My Top Ten Podiatric Pet Peeves

10. Podiatrists instructing patients to cut their toenails straight across. Where did this originate? Where is the evidence-based medicine for this approach? If everyone’s nails are shaped differently, why would everyone cut them the same? I have always told patients to follow the shape of the nail when trimming.

9. The heads of screws not using a universal screwdriver. This is especially annoying when you are trying to remove hardware and the right screwdriver is not available. Although it helps to get the prior operative report, sometimes that is not possible. Not having the correct screwdriver transforms a simple case into a nightmare. If the Food and Drug Administration wants to do something useful, it should mandate that all orthopedic companies use the same screwdriver.

8. Midtarsal fusions. I love the Lapidus procedure and I am not including it in this pet peeve. I am talking about the second and third metatarsal-cuneiform joint arthrodesis. Any articles on this procedure discuss fixation of the fusion, healing rates, complications, etc. The articles never provide detailed descriptions for the dissection or joint debridement portions of the procedure. Why? I think it is because this procedure is such a hassle to do.

7. Patients who argue about a podiatrist’s treatment recommendations. I know it is not a paternalistic relationship between doctors and patients. I treat my patients the same as I would treat any of my family. It is alright if they do not want to heed my recommendations but patients do not need to be rude, confrontational and argumentative.

6. Podiatrists who complain about the American Podiatric Medical Association (APMA) or state Political Action Committees (PACs) but do not contribute to these associations. Am I missing something here? How can someone expect these organizations to help if they do not contribute anything? Should contributing podiatrists pay for non-contributors? If podiatrists want their profession to be strong and vibrant, they need to provide it with the money to protect their professional interest in state and national legislation.

5. Those who do not participate in their state associations or the APMA. How can someone not give back to the profession that has done so much for them? The podiatric profession has probably helped in providing food, clothes and shelter for their family. Is it too much to ask that one be on a state committee and give something back?

4. Negativity at any conference. I often stay at a different hotel from where a conference is located since I cannot handle all the negative talk about the podiatric profession. I know things are more challenging and laborious than ever but if someone is that unhappy in podiatry, he or she should go work at Sears selling appliances.

3. Plaintiff malpractice professional experts. I was going to use a much more derogatory word than professional experts but I refrained. These “colleagues” are the slime at the bottom of the barrel. If we find them to be fraudulent in their testimony, our professional associations should censor them. My feeling is: do not let the door hit you on your way out of the podiatric profession.

2. Not understanding the difference between a bad outcome and an outcome that is below the standard of care. I do understand why patients do not see the difference. They have a personal involvement in their own case. However, we should hold lawyers who take bogus cases and physicians who instigate an unwarranted malpractice case as equally accountable as those who do commit malpractice.

And my number one podiatric pet peeve is …

1. Discrimination based on the letters behind my name. This goes for insurance companies, government agencies, lawyers and other physicians who discriminate against podiatrists based solely on the letters behind their name. In all other walks of life, people do not tolerate discrimination nor should they. However, more people accept discrimination in medicine. This is something that makes my head want to explode and angers me more than I can express without vulgarity. We will fight for equality and we will not quit until we have it.

Happy holidays to you and your loved ones. Here is wishing you peace and prosperity in the new year. Stay diligent.