How Collegiality And Professionalism Will Advance The Profession

While podiatrists are perceived as being technically adept at performing foot surgery, some have suggested the podiatrist is nonetheless a technician but not a true physician.

For many years, I worked with a wonderful Falstaffian attorney on the East Coast. He was an excellent defense attorney, whom I had worked with on several occasions. He was dedicated to our profession and had been an integral part of education at many state meetings.

We were sitting in the hall at a state meeting. He turned to me and said, “Would you like to know the difference between medicine and podiatry? The difference,” he said, “is that the podiatrist and podiatry societies lack collegiality and professionalism.”

I am reminded of these episodes as the result of a dinner I had with my wife recently. We were at my favorite restaurant enjoying a late dinner following a busy day at the office. We had to sit at a booth because there were dinner meetings being held that evening.

One meeting was a journal club that the foot and ankle surgeons hold every two months here in St. Louis and by foot and ankle surgeons, I mean orthopedic foot and ankle surgeons and not podiatrists. These journal clubs have been going on for many years. Every several months, the foot and ankle surgeons would gather at the restaurant and participate in continuing medical education. There were no CME credits for attending. There was no corporate support of these meetings in general although a corporation is occasionally allowed to participate but not determine the content of the meeting. For the most part, the doctors attending these journal clubs actually paid for their own dinner and drinks. The room was filled with practicing foot and ankle orthopedic surgeons as well as fellows and invited residents. The meeting did not include any podiatrists.

Those attending the meeting were present for one purpose and one purpose only: to become a better foot and ankle surgeon and better serve their patients. Professionalism. Collegiality.

Participating in continuing medical education for self-improvement without the need for CME credits for relicensure. Non-reliance on corporate support for continuing medical education. Professionalism. Collegiality.

When you attend a podiatric continuing medical education program or read the program brochure, you will see terms such as “unrestricted educational grant” or references to platinum sponsors, gold sponsors, diamond sponsors, all the way down to just plain old rock sponsors.

What these references mean is that there will be a biased lecture in your program advocating the use of some product distributed by the corporation involved. It is contrary to the actions of our MD colleagues. It is something that is perhaps appropriate for technicians but not for a learned profession.

There is nothing wrong with accepting educational grant money or sponsorship from corporations as long as they do not dictate the content of the CME program. However, it is generally fantasy to pretend this is not the actual situation.

It does seem to me that there are some individuals who, although they have received corporate sponsorship support, present unbiased educational lectures. Although they have received corporate sponsor support or otherwise disclosed some corporate interest, they present educational material at our meetings that is in fact unbiased and worthy of your attendance. Unfortunately, this is not the case with the majority of speakers at the majority of meetings.

There are some meetings, such as the New York State Podiatry Association annual meeting, meetings held by Kent State University or the No Nonsense Seminar, that invite presenters regardless of their corporate sponsorship status. At these meetings, presenters are invited based on their individual accomplishments and ability to provide true continuing education. This indeed is professionalism. This indeed represents collegiality.

Conversely, in my opinion, the content of the majority of meetings in our profession is based upon the ability of the speaker to present without cost to the meeting. In other words, if you do not have corporate sponsor support, it is unlikely that they will allow you to speak at the meeting.

Collegiality. Professionalism.

Hopefully, the next generation of podiatrists will do a better job with these concepts than my generation did. In doing so, they will advance podiatry from a technical to a learned profession.

Dr. Jacobs is a Fellow of the American College of Foot and Ankle Surgeons, and a member of the Association of Physicians in Wound Healing. He is in private practice in St. Louis.  

Editor’s note: This column has been adapted from a previously published DPM Blog by Dr. Jacobs at https://tinyurl.com/lvamsrb .