U of Utah Limiting Pods

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I grew up in Utah and now I see another reason why I left!

We should just merge it with Arizona and add Puerto Rico as a state. Then you don't need to change the flag.

I love the excuse that is presented in the article. The U of U is a MEDICAL school...not a podiatry school. So a F&A ortho resident couldn't learn from pods who have specialized in orthopedics?

Here is my favourite quote from the above linked article:

"Our view is [podiatrists] have provided excellent care for our patients. But I think orthopedic surgeons can provide the highest possible quality care. I'd be dishonest if I said I thought (podiatrists) could provide the same qualify of foot and ankle surgery as a physician board-certified" in that care, Bjorkman said

How insanely backward.
 
theres still 49 other states hurr hurr
 
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I don't know how accurate this is, but I have heard that the Orthopaedics Dept at a UC Medical Center (I'm not going to name which one because I'm not sure) is winning the turf battle against Podiatrists, and limiting what Pods can (basically non-surgical procedures), whereas at the UCLA Medical Center Podiatric surgeons are able to perform the surgeries they are trained to do.

How would you fix this problem though, esp. if management is old school?
 
"Our view is they have provided excellent care for our patients. But I think orthopedic surgeons can provide the highest possible quality care. I'd be dishonest if I said I thought (podiatrists) could provide the same qualify of foot and ankle surgery as a physician board-certified" in that care, Bjorkman said.


When will this crazy talk and idiocricy end. APMA should seriously do something abt it. lol how abt a foot & ankle competition. The winner gets the bragging rights:D
 
in all seriousness, i feel bad for whoever was doing their residency there
 
That article is ridiculous. It saddens me how ignorant and egotistical people can be at times...

I too feel for the pods at that institution.
 
Turf wars are a part of medicine. But it is sad for the patients that go there. It is no secret that F&A orthos and pods are trained very differently. They are about to lose a complete dynamic of foot and ankle medicine and surgery. It shouldn't really hurt the pods though. There are plenty of places to do surgery in SLC. They will simply take their patients elsewhere. On the other hand, I'm sure there will be some legal action taken. I have a few friends at that program. We'll see what happens.
 
Saltzman has a lot of pull in the ortho F&A world and seems like a very intelligent doc. That's why I'm surprised he hasn't realized what pods can do by now. You'd think he'd want DPM attendings to assist in teaching of FF surgery at the very least. I've heard a few times that he and Mann are really anti-pod, though. This pretty much confirms it.

It's too bad when egos get in the way of good patient care.

jonwill said:
...On the other hand, I'm sure there will be some legal action taken. I have a few friends at that program. We'll see what happens.
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That would make sense IMO also^
 
Feli said:
Saltzman has a lot of pull in the ortho F&A world and seems like a very intelligent doc. That's why I'm surprised he hasn't realized what pods can do by now. You'd think he'd want DPM attendings to assist in teaching of FF surgery at the very least. I've heard a few times that he and Mann are really anti-pod, though. This pretty much confirms it.

It's too bad when egos get in the way of good patient care.

That would make sense IMO also^
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I just spoke with one of my buddies who is finishing his first year at the program. He says that they really never had a very strong presence at U of U in the first place. Only two attendings were ever on staff there. They are actually with Intermountain Healthcare now and apparently, it has been a very positive move that has added quite a few attendings and hospitals/surgery centers.
 
jonwill said:
Turf wars are a part of medicine. But it is sad for the patients that go there. It is no secret that F&A orthos and pods are trained very differently. They are about to lose a complete dynamic of foot and ankle medicine and surgery. It shouldn't really hurt the pods though. There are plenty of places to do surgery in SLC. They will simply take their patients elsewhere. On the other hand, I'm sure there will be some legal action taken. I have a few friends at that program. We'll see what happens.
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I think there will be an increase in BKA's in Utah based on one hospital.

I should tell my brother to move there to defend patients for medical mal-practice after their BKAs - LOL.

This really does hurt the patients the most.
 
with more decisions like this (see Texas), I wonder what is happening to the profession? Is it about to be slowed in it's progress towards national recognition? It's no secret that the ortho department is a money-making department for the hospitals, so it's not unexpected that they have so much power.

But if this keeps occurring, vision 2015 looks more like a pipe dream, than an eventual reality.

Is it possible that pods could be reduced to forefoot workers? Regardless of training? I'm just wondering how far ortho could go with this. They wave a mighty strong hand, and with the apparent changes occurring with the APMA and ACFAS etc, I'm wondering if we will see some big changes over the next few years.

I'm not a doom and gloom guy, but all of the recent news in the podiatry world does not appear to me as positive. Would anyone care to elucidate this mess?
 
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I think part of our problem is that many MD's do not know the breadth of podiatric training and exactly what we are trained to do and can do. Also the APMA and the other organizations have not really pushed for our rights. Instead of battling for the right to do H&P's we should be cementing our right to do all types of foot and ankle surgery.

In my opinion the powers that be need to advertise to other practitioners and the general public exactly what a podiatrist is and that we do go to school for 4 years and do at least 2 years of post grad training. Many people still believe that all we are is glorified pedicurists.

I for one believe that we need to lobby for a national scope of practice and the "physician” title with Medicare/Medicade and stop fighting state to state turf wars.
 
biocmp said:
with more decisions like this (see Texas), I wonder what is happening to the profession? Is it about to be slowed in it's progress towards national recognition? It's no secret that the ortho department is a money-making department for the hospitals, so it's not unexpected that they have so much power.

But if this keeps occurring, vision 2015 looks more like a pipe dream, than an eventual reality.

Is it possible that pods could be reduced to forefoot workers? Regardless of training? I'm just wondering how far ortho could go with this. They wave a mighty strong hand, and with the apparent changes occurring with the APMA and ACFAS etc, I'm wondering if we will see some big changes over the next few years.

I'm not a doom and gloom guy, but all of the recent news in the podiatry world does not appear to me as positive. Would anyone care to elucidate this mess?
Click to expand...

No, I don't see any threat simply because there aren't enough foot and ankle orthos out there to make much of a difference. So while things like this may happen at select hospitals (turf wars are fought everywhere), I don't see it as an issue. In fact, as the number of foot and ankle orthos continues to dwindle, you will see less and less of this.

Legally, this is going to be interesting. Surgical training widely varies in all aspects of medicine, not just podiatry. I'm not sure that legally you can take surgical privileges away from a physician that has already been granted the privileges without due cause. I am a firm believer that as is the case with ANY surgical subspecialty, surgical privileges should be reviewed and granted on a case by case basis. They'd better be careful though because comparing podiatric surgical training to a one year foot and ankle fellowship is a road they don't want to go down.
 
biocmp said:
with more decisions like this (see Texas), I wonder what is happening to the profession? Is it about to be slowed in it's progress towards national recognition? It's no secret that the ortho department is a money-making department for the hospitals, so it's not unexpected that they have so much power.

But if this keeps occurring, vision 2015 looks more like a pipe dream, than an eventual reality.

Is it possible that pods could be reduced to forefoot workers? Regardless of training? I'm just wondering how far ortho could go with this. They wave a mighty strong hand, and with the apparent changes occurring with the APMA and ACFAS etc, I'm wondering if we will see some big changes over the next few years.

I'm not a doom and gloom guy, but all of the recent news in the podiatry world does not appear to me as positive. Would anyone care to elucidate this mess?
Click to expand...
i agree. we can't ignore these things or brush it off as 'it's only one state' or 'just one hospital'. that one state or one hospital could easily represent a microcosm of the health care field at a national level and of what's to come. jonwill you state that there arent enough F/A orthos out there to make a difference, but the fight isn't against the F/A orthos per se, it is against the Orthos in general, and they outnumber pods and they bring in the money for the hospitals and they have the upperhand.

i'd really appreciate if the experienced pods/residents would chip in on this matter. just look at these *recent* problems:
-CA school (samuel merrit) problems/probation
-new CA school Western University opening up but when i called i was told the classes were *not* integrated with the DO students, then another person there said 'some' of them were... either way it is not any closer to our goals.
-APMA/ACFAS seperation
-Texas limits pods
-Utah hospital limiting pods
-and from what i've heard from a few graduates this year residency placement was pretty rough this year.
-classes still are not filling up and all the schools except Barry (at this very moment) are still accepting applications.

granted the profession has some problems and noone said this fight was going to be easy, but these are big problems that are recently coming up which could be the start of a downward spiral. we need some answers.
 
spo01 said:
jonwill you state that there arent enough F/A orthos out there to make a difference, but the fight isn't against the F/A orthos per se, it is against the Orthos in general, and they outnumber pods and they bring in the money for the hospitals and they have the upperhand.
Click to expand...

There really is no "fight" per say. These are limited scuffles. You are correct in that there are a lot of orthopods out there. However, the vast majority do absolutely no foot surgery. In most parts of the country, ortho and pod work well together. I also find it misleading to represent this as something that happens only between pods and orthos. There are plenty of turf wars in medicine that involve various specialties. As far as your other concerns:

Samuel Merrit - should probably close with the new school opening up.
Western - I thought it was integrated but regardless, I believe that all schools should be associated with a medical school.
APMA/ACFAS - I'm not really sure if this will have much of an effect on anything. It is too early to tell. The majority will still join both. My only concern is that if APMA loses too many members, this COULD affect its legislative power. That is assuming ACFAS doesn't step in.
Texas - I'll be shocked if pods actually lose ankle and I highly doubt it will happen (as was the case in Florida a few years ago). It WILL force Texas lawmakers to actually evaluate our training which is a very positive thing.
Utah - This is limited to one hospital in the state and probably won't fly pending an inevitable lawsuit
Residency placement - It shouldn't be "easy". The top slots are and should be very competitive. My concern is that everybody get something as you now need residency training to practice.
Enrollment - This is probably the biggest issue with our profession. There are too many programs that take too many unqualified students. This causes big problems down the road. I have always been a big proponent of schools taking less students. The problem then becomes with the independent schools that depend on tuition dollars and enrollment to survive.

Podiatric Medicine is not without its problems but is and will continue to be a stable and integral part of mainstream medicine.
 
I work at a University, and I'm seeing the happy trend of a lot of very smart undergrads getting turned on to podiatry. They are beginning to hear the same complaints many of us heard from the MDs/DOs, 'ever-increasing overhead and malpractice, less time with patients, not the same field as when I entered it'. That, paired with the fact that it is becoming increasingly difficult to get into medical school, is turning really good people to this profession. I have a feeling that podiatry schools will start seeing an increase in applicants, and applicant quality. Gone are the days of most folks saying, "I didn't get into med school, so I'm going for podiatry" and hello are the days "I looked at all my options in healthcare, and podiatry is awesome!". I can't tell you how many students I've spoken with in the past year or so where that is their sentiment.
 
Thebee,
While I don't share your excitement, I do share your sentiment, that podiatry is a good field. It really is like Baskin Robbins, with it's 31 flavors of medical interests. I'm just worried that the profession itself is being fractionally distilled in the heat of the moment. I'm hoping what remains after all of this, are fire-tested solid podiatric physicians that are a testament to the field.

From reading what Jonwill, Dr.Feelgood, Krabmas, DpmGrad, etc have posted over the years, it is obvious that the profession is trying to head in the right direction, but I fear the road blocks ahead. The APMA needs to take a definitive stance on it's membership requirements, on it's affiliation with other organizations, and with the board certification requirements. If nothing else, the small community of podiatrists needs to be unified. At least then, the voice is as strong as possible.

With school loans and a professional future at stake, I'm sure I share my apprehension with others when it comes to this field. Hopefully we begin to see some positive stories. As always, I love replies from those in residency/practice.
 
biocmp said:
...Is it possible that pods could be reduced to forefoot workers? Regardless of training?...
Click to expand...
No. That's discrimination.

If you are well trained but others do not realize or respect your training, then you have to fight for your rights sometimes. Hopefully the "fight" will just be a simple discussion and presentation of your CV, case logs, and competence. That is probably how the fantastic limb salvage teams at Yale, Georgetown, etc were formed. When you put egos aside, put your heads together, and let everyone do what they're good at, great patient care tends to happen.

Other times, you may run into real opposition. If being reasonable and diplomatic fails, then there are other avenues which can be explored. If you have the degree, training, skills, valid license, certifications, case logs, etc with the documentation to prove it, then you cannot be limited (the exception is privately owned hospitals/facilities which can limit any doc, dept, etc because it's their $ and their rules). As for other limits that are unfair, you can simply take legal action. How do you think DPM scope advanced in the first place? I really doubt ED McGlamry, Fallat, Kalish, Feldman, and other pod surgery trailblazers just walked up to the surgery desk and booked a triple, ankle implant, or a met adductus correction...
 
In my opinion this revolves around the entire medical community locked in a fight over who will produce the doctors and the role of each staff member.

It's not just the orthopods that don't want us doctoring around it's IMO the entire physician community in an attempt to stop HEALTH CARE EXTENDERS from making doctors too.

Imagine Dr Aholer D.N. (doctor of nursing) doing knee replacements.

Or Dr. Phlem D.P.A. (doctor of physician assitance) doing brain surgery.


Now imagine DPM's saying that they want to be full scope doctors.

Ummm this opens the door for 2 million nurses who always wanted to be a doctor to finally become one under a new model which the AMA has no control.

The medical community no longer really controls the information like they did 50 years ago. The information age has made many things available that used to be pretty restricted. INformation is everywhere and the MDs no longer control it.

------------

My next observation revolves around unity in Podiatry.
IMO there is no unity in this tiny field. It is filled with as many egos as there are feet in the profession. Everyone wants to be the leader and the big shot but most have no natural leadership ability and instead of leading by action, lead by self proclamation and podiatric family history.

IMO as soon as podiatry stops looking for their next self-serving prom king/queen as their leader(s), the sooner they will be able to navigate these issues.

But I'm not sure that most in Podiatry know good leadership when they see it.
 
drmeggo said:
I for one believe that we need to lobby for a national scope of practice and the "physician" title with Medicare/Medicade and stop fighting state to state turf wars.
Click to expand...

There will never be a national scope of practice for DPMs, just as there isn't a national scope of practice for MDs. It would require a constitutional amendment taking power away from the states which allows them to govern the practice of medicine. I don't think that's very likely.

The MDs authority to diagnose and treat "humans" comes from the state (individually).

Podiatrists, dentists, PAs, NPs, etc. all have licenses, like the MD - governed by the state. To suggest that, just for podiatrists, the federal government might make a law delineating our scope of practice, is not realistic.

LCR
 
It has been said "Just because you deserve it doesn't mean that they're going to give it to you. Sometimes you have to take it." The only way to continue to maintain the strides that podiatry as a profession has made recently is to continue to outwork the F/A orthopods in surgical volume, outcomes and patient satisfaction. Additionally, podiatrists who want to be seen as the lower extremity surgeons need to aggressively market their skills, training, and bedside manner to the people that matter most, the public. If this isn't done how on god's green earth does anyone expect the lay public to come to the conclusion that podiatrists are the best physicians to see for their foot and ankle problems? Lastly, it seems like everyone here just expects that the F/A orthopeadists are just going to let you take their business, and see podiatrists as a fellow collegue, and not a competitor, which is ludicrous. Pods and F/A orthos are head to head competitors and with the pending changes in our fractured sick-care system they're doing everything they can to lock up their corner on the market, and do you blame them? I think the sooner that podiatry loses its inferiority complex the better the profession will be. If we as podiatrists are going to maintain our ankle and rearfoot surgical privilleges we must out compete the F/A orthopeadists, and do so in a professional manner.
 
iceman69 said:
Lastly, it seems like everyone here just expects that the F/A orthopeadists are just going to let you take their business, and see podiatrists as a fellow collegue, and not a competitor, which is ludicrous. Pods and F/A orthos are head to head competitors and with the pending changes in our fractured sick-care system they're doing everything they can to lock up their corner on the market, and do you blame them?
Click to expand...
Nice analysis. When it comes down to it, sometimes it's just a matter of money. There's a lot of it at stake and in business people aren't always collegial. Even between podiatrists, we try to bring in patients, which you can interpret as taking business away from local colleagues. We act nice and shake hands at conferences but back in the office we check out each others' yellow page ads and websites, seeing if we've been outdone. It's a fine balance between looking out for your colleague and looking out for yourself.

Nat
 
lol... you should try to talk big Ben into sending a "mock" application down to Salt Lake :thumbup:

"Attn: Dr. Saltzman, here are my logs... do you think I even need to do a fellowship?" :D
jonwill said:
Feli said:
Yes, this thread is kinda dead, but just thought it was rather interesting that after all this politicking

(drumroll please)

...Saltzman's U of Utah's F&A fellowship went unfilled:
http://www.aofas.org/userfiles/file/Fellowship%20Program%20docs/Available_2008-09_FA_Fellowships.doc (see bottom)
Click to expand...
WOW, a foot and ankle fellowship going unfilled? That NEVER HAPPENS!!! Maybe a pod will apply :laugh::laugh::laugh:
Click to expand...
 
jonwill said:
Samuel Merrit - should probably close with the new school opening up.
Click to expand...



Are you serious? Close down the school? How misinformed are you? The reason they were on probation was an administrative probation, NOT an academic one. And the issue was resolved months ago. If you want shut down a school where 95% of the students pass their second year boards on the first attempt, you must not have the whole story. Maybe you are jealous because you are freezing your ... off in (insert your location here).

Before you go bash someones school, at least do your homework.:idea:
 
DJ Quik said:
Are you serious? Close down the school? How misinformed are you? The reason they were on probation was an administrative probation, NOT an academic one. And the issue was resolved months ago. If you want shut down a school where 95% of the students pass their second year boards on the first attempt, you must not have the whole story. Maybe you are jealous because you are freezing your ... off in (insert your location here).

Before you go bash someones school, at least do your homework.:idea:
Click to expand...

I didn't realize there were different forms of probation until a CSPM admin along with current students, explained it to me. I feel a lot of other people on these forums heard the word "probation" and got scared ( I did!). From what I understand, it was paperwork (on research I believe) that was not submitted to the CPME on time. However, the administrative probation was lifted once they sent it in. CSPM has been off probation for a while.

I think its farfetched now for individuals to think CSPM will close down. I feel if they were gonna close, it would have been in 2000/2001 when they sold their independent SF campus and moved up to Touro-COM in Vallejo. I talked to a faculty member who has been with Cali since they were CCPM, and they said that was a pretty bad time for the school. He seemed quite honest and felt that CSPM is doing extremely well right now.

Sure, they had problems in the past but now part of a university and fin. stable. The DPM is the highest degree offered at Samuel Merritt, but there are plans to bring in a PharmD program. Furthermore, the school is going under a lot of renovation (starting next summer I think) to expand the facilities. I believe Samuel Merritt College is owned by Alta Bates Medical Center (lot of dough). New dean from Scholl who took over this summer. Have been MCAT only since last year while a few schools currently are still taking the DAT and GRE.

Overall, do you guys really think CSPM will get canned? They may lose a few students to Western, but I cannot see the program being dissolved, especially while being supported by an expanding healthcare university.
 
DJ Quik said:
Are you serious? Close down the school? How misinformed are you? The reason they were on probation was an administrative probation, NOT an academic one. And the issue was resolved months ago. If you want shut down a school where 95% of the students pass their second year boards on the first attempt, you must not have the whole story. Maybe you are jealous because you are freezing your ... off in (insert your location here).

Before you go bash someones school, at least do your homework.:idea:
Click to expand...

Wow, I haven't been called out by a first year in a long time! :laugh: Don't be too offended though. I did a lot of work on the state and national level while I was I student in Iowa and even went to Northern Cali a few times. I believe that one thing that MUST happen for various reasons is that each school must be affiliated with a major medical school (and Samuel Merritt isn't the only one). CSPM actually did merge with Touro for a year 5 or 6 years ago but it didn't work out. That is why the school moved twice in three years. I really think that they went in the wrong direction though when they hooked up with Samuel Merritt.

Couple that with the fact that there are too many schools with too many students and not enough residency slots, and it starts to make sense. So between the two cali schools, Samuel Merritt's program would be on the chopping block in my mind. Will it ever happen??? No, probably not in the near future. Instead, this trend will continue until word gets out that podiatry programs are graduating too many students with not enough residency slots and admissions will tank just like happened in the late 90's and early 00's. Most likely, not all of the free standing schools will survive another one of those (as cali almost didn't a few years ago and hence, the move). And that is VERY BAD for the profession.

Remember, affiliation with a major medical school like DMU, Scholl, or AZPOD = less tuition dependence which = increased admission standards AND less desperation to take every living, breathing soul in order to pay the bills. Taking less and better qualified students = better qualified physicians, all of who now get surgical residency training. Now, merely getting a residency is not the same as getting a GOOD residency and you shouldn't assume that just because there are enough residency slots, that they are all good but we won't go there right now.

Again, I'm not trying to offend anyone but these are real and valid concerns that you probably haven't had time to think about or see. Give it a few years and I think you'll understand what I am saying.

As far as being jealous and freezing to death, you are dead on. I'm not a big fan of this Michigan weather. But being at one of the top surgical residency programs in the country makes me feel a little warmer!!! :)
 
Last edited:
jonwill, i take it you were a APMSA delegate at DMU?
 
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