I would like to take a break from the ex-fix series this month to discuss something that has recently happened in our state and how it relates to the June 2010 cover story “What Does The Future Hold For Podiatric Surgeons?” (see http://www.podiatrytoday.com/what-does-the-future-hold-for-podiatric-sur... ). I would like to preface all this by saying that my opinions are my own. I am not pointing fingers but I hope this stimulates some healthy discussion.
We recently had our Virginia state conference. All members were invited to participate in our business meeting and many of us attended as we had a lot to celebrate this year. Seven states were threatening to eject podiatry from participation in the Medicaid plan and our state was only one of two that successfully retained our ability to continue seeing our Medicaid patients.
We were also faced with an issue that many, many years ago, somehow the word “diagnosis” was omitted from the state’s scope of practice and some within the medical profession were rallying to make sure we could no longer actually diagnose anything or anyone. This would have had a huge impact on the viability of our profession in Virginia and I imagine a slippery slope would have started. Our state society, with the help of the American Podiatric Medical Association (APMA), was instrumental in helping us get that language put back into the state scope of practice, which was a monumental task.
At this meeting, the outgoing president of our state society asked us to help do one thing. We had to find all the podiatrists in our state who will be taking advantage of this successful fight and get those who are not APMA members to support our national organization.
I will be honest. I am a huge APMA fan. I always have been and always will be. Without the APMA, our profession would be lost. I truly scratch my head as to why any single one of my colleagues is not an APMA member. Maybe I am just young and naïve. I am on the Internet quite a good bit and read a lot of our trade journals and the APMA is everywhere. Anytime the advancement of our profession is at stake or there is a challenge to some aspect of podiatry, the APMA is our frontline defense.
The Podiatry Today June cover story was right. The American College of Foot and Ankle Surgeons’ (ACFAS) decision to no longer require its members, after the first year, to be APMA members -- thereby causing this “split” -- was very controversial. I run one of the affiliate organizations of the APMA, and the golden rule is that all of the members of the affiliate organization’s members must be APMA members or the organization can no longer be an affiliate within the association. This membership requirement is not arbitrary. It is an APMA bylaws requirement. What I do not really understand is this ingrained sense of animosity that seems to exist. I haven’t been around long enough to see where it started and why it continues.
I was at an APMA meeting years ago at the association headquarters in Bethesda, Md., to discuss the APMA’s participation with the affiliate organizations. To say that I was intimidated at this roundtable discussion was a mild understatement. Here I was, right out of residency, sitting at a table with some of the people I have been reading about for years and they were asking me for my opinion on certain matters. I can tell you that even at this meeting, the tension between the leaders of ACFAS and the leaders of the APMA was palpable.
So now, ACFAS is no longer an affiliate of the APMA. It still is able to do its thing very well. I am a proud Fellow of that organization and will be as long as I practice podiatry. The ACFAS is an extremely valuable resource for all of us. Its Journal of Foot and Ankle Surgery is of a very high quality and although I have never been to one of the ACFAS conferences, I understand it is an excellent weekend of education.
What truly saddens me, however, is that this “split” had to do with some members not necessarily agreeing that they should be APMA members in order to continue their affiliation with the ACFAS. I know it is not as simple as that but I like to take clear eyed view of this situation without the knowledge of all the past politics. Every single podiatrist should be an American Podiatric Medical Association member.
I am also quite sure that the APMA has also made efforts and strides in dealing with the American Academy of Orthopaedic Surgeons and the American Orthopaedic Foot and Ankle Society. I think it is also important to note that depending on how the ACFAS was initially set up and runs itself as an organization, it may not have the lobbying experience or power to the degree that the APMA has these attributes.
Clarifying Some Points About The ASPS
Now along comes the American Society of Podiatric Surgeons (ASPS). Since I do run an affiliate organization, I know the due process of getting a new affiliate off the ground. Many point out that the APMA started this new organization and fully funds it, potentially sapping resources that could be used for other association activities.
This is clearly a misconception of the due process required. If you want to get technical, certain APMA members did their due diligence and filed the necessary paperwork with the association to start up a new affiliate. The APMA went through the due process to evaluate the application and then accepted this new affiliate, based on certain criteria and at the recommendation of the APMA Board of Trustees.
I imagine the association members who initiated this wanted a surgical society that was unequivocally affiliated with the APMA and was willing to follow the bylaws concerning the APMA and affiliate membership. Also, for the APMA to get financially involved, a formal legal agreement must exist between the two organizations and then the APMA can then offer certain agreed upon services for an agreed upon fee. There are no free rides.
This is about choice. In my opinion, the ACFAS members wanted the choice of whom they could allow to be members within their organization, which is perfectly reasonable. However, I think the main crux was that the ACFAS wanted to allow its members the choice of whether they wanted to belong to both organizations or just to the ACFAS. The APMA members wanted to have a choice between a surgical affiliate of the APMA and a surgical organization non-affiliate.
I have chosen both surgical organizations because there is value in both. There is no question in my mind that both groups need our support. The ACFAS is the elder statesman. Its conferences are well run, according to local colleagues who have attended their conferences and the journal is solid as far as I’m concerned.
My one personal beef is that I lecture for at least two conferences a year and support my state organization by attending that conference as well. I get more CMEs a year than I know what to do with so I have not attended an ACFAS meeting yet. I asked the college officials if they would consider me as a potential lecturer last year and they told me that in order to be considered as a potential lecturer, I had to have attended one of their conferences within the last five years. I am not sure what that is about but when I do eventually get to go to one of the ACFAS conferences, I will put in another application.
Conversely, the APMA has a yearly open call for lecturers available to all its members without any pretenses as to attendance at its annual scientific meeting.
The ASPS is the new kid on the block. It already has made a name for itself and its roster already includes some of the more notable names in our profession. I am also a proud Fellow of this organization and will be as long as I practice podiatry. New blood is good. Evolution happens in the face of adversity and competition. Our allopathic brethren have many societies for each specialty, not just one. The choice is theirs to join which organization suits them and strikes their fancy.
Both the ACFAS and ASPS have much to offer. One has a proven track record and the other will prove itself valuable as our profession evolves.
The ASPS has already changed things up by offering one workshop at the APMA Annual Scientific Meeting in Seattle this summer. I had lot of training in arthroscopy in residency and have been wondering why someone with no training in arthroscopy would spend $1,500 to sign up for a weekend course and then pay to fly out there, spend money on a hotel and food for an introductory course on arthroscopy. The ASPS has already addressed this by offering an arthroscopy workshop for a very nominal fee at the Seattle meeting. I believe this is the first time in recent memory that a course like this has been offered at the annual scientific meeting. (On a side note, I really do not think a weekend course makes you skilled enough in arthroscopy to offer this as a surgical option to your patients but that is a whole other blog.)
Ultimately, would I like to see everyone just get along? Of course. Realistically, I really do not see that happening. What I do see happening is that our profession will continue to evolve in a positive way and even though these organizations might not always agree with one another, their common goal of excellence will help us all forge ahead.