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Podiatry Bill Raises Issue of Who Is Physician at VA

by U.S. Medicine

June 13, 2017

By Sandra Basu

At Stand Down South Jersey, an annual event at the Cherry Hill Armory of the New Jersey National Guard, Karen Galli, DPM, examined the feet of Marine Corp. veteran Don Morton. Photo from the American Board of Podiatric Medicine website.

WASHINGTON — Who should be considered a physician at the VA?

That question was discussed by lawmakers and advocacy groups in response to introduction of a recent bill that would revise current VA law to include podiatrists in the physician and dentist pay category.

The bill, introduced by House Committee on Veterans’ Affairs Health Subcommittee Chairman Rep. Brad Wenstrup, DPM, (R-OH), a podiatrist, would include those healthcare providers within the VA definition of physician and would increase their pay grade to match the compensation of other VA physicians.

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Wenstrup said this is “not about expanding the realm of credentialing that a podiatrist has or has had.”

“It’s about access, access that is stymied by a classification, a limited career path for podiatrists and opposition that has come against the notion of moving podiatrists to the category of physicians and surgeons,” he noted.

Podiatric groups sought the change in prior years, but a legislative fix has not made it out of Congress.

During the hearing, advocates of the change pushed for moving podiatric surgeons and physicians into the physician pay category. Seth Rubenstein, DPM, a trustee for the American Podiatric Medical Association, told lawmakers “that simply changing the law to recognize podiatry, both for the advancements we have made to our profession and for the contributions we make in the delivery of lower extremity care for the veteran population, will resolve recruitment and retention problems for VA and for veterans.”

VA also is among the backers of the legislation.

“Our compensation system has fallen behind the times as the current pay authority is over 41 years old … As a result, it has been increasingly difficult in the past several years to recruit and to retain experienced providers,” VHA Chief of Podiatry Jeffrey Robbins, DPM, told lawmakers.

Robbins said that, in FY 2015 and FY 2016, VHA brought in 142 new hires for a net gain of 54 podiatrists.

“What this means is that 88 providers left the system or almost 62% of medical centers had to replace providers disrupting patient continuity,” he pointed out.

Robbins said that a pattern emerging in podiatry in VA over the past several years is of young providers coming into the system “gaining experience as well as cases for board certification, becoming board certified and then leaving for the private sector, where the average compensation is $30,000 higher than the highest compensation in VA.”

A VA white paper on podiatry pay explained that “the VA podiatrist compensation package has remained unchanged since 1976, except for those changes that include adjustments for basic pay and locality rates.”

“Meanwhile, clinical responsibilities of VA podiatrists have greatly expanded and podiatrists in the Veterans Health Administration (VHA) have assumed equivalent professional and administrative duties to other physician groups,” the paper explained.

Furthermore, the paper explained that there “is a growing healthcare demand for primary and specialty podiatric services, especially among veterans suffering from polytraumatic injuries, spinal cord injury, and limb amputation. This is in addition to the approximately 1.8 million veterans (up 21% from 2015) who are receiving VHA care and are at risk for major foot wounds, infection and amputations.”

Physician Classification

Objections to provisions in the bill were voiced by retired Col. James Ficke, MD, on behalf of the American Orthopaedic Foot & Ankle Society and the American Association of Orthopaedic Surgeons.

He acknowledged that the current statistics are “staggering” regarding the burden of injury and disability and agreed that musculoskeletal care for veterans is “imperative.”

Ficke suggested that the organizations agree that podiatric surgeons should be more equitably paid to support their recruitment and retention in VA. He emphasized, however, that the organizations he represents do not support the use of the term “physician” for podiatrists.

 

“While recent changes have improved podiatric education, it is not the same as a multisystem medical education required to become a DO or MD, nor is it the same accreditation process,” he explained. “Podiatry does not participate in the U.S. medical licensing examination, which is the standard for all advanced medical care and is essential for practice as a physician.”

“We believe the title of physician should be obtained through the accreditation process and not the legislative process,” he added.

Ficke said the definition by various dictionaries and several other organizations for “physician” is that they have passed the U.S. medical licensing examination.

He also maintained that the “public and our veterans need to understand there are differences in training” [between MDs and DPMs].

Rep. Ralph Abraham, MD, (R-LA), however, said that he thought it was “tragic that we are arguing over semantics.” He said that patients and veterans know there are differences but do not make a distinction.

“These are all physicians in their mind and certainly in the mind of myself. They want to be healed. The definition of a physician is a healer,” Abraham stated.

Wenstrup said he hoped the groups can “get beyond this.”

“Some of the definitions I looked at [for physician] gave the example of MD, but it didn’t limit it to that. So for us to be hung up on this word at the expense of the veteran having a large pool of physicians able to take care of them, I think it is a shame,” he said.


40 Comments

  • Daniel R Cruz, DPM says:

    As a podiatrist and short lived employee of the VA I can attest to the pay discrepancy a podiatrist feels when entering the VA system. I moved to the VA to continue to serve our veterans after I was a contract employee at Carl R Darnall Army hospital for three and a half years. I deeply enjoyed working with the soldiers and family members of our nation. I thought it would be a great fit to work with veterans as well and it was! When I took a GS position I knew I was not going to make what an orthopedic surgeon would even though I did foot and ankle surgery just like one. Once I began working it became more discouraging to see that the time spent in the system was not going to translate to much advancement or better pay while other job opportunities outside were clearly more lucrative and close to my home. Though there are many great benefits that come with a federal job, the pay disparity for someone who has spent 11 years in school and residency training and has debt related to their education is too great! A podiatric physician cannot pay loans , raise a family, and save for retirement at the same pay of a skilled nurse in this system. If a dentist with 8 years of training can qualify to earn a doctors pay I surely hope a podiatrist with the same or more years in training would as well. This would absolutely help retention issues and improve care for our veterans!

    Sincerely,
    Daniel Cruz, DPM

  • RUTHANN TADDIE says:

    You must look deeper into the medical services these dedicated (and highly educated) committed people provide to our Vets. Just think of the medical issues that will remain untreated if we loose our Podiatrists!! !What are the opponents thinking. We need MORE of these speciality educated doctors with the growing baby boomer population coming of age…….not fewer.

    This issue needs to be addressed NOW. 41 years of getting something for nothing is going to backfire soon.

  • David Jerry Haile DPM says:

    Podiatrist are physician’s. This is axiomatic with our training and licensure. This is really a question about the VA catching up with the rest of America.
    Thank you Dr. Robbins for your work as a doctor and physician in service to the US.
    Thank you Dr. Wenstrup for you special service as a US Represenative.

  • R. Cameron says:

    Why are we focusing on podiatrists? The problem that is described is rampant in the VA and that is the VA system pay is light years behind the times, even for physicians, nurses, etc. If recruitment is a fix, why not just raise the salaries of podiatrists (and in the process, raise them for physicians and nurses also!)
    This will fix much of the problem and finally provide some stable workforce for the VA because all professionals won’t end up leaving for greener pastures.

  • Daniel R Cruz, DPM says:

    As a podiatrist and short lived employee of the VA I can attest to the pay discrepancy a podiatrist feels when entering the VA system. I moved to the VA to continue to serve our veterans after I was a contract employee at Carl R Darnall Army hospital for three and a half years. I deeply enjoyed working with the soldiers and family members of our nation. I thought it would be a great fit to work with veterans as well and it was! When I took a GS position I knew I was not going to make what an orthopedic surgeon would even though I did foot and ankle surgery just like one. Once I began working it became more discouraging to see that the time spent in the system was not going to translate to much advancement or better pay while other job opportunities outside were clearly more lucrative and close to my home. Though there are many great benefits that come with a federal job, the pay disparity for someone who has spent 11 years in school and residency training and has debt related to their education is too great! A podiatric physician cannot pay loans , raise a family, and save for retirement at the same pay of a skilled nurse in this system. If a dentist with 8 years of training can qualify to earn a doctors pay I surely hope a podiatrist with the same or more years in training would as well. This would absolutely help retention issues and improve care for our veterans!

    Sincerely,
    Daniel Cruz, DPM

  • RUTHANN TADDIE says:

    You must look deeper into the medical services these dedicated (and highly educated) committed people provide to our Vets. Just think of the medical issues that will remain untreated if we loose our Podiatrists!! !What are the opponents thinking. We need MORE of these speciality educated doctors with the growing baby boomer population coming of age…….not fewer.

    This issue needs to be addressed NOW. 41 years of getting something for nothing is going to backfire soon.

  • David Jerry Haile DPM says:

    Podiatrist are physician’s. This is axiomatic with our training and licensure. This is really a question about the VA catching up with the rest of America.
    Thank you Dr. Robbins for your work as a doctor and physician in service to the US.
    Thank you Dr. Wenstrup for you special service as a US Represenative.

  • R. Cameron says:

    Why are we focusing on podiatrists? The problem that is described is rampant in the VA and that is the VA system pay is light years behind the times, even for physicians, nurses, etc. If recruitment is a fix, why not just raise the salaries of podiatrists (and in the process, raise them for physicians and nurses also!)
    This will fix much of the problem and finally provide some stable workforce for the VA because all professionals won’t end up leaving for greener pastures.

  • Michael Rynn,DPM says:

    I am a podiatrist ,with 35 years of private practice and now VA experience. While podiatry is a single tract professional degree, our graduates are now required to have 3 years of post-grad hospital based training that encompasses rotations in medicine and surgery. When I perform my duties at the VA, my referring physicians don t care what my degree is,but what relief I can provide a veteran for foot, ankle and lower leg pathologies. I am treated as an equal. The VA must attract and retain the best practitioners ,regardless of degree to provide our veterans the best care. I am not sure how detractors of this initiative can distinguish podiatry from dentistry in their arguments against this initiative. A general practice dentist will have one year of post grad training but is welcomed as a full member of the staff. As I write this, I am listening to news reports about an attack on Republican members of congress. Do you know that the “physician” on site was a podiatrist, the Hon. Brad Wenstrup, who ran a medical unit during his overseas combat deployment

  • Martin Girling says:

    Amazing one would vote no but be ok with dentist paid on physician scale. Podiatrist doing reconstructive surgery paid like Chiopractors and optometrist who do no surgery write no Rx and have little to no stress. I’m amazed at the ignorance.

  • Michael Rynn,DPM says:

    I am a podiatrist ,with 35 years of private practice and now VA experience. While podiatry is a single tract professional degree, our graduates are now required to have 3 years of post-grad hospital based training that encompasses rotations in medicine and surgery. When I perform my duties at the VA, my referring physicians don t care what my degree is,but what relief I can provide a veteran for foot, ankle and lower leg pathologies. I am treated as an equal. The VA must attract and retain the best practitioners ,regardless of degree to provide our veterans the best care. I am not sure how detractors of this initiative can distinguish podiatry from dentistry in their arguments against this initiative. A general practice dentist will have one year of post grad training but is welcomed as a full member of the staff. As I write this, I am listening to news reports about an attack on Republican members of congress. Do you know that the “physician” on site was a podiatrist, the Hon. Brad Wenstrup, who ran a medical unit during his overseas combat deployment

  • Leonard A. Levy, DPM, MPH says:

    The DPM completes 4 years of undergraduate college, 4 years of professional school, and at least 3 years of hospital based graduate medical education (residency). Like the MD or DO, to achieve licensure they also must pass three National Board examinations; one at the end of 2 years, another at the end of four years, and a third at the end of the 1st year of residency. They are permitted/and qualified to admit patients to hospitals, perform preoperative physical examinations, prescribe and administer any drug needed for podiatric care (topical, oral, injectable)including narcotics and perform soft tissue and bone surgery. Their practice scope is quite analogous to that of an ophthalmologist or otorlaryngologist. By definition and function, the DPM is a physician.

  • Martin Girling says:

    Amazing one would vote no but be ok with dentist paid on physician scale. Podiatrist doing reconstructive surgery paid like Chiopractors and optometrist who do no surgery write no Rx and have little to no stress. I’m amazed at the ignorance.

  • Dr. Timothy Byron says:

    I have serve the U.S. Armed forces in Podiatric Medicine & surgery operating rooms , since 1971 as a young Capt. I retired in 1996 as a LTC. I stared the Long Beach VA in Calif. in 1984. I am Now about to RETIRE from This august body in APR of 2018. I have served for 45 yrs. in Federal Services, without the recognition or pay grade I deserve for the daily tasks I perform. Since 1976, there has been no changes to our status as Doctors of Podiatric Medicine (D.P.M.). It is Now Time to accomplish. The Bill, HR1058, is authored by another distinguished Military Surgeon COL. WENSTRUP, a combat Vet. We have done the job, now it is time to be recognized for the tireless efforts we have provided, all these yrs.
    PLEASE ,Vote “YES”. To the House & Senate, Vote this bill thru for the Presidents signature.
    Thank You, Tim Byron, DPM, MS ( Ed) ,Ret. USAR, LTC, Diplomate , American Board of Foot & Ankle Surgery.

  • Steven Zeitzew says:

    Why do we need to call podiatrists physicians to pay them more? Why not just pass a bill allowing the VA to pay podiatrists appropriately? There is no need to pretend their duties, responsibilities, or training is equal to a physician’s, or to lie about their credentials in order to address this issue fairly. The VA would be better off telling the truth.

  • Evan F. Meltzer, DPM< FACFAS says:

    I am commenting on this proposed bill to personalize this issue so that readers may view this vital legislation through the eyes of one senior VA podiatrist and Army veteran. The following comments are my own and do not reflect any official opinion of my employer, the Department of Veterans Affairs.
    When the House was debating their initial version of this bill last year, the need for its passage was tied to retention and recruitment considerations, and hence, to veteran waiting times to see a VA podiatrist. It was pointed out during their deliberations that 20% of VA podiatrists like me are of retirement age. If the VA Provider Equity Act passes, we of retirement age will be highly motivated to continue working at least another three years to maximize our pensions at retirement. This would contribute greatly to the continuity of experienced podiatric care within the VA. It was also mentioned that 43% of new podiatrists hired by the VA leave after five years primarily due to the current inability of the VA to compete with salaries in the private sector. The VA Human Resource Management Service was sharply criticized by several physician members of the House Veterans Affairs Committee for their long delay in new DPM hires, thus leaving veterans waiting times for podiatric care unacceptably long.
    When I decided to become a podiatrist the thought of saving lives with my professional skills was not part of my decision process. As I continued on my professional journey, however, I found that I was doing exactly that at the three VA Medical Centers I have worked at. Diabetes is rampant among the veteran population, especially among the Agent Orange-exposed Vietnam veterans. Myself and my three colleagues devote 40% of our practice to treating the lower extremity complications of diabetes at our VA hospital. There are several valid scientific publications that show that amputation prevention has a lifesaving effect.
    The five-year survival rate after a major limb amputation is only 50%. This condition is deadlier than either breast or prostate cancer.
    No profession is more skilled or knowledgeable at treating diabetic foot ulcers than podiatry. Healing these ulcers prevent major amputations. A veteran’s limb saved is a veteran’s life saved.
    Finally, if the VA Provider Equity Act is not passed during this legislative session, as many as 20% of us will retire. It currently takes an average of a year to bring a civilian podiatrist on board at the VA.
    How many veterans will die due to lack of access to VA podiatric care if this is allowed to happen?

  • Rob Schopf says:

    I am a podiatrist almost 2 years out from completing my residency training. My best rotations as a student and resident were in the VA medical system. I would have loved the opportunity to continue serving veterans after residency training but the large pay disparity dissuaded me from even considering this option. This is sad because I am a veteran of both the Iraq and Afghanistan wars. We preach that we want the best for our veterans but are not willing to compensate the people responsible for their care. Please do the right thing for our veterans!

    De oppresso liber

  • George Tsoutsouris, DPM says:

    As graduates of a four-year medical school who make life-and-death medical decisions on a daily basis and who perform complex surgical procedures, it is an anachronism not to define podiatrists as physicians in the Veterans Administration or in any other context.

  • Val says:

    Podiatrist spend as much time in preparation educationally and clinically as their DO and MD counterparts. Podiatrist take a licensing exam that is just as rigorous as any medical exam and obtain board certifications as well, many for podiatric medicine and surgery. I really see this as a specialized medical care. As I have ben schooled by many podiatrist, “the condition of the feet tells a complete story of a patient’s complete medical condition.” By definition, a physician is “a person skilled in the art of healing; specifically,” https://www.merriamwebster.com/dictionary/physician By definition, podiatrist are physicians specifically working with healing of feet.

  • Dr. Timothy Byron says:

    I have serve the U.S. Armed forces in Podiatric Medicine & surgery operating rooms , since 1971 as a young Capt. I retired in 1996 as a LTC. I stared the Long Beach VA in Calif. in 1984. I am Now about to RETIRE from This august body in APR of 2018. I have served for 45 yrs. in Federal Services, without the recognition or pay grade I deserve for the daily tasks I perform. Since 1976, there has been no changes to our status as Doctors of Podiatric Medicine (D.P.M.). It is Now Time to accomplish. The Bill, HR1058, is authored by another distinguished Military Surgeon COL. WENSTRUP, a combat Vet. We have done the job, now it is time to be recognized for the tireless efforts we have provided, all these yrs.
    PLEASE ,Vote “YES”. To the House & Senate, Vote this bill thru for the Presidents signature.
    Thank You, Tim Byron, DPM, MS ( Ed) ,Ret. USAR, LTC, Diplomate , American Board of Foot & Ankle Surgery.

  • Steven Zeitzew says:

    Why do we need to call podiatrists physicians to pay them more? Why not just pass a bill allowing the VA to pay podiatrists appropriately? There is no need to pretend their duties, responsibilities, or training is equal to a physician’s, or to lie about their credentials in order to address this issue fairly. The VA would be better off telling the truth.

  • Rob Schopf says:

    I am a podiatrist almost 2 years out from completing my residency training. My best rotations as a student and resident were in the VA medical system. I would have loved the opportunity to continue serving veterans after residency training but the large pay disparity dissuaded me from even considering this option. This is sad because I am a veteran of both the Iraq and Afghanistan wars. We preach that we want the best for our veterans but are not willing to compensate the people responsible for their care. Please do the right thing for our veterans!

    De oppresso liber

  • George Tsoutsouris, DPM says:

    As graduates of a four-year medical school who make life-and-death medical decisions on a daily basis and who perform complex surgical procedures, it is an anachronism not to define podiatrists as physicians in the Veterans Administration or in any other context.

  • Karen says:

    I spent years in school, and residency, at great cost, and educational time. If they get the same pay… I may leave the VA, because that tells me the VA does not value my work skills, education and training. Their education and training time, their cost for school and training, and work is not even near equivalent to that of an MD or DO!

  • Larry S Winsberg,DPM says:

    Dr Fick alleges that Podiatrists trained as Foot and Ankle Surgeons doesn’t meet the standard of training in Orthopedics.The majority of the required three year residency programs are in accredited allopathic hospitals.The Podiatry training must meet the same standards as Orthopedics when applied to foot and ankle surgery.There are four groups of practitioners that can prescribe and operate at the V.A.It is interesting that only Orthopedics challenges our education and training pursuant to the definition of physician.

  • Anthony Grasso says:

    I truly feel that the work of a V.A. Podiatrist is a lot harder and requires more skills then the work of a private Podiatrist. This is due to the sheer volume, complexity and diversity of their work. The fact that they are not considered ‘Physicians’. and paid as such, is just ludicrous to me.

    Sincerely
    Anthony J. Grasso

  • Michael John Thomas Knitter, M says:

    Quote: from Paul with today’s [Holy Spirit]
    “For in fact the body is not one member but many.
    If the foot should say, “Because I am not a hand [surgeon], I am not of the body,” is it therefore not of the body?”

    The foot is the body and the base foundation of the Human to stand upright.

    The occupation and title of “physician” /”The profession of medicine comes from God, who makes the earth yield healing herbs and gives the physician knowledge of their power.” “Sirach” (Jesus grandson of Sirach) (Years prior to Jesus of Nazareth) Sirach also wrote “Then give the physician his place, for the Lord created him/[her]do not let him/[her] leave you, for you need him/[her].”

    Then Definition by Merriam-Webster’s Dictionary:
    Physician is a doctor of medicine.
    Podiatry is the medical care and treatment of the human foot.

    I also Honor and read State Law and where the “doctor” obtains his/her medical license. All “doctors” are not physicians. All physicians are doctors. The term Physician has greater authority and responsibility than the man made very frequent current term of doctor. Have the VA follow the Administrative Procedure Act Law and go through the steps if it too wants to ignore State Law here too. Get the consensus of the 50 States that make up this One Nation Under God.

  • Michael John Thomas Knitter, MD says:

    Quote: from Paul with today’s [Holy Spirit]
    “For in fact the body is not one member but many.
    If the foot should say, “Because I am not a hand [surgeon], I am not of the body,” is it therefore not of the body?”

    The foot is the body and the base foundation of the Human to stand upright.

    The occupation and title of “physician” /”The profession of medicine comes from God, who makes the earth yield healing herbs and gives the physician knowledge of their power.” “Sirach” (Jesus grandson of Sirach) (Years prior to Jesus of Nazareth) Sirach also wrote “Then give the physician his place, for the Lord created him/[her]do not let him/[her] leave you, for you need him/[her].”

    Then Definition by Merriam-Webster’s Dictionary:
    Physician is a doctor of medicine.
    Podiatry is the medical care and treatment of the human foot.

    I also Honor and read State Law and where the “doctor” obtains his/her medical license. All “doctors” are not physicians. All physicians are doctors. The term Physician has greater authority and responsibility than the man made very frequent current term of doctor. Have the VA follow the Administrative Procedure Act Law and go through the steps if it too wants to ignore State Law here too. Get the consensus of the 50 States that make up this One Nation Under God.

  • Michael John Thomas Knitter, M says:

    The eventual definition and title/occupation of PHYSICIAN needs to stay in State Licensing Boards.
    Federal Law for who as “physician” Rx medical device, drug , therapy mode may mandate Federal Law (FDA CFR) package label ; yet WHO is considered Physician is indeed a STATE matter to protect the public from many practical deceivers given the name of “practitioners”. Many practitioners also have PhD title “doctor”. The PhD may be in metaphysics. I also believe in faith healing, yet I also have classical MD training and testing to verify my true credentials. What is important is that the STATE define physician activity and what is not and what is against STATE Law to protect the public. I believe Podiatry fully trained and verified will pass the test of most if not all 50 STATES. Pursue this.
    My belief dose not give me a vote in the Federal VA system, it is up to the STATE citizenship to vote and the Governor of each STATE/COMMONWEALTH to determine definition of PHYSICIAN given license from such STATE. Who is physician and who is governor again is made/allowed by God and not just man. AMEN.

  • Michael John Thomas Knitter, MD says:

    The eventual definition and title/occupation of PHYSICIAN needs to stay in State Licensing Boards.
    Federal Law for who as “physician” Rx medical device, drug , therapy mode may mandate Federal Law (FDA CFR) package label ; yet WHO is considered Physician is indeed a STATE matter to protect the public from many practical deceivers given the name of “practitioners”. Many practitioners also have PhD title “doctor”. The PhD may be in metaphysics. I also believe in faith healing, yet I also have classical MD training and testing to verify my true credentials. What is important is that the STATE define physician activity and what is not and what is against STATE Law to protect the public. I believe Podiatry fully trained and verified will pass the test of most if not all 50 STATES. Pursue this.
    My belief dose not give me a vote in the Federal VA system, it is up to the STATE citizenship to vote and the Governor of each STATE/COMMONWEALTH to determine definition of PHYSICIAN given license from such STATE. Who is physician and who is governor again is made/allowed by God and not just man. AMEN.

  • Tim says:

    I read your comments with great interest. I would agree with you completely. I too spent 4 year in under graduate school 2 years in graduate school, 4 years in medical school. Three years in residency and two years in fellowship. I am almost 325k in debt for my education. I think individuals with our education should be paid more than those who have invested less… but since I am a Podiatrist, the VA and you currently disagree.

  • Tim says:

    I read your comments with great interest. I would agree with you completely. I too spent 4 year in under graduate school 2 years in graduate school, 4 years in medical school. Three years in residency and two years in fellowship. I am almost 325k in debt for my education. I think individuals with our education should be paid more than those who have invested less… but since I am a Podiatrist, the VA and you currently disagree.

  • Rita Lee says:

    Federal law prohibits non-physicians from practicing medicine without the appropriate medical license. Physicians are licensed under the Medical Board of California in California.
    Podiatrists are licensed under a different Board.
    If the salary is the main concern for the podiatrists, we do not need to change their licensure or title. VA needs to upgrade the salary scales for the podiatrists. In fact, they need to upgrade them for all the professions, including nurses, physicians, dentists, N.P., P.A., R.T. etc.

  • Rita Lee says:

    Federal law prohibits non-physicians from practicing medicine without the appropriate medical license. Physicians are licensed under the Medical Board of California in California.
    Podiatrists are licensed under a different Board.
    If the salary is the main concern for the podiatrists, we do not need to change their licensure or title. VA needs to upgrade the salary scales for the podiatrists. In fact, they need to upgrade them for all the professions, including nurses, physicians, dentists, N.P., P.A., R.T. etc.

  • Leonard A. Levy, DPM, MPH says:

    The DPM completes 4 years of undergraduate college, 4 years of professional school, and at least 3 years of hospital based graduate medical education (residency). Like the MD or DO, to achieve licensure they also must pass three National Board examinations; one at the end of 2 years, another at the end of four years, and a third at the end of the 1st year of residency. They are permitted/and qualified to admit patients to hospitals, perform preoperative physical examinations, prescribe and administer any drug needed for podiatric care (topical, oral, injectable)including narcotics and perform soft tissue and bone surgery. Their practice scope is quite analogous to that of an ophthalmologist or otorlaryngologist. By definition and function, the DPM is a physician.

  • Val says:

    Podiatrist spend as much time in preparation educationally and clinically as their DO and MD counterparts. Podiatrist take a licensing exam that is just as rigorous as any medical exam and obtain board certifications as well, many for podiatric medicine and surgery. I really see this as a specialized medical care. As I have ben schooled by many podiatrist, “the condition of the feet tells a complete story of a patient’s complete medical condition.” By definition, a physician is “a person skilled in the art of healing; specifically,” https://www.merriamwebster.com/dictionary/physician By definition, podiatrist are physicians specifically working with healing of feet.

  • Evan F. Meltzer, DPM< FACF says:

    I am commenting on this proposed bill to personalize this issue so that readers may view this vital legislation through the eyes of one senior VA podiatrist and Army veteran. The following comments are my own and do not reflect any official opinion of my employer, the Department of Veterans Affairs.
    When the House was debating their initial version of this bill last year, the need for its passage was tied to retention and recruitment considerations, and hence, to veteran waiting times to see a VA podiatrist. It was pointed out during their deliberations that 20% of VA podiatrists like me are of retirement age. If the VA Provider Equity Act passes, we of retirement age will be highly motivated to continue working at least another three years to maximize our pensions at retirement. This would contribute greatly to the continuity of experienced podiatric care within the VA. It was also mentioned that 43% of new podiatrists hired by the VA leave after five years primarily due to the current inability of the VA to compete with salaries in the private sector. The VA Human Resource Management Service was sharply criticized by several physician members of the House Veterans Affairs Committee for their long delay in new DPM hires, thus leaving veterans waiting times for podiatric care unacceptably long.
    When I decided to become a podiatrist the thought of saving lives with my professional skills was not part of my decision process. As I continued on my professional journey, however, I found that I was doing exactly that at the three VA Medical Centers I have worked at. Diabetes is rampant among the veteran population, especially among the Agent Orange-exposed Vietnam veterans. Myself and my three colleagues devote 40% of our practice to treating the lower extremity complications of diabetes at our VA hospital. There are several valid scientific publications that show that amputation prevention has a lifesaving effect.
    The five-year survival rate after a major limb amputation is only 50%. This condition is deadlier than either breast or prostate cancer.
    No profession is more skilled or knowledgeable at treating diabetic foot ulcers than podiatry. Healing these ulcers prevent major amputations. A veteran’s limb saved is a veteran’s life saved.
    Finally, if the VA Provider Equity Act is not passed during this legislative session, as many as 20% of us will retire. It currently takes an average of a year to bring a civilian podiatrist on board at the VA.
    How many veterans will die due to lack of access to VA podiatric care if this is allowed to happen?

  • Karen says:

    I spent years in school, and residency, at great cost, and educational time. If they get the same pay… I may leave the VA, because that tells me the VA does not value my work skills, education and training. Their education and training time, their cost for school and training, and work is not even near equivalent to that of an MD or DO!

  • Larry S Winsberg,DPM says:

    Dr Fick alleges that Podiatrists trained as Foot and Ankle Surgeons doesn’t meet the standard of training in Orthopedics.The majority of the required three year residency programs are in accredited allopathic hospitals.The Podiatry training must meet the same standards as Orthopedics when applied to foot and ankle surgery.There are four groups of practitioners that can prescribe and operate at the V.A.It is interesting that only Orthopedics challenges our education and training pursuant to the definition of physician.

  • Anthony Grasso says:

    I truly feel that the work of a V.A. Podiatrist is a lot harder and requires more skills then the work of a private Podiatrist. This is due to the sheer volume, complexity and diversity of their work. The fact that they are not considered ‘Physicians’. and paid as such, is just ludicrous to me.

    Sincerely
    Anthony J. Grasso


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