Acceptance Address. APMA Annual Meeting. Houston, Texas August 11, 1999

Mr. Speaker, Board of Trustees, delegates, distinguished visitors, colleagues, family, and friends:

I am truly humbled by the honor of being selected as the 74th president of APMA. I will always cherish this day, and will do my best to live up to your standards and expectations for one who is so fortunate to have received this ultimate trust.

I will especially remember with joy the feeling of being inaugurated in Houston, my hometown, surrounded by so many people I love and respect with whom I have lived and worked for so many years. Ironically, it was almost 27 years ago to the day that I was notified by the Texas State Board of Podiatric Medical Examiners that I had been granted a license to practice our chosen profession in this great state. Two of the men who signed that license are here by my side today.

Here also is your dedicated Board of Trustees and many of its fine staff, with whom I have had the privilege of serving for over a decade: years that have prepared me for the wonderful adventure ahead. As my role changes, I know I will miss much of the work I have fostered over the years, but I know too that new challenges loom on the horizon and there is much more work to be done.

Helen Keller put it well when she said, “I long to accomplish a great and noble task, but it is my chief duty to accomplish humble tasks as though they were great and noble. The world is moved along not only by the mighty shoves of heroes, but also by the aggregate of the tiny pushes of each honest worker.”

And so I hope that my honest efforts, whether they be mighty shoves or tiny pushes, move us toward a brighter future. And what is that future? That legacy? What are we here to talk about?

You have had the chance to view the slide behind me over the past two days: 1998–Let’s Do It Together; 1999–Together for Tomorrow; 2000–Tomorrow Is Today.

Tomorrow is today. What do I mean by that? I mean that we have laid the foundation and are ready to take our profession into the 21st century—today. I mean that we have done our homework, and we’re ready to deliver in our clinical endeavors, in our public and private podiatric practices, and in the work of our county, state, and national organizations—today. It is a call to action—today. There will be no excuses, no pointing of fingers—we’ve got the team to get the job done.

Our profession has matured rapidly over a relatively short period of time. Much of our progress is attributable to the brilliant leadership of so many presidents who have come before me. I am particularly proud to have had a wonderful working relationship with my two immediate predecessors, Dr. Lenet and Dr. Albright, during their very successful terms of office.

Today I want to talk to you about where my team hopes to lead you. I want to discuss areas of our organization where we can improve, expand, and grow professionally. It is in these areas that it will become clear to you just how tomorrow is today.

A perfect example can be found in telecommunications. Computer technology and Internet activity have grown exponentially and have brought us to the threshold of a new age bursting with opportunity for our association. This resource is limitless.

Computers are essential for every aspect of APMA as well as for us as individuals. For our members, computers mean ease and simplicity; for our association, savings of innumerable dollars that can be spent on new programs and enhanced membership benefits. For that reason, I will create new incentives for each and every one of our members to get online and become computer literate—and, if already literate, to improve upon those skills that open up an entire world. Leading our charge into that world will be Dr. David Schofield, Chairman of the Internet and Computer Technology Committee. I have requested that, beginning in September, Dr. Schofield write a regular column in the APMA News as a guide for all DPM Internet users. I have also asked Dr. Schofield and his committee to prepare a fall continuing medical education program for our members that would count toward at least three credit hours for 1999– 2000 relicensure.

Think about the other advantages: a member web site that gives you access to all APMA publications; electronic commerce of all APMA products; and, of course, a venue for our corporate friends to bring new products and promotions to our attention.

Computers mean limitless communication opportunities—not just House of Delegates reports, resolutions, and propositions, but year-round, real-time discussions on topical issues with an audience of willing and excited colleagues from all over the country and possibly the world. I have asked our committee to formulate a strategic plan to market this technology to our members in order to ensure that they are educated and aware of ways to improve their professional lives and their connections with their national and component societies.

I believe this is only a start, but computer technology is a signal that tomorrow has arrived, and we will begin the process of embracing it today!

Certainly computers are making the world grow smaller, and the new millennium will see other changes that bring people even closer together. I believe doctors who practice foot and ankle medicine around the world need to begin to communicate better for the benefit of the millions of patients we treat.

This is not a new concept. However, the process itself needs to become more expansive and inclusive. Our friendship protocols need to extend to all countries, not only our friends and colleagues in Englishspeaking countries. Think of the possibilities: worldwide public education and awareness of podiatric medical specialists, professional growth, and image enhancement of foot specialists around the globe.

Today we must accept our responsibility as world leaders. It is our duty, and should be our pleasure, to broaden the practice opportunities of our colleagues throughout the world, and aid them in the challenges they face in the delivery of patient care. Their professional growth will be followed by the growth of our association as we extend our membership abroad. I have asked our executive director to compose and send a letter from APMA to countries that have contacted us in the past. In this way we will gauge their interest in exploring a mutual exchange of ideas and in expanding our professional relations. We will share with them our tomorrows, beginning today.

Looking closer to home, we as a professional organization have many issues of our own that still must be resolved. Their resolution will not occur overnight, but it is time to begin these projects. We must look to you and the rest of the leadership of our organization to guide us. However, we all must understand and appreciate the personal responsibility and commitment necessary to prevail in very difficult times.

Before you is a dedicated and driven Board of Trustees and among you are the future leaders who will be dedicated and driven board members. It is time to look seriously at this next generation of decision-makers who will face problems that we know are not going to be resolved in the foreseeable future. We need to cultivate these women and men, nourish their talent, and prepare them for the passing of the torch of leadership.

The appointments I have made for my tenure will soon be known to you. It is a strong team that will make the most of its talent and ability, allowing those qualities to flow freely in order to tackle issues. We will see changes in committees, fresh faces and new ideas to invigorate our organization for the years to come.

The association will see more women assume leadership roles, beginning today. We are working to correct a gender imbalance in the politics of the profession, a correction that is long overdue. For too long we have underutilized this rich resource within our ranks. I have appointed at least twice as many women to key committee positions this year as at any other time in our history. I will meet this week with the president of the American Association for Women Podiatrists as well as the leadership of the National Podiatric Medical Association to ensure that their members are empowered to direct the business and to guide the future of this association in the years to come.

Our women colleagues have looked too long to tomorrow for their right to lead. For them, tomorrow is today!

We look to our leaders, be they men or women, for guidance, because we all have a large personal stake in the promotion of podiatric medicine in our communities and in our nation.

Last spring, I asked headquarters to conduct a survey seeking to determine who is and who should be responsible for achieving a successful podiatric medical practice. The findings were interesting and will be reported in detail in the coming months, but let me share a couple of things that grabbed my attention.

First, the expectations of most of our members are generally being met, which is, of course, encouraging to hear.

Second, many members perceive that they bear too much of the burden for establishing and maintaining professional success. They believe the primary way to ease that burden is to increase the level of collaboration among all of the groups whose stated purpose is to help them achieve that success.

Even though some of our colleagues indicated that they currently share responsibility among themselves, their state organization, and APMA for most actions, the majority of members believe that there should be more of a coordinated group effort. I agree with that sentiment, and I intend to press this team approach to success as I travel around the country and speak to our national membership throughout the year.

The survey also showed that our members are disappointed with APMA’s initiatives in negotiating with managed-care organizations. Well, we are going to address that this year, and I’ll get to that in a moment.

To sum up, the message here is that we should not expect or believe that a single group or individual should assume all of the responsibility for continuing the success of a practice. Each entity brings an important element of expertise to the table.

Remember those famous words of yesterday that spoke of an unknown tomorrow: “United we stand, divided we fall.” That was never truer than today.

The membership has spoken, and your leaders are listening. The APMA needs to become a greater resource for the profession in dealing with privatepayer issues. We need to invest the energy and talent in our health systems effort to equal the magnificent work performed by Drs. Smith and Sowell on the public side over the last several years.

To address this, I have assembled a dynamic group of leaders to assume the enormous task of acting to halt the recent trend of cutting reimbursement below a livable wage and denying citizens access to the podiatric physician of their choice. This team will meet with payers and promote the value of podiatric medicine as a resource to their affiliated insurance companies. It will establish relationships with provider coalitions who have similar insurance issues and enlist them as allies in dealing with private payers. It will cultivate partnerships with consumer groups that will be assets in dealing with private insurance companies. This team will also work on determining problems with third-party administrators and developing strategies for dealing with those problems, whether they be legislative, regulatory, or administrative.

To assist our members, this team will establish a rapid deployment force that will be available to supply information on how to deal with regional or local insurance problems. It will develop guidelines to evaluate potential managed-care contracts and to inform the membership of negotiating strategies.

I have charged them with all of these responsibilities. The people chosen for this Herculean task are among you today, in this very hall. They are people you know and trust, people unafraid of getting into the trenches for podiatric medicine. These are tough times, and these people will not back away from our objective to succeed. Their commitment brings to mind the stirring words of Thomas Paine spoken to our brave revolutionary soldiers faced with retreat across the Delaware. He said, “These are the times that try men’s souls. The summer soldier and the sunshine patriot will, in this crisis, shrink from the service of their country; but . . . I love the man that can smile in trouble, that can gather strength from distress, and grow brave by reflection. ’Tis the business of little minds to shrink; but he whose heart is firm, and whose conscience approves his conduct, will pursue his principles unto death.”

This attitude is embodied in the person I have chosen to lead the Health Systems Committee: Dr. Ross Taubman. The serious problems with which he will have to deal will be approached cautiously but tenaciously. I have spoken with Dr. Taubman on the subject of reimbursement and patients’ rights, and he agrees that the time has come to act. He and I have no time for tomorrows, there is only today. In short: We’re mad as hell and we’re not going to take it anymore!

Today, we happily look back upon 25 years of progress that has seen public awareness of the need to treat foot and ankle problems dramatically increase. In the last 24 months we have seen an extraordinary amount of intensive media coverage about foot and ankle medicine.

Public relations has paid dividends. The efforts of the Foot Health Foundation of America, component societies, the American College of Foot and Ankle Surgeons, and others have provided outstanding educational opportunities for the public on this subject. Our public awareness initiatives are essential to accomplishing our stated goals of:

• improving foot health in the general population;
• reducing amputations in diabetics; and
• increasing awareness of foot and ankle problems in minority communities.

Established annual events, such as Diabetes Awareness Month in November, the annual spring renewal of the 75,000-mile checkup campaign, and the summer USA Today hotline, are the centerpieces of our year-round effort to introduce podiatric medicine and physicians to the people of this country. Radio, television, and print media have delivered more than a billion impressions over the past 12 months.

As you know, I have been deeply involved with this activity for the last two years, and I can honestly tell you that the work of our staff—our director of public relations, George Tzamaras, and PR counsel, Hill & Knowlton—has been extraordinary. I am so proud that I don’t think I could ever express my complete gratitude and appreciation. We will use the PR experience we have gained over the past two years as we move more of this work into APMA headquarters.

We will still seek the advice of outside consultants for special events, but a greater concentration of public education will be directed in-house by our Public Affairs Committee. They will be charged with turning the focus of our future public education needs to our news bureau outlets, which will be fueled by clinical and consumer outcomes data.

Plans are well under way to deliver the greatest amount of raw data to individuals and insurance companies ever in the history of our profession. Regaining control of health-care decisions depends to a great extent on having the necessary data to prove quality care. Anecdotal data won’t work; we need hard, objective data to make our point.

I want to thank Dr. Robertozzi for his tenacity on this subject. He has worked extremely hard on this project, and I have expressed to him my desire to see evidence-based medical outcomes placed on the fast track to completion. Our Podiatric Research Advisory Committee continues to evaluate, monitor, and award grants for worthwhile research projects. Whether defined in strategic assumptions or as envisioned future activity, outcomes data is a crucial aspect of this organization’s strategic plan.

I would like to thank Dr. Viehe for his leadership in this area. He has guided our committee well, and we are now poised to intensify our efforts to educate the public and managed-care organizations. There is no substitute for this critical information.

Our other education priority is our students. They are the foundation of our profession. As we enter the new millennium, the Educational Enhancement Project will help to prepare each and every one of our students for the challenges of becoming a successful podiatric physician. As chair of the Education Committee and a former member of the Council of Podiatric Medical Education, Dr. Jerry Ferritto not only has the background and perspective, but he has committed his entire professional life to the advancement of podiatric medical education. Thank you, Jerry, for all your hard work. I know it is a labor of love.

My administration is committed to moving this agenda—today. Is it ambitious? You bet! Is there a lot of work to be done? Absolutely! Is it worth it? I wouldn’t be standing before you today if it weren’t. What is at stake here is nothing short of our entire profession, which means the health of our patients and our careers.

That is pretty heady stuff, and certainly worth fighting for, but the cost will be high—not just the monetary expense, but the human expense in work hours as well. Thankfully we have been blessed with a superlative staff.

Under the expert guidance of Dr. Gastwirth and our deputy director, Dr. Levrio, we have enjoyed a great year, and the future promises more of the same. From our department directors to our parttimers, this staff is eagerly responsive to membership requests despite enormous workloads. Their tireless efforts make the work of the Board of Trustees easier and more pleasant to complete. We all owe a great deal of thanks to these committed team players who work with our leadership to continually reach the lofty goals of our association. This group will absorb much of the human cost of which I spoke, but there are still serious financial concerns.

The price of our goals can also be measured in real dollars. So how will we pay for all of this? Many asked this same question six years ago, when our corporate support was less than $50,000, but that was before our modern-day Development Department and its director, Cheryl Reinhardt.

At the close of the fiscal year 1998–1999, the department had actualized nearly $1.5 million in nondues income, while the Fund for Podiatric Medical Education generated more than $900,000 in funds. A $2.4 million record year!

This is a remarkable achievement, and a credit to all those who worked so hard to reach this milestone. One of our leaders has played a key role in both of these efforts. Dr. Harold Glickman is the only trustee to sit on the boards of both APMA and the Fund for Podiatric Medical Education simultaneously and has been very instrumental in the successful fund-raising efforts of both organizations. A job well done!

So what now? Will the cost of doing business go down? I don’t think so! Will obtaining unrestricted grants get any easier? I don’t think so! Will the cost of education be reduced? I wouldn’t count on it! Will membership needs diminish? Probably not. So how are we going to meet the challenges of tomorrow today? How are we going to keep up with the cost of living and still see our vision for the profession become a reality?

I have a plan. I call it my “Five-by-Five Plan.” It calls for at least $5 million a year in nondues income by the year 2005.

To achieve this, the Board of Trustees has approved a plan to establish a task force charged with developing a step-by-step process for reaching this goal. We are currently working with a leading fundraising consultant to complete a development planning study. This study will lead to a methodology that will show us how to take our association to the next plateau in our solicitation strategy. This project will involve staff, members, corporate friends, and all who have a stake in the success of the American Podiatric Medical Association today and for all our tomorrows.

If only I had all my tomorrows to thank those I should. Earlier I mentioned two honored guests who stand with me today. Both of these gentlemen have had long and distinguished careers in podiatric medicine: Dr. Louis Bogy and Dr. Joseph Ordile. Dr. Ordile was the 52nd president of the APMA and the only other DPM from Texas to hold this high office.

Speaking of Texas, I cannot resist the temptation to boast about the terrific job done by Don Canada and his staff at the Texas Podiatric Medical Association in preparation for this annual meeting. Our general chairman, Dr. Larry MacTavish, and hundreds of our colleagues around the state have worked hard to ensure the enormous registration success of this annual event. As you know by now, this is the second largest meeting in ten years, exceeded only by the 1994 attendance in San Francisco.

This also speaks to the commitment of our membership to redefine the national as one of the largest and most prestigious events of our calendar year. You spoke, and again the leadership listened. You said: Give us an excellent venue with cutting-edge science and technology, at an affordable price, and we will come. So, we did our part, and now you have done yours.

Thank you to all who have worked so hard to achieve this success, and a special thank you to Anne Martinez and the entire APMA staff for pulling it all together so beautifully.

Permit me some time to introduce a few others who have meant the most to me. Sitting among this special group is Dr. Bernie Hirsch, a man who was instrumental in the beginning of my professional career and has been a mentor and friend for almost 30 years. I am blessed to have such wonderful friends and family members to share in this happy occasion. My parents, Dr. and Mrs. Morris Lepow, and my mother-in-law, Mrs. Hilda Harwood, are here today. So are my brothers and lifelong business partners Dr. Gary Lepow and Dr. Randy Lepow and their beautiful wives, Gloria and Dana. Our years together have been exciting and successful, and I can only pray that there will be many more in the future. Our brother Dr. Kenny Lepow and his wife, Eileen, as well as my sister Lisa and my only brother-in-law, Philip, are joining the celebration today. I am proud, also, to have our two associates, Dr. Linda Nachmani and her husband, Scott, and Dr. Maria Bertorello and her husband, Jeff, among this special group of people. The success and growth of our group over the last ten years has been in large part attributable to a lady who has dedicated herself to the success of Lepow Foot Specialists. She is truly the glue that has kept us united and excited. Thank you to Terry Albin, our practice administrator, who is here today with her husband, Sterling.

While interviewing me for the APMA News, David Zych asked me what my family thought about my receiving this high honor. Well, my family shares this honor with me. Podiatric medicine has always been part of my family life, at the dinner table, on vacation, nights, weekends, and holidays. To have that kind of support from my lovely wife and children has to make me one of the luckiest guys in the world. Diane has been in podiatry almost as long as I have, and this summer we celebrated our 30th wedding anniversary. You see, I was in podiatry school when we married.

I am so proud of my children, Jeffrey and beautiful Natalie. We are happy to have Jeff’s girlfriend, Heather, with us today as well. To Diane I say thank you for all of your patience and support all of these years. You have been an inspiration in all my work. I know that you, Natalie, and Jeffrey have made many sacrifices over the years for my career and I hope you know how much I appreciate and love you.

I would like to close my remarks with one of my favorite quotes. I practice this philosophy every day of my life, and all who know me can attest to my belief in these profound words from George Bernard Shaw: “I am of the opinion that my life belongs to the community, and as long as I live, it is my privilege to do for it what I can....Life is no brief candle to me. It is a sort of splendid torch which I have hold of for a moment, and I want to make it burn as brightly as possible before handing it on to future generations.”

Yes, I am excited and prepared to be your leader. I know that, together, we can continue to see our wonderful profession grow and flourish as a major contributor to the health and well-being of all people. Tomorrow has definitely arrived, and it is today.

Thank you.

R_ONALD S. L_EPOW, DPM

President