A DDS does triage, but a DPM can't do anything during wartime!!!!

[mrfeet]

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As I continue my series on the injustices of the military against DPM's, I recently found out that the military does not allow DPM's to serve as wartime physicians. MD's and DO's can serve as generalists. Then the question becomes, "what can dentists and veterinarians do?" After all, they are given scholarships by the military to go to school.

Well the answer boys and girls is: During wartime, veterinarians are in charge of sanitation and dentists are in charge of triage. Does anyone see a problem here? You mean to tell me that the greatest military that the planet has ever known is going to put a freekin' dentist in charge of triage!!!

I mean, what experience do these guys have in trauma or emergency medicine. I will admit that some oral surgeons deal with traumas, but most of them don't know anything about trauma or especially triage. They don't even do trauma or EM rotations in dental school, which ofcourse DPM's do much of in school and in residency.

The bottom line here is that we are being treated as second-class citizens. I mean what's next, Chiropractors in charge of orthopaedic surgery??? We must fight for our rights!!! I agree that most people on here have no desire to serve in the military, but we should all be disgusted by the fact that our nation only pays a Colonel who has been in the Army for 20+ years and who is a podiatrist a salary of $75,000 dollars a year, while an MD or DO as a captain starts at $100,000 their first year!

And please, if you're an MD or DO, don't post on here that we can't do anything during wartime. If a dentist can triage, we certainly can do something!

😕 😕 😕

 

[jonwill]

Podiatric medicine has changed a great deal over the last 10 years. As with anything else run by the government, the military will take a while to catch up. Don't take it personally. Politics rarely make sense!

 

[ProZackMI]

As I continue my series on the injustices of the military against DPM's, I recently found out that the military does not allow DPM's to serve as wartime physicians. MD's and DO's can serve as generalists. Then the question becomes, "what can dentists and veterinarians do?" After all, they are given scholarships by the military to go to school.

Well the answer boys and girls is: During wartime, veterinarians are in charge of sanitation and dentists are in charge of triage. Does anyone see a problem here? You mean to tell me that the greatest military that the planet has ever known is going to put a freekin' dentist in charge of triage!!!

I mean, what experience do these guys have in trauma or emergency medicine. I will admit that some oral surgeons deal with traumas, but most of them don't know anything about trauma or especially triage. They don't even do trauma or EM rotations in dental school, which ofcourse DPM's do much of in school and in residency.

The bottom line here is that we are being treated as second-class citizens. I mean what's next, Chiropractors in charge of orthopaedic surgery??? We must fight for our rights!!! I agree that most people on here have no desire to serve in the military, but we should all be disgusted by the fact that our nation only pays a Colonel who has been in the Army for 20+ years and who is a podiatrist a salary of $75,000 dollars a year, while an MD or DO as a captain starts at $100,000 their first year!

And please, if you're an MD or DO, don't post on here that we can't do anything during wartime. If a dentist can triage, we certainly can do something!

😕 😕 😕

Where did you get this from? It sounds completely dated to me. Why would a dentist being doing triage, and what the hell business does a vet have doing anything related to human medicine?

But...none of that is relevant. The military is the military. Were you expecting logic? Christ, it's the government. You also talk about fairness. I have a friend who is a veterinarian for the State of Michigan Department of Agriculture who makes $45,000 a year. A social worker with Social Services, with a BSW degree, makes $50,000. An optometrist for the State of Illinois makes $60,000 a year, whereas a school teacher with a master's makes 70K in some school districts. I won't even comment about how much some bank presidents and other business types make with much less education.

Life isn't fair.

 

[IlizaRob]

Podiatric medicine has changed a great deal over the last 10 years. As with anything else run by the government, the military will take a while to catch up. Don't take it personally. Politics rarely make sense!

I agree with JonWill. Perhaps 20 years ago the training of a pod was not sufficient enough to be in these positions. The changes in podiatric training is fairly recent relatively speaking. Unfortunately changes in politics takes longer. Rather than getting upset, take the time to educate and things will continue to change as they have been.

 

[doclm]

I agree with JonWill. Perhaps 20 years ago the training of a pod was not sufficient enough to be in these positions. The changes in podiatric training is fairly recent relatively speaking. Unfortunately changes in politics takes longer. Rather than getting upset, take the time to educate and things will continue to change as they have been.

I have heard that the lobbying from APMA for DPM rights has been weak in the past. However, are they catching up like the AMA or even AOA?

I believe that once DPM's are seen as equals with MD/DO's, that a lot of politics may be able to change.

 

[efs]

As I continue my series on the injustices of the military against DPM's, I recently found out that the military does not allow DPM's to serve as wartime physicians. MD's and DO's can serve as generalists. Then the question becomes, "what can dentists and veterinarians do?" After all, they are given scholarships by the military to go to school.

Well the answer boys and girls is: During wartime, veterinarians are in charge of sanitation and dentists are in charge of triage. Does anyone see a problem here? You mean to tell me that the greatest military that the planet has ever known is going to put a freekin' dentist in charge of triage!!!

I mean, what experience do these guys have in trauma or emergency medicine. I will admit that some oral surgeons deal with traumas, but most of them don't know anything about trauma or especially triage. They don't even do trauma or EM rotations in dental school, which ofcourse DPM's do much of in school and in residency.

The bottom line here is that we are being treated as second-class citizens. I mean what's next, Chiropractors in charge of orthopaedic surgery??? We must fight for our rights!!! I agree that most people on here have no desire to serve in the military, but we should all be disgusted by the fact that our nation only pays a Colonel who has been in the Army for 20+ years and who is a podiatrist a salary of $75,000 dollars a year, while an MD or DO as a captain starts at $100,000 their first year!

And please, if you're an MD or DO, don't post on here that we can't do anything during wartime. If a dentist can triage, we certainly can do something!

😕 😕 😕

Your information is incomplete and not accurate.

Cool off a little. Indignant posts on a website are not going to help anything. There are other ways of working on this issue to push for changes. But before you can do that you need to understand the issues.

Believe me, these issues are well known and are discussed by and with people who can make changes. There is also not likely to be any significant changes anytime soon.

 

[doclm]

Your information is incomplete and not accurate.

Cool off a little. Indignant posts on a website are not going to help anything. There are other ways of working on this issue to push for changes. But before you can do that you need to understand the issues.

Believe me, these issues are well known and are discussed by and with people who can make changes. There is also not likely to be any significant changes anytime soon.

What issues are well known by the people who can make changes? 😕

 

[mrfeet]

Your information is incomplete and not accurate.

Cool off a little. Indignant posts on a website are not going to help anything. There are other ways of working on this issue to push for changes. But before you can do that you need to understand the issues.

Believe me, these issues are well known and are discussed by and with people who can make changes. There is also not likely to be any significant changes anytime soon.

Actually, my information is quite accurate. I have spoken with several people in the military, including my father who confirm that vets are indeed in charge of sanitation during wartime and yes, dentists are in charge of triage. I agree, it sounds ludicrous, and that's why I posted this information on the forum. I wanted to point out just how crazy is our military's health system.

You guys act like I'm raging mad or something. I'm just trying to make a point. I'm sure that when the D.O.'s were fighting for their rights 30 years ago, they didn't just sit back and sing Kumbaya and act like everything was honky dorey. No, they took a stand.

Its real easy to say that everything will be alright and that things will work themselves out when you're in a profession that already has. Oh yeah, and as far as the comment for "life isn't fair" goes, well, that's commonly used by people on the other side of the fence. Try being deprived of basic rights and see if you still use the same worn out cliche!

Now I'm mad!

 

[efs]

Actually, my information is quite accurate. I have spoken with several people in the military, including my father who confirm that vets are indeed in charge of sanitation during wartime and yes, dentists are in charge of triage. I agree, it sounds ludicrous, and that's why I posted this information on the forum. I wanted to point out just how crazy is our military's health system.

You guys act like I'm raging mad or something. I'm just trying to make a point. I'm sure that when the D.O.'s were fighting for their rights 30 years ago, they didn't just sit back and sing Kumbaya and act like everything was honky dorey. No, they took a stand.

Its real easy to say that everything will be alright and that things will work themselves out when you're in a profession that already has. Oh yeah, and as far as the comment for "life isn't fair" goes, well, that's commonly used by people on the other side of the fence. Try being deprived of basic rights and see if you still use the same worn out cliche!

Now I'm mad!

I am a DPM, and I am in the Army.

Since we got rid of the horse drawn artillery pieces, the vets have shifted their focus. Food sanitation is a big part of what they do for the military. In fact, they do the similar work out of the military. Lots of vets work for the USDA.

Yes, the DDSs are tasked with Triage in the CSH scenario. In reality it is often the ER nurses doing this work though. In a mass casualty situation the DDS doesn't have anything more pressing to do, so this is why they have this task. But it is not written in stone that they have to do it or that they alone can do it.

These things are not ludicrous. They have actually been well thought out. The people I work with are not sitting around singing Kumbaya. The Podiatry Consultant to the Surgeon General is aware of the parity issues with regard to loan repayment, not being part of HPSP, variable special pay, potential wartiem missions, etc. Working through these issues and talking with the people that can make changes is something that he does on a regular basis. This is a more effective way of trying to change things than posting a rant on a student forum.

I just did a quick run through the numbers on the pay chart. A DPM Colonel is making a bit over $120000/year before factoring in all the benefits. The MD Captain as an intern is closer to $50000/year.

As an aside, I think it was mentioned on another post that the low civilian salaries (75000/yr) is why the Army is able to keep up the numbers of podiatrists that it needs without providing any additional pays. This is also untrue. The residency program is how and why the Army has been able to keep it's numbers up. I don't think it is going to keep up much longer though. Recent graduates have had a 3 year service obligation following graduation. Current residents will have a 4 year obligation (since the program changed from a PSR-24 to PM&S-36.) Essentially all of the recent graduates (those past their obligations) are out or making plans. Job offers on the civilian side are much better, but they are headed to the job market with excelent training and experience.

 

[efs]

What issues are well known by the people who can make changes? 😕

The ones that students will always jump on are the fact that DPMs are not included in the HPSP programs. (Military paying for school in return for service). There are also no student loan repayment programs available (at least in the Army). The Navy does offer some student loan repayment, but it's not going to be available to someone just getting started.

The Army has a number of programs used to boost pay for Medical officers. The Army uses these to maintain the ranks and numbers that they need. So, if radiologists are a shortage, their Incentive Special Pay goes up. If there are enough FPs their ISP goes down. etc. These pays are a way to bring the compensation closer to the level in the civilian world. It's still not the same, but there is more to it than just pay. In any case, podiatrists are left out of this. There is a Board Certification pay available, but it doesn't amount to much.

There are other areas of disparity, but for the most part those have been dealt with. There are some administrative duties that the MDs and DOs are just left of the rosters completely. (Difficult to do with clinic schedules and so on.) Being in the Medical Service Corps rather than Medical Corps, DPMs are not automatically excluded from some of these things. We can be, but sometimes it means going through a bit more hasssle to get it taken care of. This type of thing is just typical for the military (or any big bureaucracy), and not intentionally singling out DPMs. If you talk to others (Psychologists, Optomotrists, etc) you can find many similar issues.

There are certainly other issues, but these may be the main ones that students might key in on.

 

[diabeticfootdr]

I am a DPM, and I am in the Army.

Since we got rid of the horse drawn artillery pieces, the vets have shifted their focus. Food sanitation is a big part of what they do for the military. In fact, they do the similar work out of the military. Lots of vets work for the USDA.

Yes, the DDSs are tasked with Triage in the CSH scenario. In reality it is often the ER nurses doing this work though. In a mass casualty situation the DDS doesn't have anything more pressing to do, so this is why they have this task. But it is not written in stone that they have to do it or that they alone can do it.

These things are not ludicrous. They have actually been well thought out. The people I work with are not sitting around singing Kumbaya. The Podiatry Consultant to the Surgeon General is aware of the parity issues with regard to loan repayment, not being part of HPSP, variable special pay, potential wartiem missions, etc. Working through these issues and talking with the people that can make changes is something that he does on a regular basis. This is a more effective way of trying to change things than posting a rant on a student forum.

I just did a quick run through the numbers on the pay chart. A DPM Colonel is making a bit over $120000/year before factoring in all the benefits. The MD Captain as an intern is closer to $50000/year.

As an aside, I think it was mentioned on another post that the low civilian salaries (75000/yr) is why the Army is able to keep up the numbers of podiatrists that it needs without providing any additional pays. This is also untrue. The residency program is how and why the Army has been able to keep it's numbers up. I don't think it is going to keep up much longer though. Recent graduates have had a 3 year service obligation following graduation. Current residents will have a 4 year obligation (since the program changed from a PSR-24 to PM&S-36.) Essentially all of the recent graduates (those past their obligations) are out or making plans. Job offers on the civilian side are much better, but they are headed to the job market with excelent training and experience.

Hi Dr. EFS,

Nice to see you post as always. I'm curious, does a DPM have a "wartime mission"? What would you do during wartime as a DPM foot/ankle surgeon? Are you at risk of being transferred to a war zone?

LCR

 

[WildcatDMD]

Do you think dentists only study or understand teeth? Much like podiatrists, we study much of what medical (MD and DO) students study in addition to our specific area of expertise. To my knowledge all dentists that enter any of the military scholarship programs are required to do at least a one year GPR (general practice residency), which is a hospital based residency. These residents will spend a significant amount of their time in general medicine, emergency medicine, and anesthesiology (I believe all now give ACLS and level III sedation certificates). I see no reason these dentists could not handle triage in times of war. I believe it is true that only dentists, MDs and DOs have full prescription rights in all 50 states. Correct me if I am wrong. Also, dental disease is a very real problem, even in times of war.

Also, veterinary science is very involved in microbiology and microbiological research, I don't find it surprising they would be called upon for sanitation direction.

As for the point that podiatrists are not given equal standing in the eyes of the government yet, keep fighting for your rights and improving your profession as it appears to have been the case over the past couple decades.

 

[Dr_Feelgood]

Do you think dentists only study or understand teeth? Much like podiatrists, we study much of what medical (MD and DO) students study in addition to our specific area of expertise. To my knowledge all dentists that enter any of the military scholarship programs are required to do at least a one year GPR (general practice residency), which is a hospital based residency. These residents will spend a significant amount of their time in general medicine, emergency medicine, and anesthesiology (I believe all now give ACLS and level III sedation certificates). I see no reason these dentists could not handle triage in times of war. I believe it is true that only dentists, MDs and DOs have full prescription rights in all 50 states. Correct me if I am wrong. Also, dental disease is a very real problem, even in times of war.

Also, veterinary science is very involved in microbiology and microbiological research, I don't find it surprising they would be called upon for sanitation direction.

As for the point that podiatrists are not given equal standing in the eyes of the government yet, keep fighting for your rights and improving your profession as it appears to have been the case over the past couple decades.

I think that at time of war everyone that is skilled in medicine should be used. Also, I don't think that people were trying to insult dentists; I think they were puzzled. Personally, I did not know that dentists do a residency in general medicine. I was puzzled that they would not use a medical field that is trained in trauma (many of the podiatric residencies are at level 1 trauma centers).

That being said, I know that there is a major need for dentists in the armed forces just like they need podiatrists. Thanks for your support and I hope PPAC keeps fighting the fight for pods everywhere. Frankly, podiatry would be wise to follow the foot steps of the dental industry. No other group has done better to promote their industry.

 

[WildcatDMD]

I think that at time of war everyone that is skilled in medicine should be used. Also, I don't think that people were trying to insult dentists; I think they were puzzled. Personally, I did not know that dentists do a residency in general medicine. I was puzzled that they would not use a medical field that is trained in trauma (many of the podiatric residencies are at level 1 trauma centers).

That being said, I know that there is a major need for dentists in the armed forces just like they need podiatrists. Thanks for your support and I hope PPAC keeps fighting the fight for pods everywhere. Frankly, podiatry would be wise to follow the foot steps of the dental industry. No other group has done better to promote their industry.

Just to clarify, I am certainly not saying that dentists do a residency in general medicine, but that general medicine is a part of the hospital based GPR programs.

Sorry to jump over to your forum again, I'm just exceptional at procrastinating. 👍

 

[Dr_Feelgood]

Just to clarify, I am certainly not saying that dentists do a residency in general medicine, but that general medicine is a part of the hospital based GPR programs.

Sorry to jump over to your forum again, I'm just exceptional at procrastinating. 👍

Excuse my ignorance, what is the difference? What is a GPR? Does it include a trauma rotation?

 

[WildcatDMD]

Excuse my ignorance, what is the difference? What is a GPR? Does it include a trauma rotation?

A GPR is a General Practice Residency in dentistry. It is a hospital based program giving advanced training in dentistry, especially in the treatment of medically compromised patients. These programs are obviously centered on dentistry, but also give some training in medical diagnosis and management, oral-facial trauma, internal medicine, anesthesiology, etc. All graduates on military scholarships must complete a GPR through their serivce. I assume those residencies are similar.

I just randomly (google for "general practice residency") looked up some programs here for reference, they do vary a bit, but have most of the same general goals:

University of Michigan GPR
-a little more than halfway down this page are the medical related experiences of this GPR.

University of Washington GPR

Utah

 

[Dr_Feelgood]

Thanks for the knowledge brother.