Podiatry Journal: Meet The Masters Dr. Harvey Franklin Bunny Brown Part - 4

BR:I think in certain capacities, you know, 25 years of doing this

, I am starting to understand some stuff, but I could see where there is a lot of things I don"t know that maybe somebody who are bookers, you know, book smart on things I didn"t spend as much time on especially in general medicine. You can see some changes. You have been through 2 or 3 waves of residency crises or there haven"t been enough programs for residents over the years. Are there any guidelines and tricks or something you would give the people? Could there still number of people who walked in a residency this year and a few who didn"t get one last year?

HFB:Well, fortunately, when we had the residency crises when I was president, we could always rely on the VA to have residency programs and unfortunately that has dried up. That"s just not going to happen anymore. I don"t think. Not any follow up of Jeff Robins because he is doing a fabulous job, but it"s just not there. And I really don"t know what the answer is gonna be. We"re gonna have to"

BR:And should we be looking at the number of people we enroll in the school? Should that be our limiting factor? Because, you know, we"ve open two new podiatry schools in the last couple of years and I think only one school has lowered their number of people they"ve accepted. So, you know, we are looking four years from now even a bigger problem.

HFB: Yes, I agree. I"m not sure I know what the answer is, Bret, other than those people who have a residency programs now, we are going to have to encourage them to take on more residence and course. We"re needing 3-year and even 4-year programs now, so they"re going to have to explain on those.

BR:Should podiatry be a surgical specialty onto itself?

HFB:Well, I practice general podiatry. I do surgery. I do palliative care. I don"t do a heck of a lot of orthotics, but I have in the past. But I try to practice global podiatry. I guess it"s what I have to call it. I do a little bit of everything and I think my patients appreciate that. You know, if they want to have their bunion fixed, they"ll come to me or if they want an ingrown toenail fixed or if they want their callus cut, you know, they can rely on me.

BR:So you"re I guess just like almost every other specialty, from an urologist or let"s say an ENT who takes wax out of somebody"s ear, who does a radical neck dissection for a tumor. You kind of do a little bit of everything. But it seems that, you know, the mission of podiatry, you"ve been through the project 2000 and now project 2015. The goal for amalgamation into more mainstream medicine and to following this course that for everyone to be free of residency training then have, you know, this whole high level of training. You think it"s the right thing to do at this point? I mean we have states in this country where you can"t do those things.

HFB:If we want parody with our medical colleagues, we"re going to have to do that. We"re going to have to be able to compare and show that we are their equal. I personally think that we"re better than they are when it comes to the lower extremity. There is no doubt in my mind that I have more knowledge about the foot, the ankle, and the lower extremity than "" I have probably forgotten more than some of my medical colleagues ever you knew.

BR:Don"t disagree because I think we all have a little bit of that. My concern was, last few years we"re pushing for acceptance from medicine.

HFB:Right.

BR:And you look at like dentistry it could care less. They"re not pushing for acceptance from anyone. They"re content unto themselves.

HFB:Right.

BR:You think in podiatry the push for acceptance rather than autonomy is the right direction?

HFB:You"re giving me a double-edge sword, but yeah, I think we have to be accepted by the medical community and especially if we want to be on staff in the hospitals and do surgical procedures in the hospitals. The other issue, a good example is, you know, I was like heck. We never even thought about taking Medicare or Medicaid. You know the dentist don"t and they"re much better off for it.

BR:Well, you _____ point because you have the fortunate opportunity to sit on the Board of Podiatry and Insurance Corporation of American. I"m sure you have gone through committees and seen a lot of the malpractice cases that have come up in the last few years. Is there any comment that you"re going to have based on our law suits being or coming in because there is more aggressive surgery being done or is it still just lack of communication with patients about the bad results. Because I mean everyone gets a bad result.

HFB:Yes, you"re right. Everyone does get a bad result but I think the biggest problem Bret is that its communication with your patients. If you tell your patients the truth, you don"t lie to them, you say, "Hey, I messed up," or "Let"s fix something here," or "This is a result that was less than what you and I both expected," I think they"re more understanding. That also depends upon where you practice. But I don"t ever, ever try to lie to the patient and tell them something didn"t happen. I"ve been very, very fortunate I"ve never had a law suit but I will tell you, I do a lot of claims review. Our not claims review but review for malpractice cases. It"s interesting because I had an attorney chew me out one day and he says, "I knew you were gonna do this and you weren"t gonna be on my favor of suing this patient." And I said, "Let me tell you something. When the patient"s daughter comes in and changes the dressing in the middle of the night and puts this sap from Cuba on the leg and they lose the limb, don"t blame that on our doctor, you know. That wasn"t his fault."

Continued"

by: Rick P

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