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science
by anonymous (no login)
Can anyone name a single idea or scientific advancement originating from Podiatry?
Don't say MIS.
Don't say the work of Root on biomechanics because if you read the work upon which his conclusions are based you will realize he fudged.
Posted on Feb 8, 2003, 11:17 AM from IP address 63.185.17.205
I agree that research has always been our weakest point. Fortunately (And I know this as fact working with several foot and ankle orthos over the years)they have taken our techniques borrowed them and done research. Sometimes biased but atleast investigated.
We can't blame this entirely upon our profession. For years the ortho community has attempted to keep us out the ORs and the universities. Ever see what happens when DPMs finally obtain privileges at a hospital. Check the stats and within 3 years they will dominate the foot caes. Even the employees seem to migrate to them once the word gets out.
I have discussed this research and unversity access to many MD foot surgeons. They all say we need this to prove we are trained. When I offer to start such a program with their help, support, and guidance. They head for the hills. Gee I wonder why?
Simple then they couldn't use this arguement to discredit us. And can you imagine a sharp DPM eventuall becoming chief of the service some day?
my opinion........
Posted on Feb 10, 2003, 7:35 AM from IP address 152.163.206.176
No need to attack the messenger. Minimal Incision Percutaneous techniques in Podiatry are proven and are here to stay. If you have not been able to obtain training or are unable to perform these difficult procedures then practice what you able to do. Writing false, bogus statements on this forum about MIS procedures, when you're not an MIS expert, in an attempt to discourage young students from seeking any knowledge or training makes your motives appear very suspect. Doctors should simply not attempt to perform any PERCUTANEOUS Bunionectomies, metatarsal osteotomies, hammertoe corrections, exostectomies, bunionette corrections, heel spur corrections, etc. without having the appropiate training and specialized instrumentation. Because students and residents are not being exposed to these procedures they risk financial ruin when it's time to earn a living. MIS/Percutaneous doctors are able to give the public what they crave...in-office procedures WITHOUT the traditional use of stitches, pins, wires, screws, casts, crutches, dry bandages, surgical shoes and quicker healing. In addition, infections are practically non-existent since stitches are never used and the foot is soaked post-op. I am not going to debate the effectiveness of these 40 year old procedures on this forum with any old school traditional surgeons. In the right hands these procedures obtain miraculous results while in the hands of incompetent doctors results can be undesirable. The purpose of my participation on this forum has been and still is to promote discussion about why our profession has been intentionally hindering the teaching and exposure of MIS/Percutaneous techniques in the podiatry schools. Students should speak up and demand answers to the following. Why have all the texts pertaining to MIS surgery been removed from podiatry schools? Why do the schools refuse to offer training in MIS? Why are traditional surgeons so against schools or the public's exposure of MIS? Students should realize that its never the MIS doctors in podiatry complaining about making a living and ask why.
Posted on Feb 7, 2003, 3:18 PM from IP address 205.188.208.42
You did answer one of the questions that was put to you by the posters about MIS. You say you are not going to debate these issues. And why not? Simple you can not debate because you don't have the answers.
You said it, you are the messenger. You come on this site and state all of these wonderful things that MIS does. That every other surgeon be it DPM, MD, DO has been brain washed and that you are the only enlightened one. We do not need fixation, immobilization, that bone heals faster when it is fractured via a stab incision, that this is what the public craves and yet no proof. I would say we are not killing the messenger but exposing you. Why not take the questions we put forth and present literature or concepts in wound healing that the majority of us can not seem to find. Your antedoctal 40 years proven BS is just that. Do you know any other aspect of medicine that has not evolved over the last forty years of course not so why would say that MIS remains a 40 year proven technique. Heck 40 years ago the majority of DPMs were not even doing bone surgery.
So let's make it simple and neutral answer a fewquestions specifically and then we can move on:
1. You talk about that you need special training and that is why most can not do MIS. Where does one get that training? Is is organized, accreditated, peer reviewed,and documented within the literature? Does one have to pay the faculty or like real residencies will I be paid while performing this training? How long does it take to be trained to do all of these wonderful procedures. A weekend, a week, a month, 3 years? What do your guidelines recommend? How does one know they are competent after their training? Are evaluations of "students" and "faculty" performed? Should one complete open training prior to taking on these "advanced techniques"?
2. Show me where any anatomical structure heals faster through stab vs open incisions. Specifically bone, tendon, capsule, ligaments and even skin.
3. Show me that nonunions, mal unions and synostosises do not occur when you do not immobilize or fixate osteotomies. Yes they occur when opened and fixated. But we all know that motion across a fracture of any type increases these risks. Do you place a traumatic fracture of a metatarsal in a cast(Jones Fracture)? Then why not a transverse fracture created by a bur?
4. If you are trying to compare laproscopic surgery explain why all laproscopic surgery utilizes a camera and monitor to visualize all structure that are vital while they do this work. Yet MIS does not. Even with a Xi-scan all you see is bone what is the bur doing to the soft tissues? And how do you know?
5. If you have a complication, osteomyelytis, nonunion, AVN, nerve entrapment, RSD etc. how do you handle this is in the office with MIS? Where is your team approach? Where do you get this training?
I could go on and on. Look you are entitled to your opinion as I am to mine but when you come a public forum and essentially advertise MIS, we owe the students and the public the right to ask you questions. If the public wants office surgery many still can be done in the office with proven open techniques. But they should have a informed consent about any procedure they choose and the risks, benefits, and ramifications should be discussed. These should have been proven and documented scientifically rather than this never happened to me therefore it never will. Perhaps your next 10 MIS get infections do you abandon it? I had a friend who thought for years he would NOT cause pregnancy if he withdrew before the critical moment. He felt that this was as good as any contraceptive technique. I as a doctor and friend would tell him of the poor logic and show him the failure rates of this technique and others. His response was I have been doing this for 10 years it works. I just sent his 2 wonderful but surprise daughters Christmas gifts. See my point?
My opinion.............
Posted on Feb 10, 2003, 7:20 AM from IP address 152.163.206.176
You know the answers, why ask the questions? (this is not an attack)
by Anon (no login)
In your post, your questions are:
"Why have all the texts pertaining to MIS surgery been removed from podiatry schools?
Why do the schools refuse to offer training in MIS?
Why are traditional surgeons so against schools or the public's exposure of MIS?"
The answers are: MIS procedures are (in your own words), "difficult procedures", so we, the traditionalists, practice what we are able.
You also wrote, "I am not going to debate the effectiveness of these 40 year old procedures on this forum with any old school traditional surgeons." Well guess who is running the podiatric colleges? YUP, (in your words (again)) "old school traditional surgeons".
The criticisms of your posts are not an attack on the messenger. You may be the best MIS DPM in the world and expressing your opinion. We are re-iterating negative comments that we have heard or read about MIS wrt podiatric surgery. Recently, I read about a MD surgery professor who was demonstrating an abdominal procedure with a scope to a resident (who was assisting in a minor role) and major untoward effects occurred during the procedure. So the patient's abdomen had to be cut open to correct the errors that had occurred. In general, I think that the jury is still out on podiatric MIS and much more time will pass before MIS will be taught in the podiatric colleges. BTW anyone who feels like it can criticize my statements. If my opinions are wrong please point out the errors.
Posted on Feb 10, 2003, 11:09 AM from IP address 199.212.26.244
why don't use answer the questions that have been posted in response to your posts.
I for one would like to know how you viusalize and release the adductor tendon and fibular sesmoidal ligament during hallux valgus correction. Do you use fixation? What type of osteotomy do you use for hallux valgus correction?
Maybe if you discuss these types of concerns than maybe than we can discuss why there are no books.
Just post an op report for a typical hallux valgus correction you do- I am very interested in these "advanced techniques".
PS
If you can convince me and others i'll go back to where i received my surgical training and complain about the lack of "modern advanced podiatric surgery training".
Posted on Feb 10, 2003, 7:10 PM from IP address 24.73.160.198
Somethings are TRUE whether you believe them or not. Percutaneous techniques (puncture surgery) presently allows the trained podiatrist to perform bilateral bunionectomies, multiple metatarsal osteotomies, multiple hammertoe corrections, bilateral bunionette corrections, etc. in one office visit via tiny pin-head sized punctures. Why shouldn't students be given the opportunity to learn and practice these techniques? Why is the podiatry establishment so scared? If I were a student I would be mad as hell if I discovered the schools were withholding training in the latest technology available.
Posted on Feb 4, 2003, 1:33 AM from IP address 152.163.213.186
The truth is as follows: MIS has limited applications in foot and ankle surgery. Simple exostectomies, EPF, and joint arthroscopies are a few instances where this approach is viable and has documented literature.
MIS peaked in the mid 80s when 50%+ of the graduates were not receiving any postgraduate training. Many of those who touted these "innovated techniques" had little or no "open training" and were using the procedures as advertising tools. Walk in walk out surgery, come in and have your bunion fixed over lunch ads were seen in various cities.
If these techniques are better or even the same as open, please show me the literature to back this up. Many of the fathers of these procedure have found themselves more in the courtroom than the library. A report entitled the walking wounded surfaced in Chicago in the 80s where some of the devasting results of multiple osteotomies performed on the first visit were shown and the high number of malpractice cases these doctors generated.
Some of the advocates try to draw a parallel between this and laproscopic techniques used by general surgeons today. 2 big differences exist, first many/ most of these MIS surgeons( unlike the general surgeon) have litle or no open training, making their experience limited and their ability to handle complications difficult. Two, the general surgical procedures are the same whether open or closed with the same indications and have been proven scientifically. Many of the MIS gurus advocated transmetatarsal oseteotomies and other unproven techniques that are rarely indicated whether open or closed. Today, even the concept of outpatient surgery isn't an arguement since the majority of the procedures are now done as an outpatient whether through a stab incision or a 5 cm incision.
Finally this arguement that in certain areas this is done because of the lack of hospital privileges is also a sham. Sterility and general OR techniques should be the same be it for MIS or open surgery. An office OR can be setup for open as easily as closed procedures. It is either an OR or it isn't. Plastic surgeons for years have had office surgical suites equipted to do complex procedures. If the DPM does not have hospital privileges, I would question if they should be doing any surgery in today's world. Where will these doctors handle their severe postop infections, nonunions etc. We all know these can not be handle through MIS techniques. Is justified to pass these off to credentialed doctors when they occur?
Bottomline is as always put up or shut up. Show me where these techniques have been proven and show me how you received this training and answer the above questions. Why keep us in the dark?
My opinion................
Posted on Feb 4, 2003, 10:44 AM from IP address 64.12.104.177
Just because you believe somethings does't mean that they're true!!!!
by AnonPod (no login)
Do you actually believe what you wrote, "Percutaneous techniques (puncture surgery) presently allows the trained podiatrist to perform bilateral bunionectomies, multiple metatarsal osteotomies, multiple hammertoe corrections, bilateral bunionette corrections, etc. in one office visit via tiny pin-head sized punctures"? What planet are you from?????
"Tiny pinhead sized punctures" are the result of administering local anesthesia period!!!! MIS produces much larger puncture wounds than "tiny pinhead sized punctures". These larger puncture wounds are smaller than incisions used for traditional podiatric surgery and they do heal faster than long incisions. However visualization is very difficult and so MIS is not used much because the results are not good; also, there is a higher incidence of infection. Years ago, I attended a foot surgery conference hosted by a university and one of the leading orthopods, from Seattle, WA, was speaking. During his slide show presentation, he said he tried MIS foot surgery 20 years ago and didn't like the results so he abandoned it. He would do 3-5 procedures that were in close proximity on one foot, he preferred making 3-5 small incisions rather than making 1 or 2 long incisions. It was very clear on the slides that some incisions were only 1-2 cm long and you could see that the incisions were not "tiny pin-head sized punctures". So I have to ask Percutaneous Pod: if one of the leading orthopods in America is not utilizing MIS because he found that the results were not as good as those from traditional surgery, then why should podiatrists be using it?
Posted on Feb 4, 2003, 2:27 PM from IP address 199.212.26.244
Look...podiatry is a very respectable and needed profession. It is doing just fine as it is. Don't give yourself a bad name by bringing up this quackery called MIS. That butchering age has passed. JUST leave it alone! Why don't I just bring up the fact that past MDs used to perform bleeding and used arsenic to cure pneumonia...and how great that was.
Posted on Feb 4, 2003, 9:21 PM from IP address 204.185.73.151
I am considering entering the profession of podiatry. I hold a BA (GPA 3.7) and an MA (GPA 4.0) from two of America’s top-ranked schools. Both degrees are in the humanities. Because a liberal arts bachelor’s degree is so economically unviable for those who have no interest in teaching, I took a well paying blue-collar job and enrolled in some science courses at a local state college during the four intervening years between college and graduate school. I did very well in science (GPA 3.8), but was never able to perform well enough on the MCAT to be admitted to medical school. I decided that since I loved what I studied as an undergraduate, I would pursue a Ph.D. and enter academia. While in graduate school, I realized the full (ugly) picture of doctoral level research in my field. I knew of people who had agonized over their dissertations for five to eight years (post-Master’s)! In addition to this, those who were lucky enough to convince their defense committees that 10 years of postgraduate research warranted receiving a degree were having difficulty landing real jobs. One degree recipient took a yearlong visiting lectureship for $29,000. Another took a teaching job at a private high school for $31,000. One of the professors I admired the most encouraged me seriously to consider a career outside of academia: “With your record, you’ll have no problem landing a good job in publishing, the government, you name it.” So I took my MA, thanked them very much and bowed out.
Well, needless to say those “good jobs” are all very elusive, and I found myself returning to my erstwhile blue-collar “career” by summer’s end. A foot problem landed me in a podiatrist’s office shortly thereafter. I had no prior knowledge of, or exposure to the field of podiatry. Having become fascinated by the craft of this particular doctor, I spent much of the appointment asking about the profession. The podiatrist thought I might be a good candidate for podiatry school and encouraged me to investigate podiatry as a career. I have since visited numerous foot clinics and met with podiatrists, residents and students. I also established a shadowing relationship with a podiatrist in my town who has been unfalteringly kind and supportive. On the whole, I have been much impressed by my observations. The practitioners seemed generally to be leading rewarding, interesting, and content lives. This is not to say that I have been sheltered form the less agreeable aspects of the profession. More than one doctor expressed palpable frustrations: “I hate spending all f’ing day clipping f’ing toenails.” “Managed healthcare is an unmitigated nightmare.” “Medicare will be the downfall of this profession.” But I have seen a lot of really interesting things and a lot of satisfied people. So the tack that I have taken has been to proceed mindful that every field has its nauseating aspects: even dentists tire of “drill and fill” and scaling plaque from the fetid mouths of people with appalling oral hygiene. And medicine in general – not just podiatry – has suffered from the headaches occasioned by our country’s health insurance system.
I went ahead and applied to all the schools, submitting my (non-science) GRE in lieu of the MCAT. To my astonishment, within mere hours of submitting my application I received messages from four schools expressing keen interest and proffering eager invitations for interview. The next day I received similar messages from the remaining schools. One particular school surprised me with its prompt response, since it had received neither my recommendations NOR my transcripts due to a blunder on my part with the school’s address. What at first was wonderful news started to seem a little puzzling. I had anticipated having to wait rather longer because of my late application and the competitive nature of health-professional school admissions. But then I thought, “Why look askance at an unexpected stroke of good luck?”
Last week, my lovely wife was browsing for information about podiatry when she happened upon The Podiatry Forum. She called me straightaway and we both read in stupefied horror some of the nightmarish experiences of both recent grads and long-struggling practitioners. Our jaws nearly hit the floor. No amount of investigating or shadowing could have revealed the personal suffering and professional bleakness that is here attested to again and again. Granted, there are some who dismiss these tales as the vengeful rants of the few and unhappy who are untalented, unaccomplished and unambitious. But if even a miniscule fraction of these accounts is truthful, one cannot but ask himself, “am I boarding a ‘sinking ship’?”
That it is even possible for a “few” to suffer personal and financial ruin with so many years of schooling AND training in medicine – the economically viable field par excellence – is nothing short of atrocious. Can so much of one’s life and resources be gambled away in pursuit of a career that offers limited opportunities to receive equality (let alone thoroughness) in training?
I am grateful to The Forum for allowing me the opportunity to learn of the experiences of these people. Before my newlywed wife and I pack up and move across the continent to risk everything we have on a life that might not even be possible, I need to arm myself with as much information as I can glean. These posts have given me information that even the most candid of my interviewees couldn’t or wouldn’t offer. I shall be interviewed by the schools in the weeks to come. Thanks to The Forum, I consider myself better prepared and better informed as I proceed. I thank you for this service, and I will report later on where my applications lead.
Gratefully,
G. Wexford
Posted on Feb 3, 2003, 2:10 PM from IP address 152.163.207.83
Dn NOT go to podiatry school if your first, second and only choice was EARn acceptance into a real medical school (MD, DO) The first severe warning was your almost immediate acceptances and requests for an "interview" for podiatry school.
they are accepting almost anybody, ask for the stats.
Call 10 pods recently graduated of all various training "residency" lengths and aks them for their salaries AFTER taxes and hours worked.
Good luck.
The schools are incredibly desparate for money and each applicant represent money from the govt in the form of "loans." Steer clear, you won't find the satisfaction of MD/Do with a podiatric degree, in addition there are problems that plague podiatry solely and only--do not dismiss the PR rhetoric spin story of problems afflicting all of medicine--in some states podiatry is seperate from medicine and it is already 2003.
Good luck, run away.
Posted on Feb 5, 2003, 10:55 AM from IP address 134.174.248.58
Mr Wexford and any other podiatry applicant to consider going to a good med school in the Carribean. Through the grapevine I heard that St Georges is supposed to have a good reputation. I deeply regret that I didn't do this 20 years ago and am stuck in a low paying profession and having to compete with new grads which like to open up in my area and spend a lot of money advertising and also under-cut my fees.
Posted on Feb 8, 2003, 2:22 PM from IP address 65.48.41.73
Most recent graduates do very well. I know i graduated in 1996(maybe that's not considered recent anymore i'm getting old at age 32!) I happy with what i do and i am compensated very well. All of my friends are in similiar situations. While i do not know anybody personally who has failed I do know of a few people that have not done well. You can't help but say to yourself "I kind of can see that happening" But i still thinks it's unfortunate. I don't think that happens in medical schools this may have something to do with the fact that the admission standards are lower for podiatry school compared to medical schools. Thus you have a few students graduating that should never of been doctor's in the first place.
Many will argue- but i had a 3.5 gpa and i didn't get a surgical residency the process is rigged.
You need a surgical residency and get board certified to be successful. There are not enough surgical residencies for everyone- this is a risk-your main goal in school will be ensuring you get that surgical residency. It's competitive and you need to be geared towards this.
They are changing the residency's so that by 2008 every residency will be at least 2 years(at least ppmr/psr) But will there be enough for all graduating students? I don't know.
I wouldn't call podiatry a sinking ship- but one thing is for sure there is no guarantees. Graduates of medical schools do not face this risk-everyone gets some sort of residency that will prepare them. However, in podiatry if you don't get the training your future will be uncertain. If your confident you will get a surgical residency than go for it- if you are uncomfortable with this in any way don't go to podiatry school.
I hope this helps. Good luck to you.
Posted on Feb 7, 2003, 9:39 PM from IP address 24.73.160.198
I'm one of the people who had a 3.55 GPA, was very out-going and well-liked, volunteered untold hours, hardly missed a lecture, participated in lectures/labs FAR MORE than any of my classmates, etc., etc. and the BS politics and haphazard "system" of podiatry took a big fat dump on me (re: PPMR).
Do you think I'm bitter? Damn right. In fact, I have nothing good to say about the process of podiatry (but have plenty of good things to say about most of the podiatrists who survive it). But, at least I'm the type of person who picks himself off of the dusty, detritus-ridden floor and continues to push forward. I finally became so disgusted with so many aspects of podiatry that I decided to flay myself open yet again and enter DO school.
Now that I've been accepted, I can breathe a huge sigh of relief. My future children won't have to see the face of their underworked, underpaid, underappreciated Daddy. I will no longer have to justify the gigantic financial sacrifrice I made, nor will I have to rationalize that, somehow, by cutting toenails and calluses, I AM a doctor. I won't be plagued with the knowledge that podiatric biomechanics and orthotic theory is just a pile of nonsense. I will no longer have to explain podiatry to a doubting public. I won't have to feel slighted by my school or "residency" even though I did everything they asked and more.
Bitter? Yes. But better because I took a stand.
Posted on Feb 10, 2003, 2:00 PM from IP address 64.161.168.54
I had a 3 year "surgical" residency and couldn't land a real job (1099s don't count) , I can also name 4 residents with 3 years of "surgical" residency who are making peanuts (i.e. under 65K) with huge student loans. The serious podiatry problems do not merely plague PPMR and POR "trained" podiatrists.
Posted on Feb 10, 2003, 3:15 PM from IP address 134.174.248.58
Mark you never followed up on my posts to see if I could help you find a job. Why would you do this and then come back and complain. Please go back a few pages and reread the posts.
Posted on Feb 13, 2003, 3:49 PM from IP address 152.163.206.191
In Ontario, where DPMs only perform office-based osseous bone sx, MIS is the standard of care. I suspect because they can only do osseous sx in-office without any anaesthetic except local.
Posted on Feb 2, 2003, 8:13 PM from IP address 207.166.216.217
I know bec I asked, they didn't like the higher incidence of infections. All DPMs do in office sx under local anesthesia bec no hospitals permit DPMs to having admitting priviledges. The DPMs that do bone sx, do not do many bec the province's health plan fully covers the sx procedures when performed by an orthopod whether in office or in an OR at a hospital. So the patient's sx, x-rays, other diagnostic tests and 1-3 day stay are completely covered and the patient doesn't pay one penny.
Posted on Feb 3, 2003, 5:22 PM from IP address 199.212.26.244
So let's do unproven surgery on patients because it is the only way you are allowed. Come on would you let you child have surgery by a MD who could only do their surgery in the office? I am sure a family MD could do ofice procedures in the office that they were not credentialed to do in the hospital. Would you have it done there?
If so why risk it if not is this hypocritical?
Posted on Feb 4, 2003, 10:48 AM from IP address 64.12.104.177
That's the law. No DPMs have admitting priviledges to hospitals in Ontario, Canada. But Orthopods do and they admit their patients from private practice and bill medicare entirely for the surgery and for the hospital OR and stay.
BTW, in Ontario, Canada DPMs are also not allowed by law to take a swab for c&s or to do a biopsy for analysis and bill it to medicare. If they take a swab for a c&s or do a biopsy for analysis, they send it state-side to a lab and have to pay for it.
Posted on Feb 8, 2003, 2:04 PM from IP address 65.48.41.73
Can anyone tell me anything about the board exam part 1? I am a second year student and cannot get anyone to give me a straight answer on how hard it is, or what they used to study. Some 3rd year students say its very difficult and some say its not a big deal. Can I please hear from someone who knows?
Thanks
A.B.
Posted on Feb 2, 2003, 4:37 PM from IP address 66.171.26.42
I would recommend studying 4 hours a day for the month prior to the test. That is probably overkill, but I'd rather overstudy a little rather than worry that I didn't review enough. I bought First Aid for the Boards, ripped out the psychology section and the other sections on how to study (about 100 pages) and had it re-bound by Kinko's with wire ring binding for easier use. Most of the people in our class did the same thing. I used that guide, my lower limb anatomy text, and briefly reviewed some of the general anatomy drawings in Netter's. Buzzwords for the Boards is probably another good resource, but I didn't spend much time with it. I felt that the test was a little harder than the sample questions they provided, but was very fair on the whole. On the questions I wasn't sure of, I felt I could narrow it to 2 answers pretty easily. Hope that helps.
Posted on Feb 2, 2003, 11:13 PM from IP address 12.75.118.61
It is just unbelievable that today's students and young doctors have never questioned their podiatry schools and residency programs as to why they are still suppressing the teaching of "Minimally Invasive Percutaneous Surgical Procedures" when every other surgical field is teaching doctors to perform these techniques. Most medical schools and major hospitals now have Minimally Invasive Surgery centers that train doctors in these latest techniques. Podiatry schools are still only teaching traditional barbaric orthopedic surgery. So why have students and doctors not been exposed to procedures that exist which allow the "modern" doctor to perform 99% of all foot surgeries in the office, via tiny pin-head sized punctures under local anesthesia, without the need for any stitches, wires, staples, pins, surgical shoes, casts or crutches?
Posted on Jan 30, 2003, 12:58 AM from IP address 205.188.208.42
It's b/c these techniques were invented and performed by doctors that could not get a surgical residency and it's a way to do surgery w/o having to admit the pt in a hospital.
Posted on Jan 30, 2003, 8:31 PM from IP address 169.147.155.7
Wake up and see the bur. How are rhinoplasties performed and most dental procedures? Podiatry should only be in a class with dentistry. Just face it...your residency program and most of you podiatry training is a waste of time! If you were taught how to perform radical bunionectomies, hammertoes, metatarsal osteotomies, bunionette corrections, heel spur correction, tenotomies, capsulotomies and exostectomies via percutaneous methods you would make a fantastic living. These methods allow surgeons to perform all these procedures in the office and under local anesthesia. There is no longer any need for any long incisions, stitches, wires, screws, casts or surgical shoes in "modern" podiatry. Catch up to the 21st century!
Posted on Feb 1, 2003, 1:55 PM from IP address 152.163.206.207
What about the devastating complications that occur from these blind osteotomies? How can you visualize the adductor tendon and fibular sesmoidal ligament during a hallux valgus correction? Metatarsal osteotomies should rarely be performed. I perform a weil decompression osteotomy for a long 2nd met associated with pain sub met and a 2nd hammertoe. Can't think of any other reason to do a lesser met osteotomy. Actually i have performed open osteotomies with mini-external fixator(to re-lengthen the shortened bone and re-plantarflex the elevation) to fix horrible deformities that have resulted from "laser surgery that i didn't need a stitch for". I do EDIN's and EPF's, simple percutaneous flexor tenotomies for a elderly person's corn on the tip of a flexible hammertoe, percutaneous exostectomies(although this is rare it's better to fix the underlying reason for the exostosis), endoscopic gascrocnemious lengthening, Ankle arthroscopy(maybe one day with new smaller instruments 1st MPJ) There is a place for MIS, but not for correction hallux valgus, hammertoes, tailor's bunions, or for fusions! What may revolutionize podiatric surgery is the new computer aided injection system that may allow painless injections- This may allow us to start doing hallux valgus corrections in the office. Just my opinions- be careful with those blind osteotomies! How do you fixate a blind osteotomy by the way? You must have to use fluoro for proper placement or is there no fixation?
Posted on Feb 2, 2003, 11:36 AM from IP address 24.73.160.198
It's because no books were written. It was all "by word of mouth" and some were experimental. What do you think "podiatry" did...burn all the book? Even the ones at the Library of Congress? Get real!
Posted on Feb 1, 2003, 11:22 AM from IP address 216.23.27.66
Why don't you ask your library about the following publications and why they are not available?
"Non-disabling Surgical Rehabilitation of the Forefoot" - M. Roven,DPM 1976
"Forefoot Minimal Incision Surgery in Podiatric Medicine" - L. Hymes,DPM 1977
"Minimal Incision and Laser Surgery in Podiatry" - Gorman & Plon 1983
"Bycura on Minimal Incision Surgery" - B. Bycura, DPM 1986
"Clinics in Podiatry - Minimal Incision Surgery" - July 1985, Vol.2 #3
"Clinics in Podiatric Medicine and Surgery - Minimal Incision Surgery" - Jan. 1991, Vol 8 #1
"Current Podiatry" Magazines etc.
So since these books DO exist and its proven Percutaneous Surgery provides patients with a quicker, safer, less painful and less truamatic recovery than traditional podiatric/orthopedic surgery why do you think the teaching of these procedures are being suppressed?
Posted on Feb 2, 2003, 12:46 PM from IP address 64.12.104.164
How can you say something so silly? No, strike that. You don't know any better as the Libraries have removed the books on Podiatric Minimal Incision Surgery.
Get educated, if you wish. But, if you don't, I wont be surprised. "Brainwashing" could very well be part of the curriculum.
Posted on Feb 2, 2003, 7:53 PM from IP address 67.24.15.18
The schools and residency programs are not teaching "Percutaneous" Surgery because they can't perform it! This type of surgery is harder to do than traditional orthopedic surgery and obviously not easy to learn. Just check any search engine for "minimally invasive" or "minimal incision surgery"...every other surgical specialty is doing it. This type of surgery makes podiatrists unique...like dentists. Patients want these procedures but are not even told by doctors they even exist. Patients do not want long incisions, stitches, wires, pins, screws, casts or surgical shoes with a long recovery. You'll have no competition when you offer patients correction of all their foot deformities without any incisions, stitches, casts etc. and allow them to shower or bathe immediately!
Posted on Feb 1, 2003, 1:35 PM from IP address 64.12.104.158
Would you let your mechanic work on your engine with the hood closed? Of course not. Comparing an MIS bunion where none of the soft tissue and many times bone is not visualized is nothing like a laproscopic technique where everything is seen on a monitor.
It's just common sense
Posted on Feb 4, 2003, 10:56 AM from IP address 64.12.104.177
Been in practice almost 20 years & use ambulatory surgey (MIS ) only! And yep several books available & also seminars & during education at OCPM Dr. Marvin Arnold taught a great course! Works for me.
Posted on Feb 3, 2003, 8:02 AM from IP address 64.12.105.52
Yeah, I let some pod blindly stick a burr into my foot, where a vast array of vital anatomical stuctures happen to lie in extremly close quarters, and buzz away. This is not abdominal surgery for crying out loud where you have lots of roomy abdominal space for your instruments to chill out in. If I was a patient I'd vote for the filet. That being said, I think their are a limited number of MIS techniqes that can be utilized with minimal risk and impressive results. They are few and far between.
Posted on Jan 31, 2003, 8:21 AM from IP address 155.247.166.24
It appears you are upset that you were never taught or have no training in these procedures. Just because they are harder to do and not easy to learn is no reason for you not to seek appropiate training. Don't you think your patients deserve the best and latest treatments available?
Posted on Feb 1, 2003, 2:08 PM from IP address 152.163.206.207
How you are so able to avoid the "vast array of anatomical structures that happen to lie in extremely close quarters" in the foot when you blindly anesthetize or give injections into the foot? As far as patients deciding as to what type of surgery they can have, I at least give them the option of traditional or Percutaneous. Guess what?...none of them ever want to be "fileted open". They are all extremely thankful they can have any deformity corrected in the office without the need for any incisions, stitches, wires, casts, pins etc. Lets all just try to keep podiatry 100 years behind every other surgical field.
Posted on Feb 2, 2003, 7:15 PM from IP address 152.163.207.191
I have been in the profession for 19 years and have seen silicone joint implants, bovine collagen injections and MIS come and go. The reason why they are not being used is that the results were not good. The pods who tried MIS, in my area, noticed that there was a higher incidence of infections than with traditional open surgery, so they abandoned MIS. I never took the MIS training when I heard the negative comments.
Posted on Feb 1, 2003, 10:53 AM from IP address 65.48.41.73
Any surgery performed by doctors that did not learn these procedures from qualified surgeons would result in disaster. Most of the negative results came from podiatrists that learned a procedure or two from another pod that learned them from another pod, etc. Since these procedures are performed via tiny punctures and patients are able to bathe their feet immediately because there are no stitches or casts, infections are almost non-existent. Infections came about from untrained doctors burning the osseous and soft tissue structures with their high speed drills.
Posted on Feb 2, 2003, 1:05 PM from IP address 64.12.104.164
Please name the article that demonstrates a lower postop infection rate with MIS foot and ankle surgery than open techniques.
Also I would be interested in the article that shows that postop bathing decreased postop infections. And what do you do to immobilze the osteotomy while they bathe etc?
Posted on Feb 5, 2003, 11:18 AM from IP address 152.163.189.129
How can one perform a bunionectomy with an osteotomy without at least a surgical shoe?
It would be interesting to get details of closed claims involving mis.
I was exposed to mis in my residency, and I'm not surprised that there are no texts on the subject. It is predominately practiced by pods without training.
You can not compare mis foot surgery to a laparoscopic procedure or a minimally invasive CABG (not performed anymore).
I did perform some mis in practice. Most commonly to reshape the medial aspect of the distal phalange of thelittle toe. But to have a surgical practice consisting of wilson bunionectomies, calcaneal decompressions, blind metatarsal osteotomies, and the brilliant procedure of metatarsal osteotomies of the 3rd and 4th to relieve the pain of a neuroma is ludicrous.
I remember a patient who had a nonpainful diffuse callus under the 3rd met head. she would come to my office every 3 months for routine foot care and ask about what could be done for her ninpainful and completely cosmetic problem. I would tell her to use a pumice stone or whatever and return periodically for RFC. Somehow she got referred to a pod in memphis who performed an osteotomy just proximal to the subchondral bone (let's say 1 cm too distal).
She returned to me because she still had a callus and her "surgeon" didn't trim calluses, he only did surgery.
What a load of BS.
She had a stiff painful toe, but a didn,t reveal to her that her surgery was botched.
The reason that there are no texts dedicated to MIS is that the pods who rely heavily on the technique are quacks who have never had any real training, they probably have never read any surgery text, they have only presribed 1 antibiotic in practice(erythromycin), and they are the disgrace of the profession.
Posted on Feb 2, 2003, 10:46 AM from IP address 63.185.49.120
It is you guys, the "Open" surgeons who are the un educated, misinformed and ignorant. Every single patient who has had one foot done your way was sorry they did so after I operated percutaneously on the other. They all said with the percutaneous method they healed faster, better and with minimal down time. They couldn't believe the difference. They all thought the surgeons who operated on them in the hospital were a disgrace to the profession. "How could they put me through that, long incisions; stiches; pins; casts; not bathing for a month, losing work; pain; pain and more pain when you did the same procedure on my other foot with a better result, no pins, no incisions, no casts and no pain? Why would they torture me so?" I had to tell them the truth. It is much harder to do the work percutaneously. It requires years of practice, great skill and dedication that most podiatrists are unwilling to put into their profession. They never realize that the name of the game is doing what's the best for the patient not what's the best for their ego.
"If the orthopedists don't do it, it's not good medicine." Podiatry is not orthopedics. As soon as you guys realize this and try to develope podiatry as an alternative to orthopedics, you will always be treated as second class doctors in the hospitals and will eventually lose your practices as so many of you have done already. All the practices of open guys I know have failed while those who do Percutaneus surgery have not only thrived but are million dollar practices. Percutaneus surgery is the future of podiatry, you open guys are living in the past.
Posted on Feb 3, 2003, 5:00 PM from IP address 24.47.81.215
yea right- that's believable! NOT I responded to the post above "brainwashed" still no response- what a joke you guys are. The fact that you even respond to patients questions shows you are a farce. Professionals do no bad mouth other doctors in front of patients-Even when they come in with horrible deformities from "no stitch surgery" Get a clue.
Posted on Feb 4, 2003, 10:55 AM from IP address 24.73.160.198
Skin, soft tissue, cartilage, and bone heal the same whether they are traumatized opened or closed. Are you saying that MIS permits bone healing to occur faster? Did you read any books on wound healing?
If your "theories' are correct then the fastest healing bones would be fractures since NO incision was made.
Who is 100 years behind?
Posted on Feb 4, 2003, 11:01 AM from IP address 64.12.104.177
As an expert in medical malpractice cases. Beware. If you buy into this you will not have a leg to stand on. Now it is not only open vs closed but no fixation vs fixation. Please!!!!!!
Seek your own level BS has dissappeared a long time ago. Please tell the truth. This is usually done by nonopened trained DPMs who sink quickly in the face of a postoperative complication. And how much of this done on the spot, on the first visit?
Posted on Feb 4, 2003, 10:52 AM from IP address 64.12.104.177
Can you still get board certified in surgery with a psr-12? Or is the new rule of a psr24 already implemented? I have a friend that is graduating this summer with a psr 12. Thanks
Posted on Jan 29, 2003, 10:33 PM from IP address 204.185.73.165
My understanding is that a psr-12 can currently get you board-qualified, and later board-certified for forefoot surgery. The APMA just posted today that the CPME will be certifying residencies as either PSR-24's or PSR-36's starting in June, if I am interpreting the post correctly. I believe the new PSR-24's get one certified for forefoot surgery, and the new PSR-36's lead to forefoot and rearfoot certification. It sounds like the PPMR's and POR's have been discontinued. If that's the case, it sounds like anyone that gets a residency should have the opportunity to get surgical training.
Posted on Jan 31, 2003, 2:30 PM from IP address 12.75.118.157
I will have to hand it to Temple University. I know there are lots of people who say that podiatry is a loser profession, but frankly I have the confidence that I can make it in this career. However, I am very interested in the dual degree program for an MBA from Fox School of Buisness. The Fox MBA's average $75,000 their first year out (this info is NOT provided by the school, it comes from an outside examiner). If Chicago med offered the same program(an MBA from the University of Chicago is second to none) I would definitly be extremely interested. Savvy business knowledge and communication skills are crucial in maintaining a lucrative private practive business. I believe the Barry University also offers this program. Also, DPM, MBA would not be a difficult sell to the business department of liberal arts college. Last time I checked, compensation for business professors was an all-time high.
My Opinions, Nothing More.
Posted on Jan 28, 2003, 11:48 PM from IP address 152.10.192.70
Once again, you say the same thing that I do. The DPM is yesterdays news but is kept alive by the ease of getting $100,000 of Government loans to finance the podiatric education.
This is driven by students who want to "be a doctor", but who can not get into Medical School. At one time, it was a good substitute as the income was fine. But, the income has gone into the toilet.
Within the lifetime of todays students, their profession will be flushed away along with their income.
S. Sodman, DPM, BSD
Posted on Jan 30, 2003, 12:52 PM from IP address 67.26.41.75
20 yrs ago, a friend of mine could have attended pod college but instead chose to pursue a MBA. He thought that he would have more options to pursue in the business world. He was right, he got an executive position in a bank and began to climb the corporate ladder. He makes $150K p.a. working in the international division. He has to put up with office politics. During the past 10 years he has gone on 2 week business trips to each of these countries: Hong Kong, Malaysia, Thailand, Australia, Egypt and lots of European countries. He considers them working holidays, takes his wife along (pays for her airfare) and stays in 4 star hotels in the downtown area of major cities. The airfare, hotel and meals are all covered. His Hong Kong trip cost his employer what I net in one month. In retrospect, I should have pursued a MBA instead of a career in podiatry.
Posted on Feb 2, 2003, 11:26 AM from IP address 65.48.41.73
Yeah, seems that podiatry school just kills the marriage...maybe the spouse's get tired of us smelling like toes or coming home with a toenail sticking out of our hair. Best to stick to our own kind..best for pods to date and marry other pods, at least we'll understand each other.
Posted on Feb 1, 2003, 2:22 PM from IP address 152.163.204.181
Just went through a soap opera-like engagement with a non-pod while having an affair with a class mate. I fell in love with my class mate and lost her because of my stupidity... Maybe I'll never get her back, but I tell you, I still love her and find myself growing apart from my fiance... How did you deal with it?
Posted on Feb 2, 2003, 4:25 PM from IP address 152.163.194.191
Grow up. The intent of this forum is for DPMs to support DPMs... if you do not like it start your own. Maybe there you can ponder the treatment of toenail fungus or duct tape for warts.... or maybe cry because you can't pay your loans....
Posted on Feb 10, 2003, 3:31 PM from IP address 205.188.208.42
How can a post about a DPM having an affair be helpful? And to insinuate that DPMs have a higher divorce rate than other professionals without the proof is typical for this site.
One reminder this site is not just visited by whining DPMs it is also visited by the public, orthopods, and even some state legislators. Are you proud about what they are reading?
Posted on Feb 15, 2003, 8:40 AM from IP address 64.12.107.169
John Anderson gave the "Full Monty" so well, that it needs to be repeated:
Why is truth regarding podiatry labelled by sugar coated people "negative"-telling students and young pods that everything is good and great is also "negative". Truth is truth, a ball is ball, strikes a strike. Students need absolute FULL disclosure simialar to buying a house you hire an inspector, run a title search, hire an honest "lawyer" (good luck) etc....
better yet, how about the outdated stats regarding bloated salaries, lifestyles of no beepers and 40 hr work weeks and making "lots" of money,lack of consistent bruttally rigorous REAL residencies, real clinical training (no plastic orange seats allowed), and podiatry board/societies that tolerate and accept the status quo.
Thank you Dr. Anderson.
Posted on Jan 26, 2003, 2:31 PM from IP address 67.24.14.59
As a senior coming out of one of the most impressive undergraduate chemistry programs in the country, I have come to a cross-roads. I recently required podiatric treatment, and was interested in the profession immediatly. I had several shadowing experiances with many different podiatrists. None of them seemed to have any of the concerns that are posted on this board such as: lack of respect, patients or monetary compensation. I have not decided wether or not to pursue podiatry, but I do have several questions for any informed person to answer.
1. Which schools offer the best training for the podiatric student?
2. Why is there so much negative "noise" circulating around podiatrist.
3. I have my options open to several different fields. With a 3.4 overall GPA and a 3.04 science GPA in the most difficult chemistry department on the east coast, what would be the benefit of sitting out a year and pursuing DDS, MD, OD, or Chiro?
Posted on Jan 25, 2003, 5:16 PM from IP address 152.10.192.70
1. Best School? I was pleased with my experience at Iowa, however, I met good students from all schools during the 4th year.
2. Why the negative noise? Although this forum is by no means representative of the profession as a whole, there are some that didn't make it, and this forum is their voice. Most of today's graduates with surgical training are getting great job offers from what I've seen. However, a small percentage still does not get a surgical residency which makes for a much tougher road. Once the comprehensive surgical residencies are guaranteed for all qualified graduates, I'd match this profession against any out there.
3. MD, DO, DDS, or Chiro? Depends on what you want to do and whether you want to specialize.
My opinions.
Posted on Jan 26, 2003, 10:02 PM from IP address 12.75.116.8
don't forget DO or Foreign MD. Get into medicine in the USA first if that is what you want. If can't get in the US, you will have no problem at a topnotch foreign school.
Posted on Jan 26, 2003, 11:10 PM from IP address 67.8.218.78
I think nowadays, one going into the medical field in general has to ask themselves if this is something they love or greatly desire to do. The reality is that if money is your inspiration, none of these fields are going to satisfy you. I'll admit that wages tend to be lower for Podiatrists than most MDs. But, I commonly come across MDs complaining about not making what they feel they should make.
Next, going into Podiatry, you have to accept that making it in this field may take some perserverance. For some, things will fall in their lap, either because they earned it, luck, or personal connections. Others will have to work a little harder. But, if you put in the effort, you can make it in Podiatry. I know a few people who have failed. Many of those that failed were lacking in certain traits that would make them successful.
Podiatry can be a good profession, but there are no guarantees. For those that don't make it, paying off the type loans we had to take out can be pretty daunting.
For me, I'm very happy with my desire to go into this field. During my residency I found that I enjoyed doing Podiatry much more than other fields. Things aren't always brighter on the other side. I remember one day during my residency I had a patient walk out of my treatment room and tell me,"I feel much better." An internist in the next room over told me,"It must be nice to hear that once in a while."
1) I think that any of the schools are fine. People from all the schools get into good residency programs. My recommendation would be to go to the school that will cost you the least in loans overall.
2) In the retail industry they talk about how one negative customer negates 10 positive customers. This is simply because people tend to talk about negative occurances in life more than positive. This is just a function of humanity.
3) Spend some time with docs in different professions. Find out what you're interested in, grab onto it and go for it.
Posted on Jan 27, 2003, 11:59 AM from IP address 198.26.126.12
what do you do when the money you so desparately need to SURVIVE is based on primarily on the govt. ; medicare and ever declining fees from insurance companies-translation= REQUIRE more patients, more time, more billing, more fighting with 22 yo insurance reps, and does sound like the 40hr/week purported by several podiatry "college" reps?? Cafe latte.
Posted on Jan 30, 2003, 12:29 PM from IP address 134.174.248.58
every pod you shadow will have you there on his busiest day. Go back the next day and count how many patients he sees, for a truer impression of how busy he is.
Posted on Jan 28, 2003, 10:35 PM from IP address 205.185.131.13
You are so right. Podiatry is a great profession and I am a loser for failing. How can I be so wrong?
And, "everybody" in your city is doing so well. And the other doctors poke fun at you for making so much money.
Well, say what you want, but the sad reality is documented and the truth. Podiatry is failing as the profession of last resort for someone to become a "doctor". They can't even get a student to sit in every seat. That is a failure of a profession, but,
we don't talk about it. Too painful.
Who will tell the students the truth?
Posted on Jan 24, 2003, 9:34 PM from IP address 67.25.9.252
I lost my home and wife (didn't have a car to lose) and got lots of debt. My wife thought that I was leeching off her, she wouldn't read this forum to see that other pods were in a similar low income situation.
I'm at a library using a free computer because I can't even afford the monthly fee to access the Internet from home. Heck, I'm even behind on my interest payments. Saw one patient today (made $35 my usual fee)and that's it for my patient bookings today. Tomorrow, I have 3 patients booked and 2 on Wednesday, none for Thursday or Friday.
Posted on Jan 27, 2003, 11:03 AM from IP address 199.212.26.244
For all of those who admit that they are failing in this profession, give the students a break. First of all many of your post under many names so it appears that many are ganging up on some student who is offering his/her opinions just like you do. There may be some pie in the sky assessments but in some cases the students are more in tune with the profession than some of you who admit that they are not practicing, graduated 10-20 years agos, or obviously do not have all the answers since you admit that you are failing.
They are proud of there profession and want to defend it. So let them. If it is bad as you all say then why attack this individual who will have their work cut out for them to succeed? By instilling doubt, fear, or insinuating you know some secret they have not been let in on, do you really think you are helping a 4th year student whose options are limited. Of course not, all you do is create confusion. You hide behind the truth will save others crap but in reality you only are trying to blame others for your failure. If this profession is so bad how do you explain the successes. They all didn't kiss butt, have a daddy in the profession. Yes there may be a few that fit this description but most who have succeeded have worked their butts off, didn't expect a handout, and took the cards they were dealt and made the most of them.
If you really care then next time offer advise rather than attack. One start would be to tell them the mistakes you have made in practice since you are an example of what not to do. Admit they were your mistakes and do not blame everything on the schools, residencies, the senoir DPMS
My opinion
Posted on Jan 24, 2003, 10:04 AM from IP address 64.12.96.200
For the record, it's the profession that failed me, not me. This is why I choose to criticize the profession and offer honest examples and valid information.
I have absolutely no compunction whatsoever in lambasting this unabashed, for-profit pseudo-medical profession that does little to nothing in promoting itself or assisting the hundreds of indebted students find work each and every year.
I'll tell you the positives in writing these posts:
First, it will give another opinion that contradicts what the recruiters and schools will spew to the prospective pod students who find this site.
Second, it serves to point out the harmful inequalities in residency training, the totally overpriced tution of the schools, the inequalities in practice and the second-class nature of being a podiatrist. By keeping these facts in the forefront, maybe something can be done (but, trust me, I have no hope).
Third, it's gratifying to be able to express dissent in a free country.
Fourth, in my case, it can demonstrate that no matter how depressed or despondent you might get over your career choice, there is always hope. I finally was able to come to terms with the reality that podiatry was a 3rd choice and the future looked both bleak and non-prosperous. I finally realized that I spent an enormous amount of money on a half-ass education that set me up for endless struggling. I finally was able to let go of the never ending defense of podiatry and my training and to admit that I'm not a full physician. I knew that I hadn't achieved my dreams at all, but gave up and took what was offered me.
So, even at my relatively advanced age, I decided to pull up my suspenders, re-take the fricking MCAT, apply to medical school and get my life on the right track. The good news is that I'm starting this fall and, though I've taken a giant and expensive detour, I finally have peace of mind knowing that I am going to eventually reach my goal of becoming a physician and I'll die a satisfied man.
Hopefully, you'll at least see my point. I'm here to point out the fallacies and facts of podiatry that pre-pods will never find in a book or at a recruiting booth. I'm here to show the inevitable group of pod students that IF they become dissatisfied, there are still other roads to travel.
Posted on Jan 24, 2003, 1:46 PM from IP address 216.100.68.46
I am proud of you and your search for the truth regarding podiatry and mistruths, and skewed stats purported by this quasi-medical profession. I too, have decided to apply to medical school (MD, DO) and achieve my dreams of becoming a doctor. It is so sad, that I can't even make the interest payments on my podiatric student loans ($700 in interest a month!?) which results in negative amortization--without any emergent help from the podiatric societies that endless just collect dues and play with semantics or give BS "awards" to those with the right last name.
Congrats anaomalous on your excellent decision to be a full doctor and practice real medicine- instead as you said defending your education/training on a day to day basis and dealing with incompentence, residency inequalities, lack of rigorous consistent training, and blatant mistruths that plague podiatry.
Students, prospective students and young practitioners are realizing the truth about podiatry for a select few maybe you will break 80 or 100K after some years BEFORE TAXES, insurance etc... that is still not enough money if one also has over 120k in podiatry student loans--it is cafe latte time for some.
Posted on Jan 26, 2003, 5:43 PM from IP address 134.174.18.194
I'm looking forward to the posts from Anomylous about 4-6 years from now. It will be interesting to hear what he has to say then, both positive and negative.
Posted on Jan 27, 2003, 11:08 PM from IP address 63.186.32.213
I'm sure I'll be hanging out at the Podiatry Forum for a while.
I know that most people who know that I'm going to DO school think about money and reimbursements. This isn't the main reason I'm doing it. It's simply what I've always wanted to do (be a fully licensed physician) and, quite frankly, as long as I can pay the bills, I don't really care how much I make. I'm also lucky in that my wife makes a good living, which takes the pressure off of me.
Also, I'm going back because I was left out of the PSR country club and I have no desire to subjugate myself even more by applying again. Since I'm only a PPMR trained pod, I essentially have no future (in my opinion, of course). And, since I'm not fully trained, my experience and abilities would likely not secure any sort of reasonable job if I decided to move out of state (which my wife and I are contemplating). Correct me if I'm wrong, but I think there's a huge difference between being a PPMR trained DPM or being, say, an internist or ER physician and looking for a job in this country. I MIGHT be able to find some sort of chip and clip job in Missouri, but I know that it'll pay about as much as the manager at Wendy's. If I'm an internist, I will not make less than 100k no matter where I go and I'll have a significantly easier time of it.
Posted on Jan 29, 2003, 5:07 PM from IP address 216.100.68.46
Great to hear that you're planning to do the same!
It almost seems surreal at times when I think about what I'm doing. I always go back to the reality, though, that I really don't have a choice. I know that I can't survive as a PPMR trained podiatrist forever (not to mention the lack of interesting pathology and the feeling that all of that pre-med effort while working full-time and all of that podiatry work was only to cut away dead tissue...).
I'm not as worried about the long hours as a 3rd and 4th year or the intern abuse compared with diving into another cadaver or memorizing even more biochemical nonsense. The basic sciences, to me, are the most painful. I feel comfortable about my general medicine knowledge and my pharm knowledge, but immunology, biochem, anatomy, etc. will still kick my ass. I'm also planning on working at least part-time at my clinic (most of the class lectures are available on-line).
I'm excited though. I can at least say that I'll be really, really well educated when it's all done!
Posted on Jan 29, 2003, 5:17 PM from IP address 216.100.68.46
Why is truth regarding podiatry labelled by sugar coated people "negative"-telling students and young pods that everything is good and great is also "negative". Truth is truth, a ball is ball, strikes a strike. Students need absolute FULL disclosure simialar to buying a house you hire an inspector, run a title search, hire an honest "lawyer" (good luck) etc....
better yet, how about the outdated stats regarding bloated salaries, lifestyles of no beepers and 40 hr work weeks and making "lots" of money,lack of consistent bruttally rigorous REAL residencies, real clinical training (no plastic orange seats allowed), and podiatry board/societies that tolerate and accept the status quo.
This message has been edited by pfwebmaster from IP address 207.166.216.244 on Jan 26, 2003 2:23 PM
Posted on Jan 25, 2003, 5:28 PM from IP address 134.174.18.194
One reason why some are angry at the Podiatrists who have not been successful is that they are shining the light on what is the reality of podiatry. Podiatry is one profession for those few with the 3 year residencies who are practicing in their dad's practice.
It is another profession for those "average" podiatrists who really don't like to be preoccupied with business.
It is another profession for those without a 2 year surgical residency and hence can not or will not be allowed privileges.
It is still another group for those who do not have surgical residencies.
Older podiatrists are on Insurance Panels and Managed Care. The younger ones are LOCKED OUT!!
"Podiatry is headed toward becoming a footnote in history" (Florida Business Journal)
Posted on Jan 21, 2003, 11:00 AM from IP address 67.25.10.216
What can they (special interest govt.) do, if all you make is a paltry 40-45K and you can't even pay the full interest payments each month, are they really going to put you in jail- heh, free rent, board, heat, water in a minimum security fed. jail for inability to pay the $1600 each month for 15-30 years. In fact after 25 years the loans get wiped out, and you pay interest on the remaining loans. Create the thickest file for the feds to see the farce of podiatry.
Posted on Jan 21, 2003, 3:28 PM from IP address 134.174.248.74
I'm not sure what some people here are talking about.
What guarantee? I think I must have missed something somewhere along the line. was there supposed to be some kind of guarantee along with my student loans? Or was it mixed in with my application papers? Did it come fromthe school or was it from the APMA? I seemed to have missed it. I usually read stuff pretty carefully, but I sure don't recall seeing any guarnatee.
Maybe someone can enlighten me. What did this guarantee say? Am I supposed to make a certain amount of money? Am I entitled to some specific lifestyle for completing a course of study?
For those who don't get it, there is some sarcasm here. There IS NO GUARANTEE. There never was. I don't beleive anyone really thinks there should have been. Get over it.
Posted on Jan 22, 2003, 12:12 AM from IP address 63.186.1.185
I can say with some confidence that there wasn't a single person in my class who thought that they weren't going to make a living after their 4 years of school and 1-3 years of residency training. Not one. Nobody in my class was hearing about DPM's who were failing (although there was one volunteer DPM who was waiting tables on the side.....this, understandably, made us a trifle nervous) or who were unable to pay back their loans. I guess this was because we were sealed up in our school's cocoon. Nobody gave much thought to whether or not there was going to be any jobs available when they graduated. Probably our mistake, but it existed partly because the administration and the professors kept the truth from us and partly because we were constantly force fed only the positives of podiatry and its future.
Frankly, if I had read this stuff when I was a student, I would have dismissed it just like everyone else does. I would have thought that it was just a small group of malcontents who have some sort of huge grudge against podiatry. Truth is, as a student, just to maintain your sanity, you CAN'T subscribe to this kind of thinking.
Whether you'd like to admit it or not, there is an IMPLICIT guarantee that, as a "doctor", you're going to AT LEAST make enough money to pay your bills. My guess is that if you took a poll of 100 MD or DO students and asked them if they thought that they wouldn't be making enough money to live in a modest apartment and pay the minimum on their basic bills they would laugh at you. In our society, people are led to believe that highly trained health professionals who are called "doctor" make pretty good money and might even make enough to buy a house. And when you add the ridiculous, false rhetoric about "aging baby boomers", "increased athletic activity" and "an increase in the older population", you rightfully figure that your services are not only going to be in demand, but you may not have enough time to see these millions of people. This is the reality that pre-pods and pod students firmly believe.
Post-residency slaps you real hard.
Obviously, life holds no guarantees. But, people try and increase their chances of success by doing certain things like following the rules of the land, sharpening their social skills, getting a college degree and completing a professional program. If I graduated from "Fred's Upstairs Window Washing School", I might have some reservations as to how my future was going to unfold. However, if I graduated from a school that considered itself to be a "medical school", that showed me all kinds of glossy information about the "average income" and the plethora of foot surgeries that I'll be qualified to perform, I'd have a bit more confidence that my future may be pretty decent.
Get the point?
Posted on Jan 24, 2003, 2:25 PM from IP address 216.100.68.46
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