My candid thoughts about the APMA

[ExperiencedDPM]

For all you pro-APMA folks, let me preface this post by clearly stating that I was a member of the APMA for over 25 years and received my nice little pin. Other than that pin, I can honestly say I personally believe it wasn't money well spent. And I was also active on the state level for years. Then I did some reflecting. What if I had taken the approximately $2,000 annual dues for those 25 years and invested it in something worthwhile? Fifty thousand bucks is a lot of money.

I've heard it all, we need to support "our" organization. It's in "our" best interest. Then I finally woke up and realized it is in the interest of those who have self interests.

Each year I watched the schools accept lower quality students and then students graduating without residency positions. I look at the APMA annual report and see that with perks and bonuses the APMA exec director made over $600,000, more than 4 times the average income of DPMS. Then I read that APMA board members AND spouses fly first class for any flight over 3 hours (I know this will be challenged). Then I see past APMA presidents all patting each other on the back while hitting the lecture circuits and getting on the payrolls of large companies as a consultant. And I see the APMA "selling" it's seal of acceptance for flip flops and all kinds of crap while stidents can't obtain a residency.

I see the APMA announce that it's hired a firm for a NATIONAL search for a new exec director. Yes, a national search. And who do they hire, I believe he was the former scientific director of the APMA. A doc with a small practice. Did they hire an MBA from Wharton? No, after a national search they move up a DPM with no real executive experience who was the scientific director for a national seminar filled with fluff.

A doctor who is on the board of trustees lecturing on equinus, who happens to also sell a brace made for that condition. No conflict there!!! They have a speaker who is a self proclaimed podopediatric specialist from the northeast. He is a podopediatric expert, though he doesn't perform pediatric foot and ankle surgery. Hmmmm, that makes sense. And he treats everything with biomechanics and just happens to have ownership in a lab that makes pediatric orthotics. Those are your hard earned APMA dues at work.

Wait!! A bill was just passed for equality at the VA!!!!! Despite that being on the agenda of the APMA, the ONLY reason that has passed so far is due to a republican DPM, Brad Wenstrup. But I'm sure the APMA will be happy to take credit.

I watch the same old same old. We will be just like MDs. In the interim, some states still have archaic and limited laws with no uniformity. Lots of empty promises. I'd be a dues paying member if their salary was performance based. But it's not and I stopped paying.

Again, I DID pay for 25 years. And it didn't take much to realize the money wasn't well spent. Don't feel bad, the AMA membership is also down.

Bang your chest and tell me that my info isn't accurate and that there is strength in numbers. And I'll tell you that I had that mindset and than woke up.

I've seen too many young grads suffer while the APMA board of directors prospers. I really do NOT want to be just like them.

Relax. This is simply my honest opinion.

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Members don't see this ad.

 

[Adam Smasher]

I completely agree. I think any organization that charges $x in dues should offer $x worth of benefits. It so happens that I joined every organization I could think of in residency, since most of them charged $0-25 for resident dues. (I think I'll post an analysis of what organizations were worth it and which were jokes in another thread.) Anyway, for all the mismanagement of funds described above, I feel like I got some benefit from joining APMA in terms of networking as well as the purchase program. Not to mention a first-year attending dues are $232 so I figure why not. But they better stay relevant or I bail.

Out of curiosity, does the timing of this post have anything to do with the APMA national meeting going on now?

 

[ExperiencedDPM]

I completely agree. I think any organization that charges $x in dues should offer $x worth of benefits. It so happens that I joined every organization I could think of in residency, since most of them charged $0-25 for resident dues. (I think I'll post an analysis of what organizations were worth it and which were jokes in another thread.) Anyway, for all the mismanagement of funds described above, I feel like I got some benefit from joining APMA in terms of networking as well as the purchase program. Not to mention a first-year attending dues are $232 so I figure why not. But they better stay relevant or I bail.

Out of curiosity, does the timing of this post have anything to do with the APMA national meeting going on now?

The timing had nothing to do with the APMA national. The post was prompted by a question in another thread by a student inquiring about joining the APMA.

 

[deleted682934]

The podopediatric specialist only did a 1 year residency program and is not certified (can't be certified) by the ABFAS. This person does own the company that specializes in pediatric orthotics and for whatever reason the APMA lets him promote his lame product at "academic" conferences.

I had to go to the WSPMA conference during my last year of residency and for whatever reason a physical therapist was talking about this product to a room full of podiatrists at the Washington state meeting.

I seriously considering running into oncoming traffic.


Sent from my iPhone using SDN mobile

You are here, and you have seemingly done very well.

Just. Be. Better.

That is what I tell myself whenever I am frustrated with podiatry politics or lack of evidence-based care. It works pretty well for me.

 

[dtrack22]

APMA is our profession's lobbying body. At least that's how I believe you should think about it. The APMA affiliate organizations may be educational organizations but they could exist independently of the APMA very easily. On the one hand, a lobby needs money to be effective. On the other hand, if constituents/members don't feel like their money is being used wisely (and here's where I would agree with a lot of what experienceddpm said) they are going to stop contributing. As they should. Your mileage may vary.

 

[bunNfxr]

My post is prompted by the meeting. It was a typical DPM meeting for the most part. I was pleased and somewhat surprised that there was not really anything presented that fell strongly in the BS category.... Until the end.. the ethics lecture got me a bit peeved. They presented Faux or names changed to protect the innocent scenarios. Then asked what the audience felt about the need to discipline a professional for the scenario. First, they described someone that lies about getting their CMEs on their license re-ap. Message sent... pay for and go to conferences. Then they played out a scenario in which doctors pay for the CMEs, go to the conferences, scan into lectures but never go. So what is the difference...? But the one that got under my skin was when a doctor has a hand dipped x ray tank and films for x rays... and is "at least 2 generations behind the technology curve"(digital being the first and DR being the supposed 2nd improvement).
I have experience with digital DR and standard silver film based x rays. Honestly, they are both weak. If you want very good films you should send them to a hospital with a high res system. If you want in office films, there is so little difference between available in office digital and hand dipped or automated processed silver films, that I would choose the latter if I was to do it again. Thus, the APMA should not be pandering to its faithful to attend its vendor sponsored meetings, while pushing its attendees to drop an unnecessary 30-40,000 dollars on a sub par digital system.--During a talk about Ethics--Irony?
But that seems to be the APMA:Guilt, pay, repeat.

So what should they do/have done?

Meaningful Use-They fought supposedly to have Podiatry included, so they could get incentive money. Now most practices have an overpriced software system with more staff expenses than they previously needed and are being penalized or audited. This is now one of the leading contributors to the decline in private practice. --Well done!!

Stance on healthcare reform. APMA does not have one!! It is the biggest issue we face! Now they risk splitting off democrats or republicans if they do take a one sided position. But, They are collecting thousands of dollars in dues and have never researched and produced any forecast for surviving a continuation of the ACA, D/C of the ACA or public option etc. They do not need to take a side. But, they should be doing more than telling us to just be good little piggies and walk nicely through the big doors at the end of the barn. BANG!! Rather than creating resources to comply with a system that is asking us to buy a noose and hang ourselves with it, we should be assessing options and creating resources for those that wish to get out of Medicare and still make a living.
They (APMA) are developing resources on how to "Navigate MACRA", but nothing on how to survive without it. Or even a list of which members of congress that might be open to feedback on the effect of the program. Nothing, just shut up and drink your kool aid and buy a digital x ray system to support our vendors and comply with the DR requirement!!

Title 19 change to physician designation--APMA has lobbied and spent your money, but has been impotent.

Lastly, there should be pressure on the schools to provide an open disclosure to potential students as to what is going on in health care as a whole (My MD students and residents also have no idea what MACRA/MIPS, MU, PQRS etc is) and podiatry specifically. Most specifically, private practice has been the mainstay of the podiatry practice model and that is now shifting to a limited number of hospital and multispecialty practices. If you want to stay in private practice, compliance with the new legislation will have administrative cost burdens that can overwhelm your resources. For the uninitiated, MACRA has been temporarily reprieved to only require one measure on one patient submitted to avoid penalties. But that was never the intention of the legislation and it is not likely to remain as such. Medicare's own research suggest 70+% of solo practices will be penalized and unable to receive incentives that would be appreciated for large or hospital based practices.

I had the exact same thoughts as posted above on the VA/ Wenstrup bill.

Some articles to support the above opinions:
Medscape: Medscape Access
MACRA Will Decimate the Private Practice Physician
How MACRA will decimate the private practice physician
Doctors say goodbye to private practice
https://www.advisory.com/-/media/Ad...Inline_HCITA_Webcon_Medicare___CMO_2016Jun30_

 

[ExperiencedDPM]

My post is prompted by the meeting. It was a typical DPM meeting for the most part. I was pleased and somewhat surprised that there was not really anything presented that fell strongly in the BS category.... Until the end.. the ethics lecture got me a bit peeved. They presented Faux or names changed to protect the innocent scenarios. Then asked what the audience felt about the need to discipline a professional for the scenario. First, they described someone that lies about getting their CMEs on their license re-ap. Message sent... pay for and go to conferences. Then they played out a scenario in which doctors pay for the CMEs, go to the conferences, scan into lectures but never go. So what is the difference...? But the one that got under my skin was when a doctor has a hand dipped x ray tank and films for x rays... and is "at least 2 generations behind the technology curve"(digital being the first and DR being the supposed 2nd improvement).
I have experience with digital DR and standard silver film based x rays. Honestly, they are both weak. If you want very good films you should send them to a hospital with a high res system. If you want in office films, there is so little difference between available in office digital and hand dipped or automated processed silver films, that I would choose the latter if I was to do it again. Thus, the APMA should not be pandering to its faithful to attend its vendor sponsored meetings, while pushing its attendees to drop an unnecessary 30-40,000 dollars on a sub par digital system.--During a talk about Ethics--Irony?
But that seems to be the APMA:Guilt, pay, repeat.

So what should they do/have done?

Meaningful Use-They fought supposedly to have Podiatry included, so they could get incentive money. Now most practices have an overpriced software system with more staff expenses than they previously needed and are being penalized or audited. This is now one of the leading contributors to the decline in private practice. --Well done!!

Stance on healthcare reform. APMA does not have one!! It is the biggest issue we face! Now they risk splitting off democrats or republicans if they do take a one sided position. But, They are collecting thousands of dollars in dues and have never researched and produced any forecast for surviving a continuation of the ACA, D/C of the ACA or public option etc. They do not need to take a side. But, they should be doing more than telling us to just be good little piggies and walk nicely through the big doors at the end of the barn. BANG!! Rather than creating resources to comply with a system that is asking us to buy a noose and hang ourselves with it, we should be assessing options and creating resources for those that wish to get out of Medicare and still make a living.
They (APMA) are developing resources on how to "Navigate MACRA", but nothing on how to survive without it. Or even a list of which members of congress that might be open to feedback on the effect of the program. Nothing, just shut up and drink your kool aid and buy a digital x ray system to support our vendors and comply with the DR requirement!!

Title 19 change to physician designation--APMA has lobbied and spent your money, but has been impotent.

Lastly, there should be pressure on the schools to provide an open disclosure to potential students as to what is going on in health care as a whole (My MD students and residents also have no idea what MACRA/MIPS, MU, PQRS etc is) and podiatry specifically. Most specifically, private practice has been the mainstay of the podiatry practice model and that is now shifting to a limited number of hospital and multispecialty practices. If you want to stay in private practice, compliance with the new legislation will have administrative cost burdens that can overwhelm your resources. For the uninitiated, MACRA has been temporarily reprieved to only require one measure on one patient submitted to avoid penalties. But that was never the intention of the legislation and it is not likely to remain as such. Medicare's own research suggest 70+% of solo practices will be penalized and unable to receive incentives that would be appreciated for large or hospital based practices.

I had the exact same thoughts as posted above on the VA/ Wenstrup bill.

Some articles to support the above opinions:
Medscape: Medscape Access
MACRA Will Decimate the Private Practice Physician
How MACRA will decimate the private practice physician
Doctors say goodbye to private practice
https://www.advisory.com/-/media/Ad...Inline_HCITA_Webcon_Medicare___CMO_2016Jun30_

Amen

 

[Creflo]

I love the APMA's codingline website. I wish I could opt out of the JAPMA subscription. My last apma dues statement listed the fee for the magazine, I didn't want to pay it, but you can't opt out.

 

[TimmyTurner]

@ExperiencedDPM Thank you for your candor. I'm a lowly 2nd year student, but I have peeked behind the curtain and had some of the questions you did about the seeming extravagance of the whole operation.

The one thing I fall back on is that it is a lobbying organization so my expectations are minimal as far as what happens with my money. The money that gets donated basically changes hands with congressmen/women or senators in exchange for supporting podiatry friendly legislation (obviously this is not explicitly stated, but we all know how it works). Wonder if the APMA has any sort of public data available re: finances.

Also- really curious to know- what is the hx with the beef/ breakup of APMA and ACFAS? At the National, one Pod asked me a question I didn't have an answer for- On my 1st day as a student, ACFAS reps came in and told me how important it was to be a member and why I needed to pay my $60 dues. This Pod posed the question- "What is ACFAS doing for you?" I had no idea, and still don't. At least with the APMA I know what they are supposed to be doing with my $.

 

[Creflo]

I'm not clear if APMA handles lobbying with the dues that are paid, or if the apma pac donations are more important for lobbying. I wish more of my APMA annual dues would go to lobbying. As for ACFAS, they put on a first class annual meeting, with excellent information.

 

[ExperiencedDPM]

There does not seem to be a lot of clarity or transparency with what happens with your APMA dues. There is an annual report, and that's where you see some staggering salaries. PPAC pays for lobbying and that lobbying doesn't really seem to have much impact. Podiatry is a group of around 15,000, so their eventual voting input is meaningless. 15,000 votes decided by 50 states is a joke in any election. The recent VA bill was successful because of Brad Wenstrup, DPM.

The ACFAS is a good old boys club. Always was and always will be. As stated above, listening to lectures from someone who started shaving two weeks ago doesn't have a lot of credibility. I want someone with many years of experience, including failures and complications.