Class of 2021

[Weirdy]

Well, what does the podiatry degree offer students that an MD/DO degree doesn’t? There really isn’t a reason to go Podiatry unless you have subpar stats.

Now, you could say the same thing about DO to MD, but they have done a good job of transplanting the physician title to DOs.

Fair.

I've also thought the biggest limitation is the scope of practice.

Not everyone wants to treat only the foot.

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[GypsyHummus]

Edited.

 

[med2345]

Edited.

Gypsy, just for your own benefit I honestly hope you never take your podiatry acceptance as you clearly show everyday you talk about the negatives much more than the positives of podiatry. You can’t be happy in a profession you constantly want to beef with. No offense but it’s still pretty clear.

 

[GypsyHummus]

I thought it was funny.

Gypsy, just for your own benefit I honestly hope you never take your podiatry acceptance as you clearly show everyday you talk about the negatives much more than the positives of podiatry. You can’t be happy in a profession you constantly want to beef with. No offense but it’s still pretty clear.

 

[med2345]

I thought it was funny.

Can be sometimes but I’m just saying... like if a admissions team saw your posts they’d probably rescind your app/acceptance immediately lol

 

[DexterMorganSK]

Well, what does the podiatry degree offer students that an MD/DO degree doesn’t? There really isn’t a reason to go Podiatry unless you have subpar stats.

Now, you could say the same thing about DO to MD, but they have done a good job of transplanting the physician title to DOs.

Not everyone enters this field because they have subpar stats.

People have their own reasons but I can only speak of my own. I got in this field because of what this field has to offer including being a specialist in one field, no worries about saturation, being able to diagnose, treat, everything related to the foot and ankle and more. In addition, my family history is filled with diabetes and hypertension, so I have seen most of the foot related complications due to these conditions, thus my passion to treat them in the future. No MD/DO school would give you a scholarship based on my stats (3.3 sci and cum gpa, 3.8 mph gpa, and 497 MCAT), Pod is cheaper compared to a DO/MD program. And what Bob said above, if anyone had an interest in surgery, orthopedics, or sports medicine, then this is also the field for them since it takes a lot less long to complete.

This field is what you make out of it so if you know your stuff and when others see that, you will be compensated well.

I could have gone to LMU-DCOM or done the post-bacc program at VCOM for this years class, but for all those above reasons and more, I chose this field and I am very happy I did. My future attitude might be different choosing this field, but I would like to stay in the present and positive.

Good luck getting in a dental program.

 

[DexterMorganSK]

What makes you think this? I have my own thoughts on the matter that I have expressed, but I am interested in hearing yours.

I'll have a better response in August so I'll answer this then.

 

[GypsyHummus]

I dont know about the "no saturation" point and being able to do foot and ankle. As many of the Attending Pods have said, some hospital jobs only let you use 30% of your training. There is also an expressed concern about employment, that there are lots of grads that have to settle for 80K/year jobs in Private practice.

I shadowed a pod who was offered 70K in private practice as a base salary. Thankfully, they are making much more working for a hospital, but desperation to pay off student loans can set in.

People have their own reasons but I can only speak of my own. I got in this field because of what this field has to offer including being a specialist in one field, no worries about saturation, being able to diagnose, treat, everything related to the foot and ankle and more.

 

[DexterMorganSK]

I dont know about the "no saturation" point and being able to do foot and ankle. As many of the Attending Pods have said, some hospital jobs only let you use 30% of your training. There is also an expressed concern about employment, that there are lots of grads that have to settle for 80K/year jobs in Private practice.

I shadowed a pod who was offered 70K in private practice as a base salary. Thankfully, they are making much more working for a hospital, but desperation to pay off student loans can set in.

The people on SDN represent maybe 0.1% to real-world scenarios. I wouldn't read too much into that.
The Avg salary for an FM doc is around 140K in any major city. They can make alot more if in a rural town and be doing a bunch of procedures. The same can apply to a Pod, granted in the FM field it is easier to get a job since almost everyone will hire one.
I spoke to real, working pods last month, and it is not as bad what is being represented here, at least in terms of salary. So, I'm good.

And the saturation parts mainly shows how only less than 600 pods graduate per year and how everyone in the US getting fatter and the increased in the prevalence of DMII.

 

[feetsreets]

Ok real talk. Podiatry has a lot to offer. Besides what’s been said before, Podiatry offers a specialty right from the get go. DO and even MD does not. No offense to Family Medicine but over 60% of DO students end up in family Medicine or internal medicine which is not my cup of tea, and unfortanately not a lot of other people like it either. You have to work extremely hard especially in a DO school to have a chance at getting a competitive residency.

Podiatry also offers a very nice work/life balance. On average Podiatrists work less hours per week than most specialists. This works great for women or men who want children, and want to spend more time with their families or simply relaxing at the end of the day.

Podiatry offers Surgery. This is a big one. Lots of people want to do Surgery and this is a surefire path to getting it.

Podiatrist are great at what they do, and the training is only getting better and better. Most of the schools have some sort of integration/affiliation with another health science college. All Residency training is 3 year surgical training now. That in itself is still pretty new, so the recently and future graduated podiatrists are better trained than ever before and will only further the profession.

Podiatry offers immediate relief to patients. I shadowed podiatrists in three different states before podiatry chose me. Every single one, the majority of their patients left so much happier and in less pain. I know this is anecdotal. But I know what I saw and experienced. It was something I didn’t see shadowing other doctors. Something I haven’t felt myself as a patient in clinics and hospitals.

The US and the world needs more podiatrists. There are more and more obese people and diabetics.

People like to talk a lot about low salary of Pods, but like a lot of things in life, it’s still a lot of talk. Sure there are those pods making base 80k. But there also those pods making 400k. Or more. I’ve met some. Not saying that’s average or that most will come anywhere near that amount, but it’s possible. And average salaries are a lot higher than the bullsh** nonsense “duhhh but as a pod you will only ever be offered 80k” jobs!” If you work hard, and are smart about how you go about getting a job, you will be able to make a decent living.

At the end of the day, as a podiatrist you will be a physician. You will be a surgeon. You will be a Doctor. You will experience challenges and pitfalls just as any other profession, but maybe different ones. I’m just a student, so I can’t speak to every or even most aspects of podiatry, but seeing it from the outside and now getting a glance at the inside, the future looks bright.

 

[Windom Earle]

If you don't get a scholarship right off the bat, can you get one in later semesters if you maintain a certain GPA?

 

[wakaflocka88]

It gets tiring hearing students say they chose podiatry because of "lifestyle" and "working less hours than other specialties." You all say you like surgery - do you realize, that you may be called regarding possible questions/complications/pain/nausea/constipated/dressing looks odd/infections - at any given time? You cut them, you are responsible for everything and anything until they are healed.

 

[DexterMorganSK]

If you don't get a scholarship right off the bat, can you get one in later semesters if you maintain a certain GPA?

Yes, you can. Just check with the school for academic and non-academic related scholarships.

 

[AudiLova619]

The people on SDN represent maybe 0.1% to real-world scenarios. I wouldn't read too much into that.
The Avg salary for an FM doc is around 140K in any major city. They can make alot more if in a rural town and be doing a bunch of procedures. The same can apply to a Pod, granted in the FM field it is easier to get a job since almost everyone will hire one.
I spoke to real, working pods last month, and it is not as bad what is being represented here, at least in terms of salary. So, I'm good.

And the saturation parts mainly shows how only less than 600 pods graduate per year and how everyone in the US getting fatter and the increased in the prevalence of DMII.

Do you mind sharing what salary numbers you heard from them?

 

[DexterMorganSK]

Do you mind sharing what salary numbers you heard from them?

The majority had contracts with either hospitals or groups and made close to 200K after residency.
A few started their own clinic and although not making as much, saw great potentials in the future. This is true for any new business as you are expected to make pennies for the first few years.

 

[DexterMorganSK]

Any plans for the summer? How much of a break time you guys get?
I'm hoping to shadow and be part of a research group, also some traveling.

 

[Packers4lifeDPM]

At AZpod we get 2 weeks then start our summer quarter where it' just podiatry specific classes. Going home for 2 weeks lol wishing right now we had the same break as the DO student lol

 

[AudiLova619]

Could anyone comment on if there is saturation in the field of podiatry? Whether if its growing or dying out? I feel like since the diabetic community will grow in the future so will the demand for pods.

 

[Weirdy]

2 weeks then clinicals...but its an easy one so not too bad.

Summer starts up mid July. Heard its gonna be a special hell.

 

[DexterMorganSK]

At AZpod we get 2 weeks then start our summer quarter where it' just podiatry specific classes. Going home for 2 weeks lol wishing right now we had the same break as the DO student lol

Sounds about right. Did you take Lower anat yet? We're going into it at the moment, nerve by nerve lol

 

[DexterMorganSK]

2 weeks then clinicals...but its an easy one so not too bad.

Summer starts up mid July. Heard its gonna be a special hell.

Summer around you will probably hit the 3 digits? Still chilly here in IL, had a snow shower a few days ago lol
I believe we get about 3 weeks, but let's see!!

 

[DexterMorganSK]

Could anyone comment on if there is saturation in the field of podiatry? Whether if its growing or dying out? I feel like since the diabetic community will grow in the future so will the demand for pods.

The attendings answered these question in their forum...
Like any other healthcare field, you will find saturation in major cities and where the schools are, but Pod saturation is nothing to worry about.
Obesity and diabetes are on the rise since 2015 (like in millions throughout the US) so the need for Pods will increase.

 

[Weirdy]

The attendings answered these question in their forum...
Like any other healthcare field, you will find saturation in major cities and where the schools are, but Pod saturation is nothing to worry about.
Obesity and diabetes are on the rise since 2015 (like in millions throughout the US) so the need for Pods will increase.

Reading these reposts has been making my BP rise.

 

[GypsyHummus]

I was about to say, idk why so many people get hot and bothered with surgery and why pods hate corns calluses and toenail trimmings, to me that seems like a low risk procedure that while doesn’t bring home the bacon, certainly pays well. 35$ per 15 mins, let’s say your slow and can only do 3 an hour that’s still 105$/hour. Multiply by 8 hour days and you got more than 800$/day.

It gets tiring hearing students say they chose podiatry because of "lifestyle" and "working less hours than other specialties." You all say you like surgery - do you realize, that you may be called regarding possible questions/complications/pain/nausea/constipated/dressing looks odd/infections - at any given time? You cut them, you are responsible for everything and anything until they are healed.

 

[de Ribas]

I was about to say, idk why so many people get hot and bothered with surgery and why pods hate corns calluses and toenail trimmings, to me that seems like a low risk procedure that while doesn’t bring home the bacon, certainly pays well. 35$ per 15 mins, let’s say your slow and can only do 3 an hour that’s still 105$/hour. Multiply by 8 hour days and you got more than 800$/day.

One of the podiatrists I have shadowed, owned his own clinic for 16 years and did surgery. He still has YouTube videos about his clinic. But, now he works for a large group. When I asked him about this change, of course he didn't tell me exact figures, but he said that he doesnt regret and that his income is very decent and that he gets pretty much the same when he used to own his office and do surgery. He stopped doing any surgery except procedures that can be done in the office. He showed me costs of the procedures he was doing on a regular basis. You can have a decent living just from these procedures.

 

[Packers4lifeDPM]

Sounds about right. Did you take Lower anat yet? We're going into it at the moment, nerve by nerve lol

Doing all podiatry classes during our summer quarter. Actually excited to just focus on just podiatry for awhile!

 

[DexterMorganSK]

@Podstar

We didn't hear from you for a while, hope you doing well buddy!

 

[Podstar]

@Podstar

We didn't hear from you for a while, hope you doing well buddy!

Doing pretty well, just finishing up two more finals before a 2 week summer break. Hope everyone is doing well both in and out of school!

 

[CappnNono]

Cant believer we are almost do ewith first year guys....

 

[DexterMorganSK]

Important link to APMA regarding the scope of practice of resources for DPMs:

APMA Scope-of-Practice Resource Center | APMA

 

[DexterMorganSK]

"On May 10, the South Carolina Legislature passed H 3622, an updated podiatry scope-of-practice act to allow doctors of podiatric medicine to medically and surgically treat the ankle. The bill now moves to the governor, who is expected to sign it, and the law will take effect upon his approval. South Carolina will become the 47th state to allow podiatrists to treat the ankle."

 

[Weirdy]

Survived first year.

Hope everyone is alive and well.

 

[DexterMorganSK]

Those interested in doing any international work as a DPM in the future might benefit from:

FIP-IFP Newsletter May 2018

&

https://www.fip-ifp.org/wp-content/uploads/2018/05/Footsteps-Q2-–-2018-english_1.pdf

 

[NovaPreMed23]

Hey guys! Haven't been on here in a while. Happy to say that I have completed my first year of Pod School

I just had a question in regards to boards prep material. Does anyone know what sources I should be looking at? There isn't a specific pods boards review book so I was wondering if anyone had any recommendations. My dean recommended First Aid but I also know there is BRS. The books are expensive so I was hoping to get some feedback from folks on here as to what they plan on using. @bobtheweazel sorry to call you out on this but I know you just completed your second year at Temple (just completed my first!) but if you have any recommendations I'd love to hear them from you as well.

Thanks guys!

 

[DexterMorganSK]

Hey guys! Haven't been on here in a while. Happy to say that I have completed my first year of Pod School

I just had a question in regards to boards prep material. Does anyone know what sources I should be looking at? There isn't a specific pods boards review book so I was wondering if anyone had any recommendations. My dean recommended First Aid but I also know there is BRS. The books are expensive so I was hoping to get some feedback from folks on here as to what they plan on using. @bobtheweazel sorry to call you out on this but I know you just completed your second year at Temple (just completed my first!) but if you have any recommendations I'd love to hear them from you as well.

Thanks guys!

I hope Bob responds because I was going to post something similar as well.

I have used FA for Step 1 for few classes and it was helpful, I also tried the BRS questions for Anatomy and biochemistry, but meh..it wasn't all that helpful for lecture exams..maybe good for boards?

One of the DPMs I shadow recommended the following manual for years 3 and 4:

So, I'm also looking for any other recommendations in order to prep for Boards and would also appreciate any response from @Sweatshirt @TimmyTurner

 

[NovaPreMed23]

I hope Bob responds because I was going to post something similar as well.

I have used FA for Step 1 for few classes and it was helpful, I also tried the BRS questions for Anatomy and biochemistry, but meh..it wasn't all that helpful for lecture exams..maybe good for boards?

One of the DPMs I shadow recommended the following manual for years 3 and 4:

View attachment 234944

So, I'm also looking for any other recommendations in order to prep for Boards and would also appreciate any response from @Sweatshirt @TimmyTurner

I actually have that manual and I agree. It's pretty sweet and is filled with lots of info. I'd recommend getting it especially for third and fourth year.

I just don't know what to use for the boards......

I am going to send out an email to my academic dean and ask him for a list that he recommends (besides first aid) and see what he tells me. I'll let you know if I hear anything back. The more info we can gather about this stuff, I think the better off we are. It'll also be helpful to pass down the info to other students as well

But fyi for LEA, I have a set of flash cards that I made and they are very very helpful. I did well in LEA and on a practice boards exam just using them so I think I am also going to use them for boards.

 

[bobtheweazel]

@NovaPreMed23 @DexterMorganSK
I'm heavily involved in boards prep at my school and I'll gladly give y'all a full breakdown of what we've done and what resources we've used based on surveys and feedback of our upperclassmen as well as based on data and feedback I get from my class, but not until after my class takes boards next month. Y'all wouldn't be wrong to start looking at your favorite mixture of material from First Aid, BRS, Sketchy, Pathoma, and the Ohio LEA book as you'll probably hear upperclassmen talk about a lot of those resources. Just probably don't use all of them, because you'll overwhelm yourself with information. There's also a solid BoardVitals question bank for APMLE (if your school has access to it) and the NBPME has released two old practice test documents and there are two current online practice tests that you can also access (even before you start 2nd year). The NBPME/APMLE practice tests are all made from actual APMLE questions from past exams and altogether between those two documents and the online ones there's probably about 400+ old questions that NBPME has released that you can look over. I might advise against using too many USMLE question banks as that may discourage you, since those are on average considerably more complex than APMLE questions.

Aside from all of that I do have a detailed study plan that I've put together after speaking with the Chair of the AACPM curriculum guide committee, the Executive Director of NBPME, and lots of other people but I don't want to give the details until I'm sure it works, which I will know some time in the next month or two based on how I and some of my classmates that I've shared this info with have performed on boards.

So if you don't hear from me by mid-Augustish then tag me in here. This exam we're about to take will take NBPME longer than usual to let us know if we passed/failed since they just changed the exam specifications, so they'll be using this exam we're about to take to kind of set a standard for future exams with these specifications. That's why I'm saying we may not know till mid-August or something like that.

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[NovaPreMed23]

@NovaPreMed23 @DexterMorganSK
I'm heavily involved in boards prep at my school and I'll gladly give y'all a full breakdown of what we've done and what resources we've used based on surveys and feedback of our upperclassmen as well as based on data and feedback I get from my class, but not until after my class takes boards next month. Y'all wouldn't be wrong to start looking at your favorite mixture of material from First Aid, BRS, Sketchy, Pathoma, and the Ohio LEA book as you'll probably hear upperclassmen talk about a lot of those resources. Just probably don't use all of them, because you'll overwhelm yourself with information. There's also a solid BoardVitals question bank for APMLE (if your school has access to it) and the NBPME has released two old practice test documents and there are two current online practice tests that you can also access (even before you start 2nd year). The NBPME/APMLE practice tests are all made from actual APMLE questions from past exams and altogether between those two documents and the online ones there's probably about 400+ old questions that NBPME has released that you can look over. I might advise against using too many USMLE question banks as that may discourage you, since those are on average considerably more complex than APMLE questions.

Aside from all of that I do have a detailed study plan that I've put together after speaking with the Chair of the AACPM curriculum guide committee, the Executive Director of NBPME, and lots of other people but I don't want to give the details until I'm sure it works, which I will know some time in the next month or two based on how I and some of my classmates that I've shared this info with have performed on boards.

So if you don't hear from me by mid-Augustish then tag me in here. This exam we're about to take will take NBPME longer than usual to let us know if we passed/failed since they just changed the exam specifications, so they'll be using this exam we're about to take to kind of set a standard for future exams with these specifications. That's why I'm saying we may not know till mid-August or something like that.

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Thanks for this! I really appreciate it. I look forward to hearing the feedback that you get.

I have a question about the practice exams that you have mentioned. I know with board vitals, there is a log in and stuff (do you know if Temple students have access to that?) In regards to NBPME practice exam, is this the link for it: American Podiatric Medical Licensing Examination – Practice Tests

Or is that something completely different?

Again thanks for all the info that you continually share in these threads.

 

[bobtheweazel]

Thanks for this! I really appreciate it. I look forward to hearing the feedback that you get.

I have a question about the practice exams that you have mentioned. I know with board vitals, there is a log in and stuff (do you know if Temple students have access to that?) In regards to NBPME practice exam, is this the link for it: American Podiatric Medical Licensing Examination – Practice Tests

Or is that something completely different?

Again thanks for all the info that you continually share in these threads.

Yes, all Temple students have Access to BoardVitals. If your school doesn't pay then it's like $1000 for you to just go and buy it yourself which may not be worth it, even though it's a great resource specific for our boards.

And yes that link will take you to the online exams NBPME has up right now, including two for part 1. They used to have the older "paper versions" posted on their site but I think they took them down. People at your school prob have them though. They are the 2005 and 2008 NBPME practice exams.

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[DexterMorganSK]

Y'all start classes yet?

Biomechanics is no fun

 

[Podstar]

Y'all start classes yet?

Biomechanics is no fun

Midterms start next week for us.

 

[DexterMorganSK]

Midterms start next week for us.

Already? Dam...I guess your break was short.

We have an option to either take biomech now over summer or take a month of...I rather get it out of the way!

 

[Packers4lifeDPM]

AZpod has a full summer quarter. So we are 1 month into things but it is way more laid back than the normal quarters. Have more clinical applications and experience now which is a nice change though. So far liking besides having class all day lol used to just rewatching lectures at 1.5x speed in the comfort of my apt lol

 

[GypsyHummus]

Do you like the quarter system? Do you find it better than the traditional semester system?

AZpod has a full summer quarter. So we are 1 month into things but it is way more laid back than the normal quarters. Have more clinical applications and experience now which is a nice change though. So far liking besides having class all day lol used to just rewatching lectures at 1.5x speed in the comfort of my apt lol

 

[Packers4lifeDPM]

Do you like the quarter system? Do you find it better than the traditional semester system?

Um, I guess I don't really know how to compare it to any other since you can't really compare this type of schooling to undergrad. It is nice having a week off after each quarter and this coming year we get 3 weeks off after our spring quarter.

 

[DexterMorganSK]

I hope everyone here writes a letter to CMS regarding the Medicare changes upon our profession.
Please use this link to submit the already made letter: Oppose CMS Proposed Rule Requiring Podiatrists to Use E/M Coding Different Than for All Other Medicare Physicians

Post that link to your class Facebook group page and the SGA within your schools. This is all about the numbers so the more we submit the better. You can also ask patients and family members to do the same.

APMA - American Podiatric Medical Association

 

[GypsyHummus]

Hmm, I’m surprised this is being proposed (the legislation, not the pushback to it). I also wonder why as well, I understand the need to make cuts in Medicare, but to single out Podiatry services seems a little odd. You would think all care reimbursment would be cut by a little bit.

Are other doctor non MD/DO services being cut as well, like DDS and OD?

I hope everyone here writes a letter to CMS regarding the Medicare changes upon our profession.
Please use this link to submit the already made letter: Oppose CMS Proposed Rule Requiring Podiatrists to Use E/M Coding Different Than for All Other Medicare Physicians

Post that link to your class Facebook group page and the SGA within your schools.

 

[DexterMorganSK]

Hmm, I’m surprised this is being proposed (the legislation, not the pushback to it). I also wonder why as well, I understand the need to make cuts in Medicare, but to single out Podiatry services seems a little odd. You would think all care reimbursment would be cut by a little bit.

Are other doctor non MD/DO services being cut as well, like DDS and OD?

I don't think dds/od will be affected. CMS is singling out Pods, which was not a problem all these years. There is some good from the changes as well but overall it's bad for the profession, imo.

I don't think it will happen though, everyone is making sure of that, including students and faculty.

 

[de Ribas]

I have read through and it says that podiatrists and dermatologists are most affected. Everyone will be affected in some way.

I read that they are trying to decrease amount of paperwork and provide more time for physicians to spend with patients.

Isn't it a good thing? Isn't it what all physicians want?

 

[DexterMorganSK]

I have read through and it says that podiatrists and dermatologists are most affected. Everyone will be affected in some way.

I read that they are trying to decrease amount of paperwork and provide more time for physicians to spend with patients.

Isn't it a good thing? Isn't it what all physicians want?

Yeah, that's the good part about the changes.
The bad part is that they want to "require podiatrists to use different E/M codes than all other Medicare physicians, which would reimburse at a significantly lower rate" (so, DPMs will get much lower payment for the same procedure vs if a family med doc does it).

Let me post the letter that is being sent out to CMS from everyone concerned:


Dear Administrator Verma,

I write as a student of podiatric medicine (DPM) to ask CMS not to finalize its proposal to single out podiatric physicians by requiring DPMs use a separate and unique set of evaluation and management (E/M) codes that are different from what other Medicare provider uses, for the same E/M services, at a significantly lower rate of reimbursement. And, I oppose the proposal to collapse the existing E/M codes of 99202 through 99205 and 99212 through 99215 into two flat reimbursement payments for Medicare providers generally (except for DPMs). I also request that CMS not finalize the proposal to reduce reimbursement by 50% for the least expensive procedure or visit that the same physician (or a physician in the same group practice) furnishes on the same day as a separately identifiable E/M visit.

I will provide the exact same E/M services as my MD/DO colleagues, and I will be recognized as a physician on equal footing with MDs/DOs under Medicare, within my scope of practice. CMS’ proposal for separate payment for podiatric E/M services amounts to differential payment by specialty for the same E/M services provided by DPMs. CMS provides no explanation on how the evaluation and management required for patients seeking care from DPMs is distinct from that provided to patients seeking medical care from an MD/DO. Furthermore:

1. If a patient saw an MD/DO for a foot and/or ankle complaint, they would not be required to use these special codes.
2. The same documentation standards would apply for the new codes as those proposed for other providers’ office and outpatient E/M visits, suggesting that the services and clinical expertise provided in podiatry visits is comparable visits with other physicians.
3. CMS does not suggest that DPMs’ level of medical decision making is less than MDs/DOs, yet proposes this as a standalone basis for documenting E/M visits.

These factors clearly demonstrate that separate payment for E/M services provided by DPMs is not warranted, and that DPMs should be paid in the same manner and amount as all other Medicare physicians.

CMS’ proposal to collapse payment across Level 2 through 5 visits would reduce access to care for many vulnerable patients, leading to significant patient harm. I support CMS’ efforts to reduce administrative burden but I do not believe that this proposal would achieve this goal. Physicians will still spend the same amount of time with their more complex patients. CMS’ per visit payment would be insufficient to capture the full costs of furnishing this care. Thorough medical records are still necessary for these patients for purposes of completeness, safety, continuity of care, and risk management. None of that will change by decreasing CMS documentation requirements. These complex patients, a significant part of the Medicare population, frequently have multiple complications and require significantly more time and attention to properly treat. If this proposal goes through, the unfortunate reality is that many specialty Medicare physicians will likely face strong incentives to either limit care or require complex patients to return for multiple visits. CMS’ approach would apply a blunt payment that does not allow for more tailored care delivery. It would not decrease the amount of time I will spend with my future patients to thoroughly document their conditions or complaints.

I do not believe CMS has considered its proposals’ impacts on individual clinicians or practices. CMS only provided estimates broken down by specialty. However, patient health and population vary widely by region, even within a specialty. Practices that regularly manage or treat the most complicated patients would be especially harmed by insufficient reimbursement for complex visits.

CMS should continue its longstanding policy of providing consistent payment to all physicians, regardless of specialty and it should retain the current levels of E/M coding.

I also disagree with CMS’ assertion that separately identifiable visits occurring on the same day as a 0-day global procedure have significant overlapping resource costs. I strongly urge CMS to rescind this proposal.

According to CPT guidelines, modifier 25 is used to indicate a significant, separately identifiable, and medically necessary E/M service provided on the same day as a procedure. Providing medically necessary, separate, and distinct services on the same date of service allows physicians to provide effective high-quality care. Such services should be reimbursed appropriately and in accordance with established coding guidelines, whether used on the same date or different dates. This ensures that payments are sufficient to cover costs and leads to improved outcomes. More importantly, it makes it easier for patients who can avoid additional trips to the office and allows them to receive care that they need.

Thank you for your time and consideration.