Accountable Care Organizations and Podiatry or Lack thereof...

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doctazero

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What is being done to get podiatry included in Accountable Care Organizations? This will have a huge impact on how podiatrists are compensated in the future. Does anyone have any suggestions? As it stands today only MD/DO, NP, PA, and RNs are included. Why is podiatry left out and why aren't podiatric leaders summoning resources to accomplish these ends? No matter how many years of podiatric residency, if podiatry is not among those listed, they will NOT be eligible for remibursement. I have concerns because podiatrists at businesses I have an interest in MAY NOT be paid for services rendered.
 
ACO professionals include doctors of medicine/osteopathy, or PA/NP/RN managers. Where does that leave podiatrists/podiatric surgeons?

Agree that it does not matter how many years of post-podiatric school training, if they are not at the dinner table for health policy and actively pursuing inclusion in this new model of healthcare--where are they going to end up?

The time has come for DPM to earn an MD or practice full scope with full licensure. USMLEs, ABGME, and ABMS boards. Walkathoning and talkathoning is nice, but at the end of the day--DPMs are excluded from this new healthcare change. Where is the outrage?

Doctors of medicine/osteopathy will be part of large medical groups; fortunately/unfortunately, the era of mom/pop/small practice are over. Where are the pods in CMS/ACO. No po.
 
ACO professionals include doctors of medicine/osteopathy, or PA/NP/RN managers. Where does that leave podiatrists/podiatric surgeons?

Agree that it does not matter how many years of post-podiatric school training, if they are not at the dinner table for health policy and actively pursuing inclusion in this new model of healthcare--where are they going to end up?

The time has come for DPM to earn an MD or practice full scope with full licensure. USMLEs, ABGME, and ABMS boards. Walkathoning and talkathoning is nice, but at the end of the day--DPMs are excluded from this new healthcare change. Where is the outrage?

Doctors of medicine/osteopathy will be part of large medical groups; fortunately/unfortunately, the era of mom/pop/small practice are over. Where are the pods in CMS/ACO. No po.


This IS the issue for ALL podiatrists, podiatry students and residents.
 
What does that mean? "dyk 343"/ does that negate a fact? Perhaps, you need to read up on ACO's? Do they teach that in podiatric schooling, or does it involve arch supports, horrible flip flops, and sock talk?

Podiatry is not integral to new healthcare maintenance organizations. Look what happened in SC. TX took back the ankle. PA pods cannot discuss injury causation of bunions. Yep, bunions b/c they are not MD/DOs. read that court statement.

They are left out of CMS/ACOs, yet NP/PA/RN are included.

Can you explain podiatry's exclusion from ACO professionals? This is pretty serious stuff, what are those leaders/masters/famers doing about it?

As a podiatrics student, this directly and indirectly affects you and all podiatrists as "doctorzero" states.
 
What does that mean? "dyk 343"/ does that negate a fact? Perhaps, you need to read up on ACO's? Do they teach that in podiatric schooling, or does it involve arch supports, horrible flip flops, and sock talk?

Podiatry is not integral to new healthcare maintenance organizations. Look what happened in SC. TX took back the ankle. PA pods cannot discuss injury causation of bunions. Yep, bunions b/c they are not MD/DOs. read that court statement.

They are left out of CMS/ACOs, yet NP/PA/RN are included.

Can you explain podiatry's exclusion from ACO professionals? This is pretty serious stuff, what are those leaders/masters/famers doing about it?

As a podiatrics student, this directly and indirectly affects you and all podiatrists as "doctorzero" states.

I never commented on any fact other than there are 4 posters on here that all have the same writing style. i dont know enough about what is posted above to make a comment. Its obvious though that you are trying to stir the pot and make up new screen names to comment on your own postings.
 
I am definitely not "doctorzero" or whatever, this is coming from a father who loves podiatry and wants everyone, yes EVERYONE to thrive, not survive. Y

Most are paying hundreds of thousands with interest for podiatric schooling, and then an NON-ACGME post-school training program. The AMA does not call it residency. Read it. in the AMA briefs for CA 6/28/11. Time has come, and the time to step up, grow male/female anatomy and demand change is here. Take the USMLEs already and enough of the sock talk, or flip flop dangers.

Regardless of your forensic analysis of the "writing styles", I can assure that this is no 'doctorzero', and that the elimination or omission of podiatry/DPMs/podiatric physicians from CMS/ACO is troublesome and distrubing.

repeat, "ACO professionals include only doctors of medicine or osteopathy and NP/PAs and RN managers". Where is the integral to the health care system pods? And what exactly are the leaders, masters, famers doing about it? You are busting your hump for schooling and told ad nauseum about the 'integral member' rhetoric. AZ has eliminated podiatry from medicaid too. Where are those seeking foot care going to go to: IM/FPs/PA/NPs/derm/ortho/RN/LVN/Vasc surg/plastics....... time to become truly integral and that means LCME and USMLEs. Period. No more acryonym changing or lipstick on pig changes. Tough love.
 
I never commented on any fact other than there are 4 posters on here that all have the same writing style. i dont know enough about what is posted above to make a comment. Its obvious though that you are trying to stir the pot and make up new screen names to comment on your own postings.


I am only permitted per the board monitor to post under Doctazero and remain compliant to the board monitor's requests. If you have any questions please direct them to the board monitor for clarification.
 
I am definitely not "doctorzero" or whatever, this is coming from a father who loves podiatry and wants everyone, yes EVERYONE to thrive, not survive. Y

Most are paying hundreds of thousands with interest for podiatric schooling, and then an NON-ACGME post-school training program. The AMA does not call it residency. Read it. in the AMA briefs for CA 6/28/11. Time has come, and the time to step up, grow male/female anatomy and demand change is here. Take the USMLEs already and enough of the sock talk, or flip flop dangers.

Regardless of your forensic analysis of the "writing styles", I can assure that this is no 'doctorzero', and that the elimination or omission of podiatry/DPMs/podiatric physicians from CMS/ACO is troublesome and distrubing.

repeat, "ACO professionals include only doctors of medicine or osteopathy and NP/PAs and RN managers". Where is the integral to the health care system pods? And what exactly are the leaders, masters, famers doing about it? You are busting your hump for schooling and told ad nauseum about the 'integral member' rhetoric. AZ has eliminated podiatry from medicaid too. Where are those seeking foot care going to go to: IM/FPs/PA/NPs/derm/ortho/RN/LVN/Vasc surg/plastics....... time to become truly integral and that means LCME and USMLEs. Period. No more acryonym changing or lipstick on pig changes. Tough love.

No you aren't Doctazero. I am. But you are one literate devil, stirring the pot like that. Please, these harsh realities have no place in harsh reality.
 
CaddyPod = Mike Hunt = Traum = Doctazero ???

The board only permits one name for each individual. The board monitor knows this and I suggest you take up your questions and concerns along those lines.
 
Why can't address the question? Why are you so concerned with who the person is, does, mult log in, amateur forensic games, and nonsense?

You are podiatric student. What is your response to the questions raised? Are are you content with sock talk, flip flops, and the recycled limb team lecture?

How about medicine, how about demanding the very best in medical training for >250K in student loans with interest? Or are you concerned with who are yous? Time to put the big boy/big girl pants on and read about american medicine, and how pods are excluded. IN PA, injury causation of bunions is NOT permitted by pods in courts? Why do you think that is?

Are you a foot dentist or a physician? Physician begins with LCME and USMLEs. Let's start, and put the MEDICINE into podiatric medicine.
 
The board only permits one name for each individual. The board monitor knows this and I suggest you take up your questions and concerns along those lines.
Didnt you say in another post that you only post off of public computers? And therefore can change your handle whenever you feel? Good job.
 
Why can't address the question? Why are you so concerned with who the person is, does, mult log in, amateur forensic games, and nonsense?

You are podiatric student. What is your response to the questions raised? Are are you content with sock talk, flip flops, and the recycled limb team lecture?

How about medicine, how about demanding the very best in medical training for >250K in student loans with interest? Or are you concerned with who are yous? Time to put the big boy/big girl pants on and read about american medicine, and how pods are excluded. IN PA, injury causation of bunions is NOT permitted by pods in courts? Why do you think that is?

Are you a foot dentist or a physician? Physician begins with LCME and USMLEs. Let's start, and put the MEDICINE into podiatric medicine.

Listen caddypod, Our profession has come a loooong loong way. We have board certified podiatrist on staff, as physicians, on some of the biggest and baddest universities in the nation ( UCSF UCLA, Harvard, Yale, J Hopkins,etc..) Just google "podiatrist" and "orthopedic" and examine how many podiatrist are working with orthpods. The residency is becoming longer and more complex, The number of application has more than doubled since 2001 http://www.aacpm.org/html/statistics/PDFs/AppStats/Historical_TRENDS.pdf). And there is even talks of California evaluating the profession to further extend the scope of practice beyond the F/A. Podiatry is becoming more and more evidence based medicine. I really think you need to chill out and realize that we are on the right tract.

And quit with the 10 different screen names, its getting really annoying.
 
Its not hard to identify this guy because he rambles so much. Therefore in future (myself included) I think we should follow this... :troll:

If we stop feeding him eventually he will go away.
 
What is being done to get podiatry included in Accountable Care Organizations?

A 3 second Google search can do wonders.

Headline: APMA submits comments on ACO Proposed Rule (June 2011)

APMA said:
Comments were developed based on feedback from APMA’s ACO Task Force, members of the Health Policy Committee, health policy consultants and staff. This group reviewed, researched and analyzed a broad range of information related to the proposed rule, including webinars, legal analyses and comments by other interested parties. APMA also submitted comments on waiver designs in connection with the Medicare Shared Savings Program and CMS’ Innovation Center. These comments can be viewed in their entirety at www.apma.org/comments.
 
Didnt you say in another post that you only post off of public computers? And therefore can change your handle whenever you feel? Good job.

I was advised by the board monitor to comply with using the same login name and have complied. If you are inimating that I noncompliant please take this up with the board monitor. If you should have any questions or concerns, I am certain your questions can be ansewered.
 
CaddyPod = Mike Hunt = Traum = Doctazero ???

Again dyk343 I was advised by the board monitor that if I wanted to continue posting at this site it would be imperative to comply with the rules as set forth - per the board monitor - to post ONLY using ONE login name. If you question the veracity of my posts as solely doctazero please take that up with the board monitor. This is the third time I have answered your specious accusations /requests. There are more important issues to discuss, your fixation with my login, as I've mentioned can easily be clarified.
 
Its not hard to identify this guy because he rambles so much. Therefore in future (myself included) I think we should follow this... :troll:

If we stop feeding him eventually he will go away.


Eloquent. Exemplifies the sort of ingenuity, inventitveness you've used in earlier posts. Personal affrontery, insinuation, innuendo, and calumny seems to be the favored coloquy of podiatry students these days.
 
Listen caddypod, Our profession has come a loooong loong way. We have board certified podiatrist on staff, as physicians, on some of the biggest and baddest universities in the nation ( UCSF UCLA, Harvard, Yale, J Hopkins,etc..) Just google "podiatrist" and "orthopedic" and examine how many podiatrist are working with orthpods. The residency is becoming longer and more complex, The number of application has more than doubled since 2001 http://www.aacpm.org/html/statistics/PDFs/AppStats/Historical_TRENDS.pdf). And there is even talks of California evaluating the profession to further extend the scope of practice beyond the F/A. Podiatry is becoming more and more evidence based medicine. I really think you need to chill out and realize that we are on the right tract.

And quit with the 10 different screen names, its getting really annoying.

There are not ten different screen names, only one. I was advised by the board monitor that if I wanted to post here to use one login name which is doctazero. If you have any questions to that effect contact the board monitor for further claification.

I am chilled out and most certainly am not on an expanse of land or water (tract) rather in front of a computer. Perhaps you meant track, which I assure you, that I am and quite content in doing so.

Again if you are annoyed with a belief that I post singularly with the name doctazero, look no further than the board monitor for clarity and we can dispose of that silly notion.
 
Are you a foot dentist or a physician? Physician begins with LCME and USMLEs. Let's start, and put the MEDICINE into podiatric medicine.

"Foot Dentist"??? You're doing the same thing to dentists that they are supposedly doing to you. Real mature.
 
Just google "podiatrist" and "orthopedic" and examine how many podiatrist are working with orthpods.

I personally know a Podiatrist that is one of the ortho teachers at a local MD granting program. The way I understand it she was recruited out of the VA system to teach the med students and cover the foot and ankle and is now working on trying to get a partnered teaching hospital to start a few DPM residencies in the upcoming years. Another example of how Podiatrists are valued by MD\DO colleagues and I'm sure there are other medical schools that employ podiatrists.
 
What does that mean? "dyk 343"/ does that negate a fact? Perhaps, you need to read up on ACO's? Do they teach that in podiatric schooling, or does it involve arch supports, horrible flip flops, and sock talk?

Podiatry is not integral to new healthcare maintenance organizations. Look what happened in SC. TX took back the ankle. PA pods cannot discuss injury causation of bunions. Yep, bunions b/c they are not MD/DOs. read that court statement.

They are left out of CMS/ACOs, yet NP/PA/RN are included.

Can you explain podiatry's exclusion from ACO professionals? This is pretty serious stuff, what are those leaders/masters/famers doing about it?

As a podiatrics student, this directly and indirectly affects you and all podiatrists as "doctorzero" states.

Texas did not take back the ankle. We still have full scope here naysayer. Yesterday I performed a Tibiotalarcalcaneal arthrodesis with a IM nail (after performing my own H&P) and next week I have an ankle scope, PT tendon transfer through the interosseus membrane, and a cavus foot reconstruction. So far I haven't been arrested.

Look ACOs are a concern for everyone. They are not set yet and no one knows what will be the final form they will take. Podiatry needs to be involved and at the table. With costs and the need for providers as the uninsured get insured over the next several years, medicine will need all the help they can get (although they all are running scared of te DNP concept).
 
I hope that those who've had concerns regarding identities take a moment from your busy schedules to contact the board moderator/monitor to resolve questions and concerns regarding identities of those who post.

It might be constructive to assign each new member an ID #, after other items to filter through the dross by way of a vetting process via their, license(s), NPI # and/or school enrollment is stored by the site along with the real name of the posters. This would go to more thoughtful posts. It would also perpetuate a sense of accountability with respect to those who might use this sort of networking to reflect their attitudes, writing skills and other components for potential jobseekers, employers, colleagues and such who may at some point find this information useful.

There are some sites which utilize the national databases to vet applicants to post on which use similar processes. It might behoove these forums to look into how those sites function.
 
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I hope that those who've had concerns regarding identities take a moment from your busy schedules to contact the board moderator/monitor to resolve questions and concerns regarding identities of those who post.

It might be constructive to assign each new member an ID #, after other items to filter through the dross by way of a vetting process via their, license(s), NPI # and/or school enrollment is stored by the site along with the real name of the posters. This would go to more thoughtful posts. It would also perpetuate a sense of accountability with respect to those who might use this sort of networking to reflect their attitudes, writing skills and other components for potential jobseekers, employers, colleagues and such who may at some point find this information useful.

There are some sites which utilize the national databases to vet applicants to post on which use similar processes. It might behoove these forums to look into how those sites function.

With respect: Chill.
 
With respect: Chill.

Nicely done post regarding Texas and your work - This suggests that you approach your work with a certain degree of intensity, precision and skill.

I agree that some of the things before podiatry today may not come to fruition for a decade, perhaps longer. Nonetheless there are some issues which can and will be determinative with respect to the structuring of elements of the healthcare dynamic including but not limited to the DNP - Which, may ultimately make way for DNP subspecialties including those populated by MD/DO specialties. The nursing lobby is remarkably well funded, moreso some might suggest than the MD or DO lobbies. And, considerablly more than those of podiatry.

As to your suggestion to `Chill' - There aren't enough hours in the day.

Respectfully
 
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Can everyone please shut up on this topic and some of the other threads going on. The fact of the matter is that there is some legitamacy to what traum/doctazero are talking about, but with the exception of a few people on these forums, most of us are not on educated enough to have a legitimate conversation. Instead it makes this entire forum look stupid and petty. So stop. Now. Please.
 
Texas did not take back the ankle. We still have full scope here naysayer. Yesterday I performed a Tibiotalarcalcaneal arthrodesis with a IM nail (after performing my own H&P) and next week I have an ankle scope, PT tendon transfer through the interosseus membrane, and a cavus foot reconstruction. So far I haven't been arrested.

Look ACOs are a concern for everyone. They are not set yet and no one knows what will be the final form they will take. Podiatry needs to be involved and at the table. With costs and the need for providers as the uninsured get insured over the next several years, medicine will need all the help they can get (although they all are running scared of te DNP concept).

Traum, your above posts show that you are very well intentioned but perhaps a bit misinformed. The ACO issue is a big one and will be remedied. But it pretty much has to happen. Who is going to suddenly spring forth and start treating the foot and ankle??? Google title XIX and podiatry and you'll see the latest.

I echo Podfather's comments in that things need to be done pro-actively (and are) but on the other hand, the sky isn't falling. In nearly every part of the country, we practice as we wish and are trained to do. There are definitely pockets where things need to be resolved. And they are actively being done so. No one is trying to ignore the issues or sweep thing under the rug. It would seem that some do not want to accept that.
 
Well, if you want an answer to your question, you have to make sure everyone's willing to work for ACO reimbursement rates (and waits for those downcoded, refused, and finally accepted fees).

Liberal = Gosh, how will we be able to keep the limited "government money" paying for everyone without raising taxes? It's hard with all these people to who are minimally employable, then don't ever want to work once we start having other people pay for them to have everyting by being lazy. Then those lazy people have lotsa kids who end up... lazy. Wtf?? We better keep finding better ways to spread the wealth.

Conservative = It'll be interesting to see how the increasing trend toward concierge medicine in America evolves. It will be nice to see that more and more people who are sick of working hard or paying sky high insurance premiums for others' laziness decide to stop carrying insurance... and elect candidates who won't enable laziness either.
 
CaddyPod = Mike Hunt = Traum = Doctazero ???
You are wise beyond your years.^

...don't waste too much time on the grouches, doom-and-gloomers, and pessimists of the world. Frankly, they usually have some major malfunction which has limited them in their own life. They are trying to drag other good people down out of jeaousy, and they just aren't worth your time. Sad but true, but it's just a facts of life that you can't save the world... and def can't save some grouchy ppl from themself.

Be like me: just have a good weekend in the sun 😎

[YOUTUBE]http://www.youtube.com/watch?v=7iSRr3ZuLL8[/YOUTUBE]
 
Thank you Sir/Madam for your cogent and intellectual reply. It is refreshing to hear some level of independence and thought, other than some podiatric "students" chiming in with get life, loser, stroller, or other elementary school terminology. One can perhaps, surmise with these types of responses that they are either, brain washed, of limited intellect, or have trouble looking outside the prism of the 2011 podiatric realm and rather live in a bubble or believe whatever the masters, famers, and leaders of the foot clubs state.

The Superior Court in TX stated that podaitry board exceeded its' scope, and did not define the ankle as part of the foot, etc...The TX ortho group and medical group were against pods including the ankle in their care. In fact, the pathologist exec member stated that if pods want to do ortho surg or medicine, they should "go to medical school." "Protecting the public safety" from allied health providers, etc...

Plain hooey.

This is disturbing, we are in the middle of 2011, and we still have this type of exclusionary nonsense going on. For students and ALL practitioners to move forward and finally dismiss this nonsense, it is imperative to enance FULL scope ankle and foot medicine. Way overdue to pay >250K in student loans with interest and STILL be discriminated against.

Anecdotal examples are nice of some pods aligning with orthos, or working with limb salvation teams, however, that is not the norm.

We must rise up and demand change: for pod schools, to residencies (AMA does not call it that-post-clincal training for pods-ancillary care providers--podiatry "services"). LCME, USMLEs, ABSITE, ACGME, and then finally boards under the jurisdiction of ABMS. Enough of lipstick on pig changes, and acronym changes that is not substantive and window dressing for dues paying club members.
 
thank you sir/madam for your cogent and intellectual reply. It is refreshing to hear some level of independence and thought, other than some podiatric "students" chiming in with get life, loser, stroller, or other elementary school terminology. One can perhaps, surmise with these types of responses that they are either, brain washed, of limited intellect, or have trouble looking outside the prism of the 2011 podiatric realm and rather live in a bubble or believe whatever the masters, famers, and leaders of the foot clubs state.

The superior court in tx stated that podaitry board exceeded its' scope, and did not define the ankle as part of the foot, etc...the tx ortho group and medical group were against pods including the ankle in their care. In fact, the pathologist exec member stated that if pods want to do ortho surg or medicine, they should "go to medical school." "protecting the public safety" from allied health providers, etc...

Once again mis-informed. The supreme court never heard the case. They chose not to hear it. Therefore it went back to the apellate court's decision. The case had nothing to do with ankles but whether the state board of podiatric medical examiners had the right to make a rule. It was determined that the board's rule was not permitted. But that's all that was affected. In fact, the apellate courts ruling specifically stated they were not defining scope and podiatrists could treat conditions at or below the ankle. With the decision the original statue applied and historical privileges (which includes the ankle) are still permitted and performed in Texas. You can be "chicken little" all you want but when it comes to Texas, sorry I know quite a bit more than you.

plain hooey.

This is disturbing, we are in the middle of 2011, and we still have this type of exclusionary nonsense going on. For students and all practitioners to move forward and finally dismiss this nonsense, it is imperative to enance full scope ankle and foot medicine. Way overdue to pay >250k in student loans with interest and still be discriminated against.

Anecdotal examples are nice of some pods aligning with orthos, or working with limb salvation teams, however, that is not the norm.

We must rise up and demand change: For pod schools, to residencies (ama does not call it that-post-clincal training for pods-ancillary care providers--podiatry "services"). Lcme, usmles, absite, acgme, and then finally boards under the jurisdiction of abms. Enough of lipstick on pig changes, and acronym changes that is not substantive and window dressing for dues paying club members.

p
 
I stand corrected, thank you clarifying the TX issue and the appellate court decision stating the podiatry board overstepped its' bounds and that orthopedic surgeries of the foot and ankle can be performed by podiatrists.

If podiatry is integral and mainstream, I am again curious as why the TX AOA and AMA would align themselves to hurt or limit the known expert of the ankle and foot in healthcare?

Why did the pathologist AMA TX exec state that pods ought to go to medical school and were proud the appellete court ruled that way?

This is to "stir pots" or other podiatric "student"/"resident" frailities, but rather a discourse on what is happening to pods. I am tired of sugar coating and turd polishing, and "leaders" promising the moon and not delivering or hearing that MA cannot get ankle priv after being a limb salvation centre.
 
You are wise beyond your years.^

...don't waste too much time on the grouches, doom-and-gloomers, and pessimists of the world. Frankly, they usually have some major malfunction which has limited them in their own life. They are trying to drag other good people down out of jeaousy, and they just aren't worth your time. Sad but true, but it's just a facts of life that you can't save the world... and def can't save some grouchy ppl from themself.

Be like me: just have a good weekend in the sun 😎

[YOUTUBE]http://www.youtube.com/watch?v=7iSRr3ZuLL8[/YOUTUBE]

Thank you good person of the world,

I really do not have a response - I'm left speechless by the riveting post. I have to go about my day of grouchiness, naysaying and pessimisticly pouncing on podiatric professionals. I hope I can get my major malfunction taken care of on account of being jealous of being cool - You're right, there is no saving me from myself. Oh? What day is it, it's the weekend? - You podiatric residents taking call with weekends off - yeah, some folks'd be jealous of that….BUSPM class of `09, bet you rubbed shoulders with a few osteopaths and PAs too! - Well you've got important Grosse Pointed things to do up there in Motown, the land where podiatry ruled the highways and there wasn't an autoworker alive that hadn't had an arthroplasty, set of tenotomies and a handfull of whatever to ease the pain - How about a shout out to the autoworkers, another group who never questioned the security of their `jobs' -
 
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I am perplexed, what does a teenie bopper video have to do with podiatry and its' exclusion from ACOs, medicaid, CMS? Perhaps, putting down the strapping tape, and the 15 blade, and you will realize that podiatry is not as integral/mainstream as we think or were sold by recruiters, admission "officers" and others who are remunerated based on applicants, etc...

This not a naysayer, or loser, or get a lifer-this called cold water to the face-I cannot believe that this is the typical intellect level of a typical podiatric training school student. Teenie bopper video and podiatry is still at the back of the bus 2011 style.

USMLEs, LCME, ABSITE, ABGME, and ABMS. That's it.

Once that is obtained parity will ensue.

In the meantime, we can rearrange deck chairs of the Podo titanic all we want. The writing is on the wall, some leaders in the profession as that new CA school have male anatomy, many however, do not. They enjoy making money off of students/post-school clinical trainees, and practitioners who again, do not know, what they do not know.
 
I stand corrected, thank you clarifying the TX issue and the appellate court decision stating the podiatry board overstepped its' bounds and that orthopedic surgeries of the foot and ankle can be performed by podiatrists.

Wow you are something else. No it basically stated that any state board has limitations in what a rule can propose. And that Podiatrists can continue to practice Podiatric Medicine and Surgery comprehensively based upon their training and experience


If podiatry is integral and mainstream, I am again curious as why the TX AOA and AMA would align themselves to hurt or limit the known expert of the ankle and foot in healthcare?

Are you that naive? For the same reason they attack nurses, optometrists, psychologists, chiropractors, and in the past (and behind closed doors some still do today) osteopathic physicians. Competition plain and simple. Unfortunately it's only a handfull of orthopedists who are the rabble rousers and cost TMA over a million dollars and at the end of the day DPMs can still practice comprehensively. Many orthopedists refer surgical patients with complex foot and ankle problems to me and their groups hire our residents for full scope care. Are they crazy? Next you will spout patient safety yet orthopedists often are granted privileges they have never performed on the foot and ankle in residency or practice. They can be board certified never having performed a foot surgery. They admit their lack of training in the lower extremity by simply having a foot and ankle fellowship. Is the fellowship required to be skilled in foot and ankle conditions or is it remedial for those who just didn't get it in residency? If required then why is it a general orthopedist can be permitted such privileges without experience?

Why did the pathologist AMA TX exec state that pods ought to go to medical school and were proud the appellete court ruled that way?

Why do you think? Political rhetoric. They claimed a win yet I still have privileges. Who really won?

This is to "stir pots" or other podiatric "student"/"resident" frailities, but rather a discourse on what is happening to pods. I am tired of sugar coating and turd polishing, and "leaders" promising the moon and not delivering or hearing that MA cannot get ankle priv after being a limb salvation centre.

If you are not in DPM school then you have made your points and many choose to disagree with you. The end. If you are in DPM school perhaps you should quit and go to medical school since your cherish it so much. I was accepted to MD, DO, and DPM school and chose DPM school. I am happy with my choice, contributed much time to better the profession, and frankly find complainers who do nothing but try to incite discourse irritating.
 
If you are not in DPM school then you have made your points and many choose to disagree with you. The end. If you are in DPM school perhaps you should quit and go to medical school since your cherish it so much. I was accepted to MD, DO, and DPM school and chose DPM school. I am happy with my choice, contributed much time to better the profession, and frankly find complainers who do nothing but try to incite discourse irritating.

👍
 
Why remarks that you disagree with are disturbing to you. It is called NOT regurgitating the spoon fed nonsense from those masters, leaders, and famers.

An MD and DO can do everything and anything on that foot and ankle complex. They do not need to complete podiatric post-school training program (AKA residency, AMA does not recognize it as a residency, that is ACGME approved).

Therefore, what do pods do that is so unique and so desirable to health execs in this current healthcare arena with exclusionary practices and pods being listed with chiros, optos, and PTs? In some states, pods are registered under same auspices/general board as real estate agents massage therapists, not the MEDICAL board -MD.

Cost cutting and ensuring lack of redundancy will be the constant drum beat. That is the current rythum of the band. ACO/medicaid/lack of physician status.

PA and NPs ARE doing podiatry--it is called cost-effectiveness, wound care, nails, nail avulsions, etc. and they are full scope.. and to echo doctornada's comment's yes, there are FP/IM and others doing basic podiatry surgeries, ingrowns, etc... then the orthos can do foot and ankle surgery.

They do NOT need a fellowship to do ankle scopes, tib-fib fx, os calcis fx, etc..orthos do this, but the remuneration for these surgeries is not sexy enough, therefore, pods step in, be opportunistic and do it. That is the podiatric niche.

However, would it be great for DPMs to have full scope and training to do this. enough of the clamor and typical podiatric emotional responses, get off the inferiority complex and start practicing and demanding MEDICAL training--VEGF, CXC chemokines, right a grant, publish a paper in a basic sci journal,get podiatric medicine out there. Enough of walkathoning and talkathoning, and flip flop fiascos--foot dentist or a physician? There is a fork in the road......
 
Why remarks that you disagree with are disturbing to you. It is called NOT regurgitating the spoon fed nonsense from those masters, leaders, and famers.

An MD and DO can do everything and anything on that foot and ankle complex. They do not need to complete podiatric post-school training program (AKA residency, AMA does not recognize it as a residency, that is ACGME approved).

Therefore, what do pods do that is so unique and so desirable to health execs in this current healthcare arena with exclusionary practices and pods being listed with chiros, optos, and PTs? In some states, pods are registered under same auspices/general board as real estate agents massage therapists, not the MEDICAL board -MD.

Cost cutting and ensuring lack of redundancy will be the constant drum beat. That is the current rythum of the band. ACO/medicaid/lack of physician status.

PA and NPs ARE doing podiatry--it is called cost-effectiveness, wound care, nails, nail avulsions, etc. and they are full scope.. and to echo doctornada's comment's yes, there are FP/IM and others doing basic podiatry surgeries, ingrowns, etc... then the orthos can do foot and ankle surgery.

They do NOT need a fellowship to do ankle scopes, tib-fib fx, os calcis fx, etc..orthos do this, but the remuneration for these surgeries is not sexy enough, therefore, pods step in, be opportunistic and do it. That is the podiatric niche.

However, would it be great for DPMs to have full scope and training to do this. enough of the clamor and typical podiatric emotional responses, get off the inferiority complex and start practicing and demanding MEDICAL training--VEGF, CXC chemokines, right a grant, publish a paper in a basic sci journal,get podiatric medicine out there. Enough of walkathoning and talkathoning, and flip flop fiascos--foot dentist or a physician? There is a fork in the road......

Learned a long time ago that some people are on agendas and are only behaving in a way to promote that agenda. Your rhetoric is very familiar and I have typically heard it from a close minded, threatened, and usually subpar orthopedist. I respect orthopedists and know many who are excellent surgeons but limit what they do. I also know many good and several bad foot orthopods.

I will continue to focus on my patients and the good we do for them. I will treat those basic and complex problems referred to me by my allopathic and osteopathic colleagues with the expertise I have achieved through my education, training, and experience. Call me what you want but definitely call me when you need my care.

The Foot Dentist`
 
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Why remarks that you disagree with are disturbing to you. It is called NOT regurgitating the spoon fed nonsense from those masters, leaders, and famers.

An MD and DO can do everything and anything on that foot and ankle complex. They do not need to complete podiatric post-school training program (AKA residency, AMA does not recognize it as a residency, that is ACGME approved).

Therefore, what do pods do that is so unique and so desirable to health execs in this current healthcare arena with exclusionary practices and pods being listed with chiros, optos, and PTs? In some states, pods are registered under same auspices/general board as real estate agents massage therapists, not the MEDICAL board -MD.

Cost cutting and ensuring lack of redundancy will be the constant drum beat. That is the current rythum of the band. ACO/medicaid/lack of physician status.

PA and NPs ARE doing podiatry--it is called cost-effectiveness, wound care, nails, nail avulsions, etc. and they are full scope.. and to echo doctornada's comment's yes, there are FP/IM and others doing basic podiatry surgeries, ingrowns, etc... then the orthos can do foot and ankle surgery.

They do NOT need a fellowship to do ankle scopes, tib-fib fx, os calcis fx, etc..orthos do this, but the remuneration for these surgeries is not sexy enough, therefore, pods step in, be opportunistic and do it. That is the podiatric niche.

However, would it be great for DPMs to have full scope and training to do this. enough of the clamor and typical podiatric emotional responses, get off the inferiority complex and start practicing and demanding MEDICAL training--VEGF, CXC chemokines, right a grant, publish a paper in a basic sci journal,get podiatric medicine out there. Enough of walkathoning and talkathoning, and flip flop fiascos--foot dentist or a physician? There is a fork in the road......

Wow you sure do like to hear the clickety clacking of your keyboard dontcha?
 
As usual, the defensive posturing and back peddling, and immature statement from purporting "practitioners" in the field.

Lack of inclusion in ACOs. Lack of inclusion in Medicaid, even in those states with limb salvation experts and those that go on the paid lecture circuit recyling the same stuff. Cannot discuss bunion injury causation b/c do not have the MD/DO in PA.

Where does that leave us? Are podiatric surgeons on staff at Children's Hospital doing full scope foot and ankle surgery with full admitting priv, or is it the orthopod. Are they giving grand rounds on ankle scopes, and VEGF diabetic LE, or their laboratory results at the university medical centre?

The question is why are medical societies, medicaid, and ortho groups discounting the great work podiatric medicine can offer. Not for tit tatters, me toos, attaboys, back schlapping, and teenie bopper videos, and pretending to take call as a resident (very few are on the crash team pushing meds--please correct me if I am wrong).

ACO exclusion. Rhea ipsa loquitor. Podiatry has great potential, however, the problem is not with medicine, it is with themselves. Former podiatry professor.
 
What does Rhea ipsa loquitor mean?

I'm familiar with the term 'res ipsa loquitur'....if that's what you mean.
 
The question is why are medical societies, medicaid, and ortho groups discounting the great work podiatric medicine can offer.

The answer to your question is the MAJORITY do not. Many of my buddies work for ortho groups. Yes, I have full admitting privileges at all of the hospitals in my city and do foot/ankle surgery on peds and adults. I recently was contacted by the chief resident of peds at the level I trauma center to give a lecture on pediatric foot & ankle. Why? We went to the same medical school. The biggest problem is the ignorance of some of the older MD's who don't realize how much podiatry has changed (or don't care). The younger docs who have trained alongside us know us and what we are capable of. I think the remaining bias will die out with time. We even had an F&A ortho who requested podiatry residents for his cases over ortho residents. And ACO's will be resolved as the wheels are in motion for this. And whether a small minority of MD's want to admit or not that DPM's are an integral part of medicine doesn't really matter. We are GREATLY depended upon within the healthcare system.

You've brought up issues which definitely need to be addressed in 3-4 states but quit pretending that the exception is the rule. I can bring up the fact that in the other 46 states, we are doing just fine.
 
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Learned a long time ago that some people are on agendas and are only behaving in a way to promote that agenda. Your rhetoric is very familiar and I have typically heard it from a close minded, threatened, and usually subpar orthopedist. I respect orthopedists and know many who are excellent surgeons but limit what they do. I also know many good and several bad foot orthopods.

I will continue to focus on my patients and the good we do for them. I will treat those basic and complex problems referred to me by my allopathic and osteopathic colleagues with the expertise I have achieved through my education, training, and experience. Call me what you want but definitely call me when you need my care.

The Foot Dentist`

That was a pretty interesting exchange. I'd reckon that I won't be mistaken for Traum. The only clickety clacking I hear is that of the automobiles driving in and out of the city on the metal mesh bridge I live under. I've never taught podiatry and thanks to the kindenss of strangers I've gotten this nifty computer to fuss around with. Yeah, there was a time when I would have had any real responsibility but since dropping out of society and hiding here amongst the fringe - a lot of these things don't matter much. Sure I've got my DPM ticket and make a few bucks from time to time venturing out to the nail garden to debride a few mycotics and hang with the geriatrics. I got my MD too so if I have to, I can pull that out and say: Hey look at me whoopee. Nobody really cares. Now, where was I …. oh back to the last post- I can see where that fella with the Einstein picture is coming from….a smart guy who's done a lot of surgery. Thing is that he mentioned subpar orthepedists, and you know what? Even a subpar orthepedist is still an orthopedist. Then again a subpar anything is till that thing regardless of the par they're on. It's the uniquess or quiddity of the thing itself -So it's all relative. Traum, came here in what an ordinary and reasonable person would suspect to be, to tell a cautionary tale about getting so caught up in what we're doing that we lose sight of what's going on around us. We all do, and for the last few weeks I've seen the back and forths, the tit for tatterings, the cousins best friend who has a niece who has a job as a podiatrist at Harvard and the remarkable skills of the highly trained foot surgeons and how they can get positions in the `New' podiatry. I heard about the `New' podiatry a few decades ago and it's the same `New' it was back then only now, the `New' podiatrists are competing with new practitioners, the NPs and PAs. Traum makes a good point about other folks doing the things old time podriatrists used to do and how they've - DPMs today - have moved toward a more mini-orthopedic surgeon model than general foot docotring. That's OK, but in a few of my previous iterations on this topic, that sort of foot doctoring is being phased out and there are a bunch of new laws coming upon us in this crummy economy that require some creative ways to work podiatry into the mainstream. No, podiatry resisencies aren't part of the ACGME and the whole podiatric residency thing is pretty much a black box for people unfamiliar with podiatry and the training of foot surgeons. So that's the deal. I'm just a bum and don't have anything to prove and really enjoy this nifty computer and wonder why or how some people can be so belligerent… Humility in general goes a long way, so if you're really agling toward some edginess and derogation, maybe you ought to spend a little time groveling and see what it's like to be at the bottom of the food chain. Oh yeah, you know what they call the worst student from the worst medical school who graduates with an MD degree? Yeah, the call him an MD. And after twenty odd years the letters D P M still raise an eyebrow with a certain index of suspicion by a grocery store checkout person who says: "What's that stand for?" Is that recognition? Do you really want to have to explain yourself in twenty years from now? "I thought podiatrists were regular doctors…." You'll be getting a lot of that. I promise. Like I said. I'm just a bum with a computer. I don't have fancy picture of Albert Einstein, a rapper, an x-ray of a leg, or a cartoon picture so, you'll just have to excuse the fact that I just use the name pretty much assigned to me here.
 
Thus far, had a few interesting points raised by "Jon Will" and "Podfather."
The rest from "students" and post-grad residents have offere teenie bopper videos, get a lifer, loser, where are you, what do you do, who are you, etc...etc..creepy as doctornada has stated. That about summarizes the intellect of the SDN podiatry student and resident.

Who I am, what I do is not germane and not relevant. Who are you?

WHO cares??? We are focusing on ACOs/CMS and that does not include pods regardless of rubbin elbows with DOs, or taking a 7 year non-ACGME clinical training program.



Anecdotes, attaboys, and me too's is ok. However, the reality is that ACO do not include pods. Next story. MA cannot operate on anks, that state society says so to. 50 states, 50 diff scopes still after how many years.
Podiatrics keeps on re-inventing itself. Acronym changing. How about capsizing the boat? Start "small": LCME and then USMLEs.

So where do we go from here?
 
MA cannot operate on anks, that state society says so to. 50 states, 50 diff scopes still after how many years.

So where do we go from here?

The scope of practice is pretty uniform with minor details except for MA, Kansas, Hawaii, and a couple other states where we can't do ankles. The ankle scope is another thing the profession has been actively working on which has resulted in recent scope changes in places like Conn and NY. I would like to see a nationalized scope but in the end, as long as we can fix ankles in all 50 states, the rest wouldn't really matter to me. I think the big project for the APMA right now is Title XIX and podiatry's inclusion and that is where most of the time/money is going. The ACGME issue is not a big deal. Pod schools/residencies receive credentialing from the ABPME which is recognized by hospitals, medical governing bodies, and the government. That is how the hospitals receive funding for the podiatry residency programs like any other residency and is why pod residents receive CME money like any other resident as well as a paycheck. So honestly not really much of an issue there.
 
As usual, the defensive posturing and back peddling, and immature statement from purporting "practitioners" in the field.

There is a certain credibility that must go along with each post, and you must "consider the source" of each poster. There have been claims that "traum" and "doctazero" are the same poster.

Doctazero denies the claim, and in my opinion, actually denies it TOO many times. We all know that it would be very simple to post from different computers with different IP addresses, despite any moderator's request to refrain from that practice.

What is even MORE disturbing, would be a conversation between "traum" and "doctazero". That's just beyond weird.

Yes, I know, there will be defensive comments and reverse accusations. But for those of you who don't smell the toast burning, I've highlighted a comment from a "traum" quote above that is not a term I've read a lot on this forum, and quite coincidentally, please read a quote from "doctazero" from a post in another thread.

Here is the quote:

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.

Coincidence????? I think not. But doctazero's spin will be that great minds think alike.

Weird, way too weird.
 
Where do we go from here??

The students go back to studying, and the pods go back to teaching/working/carrying on with life.
That will free you and doczero to decide whether you want to continue hashing out things we already know or step up and be champions for this profession. Or not. It's clear you have a way with the English language, and plenty of free time on your hands. So belly up to the bar and take the fight to the hill. Many on this board have tried to assuage you that we are aware of the different situations confronting the profession, and how they are involved in one way or another. Yet you both vacillate between being ra ra cheerleaders to denigrating the profession as a whole. Please pick one, stick with it, and then kindly piss off. I for one am tired of the threads being constantly hijacked, references to secret and super duper secret websites/conferences/circle jerks in which we are barred. Great, got it. Go be our champion if you have it in you, as you do have valid points. While these points are important, they aren't likely to change within the next six years. There are people on here with more pressing problems. So to reiterate: valid points, received and well hashed over, moving on.
 
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