...I could go on and on...Progress is made by forward thinkers who take risks. Next time you meet a Podiatrist who is over 60, tell him/her thank you for all the forward thinking they did that got our profession so far in such a short period of time. Then think about how YOU will impact this profession so profoundly.
This is just a fundamental difference in philosophy. There's no right or wrong answers here.
Personally, I just tend to subscribe to the cliche mindset that "you don't want to be the first or the last guy doing something." If something works well, it will catch on (VAC, lock plating, DBM, etc), and if it doesn't, then you will be glad you weren't the guy experimenting on patients in order to get money for a study and/or to stroke your ego by being "revolutionary." The way I see it, my **** is pretty big, my wife is pretty hot, my life is pretty good, and as surgeons, we are already blessed with the skill set to change human anatomy and improve function. I'm certainly content letting some other guy be "the first" when it comes to inventing new totally new procedures or putting new devices into the body. I'm also not a huge fan of raising taxes or insurance premiums any higher than they need to be by using toys just for the sake of using them... even if "everybody else is doing it."
If a new device or procedure comes along that makes intuitive sense to me, I will certainly employ it. However, if we already have similar options which work fine for the procedure/pathology (again, we pretty much do have that for every F&A pathology I can think of... besides maybe RSD lol), then I have no problem waiting for the industry companies to create copycat products and underbid one another. I think SmartToe (buried k-wire), syndesmosis tightrope (screw), mini locking plates (crossed screws), endoscopic gastroc (mini-open), DBM (calc autograft or marrow aspirate), etc make a lot of sense... but when the costs remain pretty outrageous and there are much cheaper satisfactory options (in parenthesis), I probably won't be jumping to use the high-cost toys.
...Again, there is no easy answer, and I'm sure there's a happy medium between "cowboy" and "stone age" F&A surgeon. As far as thanking previous DPMs, I certainly do. More than anything, I'll thank them for increasing post-grad training in order to give residents the opportunity to learn the anatomy, techniques, pathology, and medicine better. The rep "toys" are great, but they have nothing to do with what has really advanced our profession: better education, training, and knowledge of the anat/pathology/treatments. I think that some individuals get too focused on the toys as a magic bullet and way to potentially compensate for inferior surgical (and clinical) evaluation/planning/technique - as well as failing to realize the exponential cost they bring.
When I look at many of the guys whom I veiw as the best modern F&A surgeons, I see that they really haven't done a whole lot besides emphasize learning or provide slight modification/enhancements to previously existing tools or procedures. Shockingly, they've managed to make quite a mark in our field without ever even naming a screw, procedure, implant, etc after themselves:
-Schuberth, Malay, Kalish, Jacobs, etc encouraging us to be scientists and lifelong learners as well as just technicians
-Ruch et al advocating strong AO techniques for improved stability in F&A surgery
-Sanders pilon protocol of plate fib and ex-fix tib... or to consider primary STJ desis if severe calc fx
-Weinraub retractor to save time on proven desis or graft procedures
-Downey, Steinberg, Camasta, etc encouraging us to focus as much on patient selection and communication as surgery itself
-Hansen theory of essential and nonessential joints
-Yu [re]popularizing the time tested mpj1 desis after the implant craze swept through podiatry
-Northwest, inc emphasizing the power of equinus on foot deformities
-Myerson educating on many minimally invasive techniques of existing procedures for faster surg and faster healing
-Coetzee adding evidence that lisfrance desis off the bat may save cost+suffering
-Catz+Mendo popularizing Lapidus, allografts, etc, in podiatry
...Again, all just my (inexperienced) views. Maybe my opinions will change someday and I'll be gunning to throw a robotic STJ into all of my patients. Who knows lol...