. I think it would be huge for APMA to adopt this bill bc, honestly, it would make the US safer bc i sure as hell dont want to send my kids to a person who claims he is a MD when he is not. Podiatry is a small profession and is not well known and i doubt there are many more people who claim they are MDs than DPMs or even DOs, DDSs.

The truth is no matter what you do someone is going to try to bring you down. I personally know someone from UMDNJ and he is constantly telling me about the UPenn Med students that constantly look down on him. As long as DPMs remain good at what they do they do not have to worry about anything.

Peapod,

As I stated in a previous post, podiatrists are not being attacked in this legislation other than the mention that no one can claim their education is equal to an MD/DO/DDS/DMD. From what I hear around here, there are some schools which do not give you an equivalent education, so this statement would be true. However, for the better schools to not be able to say this about their students is ridiculous. AZPOD students sit in the exact classroom as DO students, so this is ridiculous. I believe DMUers have a similar relationship with their osteopathic compadres.

Of note, a sizeable amount of money, according to jefguth's post, was contributed by the American Association of Orthopaedic Surgeons. Why would they contribute money? We know why dentists would (dental hygienists). We know why ophthalmologists would (optometrists). But why orthopedic surgeons? If true, this is alarming to me because I can't think of who they would want to attack with this legislation other than podiatrists.

AZPOD Rocks

[Podman]

Originally Posted by AZPOD Rocks

Peapod,

As I stated in a previous post, podiatrists are not being attacked in this legislation other than the mention that no one can claim their education is equal to an MD/DO/DDS/DMD. From what I hear around here, there are some schools which do not give you an equivalent education, so this statement would be true. However, for the better schools to not be able to say this about their students is ridiculous. AZPOD students sit in the exact classroom as DO students, so this is ridiculous. I believe DMUers have a similar relationship with their osteopathic compadres.

Of note, a sizeable amount of money, according to jefguth's post, was contributed by the American Association of Orthopaedic Surgeons. Why would they contribute money? We know why dentists would (dental hygienists). We know why ophthalmologists would (optometrists). But why orthopedic surgeons? If true, this is alarming to me because I can't think of who they would want to attack with this legislation other than podiatrists.

AZPOD Rocks

could it also be true that orthopoedic surgeons have a problem with chiropractors doing spinal manipulations?

[Dr_Feelgood]

Originally Posted by Flobber

Why would you hope for that? You are revealing yourself to be quite bitter at MD's and DDS's alike.

No my friends wife is a hygienist and I know how much work she does and how much money she gets. At least in this case, the dentist sees about 50-70 patients a day and makes 80% of the money. If this change was made this they could make a similar position to PAs and that person could work outside of the DDS system. ADA is well connected and this will never happen.

[Flobber]

Originally Posted by Dr_Feelgood

No my friends wife is a hygienist and I know how much work she does and how much money she gets. At least in this case, the dentist sees about 50-70 patients a day and makes 80% of the money. If this change was made this they could make a similar position to PAs and that person could work outside of the DDS system. ADA is well connected and this will never happen.

Did she undergo 7 years of rigorous schooling and take on loads of debt? Probably not. More likely she went through 2 years of undergraduate level training... why does this make someone eligible to operate a solo/independent practice? I don't understand why the prevailing thought these days is that anyone who works in healthcare deserves to be an independent practitioner. Just as you take pride in the degree that you are earning and want to have the priveleges associated with it, MD's and DDS's feel the same way. I don't find it fair that I should put in 11-13 years of work post high-school to surrender the priveleges I earned to a PA, who worked substantially less to get their degree. There should be no back door to obtaining a license to practice medicine independently, be it PA, NP, DC, or whatever else.

[MAC]

Originally Posted by Dr_Feelgood

No my friends wife is a hygienist and I know how much work she does and how much money she gets. At least in this case, the dentist sees about 50-70 patients a day and makes 80% of the money. If this change was made this they could make a similar position to PAs and that person could work outside of the DDS system. ADA is well connected and this will never happen.

Would you agree to give the same rights to podiatry assistants. I have heard that there are podiatry assistants out there.

[Dr_Feelgood]

Originally Posted by MAC

Would you agree to give the same rights to podiatry assistants. I have heard that there are podiatry assistants out there.

Yes and there are. PAs can work in podiatry clinics. I would welcome the help b/c you can pass your nail care to them and therefore, do more diabetic foot screening and lower limb trauma.

[Dr_Feelgood]

Originally Posted by Flobber

Did she undergo 7 years of rigorous schooling and take on loads of debt? Probably not. More likely she went through 2 years of undergraduate level training... why does this make someone eligible to operate a solo/independent practice? I don't understand why the prevailing thought these days is that anyone who works in healthcare deserves to be an independent practitioner. Just as you take pride in the degree that you are earning and want to have the priveleges associated with it, MD's and DDS's feel the same way. I don't find it fair that I should put in 11-13 years of work post high-school to surrender the priveleges I earned to a PA, who worked substantially less to get their degree. There should be no back door to obtaining a license to practice medicine independently, be it PA, NP, DC, or whatever else.

7 years??? Are you counting undergrad? There is not a dental school in the world that takes 7 years. Also, my statement was that they could increase their training similar to the PA, therefore, they would have a masters and yes they would undertake massive debt in the 5 to 6 years it takes to finish the program. If this amazing training is so important for teeth cleaning then why does the dentist look in your mouth for 5 minutes?

And I don't think that they are back door degrees. PAs fill the whole that is left by a shortage of physicians. My wife had a choice of seeing a LPN/PA or wait 2 months to see a doctor b/c her OB-GYN is that busy. I think you are being silly to put down your follow practitioners.

My question is if they operate separate who is this an insult to the DDS degree? They don't do the work that the hygienist does now. It would be like a physician getting made that a nursery does at home health care b/c they want the money. I think this is what your argument boils down to is money, not what is best for patients or health care.

[Flobber]

Originally Posted by Dr_Feelgood

7 years??? Are you counting undergrad? There is not a dental school in the world that takes 7 years. Also, my statement was that they could increase their training similar to the PA, therefore, they would have a masters and yes they would undertake massive debt in the 5 to 6 years it takes to finish the program. If this amazing training is so important for teeth cleaning then why does the dentist look in your mouth for 5 minutes?

And I don't think that they are back door degrees. PAs fill the whole that is left by a shortage of physicians. My wife had a choice of seeing a LPN/PA or wait 2 months to see a doctor b/c her OB-GYN is that busy. I think you are being silly to put down your follow practitioners.

My question is if they operate separate who is this an insult to the DDS degree? They don't do the work that the hygienist does now. It would be like a physician getting made that a nursery does at home health care b/c they want the money. I think this is what your argument boils down to is money, not what is best for patients or health care.

Yes, I was counting undergraduate, as it is a prerequisite to dental school. An undergraduate degree is not required to be a dental hygienist. I'm not "putting down my fellow practitioners", I am simply stating that the autonomy that physicians and dentists enjoy is a product of the very long and extensive training that they have to undergo. Dental hygienists should not function independently because they are not trained to inspect the oral cavity for malignancies or other disorders, read X-rays, etc. These are the most important aspects of a dental visit and they would be completely absent without a DDS. So, even though they only spend a few moments with each patient, those few minutes are crucial.

Again, people should not expect to receive the same reimbursements as doctors and dentists when they haven't been subjected to the same rigors and CANNOT provide the same care. A lot of people don't like to hear this and feel that they know just as much as doctors/dentists, but that is simply untrue.

[jefguth]

I completely agree with Flobber's statement above; until dental hygenists, podiatry assistants, opticians, what have you, have the training, experience, and tools at hand to diagnose problems when they present in patients, these professionals (which we would probably categorize as technians) should not be practicing independently of the established providers. Allowing them to do so exposes potential patients to too much risk of harm when problems go undiagnosed.

[AZPOD Rocks]

Originally Posted by Podman

could it also be true that orthopoedic surgeons have a problem with chiropractors doing spinal manipulations?

Great point!!!

[dawg44]

Originally Posted by Podman

could it also be true that orthopoedic surgeons have a problem with chiropractors doing spinal manipulations?

Nope, we could give a crap about that.

[oncogene]

Originally Posted by dawg44

Nope, we could give a crap about that.

Dawg,

What is the problem? What is the ortho community trying to accomplish? Do you have a beef with how podiatrist practice ? If so then why?

[Dr_Feelgood]

Originally Posted by oncogene

Dawg,

What is the problem? What is the ortho community trying to accomplish? Do you have a beef with how podiatrist practice ? If so then why?

I don't think that ortho is attacking the pod community. I don't think that this is not a direct attack on any medical field. I see this as an AMA and ADA bill that ensures they keep the power in the future.

[IlizaRob]

Originally Posted by Dr_Feelgood

I don't think that ortho is attacking the pod community. I don't think that this is not a direct attack on any medical field. I see this as an AMA and ADA bill that ensures they keep the power in the future.

I will admit that I am not as familiar with the specifics of this bill as some of you, but really, how much is this law really going to affect our practice? From what I gathered it is a power-struggle law that says medical professionals other than MD/DO/DDS cannot say they have equal training to those three degrees. Although I think the bill is pretty lame, I dont see myself advertising that I am trained equal to an MD in the lower extremity anyway. Nobody does it that way. What am I missing? Feelgood? I know you are the fountain of all trivial knowledge. Maybe you can enlighten me tomorrow during lab.

[dawg44]

Originally Posted by oncogene

Dawg,

What is the problem? What is the ortho community trying to accomplish? Do you have a beef with how podiatrist practice ? If so then why?

I personally don't have a problem. And I agree I haven't seen any orthopedic societies names on any of this. Inflammatory comments on how much better your training is or how you won't take any B.S. from any orthopod is just gonna hurt your cause. Some people on this website crow about how they train in real ortho programs or can get an orthopedic fellowship with a big name foot and ankle guy. Well this much is true, you will never hear an orthopod crow about being trained by a podiatrist, ever. Its just not going to happen, 99% of orthopedic surgeons are going to prefer a orthopedic foot and ankle surgeon along with most of the other MDs and DOs because that's what we know. We sat in classes together and went through residencies together so the familiarity is there. You can't change that. But, if your collegial, do the good job that you say your training will allow you to do and don't be a dick, there should be plenty of patients for everybody and we all will have a merry christmas. I will be in a community with a few podiatrists. I'd rather have a collegial environment, but if they cop an attitude and want a war, that I can give them. I really enjoy foot and ankle thats why I'm doing a fellowship, but I like general fracture work and sports medicine as well. I could have practiced 95% foot and ankle but that's not what I want. Long story short I don't have a problem, yet.

[Dr_Feelgood]

Originally Posted by dawg44

Inflammatory comments on how much better your training is or how you won't take any B.S. from any orthopod is just gonna hurt your cause.

I said nothing that what was printed in The Journal of Bone and Joint Surgery. I think that orthopods have excellent training, but in the area of the foot and ankle, podiatrist have dedicated their lives. I'm not trying to start a holy war but orthopods do learn from pods. Just as any health care field learns from each other, a positive relationship is makes work a happy place.