What will happen to DPMs when the California Probe results come back?

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The time has passed for podiatry to retreat. It is time to be proactive and cast off those fears or another state will cut podiatry from being paid. I don't know who Dr. Harkless is, but your post suggests podiatry needs more of whatever it is he'd done. There is a lot of work that needs to be done and some of us who have had both MD and DPM training and WANT to practice podiatry as MDs want to make sure that our fellow podiatrists are not left behind! There is no reason to not join the cause set out nicely by DPMer in achieving these ends. To miss an opportunity out of fear again will set back another colleague in another state. There will be new graduates and folks who have been in practice for decades who can all be given the same rights. Let's work together to achieve these ends!

Thinking back to this post, this is one thing that I have a hard time believing if you are who you say you are. Specifically if you are in California.

 

[G0dFather]

Thinking back to this post, this is one thing that I have a hard time believing if you are who you say you are. Specifically if you are in California.

I was thinking the exact same thing ... maybe he doesnt know who Dr. Armstrong is either

 

[Footsurg]

I can't find the definition of the word "aprersion" in any of my google searches.

I'm not attacking you personally. I'm questioning your intentions and credentials. My "personal" information is not on this forum either, but my credentials are in various forms.

I consider anyone with a DPM degree one of my peers. Why don't you? What exactly does your comment to the contrary mean?

Thank you for the wishes on the direction of my life. It's going quite well, thanks.

I am sorry I have to side with Doctazero on this one. I think there are to many Pods who don't want to "rock the boat" and are happy with where the profession is at. Give the guy a break. If the profession is not always trying to move forward we will probably just get stepped on. And what is up with the personal attacks, come on guys.

Peace out

 

[doctazero]

I was thinking the exact same thing ... maybe he doesnt know who Dr. Armstrong is either

Armstrong, DPM, Ph D, academic MD from Manchester University. Diabetic Wound Care authority. Right?

 

[doctazero]

Thinking back to this post, this is one thing that I have a hard time believing if you are who you say you are. Specifically if you are in California.

I forgot, WHO did I say I was? I have a DPM and an MD degree. I work in an industry outside of podiatry and medicine and keep current and contribute to several bodies including but not limited to those in the capacity of decision making in the healthcare industry.

Is this the part where you go into the rant that I have an offshore degree or some other jab about me being delusional or having some psych issues - c'mon I'm ready. I can take it.

 

[doctazero]

I am sorry I have to side with Doctazero on this one. I think there are to many Pods who don't want to "rock the boat" and are happy with where the profession is at. Give the guy a break. If the profession is not always trying to move forward we will probably just get stepped on. And what is up with the personal attacks, come on guys.

Peace out

Thanks Footsurg, I came here in good faith and get wacky emails, threats and largely posts questioning the what's and why's anyone would bother helping bring anything to podiatry and/or advancing it. Are DPMs at a point of insecurity where the only reply is taking an offensive position? You're right, the profession will not need a lot of help…..wait……it's forthcoming…..the : We don't need your help! That's on its way. Podiatry has shot itself in the foot again and again and THAT is why the obstacles I mentioned early on will remain insurmountable. Like I said, what's with the fascination as to my personal credentials, DPM, MD. Next will come the where and when and the jibs and jabs about some Banana Republic 2nd rate school or some other notions and then the personality issues and on and on….What does this do for you guys, make you feel good about yourselves because you think you're going to `smoke me out?'

Someone wanted to know what aspersions were. Really, this one you CAN look up.

 

[NatCh]

I forgot, WHO did I say I was? I have a DPM and an MD degree. I work in an industry outside of podiatry and medicine and keep current and contribute to several bodies including but not limited to those in the capacity of decision making in the healthcare industry.

I am a DPM MD who does podiatry as a DPM MD

I'm getting more confused with each new post.

 

[doctazero]

Thinking back to this post, this is one thing that I have a hard time believing if you are who you say you are. Specifically if you are in California.

What value does knowledge of my geographic location achieve. No matter what I say will be decried as bull****. What's the point?

I am who I say I am. How do I know you are who you say you are.

Wait, read my posts. What is it about my use of language strikes you as curious?

Please, you make wonderful critics. Maybe some personal speculation….yeah, that'd really bring the dyamic of this thread, taking podiatry to the next level, into the realm of the relavent. Hey you folks started with the personal queries….I'm just gathering information, offering some insight and….oh right the question of my veracity? Who am I and why am I doing this. Maybe if I took the same question to the medical student site and asked the same questions thoe answers would be different. Maybe tne MD students would jump on every phrase and question my personality and I'd get a slew of private messages, threats and insults…..Ya' think?

 

[doctazero]

I'm getting more confused with each new post.

Me too. I didn't ask for the personal attacks. But hey, that seems to be what podiatry students and podiatrists do these days as they scurry toward changes in a healtcare system in flux. If you don't understand a comlex system or conceptual framework, just bash it. OK. When ya'all settle down we can, if you or yours doesn't ban/kick me off this site, get back on point. Focus on the issue in Ca. and SC and chat about HOW to advance podiatric education and training as well as that of all podiatrists to move toward into a place in mainstream medicine via increasing scope of practice for ALL podiatrists. Unless of course you care to watch as podiatry is cut from one state payor program to the next and the scope of practice issues continue to whittle away at your time. Again, I'm trying to figure out the best way to frame these things for a presentation of sorts, which, regardless of what I write, some clown will say is bull**** and another will join in and it'll turn into a crapfest…..What's it gonna be? So far my take-away is that half of you who post are frightened, mistrusting and flat out nasty. The othe half has an open mind. I'm here to read what the open minded folks have to write about how those ends previously described can be accomplished.

 

[doctazero]

I'm getting more confused with each new post.

That's correct I AM a DPM MD who does podiatry as a DPM MD. What's so hard to get? I didn't say that's ALL I do. I didn't say where I did it. I didn't say a whole lot about ALL the other things that I do.

 

[doctazero]

That's correct I AM a DPM MD who does podiatry as a DPM MD. What's so hard to get? I didn't that's ALL I do nor where and/or when. I didn't say a whole lot about ALL the other things that I do. Why don't some of you curious ones go over to the MD DO medical student site and read the notes from the medical students regarding a similar topic?

I hope this answers your question and you review the MD/DO comments regarding a similar topic and the tone of the responses.

 

[347932]

I am sorry I have to side with Doctazero on this one. I think there are to many Pods who don't want to "rock the boat" and are happy with where the profession is at. Give the guy a break. If the profession is not always trying to move forward we will probably just get stepped on. And what is up with the personal attacks, come on guys.

Peace out

You don't know me. I rock the boat plenty. There is a difference between not rocking the boat and rocking the boat gently. Sometimes it's hard to distinguish between the two.

Also you have to back up what you say if you want to make a point. No back up, no point made. See?

 

[347932]

That's correct I AM a DPM MD who does podiatry as a DPM MD. What's so hard to get. I didn't that's ALL I do. I didn't say where I did it. I didn't say a whole lot about ALL the other things that I do.

Once again, WHY did you need an MDif you practice as a Podiatrist?

 

[doctazero]

You don't know me. I rock the boat plenty. There is a difference between not rocking the boat and rocking the boat gently. Sometimes it's hard to distinguish between the two.

Yes it is.

Also you have to back up what you say if you want to make a point. No back up, no point made. See?

Backing up what you say requires filtering through the dross. As it stands this site does not vet the contributors, therefore anyone can claim to be anyone. Granted you can point to souces, statistics and quotes as well as other sites, but the majority of information is gleanded from the posts themselves and how they are written. If you care to review how `points' (actually concepts) are reflected upon, read those among the MD and DO students regarding a similar issue, DPM > MD. Maybe you'll pick up on a certain jene sais quoie not garnered from these posts by DPM students. No. As I've said there is a degree of hedging, a defensive posturing and a nuance suggestive of some insecurities about these things. It's OK to be insecure and defensive, but; you don't need to use person affrontery and cast aspersions like a cornered animal to make a `point' when indeed there is no point indeed, just an exchange of ideas.

 

[doctazero]

Once again, WHY did you need an MDif you practice as a Podiatrist?

As in WHY in a personal sense?

I said that I got an MD as a continuation of my general education. Are you baiting me? Do you expect an answer along the lines that it was insufficient or inadequate or some other comment to be met with a: "Well it's all different nowdays. Or: "Podiatry school is full of everything you need to be a podiatrist you must be a loser who couldn't cut it as a podiatrist," and so on…. I get the sense you are looking for talking/arguing points with respect to my own personal motiviations to discredit me. I wholly believe that what I learned in medical school was not `better' or `superior' than podiatry school, it was different and the broad general knowledge as well as the opportunites became, and continue to be apparent. I also have/had CHOICE. If I wanted to remain in healtcare and wanted to do a ACGME, ABMS specialty I could. I like having choices and going to medical school was a personal choice. Which brings me to why I posted here: I know what medical school has to offer and how (at least some ideas) to integrate/introduce them into the podiatry currriculum toward unlimited scope. Because of this knowledge and experience I am seeking information to forumulate a plan, put it in writing and make a presentation. I am puzzled with the amount and degree of resistance, personal jabs and aspertions from this site. As I've mentioned the larger part of my time is spent in an industry very far from the healthcare field. From time to time I get involved in projects like this one. In full disclousure, I have a financial interest in medical facilities where physicians of many specialties practice.

 

[DancerPod]

I do have a plan of sorts which I am working out with a few others. It isn't perfect by any means, but it's a start. The ultimate goal is that podiatrists nationwide are included into the realm of full-body, full-scope physicians without having to go to med school rather expanding on what podiatry school has to or can offer. I verily believe that the basics for these things exist in the podiatry schools right now. I can only outline these things in this limited format but primarily without additional cost to the schools, a concerted effort to move toward the USMLE parts I and II and implement the core clinical clerkships in Medicine, Surgery, Peds., OB-Gyn, Psych., with electives in Card, Pulm., Urology, Endocrine, and the array of medical specialties. Furthermore these rotations specifically the core clerkships would require in-house 12hr on 12hr off year round invlolvement. It sounds onerous but I assure you once in the swing of this, it becomes routine and the intimate, intricate and complex interractions in life and death scenarios along with the responsibilites and accountabilites would be a good way to introduce the didactic and clinical aspects into the the third and fourth years. The schools would require several liasons with LCME approved hospitals, which, is not at all as difficult as some would suspect. These ad ons would enhance and broaden the students exposure and experience to a greater breadth and depth of understanding. IF you're still with me, please read on...We can move on to the post graduate training. This is where podiatry has had some irregularities that can be addressed and obtain funding from several sources including but not limited to the government, the pharmaceutical industry and private foundations. The DPM (i don't know if the MD degree is critical but it might be right for some and subject to personal choice to others) However the duties of the house officer would be that of the general rotating internship with an emphasis on foot and ankle anomalies ultimately resulting in a uniformly approved ACGME approved prgroam and universally accepted format acceptable by the FSMB. Then, DPMs or if preferred MDs who are trained with an inclination toward the podiatric medicine background would be somehow akin to the Osteopathic model where their undergraduate medical training leading to the DO degree is peppered with osteopthic theory and the osteopathic internships are such that osteopathic theory is incorporated in them. For podiatrists this model, of incorporating podiatric theory and such would result in graduating a unviversally accepted, by most state boards a well rounded graduate with an unlimited scope of practice who would, like the DO be able to practice Osteopathy, as many DOs make excellent family docs or go on to other areas of specialization, however the podiatric influences would not be lost or abandoned and the second and third year of residency training would be in the surgery of the foot and ankle.

I'm going to try this one last time, because I'd love to read some of your thoughts: Putting feelings aside for CaddyPod as an individual, whether you think he's brilliant, or a complete nut, what you think about the above idea? Is it realistic? Beneficial? Desirable? Other?
There are some very smart and very experienced people on these boards, and I'd love to read your thoughts on this, rather than have this devolve into another "True Parity" thread.

 

[DrMushroomFoot]

The ultimate goal is that podiatrists nationwide are included into the realm of full-body, full-scope physicians without having to go to med school rather expanding on what podiatry school has to or can offer. I verily believe that the basics for these things exist in the podiatry schools right now. I can only outline these things in this limited format but primarily without additional cost to the schools, a concerted effort to move toward the USMLE parts I and II and implement the core clinical clerkships in Medicine, Surgery, Peds., OB-Gyn, Psych., with electives in Card, Pulm., Urology, Endocrine, and the array of medical specialties. Furthermore these rotations specifically the core clerkships would require in-house 12hr on 12hr off year round invlolvement. It sounds onerous but I assure you once in the swing of this, it becomes routine and the intimate, intricate and complex interractions in life and death scenarios along with the responsibilites and accountabilites would be a good way to introduce the didactic and clinical aspects into the the third and fourth years. The schools would require several liasons with LCME approved hospitals, which, is not at all as difficult as some would suspect. These ad ons would enhance and broaden the students exposure and experience to a greater breadth and depth of understanding. IF you're still with me, please read on...We can move on to the post graduate training. This is where podiatry has had some irregularities that can be addressed and obtain funding from several sources including but not limited to the government, the pharmaceutical industry and private foundations. The DPM (i don't know if the MD degree is critical but it might be right for some and subject to personal choice to others) However the duties of the house officer would be that of the general rotating internship with an emphasis on foot and ankle anomalies ultimately resulting in a uniformly approved ACGME approved prgroam and universally accepted format acceptable by the FSMB. Then, DPMs or if preferred MDs who are trained with an inclination toward the podiatric medicine background would be somehow akin to the Osteopathic model where their undergraduate medical training leading to the DO degree is peppered with osteopthic theory and the osteopathic internships are such that osteopathic theory is incorporated in them. For podiatrists this model, of incorporating podiatric theory and such would result in graduating a unviversally accepted, by most state boards a well rounded graduate with an unlimited scope of practice who would, like the DO be able to practice Osteopathy, as many DOs make excellent family docs or go on to other areas of specialization, however the podiatric influences would not be lost or abandoned and the second and third year of residency training would be in the surgery of the foot and ankle.

You have my approval on the idea below 👍

Let me summarize my understanding of this topic with a few additional ideas/suggestions.

First, restructure the Podiatry schools into a curriculum IDENTICAL to the DO curriculum MINUS the Osteopathic focus (OMM, history of Osteopathy, etc) but REPLACED with the Podiatry aspects (biomechanics, pod med, etc). In the end, you would end up with a DPM degree (NOT DO or MD degree).

Students will be required to take the APMLE (scores WILL be released, none of this pass/fail nonsense) with the option of taking the USMLE. With this option of taking the USMLE, students should be allowed to apply for any residency they wish (similar to the DO's). The APMLE scores will be looked when applying to podiatric residencies.

Podiatric residencies will model a 1 year internship plus 3 or 4 year surgical residency.

With the above accomplished, there should be legal parity in the sense that MD=DO=DPM.

 

[fivescrew]

You have my approval on the idea below 👍

Let me summarize my understanding of this topic with a few additional ideas/suggestions.

First, restructure the Podiatry schools into a curriculum IDENTICAL to the DO curriculum MINUS the Osteopathic focus (OMM, history of Osteopathy, etc) but REPLACED with the Podiatry aspects (biomechanics, pod med, etc). In the end, you would end up with a DPM degree (NOT DO or MD degree).

Students will be required to take the APMLE (scores WILL be released, none of this pass/fail nonsense) with the option of taking the USMLE. With this option of taking the USMLE, students should be allowed to apply for any residency they wish (similar to the DO's). The APMLE scores will be looked when applying to podiatric residencies.

Podiatric residencies will model a 1 year internship plus 3 or 4 year surgical residency.

With the above accomplished, there should be legal parity in the sense that MD=DO=DPM.

It's an interesting plan but a quicker and cheaper version is to send all the students that want a wider choice or are not yet sure what they would like to do as it pertains to medicine towards DO\MD schools and let DPMs continue to be experts in their field. With all the negatives a person may choose to see that comes from a DPM having a focused scope there is also a lot of positives that comes with a unique and precise profession.

I'm saying this matter of factually and not aimed at any one person here but there sure does seem to be a ton of whiners in podiatry. Always looking ahead to what they "should" or "could" have instead of making the best out of what they do and using that to make a real difference in peoples lives. How many dentists do you see complaining and how many do you see providing a needed service, top quality work and helping people in a substantial way? All while living a comfortable life.

No one person can do it all, even if the law may thinly say you can. Nobody has the mental power to fix every problem. If you want to be the type of hero doctor you see on tv than you probably shouldn't be entering any health profession. I for one know I wouldn't want a person so uncomfortable with themselves anywhere near me with a knife or prescription pad.

I'm excited about hopefully entering podiatry but this places brings me down on the idea constantly. I really hope it's not like this 24/7 out in the real world of podiatric education and beyond.

 

[347932]

As in WHY in a personal sense?

I said that I got an MD as a continuation of my general education. Are you baiting me? Do you expect an answer along the lines that it was insufficient or inadequate or some other comment to be met with a: "Well it's all different nowdays. Or: "Podiatry school is full of everything you need to be a podiatrist you must be a loser who couldn't cut it as a podiatrist," and so on…. I get the sense you are looking for talking/arguing points with respect to my own personal motiviations to discredit me. I wholly believe that what I learned in medical school was not `better' or `superior' than podiatry school, it was different and the broad general knowledge as well as the opportunites became, and continue to be apparent. I also have/had CHOICE. If I wanted to remain in healtcare and wanted to do a ACGME, ABMS specialty I could. I like having choices and going to medical school was a personal choice. Which brings me to why I posted here: I know what medical school has to offer and how (at least some ideas) to integrate/introduce them into the podiatry currriculum toward unlimited scope. Because of this knowledge and experience I am seeking information to forumulate a plan, put it in writing and make a presentation. I am puzzled with the amount and degree of resistance, personal jabs and aspertions from this site. As I've mentioned the larger part of my time is spent in an industry very far from the healthcare field. From time to time I get involved in projects like this one. In full disclousure, I have a financial interest in medical facilities where physicians of many specialties practice.

No. You are not answering my question.

You claim to be a DPM/MD who is still practicing as a Podiatrist. My whole issue is why do you NEED to have an MD degree at all. Personal CHOICE I can live with, but when you have an agenda that having an MD makes being a Podiatrist somehow easier, and try to convince others of this, I DO have an issue with that. You don't NEED to have an MD to be a successful Podiatrist. What we NEED are more DPMs who will stand as one and fight the good fight imo, rather than have a fractured profession with those that think they NEED to have an MD degree to make a difference.

The other thing that I question is if you spend so much outside of the healthcare industry as you've just mentioned, how exactly are you that close to it, to really know what sways one way or the other? Desk jockeys are the last group we need giving us advice.

 

[hematosis]

You have my approval on the idea below 👍

Let me summarize my understanding of this topic with a few additional ideas/suggestions.

First, restructure the Podiatry schools into a curriculum IDENTICAL to the DO curriculum MINUS the Osteopathic focus (OMM, history of Osteopathy, etc) but REPLACED with the Podiatry aspects (biomechanics, pod med, etc). In the end, you would end up with a DPM degree (NOT DO or MD degree).

Students will be required to take the APMLE (scores WILL be released, none of this pass/fail nonsense) with the option of taking the USMLE. With this option of taking the USMLE, students should be allowed to apply for any residency they wish (similar to the DO's). The APMLE scores will be looked when applying to podiatric residencies.

Podiatric residencies will model a 1 year internship plus 3 or 4 year surgical residency.

With the above accomplished, there should be legal parity in the sense that MD=DO=DPM.

Right on. 👍

 

[347932]

You have my approval on the idea below 👍

Let me summarize my understanding of this topic with a few additional ideas/suggestions.

First, restructure the Podiatry schools into a curriculum IDENTICAL to the DO curriculum MINUS the Osteopathic focus (OMM, history of Osteopathy, etc) but REPLACED with the Podiatry aspects (biomechanics, pod med, etc). In the end, you would end up with a DPM degree (NOT DO or MD degree).

Students will be required to take the APMLE (scores WILL be released, none of this pass/fail nonsense) with the option of taking the USMLE. With this option of taking the USMLE, students should be allowed to apply for any residency they wish (similar to the DO's). The APMLE scores will be looked when applying to podiatric residencies.

Podiatric residencies will model a 1 year internship plus 3 or 4 year surgical residency.

With the above accomplished, there should be legal parity in the sense that MD=DO=DPM.

Sorry to burst your bubble, but that won't do it I'm afraid. You will still be licensed to treat foot and ankle ailments.

I'm curious what you mean by "legal parity"?

 

[DrMushroomFoot]

It's an interesting plan but a quicker and cheaper version is to send all the students that want a wider choice or are not yet sure what they would like to do as it pertains to medicine towards DO\MD schools and let DPMs continue to be experts in their field. With all the negatives a person may choose to see that comes from a DPM having a focused scope there is also a lot of positives that comes with a unique and precise profession.

I'm saying this matter of factually and not aimed at any one person here but there sure does seem to be a ton of whiners in podiatry. Always looking ahead to what they "should" or "could" have instead of making the best out of what they do and using that to make a real difference in peoples lives. How many dentists do you see complaining and how many do you see providing a needed service, top quality work and helping people in a substantial way? All while living a comfortable life.

No one person can do it all, even if the law may thinly say you can. Nobody has the mental power to fix every problem. If you want to be the type of hero doctor you see on tv than you probably shouldn't be entering any health profession. I for one know I wouldn't want a person so uncomfortable with themselves anywhere near me with a knife or prescription pad.

I'm excited about hopefully entering podiatry but this places brings me down on the idea constantly. I really hope it's not like this 24/7 out in the real world of podiatric education and beyond.

Your views on podiatry is accurate and one that I agree with completely in an ideal world where there is no financial discrimination between the degrees. However, in the real world, the issue of parity is important, especially when speaking in terms of finances. There are still areas around the US where DPMs are paid less then the MD/DO counterpart for performing the same exact procedures. Recently, in an attempt to save money, South Carolina dropped DPMs from Medicaid reinbursements. This leads to the question why DPMs and not MD/DOs? Would this have happened if there was legal parity? Although these finance issues are not yet mainstream, these are valid issues that need to be addressed prior to it becoming a major issue. States have a tendency to follow the examples of other states (especially California, they usually set the trend), what if more states decided to cut DPM from Medicaid?

Personally, finances is the sole driving force for my desire to have parity within the fields. I emphasize that I do NOT wish for there to be a degree change within our profession (DPM to MD or DO).

 

[DrMushroomFoot]

Sorry to burst your bubble, but that won't do it I'm afraid. You will still be licensed to treat foot and ankle ailments.

I'm curious what you mean by "legal parity"?

Most of if is wishful thinking on my part.

Ideally the only thing that I would like to see happen (as I'm sure most can agree upon) is that we would have financial parity with the MD/DO throughout the US. In other words, if an insurance plan decides to cut us off, they would also cut off payments to MD/DO.

 

[DancerPod]

Ideally the only thing that I would like to see happen (as I'm sure most can agree upon) is that we would have financial parity with the MD/DO throughout the US. In other words, if an insurance plan decides to cut us off, they would also cut off payments to MD/DO.

👍

Agreed! I don't WANT to be an MD/DO, if I did, that's where I would have gone. This field is my first choice, treating the foot and ankle my desire. That being said: I firmly believe in financial parity.

 

[fivescrew]

I hear what you are saying however the issue of financial parity should be left solely as a legal matter because that's what it is. If and when these battles are fought podiatry will eventually win because while the law\regulations may be able to dictate what it is your training and education allows you to do, it can't abide pay discrimination based on where you went to school....and that's what it is discrimination. As sure as if you were being paid less because you are black\white\purple. There are countless examples of other than MD\DO practitioners fighting for and winning equal treatment to practice the full scope of what they and be reimbursed equally.



Besides, you'll still make a comfortable living as a DPM in the mean time. 🙂

 

[DrMushroomFoot]

I hear what you are saying however the issue of financial parity should be left solely as a legal matter because that's what it is. If and when these battles are fought podiatry will eventually win because while the law\regulations may be able to dictate what it is your training and education allows you to do, it can't abide pay discrimination based on where you went to school....and that's what it is discrimination. As sure as if you were being paid less because you are black\white\purple. There are countless examples of other than MD\DO practitioners fighting for and winning equal treatment to practice the full scope of what they and be reimbursed equally.



Besides, you'll still make a comfortable living as a DPM in the mean time. 🙂

First off, let me start by saying, I will try my best to describe the currrent situation that I am aware of. If at any moment anyone sees any inaccuracies or flawed statements, PLEASE correct me as I truely wish to be informed, thank you in advance.

Okay, from my understanding, Medicaid does not classify podiatrist as Physicians (medicare does). Therefore if they choose to elimate payments to non physicians (that would be us), they have not done anything illegal, thus a legal battle with Medicaid would be pointless.

The issue with financial parity is not as simple as legal battles that we can take to court, we MUST first address the classification of podiatrist such that all insurance providers consider DPMs as physicians (just like DO/MD). That way if they do decide to drop us from payments, we can then legally challenge them and win. Thus the whole issue of parity is important and worth discussing.

Edit: A comfortable living is not relevant to the idea at hand. We are discussing prinicple and equality. Is it fair that we should recieve less for performing the same procedure that the MD/DO perform?

 

[G0dFather]

First off, let me start by saying, I will try my best to describe the currrent situation that I am aware of. If at any moment anyone sees any inaccuracies or flawed statements, PLEASE correct me as I truely wish to be informed, thank you ahead of time.

Okay, from my understanding, Medicaid does not classify podiatrist as Physicians (medicare does). Therefore if they choose to elimate payments to non physicians (that would be us), they have not done anything illegal, thus a legal battle with Medicaid would be pointless.

The issue with financial parity is not as simple as legal battles that we can take to court, we MUST first address the classification of podiatrist such that all insurance providers consider DPMs as physicians (just like DO/MD). That way if they do decide to drop us from payments, we can then legally challenge them and win. Thus the whole issue of parity is important and worth discussing.

Edit: A comfortable living is not relevant to the idea at hand. We are discussing prinicple and equality. Is it fair that we should recieve less for performing the same procedure that the MD/DO perform?

Honestly, If this is not clear enough, I dont know what is .

 

[DancerPod]

First off, let me start by saying, I will try my best to describe the currrent situation that I am aware of. If at any moment anyone sees any inaccuracies or flawed statements, PLEASE correct me as I truely wish to be informed, thank you in advance.

Okay, from my understanding, Medicaid does not classify podiatrist as Physicians (medicare does). Therefore if they choose to elimate payments to non physicians (that would be us), they have not done anything illegal, thus a legal battle with Medicaid would be pointless.

The issue with financial parity is not as simple as legal battles that we can take to court, we MUST first address the classification of podiatrist such that all insurance providers consider DPMs as physicians (just like DO/MD). That way if they do decide to drop us from payments, we can then legally challenge them and win. Thus the whole issue of parity is important and worth discussing.

Edit: A comfortable living is not relevant to the idea at hand. We are discussing prinicple and equality. Is it fair that we should recieve less for performing the same procedure that the MD/DO perform?

👍 Perfectly said.

 

[doctazero]

👍 Perfectly said.

Agree. Well said. I think we have a nice working plan. Thank you for taking my rough ideas and help formulate a plan. It's not perfect, but with some work these things can occur.

 

[fivescrew]

Trying to win this argument by telling them you are the same as other physicians isn't going to work because at the end of the day DPMs aren't the same, they are different. That's just how it is. That's nothing bad, it's just how it is. DPMs are specialists in the foot and ankle and should be marketing themselves only as such.

Instead of trying to bend and fit some idea of what a doctor should be in a vain attempt to be grouped with the others, podiatry needs to show whoever needs to know why podiatry is a needed part of the healthcare team. With the large diabetic community in the low income population that makes up the majority of medicaid you'd think that it wouldn't be that hard.

Public education and standing your ground is the key, not folding and changing just to get paid. It sets a bad precedent that will surely hurt you all in the long run.


...but again like yours, these are just my opinions.

 

[doctazero]

First off, let me start by saying, I will try my best to describe the currrent situation that I am aware of. If at any moment anyone sees any inaccuracies or flawed statements, PLEASE correct me as I truely wish to be informed, thank you in advance.

Okay, from my understanding, Medicaid does not classify podiatrist as Physicians (medicare does). Therefore if they choose to elimate payments to non physicians (that would be us), they have not done anything illegal, thus a legal battle with Medicaid would be pointless.

The issue with financial parity is not as simple as legal battles that we can take to court, we MUST first address the classification of podiatrist such that all insurance providers consider DPMs as physicians (just like DO/MD). That way if they do decide to drop us from payments, we can then legally challenge them and win. Thus the whole issue of parity is important and worth discussing.

Edit: A comfortable living is not relevant to the idea at hand. We are discussing prinicple and equality. Is it fair that we should recieve less for performing the same procedure that the MD/DO perform?

Spot on.

 

[doctazero]

No. You are not answering my question.

You claim to be a DPM/MD who is still practicing as a Podiatrist. My whole issue is why do you NEED to have an MD degree at all. Personal CHOICE I can live with, but when you have an agenda that having an MD makes being a Podiatrist somehow easier, and try to convince others of this, I DO have an issue with that. You don't NEED to have an MD to be a successful Podiatrist. What we NEED are more DPMs who will stand as one and fight the good fight imo, rather than have a fractured profession with those that think they NEED to have an MD degree to make a difference.

I answered your question. I wanted to get an MD education. WANT is diffent from need. If this is an issue, it's your issue. I'm well over it and it served me well. I am not trying to convince you of anything. I am presenting what Dancerpod and DrMushroomfoot had elaborated on. That's it. That's my agenda. If you hang on to that notion of NEEDING a degree as opposed to wanting one as a continuation of your general education and what turned out to be tool to open more doors, it worked out fine for me. OK? It isn't for everyone, hence my proposal to bring about these things is compelling. I don't know what your hangup is about me, but it's futile. You're not going to get any answers that'll answer whatever NEED you have in pressing me about my own motivators.


The other thing that I question is if you spend so much outside of the healthcare industry as you've just mentioned, how exactly are you that close to it, to really know what sways one way or the other? Desk jockeys are the last group we need giving us advice.

I'm not a desk jockey. The fact that I remain close to the healtcare industry is because there are parts of it that are integral to my work. Maybe you misunderstood or I mispoke, I am directly involved in the business of healthcare but not likely in the same capacity as a practitoner.

Do you want to see these things happen - podiatry increasing its scope to make for inclusion into multiple payor plans? - Or do really give more of a hoot about my motivation, who I am or what I do? One is relevant the other is creepy.

 

[doctazero]

Honestly, If this is not clear enough, I dont know what is .

Agree.

 

[tiptoeing]

I hear what you are saying however the issue of financial parity should be left solely as a legal matter because that's what it is. If and when these battles are fought podiatry will eventually win because while the law\regulations may be able to dictate what it is your training and education allows you to do, it can't abide pay discrimination based on where you went to school....and that's what it is discrimination. As sure as if you were being paid less because you are black\white\purple. There are countless examples of other than MD\DO practitioners fighting for and winning equal treatment to practice the full scope of what they and be reimbursed equally.



Besides, you'll still make a comfortable living as a DPM in the mean time. 🙂

fivescrew, good to see you in here again. Exactly, how do you suppose we should fight the financial parity SOLELY as a legal matter? If you can come up with a way that hasn't been attempted than I will recommend and back you up to be the president of the APMA. You should contact them with your great ideas!

 

[tiptoeing]

"If we don't stand up and define who we are as a profession than someone else will define it for us" The words of one of the board members who was instrumental in getting this whole ordeal going. Everyone need to relax...what will happen to all the DPMs if this thing goes through? They will gather them all up....line them up....and shoot them all because they now are useless to the Healthcare community 🙄

 

[docdonny]

"If we don't stand up and define who we are as a profession than someone else will define it for us" The words of one of the board members who was instrumental in getting this whole ordeal going. Everyone need to relax...what will happen to all the DPMs if this thing goes through? They will gather them all up....line them up....and shoot them all because they now are useless to the Healthcare community 🙄

well according to south carolina...

 

[347932]

Do you want to see these things happen - podiatry increasing its scope to make for inclusion into multiple payor plans?

I spend a lot of my free time in political action to make this happen and work with several of the political bodies within our profession to help any way I can, so please don't preach to me. What do you do other than this posts call to action?

 

[Feli]

... I expect to be called a `troll' or that I need to take psych meds and on and on or perhaps I am bitter or negative or somehow wrong. But that is not the question which is before podiatry and podiatrists now. The question is if and when there is a route to equality will it expose podiatrists in a manner that is less than favorable. Not all podiatrists are surgeons. In the cabal of podiatry should they be banished?

No, it's generally relaxed around here. I understand that a lot of people have major insecurities... good luck with that, btw. 😉

...And, by all means, feel free to add me on FB if you'd like to see how much hotter my woman is and how much better my overall life is when compared to... well... what-ever it is that you do. Sorry, but I don't even care to find out. (totally j/k on this 2nd paragraph... kinda)

This thread has a fairly singular purpose in my honest estimation... :troll:

 

[347932]

Your views on podiatry is accurate and one that I agree with completely in an ideal world where there is no financial discrimination between the degrees. However, in the real world, the issue of parity is important, especially when speaking in terms of finances. There are still areas around the US where DPMs are paid less then the MD/DO counterpart for performing the same exact procedures. Recently, in an attempt to save money, South Carolina dropped DPMs from Medicaid reinbursements. This leads to the question why DPMs and not MD/DOs? Would this have happened if there was legal parity? Although these finance issues are not yet mainstream, these are valid issues that need to be addressed prior to it becoming a major issue. States have a tendency to follow the examples of other states (especially California, they usually set the trend), what if more states decided to cut DPM from Medicaid?

Personally, finances is the sole driving force for my desire to have parity within the fields. I emphasize that I do NOT wish for there to be a degree change within our profession (DPM to MD or DO).

They chose podiatry for a very specific reason. Our services to that population costs the government a lot of money. The folks that have this insurance tend to be underprivileged and not the healthiest bunch in the lot (diabetics with all kinds of issues for example, or patients who are disabled and have a higher risk of ulceration as another). They figured that it would cost them LESS if they didn't have to pay for those services, and every time this happens they are astounded that it, in fact, ends up costing them MORE (amputation and subsequent disability vs. wound care and limb salvage for example) and they then revert back to allowing Podiatry to be covered under Medicaid, and realize the value of our services. Just btw, Medicaid just happens to be one of the worst payors, and in my experience, represents the highest number of non compliance issues of ANY patient population.

Think about this for a moment. Let's say that ALL insurances decided to drop Podiatry services from their contracts. Do you think we'd make more money or less? Just about EVERY medical professional would make tons MORE if they didn't take insurance, but with the given climate, you are FORCED to accept insurance premiums to make a living. If ALL of us (and I mean ALL of us in every city, in every state, nationwide) collectively decided to stop taking ANY insurance, making your student loan payments would be laughable.

The issue with making the same amount for the same procedure performed is one that has been raging on for a looooong time. We have not been able to solidify any PROOF that this occurs or it would be a non-issue. Do we think it happens? YES. Can we prove it? NO. Why? Because those podiatrists that work with orthopedic groups that can prove or disprove this theory, won't step up. There is no interest on their part to do so. An Orthopedist won't stick his or her neck out to prove or disprove this either. I can tell you that a PCP who bills for a Partial Nail Avulsion or a Peripheral Nerve Injection for a Neuroma gets paid EXACTLY the same as we do. FOR SURE. As a profession if we mount a legal battle without knowing FOR SURE and lose, that would be political suicide. and can slap our profession with a federal collusion lawsuit (at the APMA level). The powers that be are working on this, but until someone steps forward with PROOF one way or the other, we can't move forward.

There have been instances where our fees have been cut without justification by certain insurance carriers, and the fight was fought and we WON. There is work being done out there, which I'm sure, those of us in practice for awhile can attest to. Take heart out there, it's not even close to as bad as some try to make it out to be. You have to be carefully intelligent and know what you're doing though.

 

[PADPM]

Doctazero,

I find one recurring theme very interesting. Although you constantly default to the idea that every post is an attack and that podiatrists are constantly on the defensive, when I read your posts, I'm drawn to the obvious defensive nature of all your posts. Everytime someone asks YOU a question, your response is an attack back and filled with defensive remarks.

I find that ironic, but then again I guess it's because you have a DPM degree, and you just can't help yourself.