Anyway, during a recent clinic day I came in expecting the usual mix of new and established patients. I went from the first patient room, where a patient with a venous insufficiency ulceration was slowly improving and entered my second patient's room. I was happy to find this patient's neuropathic hallux ulcer was healed. She was given follow-up instructions and discharged from my clinic. So far things were looking pretty promising.

Well, my day only improved with patient after patient either showing improvement or healing. I discharged six patients that day with completely healed ulcerations. This turned out to be a clinic record! I was on fire. Any better and I would be turning fish into meals to feed the masses and healing people with only a touch!

The crowning point of the day was when I realized I'd finally healed my most difficult limb salvage case to date. This was a 60 year old man who had come to me twelve months previously with an osteomyelitic 2nd toe with ascending lymphangitis and severe PAD after years of smoking. I'd taken him to surgery and amputated his toe emergently while he was developing a critically ischemic limb. Of course, he didn't heal the amputation and--to add insult to injury--began ulcerating his plantarmedial arch and medial 1st metatarsal head. He eventually went on to a TMA after a femoral angioplasty that began occluding during his postoperative course. My patient refused further revascularization, in spite of advice to the contrary, as we were continuing to make progress, albeit very slowly.

So, with lots of TLC and advanced wound care modalities, I was happy to walk into his room to see a healed foot and salvaged limb! No leg amputation here! The ironic part was that he was discharged from my clinic one year to the day when he first presented to me.

Overall, this was a very good day. I tell this to you not to brag about my wound healing prowess, but to elucidate a very important point. As naive as it may sound, don't lose sight of one of the true joys of practicing medicine: healing patients. As easy as it is to get bogged down in the daily activities of practicing medicine, remember that from your patients' standpoint, you are their healer. And if that's not possible, at the very least you'll improve their quality of life. Enjoy the healing!

Jarrod Shapiro, DPM
PRESENT New Docs Editor
[email protected]

LETTERS TO THE EDITOR

***The "Podiatry" Guild***

I am a podiatrist in Monterey, Calif. I have been in practice for about 5 years. First let me tell you how great it is to have this type of outlet for doctors. I stumbled on the site looking at the board review and found the new doc section. It is great and you address many important topics and get right to the point.

A thought I wanted to throw at you is something I have been thinking about and not knowing where to express it, so here it goes. It has to do with how much news the Writer's Guild strike is getting. To me, the big studios are much like insurance companies and the podiatrists are like the writers in that relationship. They go on strike because they have a guild, the studios lose money and only then are willing to negotiate. Nurses do this too. Why don't doctors do this with the insurance companies to negotiate not getting taken advantage of? I am amazed how important not seeing a new episode of "ugly betty" is to the world and the power it brokers. What would happen if we had a guild and did the same for what we do? Just a thought for discussion.

--Scott Smith, DPM
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Editor’s Response

A Podiatry Guild, or to broaden the issue, a Physician’s Guild is an interesting idea.  I think the main issue here is the creation of a union.  Collective bargaining would be a strong way for physicians to receive fair payment for our services.  I can see the image: physicians nationally go on strike and the President has to intervene the way he did while police were striking a while back.  I bet we’d receive better treatment!  This reminds me of a novel I've read by Ayn Rand called Atlas Shrugged.  All of the biggest businessmen (and women) around the country essentially go on strike until the country falls apart, and they return to better treatment.

It’s a fascinating topic for discussion.  I’d love to hear what the rest of the online community thinks about a doctors’ union.

--Jarrod Shapiro, DPM