Category Archive: Resident News to Use

Dr. Steve Goldman Testifies before VA House Committee, Subcommittee on Health

 GoldmanWashington, D.C. On May 2, at 2:00 p.m. ET American Board of Podiatric Medicine (ABPM) President Steve Goldman, DPM, testified before the VA House Committee, Subcommittee on Health about key legislation that would help to address ongoing delays in access to quality care at the Veterans Health Administration (VHA).

The VA Provider Equity Act (HR-1058) would benefit our nation’s veterans through improved, ongoing recruitment and retention of podiatric physicians in the VHA and would ensure sufficient experienced podiatric physicians are available to treat patients with lower extremity needs.

“This bill reflects significant advancement in the education, training, and licensure requirements for podiatric physicians over the past 40 years,” said Dr. Goldman. “Podiatrists deserve parity within the VHA, and our patients deserve the proven benefits of the best-trained experts in lower extremity care as part of their health care team.”

There is overwhelming support from VA chiefs of staff and chief medical officers for a legislative remedy to include DPMs in the Physician and Dentist Pay Authority. For more information on the bill, please visit the ABPM or APMA websites.

“The number of disabled veterans enrolled in the VHA is increasing, and they have more comorbidity and more psychosocial and socioeconomic issues than non-veterans,” said APMA President Ira H. Kraus, DPM. “We need to do better in serving this vulnerable and deserving population.”

Dr. Goldman was one of several physicians asked to speak on behalf of podiatrists. Others included: Jeffrey Robbins, DPM, Director of the Veterans Health Administration Headquarters Podiatry Services and Chief of the Podiatry Section at the Louis Stokes Cleveland VA Medical Center, and Seth Rubenstein, DPM, APMA treasurer.

The American Board of Podiatric Medicine (ABPM) is the only board recognized by the Joint Committee on the Recognition of Specialty Boards (JCRSB) to certify in podiatric orthopedics and primary podiatric medicine, the specialty area that represents a significant portion of care in most podiatric practices.  Established in 1978, ABPM strives to protect the health and welfare of the public through this ongoing process of evaluation and podiatric certification, providing trusted validation of expertise to hospitals, credentialing bodies and insurance panels.  For more information please visit www.ABPMed.org .

The American Podiatric Medical Association (APMA) is the nation’s leading professional organization for today’s podiatrists. Doctors of Podiatric Medicine (DPMs) are qualified by their education, training, and experience to diagnose and treat conditions affecting the foot, ankle, and structures of the leg. APMA has 53 state component locations across the United States and its territories, with a membership of nearly 13,000 podiatrists. All practicing APMA members are licensed by the state in which they practice podiatric medicine. For more information, visit www.apma.org .

See Dr. Goldman speak about his testimony here: Video (70MB .mov)

Please click here to see a full list of witnesses and the video of this testimony.

ABPM Diplomate, Dr. H. John Visser, is Guest Lecturer and Presenter in Sweden

H. John Visser, DPM

H. John Visser, DPM

John Visser, DPM, Director of the SSM DePaul Residency Program in St. Louis, MO just returned from a week-long stay overseas where he was a distinguished guest lecturer and instructor at the Foot & Ankle techniques course in Gothenburg, Sweden. The course was held at the Sahlgrenska University Hospital, and his topics included new techniques in hallux valgus, Lisfranc dislocation, and Charcot neuroarthropathy reconstruction.

Lecturers for the course represented the countries of Sweden and Germany, with Dr. Visser being the only American distinguished lecturer and presenter. Visser was also recently inducted into the German Society of Foot and Ankle Surgery in 2016 where he also presented in front of an audience of more than four hundred professionals in Munich, Germany.

Dr. H. John Visser has been an ABPM Diplomate since 1989.

Source: PM News, Online

Fellowship Opportunity at the University of Michigan

Insights from Dr. Michael Munson, Assistant Professor Internal Medicine and Fellowship Program Director

Fellowship applications due: November 1, 2016 – contact Dr. Michael Munson for info at Munsonm@umich.edu

Over the last couple of years, the ABPM has featured the career paths of different podiatrists in our Practice Profiles section of our Residents newsletter.   While we will resume those profiles in future issues, we have been asked by many residents and members to also profile different CPME approved fellowship programs.   As more podiatrist consider pursuing careers at academic health centers or simply want to expand their knowledge in a concentrated area, there seems to be an increased interest in fellowships.

With this October issue, we launch a series of articles where you will get an in-depth understanding of a few different CPME approved residencies.  This month we focus on a research fellowship in limb preservation, wound care and diabetic lower extremity complications at the University of Michigan Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes (MEND) in Ann Arbor, Michigan    This CPME fellowship is a two-year program designed to train podiatrists interested in a career in research, teaching, clinical medicine and surgery.

“The educational opportunities in this program are quite rare. We are aware of only a few training programs of this kind that seeks to produce highly trained wound care and limb preservation experts in academic medicine while also providing the fellow the opportunity to acquire the necessary skills for statistical analysis and research design. This new program would take advantage of the unique background and training of our podiatric physicians, our relationship with MEND and the Comprehensive Diabetes Center, as well as the University of Michigan Wound Care Center. We need to train new physicians in wound care and limb preservation to coordinate care in this multidisciplinary specialty.”

What are some key aspects of this Fellowship?

“While our focus is limb preservation, we will expose the fellow to a full spectrum of lower extremity pathology in clinic.” Some of the key areas include:

  • Neuropathy: “We have the unique opportunity to have the fellow train for 2-4 weeks in our neuropathy clinic with one of the world’s leading experts in neuropathy. As many podiatrists learn shortly after residency, we are on the front lines of treating painful peripheral neuropathy.  While we get some exposure in residency, it is our goal to provide our fellows the additional training needed to be an expert in the field of peripheral neuropathy.”
  • Limb salvage: “In addition to clinical and surgical podiatry, our fellows will get the chance to spend time with expert pedorthists and orthotists fabricating and adjusting braces and orthotic devices. Further, the fellow can also work with our ID specialists on our population at risk for limb loss.  “
  • Research: “This fellowship will likely be the only time in one’s career that they have the opportunity to write and conduct research with the benefit of six months of dedicated, protected time. Our research directors, James Wrobel, DPM a leading podiatric author, and Rodica Busui, MD, an endocrinologist, and the leading expert internationally in understanding the mechanisms of diabetic complications, particularly of diabetic peripheral neuropathy and cardiovascular autonomic neuropathy, will provide expert guidance. The University of Michigan has near limitless support for those who desire to publish their work. Researchers at University of Michigan have access to world-class facilities and services, comprehensive grant administration support and a variety of other resources. Our division, and indeed our entire university, provides opportunity to collaborate with world class faculty on research projects.”

How are candidates selected? What do you look for?

“While we are generally recruiting recent and current residents, we are open to accepting applications from anyone who is interested in a career in academic medicine.  Ideally, we are looking for someone who desires a lifelong career of clinical medicine, surgery, teaching, and research.  I believe this is most easily accomplished in a medical school or academic institution. The University of Michigan is ranked as the #1 public University for research, and as such offers a great deal of opportunities for support and collaboration on research projects. As post graduate training in Podiatry is new to our University, we want someone who will represent us proudly.”

“Podiatric physicians already receive training in internal medicine, infectious disease, vascular medicine, surgery, preventative diabetic foot care and wound care in their three years of residency. They are ideally suited to expand on this knowledge through fellowship training to become a highly-trained specialist in this field. This also serves to help expand the evidence base and produce more research-minded clinicians and clinician-educators.”

Interested Podiatrists may contact Dr. Michael Munson, Fellowship Director at Munsonm@umich.edu   Deadline is November 1, 2016.

NEXT ISSUE:  Additional insights in the U of M program.  Why the ABPM credential was selected as the certification of choice for University of Michigan fellowship staff. Thoughts on the increased interest in wound care and limb salvage.    If you have or know of a CPME fellowship program that you would like featured, please email admin@abpmed.org.

 

When to Consult?

by Melissa Lockwood

A recent residency graduate from Florida, just entering private practice, asked me this interesting question last week.  How do we, as podiatrists, know when to consult another health care professional and more importantly, who to consult,  in a private practice setting?  Medicine has, for decades, been focusing on specialists and our unique skill sets, so it begs the question: how soon to consult if we don’t know the answer?  My advice is as soon as possible.  If something doesn’t look like a horse or behave like a horse, it is probably a zebra!  Referrals and consults to other specialists (or even back to a patient’s primary care physician) is a great communication AND marketing tool.  It’s easy in residency – you are all either on service with the other specialty or you can call them within the hospital setting.  In private practice, it can take time to figure out the WHO, WHAT, WHERE, and WHEN of consulting with other health care professionals. 

One easy way to figure out the WHO is to ask your current patients who they see!  If you notice someone with a scar from an angioplasty or bypass, ask who their vascular doctor was and did they like him/her.  You can glean a lot of info to hone your marketing and referral networking efforts by asking your patients.  The WHAT can sometimes be difficult.  Patient with non-specific pain who describes it both as tingly, achy, burning, and in multiple joints.  Rheumatology?  Neurology?  Physical medicine and rehab?  Start with some basic lab work to rule out specific conditions?  Order the EMG yourself?  Here is a key place to get out and ask your colleagues WHAT they do and how quickly they can see your patients (WHERE and WHEN).  The key point to remember – it’s OK to not know all the answers.  Start building your referral network now (especially if you plan on practicing in the same area after residency) and know it’s NEVER too soon to get another opinion! 

Malpractice Basics by Melissa Lockwood, DPM

For third year residents the idea of malpractice insurance coverage may feel overwhelming but it is just “one of those things” you must have as a practicing physician.  Here are a few basics to help as you transition into practice.

Malpractice insurance coverage is maintained by the individual provider.  Most states have certain minimums (for example a $1 million per incident/$3 million total claims coverage in my state!) that providers are required to carry – just like car or homeowners policies.  It is critical to know who is paying for your coverage. Your employer, hospital, or group may provide reimbursement for malpractice as a benefit of employment.

It is important to ask what happens if or when you leave that particular position and who is responsible for maintaining coverage after employment termination. This is almost always YOU, but you may be able to pay special “tail coverage” at that particular employer for a certain amount of time after leaving in case a claim is filed against you.

Also, KNOW the company you are working with – don’t base your decisions solely on premium costs.  Remember – you get what you pay for and sometimes when the premium is inexpensive, so is the actual coverage and help if you ever have a claim filed against you.

Bottom line is, do your homework, ask questions when offered employment and be a smart shopper so you are prepared and start your career on the right foot…so to speak.

Sign up for ABPM In-Training

The ABPM In-training examination is highly recommended as a way to help you prepare for the ABPM Qualification examination after you complete your residency.   This year’s In-training examination will be offered at Pearson VUE Test Centers nationally between October 31 and December 2, 2016.  The application deadline is September 12, 2016.  Program Directors are required to sign up residents for this exam, and may do so through the Podiatry Residency Resource (PRR) website.  They need to simply select the “Services Order” link in the “tasks section” on the dashboard and sign you up!

The examination is a voluntary self-assessment tool available to all current residents. It is administered as a single exam with 200 short answer items covering biomechanics, orthopedics, wound care, medicine and surgical criteria.  The ABPM In-training examination costs $200 per resident, per administration.

Questions regarding the online examination application should be directed to Podiatry Residency Resource at (415) 553-7810 or support@podiatryrr.net.

Questions regarding the examination process should be directed to ABPM Headquarters at (310) 375-0700 or sandy@ABPMed.org.

More information regarding the examination can be found on the Residents page of our website.

 

ABPM In-Training examination, Program Directors must sign up residents for the ABPM In-Training

Practice Profile: Dr. Nicole Freels

dr.freels-300Dr. Freels has been the owner of her own practice, Lexington Podiatry, for eight years.  “I went straight into private practice shortly after completing my residency program at James H. Quillen VA Medical Center,  in Atlanta, and after spending a year studying with renowned podiatric surgeons and pioneers, Drs. Douglas H. Elleby and Alan Shaw, and leading wound care specialist and podiatric surgeon Dr. Michael K. Bednarz in Atlanta, Georgia, ” stated Freels.

“While I have surgical training, my practice and my passion is for exhausting all conservative treatments before considering surgical corrections. Because many lower extremity problems stem from underlying biomechanical issues, I specialize in evaluating these issues through detailed biomechanical and gait analysis and treating my patients accordingly,” explains Freels.

For Freels, a graduate of the Ohio College of Podiatric Medicine, Cleveland, ABPM Certification was vital to her practice.   “Because I take a very conservative approach to treating the foot, it was important to me to demonstrate my specialized knowledge in medicine,” explained Freels.

Freels is honest about the upsides and downsides of having a private practice. She says ownership is tough, but rewarding.

“Besides the obvious patient care, you have to be willing to spend time worrying about mundane but maddening things like why the lobby lights dim randomly from time-to-time and who’s going to fix that to how to juggle the overhead and morale of your team. It’s definitely not just a clock-in clock-out mentality, but it can be so worth it!“

Freels has built a practice based completely on the comprehensive treatment of feet that includes a beautiful PedSpa that has earned local news coverage. In addition, she created an  all-natural, antibacterial, antifungal and anti-inflammatory, spa-quality foot care line called Doc Kelly’s Apothecary . Freels’ long term goals for her practice includes working two to three days a week, so she can expand the line. “The name of the line and the philosophy around the line honor the memory of my grandfather, the late Dr. Arthur O. Kelly. I ‘grew up’ in his podiatry practice and his memory motivates me to this day.”

When not managing her foot care line and her practice, she and her husband Rob are always looking for their next adventure. “We have made a commitment to try new and different sports and activities. We’re taking up golf and have loved getting outdoors for long weekend hikes this spring already,” explains Freels.  She also shares she has a heart for animals.  “While my mind is always thinking of the next port-of-call, my heart is also on animals. I have a soft spot for animals in need and am drawn to charities and organizations that care for lost, injured cats and dogs.”  

APMA Vision 2015 – Path to Parity : How the ABPM works with the APMA and CPME to accomplish this goal

By Melissa Lockwood, DPM

How the ABPM supports the APMA Vision 2015: Path to Parity

When I graduated from Podiatry school in 2005, there was a critical shift in residency training.  Prior to 2004/2005, there were up to seven different models for residency training, all focusing on different aspects of podiatric medicine and lengths of TIME to complete that training. In the past 11 years, times have certainly changed.  Fortunately, for you as residents, today’s 36 month training programs are comprehensive, consistent and incorporate both podiatric medicine and surgery.

The overall mission of Vision 2015 is to ensure that podiatrists are universally accepted and recognized as physicians consistent with their education, training, and experience. As a credentialing body, ABPM has worked hard to support this effort and is continually working to educate residents around the value of certifying in podiatric orthopedics and primary podiatric medicine with ABPM.  As a young practitioner, these are areas of podiatry you will use immediately in your daily practice of podiatry, and credentialing is often a prerequisite to obtaining insurance paneling and hospital privileges.   

As a young physician, you have so many opportunities ahead of you over the next few years.  By completing the most comprehensive training possible and certifying in the medicine and surgery boards, you will have an advantage that none of your predecessors ever could have dreamed of – the possibility of parity within the medical community and beyond.

Vision 2015 Objectives (from APMA Website)

  1. Evaluate and ensure that the outcomes of podiatric medical education are comparable to that of allopathic and osteopathic physicians.
  2. Demonstrate to the entire health care community that the education, training, and experience of a podiatric physician are comparable to that of allopathic and osteopathic physicians.
  3. Obtain state and federal government recognition that podiatrists are physicians.
  4. Market and promote podiatrists as physicians.
  5. Attract high quality applicants to colleges of podiatric medicine and thereby to the profession

Practice Profile: Dr. Lee Rogers – Taking initiative to be successful

Dr. Lee Rogers is a podiatric physician specializing in the diabetic foot and amputation prevention in a private, hospital-based practice. Dr. Rogers began his career basically as an entrepreneur.

“None of the jobs I have ever gotten were there already; I had to create them for myself,” stated Dr. Lee Rogers, who is now the National Medical Director of the Amputation Prevention Centers of America, a division of RestorixHealth, Inc.

After graduating from Des Moines University College of Podiatric Medicine in 2004, Dr. Rogers completed a two year residency (PM&S-24) in foot surgery at St. Vincent’s Catholic Medical Center in New York under the direction of ABPM Past-President and Diplomate, Michael DellaCorte, DPM.  He went on to complete a fellowship in limb salvage and research, with David Armstrong, DPM, a world authority on diabetic foot complications, at the Rosalind Franklin University of Medicine and Science in Chicago.

“I knew early on that I wanted to specialize in the diabetic foot.  I saw that while many podiatrists see and treat the diabetic foot, few dedicate their entire career to this subspecialty. With a mortality rate of 68% within 5 years for those with an amputation caused by diabetes, doing everything we can to save limbs, is saving their lives.  And treating the diabetic foot encompasses a lot of surgery in order to achieve limb salvage,” explained Rogers.

After his fellowship Dr. Rogers was offered a job to start his own clinic focused on amputation prevention in Des Moines, IA at Broadlawns Medical Center.  For two and a half years, he collected data on a 6 step approach to treating the diabetic foot and was able to document a reduction in the rate of amputations by 72%.  “What we found was that a team approach can save more limbs than a unilateral or individual approach,” he said.  “And these teams encompass many other medical or surgical specialties.  But the podiatrist has the opportunity to lead this team.”

He then went on to found similar Amputation Prevention Centers in Los Angeles, California.  He founded the Amputation Prevention Centers of America, creating a network of like-minded specialists dedicated to limb salvage, and a couple years ago this network merged with RestorixHealth, Inc and Rogers now acts as the national medical director.

In 2011, Rogers was given the Rising Star award by the APMA for “outstanding national accomplishments,” and Podiatry Management has selected him as one of America’s Most Influential Podiatrists for several years.

Rogers attributes much of his early success to his mentor Robert Frykberg, DPM who helped him formulate a career plan focused on an area he was passionate about.  “I think finding a mentor is critical. Find someone you respect and want to emulate. Even though healthcare is changing, and practices are changing, there is still much to be learned from seasoned practitioners and the paths their careers have taken. ”

Dr. Rogers has been an ABPM diplomate since 2008.  “For most DPMs I would recommend obtaining certification in both medicine and surgery, but becoming board certified as quick as possible by ABPM can help young podiatrists become credentialed by insurances and obtain or retain their hospital privileges.  I am only certified with ABPM because I quickly realized I didn’t need another board certification. ABPM-only certification has never been an impediment to my work as a surgeon, since I completed a surgical residency and have demonstrated proficiency.”

Dr. Rogers also took some time to run for Congress, where endorsed by the LA Times, the Mayor of LA, the Lt. Governor of California, and 20-30 Members of Congress.  He came within 5% of winning in 2012 in the general elections and was narrowly defeated the new California open primary in 2014. “I definitely see politics in my future again, but am taking a break.  You can’t balance work, family, and running for office; the campaign takes over everything,” stated Rogers. “I  see tremendous opportunities to make improvements in federal policy.  With only about 20 doctors in Congress and one scientist, I think there is room to improve our federal government’s understanding of science and medicine, and restructure America’s priorities to advance in these important areas.”

The biggest take-away Dr. Rogers wants for residents is to “take control of your future”.  “One of my favorite quotes is by George Benard Shaw ‘Life isn’t about finding yourself, it’s about creating yourself.’  I encourage all residents and young practitioners starting out to decide what their perfect job would be and create it, if necessary. If you wait around to find a job posting for your perfect job reading the blogs and e-blasts, you’ll be waiting a long time.  Take the initiative and ‘create yourself’.”

 

Loans, loans…What to do with those Student Loans!

By Vincenzo Palmieri, DPM PGY-3, Mt. Sinai/FHCC – PMSR/RRA, Chief Resident and William Chagares, DPM, ABPM Vice President

Today, the average medical student will easily accumulate a loan debt that tops six figures.  Although the Ben Franklin axiom, “An investment in education always pays the best dividends”, is certainly true, it is also true that to realize those dividends you must have a well-grounded understanding of your finances.  A few months before graduating podiatric medical college, our financial aid department gave us each a crash course on our loans. The official name for the course was “exit interview,” where terms such as consolidation and deferment were thrown at us.  Like most students, I had several individual loans with different interest rates that needed repayment and I was extremely confused.  What are my options for repayment? When does repayment begin? What are my loan interest rates?  Like most students I had very little knowledge of finances and managing debt.

There are several repayment plans that are designed to help individualize the repayment process.  Should I consolidate my loans?  Loan consolidation can greatly simplify repayment by combining your loans to one monthly bill and can lower initial payments by giving you up to 30 years to repay your loans.  However, if you increase the length of your repayment periods, you will pay more in interest.

Consolidating loans may give you alternative repayment option plans such as the pay as you earn plan or income based repayment.  Most (not all) federal student loans are eligible for consolidation.  In my specific case consolidation was my best options as it allowed for one monthly repayment bill at a lower fixed interest rate. A Direct Consolidation Loan has a fixed interest rate for the life of the loan. This also afforded me the Pay as You Earn Plan with payments up to 20 years. This plan is very friendly to residents because the payments are based on a percentage of your total income and changes as your income changes.  Keep in mind that though you are only responsible for a small initial monthly payment there is no penalty for additional repayment. Hopefully this is not the case but; if you have not repaid your loan in full after you made the equivalent of 20 years of qualifying monthly payments, any outstanding balance on your loan will be forgiven.

When it comes time to repay your student loans, there is a lot to consider. Understanding the details of repayment and your options is critical and will save you time and money. Shop around the different consolidation companies – some offer to lower rates for 36 on time payments and/or auto debit from a checking account.  Some companies may give you an added bonus of 0.25% reduction in interest if you apply for automatic bank account deductions on a monthly basis.  Find out when your loans’ grace period ends and when repayment begins. Look at all of your repayment options and plans and pick the plan that best fits your individual situation.

Make sure to do your homework and research on all your options so that you are not losing money.  Some helpful resources for loan repayment and information are: Federal Student Aid Website at studentaid.ed.gov and loanconsolidation.ed.gov

 

 

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