Actual Podiatry Job Postings

[HaimFeldman]

How realistic is 1 million in collections in a town with a population of 1k?

I've heard it's possible if you're billing 2 matrixectomy codes for doing slantbacks on both borders of a single toe, and 93923 every time you listen to someone's dorsalis pedis with your handheld doppler.

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Members don't see this ad.

 

[CutsWithFury]

Might as well share this excellent opportunity again:

View attachment 361307

Is this real?

 

[HaimFeldman]

Is this real?

It was in PMnews a couple weeks ago. It is not there anymore.
I imagine they must have filled the position with someone who's cover letter read "Yo b!tch, when can I start cuttin sum nailz????"

 

[icebreaker32]

On a positive note on IPED some practices are not as flooded with applicants for some of the 100K base jobs plus bonus potential for what seems like the first time ever. Not 15 applicants the first week adds are out anymore. If this is more than temporary, base could go up outside of saturated areas.

They speculated because numbers are down for graduating 3rd year residents and an also because an unbelievable amount of them are doing fellowships.

This confirms there are way too many fellowships for the size of our profession.....seems like a my 4th years of "residency" is better than your 3 years. Hopefully not, but I would not be surprised if competitive jobs outside of PP start using it as a filtering process.

It also confirms if the supply is cut, the base at PP jobs can go up at the practices that are really busy enough for an associate.

At current podiatry school enrollment numbers, if they hold, things might actually be much better in 8 years.

Longterm lower numbers are better for most practice owners also even if associates are harder to find. Not as many doctors in an area means the ability to be busier and also limit nail care and bad insurance plans etc.

 

[HardRoadPaved]

Well seems to be doubling down on that 300k base lie pretty hard as this is now in PMnews.

Also why do you need to live within 30 min of office if it's just an office based job?

 

[air bud]

ASSOCIATE POSITION FOR FELLOWSHIP TRAINED - SUBURBS OF NYC

Live and work in a great community. Successful and supportive practice. Only 30 minutes from NYC. Desirable area. High volume surgery to build cases for surgical boards quickly - elective, trauma, diabetic limb salvage. Busy, modern, technologically advanced offices. ABFAS BQ/BC required. Competitive Salary + Bonus, PTO, Paid Vacations, Retirement Plan with Employer Matching, All Professional Fees Paid, Generous Signing Bonus. Please send CV to: [email protected]

Well there you go, now we can't even get associate jobs without a fellowship. We are looking at the future. Any of you persons planning on going back and getting a fellowship? Its this or a future stuck in nail jail.

 

[icebreaker32]

View attachment 361314

Well seems to be doubling down on that 300k base lie pretty hard as this is now in PMnews.

Also why do you need to live within 30 min of office if it's just an office based job?

Hard to believe the risks of audits and paybacks would not be huge, but let’s assume it’s legitimate. If one assumes that, there must be a strategic location that acts like an extra non compete and maybe with all the offices he owns in the surrounding areas it would make it very hard if you wanted compete against him with a non compete. He does not want to bring in his own competition. We all know there is something too good to be true here, what this is we are unsure. Even if there was nothing too good to be true and this is the best non surgical associate job in the country a certain small percentage of associates would still be ungrateful and open up across the street if they could.

 

[icebreaker32]

ASSOCIATE POSITION FOR FELLOWSHIP TRAINED - SUBURBS OF NYC

Live and work in a great community. Successful and supportive practice. Only 30 minutes from NYC. Desirable area. High volume surgery to build cases for surgical boards quickly - elective, trauma, diabetic limb salvage. Busy, modern, technologically advanced offices. ABFAS BQ/BC required. Competitive Salary + Bonus, PTO, Paid Vacations, Retirement Plan with Employer Matching, All Professional Fees Paid, Generous Signing Bonus. Please send CV to: [email protected]

Well there you go, now we can't even get associate jobs without a fellowship. We are looking at the future. Any of you persons planning on going back and getting a fellowship? Its this or a future stuck in nail jail.

I find it hard to believe, but some on IPED speculated almost 25 percent are now doing fellowships. If this is true then the more desirable jobs wether that is hospital jobs about anywhere or decent PP jobs in saturated areas may start going primarily to fellows.

If enrollment stays down, even the typical PP jobs will get better, and the really bad ones will disappear.

They are still asking for ABFAS BQ/BC and fellowship not ABPM.

 

[Shiyuan]

Might as well share this excellent opportunity again:

View attachment 361307

Sounds so professional, doesn’t it?

 

[Boba Foot]

This is exactly what we thought it was. Not a guaranteed 300k position. Just another scam. 30-37% collections and live in the middle of nowhere. Wow. This is most podiatry job offer ever.

Based on that job description and location, it's probably a nail farm with some wounds and plantar fasciitis mixed in. Seeing only 25-30 patients a day and paying an associate 300k, the practice probably would barely break even. Total pod job spam.

 

[DYK343]

#1 I really wanna work for Jeff. That is by far the best job posted here. Jeff is killing it to have that confidence.

#2 Who uses yahoo email still?

#3 What the hell is a diabetic shoe van? How many diabetic shoes are they dispensing? Does this van actually just drive from PCP office to PCP office knocking on doors to get the authorization signed? Tax write off brilliance.

 

[NatCh]

6 figure salary!!!

Position Search Results - Classified Ads | APMA

www.apma.org

Phewww! That's more like it. Too much money freaks everyone the F out.

 

[msion]

I find it hard to believe, but some on IPED speculated almost 25 percent are now doing fellowships. If this is true then the more desirable jobs wether that is hospital jobs about anywhere or decent PP jobs in saturated areas may start going primarily to fellows.

If enrollment stays down, even the typical PP jobs will get better, and the really bad ones will disappear.

They are still asking for ABFAS BQ/BC and fellowship not ABPM.

I am a bit detached from reality so don't know what IPED is and decided to look it up.
Then I came across this:

Togel Hongkong Hari Ini – Pengeluaran HK | Data HK Hari Ini| Keluaran HK

Permainan Togel Hongkong Hari Ini serta Pengeluaran hk, data hk dan keluaran hk prize resmi. Toto hk pools bisa anda mainkan di situs togel hari ini.

podiatricexcellence.org

It's an online casino?

 

[dtrack22]

I am a bit detached from reality so don't know what IPED is and decided to look it up.
Then I came across this:

Togel Hongkong Hari Ini – Pengeluaran HK | Data HK Hari Ini| Keluaran HK

Permainan Togel Hongkong Hari Ini serta Pengeluaran hk, data hk dan keluaran hk prize resmi. Toto hk pools bisa anda mainkan di situs togel hari ini.

podiatricexcellence.org

It's an online casino?

Facebook group

 

[de Ribas]

ASSOCIATE POSITION FOR FELLOWSHIP TRAINED - SUBURBS OF NYC

Live and work in a great community. Successful and supportive practice. Only 30 minutes from NYC. Desirable area. High volume surgery to build cases for surgical boards quickly - elective, trauma, diabetic limb salvage. Busy, modern, technologically advanced offices. ABFAS BQ/BC required. Competitive Salary + Bonus, PTO, Paid Vacations, Retirement Plan with Employer Matching, All Professional Fees Paid, Generous Signing Bonus. Please send CV to: [email protected]

Well there you go, now we can't even get associate jobs without a fellowship. We are looking at the future. Any of you persons planning on going back and getting a fellowship? Its this or a future stuck in nail jail.

What is going on with fellowship requirements? Ridiculous.

This trend was started with now old pods who did like 24-month programs or who received poor surgical training in residency and wanted to do more surgeries, more rear foot. It kind of made sense for them to create new opportunites for themselves to get more training. Some did multiple short fellowships, additional courses in procedures they wanted to do, some went to Europe. Made sense. Some were driven professionally, some because of their pride and ego. But, I feel like this fellowship trend is pushed by programs whose docs can't offer great training to their residents but want to keep their programs up there, known, stand out. Telling everyone how great they are because their grads all go to fellowships. It wouldn't be needed at all if their residents were exposed to adequate surgical numbers and cases. No doubt that these older docs are highly motivated, but their programs often lack good amount and diversity of surgical cases. Low rearfoot numbers. Now they push their grads for fellowships to keep up. Now fellowship-trained pods put it out there like it is superior training. Sure. If they got poor training and barely did rear foot surgery in residency, it makes sense for them to seek fellowships. But if some graduate from residency programs with great training, great surgical exposure - it just evens out. They just compensate their poor residency training with more surgical exposure during fellowship. If we would compare surgical numbers and type of cases of fellowship-trained grads from residency programs with low numbers to no fellowship-trained grads from residency programs with high numbers, it will even out. But those fellowship trained pods get to advertise like they have superior training. Ridiculous.

In our residency program we get exposure to very high surgical numbers. More midfoot and rearfoot than forefoot. We do anything from trauma to complex midfoot and rearfoot reconstruction, lots of TARs, external fixations, lots of elective surgeries as well. We pretty much meet all our numbers during 1st year. Many cases go only with 1 resident assisting compared to these "known programs" with tons of residents watching and retracting during cases.

So why do grads from our program need to waste another year doing fellowship (which probably is less busy than our residency) just to keep up with the trend and advertise as fellowship-trained?

I feel like much is driven by selfish goals, pride, ego.

Fellowship trained orthos is completely different than fellowship trained podiatrist. They do fellowships to specialize in more specific area and to become experts in that area. As podiatrists, we are already specializing. Why in the world then 3 years is not enough to become an expert in the foot and ankle? Because many programs are run by older docs who had 12-24 month training. They cant offer much to their reaident. Basicaly soft tissue, pus, amps and hammertoes and bunions. But then they talk about complex rearfoot cases during their academics that most of their attendinga never did. Many programs barely do any rearfoot.

 

[Boba Foot]

So why do grads from our program need to waste another year doing fellowship (which probably is less busy than our residency) just to keep up with the trend and advertise as fellowship-trained?

When there's a flooded labor market, applicants need something to differentiate themselves from the other 50 applicants with roughly equal credentials. And employers ask for it, again, because the labor market is flooded and because they can.

As with wages, too many new grads and applicants with not enough quality jobs. So now suckers will sacrifice another year of their life and lost wages so they can differentiate themselves from 75% of other applicants. Even though the real solution is to just cut the applicant pool by producing less students.

 

[619]

Based on that job description and location, it's probably a nail farm with some wounds and plantar fasciitis mixed in. Seeing only 25-30 patients a day and paying an associate 300k, the practice probably would barely break even. Total pod job spam.

It is very possible to take home more than $300k seeing 25-30 patients/day in private practice ONLY if you own your practice and keep 100% of your sweat after paying overhead.

I see why the job requires the candidate to live in the city and hopefully get planted there. This job is most likely $300k the first year and then 30% straight collection after the first year. So after first year, you are back to making about $100k - $120K. They may also require a 2-3 year contract commitment so you won't bail after the first year of collecting $300k.

 

[air bud]

What is going on with fellowship requirements? Ridiculous.

This trend was started with now old pods who did like 24-month programs or who received poor surgical training in residency and wanted to do more surgeries, more rear foot. It kind of made sense for them to create new opportunites for themselves to get more training. Some did multiple short fellowships, additional courses in procedures they wanted to do, some went to Europe. Made sense. Some were driven professionally, some because of their pride and ego. But, I feel like this fellowship trend is pushed by programs whose docs can't offer great training to their residents but want to keep their programs up there, known, stand out. Telling everyone how great they are because their grads all go to fellowships. It wouldn't be needed at all if their residents were exposed to adequate surgical numbers and cases. No doubt that these older docs are highly motivated, but their programs often lack good amount and diversity of surgical cases. Low rearfoot numbers. Now they push their grads for fellowships to keep up. Now fellowship-trained pods put it out there like it is superior training. Sure. If they got poor training and barely did rear foot surgery in residency, it makes sense for them to seek fellowships. But if some graduate from residency programs with great training, great surgical exposure - it just evens out. They just compensate their poor residency training with more surgical exposure during fellowship. If we would compare surgical numbers and type of cases of fellowship-trained grads from residency programs with low numbers to no fellowship-trained grads from residency programs with high numbers, it will even out. But those fellowship trained pods get to advertise like they have superior training. Ridiculous.

In our residency program we get exposure to very high surgical numbers. More midfoot and rearfoot than forefoot. We do anything from trauma to complex midfoot and rearfoot reconstruction, lots of TARs, external fixations, lots of elective surgeries as well. We pretty much meet all our numbers during 1st year. Many cases go only with 1 resident assisting compared to these "known programs" with tons of residents watching and retracting during cases.

So why do grads from our program need to waste another year doing fellowship (which probably is less busy than our residency) just to keep up with the trend and advertise as fellowship-trained?

I feel like much is driven by selfish goals, pride, ego.

Fellowship trained orthos is completely different than fellowship trained podiatrist. They do fellowships to specialize in more specific area and to become experts in that area. As podiatrists, we are already specializing. Why in the world then 3 years is not enough to become an expert in the foot and ankle? Because many programs are run by older docs who had 12-24 month training. They cant offer much to their reaident. Basicaly soft tissue, pus, amps and hammertoes and bunions. But then they talk about complex rearfoot cases during their academics that most of their attendinga never did. Many programs barely do any rearfoot.

This

 

[msion]

As someone kinda in charge in hiring I always prefer candidates with 1 year work experience over those with fellowship trainings. Or just graduating residents. Not to mention a majority of them were practice management or "sports medicine" fellowships that we all know are there to see patients for the attendings while only getting reimbursed $60k for the work.
Some of these TAR or deformity correction fellowships may provide value. But I am not really interested in bringing these types of surgeries as they often mean disability forms, narcotic refills and using up all the kerlix in clinic with each dressing change.
We see about 90% of the foot and ankle stuff. The other 10% can go to fellowship trained foot and ankle surgeons. I just do podiatry.

 

[Pronation]

But I am not really interested in bringing these types of surgeries as they often mean disability forms, narcotic refills and using up all the kerlix in clinic with each dressing change.

Doesn’t sound like a very surgical practice at all.

 

[619]

As someone kinda in charge in hiring I always prefer candidates with 1 year work experience over those with fellowship trainings. Or just graduating residents. Not to mention a majority of them were practice management or "sports medicine" fellowships that we all know are there to see patients for the attendings while only getting reimbursed $60k for the work.
Some of these TAR or deformity correction fellowships may provide value. But I am not really interested in bringing these types of surgeries as they often mean disability forms, narcotic refills and using up all the kerlix in clinic with each dressing change.
We see about 90% of the foot and ankle stuff. The other 10% can go to fellowship trained foot and ankle surgeons. I just do podiatry.

Spot on! This is 100% how I currently run my practice and in the future when I decide to hire an associate, I will make it clear that we are not doing TAR or charcot recon or IM nails. My patients are seeing me for regular podiatry pathologies. Nothing fancy, no limb lengthening, no late night trauma call or none of that stuff. Podiatry should not be complicated.

Unfortunately most fellowship trained folks doing TAR and limb lengthening will not be doing any of that after fellowship even if they join a hospital or MSG group. Very few states and even fewer hospitals allow pods to do that.

 

[619]

Doesn’t sound like a very surgical practice at all.

You can still100% have a surgical practice as I do without having to do any muscle flap, nerve grafting, frames, TAR, deformity correction, charcot recon, IM nails, taking late trauma call etc. No need for all that headache with train wreck patients.

 

[air bud]

You can still100% have a surgical practice as I do without having to do any muscle flap, nerve grafting, frames, TAR, deformity correction, charcot recon, IM nails, taking late trauma call etc. No need for all that headache with train wreck patients.

Then why oh why do all these new fellowships focus on this?

 

[HardRoadPaved]

Then why oh why do all these new fellowships focus on this?

Many of them are in tertiary centers. No one with a wound shows up at their level 1 center and is like I need the best recon surgeon ever to fix my foot. They get through the system and eventually find the "university guy"

 

[619]

Then why oh why do all these new fellowships focus on this?

They hire these fellows to mainly run their clinics and see hospital consults. Rounding on patients before and after clinic. Further more, university and tertiary centers have more resources to handle these cases. I also did these cases at my residency program and did big cases when I was an associate in a pod group. Since going solo, I refuse to dip my toes in those cases anymore. I recognize these pathologies with what could be done and I manage conservatively.

Even foot and ankle ortho in my area which I am very close to one of them also does not like messing with these cases. Anyone who wants it can have at it. I have zero obligation to recon a train wreck non-complaint patient.

I am good on my side and have enough elective cases from clinic to fill my surgery schedule.

 

[Pronation]

They hire these fellows to mainly run their clinics and see hospital consults. Rounding on patients before and after clinic. Further more, university and tertiary centers have more resources to handle these cases. I also did these cases at my residency program and did big cases when I was an associate in a pod group. Since going solo, I refuse to dip my toes in those cases anymore. I recognize these pathologies with what could be done and I manage conservatively.

Even foot and ankle ortho in my area which I am very close to one of them also does not like messing with these cases. Anyone who wants it can have at it. I have zero obligation to recon a train wreck non-complaint patient.

I am good on my side and have enough elective cases from clinic to fill my surgery schedule.

I'm having a really difficult time understanding why you are only willing to do a 45 minute MTP fusion which reimburses about $1,000 when instead you could be doing a Charcot ankle recon with an IM nail and ex fix for $1,300.

 

[dtrack22]

Charcot ankle recon with an IM nail and ex fix for $1,300.

Don’t be chintzy. The ex fix pays $1000 by itself. Totally worth it for the privilege of getting to treat this patient for the rest of their life. Luckily they will “retire” before you do, so it won’t be for the rest of your career…

 

[air bud]

Don’t be chintzy. The ex fix pays $1000 by itself. Totally worth it for the privilege of getting to treat this patient for the rest of their life. Luckily they will “retire” before you do, so it won’t be for the rest of your career…

Yeah but when that calc pin site goes bad you can do a flap. 🤑

 

[HaimFeldman]

What is going on with fellowship requirements? Ridiculous.

This trend was started with now old pods who did like 24-month programs or who received poor surgical training in residency and wanted to do more surgeries, more rear foot. It kind of made sense for them to create new opportunites for themselves to get more training. Some did multiple short fellowships, additional courses in procedures they wanted to do, some went to Europe. Made sense. Some were driven professionally, some because of their pride and ego. But, I feel like this fellowship trend is pushed by programs whose docs can't offer great training to their residents but want to keep their programs up there, known, stand out. Telling everyone how great they are because their grads all go to fellowships. It wouldn't be needed at all if their residents were exposed to adequate surgical numbers and cases. No doubt that these older docs are highly motivated, but their programs often lack good amount and diversity of surgical cases. Low rearfoot numbers. Now they push their grads for fellowships to keep up. Now fellowship-trained pods put it out there like it is superior training. Sure. If they got poor training and barely did rear foot surgery in residency, it makes sense for them to seek fellowships. But if some graduate from residency programs with great training, great surgical exposure - it just evens out. They just compensate their poor residency training with more surgical exposure during fellowship. If we would compare surgical numbers and type of cases of fellowship-trained grads from residency programs with low numbers to no fellowship-trained grads from residency programs with high numbers, it will even out. But those fellowship trained pods get to advertise like they have superior training. Ridiculous.

In our residency program we get exposure to very high surgical numbers. More midfoot and rearfoot than forefoot. We do anything from trauma to complex midfoot and rearfoot reconstruction, lots of TARs, external fixations, lots of elective surgeries as well. We pretty much meet all our numbers during 1st year. Many cases go only with 1 resident assisting compared to these "known programs" with tons of residents watching and retracting during cases.

So why do grads from our program need to waste another year doing fellowship (which probably is less busy than our residency) just to keep up with the trend and advertise as fellowship-trained?

I feel like much is driven by selfish goals, pride, ego.

Fellowship trained orthos is completely different than fellowship trained podiatrist. They do fellowships to specialize in more specific area and to become experts in that area. As podiatrists, we are already specializing. Why in the world then 3 years is not enough to become an expert in the foot and ankle? Because many programs are run by older docs who had 12-24 month training. They cant offer much to their reaident. Basicaly soft tissue, pus, amps and hammertoes and bunions. But then they talk about complex rearfoot cases during their academics that most of their attendinga never did. Many programs barely do any rearfoot.

I would love for ACFAS, or APMA, or whatever the alphabet group that supposedly oversees residencies to take a hard look at these so called "fellowships" because the vast majority of them seem like nothing more than predatory associate positions.

 

[Pronation]

Don’t be chintzy. The ex fix pays $1000 by itself. Totally worth it for the privilege of getting to treat this patient for the rest of their life. Luckily they will “retire” before you do, so it won’t be for the rest of your career…

Yea but in private practice, insurances start chopping each additional CPT reimbursement by at least 50%. So these monster 40 RVU cases end up paying around $1300 if you aren't RVU comp.

 

[air bud]

So much for this being a thread about actual job postings...

 

[msion]

I would love for ACFAS, or APMA, or whatever the alphabet group that supposedly oversees residencies to take a hard look at these so called "fellowships" because the vast majority of them seem like nothing more than predatory associate positions.

The leaders of such groups often have their own fellowships. Chris Hyer was pushing for these fellowships. Not to mention the Weils.
But Hyer's fellowship might be of a better quality one though.
The others...meh.

 

[msion]

So much for this being a thread about actual job postings...

I can definitely see myself starting a practice management fellowship and instantly create 4-5 jobs for the field

 

[podwho]

Hot take - Charcot recon is just a glorified pet project for a hand full of podiatrist to make them feel special and offers minimal value and contribution to the greater population. Either send it to a specialist or don’t touch it. Most of these non compliant patients don’t deserve that level of care only to end up with bka.

I say this because I saw two jobs that required that training. Three months unfilled

 

[newfeet]

I can definitely see myself starting a practice management fellowship and instantly create 4-5 jobs for the field

 

[deleted1138023]

What no one talks about with fellowships is how much they hinder residents training. Fellowship programs are usually associated with a resident program and therefore turning the residents into retractor monkeys while the fellow goes at it.

 

[air bud]

What no one talks about with fellowships is how much they hinder residents training. Fellowship programs are usually associated with a resident program and therefore turning the residents into retractor monkeys while the fellow goes at it.

oh we talk about it. and it is totally true.

 

[PatchAdamsFan]

Hot take - Charcot recon is just a glorified pet project for a hand full of podiatrist to make them feel special and offers minimal value and contribution to the greater population. Either send it to a specialist or don’t touch it. Most of these non compliant patients don’t deserve that level of care only to end up with bka.

Charcot recon definitely has its place, yeah there are some that shouldn't be doing it, and yeah for some patients not very useful. And for all the disasters that can and do happen, many limbs are saved. I would play devil's advocate for the claim that most of those patients don't deserve that level of care - Does a smoker deserve to get their bunion fixed and lead to a non-union? Does a 45 BMI patient deserve a triple desis only to have hardware break? Does a high level athlete deserve a brostrum when they have a high recurrence rate with their sport? Hard to draw a line sometimes right? Do we only factor things they can control? I don't know... specifically for charcot patients, many are from a very different socioeconomic status, and our version of perfect compliance is impossible in their world.

By the way, referring to those who do not do "big" rearfoot procedures, where's the line there? Would you do an ankle fusion but refuse to do an IM nail? A DFWO but not a dwyer or PT transfer for a cavus patient? Heck, I've dealt with more forefoot and midfoot non-union complications than with TARs. S**t can go south anywhere on the foot and ankle. Maybe Im being facetious and looking for an argument. I'm well into a 6-pack.

definitely not job thread material

 

[air bud]

Charcot recon definitely has its place, yeah there are some that shouldn't be doing it, and yeah for some patients not very useful. And for all the disasters that can and do happen, many limbs are saved. I would play devil's advocate for the claim that most of those patients don't deserve that level of care - Does a smoker deserve to get their bunion fixed and lead to a non-union? Does a 45 BMI patient deserve a triple desis only to have hardware break? Does a high level athlete deserve a brostrum when they have a high recurrence rate with their sport? Hard to draw a line sometimes right? Do we only factor things they can control? I don't know... specifically for charcot patients, many are from a very different socioeconomic status, and our version of perfect compliance is impossible in their world.

By the way, referring to those who do not do "big" rearfoot procedures, where's the line there? Would you do an ankle fusion but refuse to do an IM nail? A DFWO but not a dwyer or PT transfer for a cavus patient? Heck, I've dealt with more forefoot and midfoot non-union complications than with TARs. S**t can go south anywhere on the foot and ankle. Maybe Im being facetious and looking for an argument. I'm well into a 6-pack.

definitely not job thread material

Venture on over to the meme thread where we do the podiatry god's work

 

[Boba Foot]

I would love for ACFAS, or APMA, or whatever the alphabet group that supposedly oversees residencies to take a hard look at these so called "fellowships" because the vast majority of them seem like nothing more than predatory associate positions.

 

[msion]

Charcot recon definitely has its place, yeah there are some that shouldn't be doing it, and yeah for some patients not very useful. And for all the disasters that can and do happen, many limbs are saved. I would play devil's advocate for the claim that most of those patients don't deserve that level of care - Does a smoker deserve to get their bunion fixed and lead to a non-union? Does a 45 BMI patient deserve a triple desis only to have hardware break? Does a high level athlete deserve a brostrum when they have a high recurrence rate with their sport? Hard to draw a line sometimes right? Do we only factor things they can control? I don't know... specifically for charcot patients, many are from a very different socioeconomic status, and our version of perfect compliance is impossible in their world.

By the way, referring to those who do not do "big" rearfoot procedures, where's the line there? Would you do an ankle fusion but refuse to do an IM nail? A DFWO but not a dwyer or PT transfer for a cavus patient? Heck, I've dealt with more forefoot and midfoot non-union complications than with TARs. S**t can go south anywhere on the foot and ankle. Maybe Im being facetious and looking for an argument. I'm well into a 6-pack.

definitely not job thread material

I think that answers the question: most of the patients don't deserve surgeries, forefoot or rearfoot, especially in today's society.
Forefoot is definitely a lot easier to revise IMO. A bunion that has gone wrong can always end up with a 1st MTPJ fusion if patients are okay not wearing heels. Messed up parabola you can always play with the Weils. Not so much for a varus triple. Most of time a CAM walker would suffice for forefoot cases. Rearfoot/ankles cases you gotta do that cast for post-op.
And worst comes to the worst if it ever goes to the court, the first question lawyer asks would be "Is this deviating from standard of care?" And unfortunately for us the standard of care is never surgery for these recon cases. Some expert witness pod will always say "custom orthosis with a metatarsal pad", or a "Richie style AFO."

For that reason I enjoy abroad medical mission trips more, you can make a big difference with your skills. But in the States you have to think about personal injury lawyers before you cut.

 

[Pronation]

I think that answers the question: most of the patients don't deserve surgeries, forefoot or rearfoot, especially in today's society.
Forefoot is definitely a lot easier to revise IMO. A bunion that has gone wrong can always end up with a 1st MTPJ fusion if patients are okay not wearing heels. Messed up parabola you can always play with the Weils. Not so much for a varus triple. Most of time a CAM walker would suffice for forefoot cases. Rearfoot/ankles cases you gotta do that cast for post-op.
And worst comes to the worst if it ever goes to the court, the first question lawyer asks would be "Is this deviating from standard of care?" And unfortunately for us the standard of care is never surgery for these recon cases. Some expert witness pod will always say "custom orthosis with a metatarsal pad", or a "Richie style AFO."

For that reason I enjoy abroad medical mission trips more, you can make a big difference with your skills. But in the States you have to think about personal injury lawyers before you cut.

omg surgery is rly scary

 

[wakaflocka88]

did y’all see the reply from the owner of the $300k PP job post?

 

[air bud]

did y’all see the reply from the owner of the $300k PP job post?

Sounds like all you private practice people are doing it wrong....and us employed people....

 

[heybrother]

Small note for future "millionaire" business owners - never respond to others / describe your income/revenue etc.

The more you speak the more other people know you are committing some sort of fraud and the more it makes people want to dig into your billing and coding.

They aren't posting updates but at one point the NY/WSJ both created Medicare physician payment summary databases so you could search people's billings. People used this to find fraud by looking at the doctors who were billing in the millions.

Centers for Medicare & Medicaid Services Data

Not saying I see anything (well I see something stupid) but literally - people can start picking your data apart questioning it.

 

[619]

James Baldwin DPM:
With all the chatter, I figured I should speak on behalf of Achilles Foot and Ankle Center, Inc. We are a 15 provider group with 10 DPMs and 5 Nurse Practitioners. I started the practice right out of residency seeing less than 45 patients a week. I hustled to do anything I could do to continue to grow including seeing patients for free at one of the 9 local hospitals to getting on my hands and knees to cut toenails at nursing homes. The hard work and dedication has allowed me to build a practice of 12 (soon to be 15) locations, an office based ASC , and much more. We offer every single aspect of podiatry from diabetic foot care to IM pantalar fusions. At 36, I dedicate my life to my practice because I feel that my employees are my family. I practice a 33/33/33 percent rule meaning the corporation (me) gets 33% (gross), 33% is used for overhead, and 33% goes to the provider (that’s gross). So, if a provider produces 1 million, they walk home with $333,000 plus all health care insurance, vision, dental, a dollar for dollar match on their 401K, and starts at three weeks of vacation. We turn no patient away regardless if they do not have insurance as I feel everything comes back full circle in life. I treat people well, I stay on top of LCD policies, insurance contract changes and I am not afraid to fight for what is fair and right. I wish all practice owners could do this for the profession and their employees. Lastly, one piece of advice, never take a loan to expand. I put all of the money back into the practice after my salary. I have never approached a DPM to buy their practice; they all call me and I offer a very fair price as they have dedicated their life to help improve the profession for all of us. Lastly, because our practice is so well rounded with podiatric medicine, advanced wound care, all DME including wound care DME, and the most advanced technology, we can market and continue to expand as a comprehensive practice. We call ourselves PODIATRISTS which encompasses podiatric medicine, wound care, sports medicine, and podiatric surgery. We have one provider that only wants to perform geriatric care and covers 27 nursing homes and assisted living facilities with a team of four. That means no associate has to do nursing homes or AL with the exception of the one DPM that requested we continue this division (in the end, that division pretty much breaks even but it provides employment to 5 individuals who love their job). This leads to a company of 15 generating 35-45 million per year in gross revenue and some of our providers take 7 figures home and work 40 hours per week. So, fight for your worth, join an advanced practice that wants to take care of you and your family. These mega groups and venture capitalist just take you for a heartbeat and your hands to practice. Most care less about you or your family. If anyone needs any advice feel free to reach out to me [email protected].

Regarding our $300k job posting, that location is on the water of the Chesapeake bay and it is absolutely beautiful. The practice is low volume surgery so it takes a person who loves podiatric medicine, wound care, and DME. That location generated our company 2 million last year, which is why I know the person who accepts the position will make much more than $300k. You can ask any of my employees, they are treated fairly and compensated well. At the end of the year, our lowest salary of a DPM is around $525,000 and our highest is $2.6 million (this is not me, that is one of my associates). I do not practice any longer as I have to focus on controlling quality, compliance and continued growth.

In the end, we only can enjoy our profession if we respect each other which not only comes in terms of words and action but also by fair compensation.

Achilles Foot and Ankle Center, Inc.

 

[Boba Foot]

Dude can talk about how sweet he is all he wants, but bottom line: ownership shouldn’t make the same percentage as the provider who is putting in all the hard work. Also, I don’t believe 33% overhead. Especially if they are billing $2 million a year.

 

[Feli]

What no one talks about with fellowships is how much they hinder residents training. Fellowship programs are usually associated with a resident program and therefore turning the residents into retractor monkeys while the fellow goes at it.

Yeah, this is the main reason I'm against fellowships...

I'm all for more and better training, more cases, etc... but such a significant proportion of DPM residencies are total junk with far too few cases, too few good attendings, too little diversity of cases, etc. Fellowships takes a lot of good attendings mostly or totally out of residency training. It's too bad.

The reason that probably half the "fellowship trained" DPMs did a fellowship is because their original residency was inadequate. Some others did it to try to get a better job with the fellowship group or otherwise. It's a minority who actually did it for personal enrichment or to become a better researcher, surgeon, CME speaker, etc.

 

[icebreaker32]

James Baldwin DPM:
With all the chatter, I figured I should speak on behalf of Achilles Foot and Ankle Center, Inc. We are a 15 provider group with 10 DPMs and 5 Nurse Practitioners. I started the practice right out of residency seeing less than 45 patients a week. I hustled to do anything I could do to continue to grow including seeing patients for free at one of the 9 local hospitals to getting on my hands and knees to cut toenails at nursing homes. The hard work and dedication has allowed me to build a practice of 12 (soon to be 15) locations, an office based ASC , and much more. We offer every single aspect of podiatry from diabetic foot care to IM pantalar fusions. At 36, I dedicate my life to my practice because I feel that my employees are my family. I practice a 33/33/33 percent rule meaning the corporation (me) gets 33% (gross), 33% is used for overhead, and 33% goes to the provider (that’s gross). So, if a provider produces 1 million, they walk home with $333,000 plus all health care insurance, vision, dental, a dollar for dollar match on their 401K, and starts at three weeks of vacation. We turn no patient away regardless if they do not have insurance as I feel everything comes back full circle in life. I treat people well, I stay on top of LCD policies, insurance contract changes and I am not afraid to fight for what is fair and right. I wish all practice owners could do this for the profession and their employees. Lastly, one piece of advice, never take a loan to expand. I put all of the money back into the practice after my salary. I have never approached a DPM to buy their practice; they all call me and I offer a very fair price as they have dedicated their life to help improve the profession for all of us. Lastly, because our practice is so well rounded with podiatric medicine, advanced wound care, all DME including wound care DME, and the most advanced technology, we can market and continue to expand as a comprehensive practice. We call ourselves PODIATRISTS which encompasses podiatric medicine, wound care, sports medicine, and podiatric surgery. We have one provider that only wants to perform geriatric care and covers 27 nursing homes and assisted living facilities with a team of four. That means no associate has to do nursing homes or AL with the exception of the one DPM that requested we continue this division (in the end, that division pretty much breaks even but it provides employment to 5 individuals who love their job). This leads to a company of 15 generating 35-45 million per year in gross revenue and some of our providers take 7 figures home and work 40 hours per week. So, fight for your worth, join an advanced practice that wants to take care of you and your family. These mega groups and venture capitalist just take you for a heartbeat and your hands to practice. Most care less about you or your family. If anyone needs any advice feel free to reach out to me [email protected].

Regarding our $300k job posting, that location is on the water of the Chesapeake bay and it is absolutely beautiful. The practice is low volume surgery so it takes a person who loves podiatric medicine, wound care, and DME. That location generated our company 2 million last year, which is why I know the person who accepts the position will make much more than $300k. You can ask any of my employees, they are treated fairly and compensated well. At the end of the year, our lowest salary of a DPM is around $525,000 and our highest is $2.6 million (this is not me, that is one of my associates). I do not practice any longer as I have to focus on controlling quality, compliance and continued growth.

In the end, we only can enjoy our profession if we respect each other which not only comes in terms of words and action but also by fair compensation.

Achilles Foot and Ankle Center, Inc.

our lowest salary of a DPM is around $525,000 and our highest is $2.6 million

......what is going on there

I am not judging as I have no inside knowledge on what is going on there.....but the only time I have ever heard of things like this it has ended in handcuffs or paybacks that often lead to bankruptcy

I can see the owner making a couple million, but every employee above 500K????

 

[de Ribas]

our lowest salary of a DPM is around $525,000 and our highest is $2.6 million

......what is going on there

I am not judging as I have no inside knowledge on what is going on there.....but the only time I have ever heard of things like this it has ended in handcuffs or paybacks that often lead to bankruptcy

I can see the owner making a couple million, but every employee above 500K????

So if company makes 45M gross and he keeps 33%? He keeps 15M?

Not bad.