Podiatry and the Future of Wound Care
1. Podiatrists are referred diabetic patients by M.D.’s for toenail and skin care.  A percentage of these patients will develop ulcers, infections, even neuroarthropathy. The          podiatrist thus inherits a problem to be treated.  Easy peasy. 

2. Orthopedic surgeons generally do not want these patients.  Why deal with diabetic foot problems ?  You can make a fortune just doing straight away bone and joint              surgery.  You are busy.  The PA and NP keep you immune from perioperative care.  No time or need for these crappy patients.  No money either. Yes there are exceptions. 
3. Interventional cardiologists and vascular surgeons like the patient referrals from podiatrists.  They make lots of money on their interventions.  So you give up lost leader        money for ulcer debridements and forefoot amputations.  Ain’t worth the time or money.  Let the stupid podiatrist do it.  They take the big money and actually make limb      salvage practical.  Just treat the D.P.M. respectfully, invite them to your seminars, call them doctor, tell them they are the best.
4. There was a void filled by podiatrists.  Always hunting for a vacuum to fill, for many years, as wound care needs have evolved, podiatrists filled that needed void. Wound      care centers were filled with podiatrists.  And still are.  However, increasingly, the lack of cost effectiveness of podiatry mediated wound care is becoming clear.     And NP’s, PA’s, PT’s, M.D.’s, RN’s, and others are increasingly doing wound care.

5. The wound care industry realizes podiatrists can and will use their products absent credible evidence that they actually are of benefit.  So they wine and dine the D.PM.        In exchange, the podiatrists use their generally unproven and ineffective products.  They know it is easy to buy off a podiatrist ( and to be fair ) others to be “researchers”      and speakers and consultants.  And they know it is easy to get these speakers into CME programs.  Look at PRESENTS.  It is a who’s who of this nonsense.  You pay          them to attend “workshops” on how to use these products.  That is open package a place on poorly debrided wound.  So you pay to learn to use the product, they fill          the room, and the companies pay PRESENTS to fill the room with potential customers.  Add in a mix of pseudo authorities who swear everything works and there you          go.  They have long known that where there are wound care products, there’s money in them there is.  PM News, Podiatry Today live off of this money.  So too do the big      names in wound care.  Including M.D.’s and RNs.

6. Medicare and other third party carries are cracking down.  And well they should !  Podiatrists and M.D ‘s and RN’s use unneeded wound care products like interventional      cardiologists, radiologists, and vascular surgeons do unnecessary interventions.  And again, we are talking big money. (check out InnovaMatrix grafts and get rich quick).      There is a podiatrist in West Virginia billing up to $750,000 PER WEEK.  You read that correctly.  PER WEEK.  All in wound care.  There are “grafts” being used in offices        that cost $30,000, $40,000, $50,000 per application.  And you want to know why there is a crackdown coming ?

7. Diabetes is a growing market. The USA is getting older.  PAD is increasing.  Migrants are arriving with their problems.  The wound care market is enormous and growing.      It is not going away.  Podiatry might be a bottom feeder, but there are many large catfish at the depths of the rivers leading a long and fat and happy life.  So long that is,      as they are not caught.

8. No problems getting “certified” in wound care.  Lots of junk options available.  Almost all represent nothing.

9. No shortage of wound care experts in podiatry.  You all know the names, no need to name them.  Barry Block honors them.  Podiatry Today also.  Just run a few articles     and the advertising money rains down like a nor’easter.  Maintain the illusion and you maintain the cash flow

10. Wound care is necessary and critical to those afflicted and hopeful for a cure.  M.D.’s and wound care centers have cashed in, often with unnecessary and expensive            and unproven therapies.  Podiatrists are also cashing in, and in that regard are no more guilty than other medical care providers.  To some extent, podiatrists at least do        less damage than do their M.D. wound care colleagues.  Wound care training is now a part of podiatry school education and residency training.  It has been corrupted          at the post graduate and clinical practice level.  Given the money and profit involved, the corruption is not likely to change.

     God save the queen.