j-
MassachusettsPodiatric MedicalSociety
6Boston Rd,Suite202,Chelmsford,MA01824I978256-0935
President
SusanWalsh,DPM
President-Elect
RobertJ.O'Leary,DPM
VicePresident
MichaelTheodoulou,DPM
Secretary/Treasurer
CarolineGauthier, DPM
ImmediatePast
President
Scott Aronson,DPM
BoardMembers Franks.Campo,DPM JohnJ.Clarity,DPM EmilyA,Cook,PPM JeremyJ,Cook,DPM AnthonySarage,DPM
H<;JrryP.Schneider,DPM
BarryRosenblum{DPM
WalterWolf, DPM
DarenBergman1 DPM
Themissionofthe MassachusettsPodiatric MedicalSocietyistofacilitate and promote theinterests, professionalism and recognitionofitsmembers;
tosupportahighdegreeof foot healthcare andtosupportthe principlesand goalsoftheAmerican PodiatricMedicalAssociation.
Ms.NeldyJean-Francois,Esq.,ExecutiveDirector
MassachusettsBoardofRegistrationofPodiatry
1000Washington Street
Boston, Massachusetts
DearMs.Jean-Francois:
On behalf of the over 300 podiatric physician members of the Massachusetts PodiatricMedicalSociety(MPMS), I amwritingtosubmit commentsinresponseto the ·Massachusetts Board of Registration of Podiatry's ("the- Board's") recent listening session. TheMPMSappreciates the Board1s efforts to ensure that the regulationgoverning podiatric physicians remaincurrent. Accordingly,the MPMS respectfullyoffersthefollowingcomments:
1. 249CMR2.01.Thesection titled "PurposeandAuthority"states,inthe last sentence,that "[a]ny violation of249 CMR maybeconsideredgross misconduct, misconduct,malpractice, misconduct involvingmoralturpitude and/orunprofessional.conduct andwillbesufficientgrounds forrevocation, suspensionorcancellationofacertificate. Onits face,thissentenceis incongruouswiththepromulgateddefinitions of"unprofessionalconduct" and"gross misconduct” and deceit11 in249CMR5.03 5.04, respectively. While24SCMR2.01seems to makeevery infraction apotentialcandidate
forunprofessionalconduct'and"gross misconduct; 2.49CMR5.035.04
provide an appropriate delineationof such conduct. Accordingly,the MPMSrespectfully requeststhat the last sentencein249 CMR2.01 be stricken initsentirety. ItIslargelyunnecessaryin lightoftheexisting definitionsandprocedurescontainedfurtherintheregulations.
2. 249CMR3.01(1)(d). Theexistingregulations refertoanapplicant receiving
75%orhigheron the "criterion referencedparts ofthe National Board of Podiatric MedicalExamination andthe PMLexisexamination (emphasis added). TheNBPMEhasrenamedthe examination the American Podiatric Medical LicensingExam (APMLE). Accordingly, the 249 CMR3.01[1)(d) should beamendedtoreflectthenewterminology.
3. 249CMR3.D1(4)(a)[3). Theexistingregulations, whilecorrectly Identifying the American Podiatric Medical Association within the definitions of 249
CMR 2.02, referto the “AmericanPodiatry Association”11• Accordingly,the
regulations should be amended to reflect either the"APMA'' or the
"AmericanPodiatricMedicalAssociation”.
4."249 CMR3.03. The existing regulations refer to the "Commissioner of Administration and Finance", As the nomenclaturefor this agency has changed to the "Secretary ofthe ExecutiveOfficeOf Administration andFinance",thisregulationshould beupdated.
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MassachusettsPodiatricMedical Society
6BostonRd,Suite202,Chelmsford,MA01824]978256-0935
President
Susan Walsh,DPM
President-Elect
RobertJ.O'Lealy1PPM
Vlce President
MichaelTheodoulou,PPM
Secretary/Treasurer
CarolineGauthier,DPM
ImmediatePast President
Scott Aronson,DPM
BoardMembers FrankS.Campo, DPM JohnJ.Clarity,DPM EmilyA.Cook, DPM JeremyJ.Cook,DPM Anthony Sarage,PPM Harry P.Schneider,DPM Barry Ro.senblum,DPM Wa!terWolf, DPM
DarenBergman,DPM
Themissionofthe Massachusetts PodiatricMedicalSociety istofacilitate andpromote theInterests, professionalismand recognitionofItsmembers;
tosupportahighdegreeof foothealthcare;andto
supporttheprinciplesand goalsoftheAmerican PodiatricMedicalAssociation.
5. 249CMR3,05. Theexisting regulationsprovide that "[o]nlyCMEcredits whichhavespecificallybeen approvedbythe Boardmay beusedto meet this requirement. Approval bythe APMA,Council of Podiatric Medical Education or any other organization shall not serve as a substitutefor approval bythe Board.". The MPMSrespectfully requests that the Board considerdeveloping a listof organizations,including the APMAand the Councilof Podiatric Medical Education, from whichCME credits are automatically accepted. Asmostlicensed podiatrists obtain the majorityof their 30CMEcreditsviawell-known professionalsocieties suchasAPMAor the American College of Foot and AnkleSurgeons (ACFAS), the MPMS respectfully requests the Board delineatea list of specifically approved providerswhilereservingtheBoard'sabilitytoapprove'programsoffered by providersororganizations nototherwiselistedwithinthe regulations.
6. 249CMR3.05. TheMPMSrespectfully asksthe Boardtoconsiderclarifying the painmedication /opioid requirementofMoss.Gen.Lawsch.94C§18 within the regulations. This important education requirement-may· be
completed over atwo-year cyclefor certain professions. Asaresultthe MPMSurgesthe Boardtoconsider the samefor podiatrists overatwoyear period.(i.e.two credit hoursoverthe two·yearperiodto incentivize more comprehensivecoursework).
7. 249CMR5.03. Thedefinition of"unprofessionalconduct" includesvarious infractions thatfallwithinthe meaning ofsuchterm.Whilethe MPMSurges the Board to maintain manyofthesestrongprotections,the inclusionof subsection(i)"failureto repaystudentloans"should not beIncludedinthis section..There Islittlecorrelation betweenthe failure to repay astudent loanand alicensed podiatrist unqualified to practice podiatry. Further,if a licensed podiatrist, through financialfactorsoutsidehisorhercontrol, must
declarebankruptcy, involvingthe acceptedadmission that heorshecannot
payherexistingobligations,heorshe would bedeemedt0 havecommitted “unprofessionalconduct".(Note:itisworth recognizingthat, legally failuretorepaystudentloans" couldbetriggeredbyapaymentthat occursjustone dayafter the stateddeadline under aloan paymentplan.). Asaresult,the MPMS,due to the lackofempirical evidence demonstratingthis clause's protectionof thegeneral public,requeststhatthisclausebestricken.
8. 249 CMR6.03. The existing regulations,while correctly identifying the
American Podiatric Medical Association within the definitionsof249 CMR 2.02, refer to the 11American Podiatry Association''. Accordingly, theregulations should be amended to reflect either the "APMA"or the “AmericanPodiatricMedicalAssociation”.
9. 249CMR6.03. Fromahousekeepingperspective,inthe14yearssincethese regulationswerelastupdated, thenumberofcollegesofpodiatricmedicine
Massachusetts Podiatric MedicalSociety
6BostonRd,Suite202,Chelmsford,MA01824 I978
President
susan Walsh,DPM
President-Elect
RobertJ, O'Leary,DPM
VicePresident
MichaelTheodoulou,,DPM
Secretary/Treasurer
hasincreased fromseven to nine. Accordingly,this mayrequire anupdate
Insaid11Certificatesofapproval asreferencedinthissection,
Finally1duringthe Board's recent listeningsession, acommentwas made that the Boardcouldimprove the transparencyofitsactivities. Withinthat samecomment,itwassuggestedthat the Boardseek inputfrom other health care professionals. The MPMS,inits many years dealing with the Board and its
CarollneGauthier,DPM
parent organization1
the MassachusettsDivisionofProfessionalLicensure,has
ImmediatePast
President
Scott Aronson,DPM
Board Members Frank S,Campo1 DP.M JohnJ.Clarity, DPM EmilyA. Cook1DPM JeremyJ.Cook,DPM AnthonySarage,DPM
HarryP.Schneider,DPM BarryRosenblum,DPM WalterWolf,DPM
DarenBergman, DPM
Themissionofthe MassachusettsPodiatricMedicalSocietylstofacilitate andpromote theInterests, professionalismand
recognitionof itsmembers;
tosupporta highdegreeof foothealthcare;andto support theprinciples and
goalsoftheAmerican
PodiatricMedicalAssociation.
found both entities to be exceptionally transparent. Whetherthroughthe posting of Board meetings up to a year in advance; adherence to the administrativepractice act under Mass, Gen.Laws ch.30A;publication of disciplinaryactions; or, simply,engaging individualorentity requests for clarification,the Boardhasshown ademonstratedrecordoftransparencyboth Inprocess and decision-making. Whilethe MPMSmay notagree with each decision the Board undertakes,we never doubt the integrity ofthe Board's processorprocedures.
Tothat end,theMPM recognizesthat the Boardcannot beheldresponsibleif individuals choose not to·fillan available seat on the Board. Since the enactmentofMass,Gen.Lawsch.13,§12Acreatingthe Board,therehasbeena seatspecificallyreserved for"aregistered physicianwhoshallhavehadatleast seven yearsofpractice Inmedicine In thiscommonwealth". Despite the fact, this seathas remained unfilled for·many Years. Nevertheless, the Board continuestosolicitandconsiderinputfromotherhealth care providergroups, organizationsand health insurance carriers. Moreover, the DPLhasbeen quite active In working with its sister agencies -whether the Massachusetts Department of Public Health, the Massachusetts Office of Medicaid, the MassachusettsDivisionofinsuranceorthe MassachusettsAttorney General's Office-toworkcollaborativelyonIssuesrelated to patient protection,provider qualityandlicenseediscipline. Tosuggest that the Boarddoes notseek Input from other health care professionals ignoresthe dearly demonstratedfacts to the contrary.
Onbehalf of theover300licensed podiatricphysiciansthroughoutthe Commonwealth,1 appreciateyourconsiderationofthismatter.Ifyouhaveany questionsorconcerns, pleasedonothesitatetoletmeknow.
Sincerely,
Dr.SusanWalsh,DPM