The AAOS and AOFAS agenda

[iceman55]

I did over a 100 ankle fractures ORIFS in my 3 years of podiatry residency and over 50 total ankle replacements. Since graduation from residency I’ve done another 35 or so ankle fractures in a state that historically unfair to podiatrists. I get these opportunities from the orthopedists at my hospital who are general, sports medicine and/or total joint trained who want nothing to do with them unless it’s an isolated fibula fracture because there is no way they could screw that up (sometimes).

What happens when your patient has a missed torn syndesmosis or ATFL or OCD of the talar dome that was missed and complicated the recovery period? Your patient comes to you Mr. Awesome Orthopedic Real Doctor/Surgeon MD/DO and complains of generalized ankle joint swelling and pain. At that point you might refer to your orthopedic F/A fellowship trained colleague but the patient has Medicaid and you don’t want to do that to your bro. So you repeatedly tell the patient the fracture is healed and you have no idea what’s wrong. Patient gets frustrated and they come to a podiatrist who accepts their insurance and helps the patient.

This scenario plays out almost on a weekly basis in my practice. Again it’s regional. Some areas of the country the foot and ankle ortho experience is stout in the ortho residency experience because these residents are exposed to attendings with foot and ankle practices. But there are a lot of ortho residencies where there are no attendings involved in ortho training with foot and ankle experience. These ortho residents only foot and ankle experience ends up being during their foot and ankle fellowship year. This is why the AOFAS has set up traveling residency experiences for ortho residents looking for foot and ankle exposure during their residency training. They know it’s a problem and have attempted to address it.

Lastly, I do NOT care how many ankle fractures you have done so far in your ortho residency. You are still a crappy foot and ankle surgeon at this stage of your career. Come talk to me when you understand and have mastered the techniques of complex bunion correction, hammertoes, flatfoot correction, large OCD talar dome management, ankle arthroscopic ankle fusions, total ankle replacements, tendon transfers of the foot and ankle etc etc etc etc etc etc etc etc etc

You are correct that a lot of ortho residencies may be lacking in terms of attending presence in F/A. And thus, may not see a lot of total ankle replacements, bunions, recon hindfoot cases etc. But that is ok because most non F/A trained orthopods will not be taking care of those cases anyway. They will refer them to a ortho F/A or a podiatrist that those them. The cases you mention are elective cases and should be taken care of by a specialist. And that is the goal of the AOFAS to expose residents to some of these ELECTIVE cases.

However, in regards to trauma/fracture care of the foot/ankle, i can assure you every ortho residency accredited by the ACGME gets adequate experience, this includes lisfranc fx/dx, talar neck/body fx, calcaneus fx, pilons, also other midfoot and forefoot fxs

Also at most ortho programs, the ortho trauma doc takes care of most foot/ankle fractures that are treated acutely, its part of their fellowship training

The cases you mention in your last paragraph are part of our F/A rotation, and peds ortho rotation . And we get decent experience in those. But is the average ortho resident capable of doing those solo right of residency without fellowship hell no! They are elective cases that should be referred. Even talar neck/calc/lisfrancs should probably be referred to ortho trauma or F/A. However you’ll find more ortho guys that are used to taking call that will tackle the complex foot trauma

Also your experience in the community at low volume hospitals maybe different I cant speak to that but saying a general orthopedic surgeon is not capable of fixing an ankle fracture simple or complex is like saying that physician is not qualified to be an orthopedic surgeon.

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[dtrack22]

Also your experience in the community at low volume hospitals maybe different I cant speak to that but saying a general orthopedic surgeon is not capable of fixing an ankle fracture simple or complex is like saying that physician is not qualified to be an orthopedic surgeon.

this is where I have seen issues. Community hospitals covered by a small ortho group with no F/A ortho and no traumatologist, where 50-70 yo orthos, who primarily do joints but have to take call, have a higher than expected % of complications when it comes to foot and ankle trauma. When you look at intra-op or 1st post-op films you understand why. Malreduction, inadequate fixation of posterior mal fxs, inadequate syndesmosis reduction, etc.

In the one year where I worked in a setting like that, I saw a handful of patients who had ankle trauma, fixed very poorly by local ortho. As in, our attending would have yelled at us and made us open the patient back up if our fluoro shots looked like that in residency. As in, a podiatrist who did the same work would have local orthos in town telling the patient they could sue the podiatrist. Or get reported to quality control by another doc on staff. I get why podiatrists get frustrated when they see bad work by ortho, we are usually held to a different standard when it comes to credentialing, just because of the degree.

But you are right, in an academic center setting you’ll never be exposed to any of this and are understandably hard pressed to believe it’s even possible an ortho couldn’t fix a bimal well.

 

[deleted1061086]

Your comment about general orthopedic surgeons and ankle fractures is soo wrong, literally could not be further from the truth.

Trauma , upper and lower extremity fractures is such a big part of orthopedic surgery residency. Long bone fractures , shoulder, wrist, hip and ankle fractures are bread and butter orthopedics, what do you think we do in our five years of residency, which includes taking call all five years. In general, Fracture care is the basis of our education.

As a 3rd year ortho resident I have already logged about more than 30 ankle ORIFs and i haven’t even done my ortho trauma rotations yet. Those cases have all come just from being on call. After completing residency if I had to guess, i would say the average graduating ortho resident has logged at least 150 ankle ORIF.

Almost every weekend we’re on call, an ankle ORIF is almost guaranteed. and no it’s not getting sent to our F/A specialist, it’s taking care of that weekend by the on call attending, that may normally mostly do hand/spine, or if it’s during the weekday its added on for our ortho traum doc.

Also you forget about fellowship trained orthopedic trauma surgeons

Btw, I have a relatively recent interest in F/A and thinking about possibly pursuing a fellowship in it. Hence why I’ve ended up on this page.

Also, forgot to mention, yes we do an F/A rotation but that usually involves more complex trauma cases or elective recons , most of our ankle fx experience comes from call or our ortho trauma rotations

Every ortho resident at my hospital system had very high volume to ankle fractures and fracture management of the rest of the skeletal system. Even with ortho trauma fellows they easily did a few hundred ankle fractures alone. All of them had the training to treat these injuries whether or not they went on to fellowship training in trauma or foot and ankle. There are always under performers in every profession. If I have an ankle fracture on vacation away from where I live and work, unless I know the local pod and their training extremely well, I want the orthopedist fixing it. This isn’t even a discussion. It’s important to know our strengths and weaknesses no matter the initials behind our name.

 

[iceman55]

Every ortho resident at my hospital system had very high volume to ankle fractures and fracture management of the rest of the skeletal system. Even with ortho trauma fellows they easily did a few hundred ankle fractures alone. All of them had the training to treat these injuries whether or not they went on to fellowship training in trauma or foot and ankle. There are always under performers in every profession. If I have an ankle fracture on vacation away from where I live and work, unless I know the local pod and their training extremely well, I want the orthopedist fixing it. This isn’t even a discussion. It’s important to know our strengths and weaknesses no matter the initials behind our name.

This was the point of my original post, that ankle fractures are a basic part of an orthopedic education. And saying that an orthopod may have only done 5-10 in residency is just completely ridiculous and wrong.

 

[deleted1061086]

This was the point of my original post, that ankle fractures are a basic part of an orthopedic education. And saying that an orthopod may have only done 5-10 in residency is just completely ridiculous and wrong.

Yea let’s let him take that one back.

 

[CutsWithFury]

This was the point of my original post, that ankle fractures are a basic part of an orthopedic education. And saying that an orthopod may have only done 5-10 in residency is just completely ridiculous and wrong.

Yea let’s let him take that one back.

Doing ankle fractures and managing their complications are two different things. That is my point. Again just because you are doing them in residency doesn't mean you are competent in foot and ankle surgery. Or even competent in trauma. Just because you put the fracture together doesn't necessarily mean a great outcome. There are other things that can happen as mentioned above. It really requires specialist care to see it through to obtain the best outcome for the patient. I see a lot of sequela of poorly managed ankle fractures and sprains seen initially by ortho in my geographical area. I am speaking on my practice dynamics as an attending in my geographical area. I can't speak on other podiatrists experiences with ortho in other geographical areas. These are my experiences.

 

[iceman55]

Doing ankle fractures and managing their complications are two different things. That is my point. Again just because you are doing them in residency doesn't mean you are competent in foot and ankle surgery. Or even competent in trauma. Just because you put the fracture together doesn't necessarily mean a great outcome. There are other things that can happen as mentioned above. It really requires specialist care to see it through to obtain the best outcome for the patient. I see a lot of sequela of poorly managed ankle fractures and sprains seen initially by ortho in my geographical area. I am speaking on my practice dynamics as an attending in my geographical area. I can't speak on other podiatrists experiences with ortho in other geographical areas. These are my experiences.

Competent in foot and ankle surgery as a whole after residency? No, and I'm not claiming that a general orthopod would be after just residency. Competent in managing majority of ankle fractures and after finishing residency, yes I would say so. The majority of ankle fractures that we fix at our program end up doing well, they follow up in our office/clinic. We are specialist in fracture care and that includes the ankle and other extremity fractures. And yes complications do pop up , and some orthopods that haven't taken care an ankle for years since residency should probably be referring them out. So is your point that only Fellowship trained orthopods and Podiatrist should be the ones taking care of ankle fractures?

 

[shadesofgrey]

Call me a traitor if you will, but the variance in training between the podiatry residency programs is far to wide for us to assert any form of superior management of ankle fractures. For every great program, there are 3-4 crappy programs. I would wager that the vast majority of podiatry residents are not doing anywhere close to even 60 ankle fx's during their 3 years. If I had an ankle fx and the choice of surgeon were Joe Blow podiatrist from some random program I never heard of and your average ortho doc, I would probably go ortho doc. Just because I think the basement is higher and if the ortho doc screws up its more likely to be salvageable than a bottom tier podiatrist. The bottom 15% of my podiatry class would make me nervous doing an ingrown nail.
Now having said that, I do practice within 30 min's of one the top foot and ankle ortho fellowships in the country and I routinely see their screwups. Although it tends to be more forefoot stuff that is really botched rather than rearfoot.

 

[iceman55]

Anyway I'm not here to argue Podiatry vs Ortho. We have different sets of training. But don't be fooled that we orthopods dont get adequate F/A training in regards to fracture care and management. Now in regards to elective cases, flat foot recon, bunion, charcot , hindfoot recon etc. I agree we don't get enough in those cases and a general orthopod as no business dabbling in those cases

Ill be joining in on the AOFAS virtual conference this year, hopefully Ill get to see what the Hype about F/A is about anyway.

 

[deleted1061086]

Anyway I'm not here to argue Podiatry vs Ortho. We have different sets of training. But don't be fooled that we orthopods dont get adequate F/A training in regards to fracture care and management. Now in regards to elective cases, flat foot recon, bunion, charcot , hindfoot recon etc. I agree we don't get enough in those cases and a general orthopod as no business dabbling in those cases

Ill be joining in on the AOFAS virtual conference this year, hopefully Ill get to see what the Hype about F/A is about anyway.

F/A is great. But the lower extremity swells and patients hate being NWB. And the complications can be terrible. I think that plus a whole profession practicing a similar scope makes it less popular than it should be among orthos. Fun cases though

 

[619]

Anyway I'm not here to argue Podiatry vs Ortho. We have different sets of training. But don't be fooled that we orthopods dont get adequate F/A training in regards to fracture care and management. Now in regards to elective cases, flat foot recon, bunion, charcot , hindfoot recon etc. I agree we don't get enough in those cases and a general orthopod as no business dabbling in those cases

Ill be joining in on the AOFAS virtual conference this year, hopefully Ill get to see what the Hype about F/A is about anyway.

I would say thank you for your contribution to the forum. it is always good to have a different point of view. Overall, the most important thing is adequate patient care and putting the patient first.

 

[GreenHousePub]

This was the point of my original post, that ankle fractures are a basic part of an orthopedic education. And saying that an orthopod may have only done 5-10 in residency is just completely ridiculous and wrong.

Most people, including podiatrists, understand this. I don't know anyone who seriously believes that ortho doesn't get enough ankle fracture training in residency lol.

 

[CutsWithFury]

Most people, including podiatrists, understand this. I don't know anyone who seriously believes that ortho doesn't get enough ankle fracture training in residency lol.

Getting exposure/logging ankle fractures and exhibiting actual competence are two entirely different things. I find it hard to believe the forum doesn’t understand this point. I was wrong.

 

[air bud]

Right. But the assumption that most podiatry residents get adequate ankle fracture training is also incorrect.

 

[CutsWithFury]

Right. But the assumption that most podiatry residents get adequate ankle fracture training is also incorrect.

I can get on board with that. But I’m not convinced the foot and ankle training in ortho residency is as robust as marketed. Their exposure to foot/ankle is a bunch of ankle fractures. Big deal.

How many weeks do they spend on a dedicated foot and ankle service with fellowship trained foot and ankle orthos? That is VARIABLE. The amount of time they spend is variable from ortho residency program to program and being exposed to fellowship trained foot and ankle orthos is variable and dependent on how many are involved in residency training. There are a lot of ortho residencies in the USA. Does that mean they all have access/exposure to foot and ankle orthopedists? The answer is no sometimes.

This is just as VARIABLE as the ankle fracture training in podiatry residencies.

 

[josebiwasabi]

In order to have actual competence you need to have volume. The sad truth is that most programs out there do not get meaningful significant exposure to real trauma. I mean think about how many mediocre pod residencies are out there.

I would take a well-trained DPM to do my ankle fracture over a general ortho HOWEVER there is no way for the general public to tell which DPM has superior versus mediocre training.

With the current state of training, the average ortho grad will do a better ankle fracture than the average pod grad.

 

[CutsWithFury]

In order to have actual competence you need to have volume. The sad truth is that most programs out there do not get meaningful significant exposure to real trauma. I mean think about how many mediocre pod residencies are out there.

I would take a well-trained DPM to do my ankle fracture over a general ortho HOWEVER there is no way for the general public to tell which DPM has superior versus mediocre training.

With the current state of training, the average ortho grad will do a better ankle fracture than the average pod grad.

Maybe with the execution of ankle fracture ORIF but what happens when there was a missed syndesmosis tear, ATFL tear, Talar dome OCD? We can argue about the volume of trauma in podiatry residencies all day but one thing we shouldn’t doubt is our exposure to elective foot and ankle recon.

 

[DarkHorizon]

Maybe with the execution of ankle fracture ORIF but what happens when there was a missed syndesmosis tear, ATFL tear, Talar dome OCD? We can argue about the volume of trauma in podiatry residencies all day but one thing we shouldn’t doubt is our exposure to elective foot and ankle recon.

Did you see an orthopod miss a syndesomosis rupture or something? I guess it’s possible, but it’s essential part of training to perform a stress test after fixing the malleoli to check for the syndesmosis.

Anyway, I’m not here to argue with you, I am a trauma fellowship trained orthopedic surgeon, I have two great podiatrists that are part of my group. Here’s how it goes, standard bimal/trimal, they get booked to whoever has an opening, or if it came on your call. Calc/talus/Pilons/Lis francs, I do all of those. I have revised a couple of their TTC nailed which initially failed. Also, any bad trimal (open/grossly dislocated) comes to me. I have had a couple that they gave me that showed up to their clinic 3 weeks later that I took the callus down and fixed.

Over my training, I probably did over 150 ankle fractures. I probably do one or two a week now. I respect my podiatry colleagues, but you can see, anything heavily traumatic, they give it to me. In turn, anything that needs fusion, I give to them ( no interest in elective F/A cases). I have no plans to ever dabble into elective F&A and will happily admit they are experts at that. But ortho sees so much more trauma than podiatry, it’s not even close. I trained at places with podiatry residency, both at my residency and fellowship. They only ever did ankle fractures, never anything else. Alll hindfoot frsctures/dislocations went to ortho. I think you underestimate how much foot and ankle trauma ortho residents see. I will concede that as we further sub specialize and get busy with our elective practices (sports/joints/hand) we just give it up as most are too busy.

 

[DexterMorganSK]

I don't think this thread was created to compare the educational training of an orthopedic surgeon to a podiatric surgeon.

Move on, people.

 

[air bud]

Maybe with the execution of ankle fracture ORIF but what happens when there was a missed syndesmosis tear, ATFL tear, Talar dome OCD? We can argue about the volume of trauma in podiatry residencies all day but one thing we shouldn’t doubt is our exposure to elective foot and ankle recon.

Not sure I can get on board with that. Syndesmosis? Not sure they miss it. And it's not like you are treating an ocd or ankle sprain at time of surgery. So there is a difference between fixing a broken ankle and recognizing/treating the pathologies associated with that traumatic event.

 

[CutsWithFury]

Not sure I can get on board with that. Syndesmosis? Not sure they miss it. And it's not like you are treating an ocd or ankle sprain at time of surgery. So there is a difference between fixing a broken ankle and recognizing/treating the pathologies associated with that traumatic event.

I am talking about things I see in my practice. I don’t care if you don’t get on board with it. It happens

 

[Shiyuan]

I’m gonna stay silent and go apply my low-dye to the trimal down the hall...

 

[619]

Calc/talus/Pilons/Lis francs, I do all of those.

Besides the pilon which is out of scope in some states, I don't see why any well trained DPM from a good program should not be able to fix a calc/talus/lis francs fracture. I am not bashing the two great podiatrists that are part of your group. They may not have interest in those cases and chose to do elective cases and fusions. Personally, I do trauma cases that randomly comes into my clinic but it is not my prerogative. I have no intention on chasing down ambulances for trauma cases.

Just my 2 cents

 

[DarkHorizon]

Besides the pilon which is out of scope in some states, I don't see why any well trained DPM from a good program should not be able to fix a calc/talus/lis francs fracture. I am not bashing the two great podiatrists that are part of your group. They may not have interest in those cases and chose to do elective cases and fusions. Personally, I do trauma cases that randomly comes into my clinic but it is not my prerogative. I have no intention on chasing down ambulances for trauma cases.

Just my 2 cents

Part of it is they are busy with their elective practice. Other part is that I’m fellowship trained in trauma so any complex trauma automatically come to me.

 

[ExperiencedDPM]

I am talking about things I see in my practice. I don’t care if you don’t get on board with it. It happens

I think you’re generalizing too much. We all have the experience of seeing another provider’s failures. Similarly, you have to be honest and realistic and realize that some of the orthopedic surgeons you’re mentioning are also likely seeing some of your patients with less than optimal results.

I am personally impressed by the temper and diplomacy of the orthopedic surgeons contributing to this thread. Orthopedic surgeons have incredible training and are more than well versed in fracture care. Realistically, I would say it’s safe to say that during training, the average orthopedic resident is exposed to more trauma than podiatric residents.

I think even the orthopedic surgeons on this site would agree that most general orthopedists aren’t “super” competent with the foot and ankle.

However, please don’t discount the training and expertise of a foot and ankle fellowship trained orthopedic surgeon and/or trauma surgeon.

I now work with orthopedic surgeons including foot and ankle trained orthopedic surgeons and these docs are bright, extremely well trained and competent.

We all know MD/DO/DPM foot and ankle surgeons who are extremely talented and we also know many who do low quality work.

Training alone doesn’t make a quality surgeon. It may produce a well trained surgeon, but that doesn’t always equate with a skilled surgeon. And it’s more about the training and SKILL, than the initials/degree after their name.

I would again like to thank the orthopedic surgeons on this thread who are diplomatic and respectful in their posts.

Would we be the same if we were getting trashed on their forum?

 

[GreenHousePub]

As long as they stay away from my coveted fungal nails we are good.

 

[Dr. Brandon Green]

I’ve worked with numerous well trained and respected DPMs. I got on this thread due to the AAOS and AOFAS title. As a gen surgeon my mother broke her ankle in Florida and I had a DPM do her ORIF. Private practice typically pays more in the long run. However these jobs can be lucrative for DPMs and show worth to hospital system. Employed docs can reference RVUs as well as $ made to the system tests, referrals in system, surgeries etc. We are deferring care that DPMs are more qualified than us, it’s not ‘dumping me patients it’s consulting DPMs for best patient care.

 

[CutsWithFury]

Orthopedic Foot & Ankle Surgeon v/s Podiatrist | Dallas, TX

Click here to read more about an orthopedic foot & ankle surgeon v/s podiatrist.

www.genecurrymd.com

This crosses the line of defamation because it’s promoting false information in a damaging way about our education and training. Stating we only receive training in the foot for example. I’d love for the APMA and ACFAS to weigh in but they won’t. There is no mutual respect between APMA, ACFAS or the AOFAS when the members of the AOFAS continue act in this manner. There is an agenda.

 

[SouthPod7]

"Many also do one year of internship training."

Is that a joke? Hasn't the minimum of 3 years of residency training been standardized for like, 10 years now?

 

[CutsWithFury]

"Many also do one year of internship training."

Is that a joke? Hasn't the minimum of 3 years of residency training been standardized for like, 10 years now?

Longer than that. Thats why its defamation

 

[Scrantonicity]

I think they're talking about the ones that didn't match and had to do that 1 year of "internship" lol. They conveniently forgot about the mandatory 3 year residency.

Defamation--doesn't that only apply when you're attacking/lying about an individual or a group (not a profession per se)?? I would just call this downright lies and misinformation. I guess the distinction would be important to know if there was any sort of legal action taken regarding this...

 

[DYK343]

That looks like its from one guy's personal opinion Gene Curry and not AOFAS as a whole?

Regardless that is defamation and flat out lies and should be challenged.

 

[air bud]

That looks like its from one guy's personal opinion Gene Curry and not AOFAS as a whole?

Regardless that is defamation and flat out lies and should be challenged.

Yeah but think if Dak knew about a podiatrist's real training. He might have chosen a pod instead of this guy if only he presented podiatry in a fair light

 

[DexterMorganSK]

Someone email that to PM news

 

[air bud]

Barry Block DPM JD to the rescue!!!!!

 

[CutsWithFury]

Barry Block DPM JD to the rescue!!!!!

He doesn’t do anything

 

[Scrantonicity]

He doesn’t do anything

Hey, don't say that. His newsletter has taught me many things about the evils of flip flops.

 

[ExperiencedDPM]

He doesn’t do anything

Of course he does. He posts press releases from the same 10 DPMs all the time telling the public to not walk barefoot in the winter and to make sure you don’t walk across broken glass in just socks. And he posts pictures of friggin’ “funny” shoes every day. And he posts questions from incompetent DPMs who want to know what to do with a patient who had an ulcer, bone sticking of the foot and red streaks up the leg. The doc wants to know if a Betadine whirlpool would be sufficient.

He really makes be proud of my profession.

 

[G0dFather]

He doesn’t do anything

Of course he does. He posts press releases from the same 10 DPMs all the time telling the public to not walk barefoot in the winter and to make sure you don’t walk across broken glass in just socks. And he posts pictures of friggin’ “funny” shoes every day. And he posts questions from incompetent DPMs who want to know what to do with a patient who had an ulcer, bone sticking of the foot and red streaks up the leg. The doc wants to know if a Betadine whirlpool would be sufficient.

He really makes be proud of my profession.

Sorry but i have to call out hate when i see it .... at the end of the day the guy is running a monopolistic PR/AD business that is passive and making him money while he sleeps, he saw an opportunity/ void and he capitalized on it ... dont hate the player guys, you free to compete with your own newsletter if you hate his so much

 

[CutsWithFury]

Sorry but i have to call out hate when i see it .... at the end of the day the guy is running a monopolistic PR/AD business that is passive and making him money while he sleeps, he saw an opportunity/ void and he capitalized on it ... dont hate the player guys, you free to compete with your own newsletter if you hate his so much

He also loves posting stories of DPMs getting sued. Do you think this is someone we should applaud. Ask him legal question via email and he will respond in 5 seconds stating he doesn’t hold a license in that state so he can’t help.

He doesn’t practice. He doesn’t do anything to help the profession. Somehow he’s in our hall of fame? For what?

 

[G0dFather]

He also loves posting stories of DPMs getting sued. Do you think this is someone we should applaud. Ask him legal question via email and he will respond in 5 seconds stating he doesn’t hold a license in that state so he can’t help.

He doesn’t practice. He doesn’t do anything to help the profession. Somehow he’s in our hall of fame? For what?

i hear what your saying but at least his newsletter is a huge source of connecting pods within the profession i.e. its a go to source for finding a job ... so there is SOME help there for the profession

 

[GreenHousePub]

i hear what your saying but at least his newsletter is a huge source of connecting pods within the profession i.e. its a go to source for finding a job ... so there is SOME help there for the profession

Yeah it's one of the few ways people can still stay in touch with the profession.

Also: it's a daily newsletter. People here are complaining about the content. How difficult do you think it is finding enough podiatry content to fill a daily newsletter for years?

 

[CutsWithFury]

i hear what your saying but at least his newsletter is a huge source of connecting pods within the profession i.e. its a go to source for finding a job ... so there is SOME help there for the profession

I want the drugs you are on. Groovy

 

[DYK343]

i hear what your saying but at least his newsletter is a huge source of connecting pods within the profession i.e. its a go to source for finding a job ... so there is SOME help there for the profession

Those are not good jobs. If you take an associate job off of PMNews you are guarenteed to have a story like the current "here to vent" thread.

 

[G0dFather]

Those are not good jobs. If you take an associate job off of PMNews you are guarenteed to have a story like the current "here to vent" thread.

Right i agree with you but its something to put food on the table/just get started .... but where else do you find jobs READILY in this profession ? ..... until now its pretty much PM news, pod exchange ( which is pretty much the same PM news crowd) and word of mouth

 

[msuDPM]

He also loves posting stories of DPMs getting sued. Do you think this is someone we should applaud. Ask him legal question via email and he will respond in 5 seconds stating he doesn’t hold a license in that state so he can’t help.

He doesn’t practice. He doesn’t do anything to help the profession. Somehow he’s in our hall of fame? For what?

"Podiatry Hall of Fame", LOL.

 

[heybrother]

Its also the #1 podiatry obituary for old NY and Ohio pods.

 

[Halux]

Sorry but i have to call out hate when i see it .... at the end of the day the guy is running a monopolistic PR/AD business that is passive and making him money while he sleeps, he saw an opportunity/ void and he capitalized on it ... dont hate the player guys, you free to compete with your own newsletter if you hate his so much

G0dfather is barry block confirmed!!

 

[heybrother]

He also loves posting stories of DPMs getting sued. Do you think this is someone we should applaud. Ask him legal question via email and he will respond in 5 seconds stating he doesn’t hold a license in that state so he can’t help.

He doesn’t practice. He doesn’t do anything to help the profession. Somehow he’s in our hall of fame? For what?

Grade A evasion.

I have to continue to work on mine.

Oh, hello, there if it isn't my favorite patient who read my note back to me at my last visit to argue it. I sure do love billing our visits on time.
Hi! I brought you something.
Oh thank you... a local white supremacist newspaper.
Yes, say would you like to come to my bible study.
Oh, thank you. You know, I really don't leave the house, because my wife is... immune compromised. Gotta protect her.

 

[ExperiencedDPM]

Sorry but i have to call out hate when i see it .... at the end of the day the guy is running a monopolistic PR/AD business that is passive and making him money while he sleeps, he saw an opportunity/ void and he capitalized on it ... dont hate the player guys, you free to compete with your own newsletter if you hate his so much

Sorry, it’s an embarrassment to the profession. It’s read by reps and other non DPMs. It feeds the fire against podiatry.

Shoe of the day? Really? Does a urologist show the foreskin of the day?

Posts from the same idiots asking the same questions. Posts about shoes and socks and shoes and socks. Cut your nails straight across.......

This will really advance us in the eyes of the public, reps and AAOFAS.