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newpodgrad

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Hey guys

While looking for jobs , I inquired with a few local hospitals about how to go about getting privileges.

Several of them sent me info and I wanted to highlight a board concern.

Not sure how to really take it, but here’s a excerpt from one of the docs re: board status.

“Board Certification Requirement means certification from one of the following boards: the American Board of Medical Specialties, the American Osteopathic Association, the American Board of Foot and Ankle Surgery, or those Boards which may be approved by the Executive Committee to satisfy this Requirement”

As a disclaimer, I’m not a HUGE surgery pod. I enjoyed it , and did it in residency because, well, that’s what we had to do. And I’m fine with my forefoot procedures. I believe I’ve done well with them at my current level. I don’t care to do TARS, scopes mid foot fusions etc. I have no problem referring them out. I took the ABFAS qualifying tests etc, because again, it’s encouraged in residency and passed them.

Looking at this doc, it almost seems like this board required if you wanted to be on staff. The little statement at the end regarding “or those boards” seems like it might open the door for ABPM with some petitioning or something.

What do you guys make of this? I have heard from others that ABPM will get involved with issues regarding privileges etc. Is there more to this picture than meets the eye?

Thanks in advance for everyone’s take
 
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Dr.Ron said:
The whole concept of recert is a money grab only. Do you get your CMEs to satisfy your state board? Yes. Do you have privileges and perform surgery at a licensed facility? Yes. Recert. Boom. How exactly does a written exam for a physical skill tell the public anything at all?
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Well now I'm sad...
 
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newpodgrad said:
Looking at this doc, it almost seems like this board required if you wanted to be on staff. The little statement at the end regarding “or those boards” seems like it might open the door for ABPM with some petitioning or something.

What do you guys make of this? I have heard from others that ABPM will get involved with issues regarding privileges etc. Is there more to this picture than meets the eye?
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Say "Dr. Lee Rogers" three times and @diabeticfootdr will appear and give you advice about getting credentialed at the hospital with ABPM. Or maybe send him a PM.
 
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newpodgrad said:
What do you guys make of this? I have heard from others that ABPM will get involved with issues regarding privileges etc. Is there more to this picture than meets the eye?
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Thanks @Boba Foot

Go to www.podiatryprivileges.com and click on the "get help" button. You can submit a request for help there. Upload your hospital medical staff bylaws and delineation of privileges (DOP) form.

We get involved in these issues and we've resolved almost 100% of them. Hospitals must follow federal and state laws, CMS conditions of participation, and standards of credentialing organizations (The Joint Commission).

Just with the couple paragraphs you wrote, I can already tell you there is a violation of TJC standards. They are prohibited from engaging in disparate treatment of physician professions.

If they allow an MD to be certified by any ABMS board and a DO to be certified by any AOA board, they must allow podiatrists be certified by any CPME board. We often find multiple violations and usually these things get resolved quickly when our general counsel communicates with the hospital attorney.
 
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diabeticfootdr said:
Thanks @Boba Foot

Go to www.podiatryprivileges.com and click on the "get help" button. You can submit a request for help there. Upload your hospital medical staff bylaws and delineation of privileges (DOP) form.

We get involved in these issues and we've resolved almost 100% of them. Hospitals must follow federal and state laws, CMS conditions of participation, and standards of credentialing organizations (The Joint Commission).

Just with the couple paragraphs you wrote, I can already tell you there is a violation of TJC standards. They are prohibited from engaging in disparate treatment of physician professions.

If they allow an MD to be certified by any ABMS board and a DO to be certified by any AOA board, they must allow podiatrists be certified by any CPME board. We often find multiple violations and usually these things get resolved quickly when our general counsel communicates with the hospital attorney.
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Any ideas when ABPM results will be out? We're coming into the 10th week and privileges are waiting on it.
 
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Masttt91 said:
Any ideas when ABPM results will be out? We're coming into the 10th week and privileges are waiting on it.
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The BOD just approved the cut score from the psychometrists. It’s was 86% pass rate. Everyone will get their individual results this week.
 
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Masttt91 said:
Any ideas when ABPM results will be out? ...
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I will tell you the results: if you took it, you passed. 🙂

You should be able to get any privi with BQ for ABFAS or even ABPM. Insurances requiring BC are usually the reasoning ABPM can be useful in early practice.
 
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diabeticfootdr said:
The BOD just approved the cut score from the psychometrists. It’s was 86% pass rate. Everyone will get their individual results this week.
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Thanks 😅 Dumb question but what letters do we get to use behind our names now? I know some people are still using FACFAOM but I'm not sure if that applies to the new guys too.
 
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MusicManMike said:
If you are BC: DABPM. If you join ACPM, you can use FACPM.
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You can also be a Fellow of the American Society of Podiatric Surgeons FASPS.

ABPM is the only certification that qualifies for fellowship in either of the APMA clinical affiliates: ACPM or ASPS.
 
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Who's ready for a REALLY angry post? Because I found out what cases I need to submit for ABFAS case review yesterday and I am FURIOUS.

Background: I'm 5 years out, this is my second time going through the case review process. I started out in private practice the same way a lot of us do, I was not terribly busy so I had free time. So I did what I thought a lot of good associates were supposed to do, I went out to ERs and hospital networking events and hustled and marketed myself. Eventually I was doing some fairly diverse cases. Some amps, some skin graft subs, some forefoot electives, some trauma. Nothing to brag about, but it was a mile wide and an inch deep. I figured if my name was showing up on the OR schedule, I could build a reputation for myself. For better or for worse, it worked. Plus I had the time in my schedule so why not.

As time went on, I got busier in clinic, my student loans entered repayment, and I came to realize it's bad for business to cancel an afternoon of clinic just for one ORIF. So I've become more narrowly focused with what I book, and I refer trauma out because it doesn't fit with my business model. I've done plenty of forefoot elective surgeries and have many many good outcomes. Again, nothing to brag about, I'm sure most of you reading this can say the same.

So I submit my cases and what do they do? They draft a lisfranc orif I did in 2018. The result was OK. They did fine. But I know I'm losing points on it. They are going to judge me for the surgeon I am today based on the work I did 5 years ago. I think that's bull💩

To an extent, I understand why they would want to do this. They want to evaluate your competence across ALL types of surgery that you've done. But a candidate could easily get their volume and diversity numbers without even attempting to do trauma. You could do austins and amps with the occasional bull💩 lapiplasty in the mix and theoretically pass just by going after the low-hanging fruit. But if you attempt to do anything harder you damn well better get it perfect because it will forever haunt you if you don't.

I admit there is a good rationale for case review. But we've all gone to lectures where they say, "If you don't have complications, you're either lying or not operating enough." So I don't understand the nitpickiness of the case review process. Yes, it's just one case, but all these imperfections add up to a failing score. When you dig into my cases from 2018, it makes the appearance that you are actively trying to find reasons to fail me. That's why ABFAS is a truly 💩-ty board. How bad is ABFAS? It's the second-worst certifying board in podiatry.
 
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Being board qualified by ABFAS initially and getting boarded by ABPM eventually is really all that is needed to get and keep most PP jobs and maybe even have a chance at some organizational jobs with connections, luck or being extremely open geographically.

If one wants an organizational job ABFAS, especially RRA is an edge. ABPM with a good limb salvage fellowship might be enough for some hospital and academic jobs also.

Arguing about the two boards is more of a reflection of the ridiculous over saturation in our profession. Having two boards for our profession is currently a good thing, but what will a @$&# measuring contest really accomplish? The organizational jobs need someway to weed out the stacks of CVs they receive. They decide not us what they want with supply and demand not being in our favor and like it or not having ABFAS or having a fellowship and requiring one to get ABFAS within 5 years is not uncommon.

Now that our training is more equal than ever before in the past and most can become board certified by at least one legitimate board, If podiatry was in demand being a podiatrist and having an unrestricted state license should be enough.….but of course it is not, because of over saturation.
 
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Adam Smasher said:
Who's ready for a REALLY angry post? Because I found out what cases I need to submit for ABFAS case review yesterday and I am FURIOUS.

Background: I'm 5 years out, this is my second time going through the case review process. I started out in private practice the same way a lot of us do, I was not terribly busy so I had free time. So I did what I thought a lot of good associates were supposed to do, I went out to ERs and hospital networking events and hustled and marketed myself. Eventually I was doing some fairly diverse cases. Some amps, some skin graft subs, some forefoot electives, some trauma. Nothing to brag about, but it was a mile wide and an inch deep. I figured if my name was showing up on the OR schedule, I could build a reputation for myself. For better or for worse, it worked. Plus I had the time in my schedule so why not.

As time went on, I got busier in clinic, my student loans entered repayment, and I came to realize it's bad for business to cancel an afternoon of clinic just for one ORIF. So I've become more narrowly focused with what I book, and I refer trauma out because it doesn't fit with my business model. I've done plenty of forefoot elective surgeries and have many many good outcomes. Again, nothing to brag about, I'm sure most of you reading this can say the same.

So I submit my cases and what do they do? They draft a lisfranc orif I did in 2018. The result was OK. They did fine. But I know I'm losing points on it. They are going to judge me for the surgeon I am today based on the work I did 5 years ago. I think that's bull💩

To an extent, I understand why they would want to do this. They want to evaluate your competence across ALL types of surgery that you've done. But a candidate could easily get their volume and diversity numbers without even attempting to do trauma. You could do austins and amps with the occasional bull💩 lapiplasty in the mix and theoretically pass just by going after the low-hanging fruit. But if you attempt to do anything harder you damn well better get it perfect because it will forever haunt you if you don't.

I admit there is a good rationale for case review. But we've all gone to lectures where they say, "If you don't have complications, you're either lying or not operating enough." So I don't understand the nitpickiness of the case review process. Yes, it's just one case, but all these imperfections add up to a failing score. When you dig into my cases from 2018, it makes the appearance that you are actively trying to find reasons to fail me. That's why ABFAS is a truly 💩-ty board. How bad is ABFAS? It's the second-worst certifying board in podiatry.
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I had the same feelings as you last year. I submitted RRA and one of the cases they picked was lisfranc orif. When I logged it (4 years ago?) I didn’t realize lisfranc doesn’t even qualify for RRA case. Should’ve been an automatic fail on that case. They also picked a case or 2 I had to take back and revise. I felt doomed…. But somehow they passed me. Never saw the scoring so who knows? The process is a mystery
 
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I was also somewhat surprised by my case request list. I would estimate a breakdown of my surgical numbers as approx 60% amps, I&Ds, infection/limb salvage, 25% elective forefoot, 15% other. My practice has almost no trauma. The local ortho group takes all trauma from the ED, and my patient population tends to skew more toward elderly/limb salvage and not athletic/injury type. I think I've literally done 6 ORIF procedures since I've been out of residency. Yet out of the hundreds of procedures they could have selected from, they picked two ORIF procedures. My other cases include like 5 bunions, 2 tailor's, and 2 random midfoot procedures. Can they select soft tissue procedures and just don't because they want to evaluate the xrays? Where's my limb salvage cases?

It just feels like a selection that does not represent what I do best/most. In my mind I'm mentally prepared to fail the case review a few times.
 
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IMG_2169.jpg

You can ask them when they get back from their Board of Directors retreat in Costa Rica.
 
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shadesofgrey said:
I was also somewhat surprised by my case request list. I would estimate a breakdown of my surgical numbers as approx 60% amps, I&Ds, infection/limb salvage, 25% elective forefoot, 15% other. My practice has almost no trauma. ...
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They don't tend to pick soft tissue, amps, tendon stuff, plantar fasciotomy... how would you eval it?
Besides, the diabetic and wound/amp stuff are the most basic of cases, low skill, and "first year cases" at any residency.

Even stuff that's not easy like ankle scope/stab, TA tendon repair, Achilles rupture, FHL transfer... just too hard to eval anything... besides anchor placement?

...For ABFAS, you will get fusions, osteotomies, ORIF, implants (if you do that dumb stuff 🙂 ), etc... fixation cases are pulled almost exclusively. It has been that way for years, and with good reason. Ortho boards are the same... how can they judge the rotator cuffs or knee scope quality/proficiency? They will pick ORIF radius and TKAs and spinal fusions.
 
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dtrack22 said:
How does Gen surg and plastics and vascular and ENT and… evaluate their surgical cases without X-rays?
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To my understanding (just reading their board exam reqs in the past, talking to plastics docs), they all - the ones you mention above and also OB, maybe neurosurg and urology - have a written exam... pt1 or BQ. Then, they have to produce their case logs from hospitals before they can take pt2 or BC, where they just go through oral exam standard cases (not their own) with an exp surgeon. I'm not sure if vasc, CT, CR, onco, etc have that stuff since they are offshoot from general surg... might just be societies, not certs, like the ortho fellowships are.

Plastics has before/after photos the surgeons take in the office (most of them do that anyways after board cert just for med mal) and discussed/judged by senior docs... that's their pt2 or BC.

Ortho pt2 BC has their own logs and cases, obviously (that's what ABFAS tries to cue off).

...This is why it's so hilarious (and sad) that the podiatry CAQ "surgery" can be had without producing case logs, case review, oral exam... anything. The CAQ from the non-surgery board was a horrible idea from the start, but execution of it is pitiful also... at least fake a real-world competency eval of some kind. There is no MD procedure-based specialty that doesn't do candidate case review, oral cases exam, etc. I don't think ABPM had the ability to do that for a surgical exam, though. It was going to be an easier backup or "alternate" podiatry surgery route to appearing to have a surgical cert all along, but at least fake it somewhat convincingly based on what MDs do?
 
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Feli said:
They don't tend to pick soft tissue, amps, tendon stuff, plantar fasciotomy... how would you eval it?
Besides, the diabetic and wound/amp stuff are the most basic of cases, low skill, and "first year cases" at any residency.

Even stuff that's not easy like ankle scope/stab, TA tendon repair, Achilles rupture, FHL transfer... just too hard to eval anything... besides anchor placement?

...For ABFAS, you will get fusions, osteotomies, ORIF, implants (if you do that dumb stuff 🙂 ), etc... fixation cases are pulled almost exclusively. It has been that way for years, and with good reason. Ortho boards are the same... how can they judge the rotator cuffs or knee scope quality/proficiency? They will pick ORIF radius and TKAs and spinal fusions.
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Thanks for the reply, as I've alluded to in the past, I'm ultimately just tired of the whole process. Here are a few bitter thoughts at the moment:

1) So is the evaluation completely based on the xrays? Why am I sending H&P's, postop notes, and all this documentation if the only thing that matters is the radiographs. We could save a lot of time/effort if they only asked for pre and postop xrays. That sounds foolish, but honestly if they are only going to evaluate cases with pre and post op films doesn't that show the main priority is the xray evaluation?

2) If the above is not true, then is the case selection truly designed to evaluate the candidate or just to facilitate ease of evaluation for the reviewer? Fractures represent very little of what I do (<1% of my surgical volume and yet nearly 20% of my cases), and its rather frustrating to be so heavily judged on it just because the radiographs give the reviewer a point of reference. I know this sounds rather childish/immature, but I'm the one being reviewed, so review a true representation of what I do. Yes, that means on some of the cases, your gonna have to take my legally binding medical notes as what's actually happening rather than looking at an xray(gasp).

3) Ortho boards have >90% pass rate without a required time frame to completion certification.

4) Given the cases I prefer to do, I suppose I should be more upset that ABFAS has been elevated to such a required standard in our profession. I'm the only podiatrist that covers the hospital in my area, but still have to get ABFAS certification. I intend to pass, but I do wonder if they would actually take away my privileges and have to transfer the patient if no one would see the patient.

Thanks for reading/responding. It's not meant to be an angry reply, I'm just tired and cranky about this whole thing.
 
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Here's an idea: Evaluate candidates on their thought process and not just outcomes. If an XR looks lousy, how did they make it better? If it came out mediocre, maybe that was intentional, maybe you don't want to swap out screws just to get a pretty xr. Maybe the pt achieved their functional goals and they don't need to be subjected to the trauma of further revision.

And if anyone reading this now can tell us in all honesty they were already the best surgeon they would ever be when they were fresh out of residency, I will admit my wrongness and take my L and hope for a better case draft next year.
 
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shadesofgrey said:
Thanks for the reply, as I've alluded to in the past, I'm ultimately just tired of the whole process. Here are a few bitter thoughts at the moment:

1) So is the evaluation completely based on the xrays? Why am I sending H&P's, postop notes, and all this documentation if the only thing that matters is the radiographs. We could save a lot of time/effort if they only asked for pre and postop xrays. That sounds foolish, but honestly if they are only going to evaluate cases with pre and post op films doesn't that show the main priority is the xray evaluation?

2) If the above is not true, then is the case selection truly designed to evaluate the candidate or just to facilitate ease of evaluation for the reviewer? Fractures represent very little of what I do (<1% of my surgical volume and yet nearly 20% of my cases), and its rather frustrating to be so heavily judged on it just because the radiographs give the reviewer a point of reference. I know this sounds rather childish/immature, but I'm the one being reviewed, so review a true representation of what I do. Yes, that means on some of the cases, your gonna have to take my legally binding medical notes as what's actually happening rather than looking at an xray(gasp).

3) Ortho boards have >90% pass rate without a required time frame to completion certification.

4) Given the cases I prefer to do, I suppose I should be more upset that ABFAS has been elevated to such a required standard in our profession. I'm the only podiatrist that covers the hospital in my area, but still have to get ABFAS certification. I intend to pass, but I do wonder if they would actually take away my privileges and have to transfer the patient if no one would see the patient.

Thanks for reading/responding. It's not meant to be an angry reply, I'm just tired and cranky about this whole thing.
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It's not all x-rays. It's case selection. You are allowed to have complications. It's how you deal with them. Some highlights of my previous attempts at passing to follow. One thing that certainly sucks and number 1 thing (maybe not....) I would change is to get feedback even on passing exams. You get great data points when you fail....and ZERO info other than hey you passed.

1. Early in my career had a 70-year-old lady with rheumatoid arthritis. Was not as aggressive and did not have the experience that I have now. Making her non-weight-bearing was not a good option and so instead of a first mpj fusion I chose to attempt a youngswick. She was weight-bearing day one it healed didn't get as much decompression as I wanted and she was back in the office 6 months after surgery continuing with pain and ended up with a first mpj fusion by my partner which she did well with. These days I walk all first mpj fusions off the table with zero problems. Post-op x-rays on this lady looked just fine. Again nothing like follow-up to ruin a good case.... But that one was on me. These days, I wouldn't have thought twice about it and would have just done a first mpj fusion from the start. I failed multiple categories of that case including case selection outcomes and I don't remember how all they break those down. Cases are not past fail there are subcategories.

2. Lady with no insurance did an Austin. She was perfectly happy with the outcome I got an x-ray at 6 weeks there was incomplete healing and a little bit of gapping on the dorsal arm. Saw her back for a quick follow-up at 12 weeks did not get an x-ray trying to keep costs low. Even though clinically she was doing great got dinged on the x-rays.

3. 13-year-old girl I did a lapidus on... Perfect outcome reviewer said there was an open growth plate. Because of this they failed me on like four or five of the categories within that case. There was no open growth plate not a single person ever disagreed with me when I would show them this including my old residency director who was a past president of abfs. He said dude you got screwed sorry it's not a perfect system. This was before you could pay to have a review or however it goes these days.

This was from when I failed forefoot cases. 2 years later I took forefoot again and RF first time and passed both. Highlights of these cases...

1. A guy with a first mpj fusion. Had some vascular concerns I sent him to vascular they said he's good nothing for us to do. I did a first mpj fusion on him that worked out well but he somehow ended up with an ulcer laterally on the 5th MPJ from pressure and surgical shoe. Ended up doing a fifth met head resection on him.

2. Did a triple, had wound healing problems laterally and medially.

3. Did a lapidus and second and third tmt. Day of surgery actually had to go back into the or because post-op X-rays showed that I air ball the screw into a joint, I was trying to throw a single screw proximal to the plate and go from medial cuineiform into lessers ended up just air balling it into the NC joint. Patient had a block so we went back into the OR sterile opened it up just removed the screw. Had wound healing problems dorsally required multiple trips back to the or IV antibiotics Integra etc. Fortunately hardware was fine everything healed up after a few months. Ultimately patient ended up with no pain and allowed me to operate on her other side and she referred multiple family members and friends to me.

I passed this round of testing but would some feedback on those and what they said was okay and what they didn't like would that have been helpful 100%. Not so much for me I guess but more so in terms of giving feedback to other people. It's not a perfect process....

Don't get me started on the computer testing and how stupid that is I failed foot computer two times, past rear foot the first time. But eventually 4 years out both foot and rra certification.
 
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One more thought before I take a time out of my own.

This all comes back--once again!-- to the reality that we are oversaturated.

ABFAS could give us the benefit of the doubt during case review if they at least knew we were all coming from uniformly good residencies. But we're not. We have too many schools funneling too many students into poor residencies. So finally, some 10 years after starting podiatry school, we encounter our first true gatekeeper. I think it's horse💩 to put candidates through all that.

So when some dean with *zero* academic publications (that I could find), who only got certified through abpm 3 years ago and through abfas 2 years ago, comes along and says "no profession shrinks itself into prosperity" hopefully we all recognize we're getting conned
 
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air bud said:
This was from when I failed forefoot cases. 2 years later I took forefoot again and RF first time and passed both. Highlights of these cases...

1. A guy with a first mpj fusion. Had some vascular concerns I sent him to vascular they said he's good nothing for us to do. I did a first mpj fusion on him that worked out well but he somehow ended up with an ulcer laterally on the 5th MPJ from pressure and surgical shoe. Ended up doing a fifth met head resection on him.

2. Did a triple, had wound healing problems laterally and medially.

3. Did a lapidus and second and third tmt. Day of surgery actually had to go back into the or because post-op X-rays showed that I air ball the screw into a joint, I was trying to throw a single screw proximal to the plate and go from medial cuineiform into lessers ended up just air balling it into the NC joint. Patient had a block so we went back into the OR sterile opened it up just removed the screw. Had wound healing problems dorsally required multiple trips back to the or IV antibiotics Integra etc. Fortunately hardware was fine everything healed up after a few months. Ultimately patient ended up with no pain and allowed me to operate on her other side and she referred multiple family members and friends to me.

I passed this round of testing but would some feedback on those and what they said was okay and what they didn't like would that have been helpful 100%. Not so much for me I guess but more so in terms of giving feedback to other people. It's not a perfect process....

Don't get me started on the computer testing and how stupid that is I failed foot computer two times, past rear foot the first time. But eventually 4 years out both foot and rra certification.
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You can have complications. THey want you to admit and fix them is the thing.

And like Feli said they wont chose amps or soft tissue work. I talked to John Venson about it and more or less direct quote "Look were not going to chose an amp of ganglion excision. Its going to be bunions, fusions, and trauma"
 
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Let it be known! Talk against ABPM CAQ in surgery and you will get the ban hammer! I am currently awaiting my board certification from ABPM so these other podiatrists at my hospital will finally let me do TARs.
 
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Pronation said:
I wanted to take a moment of silence this morning for our fallen brethren, SlicesWithAnger and Feline. May their dremels continue to spin at high speed.
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LMAOOO stopppp, your post cracks me up. I'm afraid you're gonna be next so I need you to chill before getting sent to purgatory cause the comic relief prevents me from stabbing myself with a nipper everyday.
 
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BubbaWub said:
Let it be known! Talk against ABPM CAQ in surgery and you will get the ban hammer! I am currently awaiting my board certification from ABPM so these other podiatrists at my hospital will finally let me do TARs.
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Ok. My sarcasm meter is beeping … but:

It really doesn’t matter about your BC for TARs. TARs are not part of the standardized residency curriculum.

On Delineation of Privileges forms, I have never not seen it listed as a “special procedure”. That means you have to separately demonstrate your education, training, and experience to get that privilege regardless of your residency or BC.

And there is a DPM in Houston-area who does the most TARs in his hospital and he’s younger, well-trained, and certified only by ABPM.
 
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diabeticfootdr said:
Ok. My sarcasm meter is beeping … but:

It really doesn’t matter about your BC for TARs. TARs are not part of the standardized residency curriculum.

On Delineation of Privileges forms, I have never not seen it listed as a “special procedure”. That means you have to separately demonstrate your education, training, and experience to get that privilege regardless of your residency or BC.

And there is a DPM in Houston-area who does the most TARs in his hospital and he’s younger, well-trained, and certified only by ABPM.
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No sarcasm. I respect what you are doing for guys like myself, Dr. Rogers. Thank you. I feel like I can finally stand up to the bullying at the hospital since I am not board certified by ABFAS. They do not let me perform complicated procedures, even though I know I am competent.
 
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Our hospital bylaws changed a year after I got here. Previously, if you showed enough case logs and was certified by either ABPM or ABFAS, you received full privileges (for the procedures you requested). Now, since the change, ABPM is only allowable for non-surgical/bedside procedures and ABFAS for any surgery. So, one can’t even do a toe amp w/o ABFAS.

I was pretty ticked, but they grandfathered me in since I was already boarded prior to the change w/ ABPM.

What a bunch of balogna. Some podiatrist probably wanted to have more control over who got credentialed and changed things. I again refer to my previous meme:
 

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MusicManMike said:
Our hospital bylaws changed a year after I got here. Previously, if you showed enough case logs and was certified by either ABPM or ABFAS, you received full privileges (for the procedures you requested). Now, since the change, ABPM is only allowable for non-surgical/bedside procedures and ABFAS for any surgery. So, one can’t even do a toe amp w/o ABFAS.

I was pretty ticked, but they grandfathered me in since I was already boarded prior to the change w/ ABPM.

What a bunch of balogna. Some podiatrist probably wanted to have more control over who got credentialed and changed things. I again refer to my previous meme:
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Sounds like you need @diabeticfootdr to tell them whats up.
 
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Because I was grandfathered I did not chase it. But IMO if a new to area well trained DPM w/ ABPM only is denied privileges, I hope they fight it.
 
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MusicManMike said:
Because I was grandfathered I did not chase it. But IMO if a new to area well trained DPM w/ ABPM only is denied privileges, I hope they fight it.
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They grandfathered you because you'd have had significant damages if they changed the rules and restricted you after you had privileges. Slam dunk lawsuit that's won every day.

But they also grandfathered you so you wouldn't fight the new requirements.

That being said, we usually win after they've grandfathered people in the past and we challenge it, because it's an unfair practice. But it takes someone to apply, then get denied privileges, so they have standing to challenge it.
 
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MusicManMike said:
Our hospital bylaws changed a year after I got here. Previously, if you showed enough case logs and was certified by either ABPM or ABFAS, you received full privileges (for the procedures you requested). Now, since the change, ABPM is only allowable for non-surgical/bedside procedures and ABFAS for any surgery. So, one can’t even do a toe amp w/o ABFAS.

I was pretty ticked, but they grandfathered me in since I was already boarded prior to the change w/ ABPM.

What a bunch of balogna. Some podiatrist probably wanted to have more control over who got credentialed and changed things. I again refer to my previous meme:
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Its funny that they only check for competency in bone types of surgeries that they can case review based on x-rays but then prohibit you do even soft tissue non-ortho type surgeries. Cool.

So if ABFAS certified people want to do only ortho type surgeries and ABPM certified will not be allowed to do any surgeries in the furure then who will do amps, soft tissue surgeries, limb salvage, etc.
 
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diabeticfootdr said:
They grandfathered you because you'd have had significant damages if they changed the rules and restricted you after you had privileges. Slam dunk lawsuit that's won every day.

But they also grandfathered you so you wouldn't fight the new requirements.

That being said, we usually win after they've grandfathered people in the past and we challenge it, because it's an unfair practice. But it takes someone to apply, then get denied privileges, so they have standing to challenge it.
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So being grandfathered with ABPM is not dangerous anymore to the public? So how would new pod with ABPM not allowed to do surgery at that hospital and someone hired 1 year prior with same Board certification is allowed? What is the deciding factor here? Looks like double standards.
 
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de Ribas said:
So being grandfathered with ABPM is not dangerous anymore to the public? So how would new pod with ABPM not allowed to do surgery at that hospital and someone hired 1 year prior with same Board certification is allowed? What is the deciding factor here? Looks like double standards.
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It is 2 different things, one legal and one “medical”

1. Legal: A hospital must treat all providers similarly.* If they don’t require BC for MDs, they can’t do it for DPMs. If they grandfather (they use a different term not to sound as bad: “Board certification waiver”) some people, then it’s very hard for them to hold someone else to a different standard. It usually just results in a waiver for the person/complainant.

*This is actually the law and in Joint Commission standards.

2. Medical: Is it a public safety issue to either A. Not require BC or B. Provide waivers?

The hospital is required to verify a provider’s competence by considering their education, training, and experience. They are not mandated to require BC. So if only those with adequate training and current experience get privileges, is that safe enough?
 
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As a relatively recent grad, ABPM is very appealing if it can become more accepted at hospitals. The ABFAS is a long drawn out process of case reviews with most associates needing to go back to previous jobs to pick out cases. On top of this the ABFAS shows their true colors with the abysmal pass rates in what seems like one large money grab. Why would I want to support a board that has failed the majority of my colleague just to force them to pay more test dues if there is an alternative choice. The only thing right now that is holding me back from not paying the qualification dues and switching to ABPM is the fact that hospitals in my area do not recognize the ABPM. Hopefully the leadership of the board start to work on that.
 
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