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||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||| Posted to Podiatry ONLINE Newsflash 7/17/2000
From: Michael M. Rosenblatt, DPM The Honorable Joe Mazurek, JD Dear Mr. Mazurek: It has come to my attention that the State of Montana is prosecuting D. Andrew Wolfe, DPM, a licensed podiatrist for "practicing without a license" over his efforts to help a family involved in a terrible accident on Montana Highways. The screams of Kitty Genovese, who as you recall was viciously murdered in New York after nobody came to her aid, could echo in Montana. I am a podiatrist who came to the aid of a semi- comatose patient on an airline flight. This happened many years ago before even "routine" medical equipment could be found on airliners. I searched through her medications and identified several that are used to treat severe congestive heart failure and end stage kidney disease. Further evaluation revealed that she had other signs of it, including severely swollen legs and ankles. You may be surprised to know that podiatrists are trained to recognize such things. There wasn't much that I could do, save reassure her and give her some diuretics she had in her purse. There were no medical doctors, paramedics or others on the flight who had any (more) medical training. I filed a report and signed it (proudly) with my DPM degree. Fortunately she remained stable under my care. The entire concept of a "limited medical license" is confusing to lawyers and prosecutors. When a lawyer enters the Bar, they are certified for virtually any law practice. That used to be true with physicians, but of course it is only true in the statutes. In reality, most internists, psychiatrists and non-surgically trained medical doctors know that it is best to leave true emergencies to paramedics and emergency room trained personnel. This issue has occasionally come up when "limited" license practitioners have hospital privileges. Who comes for a "Dr. Heart" emergency page? In most cases committees that develop these guidelines conclude that anesthesiologists (to handle airway issues), general or thoracic surgeons (if there is a surgical emergency), cardiologists, and especially emergency room personnel-including nurses and paramedics (if any are available) will come first, since they are the most qualified. Frankly, most other physicians, limited license or not, simply are not. The licensure status turns out to be irrelevant. Even though I am not an attorney, this prosecution seems a direct conflict of two existing Montana statutes. Surely this has happened before. I believe the Montana Legislature, in its wisdom, realized that a lonely highway with bloodied bodies strewn across it is not a full service general hospital with multiple highly trained personnel available at a moments notice. Everyone agrees that Dr. Wolfe did not seek this incident. He didn't open an office as a licensed podiatrist and start doing facial plastic surgery. Your prosecutor is sworn to uphold the law. At the very least, a poll of the Montana Legislature should be taken before you proceed with this prosecution. Your office could very well be exceeding (or ignoring) their constitutional mandate. At the very least, it is arguable. If a member of my family were lying almost dead on a highway and a dentist stopped and made an attempt to control their bleeding, even if it failed, I would be grateful. I would not care if they "mislead" anyone about their training. If they were there to hold my loved one's hand and reassure them as they faded into death, it would be an honorable act of kindness. I would greet them with tears and hugs of gratitude. I think you would also. Ironically, many podiatrists have considerable surgical skills, involving the use of bone saws, controlling bleeding, surgically treating small joints with multiple tendon attachments and handling surgical instruments and living tissue. They could hardly be considered "amateurs." A number of podiatrists routinely operate ankle fractures. I myself have repaired completely ruptured Achilles tendons, and operated on the lower leg. I operated a fully Medicare Certified Surgical Center for years. I could be mistaken, but through the news media, it has been suggested that you do not "necessarily" favor this prosecution. Dr. Wolfe was under the stress of not being able to help several people who were already dead on the road. It was a painful, emotional time. Prosecuting Dr. Wolfe could instill a "chilling effect" on others who might wish to help, but fear a rogue prosecutor. Kitty Genovese's screams will again go unanswered. Respectfully, Michael M. Rosenblatt, DPM ____________________________ |