Depressed and wanting to change careers

[Jummy Biffett]

I get this question at least once daily. Why feet. I usually just lick my lips and say I’m really into feet. Usually these questions come from patients with toenail complaints or some nonsense issue like “sometimes my feet tickle me so I’m just here to get them checked out… oh also clip my nails because my gut gets in the way when I try to do it”

Do you think proctologists get the same question? Do you think patients schedule an appointment with their proctologist because they can’t reach their arse to wipe?

If you trim someone's toenails for them, they will not respect you. Sure, they may appreciate you and be grateful for you, but they will not respect you as a doctor. It is an inherently demeaning task. It is what it is.

---

Members don't see this ad.

 

[GreenGreen]

Let me tell you a secret. There are no smart podiatrists. Why? because if they had the grades and test scores they would have gone DO/MD. If the podiatrist had the grades and test scores but still went for DPM, well that kind of speaks for itself.

Hey now! My MCAT and GPA were enough to get into DO school - but I didn't want to become a PCP and I knew my board scores would not be good enough to secure a good specialty. Do don't knock the minority of us who wanted a more secure career path .

I'll take being a podiatrist over PCP 9 out of 10 times.

Seriously though, most pods would have preferred to go MD/DO but settled for DPM due to grades, length of training, MCAT, etc. This has resulted in a massive inferiority complex for the profession.

This is true. Can't tell you how many people were like: MD>FAIL. DO>FAIL. LAST RESORT: PODIATRY!!!!

 

[shadesofgrey]

Hey now! My MCAT and GPA were enough to get into DO school - but I didn't want to become a PCP and I knew my board scores would not be good enough to secure a good specialty. Do don't knock the minority of us who wanted a more secure career path .

If the podiatrist had the grades and test scores but still went for DPM, well that kind of speaks for itself.

I stand by my original statement...

 

[Adam Smasher]

when people ask me, "why podiatry?" I just say, "It's a living"

 

[GreenGreen]

If the podiatrist had the grades and test scores but still went for DPM, well that kind of speaks for itself.

Speaks for itself? Let's have it then. I'm thick skinned I won't go cry in a corner (maybe).

 

[air bud]

Hey now! My MCAT and GPA were enough to get into DO school - but I didn't want to become a PCP and I knew my board scores would not be good enough to secure a good specialty. Do don't knock the minority of us who wanted a more secure career path .

I'll take being a podiatrist over PCP 9 out of 10 times.


This is true. Can't tell you how many people were like: MD>FAIL. DO>FAIL. LAST RESORT: PODIATRY!!!!

I agree. I was terrified of being PCP. Looking back could have for done ER and that would have been great to do shift work. Did well at DMU imagine could have at least gotten surgery. Oh well.


And ultimately the worst part about being a podiatrist is the job market and location availability. Within reason a MD/DO can get a good enough job in whatever area they want. Not so with podiatry.

 

[SouthPod7]

I don't understand everyone who says they would be horrified to become a PCP. What's so wrong with being a PCP? Their job market and compensation (I'm talking overall; I know there are some Pods making more than PCPs but I wouldn't say that's the norm) is MASSIVELY better than our own. You think they are applying to Shiprock or Montana or whatever their last year of residency just praying to get a job that pays more than 120k? Who cares if you enjoy Podiatry if you can't make a living off it?

I also think that until the last 3 podiatry schools opened up in the last 14 years, Podiatry actually had a decent niche. There will always be a small subset of pre-meds that didn't get into MD/DO, didn't want to do an SMP (or did one but didn't improve much), but also don't want to do Carib but still want to be a "doctor" and Podiatry was able to scratch that itch. The greed that turned podiatry non-viable for pre-pods and pod students nowadays didn't take much; just a couple of new schools in an already horribly saturated market. It's not like pharmacy school where it took dozens upon dozens of new and unneeded schools to cripple the job market.

 

[newfeet]

I don't understand everyone who says they would be horrified to become a PCP. What's so wrong with being a PCP? Their job market and compensation (I'm talking overall; I know there are some Pods making more than PCPs but I wouldn't say that's the norm) is MASSIVELY better than our own. You think they are applying to Shiprock or Montana or whatever their last year of residency just praying to get a job that pays more than 120k? Who cares if you enjoy Podiatry if you can't make a living off it?

I also think that until the last 3 podiatry schools opened up in the last 14 years, Podiatry actually had a decent niche. There will always be a small subset of pre-meds that didn't get into MD/DO, didn't want to do an SMP (or did one but didn't improve much), but also don't want to do Carib but still want to be a "doctor" and Podiatry was able to scratch that itch. The greed that turned podiatry non-viable for pre-pods and pod students nowadays didn't take much; just a couple of new schools in an already horribly saturated market. It's not like pharmacy school where it took dozens upon dozens of new and unneeded schools to cripple the job market.

I am in that subset. I did not want to go the Caribbean or Ireland or Australia. I had a fear of being aboard. I didn't need to change my essay for podiatry school because my interest in applying to medicine was because of my family member's experience with diabetes and amputations. It made so much sense at the time.

 

[SouthPod7]

I am in that subset. I did not want to go the Caribbean or Ireland or Australia. I had a fear of being aboard.

Yep, same here.

It's also why Pod schools take the MCAT because that is exactly the demographic they depend on to fill their seats (MCAT score not what you hoped? Don't worry! You can still be a doctor!) I distinctly remember when I applied that there were Pod schools that took the DAT too (although I think they have since stopped that practice).

 

[GreenGreen]

I agree. I was terrified of being PCP. Looking back could have for done ER and that would have been great to do shift work. Did well at DMU imagine could have at least gotten surgery. Oh well.


And ultimately the worst part about being a podiatrist is the job market and location availability. Within reason a MD/DO can get a good enough job in whatever area they want. Not so with podiatry.

That's so funny, 100% agree if I could go back I honestly would have done ER. 100% fell in love with the ER and ran codes during covid and the whole nine yards. During that hell no-one cared who you were - so I was running codes and intubating with my ortho bros.

Other than that still happy with podiatry despite the drawbacks.

Totally agree about job market. My PCP buddies could go anywhere they want pretty much.

 

[newfeet]

Yep, same here.

It's also why Pod schools take the MCAT because that is exactly the demographic they depend on to fill their seats (MCAT score not what you hoped? Don't worry! You can still be a doctor!) I distinctly remember when I applied that there were Pod schools that took the DAT too (although I think they have since stopped that practice).

Yup. I had one classmate who wanted to be a dentist and couldn't get into dental school. They took her DAT. And I had another classmate who was told to take the DAT without study and they would take whatever score.

During 4th year I did a rotation in Israel and realized I would have been fine overseas.

 

[msion]

Podiatry certainly meets the needs of society. It's not like it's a bogus specialty. It's evidence based and can incorporate derm, neuro and surgical skills at the same time.

I think ideally this specialty can be practiced in the following ways:
1. Minimally surgical. Bill level 3 visits, procedure codes in clinic all day. Make DMEs. Perform injections. Once a week or every other week a bunion or a hammertoe surgery. You can actually earn a pretty good living with this.

2. Be the diabetic pus guy. Take hospital calls and I&Ds after hours. Debride wounds. Can be lucrative as well.

3. Be the foot and ankle guy doing TARs, fusions, recons. Profit sharing with surgery centers. Salary is based on RVUs. Mainly with hospital groups or ortho groups.

Our profession is trying to push everyone into #3, (or at least get people to think that way), while most of us would be fine just doing #1. Yet too many of us are produced in the pipeline that lots of people are scrambling to do #2.

 

[dtrack22]

I don't understand everyone who says they would be horrified to become a PCP. What's so wrong with being a PCP? Their job market and compensation (I'm talking overall; I know there are some Pods making more than PCPs but I wouldn't say that's the norm) is MASSIVELY better than our own. You think they are applying to Shiprock or Montana or whatever their last year of residency just praying to get a job that pays more than 120k? Who cares if you enjoy Podiatry if you can't make a living off it?

I also think that until the last 3 podiatry schools opened up in the last 14 years, Podiatry actually had a decent niche. There will always be a small subset of pre-meds that didn't get into MD/DO, didn't want to do an SMP (or did one but didn't improve much), but also don't want to do Carib but still want to be a "doctor" and Podiatry was able to scratch that itch. The greed that turned podiatry non-viable for pre-pods and pod students nowadays didn't take much; just a couple of new schools in an already horribly saturated market. It's not like pharmacy school where it took dozens upon dozens of new and unneeded schools to cripple the job market.

It’s easier to make over $200k working as a PCP and you can go anywhere in the country, but your income is capped (none of our PCPs come anywhere close to my compensation) and I would kill myself if I had to do their job. It’s miserable work. The only way you could talk me into being a PCP would be if you could assure me after a few years I could move into a completely non clinical role somewhere with a $250-300k income.

I genuinely like the practice of podiatry. I had an MCAT that would have easily got me in to DO school, and probably an MD program somewhere if applying broadly enough. At the time I was worried about the lack of guarantee from a specialty standpoint (especially as a DO) and I didn’t like my experiences as an undergrad in the ED (smaller community hospital, volunteered and then worked as a tech), or with medicine docs. So I chose podiatry because the experience I had shadowing a local podiatrist was more enjoyable than others. Having said all that…I now realize there are plenty of Physician specialties I would have enjoyed. Shadowing Podiatrists did not reveal how hard it was to get a good job where you wanted. I had no idea that the ability to transition out of clinical healthcare would be valuable, and that it is nearly impossible with a DPM degree. My biggest problem with Podiatry was my experience the first 4 years out of residency. I don’t wish it on anyone. Well, other than the “leaders” of our profession who insist on adding more podiatry students and keeping bad residency programs open. But if I had gotten the job I have now right out of residency, I wouldn’t have many bad things to say about the profession. I live where I want. I don’t work hard. I get compensated fairly for the work I do. I have 3 day weekends every week. I coach kids sports teams and spend time outside. I have money for expensive toys. My life is good…now. It took way too long and it took too much luck to get here though.

I still like practicing Podiatry more than I would many Physician specialties. But there are certainly more Physician specialties/jobs that I would enjoy more than I THOUGHT I would as an undergrad student. I also didn’t realize how easy it would be to match into any one of those specialties as a DO. We took the same classes and tests as them. I would have been ranked in the top 25% of the DO class easily. I was scared for no reason. But I knew none of this as a senior in college. It’s all hindsight.

 

[air bud]

Yep, same here.

It's also why Pod schools take the MCAT because that is exactly the demographic they depend on to fill their seats (MCAT score not what you hoped? Don't worry! You can still be a doctor!) I distinctly remember when I applied that there were Pod schools that took the DAT too (although I think they have since stopped that practice).

Oh yeah I remember all the what are my chances and they listed the DAT and would get accepted....2007ish

 

[newfeet]

Podiatry certainly meets the needs of society. It's not like it's a bogus specialty. It's evidence based and can incorporate derm, neuro and surgical skills at the same time.

I think ideally this specialty can be practiced in the following ways:
1. Minimally surgical. Bill level 3 visits, procedure codes in clinic all day. Make DMEs. Perform injections. Once a week or every other week a bunion or a hammertoe surgery. You can actually earn a pretty good living with this.

2. Be the diabetic pus guy. Take hospital calls and I&Ds after hours. Debride wounds. Can be lucrative as well.

3. Be the foot and ankle guy doing TARs, fusions, recons. Profit sharing with surgery centers. Salary is based on RVUs. Mainly with hospital groups or ortho groups.

Our profession is trying to push everyone into #3, (or at least get people to think that way), while most of us would be fine just doing #1. Yet too many of us are produced in the pipeline that lots of people are scrambling to do #2.

My current job is closest to 2. It’s a non surgical university job at diabetes center. It would be more like 2 if Ortho wasn’t involved. I take no call. Podiatry is part of their department at the hospital but I’m employed by the endocrinology division at the University. Lots of politics.

 

[SouthPod7]

It’s easier to make over $200k working as a PCP and you can go anywhere in the country, but your income is capped (none of our PCPs come anywhere close to my compensation) and I would kill myself if I had to do their job. It’s miserable work. The only way you could talk me into being a PCP would be if you could assure me after a few years I could move into a completely non clinical role somewhere with a $250-300k income.

I still like practicing Podiatry more than I would many Physician specialties. But there are certainly more Physician specialties/jobs that I would enjoy more than I THOUGHT I would as an undergrad student. I also didn’t realize how easy it would be to match into any one of those specialties as a DO. We took the same classes and tests as them. I would have been ranked in the top 25% of the DO class easily. I was scared for no reason. But I knew none of this as a senior in college. It’s all hindsight.

Oh for sure. But it's not a completely even comparison, right? I'm sure there are SOME parts of practicing Podiatry that you don't enjoy. Plus, they have the flexibility to pick up shifts in urgent care/ER/hospitalist/etc. They don't have to take call. They can pivot into non-clinical/admin much easier.

Also, I am genuinely happy that you like your current job. I like my current job, too. But what would happen if you lost that job? What would your next move be? A PCP doesn't have to move states to get a new job.

Personally, if I lost my current job, I don't know if I'd even want to keep practicing Podiatry anymore. I can't subject my family to another cross-country move and I genuinely do not want to open my own practice. I do think Podiatry is viable for people who are committed to opening up shop day 1 after residency. It's just not for me. I never really wanted to be a business owner and prefer being employed.

 

[newfeet]

Oh for sure. But it's not a completely even comparison, right? I'm sure there are SOME parts of practicing Podiatry that you don't enjoy. Plus, they have the flexibility to pick up shifts in urgent care/ER/hospitalist/etc. They don't have to take call. They can pivot into non-clinical/admin much easier.

Also, I am genuinely happy that you like your current job. I like my current job, too. But what would happen if you lost that job? What would your next move be? A PCP doesn't have to move states to get a new job.

Personally, if I lost my current job, I don't know if I'd even want to keep practicing Podiatry anymore. I can't subject my family to another cross-country move and I genuinely do not want to open my own practice. I do think Podiatry is viable for people who are committed to opening up shop day 1 after residency. It's just not for me. I never really wanted to be a business owner and prefer being employed.

Same. I want to know how the DPMs who became CMO, CMIO etc did it because I would love to transition into a non-clinical role at some point. If I lost my current job it would be a disaster. I have no interest in dragging my family to whatever job I find. I also have no interest in private practice. Worst case I open one just so we don't move again but there are a lot of practices already in the area now and I would never go work for them. I rather do nursing homes at that point and set up a practice even an hour away just to stay in these area.

 

[diabeticfootdr]

Same. I want to know how the DPMs who became CMO, CMIO etc did it because I would love to transition into a non-clinical role at some point.

Explore another degree or formal education in healthcare management. Field promotions based solely on experience are becoming more rare.

 

[diabeticfootdr]

As I enter my PGY3 year I must say that podiatry was the worst choice I've ever made in my life. I am completing a grueling residency. The work is nonstop. I feel surgically competent in some areas and deficient in others. I have looked at jobs and have been in talks with some people and the offers are all below $150k. I have nearly $300,000 of student loans. I completed 4 years of undergrad, 4 years of podiatry school, and now I am finishing a 3 year residency. In total I have went 11 years beyond a standard high school education. All of the time and effort I have put into this career is not worth it. There are others who did not waste all of their "prime" years of their life and their 20's to a profession with no reward. I am called a doctor, but I cut toenails.

This post is not a troll. This post is a cry for help. At what point is this just the sunk cost fallacy? What can I actually do with my life now that I have a degree that will never payback my loans? Cost of living is outrageous right now even in rural areas.

First, I’m sorry you’re becoming depressed about the profession.

There are many options, but just like any other profession, many times you have to create these opportunities for yourself. I tell residents they can’t just “look for a job”. You have the opportunity to create the perfect job for yourself. Write down goals and a plan on how to get there. Find people who can mentor you (probably most important).

And lastly, providing nail care isn’t just about nails. That’s not why it’s a paid service. It is about conducting a risk assessment. That’s why it’s a doctor’s job. Focus on strategies to prevent ulcers and amps and keep patients active. Remote Patient Monitoring is the future and reimburses quite well, for the work involved. But it’s part of a comprehensive program that you create.

Diversifying yourself (in work or life) helps keep you interested and happy. I produced movies, dabbled in politics, invented devices/processes, invested in various companies, etc. I enjoy teaching and traveling. Podiatry gave me access to all these things.

Keep your chin up (create an action plan) and PM me if you need to chat.

 

[newfeet]

Explore another degree or formal education in healthcare management. Field promotions based solely on experience are becoming more rare.

Thank you! I have and I’ve turned down two master programs because traveling out of the area to attend classes wasn't a good idea at this time. I’m looking at online programs right now but online courses are little nerve wreaking.

But we will see.

 

[HardRoadPaved]

And lastly, providing nail care isn’t just about nails. That’s not why it’s a paid service. It is about conducting a risk assessment. That’s why it’s a doctor’s job. Focus on strategies to prevent ulcers and amps and keep patients active.

I have to disagree unfortunately. 1172x is reimbursed for the nail cut and that's it. The nail salon next to me charges $35-50 for a pedicure. That requires minimal education and a simple business plan. Ours requires 11 years of post graduate education and medical licensure with CME and malpractice insurance.

While I agree that we should be working on patient plans and strategies, Medicare and commercial insurances see it differently. There is no such thing as a "diabetic foot risk visit." An e/m requires a chief complaint and having a foot and also having diabetes is called a screening. Screenings are not medically necessary in many instances.

Annual Diabetic Foot Exams | TLD Systems

“I think it is time for this topic to resurface. Being a coder/biller for a number of podiatrists around the U.S., I am finding that some are still scheduling “annual diabetic foot exams” as a routine on all of their diabetic patients. They are then performing a “full physical exam” and trying...

www.tldsystems.com

"Medicare Part B covers foot exams every 6 months if the patient has diabetic peripheral neuropathy and loss of protective sensation, as long as the patient has not seen a foot care professional for another reason between visits."

G0245/6 is reimbursed less than 99202/12.

So basically Medicare is saying you got paid for your nails... go pound sand if you want more money for actually caring for their other ailments.

 

[Boba Foot]

I don't understand everyone who says they would be horrified to become a PCP. What's so wrong with being a PCP?

I actually routinely think about how being a PCP is probably worse than being a podiatrist.

I get at least one patient a day where I wonder why they are in my office wasting my time because nothing is wrong with them or they have a generalized vague complaint like “my whole foot hurts everywhere every once in a while” and they have no real diagnosis. Being a PCP, I imagine you get much more of those with people coming in because their tummy hurts or because their HMO forces them to get a referral for every specialist. And PCPs get way more paperwork than we do. I appreciate what PCPs do, but I do not envy what they have to deal with.

 

[DYK343]

Remote Patient Monitoring is the future and reimburses quite well, for the work involved.

How does this work being hospital employed/wRVU?

 

[diabeticfootdr]

How does this work being hospital employed/wRVU?

There are CPT codes, so there are associated RVUs, but the biggest benefit is actually to the payer. I’ve had discussions with progressive local payers about a shared savings program, which would then provide more financial benefit on the prevention side for the provider.

Alternatively, see if you can get a carve out for the RPM CPTs for you specifically, as a new source of revenue.

There are about 15% positive alerts on temperature monitoring per year. Those turn into regular visits and/or surgeries above the RPM revenue that go into the regular system.

Average reimbursement per patient is ~$1300/year for RPM, billed monthly. Subtract costs, depending on if you (or your team) will handle the data monitoring and alert response. We’re projecting about 54-58% overhead for devices, software, data management, and monitoring.

 

[Feli]

I think Dippin Dots was ice cream of the future at one time too.

 

[Feli]

I think I understand where you're coming from. I agree that for most people, podiatry may not provide a good return on investment.

However, I'd like to suggest a change in your mindset. It's easy to let stress and other factors overshadow your happiness, leading to discouragement. Instead, try to find positivity in your day-to-day experiences (toenails and all).

By treating your patients with kindness and maintaining a positive outlook, you'll attract more opportunities and patients. Success will come your way, but it requires patience....

Generally great info. I agree that podiatry can have great ROI, but few will attain that, and it requires a lot of pro-activity when compared to most health professions.

In podiatry, one basically has to keep trying and trying for lender and/or being very frugal to get a chunk of $ to start up or buy out a PP.

The other choice is to aggressively cold call, network, and check obscure job sources... fire off a readied CV very fast before the job closes due to overflow of apps.

And yes, I agree 1000% with positivity in the current exp, whatever that maybe... that's critical. Think of associate gig as a (higher paid) fellowship in PP so that you can become owner one day... consider the stuff you don't like as ammo for saving to get out of that grind. Joke about the dinky VA or rural hospital job as minor leagues for a real major league system where your partner won't be bored to tears or you'll be doing more fractures than amps one day. Even a nursing home side hustle is just a bridge to get the patient volume up or pay off the loans.

...I hate to say it, but anyone passively working their 30% associate DPM job and barely paying their loans and not saving much and waiting for some luck won't just find a $250k hospital job in PM News one day or even tend to get a call back for a VA job. Not in podiatry. It takes patience and persistence. The vast majority of DPMs end up here: mediocre income, not saving much, stuck in the loop as CV shows more and more mediocrity (and usually not the ABFAS or hospital job exp that most of the highest pay employed jobs want).

Luck is the intersection of preparation and opportunity... and the opportunity part frequently needs to be dug out of the deep deep deep rough in podiatry.

 

[dtrack22]

But it's not a completely even comparison, right? I'm sure there are SOME parts of practicing Podiatry that you don't enjoy. Plus, they have the flexibility to pick up shifts in urgent care/ER/hospitalist/etc. They don't have to take call. They can pivot into non-clinical/admin much easier

I mean, yeah, the marketability of the MD/DO degree for non clinical work is a huge plus for them and a huge negative for us. But the day to day job of being a PCP blows. And they can pick up those shifts but then why do a family medicine residency? Like I said, I would rather practice podiatry than be a family medicine doc. If I was a family medicine doc the only perk would be that I could (and would) leave.

But what would happen if you lost that job? What would your next move be?

I would open up shop and run my own practice across the street like I did before I started my current gig. I don’t really want to be in private practice, but I could keep my current income in my current location without much difficulty.

And PCPs get way more paperwork than we do.

Yes. The doctors in our group that complain the most is by far and away PCPs. And those complaints are centered around paperwork they aren’t being compensated for 90% of the time and production/income the remaining 10% of the time.

 

[Boba Foot]

Yes. The doctors in our group that complain the most is by far and away PCPs. And those complaints are centered around paperwork they aren’t being compensated for 90% of the time and production/income the remaining 10% of the time.

Having to sign off on every diabetic shoe request, lol.

 

[PatchAdamsFan]

The hospitalists in my group hit 350k+ working 7 days on 7 days off, and their mean $/wRVU is in line with MGMA data which is about $20 higher than podiatry. The only ceiling is how much you want to work. I'm not even going to mention the surgical specialists, who we should be "comparing" ourselves too. We are severely underpaid even in MSG/Hospital settings, let's not kid ourselves. You can make good money in the right position - the less we count other people's money, the happier we'll be.

 

[newfeet]

The hospitalists in my group hit 350k+ working 7 days on 7 days off, and their mean $/wRVU is in line with MGMA data which is about $20 higher than podiatry. The only ceiling is how much you want to work. I'm not even going to mention the surgical specialists, who we should be "comparing" ourselves too. We are severely underpaid even in MSG/Hospital settings, let's not kid ourselves. You can make good money in the right position - the less we count other people's money, the happier we'll be.

At my old gig the CRNAs were paid more than I was. 😒

 

[dtrack22]

We are severely underpaid even in MSG/Hospital settings, let's not kid ourselves.

Correct. I tried to mention this in a VA thread and some VA folks seemed offended. I’m underpaid purely from a $/wRVU standpoint. Our median is closer to medical specialties/primary care than it is other surgical specialties. We should be at or over $60 per wRVU, not low to mid $50’s.

 

[DYK343]

Correct. I tried to mention this in a VA thread and some VA folks seemed offended. I’m underpaid purely from a $/wRVU standpoint. Our median is closer to medical specialties/primary care than it is other surgical specialties. We should be at or over $60 per wRVU, not low to mid $50’s.

Someone with up to date MGMA data please correct me but isnt the national average wRVU for DPM more in the $48-49 range?

 

[dtrack22]

Someone with up to date MGMA data please correct me but isnt the national average wRVU for DPM more in the $48-49 range?

If a survey showed it that low it was the one following covid lockdowns or one that had a lot of months were production was way down due to COVID/lack of office visits and elective cases. It was higher than that in the 2019 survey. I just checked, the 2019 survey (2018 calendar year data) had a national median $/wRVU compensation of $51.87

The west region median was $54 in spring 2021 which is when I signed. That was pulled from the MGMA website (right in front of me) I would assume that isn’t “live” but just a database of the most recent survey. So maybe 2020 survey from 2019 data? The west region is generally higher than the national median but not by $6.

 

[NatCh]

Let me tell you a secret. There are no smart podiatrists. Why? because if they had the grades and test scores they would have gone DO/MD. If the podiatrist had the grades and test scores but still went for DPM, well that kind of speaks for itself.

Seriously though, most pods would have preferred to go MD/DO but settled for DPM due to grades, length of training, MCAT, etc. This has resulted in a massive inferiority complex for the profession.

That's terrible.

 

[air bud]

That's terrible.

Terribly accurate?

 

[air bud]

Terribly accurate?

I mean just looking for clarification. That's terrible is vague and can be misconstrued....and this is the internet we don't need any wild speculation.

 

[Pronation]

Was NatCh’s account hijacked by LCR?

 

[prepod2016]

Just a thought , and this isn’t my goal. Why don’t more people pursue a career in nursing homes ? Seems low stress, only have to work a couple days a week and possibly feasible to do other things during the extra time to make money unrelated to podiatry. I figure it’s partly an ego thing but I wanna hear from actual podiatrists

 

[NatCh]

Just a thought , and this isn’t my goal. Why don’t more people pursue a career in nursing homes ? Seems low stress, only have to work a couple days a week and possibly feasible to do other things during the extra time to make money unrelated to podiatry. I figure it’s partly an ego thing but I wanna hear from actual podiatrists

I don't do that because I have no need to.

 

[SouthPod7]

Has anyone seen REALLY good nursing home contracts? The couple I've seen were 100k, independent contractor, no bennies, with strict non-competes. Hardly seems much better than a typical associate contract.

 

[DYK343]

Just a thought , and this isn’t my goal. Why don’t more people pursue a career in nursing homes ? Seems low stress, only have to work a couple days a week and possibly feasible to do other things during the extra time to make money unrelated to podiatry. I figure it’s partly an ego thing but I wanna hear from actual podiatrists

A lot of bending over all day. Would kill the back

A lot of fraudulent billing so you can get it covered. Remember medicare doesnt cover nail care or callus care unless XYZ is met.

Pay is garbage when you do it at their facility. If you do it in your own practice it pays a lot more. At a nursing home the reimbursement is terrible (someone can quote direct reimbursements but something along the lines of $100 vs $30)

To do it correctly you need to sterilize instruments - autoclave.

Most importantly I would kill myself.

 

[icebreaker32]

Just a thought , and this isn’t my goal. Why don’t more people pursue a career in nursing homes ? Seems low stress, only have to work a couple days a week and possibly feasible to do other things during the extra time to make money unrelated to podiatry. I figure it’s partly an ego thing but I wanna hear from actual podiatrists

Not an ego thing.

Pay is extremely low. Like under $20 at a facility for a nail trim. Some in charge of deciding what podiatrist comes to their facility wrongly believe it is very lucrative and expect gift cards etc I have been told. Back breaking work many times with no one helping you at a facility. Lots of audits. Temptations to bill nail avulsions for nail trims and do fraud....stupid most get caught.

Now home visits and assisted living facilities can be a bit more lucrative if do shady things on every patient because most extra services in a nursing home will not reimburse like vascular testing and ultrasound. That is why those mobile podiatry buses were built....have no idea if this is a legitimate or fraudulent work around for another place of service.

The problem with home visits is scheduling at the patient's convenience and driving to the poor part of town and nasty homes.

Assisted living facilities might be a bit better but how many would it take to make a living.....probably at least 90.

 

[prepod2016]

Not an ego thing.

Pay is extremely low. Like under $20 at a facility for a nail trim. Some in charge of deciding what podiatrist comes to their facility wrongly believe it is very lucrative and expect gift cards etc I have been told. Back breaking work many times with no one helping you at a facility. Lots of audits. Temptations to bill nail avulsions for nail trims and do fraud....stupid most get caught.

Now home visits and assisted living facilities can be a bit more lucrative if do shady things on every patient because most extra services in a nursing home will not reimburse like vascular testing and ultrasound. That is why those mobile podiatry buses were built....have no idea if this is a legitimate or fraudulent work around for another place of service.

The problem with home visits is scheduling at the patient's convenience and driving to the poor part of town and nasty homes.

Assisted living facilities might be a bit better but how many would it take to make a living.....probably at least a 90.

90 per day ?

 

[icebreaker32]

90 per day ?

90 assisted living facilities (I am sure some do with less and up the charges one way or another....depends of if you are seeing a half a dozen or 20 per facility also).

 

[Jummy Biffett]

Not an ego thing.

Pay is extremely low. Like under $20 at a facility for a nail trim. Some in charge of deciding what podiatrist comes to their facility wrongly believe it is very lucrative and expect gift cards etc I have been told. Back breaking work many times with no one helping you at a facility. Lots of audits. Temptations to bill nail avulsions for nail trims and do fraud....stupid most get caught.

Now home visits and assisted living facilities can be a bit more lucrative if do shady things on every patient because most extra services in a nursing home will not reimburse like vascular testing and ultrasound. That is why those mobile podiatry buses were built....have no idea if this is a legitimate or fraudulent work around for another place of service.

The problem with home visits is scheduling at the patient's convenience and driving to the poor part of town and nasty homes.

Assisted living facilities might be a bit better but how many would it take to make a living.....probably at least a 90.

I think with a large enough catch area and only taking cash/Medicare you could probably do pretty well. @Creflo seems to have figured that out. Overhead is very low compared to brick and mortar PP office. If you can see 20-30 patients in an ALF even just 3 or 4 days a week I bet that translates to a better living than an associate job

 

[dtrack22]

Just a thought , and this isn’t my goal. Why don’t more people pursue a career in nursing homes ? Seems low stress, only have to work a couple days a week and possibly feasible to do other things during the extra time to make money unrelated to podiatry. I figure it’s partly an ego thing but I wanna hear from actual podiatrists

It’s not easy work. It’s no different than going to a construction site every day. You’re going room to room and/or sitting on foot stools or the ground or bending over while patient lies in bed. The facility rate for nail debridement is around $20. Actual nursing home patients don’t have calluses because they don’t ambulate enough to get them. You could get some facilities that set you up in a room and are good at bringing patients to you but that’s unlikely, so it’s inefficient. 20-30 patients will easily take you most of the day. If you want to make more than associate pay ($100-120k) then you either make stuff up (fraud) or you see way more than 20 patients in a day and work way more than 2-3 days per week. You could knock out a lot more patients with an MA, but now you have overhead and you HAVE to see that many more patients to make the same amount of money.

If you’re going to bust crumblies all day you are much better off doing it in your own office with a cheap EHR system and like a single employee. There is no reason to go to a nursing home (or assisted living facility where many/most don’t qualify) to cut toenails. The ONLY reason it even exists is because there are so many podiatrists that a small % have no other choice but to take a job busting crumblies in nursing facilities because they literally can’t do or find anything better

 

[Poddy2Hotty]

Keep your chin up! Stay positive and remember...

 

[newfeet]

Keep your chin up! Stay positive and remember... View attachment 371212

Where is this bus from?

 

[Hybrocure]

Where is this bus from?

That’s the pus bus

 

[dtrack22]

Where is this bus from?

Seattle. Unless the Polyclinic exists in other cities/regions?