Is it happening?

[icebreaker32]

What will job options be like if NPs and PAs take over chiropody?

Although we are trained too long for chiropody it does provide jobs (even if a plan B) in a saturated job market.

Does our license allow us to have PAs and NPs under us doing this? I imagine not in most states.

People claim NPs and PAs will not take these jobs, but if they do will podiatry have negative job growth?

Job below

Nurse Practitioner / Physician Assistant / Podiatry Consultant - NEA NH​

Access Medical Clinic LLC
Arkansas


Job details

Salary
$95,000 - $120,000 a year
Job Type
Full-time
Shift and Schedule
Monday to Friday
Nurse Practitioner - NP / Physician Assistant - PA Benefits:

• $95,000.00 - $120,000.00 per year
• 401(k)
• Continuing education credits
• Dental insurance
• Flexible spending account
• Health insurance
• Malpractice insurance
• Paid time off
• Vision insurance
• Relaxed, team-based working environment

Nurse Practitioner - NP / Physician Assistant - PA Qualifications:

• Must be licensed in the state you will be practicing in.
• New grads welcome to apply!
• Family Nurse Practitioner Certification or Physician Assistant preferred

About Us:
Access Medical Clinic (AMC) is seeking individuals to join its team that have the desire, drive, and dedication to assist AMC in providing individualized care based on each patient’s unique medical needs and lifestyle factors, including age, for optimal health and wellness in patients of all ages, including pediatric patients and seniors. AMC is a leading family practice providing a complete complement of care and treatment options for patients throughout Arkansas, Oklahoma, Tennessee, Georgia, North Carolina, and Indiana. With its dedicated team of physicians, family nurse practitioners ( APRN ) , physician assistants ( PA ) , nurses and other healthcare providers and support staff, AMC is committed to helping their local communities' citizens stay as healthy as possible at every age and every stage of life. We are seeking to hire a Nurse Practitioner / APRN or Physician Assistant / PA to do podiatry consultations in nursing homes in the Blytheville and Northeast Arkansas area.
Job Type: Full-time
Pay: $95,000.00 - $120,000.00 per year
Medical specialties:

• Geriatrics
• Podiatry

Weekly schedule:

• Monday to Friday

Work setting:

• Nursing home

License/Certification:

• Nurse Practitioner or Physician Assistant Certification (Required)

Work Location: On the road

---

Members don't see this ad.

 

[deleted1138023]

They don’t want to do this. They have better opportunities than chiropody. Hiring a NP for $95k to cut nails? Good luck. You can find a graduating pgy3 tho

 

[Pronation]

They don’t want to do this. They have better opportunities than chiropody. Hiring a NP for $95k to cut nails? Good luck. You can find a graduating pgy3 tho

Oh absolutely they don’t want to do this crap for such low pay on top of it. Now the hospital NP gigs for 150k+ are going to get snatched up and so the likelihood of a new grad getting an institutional job will be even lower. The only remaining jobs will be 100k private practice jobs.

 

[shadesofgrey]

Oh absolutely they don’t want to do this crap for such low pay on top of it. Now the hospital NP gigs for 150k+ are going to get snatched up and so the likelihood of a new grad getting an institutional job will be even lower. The only remaining jobs will be 100k private practice jobs.

Shhhhhhh, the APMA wants you not to say anything

 

[Shiyuan]

Great post here on PMNews. I’m glad someone else gets it.

 

[deleted1138023]

View attachment 369732

Great post here on PMNews. I’m glad someone else gets it.

That dude is a legend

 

[Adam Smasher]

What will job options be like if NPs and PAs take over chiropody?

 

[Pronation]

View attachment 369732

Great post here on PMNews. I’m glad someone else gets it.

Could not agree more. The only thing I would add is that the best speed setting for the dremel is 69,420 RPM.

 

[dtrack22]

They don’t want to do this. They have better opportunities than chiropody. Hiring a NP for $95k to cut nails? Good luck. You can find a graduating pgy3 tho

Yup. PAs can sit in an ED doing low acuity stuff and get $100-150 per hour. NPs can practice independently and get more than $95-120k to do primary care. PAs in surgical specialties get to assist with surgery, which I would imagine makes them feel more like a real doctor and therefore more professionally satisfying than busting crumblies. And they are still gonna make $120k doing that.

Think about it. One of the things that our profession holds onto the tightest, and often times fights the hardest for (RFC), is something that we probably can’t even get NPs and PAs to do. Nail care is something RNs should be able to do/bill for at minimum, I would stop reimbursing it entirely, make it cash, and let anyone hire nail techs at $20/hr or whatever it would cost to do this kind of work.

 

[icebreaker32]

So the conclusion is the future of podiatry is 💪 as long as someone one desires 7-8 years of training after college to trim toenails for 100-120K a year with weak/no benefits.

The retired mustache podiatrists must be so happy we have held onto our turf. 🤫 don't tell them no one else wants it.

 

[Adam Smasher]

I wrote about this in another thread about how it has to do with health economics/insurance dynamics as well as risk management.

On the economics/insurance side of things, nail care is a service and insurance (assuming pts qualify and so on) reimburses for the service. So pt pays $0 and provider is reimbursed by the insurance for the service. If the provider is a nurse or technician, than the service would have to be rolled into a broader service that is ordered by a doctor/provider. Hypothetical example: doctor orders VNA service for "nail care," VNA renders the nail care, pt still pays $0, VNA is paid by the agency, agency is reimbursed by the insurance for VNA services. But unless reimbursement for VNA services go up, and unless that increase spills over to the VNA who's doing the work, there's no incentive to offering this service, because it's extra work for no extra $$$. And they're going to say just go to a rich podiatrist.

Furthermore the APMA/PCPs/endocrinologists have misled patients and hospital admins alike into believing that trimming toenails is this high risk, limb threatening activity. Now risk management is involved. If any nurse/technician at a hospital or of a VNA service or anything else is doing this, admins start to wonder why are we taking on this supposed liability for no extra money? If hits the fan, who's taking the fall? Hence why nail care is preferred to be done by an independent licensed provider (i.e. us), because the patient wants someone they can sue if it's not done right.

So @dtrack22 is correct. The minute nail care stops being reimbursed ("cash for keratin") is the minute everyone in this country gets their head on straight about who can be doing it: anyone.

 

[wakaflocka88]

I wrote about this in another thread about how it has to do with health economics/insurance dynamics as well as risk management.

On the economics/insurance side of things, nail care is a service and insurance (assuming pts qualify and so on) reimburses for the service. So pt pays $0 and provider is reimbursed by the insurance for the service. If the provider is a nurse or technician, than the service would have to be rolled into a broader service that is ordered by a doctor/provider. Hypothetical example: doctor orders VNA service for "nail care," VNA renders the nail care, pt still pays $0, VNA is paid by the agency, agency is reimbursed by the insurance for VNA services. But unless reimbursement for VNA services go up, and unless that increase spills over to the VNA who's doing the work, there's no incentive to offering this service, because it's extra work for no extra $$$. And they're going to say just go to a rich podiatrist.

Furthermore the APMA/PCPs/endocrinologists have misled patients and hospital admins alike into believing that trimming toenails is this high risk, limb threatening activity. Now risk management is involved. If any nurse/technician at a hospital or of a VNA service or anything else is doing this, admins start to wonder why are we taking on this supposed liability for no extra money? If hits the fan, who's taking the fall? Hence why nail care is preferred to be done by an independent licensed provider (i.e. us), because the patient wants someone they can sue if it's not done right.

So @dtrack22 is correct. The minute nail care stops being reimbursed ("cash for keratin") is the minute everyone in this country gets their head on straight about who can be doing it: anyone.

Stopping all nail care will shrink the profession into oblivion. Then from there will the revisional reconstructive foot and ankle surgeons rise from below to change the landscape of our profession.

Wait, that’s what orthopods are for. Jokes on us.

 

[air bud]

Stopping all nail care will shrink the profession into oblivion. Then from there will the revisional reconstructive foot and ankle surgeons rise from below to change the landscape of our profession.

Wait, that’s what orthopods are for. Jokes on us.

And we know this doesn't work.

 

[MoostashPod]

Stopping all nail care will shrink the profession into oblivion. Then from there will the revisional reconstructive foot and ankle surgeons rise from below to change the landscape of our profession.

Wait, that’s what orthopods are for. Jokes on us.

This is why they need us to do the job at cutting toenails. We're the bottom feeders at the very low end of medicine trying to me make our way up. We do the dirty work and very proud of it.

 

[Feli]

So the conclusion is the future of podiatry is 💪 as long as someone one desires 7-8 years of training after college to trim toenails for 100-120K a year with weak/no benefits.

The retired mustache podiatrists must be so happy we have held onto our turf. 🤫 don't tell them no one else wants it.

Shoot, don't forget the moustache gifts of all of the revision HAV surgery from using McBride on every bunion and plasty on every hammer time.

 

[deleted1138023]

Wait has a podiatrist ever gotten sued for nail care? I’m not talking ingrown. Just busting a crumbly and nicking someone

 

[Adam Smasher]

@ToeFather
yes

 

[Pronation]

Wait has a podiatrist ever gotten sued for nail care? I’m not talking ingrown. Just busting a crumbly and nicking someone lol

Oh man, if any lawyers are reading this... "If you or a loved one has been nicked by a podometrist you may be entitled to financial compensation. "

 

[Feli]

Wait has a podiatrist ever gotten sued for nail care? I’m not talking ingrown. Just busting a crumbly and nicking someone lol

Lol, it's mostly what you'd fail to do or would lie about doing... missing PAD, billing fraudulent, etc during the nail trim visit.

Some of the dumbest [charted] mistakes you ever see are doing procedures (even nail or callus care) on vasculopaths. Always smart to just send for eval and not do or document any inject, wound debride, C&C etc for someone who has paper thin skin or cool feet and could go gangrene any day. I have seen too many ingrown procedures done/documented for PAD pts that went to dry gangrene and hallux auto-amp, or much worse.

I don't think you can really do any damage just cutting nails. Maybe you can.
..."he debrided my nails in length, but not really in thickness!"

 

[Boba Foot]

View attachment 369732

Great post here on PMNews. I’m glad someone else gets it.

I assumed someone from SDN wrote this.

 

[icebreaker32]

I assumed someone from SDN wrote this.

You certainly don't have to be on SDN to get it or admit it.

We are extremely, extremely saturated if you consider going to a professional school should typically lead to a good job with a good number of different choices as to where you can work at geographically.

I know of no other healthcare profession that calls themselves a doctor that puts in 7-8 years after college that is not heavily recruited for organizational jobs.

Like he said look at the job boards.....chiropody jobs. The lame excuse some use that podiatry is different and we are a small profession so jobs are all word of mouth is just a nicer sounding way of saying we are extremely saturated. News Flash....this in not just a podiatry thing. It is not uncommon in other professions to get jobs through word of mouth. They also have the option of applying to posted jobs all over the country that don't get 100-200 applicants.

 

[DYK343]

Wait has a podiatrist ever gotten sued for nail care? I’m not talking ingrown. Just busting a crumbly and nicking someone

LOL. Yes. People try to sue for anything and everything they can. How long have you been in practice?

A DPM was shot, point blank after opening a door, for toenail care that ended in amputation.

 

[HardRoadPaved]

View attachment 369732

Great post here on PMNews. I’m glad someone else gets it.

Podiatry Management Online

Podiatry Management is the national practice management and business magazine, reaching over 22,024 subscribers.

podiatrym.com

This reply missed the boat entirely......

Literally ends off the post proving that we need to graduate people to take care of toenails

"Onychomycosis, a commonly seen attribute of aging is not showing any signs of diminishing."

 

[Shiyuan]

Podiatry Management Online

Podiatry Management is the national practice management and business magazine, reaching over 22,024 subscribers.

podiatrym.com

This reply missed the boat entirely......

Literally ends off the post proving that we need to graduate people to take care of toenails

"Onychomycosis, a commonly seen attribute of aging is not showing any signs of diminishing."

You bet. Another TFP just begging for new associate labor.

 

[Adam Smasher]

Michael Rosenblatt was a Bret Ribotsky interviewee on meet the masters, lol, they're buds