To be more specific

"Is it the schools?"

This is easy. The schools fail the students in a number of ways. Back in the 90's, the schools continued to market podiatry and recruited students very agressively. This, while they knew full well that there was a residency shortage (quality residencies if not just the number) and that there would never be enough residencies in the future to support the number of students that they were admitting. Also, the schools are not uniform in their training and many of the schools have failed to negotiate with hospitals/clinics to afford students the necessary clinical training. The tuition continued to rise, but the quality of education did not.

"Is it the APMA?"

What is the APMA? Oh, yeah. They're that organizaion that purports to represent podiatry and the DPM's who pay them. The APMA should have taken the lead in Brian Gale's situation, they should have a system to help new residency grads find work, they should help the schools in improving the educational standards and clinical rotations, they should help struggling podiatrist, in general, so they don't end up killing themselves or go bankrupt (but not those students loans, God forbid!). They should also find a way so that DPM's can ALSO get their loans forgiven like other doctors. Just what is it that they do?

"Is it those already in practice?"

Yes. By offering sub-standard wages to residents and post residents, they are contributing to the problem. They are also, generally, not involved with the politics of health care, do not give back to the schools and hide in their little cubby holes and count their dollars. Not all DPM's, mind you, but most.

"Is it those hiring new associates?"

Yes. At sub-standard wages.

"Is it the insurace companies?"

What are you going to do about insurance companies? They are all for profit and find it more profitable to exclude DPM's from plans. They also crumble under the weight of the surgically trained DPM to exclude the non-surgically trained DPM from their programs.

"Is it the government (Medicare/Medicaid)?"

Only in that Medicaid is continually trying to close podiatry out of the system (in California, periodically, and in other states). Medicare is limiting payment to all docs.

"Might it have anything to do with individual choices?"

Absolutely! Everyone who decided to become a DPM did it without a single weapon pointed at their head! But, they weren't given the full story by the schools or the APMA, which put them at a distinct disadvantage.

"I'd like to know exactly who you are putting the blame on."

In my opinion, the blame is shared both by the individual and the system.

What do you propose for a solution? (Is it achievable?)

Reform the educational program to better mimic MD/DO training, thus gaining respectability by the health care system, workers, public.

Raise the standards for admission after earning the right by reforming the educational process.

Hire full-time staff of professors.

All students should be trained at a minimum for 2 years (first year needs to be a traditional PGY-1 so that they can understand medicine). Second year should be an intensive period of podiatric surgery.

Once the respect is achieved, then podiatry/APMA can promote podiatry through marketing/advertising, etc.

Obviously, there are a lot of other items to be addressed

And, I doubt much of it will happen because it requires organization and money, which the current system lacks.