Why Orthopedic Denigrators Of DPMs Just Make Themselves Look Bad

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John H. McCord, DPM

A couple of months ago, I learned about that orthopod from South Carolina and his video blog that slammed our profession. I watched the thing and it reminded me of the horse poop we had to put up with 30 years ago. My wife leaned into my den to see what I was doing and asked why I was watching reruns of The Simpsons. The guy really did look and sound like Bart Simpson.

   We need to consider these stupid attacks on our profession as opportunities. Intelligent people will see through these buffoons and realize these doctors are really worried about their turf, what is left of it.

   Some of my closest friends are orthopods and I do not want to paint them all with the same brush like Dr. Bart did to podiatrists. However, I have not always enjoyed my relationship with some orthopedic surgeons.

   I had a patient 20 years ago who was a bit difficult. Her personality was abrasive and she was demanding. Unfortunately, she also had a terrible bunion that needed surgical attention. I described a simple procedure that would relieve the pressure. A more complex operation with an osteotomy would have created better correction but she was habitually non-adherent so I proposed a McBride procedure and discussed the risks and alternatives.

   She showed up at my clinic a few days later demanding copies of her records and X-rays. Her sister, a RN, recommended a well-known sports medicine orthopedist from a larger city and let my patient know that podiatrists were not in fact “real doctors.” My patient told me she was going to have the famous orthopedist do her bunion surgery because he was a real doctor and operated on professional sport stars.

   I quietly thanked God as she stomped out of my office. I felt I had dodged a bullet.

   I got a call from this patient about two weeks later on a Sunday morning. She told me the famous doctor had done her surgery and she was in great pain and running a fever. She asked if I could see her. I suggested she call her orthopedist. She said, “Oh, I can’t bother him on a Sunday. He’s so busy.” I saw her that day.

   I removed her dressing to reveal a red, swollen foot with a foul smelling exudate at the surgical site. Her right first toe was signaling for a left turn. X-rays revealed a surgical disaster. The first toe was in varus. There was a poorly executed chevron osteotomy mid-shaft of the first metatarsal. The osteotomy was not fixated and was displaced. The distal portion of the osteotomy was floating with the metatarsal head elevated.

   I opened and drained the site, obtained a deep culture, and then attempted to call the orthopedist. His exchange told me he was unavailable and did not have the name of a covering physician.

   I started the patient on a broad-spectrum antibiotic and arranged to see her the next day. I also instructed her to call me if her temperature went above 101º or if the redness spread.

   I finally reached the famous orthopod the next day. I waited on hold for 20 minutes before he took my call. I explained the situation, which did not seem to concern him much. He agreed with my treatment plan for the infection. Then he commented, “Don’t you think you people should let patients know that you are not MDs and have not gone to medical school before you try to operate on them?”

   I said, “Yeah, maybe so but don’t you think you orthopods should let patients know that you aren’t actually podiatrists and haven’t gone to podiatry school before you attempt foot and ankle surgery?” There was a long silence. Then he told me to send the patient to one of our local orthopedists for follow-up.

   It was a pleasure to turn this lady over to an orthopedic friend and to present all the gory details that led to this disaster. He kindly agreed to co-manage the case with me. In the end, the infection cleared and she wore a custom shoe to accommodate the badly deformed foot.

   I was always happy to share my turf with any physician who performed quality foot and ankle surgery. When orthopedic surgeons and podiatrists work well together, patients benefit.

   Unfortunately, guys like Dr. Bart will always be a liability and probably dangerous to their patients. I doubt that he hurt podiatry much. He just made himself look stupid.

   Dr. McCord retired in December 2008 from practice at the Centralia Medical Center in Centralia, Wash.

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