Fellowship after residency F.A.C.F.A.S

[PmDawn]

I have a question relating to fellowships and post residency for DPMs.

1. How hard is to obtain F.A.C.S or F.A.C.F.A.S after podiatry residency and what kind of advantages do you have vs. non FACFAS?

2. What are the chances/procedures of obtaining an Orthopedic ankle and foot fellowship? (I have heard of a few DPMs that have done this)

3. Will a DPM who performs a surgery be compensated differently than a Ortho Pod that performs the same procedure.

Comments will be appreciated

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[Feli]

1. To be a fellow of ACFAS (FACFAS), you have to be ABPS certified (passed written, compiled case logs, and passed orals). To be an associate member (AACFAS), you have to have passed ABPS written ("board qualified") and be in the process of compiling cases for the oral exam.

It's reasonably hard to reach the point of ABPS certification and joining as a FACFAS. A bigger and bigger % of DPM grads accomplish it due to more advanced training programs, but it's certainly not a cakewalk or something everyone who graduates podiatry school ends up doing. Even grads who complete a 3yr program have no guarantee they'll pass ABPS exams, get the cases, etc. It's pretty hard work.

ABPS is the certifying board, and advantages are that their certification is required to be on staff and get privileges at many hospitals as well as required to be included in many insurance plans. ACFAS is the professional organization, and they are more involved on the continuing medical education: scientific meetings, journal, skills labs, resources for F&A surgeons, etc.

2. You can always apply for ortho F&A fellowships or jobs as a DPM, but the ortho F&A fellowships training a DPM is fairly rare and largely based on connections (ie you rotated with that ortho dept during your residency or your residency director know the guy).

#3 I'm not sure about... don't think so assuming the insurance is the same, but I'll defer to practicing docs?

www.acfas.org
www.abps.org

 

[PmDawn]

1. To be a fellow of ACFAS (FACFAS), you have to be ABPS certified (passed written, compiled case logs, and passed orals). To be an associate member (AACFAS), you have to have passed ABPS written ("board qualified") and be in the process of compiling cases for the oral exam.

It's reasonably hard to reach the point of ABPS certification and joining as a FACFAS. A bigger and bigger % of DPM grads accomplish it due to more advanced training programs, but it's certainly not a cakewalk or something everyone who graduates podiatry school ends up doing. Even grads who complete a 3yr program have no guarantee they'll pass ABPS exams, get the cases, etc. It's pretty hard work.

ABPS is the certifying board, and advantages are that their certification is required to be on staff and get privileges at many hospitals as well as required to be included in many insurance plans. ACFAS is the professional organization, and they are more involved on the continuing medical education: scientific meetings, journal, skills labs, resources for F&A surgeons, etc.

2. You can always apply for ortho F&A fellowships or jobs as a DPM, but the ortho F&A fellowships training a DPM is fairly rare and largely based on connections (ie you rotated with that ortho dept during your residency or your residency director know the guy).

#3 I'm not sure about... don't think so assuming the insurance is the same, but I'll defer to practicing docs?

www.acfas.org
www.abps.org

Great advice Feli thanks,
Some DPMs say that the more specialized you get the less likely hospitals are to hire you, because they would have to pay you more. Is this true?

 

[car36]

Yes pods do get paid less than ortho surgeons for the same procedure. Doesn't make sense but the reimbursment rates are still different for pods. Something APMA needs to fight harder for.

 

[southern dpm]

At least in my case, board certification does not make a good surgeon. I need it because some insurance companies require it to be on their plans, they do give you time to obtain it. My hospital actually requires it after a certain amount of time to be a full staff member. I have never had a patient want to see my partner over me due to the fact he is board certified and I am board qualified. If I dont pass my oral boards in june, I dont think the next day I am suddenly less of a surgeon. I dont think you are a bad surgeon if you dont pass it. Might have just had a bad day. But I think it is necessary to establish some consistency with in the podiatry field. Just like mandating 3 year surgical residency.

 

[PADPM]

Yes pods do get paid less than ortho surgeons for the same procedure. Doesn't make sense but the reimbursment rates are still different for pods. Something APMA needs to fight harder for.

I don't know where you've obtained this information, but this is absolutely not true. I practice in two different states and can tell you as a FACT that no matter what type of doctor bills for a procedure, the reimbursement is exactly the same.

As a general rule, orthopedic surgeons are PAID more as an income by their actual employer, but not by the insurance company when a claim is submitted.

An MD, DO, DPM all receive the same reimbursement from an insurance company for the same procedures performed.

 

[krabmas]

I don't know where you've obtained this information, but this is absolutely not true. I practice in two different states and can tell you as a FACT that no matter what type of doctor bills for a procedure, the reimbursement is exactly the same.

As a general rule, orthopedic surgeons are PAID more as an income by their actual employer, but not by the insurance company when a claim is submitted.

An MD, DO, DPM all receive the same reimbursement from an insurance company for the same procedures performed.

I think this is only true if your state has a parody law.

 

[PADPM]

First of all, I believe you mean "parity" law, and second of all I'm not sure that there really is such as thing as a "parity" law of if that's just urban legend.

 

[PharoPod]

Yes pods do get paid less than ortho surgeons for the same procedure. Doesn't make sense but the reimbursment rates are still different for pods. Something APMA needs to fight harder for.

Thanks for clarifying this issue (PADPM).

I totally agree since I have worked as a biller and a CPT code is a CPT code regardless of the provider.

MDs who bill for physical therapy get paid at the same rate as a physical therapist (I know an MD who used to do the therapy himself), same thing for procedures done by podiatrists, you get paid for a derm procedure as a dermatologist, for ortho as an orthopedist, for surgery as a surgeon,....etc

car36, no insult, but I see you are a pre-podiatry, and it is clear that you are not qualified to give information regarding issues like this.

Please, please, people be careful with the information you spread about the profission!!!

 

[Feli]

...I have worked as a biller and a CPT code is a CPT code...

That experience will probably be solid gold if you go into private practice.

 

[PharoPod]

That experience will probably be solid gold if you go into private practice.

I used to earn a living doing this and it is an advice to all students doing externships at private practices. Do not make your main concern doing procedures, the residency is waiting for you, you should also try to figure out what they do the in the back office and the front desk and how to manage a practice if you plan to have your own in the future.

 

[PADPM]

I couldn't agree more. I know many doctors in private practice that are completely at the mercy of their office staff. If an office staff member is out one day, the doctor is lost or the entire operation has the potential to come to a sudden halt.

If you go into private practice, make sure you know EVERYTHING about your own practice. I mean EVERYTHING.

When I first started practice, computers were in their infancy, and most practices were not yet computerized and billing was done the old fashioned way....by hand via a "peg-board" system with billing cards, etc. It was actually a very efficient system and very easy to track patient balances, etc. Additionally, typewriters were still a staple in most offices.

I was capable of handling every aspect of my own practice, from ordering supplies, to developing x-rays, to booking patients, to checking on insurance claims, to obtaining insurance referrals, to typing a letter, to billing patients and posting insurance payments. This way I had total control of my office and was dependent on NO ONE.

Of course as my business grew, I delegated more responsibility to others, but to this day I know how to do everything in our office, despite the fact that we have a huge practice with over a dozen doctors and staff in some of our offices that I've never even met!!!

So the bottom line is that in addition to being a great doctor, IF you open your own practice, please make sure YOU know your own business and please don't depend too heavily on others to make YOUR practice successful.

And always have a good accountant and attorney......in that order.

 

[PharoPod]

I couldn't agree more. I know many doctors in private practice that are completely at the mercy of their office staff. If an office staff member is out one day, the doctor is lost or the entire operation has the potential to come to a sudden halt.

If you go into private practice, make sure you know EVERYTHING about your own practice. I mean EVERYTHING.

When I first started practice, computers were in their infancy, and most practices were not yet computerized and billing was done the old fashioned way....by hand via a "peg-board" system with billing cards, etc. It was actually a very efficient system and very easy to track patient balances, etc. Additionally, typewriters were still a staple in most offices.

I was capable of handling every aspect of my own practice, from ordering supplies, to developing x-rays, to booking patients, to checking on insurance claims, to obtaining insurance referrals, to typing a letter, to billing patients and posting insurance payments. This way I had total control of my office and was dependent on NO ONE.

Of course as my business grew, I delegated more responsibility to others, but to this day I know how to do everything in our office, despite the fact that we have a huge practice with over a dozen doctors and staff in some of our offices that I've never even met!!!

So the bottom line is that in addition to being a great doctor, IF you open your own practice, please make sure YOU know your own business and please don't depend too heavily on others to make YOUR practice successful.

And always have a good accountant and attorney......in that order.

I am impressed doctor. This is exactly how I plan to be in few years

 

[car36]

I know PADPM is very experienced since he is running his own show, and I understand the experience of others in coding, but you are wrong. Just what you think is the cases isn't true. There are insurance providers and states that DO NOT pay the same for a podiatrist doing a bunion and an Ortho doing a bunion. That's just one example. This is 100% true. I can tell you from experience in trying to fight this case with insurance companies and state legislatures. So don't be surprised if you run into this when you actually practice and are not a resident or an experienced coder...you need to do some more homework before you throw stones at things YOU DO NOT KNOW.

 

[that1guyfromFL]

I know PADPM is very experienced since he isn't in practice yet and running his own show, and I understand the experience of others in coding, but you are wrong....get out more before you throw stones at things YOU DO NOT KNOW.

The heck are you talking about/to?

 

[car36]

read the thread it is posted to, that could help you

 

[that1guyfromFL]

read the thread it is posted to, that could help you

What you initially wrote (before you edited it today) was completely unintelligible, your original reference to PADPM made zero sense in the context of the thread. Nice try.

 

[car36]

The heck are you talking about/to?

Just like this "unintelligible" comment? You're an idiot

 

[244869]

Just like this "unintelligible" comment? You're an idiot

Why did you put quotes around unintelligible?

Read your original post...that1guyfromfl quoted you...it doesn't make any sense.

You are a podiatry student...not a podiatrist.

You're the idiot.

 

[krabmas]

please maintain civility.

Just because this can be an anonomous forum does not mean that you must insult and disrespect others.

I once received great advice, which I'm sure you have heard before:

If you have nothing nice to say, then don't say anything at all.

Some other things to think about:

Would you make that comment to the other poster's face, if so, you may want to re-think medicine, there is no room for egos although there are lots that get in the way.

 

[PADPM]

I know PADPM is very experienced since he is running his own show, and I understand the experience of others in coding, but you are wrong. Just what you think is the cases isn't true. There are insurance providers and states that DO NOT pay the same for a podiatrist doing a bunion and an Ortho doing a bunion. That's just one example. This is 100% true. I can tell you from experience in trying to fight this case with insurance companies and state legislatures. So don't be surprised if you run into this when you actually practice and are not a resident or an experienced coder...you need to do some more homework before you throw stones at things YOU DO NOT KNOW.

car36,

Since your post is pretty unclear and ambiguous, I sure hoping that some of the negative comments you made were not directed at me.

I didn't become involved with building one of the busiest practices in the country by not knowing what I'm talking about.