How Much is Surgery Worth to You?

[Scrantonicity]

Commonly hospitals provide a stipend for consulting providers for uninsured/underinsured patients.
Typically pays medicare rates.
I had it at my last gig. Not sure how common it is for DPMs but it does exist.

I wouldnt take call for free. I wouldnt accept less than $800 a day to take call if I were private practice.

Man...that would have been nice. Nothing like that existed in any of the hospitals I was affiliated with. Oh well. I guess it prepared me for the VA in house stuff I do now. Thankfully very few cases after normal working hours, though.

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[DYK343]

Man...that would have been nice. Nothing like that existed in any of the hospitals I was affiliated with. Oh well. I guess it prepared me for the VA in house stuff I do now. Thankfully very few cases after normal working hours, though.

I saw the breakdown on some of the cases I do. Some of the easiest stuff like 5th toe arthroplasty is billed out at 15k.
Crazy.

They can afford to pay you but wont when a scab down the road will do it for free.

Luckily all the DPMs where I used to work in the whole area banned together and refused free call.
If they wanted us they had to pay us - and they did.

 

[Scrantonicity]

I saw the breakdown on some of the cases I do. Some of the easiest stuff like 5th toe arthroplasty is billed out at 15k.
Crazy.

They can afford to pay you but wont when a scab down the road will do it for free.

Luckily all the DPMs where I used to work in the whole area banned together and refused free call.
If they wanted us they had to pay us - and they did.

You're right. I was that scab down the road lol. Being a "yes" man all the time isn't the way, and looking back I wish I had stuck up for myself more! Both to my employers (DPM's that would hardly do the work themselves) and to the hospitals. In some ways I think a lot of us just want to be liked by the hospitalists and others who we want to work "shoulder to shoulder" with, so we put up with the downright disrespect of our valuable time just to garner some sort of "professional respect." Looking back though, it gets you nowhere...

 

[DMEpod]

It may just be my location because it was a good amount of medicare and united that came into the ED. The 250/day stipend was more of a slap in the face than a real cover. One of the reasons I stopped because the ortho and vascular is getting well over 1k a day.

 

[Feli]

It may just be my location because it was a good amount of medicare and united that came into the ED. The 250/day stipend was more of a slap in the face than a real cover. One of the reasons I stopped because the ortho and vascular is getting well over 1k a day.

The ER and consult and refer and WC center providing train of wound/amp/pus patients is better than nothing at all in the early goings of PP. It works ok as a bridge to true PP.

I wouldn't intentionally build a practice base on it - esp solo. It may work ok financially in some areas, but it will wreck your good hours (which is one of the main $trength$ to doing PP in the first place). It's usually best to phase pus pts out and let the hospital FTEs do that stuff if you have better options. In any area where wound pod PP would be viable (good payers), derm/ortho/nail would still be better and more profitable than wounds. The hard part is balance of keeping some time open for the good new pt appts... not letting the wounds clog your appointment slots.

The only long haul wound-based PPs that I see generally are the startup ones that don't have enough good appt/refer yet, the associate mills or resident coverage (cheap labor does the wound/amp work), or ones in ultra-competitive areas where that wound work is their niche out of necessity (and the have a group of docs to share call/rounding). Wound patients tend to largely be disabled or under/unemployed. It's just a real grindy way to make a living.... totally non-viable in many areas.

...Besides, honestly, there is a good reason MDs avoid that work like the plague. It sucks. It is easy and boring... yet depressing and low pay and high legal risk. I'm not above doing wound/amp, but I sure don't go looking for it or asking for it.

Man...in what universe? I did PP pus patrol for 10 years, and I only gathered treasures in heaven. Almost never got paid for it here on earth. Almost always indigent with no insurance. Or maybe they are in the process of applying for Medicaid so I can get paid my $50 or whatever it ended up being lol. People with good insurance tend to take better care of themselves, period. I'm sure I got paid for some, but man it's really just charity most of the time--which is OK, I mean someone has to do it, and I mostly did it gladly...but literally everyone else around you (the scrub techs, nurses, everyone helping with the case) is getting paid for it but you haha.

Ya, pretty much that.^

 

[DYK343]

high legal risk.

Is it though? Pretty hard to get sued for a pus filled foot.

I would say its on par with trauma in difficult to be sued for.

Isnt a matrixectomy the #1 thing a DPM will be sued for? (Someone somewhere - possibly on here - told me this)

 

[Adam Smasher]

Re: indigent/uninsured: if they have type 2 DM, they probably have medicaid at the very least because how else do they get their insulin? Actually nevermind, I know the answer to this...

Re: reimbursement: don't look at just the fee for the surgery. after amputation, they qualify for diabetic shoes plus the phat L5000. Also amputee=automatic coverage for routine nail care ever after.

This is a highly podiatric comment.

Even in suspension, his words are haunting

 

[Feli]

Is it though? Pretty hard to get sued for a pus filled foot.

I would say its on par with trauma in difficult to be sued for.

Isnt a matrixectomy the #1 thing a DPM will be sued for? (Someone somewhere - possibly on here - told me this)

Anything where the pts don't know you much/any before surgery is easy to get sued on (trauma, infection).
That is why any malpractice company app asks if you do wound care or if you take call: it's higher risk probabilty.
(the other standard questions like professional athletes or clinical trials or off label and stuff are due to potentially higher settlements)

BKAs are serious morbidity and decent sized settlements, and it can always be pinned to the wound care doc or foot amp attempt (not necessarily successfully... but just settlement attempt, try for a big "nuisance" settlement from the lawsuit). Sad but true. All it takes is somebody getting into a BKA patient's ear at the bar a year after the amp and telling them they deserve a payday. Plenty of med mal attorneys do contingency, and that is a major amp disability settlement to try for a % of it (even more if the pt was working prior to BKA). The patients obviously have nothing to lose and plenty of time on their hands... why not try for a big check?

You can get sued for anything, but wound/salvage is near the top in podiatry. Infections are top likelihood for DPM med mal settlements.
The re re docs doing ilizarov chopart tendon transfer nonsense that gets osteo and BKA a couple months later won't face the music as they are univ/VA employed, but you can't get away with that junk in PP (for payers and efficiency and malprac reasonings). It's buyer beware... esp when it's often little or no pay for PP docs.

...last, not to be discounted is that in PP, you also carry biz insurance, liability, work comp, etc policies. The wound pts are often BIGGUNS, poor balance, geriatric, poor health, etc. It is certainly NOT ideal as a small biz owner to have those pts running over your staff's feet with wheelchair, staff pulling out their back transferring the pt to chair, pt pinches their finger on wheelchair on door frame, staff gets knee caught under a power chair, pt has a fall or medical issue in office, heifer pt breaks your office room $10k power chair, etc. Those are things that are not the DPM's problem in a hospital. In PP, those are other liability angles aren't med malprac... but still not insignificant, still legal risk. You just don't really have those problems with kids' ingrowns and SAHM bunions and weekend warrior SER-2 and Achilles stuff.

 

[heybrother]

Maybe I should thank my WHC doctor. I've actually done a bunch of offloading surgeries on people with recurrent wounds who have good commercial insurance. I've mentioned before that some small business have deteriorating health insurance (ie. PPO->HMO), but a lot of the big box businesses have BCBS PPO. Walmart, HEB, "car mechanics" chains, etc.

 

[air bud]

Yeah, you get paid for everything if your employed with RVUs. If you had Private Practice people staying out of hospitals and taking free call it would actually be much better for the profession.

 

[Feli]

Yeah, you get paid for everything if your employed with RVUs. If you had Private Practice people staying out of hospitals and taking free call it would actually be much better for the profession.

This would be awesome. ^^
Hospital DPMs could get paid for pus bus, and PP could have their nights/lunch/weekends.

Unlikely to ever happen in any decent insurance area since PP will be saturated and PP will do the pus/wound (or hire associates to do it) while they try to build up ortho/derm pt base in the office. PP will think the hospital pod is stealing their pts, and hospital pod will think PP is taking all of the good stuff. Everyone's scared of "losing the patient." Scarcity mentality.

The only place you really see it is weird payer bubbles, like VA/IHS or in super bad payer MCA immigrant/poverty areas... PP won't (or can't) take call or consults, and hospital pods are super busy (although not usually paid too well).

 

[DYK343]

Anything where the pts don't know you much/any before surgery is easy to get sued on (trauma, infection).
That is why any malpractice company app asks if you do wound care or if you take call: it's higher risk probabilty.
(the other standard questions like professional athletes or clinical trials or off label and stuff are due to potentially higher settlements)

BKAs are serious morbidity and decent sized settlements, and it can always be pinned to the wound care doc or foot amp attempt (not necessarily successfully... but just settlement attempt, try for a big "nuisance" settlement from the lawsuit). Sad but true. All it takes is somebody getting into a BKA patient's ear at the bar a year after the amp and telling them they deserve a payday. Plenty of med mal attorneys do contingency, and that is a major amp disability settlement to try for a % of it (even more if the pt was working prior to BKA). The patients obviously have nothing to lose and plenty of time on their hands... why not try for a big check?

You can get sued for anything, but wound/salvage is near the top in podiatry. Infections are top likelihood for DPM med mal settlements.
The re re docs doing ilizarov chopart tendon transfer nonsense that gets osteo and BKA a couple months later won't face the music as they are univ/VA employed, but you can't get away with that junk in PP (for payers and efficiency and malprac reasonings). It's buyer beware... esp when it's often little or no pay for PP docs.

...last, not to be discounted is that in PP, you also carry biz insurance, liability, work comp, etc policies. The wound pts are often BIGGUNS, poor balance, geriatric, poor health, etc. It is certainly NOT ideal as a small biz owner to have those pts running over your staff's feet with wheelchair, staff pulling out their back transferring the pt to chair, pt pinches their finger on wheelchair on door frame, staff gets knee caught under a power chair, pt has a fall or medical issue in office, heifer pt breaks your office room $10k power chair, etc. Those are things that are not the DPM's problem in a hospital. In PP, those are other liability angles aren't med malprac... but still not insignificant, still legal risk. You just don't really have those problems with kids' ingrowns and SAHM bunions and weekend warrior SER-2 and Achilles stuff.

Proper documentation will hold up well in a diabetic foot infection.

Can get sued but if you document correctly, order arterial studies, consult vascular, get ID involved (if available), and work quickly to get infection out getting convicted isnt going to be easy.

Kinda like a fracture where you get adequate reduction. As long as you do a good job and document well they can talk to their bar buddies all they want. They can sue all they want. But most will be dropped.

I feel bunions, hammertoes, etc are much more likely to get sued and lose than a toe amp, TMA, I&D etc.

 

[Hybrocure]

Proper documentation will hold up well in a diabetic foot infection.

Can get sued but if you document correctly, order arterial studies, consult vascular, get ID involved (if available), and work quickly to get infection out getting convicted isnt going to be easy.

Kinda like a fracture where you get adequate reduction. As long as you do a good job and document well they can talk to their bar buddies all they want. They can sue all they want. But most will be dropped.

I feel bunions, hammertoes, etc are much more likely to get sued and lose than a toe amp, TMA, I&D etc.

I agree completely. Especially when a surgeons idea of a good bunion or hammertoe correction in X-ray is vastly different from the picture perfect foot or toe the patient expects when they look at the foot itself. They don’t care about X-rays. All that matters is if the pain is gone and if the toe is straight

 

[Feli]

Proper documentation will hold up well in a diabetic foot infection.

Can get sued but if you document correctly, order arterial studies, consult vascular, get ID involved (if available), and work quickly to get infection out getting convicted isnt going to be easy.

Kinda like a fracture where you get adequate reduction. As long as you do a good job and document well they can talk to their bar buddies all they want. They can sue all they want. But most will be dropped.

I feel bunions, hammertoes, etc are much more likely to get sued and lose than a toe amp, TMA, I&D etc.

I agree in theory, but you don't get 'convicted' in medical malpractice (unless you truly screwed up, and even then, it's large settlement as opposed to guilty/not). It's not black and white. Everything's gray.

In any med malpractice suit, the plaintiff pt attorney, typically on contingency, just wastes your doc time and wastes your med mal company attorney's time and makes accusations until they get a settlement offer. They sue the surgeon, the PCP or hospitalist, the hospital, radiologist, everyone. Very few medical suits are dropped once initiated; the plaintiff side paid (probably some loser doc with no pts and time to read) for chart review and will then push and push to make profit on the case.

Defense (doc) malpractice company knows any chance of trial loss like a BKA or puncture-to-TMA or whatever is a pretty big standard amount... and the trial would cost the malpractice company much $ win or lose (week trial is well into six figures!), so even if only a 1% or 2% chance of losing trial costs + $500k or more, they usually will just settle for $25k, $50k, 100k, etc (based on pt job, age, med facts, etc). Malpractice plaintiff side attorneys know this very well. Defense attorney knows also. The plaintiff side will take marginally strong cases and still get settlements, even if doc/hospital charts are good in defense. This is much worse in some states than others. It is very common in govt hospitals (govt workers and vets get higher settlements typically). You have no say in it.

It sadly has very little to do with objectivity, and the goal of most med mal is simply fear factor to get settlement. They know the defense doesn't want jury trial since it's an expense and chance of very huge judgement. Medical facts absolutely might make the pre-trial settlement higher or lower, but the only facts that matter are pt came in with a foot, left missing a large chunk of foot or the leg a week later. That is their bluff... and bluff they will. They have bogus 'experts' to say whatever (delay of care, wrong surgery, wrong abx, wrong imaging, pt didn't understand instructions... doesn't matter). The patient will give deposition that they mysteriously forgot all instructions the doc chart says were given, all charted things were *poof* not in fact explained to them. Consent was also not informed.

The trauma and infection pts are higher risk for this nonsense due to them not knowing the doc before the admit or surgery, and they also have need for $ typically (often unemployed, MCA, possibly substance use pts). The "Jerry Springer" patients are the ones who sue docs most (and sue the city, trucking companies, their landlords, whatever). Attorneys have ads at bus stops and in bad neighborhoods and by the freeways for good reason!

I hope you never find out how it works firsthand. It is not a fun way to learn.

...the elective is certainly not risk free by any means, but you have some rapport with them, and they seldom go on to have amp of even a toe. A crooked toe is just not the end of the world, and it's nothing compared to septic ankle BKA. The worst they could bluff on elective is CRPS or worse deformity or disfigure scar or work missed due to nonunion or something. Deep infections or bad dehiscence from elective are definitely a problem, though... particularly in good earning pts or young ppl. At the end of the day, ppl tend to avoid litigating with a doc they like and believe was trying to help them, so the point is to be nice to pts. Working people also have $ and don't tend to want to get into a legal mess or time waste unless there was a ridiculously bad outcome.
Unfortunately, you just don't have that trust in the bank with ER type pts (hence malpractice insurance app 'do you take call' question). Orthos get sued a ton. Same for trauma surgeons. Ditto for ER docs. It doesn't mean they are bad; it's just part of the territory with doing procedures on what are basically sick or injured strangers. They often won't think twice about suing (esp if PA doing post-op visits, as many surgeons use).

 

[Prehealth1011]

That's is pretty close to mine at $348K. The podiatry scam is real and it's taking years to bring it down. I'm getting close to finishing mine. With the resumption of student loans burden coming up soon I wish the very best for recent and upcoming graduates.

Why not consider a fellowship? It’ll solve all your problems 😃

 

[FutureDPM323]

Quoting our dear friend, mentor and fellow director of mine Dr. Pronation who's no longer with us, "Pus Patrol, Pus Camp, Pus Brigade."

I miss them.

What happened to Pronation?

 

[NatCh]

What happened to Pronation?

Did he over-STA his welcome?

 

[Feli]

What happened to Pronation?

He got banned for joking on his 1 board devoted and fellowship-adoring highness.

That name and respect calling is a one-way street...some DPMs go to non-podiatry SDN and pod forums starting fights and name-calling repeatedly, and others get banned for getting baited in the pod forum by that same person. There are dozens, if not hundreds, of examples of such on SDN, yet LCR gets others banned. Again and again. Down goes Cuts, Pronation, many others, me suspended awhile, list goes on. Go figure. Money and complaining talks?

 

[DYK343]

I agree in theory, but you don't get 'convicted' in medical malpractice (unless you truly screwed up, and even then, it's large settlement as opposed to guilty/not). It's not black and white. Everything's gray.

In any med malpractice suit, the plaintiff pt attorney, typically on contingency, just wastes your doc time and wastes your med mal company attorney's time and makes accusations until they get a settlement offer. They sue the surgeon, the PCP or hospitalist, the hospital, radiologist, everyone. Very few medical suits are dropped once initiated; the plaintiff side paid (probably some loser doc with no pts and time to read) for chart review and will then push and push to make profit on the case.

Defense (doc) malpractice company knows any chance of trial loss like a BKA or puncture-to-TMA or whatever is a pretty big standard amount... and the trial would cost the malpractice company much $ win or lose (week trial is well into six figures!), so even if only a 1% or 2% chance of losing trial costs + $500k or more, they usually will just settle for $25k, $50k, 100k, etc (based on pt job, age, med facts, etc). Malpractice plaintiff side attorneys know this very well. Defense attorney knows also. The plaintiff side will take marginally strong cases and still get settlements, even if doc/hospital charts are good in defense. This is much worse in some states than others. It is very common in govt hospitals (govt workers and vets get higher settlements typically). You have no say in it.

It sadly has very little to do with objectivity, and the goal of most med mal is simply fear factor to get settlement. They know the defense doesn't want jury trial since it's an expense and chance of very huge judgement. Medical facts absolutely might make the pre-trial settlement higher or lower, but the only facts that matter are pt came in with a foot, left missing a large chunk of foot or the leg a week later. That is their bluff... and bluff they will. They have bogus 'experts' to say whatever (delay of care, wrong surgery, wrong abx, wrong imaging, pt didn't understand instructions... doesn't matter). The patient will give deposition that they mysteriously forgot all instructions the doc chart says were given, all charted things were *poof* not in fact explained to them. Consent was also not informed.

The trauma and infection pts are higher risk for this nonsense due to them not knowing the doc before the admit or surgery, and they also have need for $ typically (often unemployed, MCA, possibly substance use pts). The "Jerry Springer" patients are the ones who sue docs most (and sue the city, trucking companies, their landlords, whatever). Attorneys have ads at bus stops and in bad neighborhoods and by the freeways for good reason!

I hope you never find out how it works firsthand. It is not a fun way to learn.

...the elective is certainly not risk free by any means, but you have some rapport with them, and they seldom go on to have amp of even a toe. A crooked toe is just not the end of the world, and it's nothing compared to septic ankle BKA. The worst they could bluff on elective is CRPS or worse deformity or disfigure scar or work missed due to nonunion or something. Deep infections or bad dehiscence from elective are definitely a problem, though... particularly in good earning pts or young ppl. At the end of the day, ppl tend to avoid litigating with a doc they like and believe was trying to help them, so the point is to be nice to pts. Working people also have $ and don't tend to want to get into a legal mess or time waste unless there was a ridiculously bad outcome.
Unfortunately, you just don't have that trust in the bank with ER type pts (hence malpractice insurance app 'do you take call' question). Orthos get sued a ton. Same for trauma surgeons. Ditto for ER docs. It doesn't mean they are bad; it's just part of the territory with doing procedures on what are basically sick or injured strangers. They often won't think twice about suing (esp if PA doing post-op visits, as many surgeons use).

All good points.

If I got a culture. Got vascular involved. Got ID involved. Acted quickly. Did everything right and they sued me.

I wouldnt allow a settlement. It goes on your record as guilty for all times.

Im not sure if my defense attorney would allow me to take it to court. Someday I will be in this situation but to date have not. But I dont see myself giving in.

Diabetics are fairly straight forward in what needs done. I also WAY over document everything. I document every case like im going to be sued.

- - -

I did have an attorney contact me on a patient I operated on once. Wanted every and all medical records. Patient was clearly wanting to sue but I spelled out XYZ is a potential and very possible complication because of ZYX pathology and stated it was high risk for this. Well the patient wanted the procedure/took the risk and it happened. I never heard back from the attorney after they got my notes.

Document every case like youre about to be sued.

 

[Feli]

All good points.

If I got a culture. Got vascular involved. Got ID involved. Acted quickly. Did everything right and they sued me.

I wouldnt allow a settlement. It goes on your record as guilty for all times. ...

Correct, always wise to protect yourself. Charting missed surgical f/u, failed to fill Rx, got cast wet, etc is important.

However, the malpractice company gets the decision. It is not your call.
Their attorney, representing you, and a "risk manager" make the call. They choose to "advise" a settlement to avoid trial... or continue on your own.

If you want to fight it and go to trial after they have advised settle (and offered to pay the $25k or $50k or whatever settlement), you do that trial on your own time and expense (6 figures for trial) with a new attorney... the malpractice is off the hook. There are rare malpractice insurances with a no-settle clause, but they will cost much higher rates; check your policy or call the company to find out. And honestly, even if the case is a slam dunk win (for your malprac attorney/company or on your own), they will offer a nuisance settlement (no admission of guilt) to save trial cost. You have no real say in the matter. Further, you probably actually will agree, being so sick of the slow drain of depositions and missed work and stress by that point that it's almost a minor win to settle and be done. It's lame.... 100%.

This process plays out every week, every day. Malpractice defense attorneys drive a nice Buick or Cadillac... while good malpractice plaintiff attorneys drive a fleet of Bentleys and RR and Lambo.

This is why the majority of busy surgerons (any specialty) have settlements. A lot of orthos have them almost every year. OBs and neurosurg often just keep $ in the bank and their own attorney on retainer since their malprac is so high and so many nonsense suits from late term preg comp and head injuries. The majority of busy DPMs I know have one or more settlements, especially if they do call. And yes, it is on your permanent NPDB record (but most malprac settlements for nuisance value and over ~7yrs old don't affect your rate).

 

[DYK343]

Correct, always wise to protect yourself. Charting missed surgical f/u, failed to fill Rx, got cast wet, etc is important.

However, the malpractice company gets the decision. It is not your call.
Their attorney, representing you, and a "risk manager" make the call. They choose to "advise" a settlement to avoid trial... or continue on your own.

If you want to fight it and go to trial after they have advised settle (and offered to pay the $25k or $50k or whatever settlement), you do that trial on your own time and expense (6 figures for trial) with a new attorney... the malpractice is off the hook. There are rare malpractice insurances with a no-settle clause, but they will cost much higher rates; check your policy or call the company to find out. And honestly, even if the case is a slam dunk win (for your malprac attorney/company or on your own), they will offer a nuisance settlement (no admission of guilt) to save trial cost. You have no real say in the matter. Further, you probably actually will agree, being so sick of the slow drain of depositions and missed work and stress by that point that it's almost a minor win to settle and be done. It's lame.... 100%.

This process plays out every week, every day. Malpractice defense attorneys drive a nice Buick or Cadillac... while good malpractice plaintiff attorneys drive a fleet of Bentleys and RR and Lambo.

This is why the majority of busy surgerons (any specialty) have settlements. A lot of orthos have them almost every year. OBs and neurosurg often just keep $ in the bank and their own attorney on retainer since their malprac is so high and so many nonsense suits from late term preg comp and head injuries. The majority of busy DPMs I know have one or more settlements, especially if they do call. And yes, it is on your permanent NPDB record (but most malprac settlements for nuisance value and over ~7yrs old don't affect your rate).

BRB im gonna go sue my primary.
I got loans to pay!

 

[Hybrocure]

BRB im gonna go sue my primary.
I got loans to pay!

LOL right. I feel like every MD or DO note I read is nowhere near as defensive as the average podiatry note

 

[DYK343]

LOL right. I feel like every MD or DO note I read is nowhere near as defensive as the average podiatry note

My PCP is really a nice guy. Sends me patients. A lot of patients.

But Feli just paved the way for financial freedom.

 

[shadesofgrey]

He got banned for joking on his 1 board devoted and fellowship-adoring highness.

That name and respect calling is a one-way street...some DPMs go to non-podiatry SDN and pod forums starting fights and name-calling repeatedly, and others get banned for getting baited in the pod forum by that same person. There are dozens, if not hundreds, of examples of such on SDN, yet LCR gets others banned. Again and again. Down goes Cuts, Pronation, many others, me suspended awhile, list goes on. Go figure. Money and complaining talks?

View attachment 376291
View attachment 376292

I don't agree with the moderators banning those individuals because I felt they contributed valuable info to the forums, but they definitely should have known better. I read their posts and knew they were gonna catch flack for it given how much closer the boards are moderated.
However, I don't think finding a post where LCR bashes someone from nearly 20 years ago proves your point. If anything it comes across as a tad desperate, but if it doesn't work maybe check his Myspace page??

 

[Shiyuan]

If anything it comes across as a tad desperate, but if it doesn't work maybe check his Myspace page??

Asking for a friend (@BubbaWub): What is this Myspace you speak of? I might have to advertise my practice info on this website. Please PM me details.

Thank you.

 

[Hybrocure]

I thought it was because Bubbawub was Pronation and mods told him pick one or the other

 

[dtrack22]

I don't agree with the moderators banning those individuals because I felt they contributed valuable info to the forums, but they definitely should have known better. I read their posts and knew they were gonna catch flack for it given how much closer the boards are moderated.
However, I don't think finding a post where LCR bashes someone from nearly 20 years ago proves your point. If anything it comes across as a tad desperate, but if it doesn't work maybe check his Myspace page??

Pronation really didn’t contribute anything recently. At all. It was literally the same 2-3 posts over and over again and they stopped included anything meaningful or beneficial. And Feli has LCRDS. It’s all pretty predictable at this point.

 

[Scrantonicity]

Pronation really didn’t contribute anything recently. At all. It was literally the same 2-3 posts over and over again and they stopped included anything meaningful or beneficial. And Feli has LCRDS. It’s all pretty predictable at this point.

It’s a pretty hilarious feud, but yeah it has gotten old…

 

[Adam Smasher]

I will go on record saying I have found Pronation amusing. It's no fun if all of us are writing thoughtful serious posts. Also, it will never get old when Feli keeps LCR in check, even if he's turning into Captain Ahab. Without this interpersonal drama what else do we have? Other than toenails?

 

[Feli]

I don't agree with the moderators banning those individuals because I felt they contributed valuable info to the forums, but they definitely should have known better. I read their posts and knew they were gonna catch flack for it given how much closer the boards are moderated.
However, I don't think finding a post where LCR bashes someone from nearly 20 years ago proves your point. If anything it comes across as a tad desperate, but if it doesn't work maybe check his Myspace page??

There are 100+ examples of where LCR has gone into ortho, pre-med, whatever other non-pod SDN forums (in that case optometry) looking for fights, bickered with mods, name-calls ppl, acts rude, or swore at ppl). He used to bash ABPOPPM (ABPM), bash low quality residencies, various pod schools. Now, he champions same stuff he wound make fun of since that's where he happened to end up in life. I picked an old example, sure... but it easily could have been any of a ton of examples on SDN.

I just think it's pretty ironic he never gets banned, yet he has gotten dozens of other SDN podiatry users banned for same stuff.. Some are probably deserving... but more often, LCR baits them and then reports them when they predictably call him out or retaliate.

 

[Hybrocure]

I don’t agree w pronation getting banned but some of the others were unnecessarily aggressive. It’s fine to be negative but some people get way too worked up out of nowhere. Personal attacks are never cool. Feli and Lee are both good posters I wouldn’t support banning either of them though

 

[icebreaker32]

There are 100+ examples of where LCR has gone into ortho, pre-med, whatever other non-pod SDN forums (in that case optometry) looking for fights, bickered with mods, name-calls ppl, acts rude, or swore at ppl). He used to bash ABPOPPM (ABPM), bash low quality residencies, various pod schools. Now, he champions same stuff he wound make fun of since that's where he happened to end up in life. I picked an old example, sure... but it easily could have been any of a ton of examples on SDN.

I just think it's pretty ironic he never gets banned, yet he has gotten dozens of other SDN podiatry users banned for same stuff.. Some are probably deserving... but more often, LCR baits them and then reports them when they predictably call him out or retaliate.

Maybe he is playing the long game? He can get rid of all "10" of us on here one by one and then he can have high the SDN podiatry site all to himself.

 

[Hybrocure]

Maybe he is playing the long game? He can get rid of all "10" of us on here one by one and then he can have high the SDN podiatry site all to himself.

For the record I’ve always been a LCR fan and am super pro ABPM please take that into account in judgement day

 

[Adam Smasher]

There's a difference between being snarky and being mean. Pronation learned the hard way.

RIP

 

[Prehealth1011]

I’m waiting for him to come back here as Supination

 

[Feli]

For the record I’ve always been a LCR fan and am super pro ABPM please take that into account in judgement day

It's a bit of a binary thing, though...

Just because ppl don't pass ABFAS doesn't make ABPM awesome.
Just beause ppl do pass ABFAS doesn't make it a perfect board/system.

It's like dem/rep ... if you're anti-Trump, you say you're pro Biden (or opposite way). But, are you really into the alternative... or are they just the only alternative?

 

[dtrack22]

It's a bit of a binary thing, though...

Just because ppl don't pass ABFAS doesn't make ABPM awesome.
Just beause ppl do pass ABFAS doesn't make it a perfect board/system.

It's like dem/rep ... if you're anti-Trump, you say you're pro Biden (or opposite way). But, are you really into the alternative... or are they just the only alternative?

I don’t think we should have any type of board certification in medicine at all. It’s a waste of time and money regardless of specialty, podiatry included. So I’m for whatever exam/process is the easiest.

 

[Hybrocure]

I don’t think we should have any type of board certification in medicine at all. It’s a waste of time and money regardless of specialty, podiatry included. So I’m for whatever exam/process is the easiest.

Fr fr

 

[air bud]

I’m waiting for him to come back here as Supination

you win today

 

[Boba Foot]

Maybe he is playing the long game? He can get rid of all "10" of us on here one by one and then he can have high the SDN podiatry site all to himself.

Like OldPod/NobodyDPM writing soliloquys to himself on the r/Podiatry Reddit.

 

[HardRoadPaved]

Like OldPod/NobodyDPM writing soliloquys to himself on the r/Podiatry Reddit.

 

[billBOB213]

To answer the OP’s original question, for me it would take $250K and no more than 40hr weeks (no call)

Chill life, get paid, go home to be with the fam
Great life right there

 

[air bud]

To answer the OP’s original question, for me it would take $250K and no more than 40hr weeks (no call)

Chill life, get paid, go home to be with the fam
Great life right there

This is my life right now it gets boring. 260k (25k bonus for "quality metrics" has never been defined...) maybe 35 to 45 patients a week, 2 to 4 inpatients a month, 2 to 4 elective surgeries a month .... basically working 3 days a week. It gets boring, your skills atrophy, your mind wanders ....

So these days I basically have a non op job at 260...it's not enough

 

[Jummy Biffett]

This is my life right now it gets boring. 260k (25k bonus for "quality metrics" has never been defined...) maybe 35 to 45 patients a week, 2 to 4 inpatients a month, 2 to 4 surgeries a month .... basically working 3 days a week. It gets boring, your skills atrophy, your mind wanders ....

So these days I basically have a non op job at 260...it's not enough

Oof don't show this comment to an associate seeing 30 pts a day in clinic 5 days a week for 120k and imaginary bonus

 

[Hybrocure]

This is my life right now it gets boring. 260k (25k bonus for "quality metrics" has never been defined...) maybe 35 to 45 patients a week, 2 to 4 inpatients a month, 2 to 4 surgeries a month .... basically working 3 days a week. It gets boring, your skills atrophy, your mind wanders ....

So these days I basically have a non op job at 260...it's not enough

You gotta get some hobbies

 

[air bud]

You gotta get some hobbies

Well we can't all live the in an outdoor mecca like @NatCh . I used to have it pretty good at my last place with outdoor activities but life happens. Where I am now is let's say flatter and hotter.

 

[NatCh]

Well we can't all live the in an outdoor mecca like @NatCh . I used to have it pretty good at my last place with outdoor activities but life happens. Where I am now is let's say flatter and hotter.

You moved? What part of the country are you in now?

 

[Weirdy]

You moved? What part of the country are you in now?

Sahara Desert. He works on camel's....feet.

 

[JustAPedicurist]

Sahara Desert. He works on camel's....feet.

camel digital deformity expert

 

[HardRoadPaved]

Camel's toe is out of our scope 😉