Job postings information thread

[dtrack22]

I'm going to start a thread that will undoubtedly get whacked by the mods after somebody complains...

I have several colleagues who are in or have been in bad situations when it comes to employment out of residency. Typically, verbal discussions with the practice owner(s) or optics of how the practice runs and how you will be treated as an associate end up being wildly inaccurate. In many cases someone else has insight into the contract, or the practice, or the area...and their knowledge could have helped prevent another young podiatrist from getting screwed. Any time I see a job posting that I have information about, I'm going to post it and share what I know. There may be enough lurkers on the forums that this could help someone. I don't think we have enough active posters to get a ton of useful information here (and obviously you can't violate any ND you may have signed), but if I can help someone by offering insight or putting them in contact with someone else that can, I'm gonna do it. I'm tired of people getting taken advantage of by older DPMs (myself included) so this is my relatively meaningless contribution

Practice for Sale | PodiatryCareers.org

I have the practice's financials and I know the area well. Including the fact that there are 4 new DPMs in town, including one in an ortho group, a new F&A ortho, and a hospital that was bought and has been discussing hiring their own DPM. Currently it is a high % of routine foot care but you will get sold on the fact that the pathology is out there (from referrals that are being sent and not scheduled due to the doc voluntarily working part time). The valuation was based on the projected ability to increase collections if the new doc was to go full time (a terrible thing for a prospective buyer to pay for). If the valuation has changed it could be more desirable, but I'd be more than happy to further discuss my experience via PM. If you are a lurker, or an active poster that knows someone looking at this particular ad you/they want my opinion...fire away. Privately so this post doesn't get edited like my perfectly legitimate Instagram thread.

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Members don't see this ad.

 

[Weirdy]

I was enjoying the instagram thread.

 

[Carbon13]

"Typically, verbal discussions with the practice owner(s) or optics of how the practice runs and how you will be treated as an associate end up being wildly inaccurate."

I couldn't agree with that statement any more. I'm another 2017 graduating resident who has already come to that realization in regards to joining the "old guy". Since I think it would be beneficial, I'll describe my situation in more detail in this thread or another.

 

[NatCh]

Practice for Sale | PodiatryCareers.org

LOL at “Work at a vacation destination in beautiful Florence, Oregon!”

 

[hematosis]

His payer profile says he sees about 28% medicare...
Medicare Unmasked: Behind the Numbers
Looks like he's consistently billed at around 160k at 260 per patient. for this 28%. If we extrapolate this to the remaining 72% (which is by far not very accurate for obvious reasons), it puts him around 500k per year in practice gross which is about what he is advertising.

or... I could be way off here.

 

[dtrack22]

No you're right. His collections were just shy of $500k last year (I have the exact numbers at home). More proof that it is not hard to make $250k before taxes as a podiatrist (as long as you aren't one of the 10,000 DPMs in and around NYC). Like I said, he may have lowered expectations in terms of purchase price, but with his current patient volume and the evolving medical community around him the numbers/asking price don't make sense. At all.

 

[TimmyTurner]

I just don't see the value in cozying up to these, all due respect, Dinosaurs. It's daylight robbery. I get they are looking out for their own bottom line, but too many associate positions are unapologetic-ally exploitative. The well-informed residency grad is aware of this accepted practice. Why does it continue? I'd have more respect for a prospective partner if they told me to my face 'Hey kid, go F yourself, this is what you'll get and you'll be grateful for it' than the smoke and mirrors postings.

 

[NatCh]

go F yourself, this is what you'll get and you'll be grateful for it

They should put that in their want ad. Kind of a guerilla marketing thing.

 

[air bud]

Why do residents accept these positions which perpetuates these offers? Because there are not a lot of HIGH quality jobs in podiatry. When you are desperate for a job after you searched high and low it comes to this.

The job I have now is the only job that would interview me. It so happened to be a great financial offer despite professional anguish I experience from not being able to do ankle surgery and dealing with orthopedics in my own hospital. If I was making half of what my salary is now then I would be in my own personal podiatry hell.

When you are desperate for cash you get blinded by the red flags that are being dangled right in front of your face.

Not trying to hijack this thread but this is true. As a resident coming out you don't know some of the questions to ask and are also afraid to ask other questions. Somebody offers you money and you take it....happened to me too.

 

[Cranjis McBasketball]

Why do residents accept these positions which perpetuates these offers? Because there are not a lot of HIGH quality jobs in podiatry. When you are desperate for a job after you searched high and low it comes to this.

The job I have now is the only job that would interview me. It so happened to be a great financial offer despite professional anguish I experience from not being able to do ankle surgery and dealing with orthopedics in my own hospital. If I was making half of what my salary is now then I would be in my own personal podiatry hell.

When you are desperate for cash you get blinded by the red flags that are being dangled right in front of your face.

Is this true for any graduate? Even those who are fine moving anywhere? or is this mainly if you are focused on living in a specific region/state?

 

[Cranjis McBasketball]

I had no geographic limitations when I took this first job out of residency. Now that I am looking for another job its just as hard. Again I am talking about high quality jobs where the pay is reasonable and your contract is reasonable. Those podiatry jobs are few and far between.

If you want a typical podiatry practice job that's going to take advantage of their associate then are PLENTY of those positions available.

People who limit the geographic areas they want to live in have an even harder time finding high quality podiatrist positions

People who find jobs where they want to live either have to get very lucky or they create their own luck by picking up the phone and cold calling potential practices/hospitals or they utilize their network connections to make something happen.

Every high quality job I apply to (hospital jobs) the recruiter always tells me they have about 50+ applicants for the same job

I've had a little more luck getting some job interviews together this time around because I have more experience in billing, doing surgery, and working in a hospital (since I am currently employed by one) compared to the resident who will be graduating soon.

Man thats depressing to hear

 

[GypsyHummus]

Do you foresee it ever getting better?

I had no geographic limitations when I took this first job out of residency. Now that I am looking for another job its just as hard. Again I am talking about high quality jobs where the pay is reasonable and your contract is reasonable. Those podiatry jobs are few and far between.

If you want a typical podiatry practice job that's going to take advantage of their associate then are PLENTY of those positions available.

People who limit the geographic areas they want to live in have an even harder time finding high quality podiatrist positions

People who find jobs where they want to live either have to get very lucky or they create their own luck by picking up the phone and cold calling potential practices/hospitals or they utilize their network connections to make something happen.

Every high quality job I apply to (hospital jobs) the recruiter always tells me they have about 50+ applicants for the same job

I've had a little more luck getting some job interviews together this time around because I have more experience in billing, doing surgery, and working in a hospital (since I am currently employed by one) compared to the resident who will be graduating soon.

 

[Cranjis McBasketball]

I think eventually a podiatrist will be on staff with every hospital in the future. The private practice podiatrist will then be left out in the cold because every hospital will refer to their own podiatrist. I think this is our future.

I also feel these hospital based podiatrists will be more likely diabetic limb specialists (charcot, IM nails, frames muscle flaps, wound care, etc) and provide elective foot and ankle reconstruction procedures. I think less and less will do actual foot and ankle trauma. That’s something most orthos believe podiatrists shouldn’t do. Are there exceptions? Yes. Some DPMs work in hospitals where they perform trauma but they paid their dues to get to that point (think Schuberth).

Do you think the private practice model will still thrive in rural areas? Or, while you were job hunting, is there just not a huge demand for podiatric services?

 

[GypsyHummus]

Is it every hospital that has 50+ pod applications, or just ones in the big cities?

I would think hospital systems in cities with 100k or less people is where it’s at.

I think eventually a podiatrist will be on staff with every hospital in the future. The private practice podiatrist will then be left out in the cold because every hospital will refer to their own podiatrist. I think this is our future.

I also feel these hospital based podiatrists will be more likely diabetic limb specialists (charcot, IM nails, frames muscle flaps, wound care, etc) and provide elective foot and ankle reconstruction procedures. I think less and less will do actual foot and ankle trauma. That’s something most orthos believe podiatrists shouldn’t do. Are there exceptions? Yes. Some DPMs work in hospitals where they perform trauma but they paid their dues to get to that point (think Schuberth).

 

[Cranjis McBasketball]

Hard to say. I still believe the private practice model will still have a place in rural America but private practice in suburban and cities will continue to fight other private practices for business and their referral base will shrink as more and more hospitals are hiring their own doctors to keep all the cash for themselves.

Hospitals have the cash to out advertise any local private DPM in the near vicinity. I know from my experiences at my job. If I come up with a bright idea, such as, a free foot clinic then the hospital will take out a page in several local newspapers and promote it.

So.. do you have regrets becoming a podiatrist? What about you @air bud? Regrets about becoming a podiatrist?

 

[DexterMorganSK]

I’ve had a rough go of it in the place where I practice. I’m sure I’d be a lot happier once I get a new job. I’ll be more specific about my circumstances once I get a new job and will create a thread about it.

But all in all if I knew what I know now I probably would still become a podiatrist but I probably would have tried to go DO too.

I’d also consider being a travel nurse (my GF is one). A travel OR nurse makes a lot of money (6 figures). Especially in areas that are in dire need for nurses (such as California).

Would you consider working for the VA in the future, if the equity bill passes thus raising the Pods salary?

At that point, I'd assume the benefits and the job security that comes when for the VA outweighs the less potential income you might make at a private/hospital practice?

 

[GypsyHummus]

Could have been a Dentist, make crazy bucks.

I’ve had a rough go of it in the place where I practice. I’m sure I’d be a lot happier once I get a new job. I’ll be more specific about my circumstances once I get a new job and will create a thread about it.

But all in all if I knew what I know now I probably would still become a podiatrist but I probably would have tried to go DO too.

I’d also consider being a travel nurse (my GF is one). A travel OR nurse makes a lot of money (6 figures). Especially in areas that are in dire need for nurses (such as California).

 

[Weirdy]

Would you consider working for the VA in the future, if the equity bill passes thus raising the Pods salary?

At that point, I'd assume the benefits and the job security that comes when for the VA outweighs the less potential income you might make at a private/hospital practice?

Raising salary is one thing.

Bureaucracy is another. Even when I was shadowing other health professions, VA was a black shadow.

Someone correct me if they've experienced otherwise in the VA system.

 

[Cranjis McBasketball]

Could have been a Dentist, make crazy bucks.

I feel like the similar thing is happening to dentists too though. Corporations like Aspen and stuff are hiring grads who have astronomical debts, because they can't afford to open practices. And these corporations have tons of funding for advertising and now refer in house, so its starting to leave the private practice model behind. It seems like a lot of dentists are having to do large group practices now, or work in rural areas. Health care is just changing with every profession!

 

[Cranjis McBasketball]

I’ve had a rough go of it in the place where I practice. I’m sure I’d be a lot happier once I get a new job. I’ll be more specific about my circumstances once I get a new job and will create a thread about it.

But all in all if I knew what I know now I probably would still become a podiatrist but I probably would have tried to go DO too.

I’d also consider being a travel nurse (my GF is one). A travel OR nurse makes a lot of money (6 figures). Especially in areas that are in dire need for nurses (such as California).

That will be a good thread to read about. My wifes starting nursing school next month so I am hoping she goes the traveling nurse route or CRNA route. They seem to have it real nice

 

[GypsyHummus]

That’s true! I know many dental grads who are taking jobs at Aspen for 130k range. 500k in student loan debt is nothing to mess with, interest alone takes out a huge chunk of salary.

Luckley, Podiatry still has one of the lowest costs of entry tuition wise. Combine that with getting scholarships and you can get out with only 250k in debt.

I feel like the similar thing is happening to dentists too though. Corporations like Aspen and stuff are hiring grads who have astronomical debts, because they can't afford to open practices. And these corporations have tons of funding for advertising and now refer in house, so its starting to leave the private practice model behind. It seems like a lot of dentists are having to do large group practices now, or work in rural areas. Health care is just changing with every profession!

 

[TimmyTurner]

you can get out with only 250k in debt.

ONLY 250k? Now THAT's a deal! Sign me up!

Sarcasm aside, I had a steady job out of college at a very strong and safe company, making 50k, with full funding to obtain a Masters degree, and a salary max at 15 years of $88k (assuming I stayed in the same position and did not move vertically within the company)

Following the salary ladder provided at my old job, I ran a crude excel spreadsheet of total income if I stayed on the current path at my old job vs. Loans and Income estimates if I pursued Podiatry.

Even using conservative salary estimates following residency, with minimal increments for experience, I would accumulate the total sum of debt+interest, AND the total earnings I would have grossed had I stayed at my old job sometime between the ages of 48-52. That still leaves at least 10 years, and likely more, of an earning potential at least double what it would have been at my old job.
Not to mention the inherent advantages excess capital provides for a 401k or other investment vehicles.

In the end, barring a collapse of our profession, the degree does pay for itself. It takes awhile to get there sure, but worst case scenario, I still get 10 solid years of 2x earning potential.

That said, there were some unforseen consequences of taking on that mountain of debt.
I kept getting spammed by JetBlue for their credit card. I fly JetBlue almost exclusively (both the airports closest to my school and hometown are JetBlue hubs), so I figured I'd get the card just to use when purchasing Airline tickets so I can at least get 3x the points/miles for each dollar spent.

I was surprised to find out my application was instantly rejected, despite having a transunion FICO of 780.

I called BarclaysCards to make an inquiry as to why it was rejected. They explained in spite of my score, I was rejected based on my debt to income ratio. The income I listed was the annual total I receive in loans through the school. They didn't care that it was graduate school, or my future earning potential, or that all the loans are deferred.

So basically, if I want to open a new line of credit or increase an existing line, I don't anticipate doing so for the next 7 or so years, at least. Certainly an unforseen consequence of carrying that amount of debt.

TL;DR- Long term, the DPM degree pays for itself. Apply for as many lines of credit as you can before starting school.

 

[GypsyHummus]

What about all that Gov’ment money? Do you even need credit when you got Uncle Sam shelling out 60k/year at 7% interest?

It’s a good thing you ran the numbers. Most people just jump in head first saying “But muh dream 2-b doctur”.

What Pod salary did you base your numbers off of, net takehome? Remember, when you start making 170k+ gross, The IRS thinks you are filthy rich and hiked you up to a new tax bracket.

I recently looked up the tax rates, for everything included; social security, federal, state, Medicare, etc. it’s like you get to keep 60% of your income after it’s all done. What craziness is this.

Yeah, unless you go to a state MD or PharmD school, Podiatry seems like the best return on investment for healthcare professionals. Ideally the best return would be state MD and do a high powered specialty like Ortho.

ONLY 250k? Now THAT's a deal! Sign me up!

Sarcasm aside, I had a steady job out of college at a very strong and safe company, making 50k, with full funding to obtain a Masters degree, and a salary max at 15 years of $88k (assuming I stayed in the same position and did not move vertically within the company)

Following the salary ladder provided at my old job, I ran a crude excel spreadsheet of total income if I stayed on the current path at my old job vs. Loans and Income estimates if I pursued Podiatry.

Even using conservative salary estimates following residency, with minimal increments for experience, I would accumulate the total sum of debt+interest, AND the total earnings I would have grossed had I stayed at my old job sometime between the ages of 48-52. That still leaves at least 10 years, and likely more, of an earning potential at least double what it would have been at my old job.
Not to mention the inherent advantages excess capital provides for a 401k or other investment vehicles.

In the end, barring a collapse of our profession, the degree does pay for itself. It takes awhile to get there sure, but worst case scenario, I still get 10 solid years of 2x earning potential.

That said, there were some unforseen consequences of taking on that mountain of debt.
I kept getting spammed by JetBlue for their credit card. I fly JetBlue almost exclusively (both the airports closest to my school and hometown are JetBlue hubs), so I figured I'd get the card just to use when purchasing Airline tickets so I can at least get 3x the points/miles for each dollar spent.

I was surprised to find out my application was instantly rejected, despite having a transunion FICO of 780.

I called BarclaysCards to make an inquiry as to why it was rejected. They explained in spite of my score, I was rejected based on my debt to income ratio. The income I listed was the annual total I receive in loans through the school. They didn't care that it was graduate school, or my future earning potential, or that all the loans are deferred.

So basically, if I want to open a new line of credit or increase an existing line, I don't anticipate doing so for the next 7 or so years, at least. Certainly an unforseen consequence of carrying that amount of debt.

TL;DR- Long term, the DPM degree pays for itself. Apply for as many lines of credit as you can before starting school.

 

[dtrack22]

Not trying to hijack this thread...

well mission accomplished

 

[air bud]

So about those job postings...?

Ankle breaker right about hospitals and podiatrists. There is a current (or very recently closed , long advertised ) job in Billings Montana. It is with a huge group, Billings clinic. I was all set to visit there but cancelled my interview. I was at the top of the recruiters list, she loved me. But I had conversations with people there about the job. There was Ortho trauma, there was a F& A Ortho. They already had 2 pods. Some elective surgery, mostly wounds and diabetic stuff. I ended up accepting another offer just before cancelling with a large MSG. The deciding factor was what I would be able to do professionally. I would have MUCH preferred Montana over my current state in terms of lifestyle but I knew the position would not make me happy. Yes they were offering 200k, 25k signing, Max 401k etc, but so was my current job. Well turns out I too have problems at my current job in terms of scope. Anyways there is a reason that a hospital job like that has been open and advertised for so long. Once people look into it they realize the limitations. Same thing with a long time advertised Alabama hospital job. No ankle in the state. It comes down to what you are willing to sacrifice. I will get into this in the near future I but Ego often gets in the way. It's one thing to choose not to do certain procedures, it's another thing to be told you CANT do certain procedures.

 

[de Ribas]

A travel OR nurse makes a lot of money (6 figures). Especially in areas that are in dire need for nurses (such as California).

they do but aren't you limited to like 8-10 weeks per location and next one has to be like at least 50 miles away?

 

[Pronation]

I think eventually a podiatrist will be on staff with every hospital in the future. The private practice podiatrist will then be left out in the cold because every hospital will refer to their own podiatrist. I think this is our future.

I also feel these hospital based podiatrists will be more likely diabetic limb specialists (charcot, IM nails, frames muscle flaps, wound care, etc) and provide elective foot and ankle reconstruction procedures. I think less and less will do actual foot and ankle trauma. That’s something most orthos believe podiatrists shouldn’t do. Are there exceptions? Yes. Some DPMs work in hospitals where they perform trauma but they paid their dues to get to that point (think Schuberth).

Agree with more pods at hospitals taking on the beetus feet (what nobody else wants to deal with) but I also believe F&A trauma exposure will increase, not decrease.

 

[GypsyHummus]

I agree

I have a family member gunning for Ortho at an MD school and from what he tells me, Foot and Ankle Ortho fellowship is the bottom tier for fellowships in the Ortho world. I would wager pod schools are pumping out more DPMs than F&A fellowships are pumping out MDs. With this increase in pods in the world, y’all are bound to be recognized.

Agree with more pods at hospitals taking on the beetus feet (what nobody else wants to deal with) but I also believe F&A trauma exposure will increase, not decrease.

 

[GypsyHummus]

How are the laws in Flyover country?

Based on what real life experience?

Everything is regional. You may be training in the area where podiatry does more trauma but things are highly variable from state to state.

Trauma will always belong to Ortho. Even if they aren’t trained in it a lot of orthos would prefer they do it than a podiatrist.

I’ve trained on the west coast where podiatry scope is outstanding. We still ran into our issues with getting trauma.

Go to the east coast, specifically the northeast and New England area and it’s a whole new ballgame.

Podiatrists more and more will be handling Diabetic limb salvage, wound care, charcot, muscle flaps. As well as elective foot and ankle surgery.

Trauma is truly hit or miss. Podiatrists who can actually do a good job at foot and ankle trauma is truly hit or miss. Just because you can do it doesn’t mean you should. Your outcomes with trauma will ALWAYS be more highly scrutinized with Ortho than anything else you do. Most lawsuits surround podiatrists doing trauma and then the patient gets a second opinion from the Ortho who hates podiatry.

 

[dtrack22]

Thanks to the last couple of posters for totally detailing and ruining yet another thread on SDN. You guys are the worst.

I mean, what do “laws in flyover country” have to do with the thread title? Now I know why the practicing physician forum chose to lock it...

 

[air bud]

Thanks to the last couple of posters for totally detailing and ruining yet another thread on SDN. You guys are the worst.

I mean, what do “laws in flyover country” have to do with the thread title? Now I know why the practicing physician forum chose to lock it...

Don't forget about rules for traveling nurses or questions that graduating resident are afraid to ask

 

[Robert De Niro]

In order to get the thread back.....

Anyone know anything about scope in Maine? There’s a posting for a Pen Bay Medical center in Rockport, ME. Initial read of the posting sounds intriguing. First year resident so not really looking yet, just trying learn what to look for.

 

[dtrack22]

If a practice or hospital does not involve some of their docs in the interview/visit process, and/or doesn't freely offer contact info for those docs...something is wrong. Get a hold of that other DPM or other DPMs on your own and talk to them.

I had a hospital that didn't schedule any time to meet with the current DPM that was leaving. In fact he didn't even know I was interviewing that day. That's a red flag.

 

[apollofx]

Where are all these hospital, ortho, or multi-specialty group jobs? All I can find are garbage private practice jobs that want to lowball you with a disgusting salary. I will graduate from a solid program with excellent numbers and excellent surgical/clinical experience and I can’t find a high quality job no matter how far I search. I have no real geographic limitations, pay is important but what I really want is to use my surgical experience. I have contacted hospitals directly some of which will flat out say they won’t hire a “Doctor of Podiatric Medicine” or aren’t at this time. I don’t have professionals connections besides those in the city my residency is in but it is the only place I do not want to work for personal reasons. I’m exasperated and I see my coresidents just taking the first position that shows interest or offers them any money at all. Looking for suggestions or experiences...

 

[AudiLova619]

Where are all these hospital, ortho, or multi-specialty group jobs? All I can find are garbage private practice jobs that want to lowball you with a disgusting salary. I will graduate from a solid program with excellent numbers and excellent surgical/clinical experience and I can’t find a high quality job no matter how far I search. I have no real geographic limitations, pay is important but what I really want is to use my surgical experience. I have contacted hospitals directly some of which will flat out say they won’t hire a “Doctor of Podiatric Medicine” or aren’t at this time. I don’t have professionals connections besides those in the city my residency is in but it is the only place I do not want to work for personal reasons. I’m exasperated and I see my coresidents just taking the first position that shows interest or offers them any money at all. Looking for suggestions or experiences...

Do you mind sharing what the "disgusting salary" numbers are?

 

[apollofx]

Do you mind sharing what the "disgusting salary" numbers are?

Disgusting may have been a dramatic choice of words but 80K base with a poor incentive structure is low IMHO, one incentive structure probably would have had you lucky to hit 100k. It's not purely about the money but I do have loans and a family to provide for.

 

[AudiLova619]

Disgusting may have been a dramatic choice of words but 80K base with a poor incentive structure is low IMHO, one incentive structure probably would have had you lucky to hit 100k. It's not purely about the money but I do have loans and a family to provide for.

I have the same concerns about salary too.

 

[air bud]

Disgusting may have been a dramatic choice of words but 80K base with a poor incentive structure is low IMHO, one incentive structure probably would have had you lucky to hit 100k. It's not purely about the money but I do have loans and a family to provide for.

No disgusting is accurate

 

[med2345]

Disgusting may have been a dramatic choice of words but 80K base with a poor incentive structure is low IMHO, one incentive structure probably would have had you lucky to hit 100k. It's not purely about the money but I do have loans and a family to provide for.

What have you seen that’s usually fair offers for your fellow residents or other residents?

 

[dddunit]

First year i think you need some sort of base plus bonus structure. Base so you can live. I would say base should be 100k min. Bonus needs to be reasonable to obtain. After 1st year usually a straight percentage (think 40%+) would yield a better salary.

Before you join a practice. Background check the "old guy" and talk to previous associates. Do you get paid for all the patients you see? Is the old guy milking you out while you may be pending insurance plan (old guy pocketing money for patients you rendered service since you may initially be under his name...is this fraud?). I hope in our new generation we stop this practice. Didnt we all go into this to help people not to harm people?

 

[ExperiencedDPM]

First year i think you need some sort of base plus bonus structure. Base so you can live. I would say base should be 100k min. Bonus needs to be reasonable to obtain. After 1st year usually a straight percentage (think 40%+) would yield a better salary.

Before you join a practice. Background check the "old guy" and talk to previous associates. Do you get paid for all the patients you see? Is the old guy milking you out while you may be pending insurance plan (old guy pocketing money for patients you rendered service since you may initially be under his name...is this fraud?). I hope in our new generation we stop this practice. Didnt we all go into this to help people not to harm people?

I assure you this type of situation isn’t reserved for the “old guys” in the practice. They used to say it’s the old eating the young, but I’ve seen more young eating the young lately.

I’ve also seen a LOT of fraud from some very agressive young doctors. The “old” guys used to fraud insurance by billing nail avulsion when they only trimmed nails. The “old” guys committed fraud by performing RFC in patients who really didn’t qualify.

The young guys commit fraud by popping in an arthroreisis implant and billing for a subtalar arthrodesis or ORIF of a talo tarsal dislocation. The young guy bills for an ankle arthroscopy for an OCD lesion with negative X-rays and MRIs. The young guy listens to the “gurus” telling you how to use modifiers inappropriately and then perform a bunionectomy and unbundle one procedure to 9 procedures and bill $25,000 for a bunionectomy. And it goes on and on.

So please don’t blame it all on the “old” guys because it’s not accurate. Unfortunately it doesn’t say much about the character of our peers, old, young or anywhere in between.

 

[apollofx]

First year i think you need some sort of base plus bonus structure. Base so you can live. I would say base should be 100k min. Bonus needs to be reasonable to obtain. After 1st year usually a straight percentage (think 40%+) would yield a better salary.

Before you join a practice. Background check the "old guy" and talk to previous associates. Do you get paid for all the patients you see? Is the old guy milking you out while you may be pending insurance plan (old guy pocketing money for patients you rendered service since you may initially be under his name...is this fraud?). I hope in our new generation we stop this practice. Didnt we all go into this to help people not to harm people?

I agree 100k should be the bottom but it clearly isn’t. I’m not interested in joining the “old guy” just to make him money, I’m a go getter and I’m ready to work. I call hospitals and groups and as I expect get shot down 98% of the time. I understand that’s the nature of the cold call but I think quality jobs are hard to come by directly out of residency in my experience.

 

[GypsyHummus]

That stinks. Might as well open up your own practice in rural North Dakota, hire a secretary, buy two used office chairs, tool set, sterilization machine, and go ham doing every and anything that comes your way. There are dentists that still open up those own practice cold, even in a saturated field.

I’d like to see this fly in the MD/DO world, or even in the PA world lol.

Where are all these hospital, ortho, or multi-specialty group jobs? All I can find are garbage private practice jobs that want to lowball you with a disgusting salary. I will graduate from a solid program with excellent numbers and excellent surgical/clinical experience and I can’t find a high quality job no matter how far I search. I have no real geographic limitations, pay is important but what I really want is to use my surgical experience. I have contacted hospitals directly some of which will flat out say they won’t hire a “Doctor of Podiatric Medicine” or aren’t at this time. I don’t have professionals connections besides those in the city my residency is in but it is the only place I do not want to work for personal reasons. I’m exasperated and I see my coresidents just taking the first position that shows interest or offers them any money at all. Looking for suggestions or experiences...

 

[med2345]

That stinks. Might as well open up your own practice in rural North Dakota, hire a secretary, buy two used office chairs, tool set, sterilization machine, and go ham doing every and anything that comes your way. There are dentists that still open up those own practice cold, even in a saturated field.

I’d like to see this fly in the MD/DO world, or even in the PA world lol.

This is what I think all of the time.. Why is this only happening to POD? because most employed are in private practice? or is there another reason? If pods are profitable to hospitals and obviously there jobs are needed then why aren't more being employed and why are there hospitals that don't even have a pod they can just send referrals to? My local hospital employed 2 just in the past 2 years and every primary care doc in the area talks about the need for more, yet I keep seeing stuff like this.. Im really excited to start pod school but seeing threads like this sucks. Some seem to find great jobs and some get shafted for no good reason. I know having connections is important but that doesn't explain it all.

Can anyone chime in why?

 

[bunNfxr]

W

I assure you this type of situation isn’t reserved for the “old guys” in the practice. They used to say it’s the old eating the young, but I’ve seen more young eating the young lately.

I’ve also seen a LOT of fraud from some very agressive young doctors. The “old” guys used to fraud insurance by billing nail avulsion when they only trimmed nails. The “old” guys committed fraud by performing RFC in patients who really didn’t qualify.

The young guys commit fraud by popping in an arthroreisis implant and billing for a subtalar arthrodesis or ORIF of a talo tarsal dislocation. The young guy bills for an ankle arthroscopy for an OCD lesion with negative X-rays and MRIs. The young guy listens to the “gurus” telling you how to use modifiers inappropriately and then perform a bunionectomy and unbundle one procedure to 9 procedures and bill $25,000 for a bunionectomy. And it goes on and on.

So please don’t blame it all on the “old” guys because it’s not accurate. Unfortunately it doesn’t say much about the character of our peers, old, young or anywhere in between.

What it does say (and what this off rail thread reinforces) is that it is harder to make the income you expected by going into podiatry. So many people find "tricks" to get to where they expected to be.

 

[ldsrmdude]

Where are all these hospital, ortho, or multi-specialty group jobs? All I can find are garbage private practice jobs that want to lowball you with a disgusting salary. I will graduate from a solid program with excellent numbers and excellent surgical/clinical experience and I can’t find a high quality job no matter how far I search. I have no real geographic limitations, pay is important but what I really want is to use my surgical experience. I have contacted hospitals directly some of which will flat out say they won’t hire a “Doctor of Podiatric Medicine” or aren’t at this time. I don’t have professionals connections besides those in the city my residency is in but it is the only place I do not want to work for personal reasons. I’m exasperated and I see my coresidents just taking the first position that shows interest or offers them any money at all. Looking for suggestions or experiences...

The unfortunate reality is that there simply aren't enough hospital/ortho/MSG jobs for the graduating residents and docs in practice looking to change and most of the jobs are still in private practice. It's changing, but not fast enough and we're still in a situation where most opportunities are in private practice.And many private practice jobs in podiatry are being offered by doctors looking to make a quick buck off of a new associate and, yes, "old eating their young" as well as "young eating their young." For some reason there is a mentality in many of the private practices I interviewed at or know of personally that because the boss had to work in a miserable job, be treated like dirt, and paid less than most PA's make that the associate should too.

It's also reality that most jobs are >80% non-operative, and as has been mentioned, most of the cases we do can be done by other specialties. Where I practice, general surgery wants to do the toe amps and diabetic foot pus. Ortho wants the trauma, bunions, and sports medicine. So I ran into several jobs that were looking for someone to treat heel pain, ingrown toenails, diabetic foot care, etc but jobs that allow you to use your full training can also be tough to find.

I think that luck has a big part to do with finding the good jobs for a lot of people. For me, I worked in a practice that I could tell offered no future for me. I went and interviewed for jobs and was offered a job across the country at the same time that a local hospital system bought the practice I was working for and offered me a job. Now I work for a hospital system, and make twice what I made in private practice. Luck was a big part of being where I am now. I will say that being persistent will pay off at some point. Sometimes having no geographic limitations can be overwhelming and make things less efficient. If you narrow your search down to a few smaller areas, you may be more thorough with them and have better luck. Just a thought from when I was coming out of residency in a similar situation 3 years ago

 

[GypsyHummus]

You do eventually see it horizon changing for the better however? The people entering Pod school now are essentially jumping 7 Years into the future for a job.

I cant imagine many private practices, MD/DO/DPM/OD being viable in the future. At least in my Area, Hospitals are buying up Private practices of all specialties except Dental.

The unfortunate reality is that there simply aren't enough hospital/ortho/MSG jobs for the graduating residents and docs in practice looking to change and most of the jobs are still in private practice. It's changing, but not fast enough and we're still in a situation where most opportunities are in private practice.And many private practice jobs in podiatry are being offered by doctors looking to make a quick buck off of a new associate and, yes, "old eating their young" as well as "young eating their young." For some reason there is a mentality in many of the private practices I interviewed at or know of personally that because the boss had to work in a miserable job, be treated like dirt, and paid less than most PA's make that the associate should too.

It's also reality that most jobs are >80% non-operative, and as has been mentioned, most of the cases we do can be done by other specialties. Where I practice, general surgery wants to do the toe amps and diabetic foot pus. Ortho wants the trauma, bunions, and sports medicine. So I ran into several jobs that were looking for someone to treat heel pain, ingrown toenails, diabetic foot care, etc but jobs that allow you to use your full training can also be tough to find.

I think that luck has a big part to do with finding the good jobs for a lot of people. For me, I worked in a practice that I could tell offered no future for me. I went and interviewed for jobs and was offered a job across the country at the same time that a local hospital system bought the practice I was working for and offered me a job. Now I work for a hospital system, and make twice what I made in private practice. Luck was a big part of being where I am now. I will say that being persistent will pay off at some point. Sometimes having no geographic limitations can be overwhelming and make things less efficient. If you narrow your search down to a few smaller areas, you may be more thorough with them and have better luck. Just a thought from when I was coming out of residency in a similar situation 3 years ago

 

[ldsrmdude]

You do eventually see it horizon changing for the better however? The people entering Pod school now are essentially jumping 7 Years into the future for a job.

I cant imagine many private practices, MD/DO/DPM/OD being viable in the future. At least in my Area, Hospitals are buying up Private practices of all specialties except Dental.

I do see things changing for the better, I'm just not sure how fast it's going to happen. Podiatry, for several reasons, seems to be a field that is much slower to move away from private practice. It's probably partially that hospitals/MSG still don't know or understand as much about us as other fields like general surgery or ortho, but also in part, IMO, due to many practicing pods not wanting to become part of a hospital/ortho/MSG.

 

[UnDecided92]

So is this field even worth going into nowadays? It sounds like a nightmare to find a decent job and a very unsure thing with all the bureaucratic bs in hospital administration and also with the government itself. I mean I am going to be investing 7 years and 300k into a medical education.

 

[GypsyHummus]

I dont think that the practicing pods can answer that for you. You have to decide if the field is worth it using the salary figures the practicing Pods have graciously shared with those asking about the field.

What else will you do with a worthless undergrad biology degree and semi-worthless Biology masters with a low MCAT score? Especially so if your GPA is 3.3 and below and your MCAT is 500 or below. Pharmacy and Optometry are saturated to the point you might not find full time work, and Dentistry is just as hard to get into as DO school at least. PA and NPs might be another option, but you are also easily replaceable, and you do not have the final say on treatment options.

Podiatry, for all its faults, at least right now allows you to practice as an independant doctor with surgical rights of the foot and in many states up to the ankle where you learn actual skills that are hard to outsource. The only other people that can do your job are other doctors, and that is true for other doctors in thier field. Think about it, a Primary Care doctor's work can be done by another PCP, MD/DO and in increasing cases, PA/NP. Look at other professions and compare, even those not requiring a doctoral degree. Accounting can easily be outsourced, as well as computer software jobs and IT.

And these people that claim IT makes 120-150K are leaving out that most of these jobs are in high cost of living areas, and that the jobs are few and far between. Of everyone I graduated with in undergrad, the highest earner is right around 55K/Year (around 45K after taxes). People dont make six figures right out of college, some with college degrees will never make six figures. With Podiatry, I think it is very possible to make 150K, provided you are smart and work hard, which is around 100K after taxes.

To me, an investment of 300K at 7% intrest to make 100K/year for 30 years seems financially worth it, Podiatry or otherwise, but it is on the boarderline. You will have to decide if that is worth it to you.

So is this field even worth going into nowadays? It sounds like a nightmare to find a decent job and a very unsure thing with all the bureaucratic bs in hospital administration and also with the government itself. I mean I am going to be investing 7 years and 300k into a medical education.