IMHO what is happening in my region is this. When I graduated many years ago residency was not a requirement to go into practice. Like many of my fellow colleagues in my area we went into practice either because we didn't get a residency or because there was a job opportunity available.
The states eventually changed to make residency training MANDATORY.
Over the past several years Insurance Companies have changed their requirements to include residency training as necessary to become a participating practitioner. Some practitioners have been Grandfathered into these insurance companies, however any nonresidency trained practitioner wishing to move to my region, or changing from clinic type work to private practice type work will be in the same boat that I'm in.
To make matters worse, Medicare pts are switching plans to, for ex., a Blue Cross plan that demands practitioners be board certified. Board Cert is impossible without residency training. This large group of previous Medicare only pts. will disallow any reimbursements to nonpar pods, even those pods who are on par with Medicare.
The push toward bigger better residency programs is leaving the older CC practitioners in the dust. Even those grandfathered without formal residency training who are on local insurance plans cannot move and become participating on insurances in a new location.
Yes, you and others with 3 years of residency training will have the chance to be participating and get PAID for the same exact nail debridement done by nonresidency trained pods.
When I mention parity, I'm refering to parity within our own field. Why should 1 practitioner with the same state license be eligible for insurance participation and reimbursement, and another practitioner recieves no money for the same exact procedure...nail debridement, ulcer care, etc.?
As we move the field toward a 3 year surgical residency requirement, eventually the states will change to mandate 3 years of residency training for state licensure; insurance companies will jump on the band wagon and have even more reason to prevent participation and reimbursements. Pods with less than 3 years of training will be stuck in 1 locality because they will not be able to afford to move because they cannot become participating with the local insurance companies and obtain reimbursements.
IMO a 2 year model with the bread and butter surgical training would be ideal IF available to everyone. If, after 2 years of residency, someone wants more specialized training there should be a way to apply for a 3rd year fellowship/residency.
How does one become more involved with the APMA? I can't afford to join their club, and realistically don't think I'll be able to afford to remain in podiatry without residency training.
