Freedom Of Choice: Another Perspective On The APMA/ACFAS Debate


Living in America, we are blessed with freedom, which allows us to choose the college or university we would like our children to attend. We have the right of choice when it comes to purchasing cars, houses or any other entity that has value to us. We also have the right and obligation to choose our legislators, and we can belong to any political party we choose.

However, prior to 2007, members of the American Podiatric Medical Association (APMA) who were also Fellows of the American College of Foot and Ankle Surgeons (ACFAS) were denied this freedom of choice. The APMA requires podiatrists to be members of the APMA before we can join any professional association.

I do not know about the rest of you but I resent being told that in order to belong to the ACFAS, I must be a member of the APMA. I belong to the APMA because my state association is very effective and I feel my membership is worth the fees. However, in order to belong to my state association, I must first be an APMA member.

We are the only medical profession that has a parent organization with such a policy. Why? Is it because the leadership of the APMA believes our intellect is somehow inadequate? It seems that the leadership of the APMA feels that its members are not competent to choose which organization they should belong to.

I think the APMA leadership has underestimated the importance of the ACFAS and have overestimated their own worth. The change in policy by the ACFAS has clearly not hurt the ACFAS. In fact, our membership has increased over the last year. What about the APMA? Is the APMA really suffering? I think not. In order to retain members in any organization, the organization should provide services to its membership so individuals should want to join on their own.

I am a foot and ankle surgeon. I do not perform routine podiatry care in my practice. Accordingly, the ACFAS and the activities of the American Orthopedic Foot and Ankle Society (AOFAS) provide me with the best information available. If truth be told, I have more in common with the members of the AOFAS than I do with the APMA.

What is the message that needs to be sent to the APMA? Grow up. I am proud to be a Fellow of the ACFAS. I cannot imagine why the APMA wants to start a second-rate surgical organization. Who would want to belong to an ersatz organization when a mature and strong surgical organization is available? I extend my condolences to the leadership of the APMA. If they wanted to irritate foot and ankle surgeons, they have succeeded admirably.


You may well have a strong point. But is your point to be taken more seriously by calling a new organization "second rate". Hubris. With that attitude, is is nice to see you irritated.

David E. Gurvis DPM

If ACFAS wanted to remain and "Affiliated" organization of the APMA, it had two choices: adhere to the by-laws of the APMA or garner the political support needed to change the by-laws of the APMA.

As a nation governed by law, our organizations have by-laws which are ratified by their members. The APMA followed its by-laws.

ACFAS chose a path which they knew in advance would lead to the loss of their "Affiliated Status", and yet members of ACFAS are trying to saddle the APMA with the blame for these consequences. Go figure!

John M. Wray, DPM
Chicago, IL

Being a podiatrist is something, I fear, Dr. Jolly regrets. His previous comments and those of ACFAS on this and other subjects have been fairly clear.

I congratulate the ACFAS for their change in status. It has allowed the APMA to create a surgical organization that will work cooperatively with all podiatrists to advance our collective mission.

I am certain both organizations will flourish and ultimately our patients and our practices will benefit.

Lloyd Smith, DPM

After many years of discussion, and for a long list of reasons, in October 2007 the ACFAS Board voted to remove a policy that mandated continuous dual membership in APMA to be a member of the College. APMA membership is still required for admission to the College, but not after the first year. The College’s paramount belief was (and is) that physicians should have the freedom to choose their affiliations as a fundamental right and a simple matter of fairness. All other branches of organized medicine allow such freedom (e.g., you can join AAOS without mandated membership in the AMA). In April 2008 ACFAS put the issue to a membership vote and the majority voted in favor of their right to choose their own professional affiliations.

This decision meant ACFAS was not considered an affiliate organization of APMA, although the only obligation or right of affiliate status was the dual membership requirement. In fact, the APMA House of Delegates defeated three attempts to give affiliate organizations representation in the House, a right that AMA and AOA gives to specialty organizations even without mandated dual memberships.

Since the membership vote, ACFAS has offered three times to meet with APMA and work out a new relationship, including its willingness to reconsider the dual membership question if a mutually agreeable relationship could be forged. APMA rejected those invitations,Let me repeat that, APMA REJECTED THOSE INVITATIONS saying ACFAS had to reverse its policy before it would talk. Clearly no organization should be required to come to the negotiation table with any type of precondition.

Meanwhile, APMA did respond by creating a new surgical organization, the American Society of Podiatric Surgeons (ASPS) that will be “owned and operated” in-house by APMA. APMA/ASPS started membership recruitment in early June 2009. There was no “demand” for this entity. In my opinion, this new entity has not been created to advance the competency of podiatric surgeons and the care of our patients, but for economic self-interest. I also believe this new entity is wasting valuable APMA resources that should be devoted to its primary mission – representing podiatry in federal public policy debates.

Despite this controversy, ACFAS is as strong as ever – and growing. ACFAS is financially strong, even in the midst of the current economic downturn. Recent surveys show that ACFAS is, without question, the “gold standard” for CME and scientific research (e.g., our Journal, Clinical Practice Guidelines, clinical studies, etc.). And the College is significantly increasing both its online and “event” CME, and a dynamic new Web site that will debut in October.

I hope this clarifies the situation and represents a balanced picture.

Glenn M Weinraub, DPM, FACFAS

The problem still remains by the lack of appreciation and knowledge MDs of the distinct difference between a foot and ankle surgeon and a general podiatrist. Similar vein to dentist and OMFS. This is an area that needs to be continually addressed and ACTED upon. The ACFAS needs to better inform MDs of this distinction for their care of foot and ankle issues.

Sam Bradely

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