I need help interpreting an xray
Started by GeauxT
Wondered about that too.
Shame there were no podiatrists in Louisiana to take her to the OR for one fungal nail that will grow back fungal, some plantar fasciitis, and one HT.
Shame there were no podiatrists in Louisiana to take her to the OR for one fungal nail that will grow back fungal, some plantar fasciitis, and one HT.
YOU READ MY MIND. I was cursing at the TV and my wife was like "what's your problem?". That episode was an embarrassment for our profession.
Another thing that chaps my ass about this TV show is that they don't even refer to themselves as a podiatrist. It says "foot and ankle specialist" underneath their names. The one time we finally have NATIONAL attention and we hide behind "foot and ankle specialist" instead of just calling ourselves what we are...PODIATRISTS. Say it. Saaaaay it. You can do it.
We are not foot and ankle orthopedists. Your fellowship training does not make you a foot and ankle orthopedist
To the common person watching the show this would have been a GREAT time to educate the national audience on who we are and what we do. But now they think they are just foot and ankle specialists and not podiatrists.
This is the final xray.
This is a terrible X-ray.
My feet are killing me should be renamed "Modern day TFP"
Yikes
Im pretty happy DPM is not attached to that xray for everyone to see....
This is the final xray.
This is crazy .. why would they let this be public ?!
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My wife and I are both podiatrists, and we were just in awe. I'm not trying to cut down others in our profession, but if you choose to make yourself a very public figure you should at least have some idea what the hell you are doing.
The doctor who performed that procedure is only 1 year out of residency. Her own bio states "As a highly regarded expert in the field of podiatry."
Our profession always finds new and exciting ways to set ourselves back...
The doctor who performed that procedure is only 1 year out of residency. Her own bio states "As a highly regarded expert in the field of podiatry."
Our profession always finds new and exciting ways to set ourselves back...
still trying to figure out how she got asked to be on the show....
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D
deleted1003403
reality tv. Both people are marketable.
yeah, i guess being fat and bald isn't going to attract the viewers
He was on the Rock's Titan Games.
Neal Blitz, Khosroabadi, and that whole cali crowd etc.. should have been on that show and would rep the field correctly ... just noone from park ave in nyc
I think the episode title is the PERFECT interpretation of the image.
S1 Ep2 - "Looks bad, Feels worse."
S1 Ep2 - "Looks bad, Feels worse."
Maybe feels bad, ends up looking worse
Yes, then one will need to go in and remove it on the 92nd day post op to help "maximize the outcomes"
She knows. She’s an expert of our field. She’s been practicing for one year
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Amazing that they choose two docs who aren’t even ABFAS certified.
No one in the world has to fly from Atlanta to NJ for a toe amp. So it’s pretty obvious the show is doing marketing nationally to find unique cases.
i could only watch the first episode without throwing an old Miltex tissue nipper at the screen.
My review:
1) how many of YOU take off the patient’s shoes and socks?
2) how many of YOU would take off a patient’s shoes and socks without wearing gloves?
3) how many of YOU would alarm a patient that schniding the callus on a hemophiliac can cause the person to “bleed out”?
4) How many of YOU would then announce “oops I just cut you”.
5) How many of YOU did a TAL surgery that re-ruptured AND dehisced?
6) How many of YOU need another DPM in the room for a toe amp?
7) How many of YOU make a circular incision around the toe to perform a toe amp vs a racquet or ellipse?
8) how many of YOU need to take out a power saw to disarticulate an extra toe that has no synostosis or branching from the metatarsal?
9) how many of you bend over into unnatural positions to amp a toe instead of just adjusting the OR table?
Obviously they chose these docs for their looks and not experience or skills. It’s really embarrassing.
And using the two docs from Cali would have been worse. These docs hawk cosmetic surgery and come up with “trade” names for a simple chevron bunionectomy.
If I was an orthopod I’d be pissing in my pants laughing.
The show should be relabeled a comedy. Or maybe a tragedy.
No one in the world has to fly from Atlanta to NJ for a toe amp. So it’s pretty obvious the show is doing marketing nationally to find unique cases.
i could only watch the first episode without throwing an old Miltex tissue nipper at the screen.
My review:
1) how many of YOU take off the patient’s shoes and socks?
2) how many of YOU would take off a patient’s shoes and socks without wearing gloves?
3) how many of YOU would alarm a patient that schniding the callus on a hemophiliac can cause the person to “bleed out”?
4) How many of YOU would then announce “oops I just cut you”.
5) How many of YOU did a TAL surgery that re-ruptured AND dehisced?
6) How many of YOU need another DPM in the room for a toe amp?
7) How many of YOU make a circular incision around the toe to perform a toe amp vs a racquet or ellipse?
8) how many of YOU need to take out a power saw to disarticulate an extra toe that has no synostosis or branching from the metatarsal?
9) how many of you bend over into unnatural positions to amp a toe instead of just adjusting the OR table?
Obviously they chose these docs for their looks and not experience or skills. It’s really embarrassing.
And using the two docs from Cali would have been worse. These docs hawk cosmetic surgery and come up with “trade” names for a simple chevron bunionectomy.
If I was an orthopod I’d be pissing in my pants laughing.
The show should be relabeled a comedy. Or maybe a tragedy.
you are exactly right with the rest of your post. But I’ve worked with several “ABFAS certified” podiatrists. That is very much a meaningless designation...
Preach it. We need to stop the narrative that ABFAS is gold standard. There is no gold standard in podiatry. You either know what you are doing and or you don’t. I’ve seen plenty of DPMs grandfathered in who can’t even do a toe amputation. I’ve seen plenty of DPMs who are rearfoot certified who honestly can’t cut and have the residents do their cases which they submitted to ABFAS in the first place to get certified. It’s a crock
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The only good I've seen from these TV shows (like "The Toe Bro", "My Feet Are Killing Me")--more and more people are becoming aware of podiatrists and what we do. I have had a pretty good influx of new patients come in stating they looked me up after watching one of these shows. I haven't watched any of them, and it sounds like I don't want to--but anyways, more public awareness is definitely a good thing. The public has no idea if the TV surgeons are hacks or not--after all, they must be amazing surgeons if they have their own TV show haha. Like someone else said, it's more concerning that these shows are an embarrassment in front of our MD colleagues...
Like it or not ABFAS is our gold standard. I'm not saying its perfect but it's the most accepted board and the board most hospitals want for credentialling. ABPM does not cut it at most places to get privileges and that's not going to change.
We are not the only profession who dislikes their board. Next time you're operating ask your anesthesia provider what they think about their board.
We are not the only profession who dislikes their board. Next time you're operating ask your anesthesia provider what they think about their board.
I’ll gladly trade whatever anesthesia or (more notably) IM doesn’t like about their boards...for their pass rates...
What’s the matter DYK? You sound like your running for ABFAS position in the future. “Like it or not” - LMAO
You sound like every other podiatrist who “gets theirs” and yet does nothing to fix the real issues facing our profession.
Your remind me of those really annoying kids in class, who KNOWS the rules are stupid, foolish, ignorant, and yet still wants to abide by them. I am working with the hospital admin for the hospital system I’ve worked for to change the bylaws here to accept other boards, so I KNOW I’ve worked to change things for the better.
What have you done? Other than defend a corrupt institution, maybe sit on the ACFAS young members committee going over goals for future fellowships.
Yeah, I got diarrhea watching that dude and his assistant attempt to amputate the toe.
Daaaaaaaaamn....but hey he/she has been keeping it real since 1981
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Really? I wont personally attack your opinion but I stand by my statment: ABPM essentially worthless and ABFAS is our gold standard.
Not getting ABFAS significantly limits places you can practice and that's a fact.
I didnt say I liked it. I didnt say there were not problems with it. I think it could be improved. But again we are not the only profession with board complaints.
I do agree our pass rates are too low.
I dont sit on any committee. I go to the conference every year to get my CME and hang out w my friends and thats about it. I'm not political and could care less about ABFAS/ABPM/any other board politics.
Just when I thought we couldn’t get any dumber. Podiatry does this...
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I also want to point out that our pass rates are low... But many of us are not overly qualified (see the xray photo that started this thread). I mean come on. That's horrible and was on national tv for everyone who is in the know to laugh about. That hammertoe correction is destined to fail.
About 50% of our residencies are less than high powered. I've visited a residency program that had 3 people triple scrubbing a hammertoe.
1/2 of podiatry students should not have been admitted to school or worse yet given a scalpel. If I were on the board and saw that hammertoe correction above that's a 100% fail. There were people in my class I would not let anywhere near me with a scalpel.
I see stuff people post on social media that is equally as bad. I saw an ankle case recently that was absolutely horrible but the doc thought they did an awesome job. I mean... it was worse than preop but with some screws. (Also to add that posting any patient's xray on social medial is not OK)
It's my opinion and I know there are flaws in the board but maybe 40% of us are not meant to be surgeons...
About 50% of our residencies are less than high powered. I've visited a residency program that had 3 people triple scrubbing a hammertoe.
1/2 of podiatry students should not have been admitted to school or worse yet given a scalpel. If I were on the board and saw that hammertoe correction above that's a 100% fail. There were people in my class I would not let anywhere near me with a scalpel.
I see stuff people post on social media that is equally as bad. I saw an ankle case recently that was absolutely horrible but the doc thought they did an awesome job. I mean... it was worse than preop but with some screws. (Also to add that posting any patient's xray on social medial is not OK)
It's my opinion and I know there are flaws in the board but maybe 40% of us are not meant to be surgeons...
I don’t disagree with any of these points but if ABFAS had just maintained some of their volume and diversity criteria a lot of these people would be weeded out from the very beginning. They would never have the cases to sit. With them lowering the volume criteria it makes ABFAS literally mean nothing to me and now looks like more of a money grab than it already was.
ABFAS is only relevant because they were smart enough to get it written into the bylaws of every state scope of practice law therefore all the hospitals just copied that. If ABPM had beat them to the punch it would be their board being relevant not ABFAS.
The people who own and run ABFAS had the foresight to make this happen and they’ve cashed in big time because of their early endeavors. It had nothing to do with quality. It’s just another podiatry scam that actually worked. Now the entire USA accepts the ABFAS board and makes it mandatory for surgical privileges.
I’d make my board pass rate extremely low too so I could get more and more monies from desperate DPMs trying to make a living. The greatest podiatry scam of all time.
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Man when they get sued and the prosecution uses their nationally syndicated evidence in court, we are done for lol
I'm glad the only people that saw my first year out of residency xrays were ABFAS.
I'm glad the only people that saw my first year out of residency xrays were ABFAS.
Given that this thread has now shifted to talking about ABFAS and APMA. I wanted to ask this question:
As a 2nd year podiatry student, I've been keeping up to date on all discussions related to what this sub-forum talks about often.
Given the uniform consensus on how bad our ABFAS pass rates are and how corrupt they are in making a profit off of us, is there any way that we can turn this around and cause an internal change? I guess what I am getting at is something similar to politics where you can vote out people in power to elect a new person/board that can represent the peoples (podiatrists) will or vision. There has not been much talk regarding this specifically so I am not accustomed to that process and apologize for my lack of knowledge regarding that. I just feel that since there is so much anger/hatred/annoyance with the system, why has nothing been done yet?
As a 2nd year podiatry student, I've been keeping up to date on all discussions related to what this sub-forum talks about often.
Given the uniform consensus on how bad our ABFAS pass rates are and how corrupt they are in making a profit off of us, is there any way that we can turn this around and cause an internal change? I guess what I am getting at is something similar to politics where you can vote out people in power to elect a new person/board that can represent the peoples (podiatrists) will or vision. There has not been much talk regarding this specifically so I am not accustomed to that process and apologize for my lack of knowledge regarding that. I just feel that since there is so much anger/hatred/annoyance with the system, why has nothing been done yet?
Those in power stay in power with the same tactics that got them there.
Just look at some of the people in your class already in APMSA positions...when you're riddled with debt, have a family to care for, a future to prepare- do you have the time, energy, or patience to deal with people who have done what they did to get there?
Again, just look at the worst examples in your school.....now imagine them being in positions of power.
I didn't understand why until I did this.
Weirdy I've seen some angry posts lately and I just want you to know - your level of dissatisfaction needs to be keyed into your position in the current DPM hierarchy.
(1) 1st year - realizing that your school sucks at teaching and it was all a lie to get you in the door. Remember those people on your tour who said "mandatory attendance is really great". Yeah. Right.
(2) 2nd year - learning podiatry from people who are soooo accomplished that they... teach at a podiatry school. But damn, they tell the best stories about that ankle fracture they did 20 years ago in residency. Great lecture...oh but its really just a summary out of Mann.
(3) 3rd year - realizing that our boards are written by the stupidest people in the world (hint, your professors). Learning for all the talk about an education devoted to the foot and the need to really examine patients and explore their problems all your professor/DPM really wants is to run in, bust that nail, and get out the door. Learning about VA podiatrists and VA patients. And they have residencies too. 'Murica.
(4) Going broke traveling around the country to realize that many of the residencies suck and that many of the residents you meet are psychopath douchebags. Trying to cow the voice in the back of your head that says - wow, that was a neat case, though the resident never seems to hold the blade...
(5) Yadda yadda yadda, getting a private practice job sucks, board certification sucks, our national leadership sucks, eventual acceptance.
In short, return to your position in line.
Jk, do whatever you want.
(1) 1st year - realizing that your school sucks at teaching and it was all a lie to get you in the door. Remember those people on your tour who said "mandatory attendance is really great". Yeah. Right.
(2) 2nd year - learning podiatry from people who are soooo accomplished that they... teach at a podiatry school. But damn, they tell the best stories about that ankle fracture they did 20 years ago in residency. Great lecture...oh but its really just a summary out of Mann.
(3) 3rd year - realizing that our boards are written by the stupidest people in the world (hint, your professors). Learning for all the talk about an education devoted to the foot and the need to really examine patients and explore their problems all your professor/DPM really wants is to run in, bust that nail, and get out the door. Learning about VA podiatrists and VA patients. And they have residencies too. 'Murica.
(4) Going broke traveling around the country to realize that many of the residencies suck and that many of the residents you meet are psychopath douchebags. Trying to cow the voice in the back of your head that says - wow, that was a neat case, though the resident never seems to hold the blade...
(5) Yadda yadda yadda, getting a private practice job sucks, board certification sucks, our national leadership sucks, eventual acceptance.
In short, return to your position in line.
Jk, do whatever you want.
I liked this statement in PMNEWS
Most people will gain interest in our profession from the show and ask more questions about what we can do.
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Would appreciate if you could expand on this and include residency. Maybe even throw in a fellowship year?
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That's the spirit champ!
lol...with all the complaints I have about the profession (legitimate as they are), I enjoy working in a rural setting. I ask just about every one of my patients that aren't retired what they do. Their jobs usually SUCK. Anything that requires steel toed boots would make me want to off myself right now. Anyways, makes me a little more thankful for what I get to do every day. I think the fact that the real world doesn't square up with what we imagined when we first begged that bitch Sallie Mae to put us into indentured servitude shouldn't get us down for too long. Everybody chin up!
And HERE lies the REAL problem!! The source of it all!
Great stuff , This is so true! what a shame ...
My last post was too bitter. So I bring you this beautiful podiatry tale. Obviously this wasn't inspired by anyone here. This is very clearly all original material.
The soft hum of anesthesia doing a crossword radiates from the top of the bed. Further down, a leg sits exposed in an overly complicated state of prep.
The sprawling OR is full to the brim with 15 different sets of hardware. Additional back tables have been borrowed from all across the hospital. An experienced tech lectures a young protégé.
“…now normally you wouldn’t be allowed in this room, but I thought this could be good for to begin familiarizing yourself with the...”
“Do we usually scrub podiatry cases?” the tech interrupts.
A gasp fractures the air from behind her mentor's mask.
“We scrub FELLOWSHIP trained foot and ankle surgery cases in this OR. Use that word again and I’ll have you in some orthopedic shoulder case trying to figure out what’s happening with a scope that doesn’t point straight…”
The tirade is cut short by the door opening.
A merry, manly laugh cuts the air, “I’m here, I’m here, shut up anesthesia, I’m here. A surgeon is here.”
Dr. Fellowbro strode into the room confidently. Immediately, he is followed by three lady device reps, each more beautiful and expensive than the last, ready to shower him with new indications for their many screws, and staples, plates, and placentas. A lone bro rep also enters, there to share in stories of his doctor’s conquests.
What can we say of Dr. Fellowbro – he is unbent by his many years of training and additional and totally necessary fellowship year. A customized lead apron sits lightly on his shoulders. Close examination would show it is covered in tibias, fibulas, calcanei – the only bones worth operating on as he would say – and dollar bills – what everything he touches turns into. The words “Foot and Ankle Surgeon” are emblazoned, XXL.
“Shall we do our time out?” the circulator asks?
“Of course. Our patient went to see a pathetic old toediatrist who couldn’t even put a needle in their ankle.”
“And what will we be doing today?”
“A TAR of my choice – I have 3 in the room, Koutsy-gots-to-get-paid, gastrocnemius recession with sural nerve obliteration, subtalar joint arthroscopy – anterior and posterior, lapidouchey, a new form of lapidus that makes Paragon and Biomet’s nails look like cavemen with sticks, and then I’ll be placing 4 different toe implants as a form of a controlled trial. I also want to try out a new technique I saw on My Feet are Killing Me… just kidding, gross.”
“Excellent. Doctor, we also have a podiatry resident here who was hoping to scrub in.”
“Ah yes, the residency the hospital started to make more money. I’m surprised they let you out clinic. Welcome. I remember when I used to be a podiatrist. You’ll of course want to do an Arthrex Approved Fellowship when you graduate. Stand here to retract.”
“Don’t you mean ACFAS?”
“No, and also I will need you to round on this patient tomorrow because they are going to be in a lot of pain. Now someone bring me my blade. The one I invented that cuts straight down to the periosteum but avoids neurovascular structures.”
“Doctor”, one of the reps interrupts, “shall I take pictures during the case?”
“Of course my rep – pictures are the lifeblood of my presentations. Why, I remember when I was a FELLOW presenting my attendings’ cases at ACFAS – people just loved it. Nothing like presenting a case you haven’t followed at all that you just know went perfectly. People can really learn from that.”
“Tourniquet up?”
“Of course. What is this – the PI Institute? We’ll need to be efficient today. I have a busy day planned after this case. Yesssss…
I’m starting the day off with a conference call to try and get non-Fellowship trained podiatrists banned from doing ankles. I’ve heard wonderful stories from the northeast of doctors working together to screw young PMSR/RRA surgeons, dinosaurs really, from operating, and I want to help.”
“Great idea.”
“And then, very ironically, I’m going to do some out of network $1000 nail avulsions for patients from Louisiana. Apparently they don’t have podiatrists there or something.”
“Very noble”.
Dr. Fellowbro’s attention returned to the ankle – his precise cuts exposing the anatomy. His skills – legendary – why Schuberth had allowed him to make TAR cuts as a visiting student! But something wasn’t right. The light wavered, the vision changed.
“Doctor?”
Where once there had been an exposed ankle, now a disgusting fungal toenail.
“Hey DOC, you cut the nails too short last time on that toe and left it too long on the other.”
The beautiful scalpel transformed into a pair of nail nippers. The nail exploded in a cloud of dust, shimmering and disappearing into the stale air like dreams in the breeze.”
A curt rap on the door is followed by the face of one of the nurses he couldn’t fire.
“Ms. Blah says you missed a callus and also she needs to come back in exactly 60 days, not 3 months.”
Exiting the room Dr. Sadbro is met by the office manager, his boss’ wife.
“Oh doc, you were asking me about your collections. Yes, they are currently zero because you are still on my husband’s insurance plans. But don’t worry, we’ve got you on a great base salary.”
The soft hum of anesthesia doing a crossword radiates from the top of the bed. Further down, a leg sits exposed in an overly complicated state of prep.
The sprawling OR is full to the brim with 15 different sets of hardware. Additional back tables have been borrowed from all across the hospital. An experienced tech lectures a young protégé.
“…now normally you wouldn’t be allowed in this room, but I thought this could be good for to begin familiarizing yourself with the...”
“Do we usually scrub podiatry cases?” the tech interrupts.
A gasp fractures the air from behind her mentor's mask.
“We scrub FELLOWSHIP trained foot and ankle surgery cases in this OR. Use that word again and I’ll have you in some orthopedic shoulder case trying to figure out what’s happening with a scope that doesn’t point straight…”
The tirade is cut short by the door opening.
A merry, manly laugh cuts the air, “I’m here, I’m here, shut up anesthesia, I’m here. A surgeon is here.”
Dr. Fellowbro strode into the room confidently. Immediately, he is followed by three lady device reps, each more beautiful and expensive than the last, ready to shower him with new indications for their many screws, and staples, plates, and placentas. A lone bro rep also enters, there to share in stories of his doctor’s conquests.
What can we say of Dr. Fellowbro – he is unbent by his many years of training and additional and totally necessary fellowship year. A customized lead apron sits lightly on his shoulders. Close examination would show it is covered in tibias, fibulas, calcanei – the only bones worth operating on as he would say – and dollar bills – what everything he touches turns into. The words “Foot and Ankle Surgeon” are emblazoned, XXL.
“Shall we do our time out?” the circulator asks?
“Of course. Our patient went to see a pathetic old toediatrist who couldn’t even put a needle in their ankle.”
“And what will we be doing today?”
“A TAR of my choice – I have 3 in the room, Koutsy-gots-to-get-paid, gastrocnemius recession with sural nerve obliteration, subtalar joint arthroscopy – anterior and posterior, lapidouchey, a new form of lapidus that makes Paragon and Biomet’s nails look like cavemen with sticks, and then I’ll be placing 4 different toe implants as a form of a controlled trial. I also want to try out a new technique I saw on My Feet are Killing Me… just kidding, gross.”
“Excellent. Doctor, we also have a podiatry resident here who was hoping to scrub in.”
“Ah yes, the residency the hospital started to make more money. I’m surprised they let you out clinic. Welcome. I remember when I used to be a podiatrist. You’ll of course want to do an Arthrex Approved Fellowship when you graduate. Stand here to retract.”
“Don’t you mean ACFAS?”
“No, and also I will need you to round on this patient tomorrow because they are going to be in a lot of pain. Now someone bring me my blade. The one I invented that cuts straight down to the periosteum but avoids neurovascular structures.”
“Doctor”, one of the reps interrupts, “shall I take pictures during the case?”
“Of course my rep – pictures are the lifeblood of my presentations. Why, I remember when I was a FELLOW presenting my attendings’ cases at ACFAS – people just loved it. Nothing like presenting a case you haven’t followed at all that you just know went perfectly. People can really learn from that.”
“Tourniquet up?”
“Of course. What is this – the PI Institute? We’ll need to be efficient today. I have a busy day planned after this case. Yesssss…
I’m starting the day off with a conference call to try and get non-Fellowship trained podiatrists banned from doing ankles. I’ve heard wonderful stories from the northeast of doctors working together to screw young PMSR/RRA surgeons, dinosaurs really, from operating, and I want to help.”
“Great idea.”
“And then, very ironically, I’m going to do some out of network $1000 nail avulsions for patients from Louisiana. Apparently they don’t have podiatrists there or something.”
“Very noble”.
Dr. Fellowbro’s attention returned to the ankle – his precise cuts exposing the anatomy. His skills – legendary – why Schuberth had allowed him to make TAR cuts as a visiting student! But something wasn’t right. The light wavered, the vision changed.
“Doctor?”
Where once there had been an exposed ankle, now a disgusting fungal toenail.
“Hey DOC, you cut the nails too short last time on that toe and left it too long on the other.”
The beautiful scalpel transformed into a pair of nail nippers. The nail exploded in a cloud of dust, shimmering and disappearing into the stale air like dreams in the breeze.”
A curt rap on the door is followed by the face of one of the nurses he couldn’t fire.
“Ms. Blah says you missed a callus and also she needs to come back in exactly 60 days, not 3 months.”
Exiting the room Dr. Sadbro is met by the office manager, his boss’ wife.
“Oh doc, you were asking me about your collections. Yes, they are currently zero because you are still on my husband’s insurance plans. But don’t worry, we’ve got you on a great base salary.”
Such elegance, very poetic, so wow
This might just be one of the best posts in the history of this forum.
this post should be stickied. Not the thread. Just this one, single, beautiful post.
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