I have started a new blog which is a continuation of discussion from 2 previous blogs. One was titled "Does NY State discriminate against board certifed podiatrists?" and the second was titles "board certification who needs it?"

This blog will differ slightly in I will supply evidence in the form of prior court decisions that will demonstrate without a shadow of a doubt the current law is unconstituitonal. I will do this in stages so that I will give a chance for any discussion to take place along the way. I will also reach out to the various DPM/JD in our community and ask them to chime in on the rational basis and legal strength of the arguement that will be presented.

The questions will then be: 1) how did this happen? 2) why do we allow this to happen? 3) who is defending podiatry?

Resistance: Resistance to podiatry is often the etiology that sets up the basis for the discriminatory acts. The resistance will often come from the orthopedic community and lately, there has been shown resistance from the dermatologic community as well.

The resistance in New York is not against any particular podiatrist, it is against a class of podiatrists as a whole. In this particular case, I am going to focus on the Board Certified Podiatrist Certified by the ABPM. We have brought up Age Discrimination as a possible arguement as well and this will be discussed further on.

Although, I will focus on the ABPM podiatrist, once the arguement and cases are viewed, more podiatrists will actually be shown to be discriminated against and we can expound on that once the discussion evolves.

Identifying the reason for the resistance is important. we must determine if they resist us based on legitimate concerns about our knowledge/education/credentials or is the resistance based on economic competition.  

The answer to me is black and white and the ONLY reason is economic competition. This is really no more than a "Turf Battle".

For the most part, it has been the Orthopedic Community that have been the outspoken group against Podiatry.

When talking to some of my older colleagues, they informed me that Sheldon Silver was a big obstacle with advancing podiatric scope. Sheldon Silver, for those that don't now, was the Speaker of the New York State Assembly for many years.

His brother was an Orthopedist. The story goes that was the problem and pretty much inroads could not be made as Mr. Silver would stop any advancement in its track at the request of his brother. (This is pure heresay and conjecture, I am just repeating what I have been told, I have no proof but it does offer an explanation of why no advancements ever occured) 

In 2015, his reign ended when he was arrested on federal corruption charges. he was conviceted on all charges, expelled from the Assembly, disbarred and fined 7 million dollars and sentenced to 12 years in prison. He ruled as Speaker through 5 New York Governors.  

(This blog will continue on a regular basis, please tune in, chime in with your thoughts, comments etc etc.)

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(Please read the blog in date order - the format recently changed and puts last entry first.)
[for all those that agree the law is discrimatory please send an email to changepodlaw@gmail.com expressing you agree.]
  • Comments (105)
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  • I am sad to say, the APMA had no interest in helping. The response was actually rather rude. It read " APMA HP&P staff does not believe this is an antitrust issue. Our staff is not going to review every antitrust case that you believe may be applicable to your situation. If you have attorneys that believe this is an anti-trust case , I would suggest you pursue moving it forward with them. I will refer you to a response from Gail Reese in January of last year"

    What an incredulous response. I asked a different question last year and the CEO is referring me to an answer on a different question.
    I belong to the APMA for approximately 25 years. I asked what 3 questions in 25 years and they aren't going to look into answering a question.
    A question that is not "for me" but for all podiatrists in the state of NY.

    You have to shake your head and laugh. I suggest APMA take off their website the part about advocating for state advocacy.
  • Quote:

    The way to find this out is to write a letter to the state education dept podiatry board. The problem is they don't always respond, and usually never do in any timely manner. I have written to them about a dozen times over the last five years. Not once did I receive a response.


    Then it's important to keep a record of each and every attempt. If the responsible organisation fails to address issues that are in dire need of clarification then a doctor cannot be held accountable when, necessarily and by default, doctors formulate their own interpretations of ambiguous 'laws'. 

    Perhaps a useful way to attract the attention of the education board is to advise the board of your intention to perform XYZ and that it is your right to do so based on the interpretation of the 'rules' and that you will continue to do so unless you receive specific instructions to the contrary together with a detailed explanation of the reason underpinning this decision.  

  • The way to find this out is to write a letter to the state education dept podiatry board. The problem is they don't always respond, and usually never do in any timely manner. I have written to them about a dozen times over the last five years. Not once did I receive a response.
  • Quote:

    Agreed. I would like to be fair and so I am giving all an update. After, I contacted the President of APMA he informed me he was referring this to the APMA attorneys. I never heard back from him. I re-emailed him to ask if he heard from the attorneys and again, no response.

    So, I moved on to the Executive director and CEO. He responded this morning that the APMA attorneys had spoken to me regarding Age discrimination - which they did. I wanted to know about the Sherman Antitrust law etc.

    He said he would get their opinion on that. I then sent him a "white paper" on all the facts. The white paper is essentially the key points on this blog with all the previous court cases that I mentioned. I cut out the interaction amongst us for the sake of brevity.

    So, hopefully we will hear back on the APMA opinion. I understand they have 3 attorneys on the payroll so this will be interesting to hear their response.

    Updates will be given as they are received.

    Jeff,

    It will be helpful if those same lawyers can also direct their legal expertise to provide clarification, from NY state about the issues you mention concerning the new laws and anatomical delineations.

    My layman's interpretation would be to interpret the spirit and specific intention of the law. In other words - the NYS law is designed to limit surgical / invasive work, to protect the public from the possible risk of harm from an invasive procedure administered by a doctor without the appropriate training & experience. Unfortunately (and incorrectly, in my opinion) the State assumes that only the ABFAS verified surgeon can do so.

    In any event, my interpretation of such a legislated restriction does not limit the non-operative efforts of the doctor e.g. treating an ankle sprain. To suggest otherwise is simply an absurdity and insult to the ABPM certified doctor, and possibly other Board certified specialists, who for many and varied reasons, prefer to look elsewhere for board certification.

    The NYS restriction, in my opinion, applies specifically to the type of work undertaken and not the anatomical boundary.

    My question therefore is this: does the Law, as it stands, specifically prohibit the NYS doctor, from participating in the non-operative treatment of a condition, such as an ankle sprain. 

  • Agreed. I would like to be fair and so I am giving all an update. After, I contacted the President of APMA he informed me he was referring this to the APMA attorneys. I never heard back from him. I re-emailed him to ask if he heard from the attorneys and again, no response.

    So, I moved on to the Executive director and CEO. He responded this morning that the APMA attorneys had spoken to me regarding Age discrimination - which they did. I wanted to know about the Sherman Antitrust law etc.

    He said he would get their opinion on that. I then sent him a "white paper" on all the facts. The white paper is essentially the key points on this blog with all the previous court cases that I mentioned. I cut out the interaction amongst us for the sake of brevity.

    So, hopefully we will hear back on the APMA opinion. I understand they have 3 attorneys on the payroll so this will be interesting to hear their response.

    Updates will be given as they are received.

  • Quote:

    I agree with you Dieter, but I also think it is difficult under the current law to get the privledge to advance.

    I suspect that to be the case. Which brings me back full circle to the fact this would need to be challenged in the court. And that requires $$$

  • I agree with you Dieter, but I also think it is difficult under the current law to get the privledge to advance.
  • Quote:

    I received an email last night from the chair of the LAC of NYSPMA. He informed me the law was not discriminatory because "the majority of ACFAS boarded podiatrists are equal to ABPM podiatrists , in that they too can't practice above the ankle without completing a three year RRA program". I opine he is wrong. All that means is the law is discriminatory against both groups.

    So the majority of ACFAS Podiatrists are equally discriminated against ... strengthens the case. Also, in time both ABPM and ACFAS will be discriminated against further as the number of 3YR RRA trained people enter the work market. I'm 3 year trained but don't agree with discriminatory laws no matter how they want to sugar coat and gloss over the issue.

  • I don't know if anyone else has looked at the provisions or language of the law closely. For that reason, I will mention the new law gives a broader definition of the ankle. Included in the ankle is now the "talus". In the old version of the law the talus was still considered part of the foot. The reason why this is problematic is there are many in New York who perform triples or isolated T-N fusions, or scope the ankle to repair cartiledge defects on the talar dome, or operate on talar beaking. or removal of steide's process. According to the law, you would now be precluded from doing these things.

    I am mystified why that doesn't seem to bother anyone.

    Incidently, because the law defines the ankle as including the talus and attached ligaments, ankle sprains can no longer be treated as well according to the definition of the law.

     

     

     

     

     

  • I received an email last night from the chair of the LAC of NYSPMA. He informed me the law was not discriminatory because "the majority of ACFAS boarded podiatrists are equal to ABPM podiatrists , in that they too can't practice above the ankle without completing a three year RRA program".

    I opine he is wrong. All that means is the law is discriminatory against both groups.

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