Do I Need A New Degree?

Doug Richie Jr. DPM FACFAS

After reading a recent blog by fellow blogger, Ron Raducanu, DPM, FACFAS, in which he gave an honest and candid view of his career and professional degree (see, I found the comments on the blog rather astounding. It is apparent that a few of our colleagues are currently disillusioned with their career choice. They feel that a simple change of professional title will suddenly make them successful and happy.

Some of the comments on Dr. Raducanu’s blog focus on a perception that the general public does not understand what a podiatrist is or what the DPM degree stands for. Several individuals state that podiatrists constantly have to explain their degree to patients.
One commenter notes that a possible solution to this perceived dilemma would be to change the degree from DPM to PMD as if this new degree will instantly provide recognition from the general public. Yet, on the same blog, a dentist comments “I don't think changing your degree to another acronym means anything” and he points out the current conflict between DDS degrees and DMD degrees.

I have practiced podiatric medicine for 32 years and interact with other medical specialists on a daily basis. I hardly ever have to explain my degree to a patient or fellow medical professional. I suspect that my experience reflects the majority of my fellow podiatric physicians.

If any of my fellow professionals are struggling to gain respect from their patients or from other health care professionals, the solution is not a simple change of degree. Like any health care professional, regardless of degree, you must earn respect for your own skill and knowledge. You will have to demonstrate to each and every patient that you are in total command of your specialty, and that the care you provide is equal to or better than the care that other doctors provide. It is not the job of the American Podiatric Medical Association (APMA) to offer public relations on your behalf. Only you can prove your worth to your patients and other referring physicians.

The remainder of the comments on Dr. Raducanu’s blog suggest that we not only seek a degree change but refocus our training to become primary care physicians. This idea is even more baffling than substituting PMD for DPM.

I currently serve as attending faculty for a three-year family medicine residency program at a nearby teaching hospital. The third-year family medicine residents spend a two-week rotation in my office. It is a rewarding experience for me and is quite different from the interactions I have with my own podiatric surgical residents at another hospital.

Most of the family medicine residents declare that they admire my practice and my professional life. This is due to the relationship I have with my patients, the blend of medicine and surgery in which I practice and the variety of conditions and patients that I see on a day-to-day basis. Family medicine residents often conclude that the podiatric practice is one in which the treating doctor has the ability to evaluate and treat the entire scope of foot and ankle conditions with extremely positive results leading to very happy patients. No family medicine resident has ever questioned my degree, my training or my scope of practice. Rather, I always sense a great deal of respect for my knowledge and skill with no concern about the acronym after my name.

In my region of southern California, a multispecialty group will hire a new graduate of a family medicine residency at approximately half the salary of a podiatric physician. If I were to redirect my career and get a new degree to become a primary care physician, I would suffer at least a 200 percent pay cut, work longer hours and see more patients per day.

Why would I do this?

To those who blame the APMA for not fulfilling their career aspirations and to those recent graduates who feel duped in piling up a huge debt of student loans, I suggest you look at yourself for the solution. The future for podiatric physicians could never be brighter. While the demand for service from geriatric and diabetic patients will double in the next 20 years, the number of podiatric physicians will continue to decline in alarming numbers. Podiatric physicians have a huge opportunity right now. Those podiatric physicians who maximize their excellent residency training and earn the respect of their patients and fellow health care professionals will flourish. Those who blame organizations and a degree they signed up for in the very beginning will be left by the wayside.


That's all well and good but what about the fact that our degree gets us paid less for the same procedure codes than our MD friends?

Clear, informative, sublime. Could I send you some e-hugs?

Dr. Crabtree,

Although I sympathize with what you are saying, and not necessarily saying this is a myth, BUT we have no hard data or proof this actually happens.

Here is where it DOES happen. In large multispecialty groups in which there are many docs of all kinds, fees can be negotiated. This is especially the case in small areas that don't have many practitioners. This happens across the board. I have a dear friend who is in a large anesthesia group in a small area and his group basically sets the fees for HIS group. Others have tried to muscle in and lower the fees globally, but his group is so big, they just drop the carrier and the patients can't get care without much higher co-pays/deductibles and the small groups just can't handle the volume. It's a win/win in my eyes. The large groups sets the fees and then the smaller guys benefit because they all TALK to each other.

This is why "Podiatric Supergroups" make so much sense. Ahhhhh, if only we could all get along. No more, "I'll do it for less, give me ALL the work!" THAT is what is killing us. Maybe not in the past (I can't speak for a time when I wasn't in practice), but now more than ever.

Agree with Dr. Crabtree. Feeling good or getting positive feedback is fine. However, it does not address the fact that the podiatry degree regardless of training, experience, etc., gets us paid in some cases less than a physician, even after a minimum of seven years of training. Time for USMLEs, ACGME and LCME. The PR for podiatry remains quite poor. Perhaps start with education. Solid foundation. Solid future akin to NPs and PAs.

Dear N.B.,

I continue to ask for anyone to provide some documentation of specific services which podiatric physicians are paid less than medical doctors. In California, this has been a rare case and when this occurred, it was reversed by our state organization, the California Podiatric Medical Association.

I have no complaints about my current level of reimbursement for all services provided. If you can provide any specifics, I am sure the readers will be interested and should enlist the help of their state association. If you are not a member of the APMA, you have no remedies available and have no grounds to complain.


Doug Richie, DPM, FACFAS

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