Fantasy Land and Podiatry

There is a subset of podiatrists who live in the land of make-believe.  These pathetic soles write into PM News regularly to express their actual thoughts for all to read.  While there are many podiatrists doing total ankle replacements, Charcot joint reconstruction, caring for foot and ankle trauma, doing MIS bunionectomies, participating in orthopedic groups, there is a remaining middle to late aged pathetic group to whom PM News caters. They will be slowly but inevitably dying out and leaving podiatry. 
Barry Block however propagates the stupidity and fantasies of this subset.  And why not ?  Look at his advertisers.  Shoes, creams, lotions, orthotics, and lots and lots of seminars. Labs like BAKO and McClain begging for toenail clippings and useless nerve biopsies.  And did I mention lots and lots of seminars?
What are the leading fantasies and myths that read like a Hans Christian Anderson child’s tale in PM News?
1.The great orthotic scam.There are those who actually believe that they can and will legislate orthotics to be prescribed and dispensed ONLY by a podiatrist.  This will NEVER HAPPEN.  NEVER.  Chiropractors, pedorthists, the Good Feet stores, shoe stores, nurses, orthopedists, any MD or DO or NP or PA, anyone can and does prescribe  sell “orthotics”.  There will NEVER be a law restricting orthotics to podiatrists.  The APMA, your state society, none have ever demonstrated the ability to restrict the sales of arch supports or so called orthotics.  It will never happen.  Many of the “orthotic labs” do business with non-podiatrists, and many podiatrists consult with entities such as the Good Feet Store.  There is also the false science of podiatric orthotics.  Multiple theories, multiple differing principles, essentially bullshit.  FORGET THE DREAM OF ORTHOTIC EXCLUSIVITY.  It lives as a hope only in PM News world.
2.The toenail debate.Ahh the outrage.  Nurses cutting toenails instead of podiatrists.  We will put an end to that.  Every block in every city has a pedicure shop where southeast Asian or Chinese is the official language. They are are do cut toenails.  Nurses, your mother, grandmother, ANYONE may cut toenails.  The toenail podiatry industrial complex has existed like USAIR has existed – nobody has thus far really noticed.  They will.  And when they do somebody better have some data actually showing that a podiatrist cutting toenails reduces amputation risk.  Not a diabetic foot exam – cutting toenails.  Wait until Elon Musk and the boys see this drain on Medicare.  Adios “at risk foot care”.  The only at risk is the podiatry income on toenails.  FORGET THE DREAM OF TOENAIL EXCLUSIVITY.  It lives as a hope only in the PM News world.
3. There is a solution to the decline in podiatry school applications.It is a new world.  There are PA degrees, NP degrees, more MD and DO graduates.  They are now better educated in foot and ankle pathology including the diabetic foot.  The very restricted DPM degree is simply not a cost-effective end point for a career unless your ego requires a doctor title, and you cannot qualify for an alternative degree.  FORGET THE DREAM OF A VIABLE 11 PODIATRY SCHOOL ENTITY.  The APMA has been too busy supporting their own financial well being and have been more asleep at the wheel on this issue than Joe Biden at 11 PM. 
4. We are the wound care experts, the best there is.Medicare is slowly getting to the reality that podiatrists have ripped the wound care product business to a point of ridiculousness.  Expensive dressings, wound care products, failure to actually lower amputation rates summarize the role of the podiatrists in wound care.  There are podiatrists making millions of dollars a year pretending to be wound care experts, meaning they will become consultants swearing that any number of worthless products improve wound care.  They are “experts”.   Sorry Charlie, only the best tunas becomes Starfish tuna.  It is increasingly clear to third parties that podiatrists abuse the system, and increasing restraints are being placed on podiatrists and their use of so called advanced wound care products.  Increasingly, plastic surgeons and nurses are doing more and more wound care.  Vascular surgeons and interventionalists bring in the blood.  ID manages the infections.  Ortho and other surgeons can and do what a podiatrist does.
5. The reality.There are some well trained young podiatrists out there doing great work on real pathology.  But the middle aged and older podiatrist is like the old drop back quarterback who cannot run or pull off the run-pass option.  They are clinging to the rim of a flushing toilet bowl, and I suppose find some peace venting in PM News.   But their fantasies are just that …………. fantasies,